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Manipulative therapy in addition to usual medical care accelerates recovery of shoulder complaints at higher costs: economic outcomes of a randomized trial
Background Shoulder complaints are common in primary care and have an unfavourable long term prognosis. Our objective was to evaluate the clinical effectiveness of manipulative therapy of the cervicothoracic spine and the adjacent ribs in addition to usual medical care (UMC) by the general practitioner in the treatment of shoulder complaints. Methods This economic evaluation was conducted alongside a randomized trial in primary care. Included were 150 patients with shoulder complaints and a dysfunction of the cervicothoracic spine and adjacent ribs. Patients were treated with UMC (NSAID's,...
The integration of bio-medicine and culturally based alternative medicine: implications for health care providers and patients
Complementary and alternative medicine (CAM) are therapies used along with or in place of bio-medicine. Many forms of CAM originate in culture, referred to as culturally based alternative medicines. Usage of CAM is high with large numbers of patients using CAM for mental health, pain and musculoskeletal problems. Their desire for holistic care may be the impetus for this interest, as alternative care practitioners spend more time analyzing illness symptoms. These factors along with the global migration of immigrants accustomed to traditional medicine but now immersed in biomedical health care systems...

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