Chiropractors: Respectable Doctors or Money-Hungry Quacks?

Great Debates
1

Kinda long, sorry…

Earlier last week I was hit from behind in a car accident. As a result, I now have nasty whiplash.

I went to my doctor who diagnosed the whiplash and recommended taking ibuprofen and applying heat to the sore areas. I was also told to take it easy and that my body should heal itself in a few weeks.

My aunt, who also happens to be a registered nurse, completely disagrees with my doctor’s recommendations. Heat she said, would only cause more swelling. She also said that if I didn’t go to a chiropractor, I could have problems for the rest of my life. I have long been against chiropractors, viewing them as quacks out to get your money. But at that point, I was willing to try anything if it would help ease my pain.

Argument for the Respectable Doctor

I went for my first appointment last Thursday. The doctor as well as his aide were very nice. The visit began with a complete check-up. The doctor checked my alignment as well as how far I could turn my neck, bend over, side-to-side, etc. Then I was given ultrasonic therapy. The sound waves penetrate deep into the muscles, creating a warm heat. Then the doctor adjusted my spine, shoulders, etc. I was also sent to get X-Rays the next day.

In all, the visit went well, much better than I had thought it would. The doctor seemed to genuinely care for my well-being. He explained everything he did, how it helped me, and what we would be doing in the future. I left the office feeling optimistic and informed - something that rarely ever occurred at my normal doctor visits.
Argument for the Money-Hungry Quack

I also told that in order to get well, I would need to come in three times a week. :eek:

Now I have great faith in my aunt and, after talking to the doctor, in chiropractors, but three times a week?!?!?! All I could think was CaChiiiinnnng!

The Chiropractor told me to put ice on the sore areas for 15-20 minutes at least 3-4 times per day. With each subsequent visit, using ice as much as possible has been heavily emphasized. This totally contradicts what my doctor told me to do.

One of my roommates (we’ll call her “A”) was in a similar accident just a few days ago. She went to the emergency room yesterday to get checked out. There, they told her to use ibuprofen, apply heat, and come back if not feeling better in a week. A told the doctor that I was told by a chiropractor to use only ice. The doctor wasn’t surprised and said that telling patients to use only ice is a common practice with chiropractors. The er doc said that ice actually causes the muscles to tighten, creating more pain, and subsequently more trips to the chiropractor. :confused: :confused: :confused:

I called my mother (a big chiropractor supporter) to tell her about my suspicions. I may as well have told her the sky is purple. She yelled at me and defended the chiropractor. She said that most general doctors don’t recognize chiropractors. The er doc’s reaction was only due to unfounded fear and a dislike for any kind of medicine that doesn’t follow what is considered the norm.

Hmm… What to do, what to do??

Now I turn to you, dear dopers to give me your opinion on the matter. I’m not sure if I want to continue my appointments or stop going. I want to make sure that my decision is made after hearing both sides of the argument.

Anyways… Enough babbling from me. Now I’ll let you all have a turn.

Note to mods: I’m not sure if this belongs in great debates or imho, so please place this thread where you see fit.

–Doper Chic

2

Check http://skepdic.com/chiro.html

In a nutshell - chiropractic can be useful for lower back pain. Otherwise it’s quackery (although lots of people have personal experience which might suggest otherwise, there is no scientific evidence for chiropractic being able to cure other conditions).

3

I’ve never been to a chiropractor, but everyone else in my family has been going for years. One thing I’ve noticed: once you start going to one of these people, you never seem to quit. The guy my mother goes to is a wonderful person who sincerely tries to do everything he can to make her feel better. So, he’s really not a money-grubbing quack. However, he is one of those people who sincerely believes there’s no need to have kids vaccinated if you keep them properly adjusted, so he’s not the most reliable medical opinion out there either.

As far as the treatment plans you’ve been offered, there are good and bad points to both. Heat does relax muscles, and ibuprofen can reduce the inflammation and soreness of your whiplash. However, until you begin to heal, you’re still going to hurt. A lot. Actually, I had a similar injury just last week and understand exactly how bad it hurts. I went the ibuprofen route for a few days, and now I’m pretty much back to normal, with only a little residual stiffness.

Your chiropractor’s plan is definitely the more expensive option. The ultrasonic therapy is really great for relaxing muscles and increasing blood flow to the injured area, but most doctor’s offices can set you up with that. Putting ice on the area is great for relieving inflammation, partially because it decreases blood flow, which counteracts part of the ultrasonic therapy.

All in all, I’d have to say that if the treatments make you feel better, and you’re all right with spending the money, go ahead and keep your appointments. Just keep in mind that you’ll probably wind up going at least twice a month for years. You’ll most likely heal about as quickly either way you go, but for some people chiropractic adjustment is a really effective method of pain control without the potential side effects of traditional methods. Good luck and a quick recovery.

4

Money-hungry quacks.

Quacks: Maybe I’m prejudiced because my wife teaches in a medical school. However, chiropractic treatment simply lacks a scientific basis.

Money-hungry: Having worked in the field of workers compensation insurance, I have paid attention to the effective lobbying efforts of chiropractors to get themselves approved for WC treatment in many states. A chiropractor with a patient on compensation can bring him back for visit after visit, almost without limit, since the patient isn’t paying for his treament. We consumers pay these costs in the form of higher prices.

5

I was in a car accident around 10 years ago and while I generally think of many chiropractors as being quacks, the third one I went to only told me to come in as needed…no “three times a week” as others recommended, and, his office didn’t have all this chiropractic propoganda like the quacks tend to have.

I can tell you this much, the electrical stimulus treatment did alot more for easing the pain than any of the pills the traditional doctors prescribed at the time, and, there were no potential side effects to worry about (I tend to avoid chemical medicine whenever possible…I believe in using natural means to treat illness whenever possible).

As with any profession your mileage may vary. There are good ones and bad ones.

6

Well, let’s see - in my previous professional incarnation I was in the property and casualty insurance business (work comp, auto liability) and saw how claimants who went to MDs usually went once or twice, folks who went to DOs went a few weeks, and folks who went to DCs went the rest of their lives…

Ice is suggested only in the first few hours when the blood and lymph is rushing to the injury to help reduce the swelling - after that it serves no real pupose…

I am now in my second professional incarnation, which is medical billing. My first such job was for …CHIROPRACTORS! They though they were “physicians” and in fact called themselves that. They were thoroughly convinced they could “cure” anything from back pain to allergies to diabetes just by jerking on someone’s neck. And if nothing was wrong with you, they would make something up - “leaky gut syndrome” was one of their favorites. Since they are not licensed to write a scrip for even aspirin, they would declare all pharmaceuticals as “dangerous” and “ineffective” but then pump their patients full of “herbs” and “vitamins” to make their “treatments” appear valid. I remember one poor guy who was taking 50 pills a day, thinking those aloe vera pills and vitamin Cs were really going to cure his slipped disk. I one time had the temerity to ask why, if they had such wonderful “cures”, nobody was ever discharged from treatment. I was soon looking for my second medical billing job…

Sorry, I’m afraid I’m going to have to vote “quacks like a duck”.

7

Chiropractors can 1.) sometimes 2.) make your back feel better 3.) for a while. Any who claim otherwise should be regarded with tremendous skepticism.

Their services are not entirely without merit. Unfortunately, treating chronic lower back pain is something that we allopaths just don’t do very well, and I’ve known several people who were helped by a chiropractor when nothing else would work. As long as they realize that what they are doing is temporary, and is an adjunct to traditional medicine rather than an alternative, I’m cool with it.

When they start claiming that they can cure various systemic diseases, they cross the line into quackery. When they start claiming that chiropractic “adjustment” can take the place of childhood vaccines, they jump over the line into outright malpractice.

Dr. J

8

In California, Prop 44 just passed which basically states that:

I don’t know if other states have similar laws but perhaps they should. I was a bit surprised to find that something like this didn’t already exist.

I was in a major car accident recently that also. similar to the OP, resulted in severe back pain. While the lawyer that I consulted wanted me to to schedule several visits to a chiropractor, I chose not to. I don’t support the idea of frivolous lawsuits and to be honest, my doctors treatment was quite effective. Two months later and I am free of pain. I have a feeling I would have been seeing a chiropractor for a hell of a lot longer than two months.

I would recommend sticking to your doctors advice and seeing if said treatment is effective. If not, explore alternatives but with caution.

9

Chiropractors are ‘specialized’ in an area of medicine that would otherwise overwork the current medical infrastructure. To that degree, over-worked and over specialized doctors can have a significant roll to play on more acute conditions. Chiropractors play quite an economic roll in this regard.

-Justhink

10

I have had back problems for many many years.

The first Chiropractor had me in 3 times a week for 2 months and after the time it did help.

The second had me twice a week for 3 weeks. He also stressed various excercises to help. which did in fact help.

The third on I have gone to and would go back to again. Was very good. He was very communicative, explained everything in detail, stressed the excersises once things were adjusted back to normal. Stated that Ice is good for the first day while the injury is swelling but after that heat works better to relax the muscles in the area. I even know of three people whom he had come in he sent to a real doc because their backs were screwed up.

He has yet to claim to fix anything but back pains and such of that nature. He does push healthy eating and diet.

I consider him the exception not the rule of dealing with Chiropractor. He even had me for my last back problem in 5 visits over the span of 3 weeks. At the end of 3 weeks he said come back only if I needed to, that time and excersise would take care of the residual pain and discomfort.

there be my 2 cents.

11

Step-Grandchild of a chiropractor checks in…

Well, how should I put this, I think the man was completely off his rocker. I was adjusted many times and I felt great for a day or so. My grandfather was one of those “proper adjustment will replace immunization” types. What made matters worse was that my stepfather idolized him.

Grandfather was among other things:

Married to a raging alcoholic who pretty much ended up killing his business. His office was in his home and she would wander out (very drunk, one time totally naked:eek:) and yell at people to get out of her house and such.

Wrote a book (self published) called “I remember Atlantis” It was accepted by several publishers until he demanded that it be published and categorized as NON-FICTION!!! :rolleyes:

I saw him get very angry with one of his friends and ask him to leave for telling my grandfather to let the BS atlantis thing die.

I have a very hard time with the idea that anyone like this should be allowed to “practice medicine” of any kind.

12

I bet you have better results from a Yogi than a Chiropractor.

13

Ice vs heat:

No science to back up either over each other. Talk to two people and get three opinions. Either ice numbs the muscles so you can do some stretching, or the heat relaxes them so you can do some stretching. Bottom line - do what feels better to you.

Some chrioropractic manipulations can do a good seal of good for a variety of muscular and painful conditions; one controlled study showed them superior to “traditional” treatment for lower back pain, but the tendency to claim to do more than they really do, and to have you come back forever, is unconscienable.

If I send a patient with back pain to a physical therapist, (s)he’ll be taught home excercises to avoid the pain in the future. Short course, continue at home, done. To the chriorpractic and the patient will still be going when I’m dead and gone.

14

I handled a large number of whiplash and lower back personal injury cases as a lawyer, most as a defense lawyer, but a good number as a plaintiff. I also have had back problems since I was 15 years old.

Like a medical doctor, the actual doctor or chiropractor you visit makes a lot of difference. Idiots can and do get through medical school and chiropractic shool and they don’t get better educated as time goes on.

A good chiropractor (I go to one when I have pain) is gentle and will emphasize exercize for chronic problems.

If you have a trauma, like an accident, you may be asked to come in up to three times a week for the first two weeks and a couple times a week totalling about 6 weeks. Much more than than for a trauma and you should be seeing a medical doctor.

The federal government has some web sites detailing studies on how chiropractic can help some problems, and I’ve used these sites from time to time, I do not have them handy now.

In short, there is some limited benefit.

15

I don’t usually recommend or discourage people with back pain from visiting chiropractors, but I would certainly discourage neck manipulation.

Here are some facts about back pain.

These pains are acute or chronic, depending on whether they last longer than would reasonably expected for tissue damage to heal. Nerves can heal slower than 1mm/day.

This (World Health Organization) definition of chronic pain applies EVEN IN THE ABSENCE of proven tissue damage. 90% of chronic back pains have no obvious cause using MRIs, imaging, often biopsies. We do not understand these pains. They may represent amplified nerve signals. Pain CANNOT be defined in terms of the stimulus since the nervous system is never a blank slate and has complex control processing.

A standard treatment includes a trial of ice, a trial of heat, proper stretching and the best possible pain control. Patients who expect any medication to get rid of ALL the pain are always disappointed. The goal is to maximize FUNCTION.

Most of the treatments are ancient, predating Romans, who also used massage, ice, heat, stretching, support, braces, opium… Heat may reduce stiffness; ice may reduce pain; these are not consistent among patients.

TENS (ultrasound) is one of the few treaments using a more modern understanding of the gate control theory of pain by blocking the large C fibres over the smaller A fibres.

The recent physiotherapy literature stresses the importance of muscle imbalance stabilzation. In some interesting studies, the transversalis muscles of the spine (stretched by Kegel exercises) seem to fire before other muscles and likely play bigger role in mechanical back pain than other muscles. These muscles can atrophy by 30% surface area within 2 weeks of injury; hence it is important NOT to stay in bed with back pain.
Not all physios do ACTIVE stretching which is more important than merely applying ice, heat, etc. You could do that at home.

Good pain control should start with regular Tylenol, Advil, Vioxx/Celebrex. I find Naproxen most effective. Based on the VIGOR study I would not use this in some patients (e.g. long-term use in elderly). Pain control should be at least good enough to get through physiotherapy. Some of these pains are opiate responsive, some are not. These should be prescribed with tight, clearly identified boundaries.

Chiropractors who do the above are not quacks. X-rays are unlikely to help, though. Three times a week seems a little too often, but I think physios often see people too often as well. I would not let a physio manipulate my beck because of some evidence this can occasionally damage the important carotid artery.

16

Guess I should clarify the above rant by saying there are times when cervical spine X-rays are very important. But they are not always needed. The chance of it showing something is low, though.

Vaccinations have been remarkably successful in reducing complications of many serious diseases, including polio and meningitis. Patients have every right to refuse vaccinations but one hopes this is done with a full understanding of the risks. Relating it to the back seems as silly as saying all medical problems are located in the foot or in the eye, both of which are claimed by certain naturopaths.

17

Hemlock wrote:

See also http://www.chirobase.org/.

18

Reading this thread as really made me stop and think. I hadn’t realised that many people have experienced the chiropractor’s ploy of keeping you coming back for years, as I have been doing for far too long.

I first visited a chiropractor when traditional medicine didn’t appear to be helping me after badly hurting my back - it’s so long ago now I can’t even remember the circumstances. But at the time, it really helped. And I got sucked in. I have been visiting my chiro once a month for at least five years.

If it meant that I would never get back or neck pain again, it would have been worth it. And most of the time, I am OK. I assumed because I was taking ‘preventative’ measures against spinal misalignment.

But recently have experienced bouts of back pain whereby after sitting in certain chairs/positons for any length of time, I can hardly move when I stand up and hobble around like an old lady for a few minutes till I get mobile again.

I have been doubting for quite a long time now that it is worth paying regular visits to a chiro (at $32 a visit - whatever that is in USD) if it cannot prevent ‘bad backs’. I think I would really like to stop going - trouble is - I got sucked in to paying in advance (for a slight reduction in the per visit fee) and I have got at least 6 more visits prepaid for.

I also did not realise that anti-immunisation was a common song for chiros to sing - I thought it was just my kooky one. That is what really started the alarm bells ringing for me. That and some of the other silly pseudo medical crap he spouts. I have just ignored it in the past, but now am really thinking hard about whether I want to continue down this path.

19

I used to get chronic back pain after an accident that prevented me from running at high speeds (I was an athlete/Australian Rules footballer). After trying everything I resorted to a chiropractor… and he gave me the relief I was after.

I went twice a week for about 6 weeks and although I still get some back pain, it is not to the point that I am prevented from doing any type of physical activity.

However, my chiro insisted that I should keep going back twice a week indefinitely, which seemed a bit odd to me.

I went to one of the other chiro’s in the clinic on an unrelated matter, who was more conerned about adjusting my wallet size then my back.

In conclusion, there is definitely some merit to chiropractic for back pain relief, but beyond that…

20

First and foremost a chiropractor is NOT a doctor. They call themselves that, and have managed to weasle into insurance policies, but they are not in ANY way comparable to a real doctor who attended medical school.

Secondly, if you’re bad off enough that you need to see a “doctor” three times a week, or even ONCE a week, you should probably be in the hospital.

Third, my only experience with chiropractors was with one who took an X-ray of my cervical vertebrae and happily informed me that I had no real damage after a horrible car accident.

Luckily, a neurosurgeon suggested an MRI, which revealed a disk that had been squashed into my spinal cord. Probably not a good idea to let someone jerk your neck around when you’ve got that type of injury…though the chiro was insistent that it was the perfect, nay the ONLY, solution.

Even GOOD chiropractors who are honest about the types of pain they think they can “treat” are misguided individuals at best. They’ve been taught that it can help, and they believe this is true. That means that your best case scenarion in the chiro’s office is that you’re about to pay a sadly delusioned person for a useless service.

L