Functional Neurology Controversy: Research Needed

How could functional neurological massage become well-accepted when its parent field is controversial?

Our 2012 Functional Neurology for Bodyworkers class was taught by a Board-Certified Chiropractic Functional Neurologist, Dr. Paul Thomas, (American Functional Neurology Society, AFNS), graduate of the Carrick Institute. Dr. Thomas trained in a rigorous three year graduate program after completing his chiropractic studies and was practicing as a Chiropractic Physician.

Chiropractic functional neurologists often have 3 to 6 month wait lists. Their patients may rave about the benefits they receive, but there is still controversy in this field. Functional neurology is not widely recognized–certainly not as a massage therapy specialty, and sometimes not even as a chiropractic specialty.

brain showing lobes, cerebellum, brain stemDr. Ted Carrick and Sidney Crosby: Functional Neurology High Style

The founder of Chiropractic Functional Neurology, Dr. Frederick (“Ted”) Carrick, treats hard-to-treat cases where there is often little hope offered: sports head injuries, especially vestibular concussions; traumatic brain injury; ADHD; brain imbalances that show as emotional issues or depression; and autism. He uses sophisticated technology as well as some of the basic neuro assessment techniques we learned in the Functional Neurology for Bodyworkers class.

Dr. Ted Carrick gained notoriety for successfully treating a very popular Canadian hockey player, Sidney Crosby. After a double concussion in Jan, 2011, Crosby’s medical doctors had given him the best rehabilitation medical science could offer, and it wasn’t enough for him to return to playing hockey 8 months later. He started working with Dr. Carrick. When he returned to the rough game and suffered concussion symptoms again, Dr. Carrick’s treatment allowed him to resume playing, and he has continued. Below is a sampling of links: a Nightline news show on Dr. Carrick’s treatment of Crosby, an ABC news show about Dr. Carrick, and an article with quotes from Crosby.

http://harmonychirocenter.com/2012/09/chiropractic-neurology-carrick-nightline/

http://www.youtube.com/watch?v=DDT90YPoC30

http://www.cbc.ca/sports/hockey/nhl/sidney-crosby

Carrick and graduates of his program have successfully treated other brain injured athletes, often using sophisticated devices (see the gyro-spin chair here) that stimulate the brain to rewire itself in novel ways. Crosby says of Carrick’s unconventional approach: “”When someone came along and invented the airplane, people must have thought they were out of their mind. Who thinks he can fly? … At the end of the day, as long as the person getting the care is comfortable, I think that’s what’s important.”1

Dr. Robert Melillo–Disconnected Kids and Functional Neurologyyay-2808173

Graduates of Dr. Carrick’s program have not only made sports enthusiasts happy, they have uplifted the lives of thousands of parents of children with ADD, autism spectrum and learning challenges. One of them, Dr. Robert Melillo, has started a series of Brain Balance centers, and written several books on working with children.

Parents’ reviews do not constitute laboratory research, but they could be a weather vane to show which way the wind is blowing. They are overwhelmingly positive on Amazon for Melillo’s Disconnected Kids: The Groundbreaking Brain Balance Program for Children with Autism, ADHD, Dyslexia, and Other Neurological Disorders, and Reconnected Kids: Help Your Child Achieve Physical, Mental, and Emotional Balance. Melillo has also written a book that explains the functional neurology behind his work: Neurobehavioral Disorders of Childhood: An Evolutionary Perspective. It has 73 pages of references, approximately 2100 peer-reviewed citations. Despite these successes, chiropractic functional neurology has its critics, and they claim it’s “not science.”

Unfortunately, cutting edge health treatment is viewed as “not science” until researchers discovers a plausible mechanism that explains its benefits. More research then validates it effectiveness. The process takes years and often is expensive. Recently, Carrick’s advances in treating vestibular disorders has reached that threshold of recognition and effectiveness, is accepted as scientifically plausible, and has demonstrated substantial benefit when compared to placebo. I believe other of his methods, and the teachings of Dr. Paul Thomas in Functional Neurology for Bodyworkers (now Functional Neurology in Clinical Practice) will follow in achieving scientific validation. However, it takes dedication, research money and many years of time.

Carrick is a outstanding clinician, not a research scientist

Although Dr. Carrick has conducted research, he is not primarily a research scientist or writer, and his research is not well accepted in the medical field. Great clinical skills and proficiency at research do not necessarily coincide, and both take considerable time to do well. He excels as a clinician. His skills are in great demand. He asserts that leaves him no time for research. Clinical excellence is equally true of Dr. Thomas.

Chiropractic neurologists are not associated with research universities. They are not funded by pharmaceutical companies. Like other chiropractic physicians, they treat people without drugs or surgery. Carrick and Melillo’s evidence is anecdotal. Their patients are immensely grateful. Carrick’s critics claim it’s the placebo effect, but he gets most of his referrals from medical neurologists. He may not be able to prove it, in well-funded, placebo-controlled trials, but it’s certainly not snake oil! The trials to prove benefit may cost a million dollars. The anecdotal evidence from hundreds of people has not been compiled or had statistical analysis applied. It does not have much weight by the standards of  scientific evidence.

This has always been a major challenge for integrative, CAM (Complementary and Alternative Medicine) cutting edge therapies.

Research barriers: writing case reports can break the controversy

The world count of chiropractic functional neurologists numbers only in the hundreds, and functional neurological massage therapists numbers only in the dozens. For our numbers to rise, and to advance this field, I believe we need to do excellent documentation, write up our findings, and get our case studies published. People who are suffering from treatable functional neurological symptoms can only benefit. I spoke with one physician who said that massage therapists may be discovering things all the time that medical science needs to know, but we aren’t writing it up. Even more so than chiropractors, we don’t have the training or funding. A few case reports sprinkled among dedicated massage therapists can change that.

Dermatomes_and_cutaneous_nerves_-_posteriorDermatomes_and_cutaneous_nerves_-_anteriorDr. Paul Thomas: Functional Neurology for Bodyworkers

Please, if you are a massage therapist considering entering this field–don’t be discouraged by the numbers, or the controversy. Dr. Thomas is offering sophisticated coursework in the neurosciences that no one else is offering to massage therapists, even though we are capable of learning and doing what he is teaching. It’s a challenging course. It has been invaluable to me and my patients. We can contribute to the low-tech, high-touch version of cutting edge neuroscience, and make a huge difference in people’s lives.

Even though it’s still controversial, please consider entering this field and not only contributing to the well being of your patients, with new-found skills you only dreamed of, but also contributing to the world of evidence-based practice (EBP) by writing up your findings as case reports.

Feel free to contact me for referrals to research or case report writing resources. For how functional symptoms are viewed in conventional neurology and the opportunity that provides, you might want to read: Functional Symptoms in Neurology. To find Chiropractic Physicians who are functional neurologists in your area, there is a list here: American Chiropractic Neurology Board. To read an abstract of my first case report, scroll 2/3 down the page here: MTF 2013 Case Report Winners.

1 David Epstein, Michael Farber. Getting Inside the Head of Sid Crosby. http://sportsillustrated.cnn.com/vault/article/magazine/MAG1190863/2/index.ht.

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