hi - help me with an argument. Where can I find decent evidence that chiropractis works/does not

I worked at a chiropractic college for a couple of years in administration. (Clerk).
I was eligible for free treatment and thought I’d take advantage of it.
Results?

A mediocre massage. :o

I think the attraction to chiropractic treatment is the hands-on “care” and the (feigned) attention they give a patient.

[george costanza]Remember: if you believe it, it’s not a lie[/gc].

Like most all homeopathic remedies, people who believe that they work get some perceived benefit from them. Does that mean they work? The mind is a powerful thing, and if pain is relieved, whether or not it’s just because you believe it to be so, who’s to argue? There is absolutely no credible evidence that things like crystals and magnets work, yet it’s a thriving industry.

My experience with a chiro was that the more I went, the more it seemed I had to return. I finally quit in disgust and my back pain got better within a few weeks.

My torts professor, on the very first day of law school, told us to remember that chiropractors were all quacks. All of them. He said that he realized that some of us may have family members that were chiropractors and that he definitely meant to insult them as well, because they were quacks too. :slight_smile:

And from my limited experience in the law, it is true. I don’t know why the AMA recognizes it. I don’t know why insurance pays for it. Except for those very limited circumstances where a massage would do the same thing, chiropractic services are worthless.

Well, if it’s going to be annecdote time, I’m an educated RN, I’ve gone occasionally and had good relief by getting joints ‘cracked’ that I can’t do myself (like I do my knuckles and neck). Last time was 2-3 years ago, for 5-6 visits with a practiioner who said up front that we should be thinking about short term care, YMMV.

It is a testament to American education that chiropractic is still around:
-it has no proven benefits
-it is not founded upon science (“subluxations” do not exist)
-it is potentially dangerous
-it is a waste of money
So, why does it still exist?
I hope Obamacare doesn’t pay for chiropractic “treatment”- a witch doctor would be more effective.

I will attest that, like a massage or two Advil, it provides temporary relief.

And FWIW, my chiropractor (while he does, yes, nag me to come in for “regular” care even when I am over the hump of the issue I went in to see him for) helped me tremendously last winter when it turned out I had a herniated disc at C6/C7. His treatments were only moderately pain relieving, but he almost immediately diagnosed that what I had was not something his treatments would get me through and got me an appointment to see a physiatrist in under 3 hours, who then got the ball rolling to get my nerve testing done and my MRI.

Fortunately, I did not wind up needing surgery, but his willingness to get aggressive with treatment and escalate the issue to “real” doctors (I met with 2 neurosurgeons before it was all over) showed me that he knew and was not afraid to recognize the limitations of chiropractic care.

Also, after a good spinal adjustment, I’m like 3/4 of an inch taller, which is nice when you’re 5’11-1/2" most of the time. :wink:

The American Medical Association does not “recognize” chiropractic as effective therapy.

In response to a successful lawsuit by chiropractors which alleged illegal restraint of trade, the A.M.A. changed its bylaws to say that it’s ethical for physicians to work with chiros or refer patients to them if they think patients will benefit.

The A.M.A. has never endorsed chiropractic or declared it to be evidence-based medicine.

My experience - I had a sore wrist, my wife frequents the chiropractor, so she persuaded me to go.

The guy said I had a small bone in the wrist out of place, he had a “thumper” device, whacked it a few times. After about 2 treatments the pain went away.

My impression is that at best, they provide the hands-on, non-pill therapy that one could also get from a massage therapist or physiotherapist. The current doctor model is to find a pill for it.

One substitute chiro my wife went to they seemed to want to take X-rays, then provide for return visits. She could not get an appointment, then eventually she got a form letter to all patients from the guy saying he had “disagreements” with the senior chiropractors running the clinic and had moved. Reading between the lines, I looked up the name of the treatment he disagreed with, and it was a different school of thought that had many comments on a negative site about the scam; basically, persuading people they needed Xrays, then a whole round of assorted vitamins and other treatments.

So chiropractors, like everyone else, fall into the good, the bad, and the ugly. That it has survived when competing contemporary quackeries like phrenology have become new-age woo jokes, is a testament to… something?

The lovely wife had shoulder surgery and goes to a Chiro regularly to get stretched, poked, prodded etc and comes home saying that she’s feeling better.

She says that the procedures are similar to the physical therapy sessions she did after the surgery but much cheaper for her and her insurance plan.

My guess is that had she not gone to a Chiro then her doc would have prescribed pain meds when her physical therapy ran out.

It’s a few years old, but here’s Cecil’s take.

Google “Simon Singh Chiropractic” and you’ll get the whole story of Simon Singh’s analysis of chiropractic and the British Chiropractic Associations libel suit against him. He also covers this in his book “Trick or Treatment”.

In a nutshell: he’s agin’ it.

:slight_smile:

J.

Homeopathy has survived and flourished for even longer than chiropractic.

I’ll let you decide what that’s a testament to.

See also Chirobase and the articles on QuackWatch. The bottom line, last I heard, was that chiropractic works on acute lower back pain about as well as aspirin. It has no effect, or a bad one, on anything else, apart from counter-irritation and placebo.

Regards,
Shodan

As a side point.

How many deaths due to doctors actions or instructions happen per year?

How many deaths due to chiropractor actions or instructions happen per year?

What I really do not understand is how people can say that something does not make me feel good.

I don’t like but a few doctors of any stripe.

I have no dog in this fight.

But.

Doctors used to do blood letting.

Maybe others ideas are just where Doctors were then?

Who knows.

If whistling makes MY throat feel better & you can PROVE it is not possible, why do you think I am lying about feeling better?

Powerful mind & all that?

Has not the placebo effect been medically accepted as existing?

Do you object to the AMA recognizing it?

I know several people who feel better and an actual physical different can be seen after a visit. One person goes about once a year and another goes a lot more because of really physical work that produces noticeable physical problems. I can pretend that the pain is all in their heads but I can not pretend the physical ramifications are not there.

I was injured 44 years ago and no doctor, witch or AMA approved, massage therapist, quack, etc. can ever find much less help with. It is a real physical only problem and if I ever find something besides unconsciousness that will help, I will do it no matter what anyone can prove.

Not sure where that puts me on the offended about chiropractic & Homeopathy meter.

We don’t think you’re lying about feeling better. We dispute what caused it.

Regards,
Shodan

I tend to agree with him on this:

When I went to a chiropractor for low back pain, she first did x-rays and explained that she wanted to make sure I didn’t have something she didn’t treat. She didn’t keep me coming back forever, and it seemed to do some good. A lot of people in my workplace were passing around reccomendations to see her, so as long as that particular employer kept giving us crappy chairs, I suppose she had a ready supply of patients.

I’ve also been to physical therapist a few times, and there seems to be an awful lot of overlap between the “good” chiropractors and the PTs. You can make a pretty good case that they’re just practicing physical therapy without a license. From what I can see, the chiro will be a bit heavier on manipulation, and the PT heavier on prescribing exercises with an overgrown rubber band and so on. Both always seem to use the TENS machines, and tell you how you ought to be sitting, etc. I’ve been tempted to just buy one of those TENS things to treat my back occasionally, since I can’t seem to make myself stay up with the back exercises when my back stops hurting, or sit at a computer with correct posture.

A lot of insurance companies cover it now. Mine certainly did, and that was ten years ago.

Insurance also covers acupuncture nowadays. shakes head

Chiro is Ok for moderate back pain. Works fine for many, at least as well as physical-therapy . Here are scientific studies showing it’s so:

RESULTS–Chiropractic treatment was more effective than hospital outpatient management, mainly for patients with chronic or severe back pain. A benefit of about 7% points on the Oswestry scale was seen at two years. The benefit of chiropractic treatment became more evident throughout the follow up period. Secondary outcome measures also showed that chiropractic was more beneficial. CONCLUSIONS–For patients with low back pain in whom manipulation is not contraindicated chiropractic almost certainly confers worthwhile, long term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain. Introducing chiropractic into NHS practice should be considered.

http://www.nejm.org/doi/full/10.1056/NEJM199810083391502
After adjustment for base-line differences, the chiropractic group had less severe symptoms than the booklet group at four weeks (P=0.02), and there was a trend toward less severe symptoms in the physical-therapy group (P=0.06). However, these differences were small and not significant after transformations of the data to adjust for their non-normal distribution

Where the hate & accusations of quackery come from is the habit of many old school Chiros who insist Chiropractic can cure many other things, including even cancer. :rolleyes:

Now, some newer Chiro’s make the point that pain causes stress and stress can make you sick, thus Chiro makes you well. It’s a stretch but not quackery as long as they just maintain that.

We’ve mostly moved on from this. :slight_smile:

And that’s a key difference between evidence-based medicine and woo. EBM changes as new evidence dictates. Chiropractic (and other alt med interventions) are still stuck in the same nonsensical paradigms and use the same treatments as they did when they started.

One difference with chiropractic is that their gadgets and devices change over time; the lack of efficacy for them doesn’t.

One hint about the level of public skepticism for chiropractic can be found in ads for chiro services. For instance, there was a half-page ad in my local paper yesterday for an outfit that touts laser therapy as being wonderful for knee pain, even that caused by severe osteoarthritis with loss of articular cartilage. :dubious: Claims are made by “Dr.” So-and-So. It is only towards the bottom of the ad in small print that you see the letters “D.C.” (meaning doctor of chiropractic). The guy never actually identifies himself as a chiropractor. I’ve seen this over and over again in chiro advertising, including practitioners who claim to treat hypothyroidism and other medical conditions.

If chiropractic is so fabulous for whatever ails you, why the reluctance to tell people you’re a chiropractor?