Response: Is chiropractic for real or just quackery?

Cecil's Columns/Staff Reports
1

Hi Cecil:
I would like to clear up some old wives tales about chiropractic that many people still believe to be true. Perhaps, after the clarification you will have a better understanding about the profession of chiropractic and the science behind what we do.
When many people think of a chiropractic adjustment they think of an “abrupt push or pull on the back or neck,” yet that is not all of the case. A chiropractor can perform an adjustment using his/her hands or a small instrument, such as an activator. In both manual adjusting and instrument-assisted adjusting motion is put into a joint, but never past the anatomical barrier. An adjustment is performed at a joint that has a subluxation, otherwise known as a joint that has a decreased range of motion. The chiropractic definition of subluxation is not to be confused with the medical definition of subluxation, for they are two different definitions. Adjustments do not only occur in the spine, but at any of the hundreds of joints in the body, including joints in your hands and feet.
History is filled with scientists that have since been proven wrong; well, even though many concepts that originated from the father of chiropractic, D.D. Palmer, still hold true, 119 years later, there are some concepts that have been proven wrong. Yet, unfortunately, these concepts gain the most public attention.
Chiropractors look at the body as a whole and evaluate each individual before treatment. We perform the exam to rule out any condition that may be beyond chiropractic care because not every patient is suited for chiropractic care. Every treatment is individualized for the patient, for instance, if a chiropractor orders radiographs and reads the radiograph to conclude the patient has osteoporosis, their treatment will include modalities that avoid a heavy thrust of a manual adjustment.
There is a lot of research stating the benefits to chiropractic care and the science that backs up chiropractic. Here are some for your enjoyment: Adjustments have been found to decrease nociceptive, or pain causing, input input to the spinal cord (Bartsch 2003). Measurable changes within a joint complex occur within one week of the start of lack of mobility of a joint (Lantz 1988). I encourage you to dabble in the plethora of other studies that will blow your mind!

Thanks for taking the time to read my response,

Karen

(ETA: Link To Column: Is chiropractic for real or just quackery? - The Straight Dope – Rico)

2

Welcome to the Straight Dope Message Boards, Karen, glad to have you with us. For future reference, it’s helpful to other readers if you provide a link to the column on which you’re commenting. No problem, I edited your post to include that, and you’ll know for next time.

Glad to have you on board.

Rico
For The SDMB

3

I vote quackery.

4

Your definition of “subluxation” is different from the standard chiropractic one. If either of your references are available online, it would help to link to them so we can evaluate their worth.

Welcome to the SDMB.

Regards,
Shodan

5

Why can’t it be both? FTR, I also believe a great deal of standard medicine is quackery as well.

6
  1. Nailing down definitions furthers understanding.
  2. “They do it too!” doesn’t address the issue at hand-it is just a diversionary tactic.
7

Cecil answer is:

My personal experience has been a very positive result from a person with a doctorate in both Physical Therapy and Chiropractic.

8

100% quackery and fraud.

9

A medical subluxation implies the presence of an incomplete or partial dislocation of a joint or organ. According to the wiki on Chiropractic Vertebral subluxation,

Where did you get your definition?

10

Speaking of old wives’ tales…

Subluxations in evidence-based medicine are real and can be seen on imaging studies. Chiropractic “subluxations” cannot be seen on imaging and have not been demonstrated to existl, which is why reform elements in chiropractic are trying (unsucessfully, so far) to eliminate this fantasy from the chiropractic curriculum. To quote chiropractor Sam Homola:

“An orthopedic subluxation, a true vertebral misalignment, or a mechanical joint dysfunction that affects mobility in the spine is not the same as a “chiropractic subluxation” that is alleged to cause disease by interfering with nerve supply to organs. Such a subluxation has never been proven to exist. There is no plausible theory and no credible evidence to support the contention that “nerve interference” originating in a single spinal segment can cause an organic disease.”

As chiro subluxations do not exist, “adjustments” cannot resolve them, but are just another form of laying on of hands that some people find beneficial (along with massage and forms of physical therapy).

Two classics commonly expounded by proponents of woo. “Science was wrong before” does not excuse current chiropractic quackery. It is ironic that Karen approvingly cites the “father of chiropractic”, D.D. Palmer, whose nonsense is still believed by many chiros today. Evidence-based medicine recognizes errors and is constantly revising and improving care, while chiros cling to concepts that were ridiculous over 100 years ago.

…the overwhelming majority of which are in chiro journals, involve minimal numbers of patients and do not support the sweeping claims made for chiro treatments.

*"In over a century, chiropractic research has produced no evidence to support the postulates of chiropractic theory and little evidence that chiropractic treatments provide objective benefits. Research on spinal manipulation is inherently difficult, because double blind studies are impossible and even single blind studies are problematic; a placebo response is hard to rule out.

There is good evidence that spinal manipulation therapy (SMT) is effective for some patients with low back pain but that it is not superior to other treatments. There is controversial evidence of lesser quality supporting the use of manipulation for neck pain and headaches. SMT is not exclusive to chiropractic: it is also used by physical therapists, doctors of osteopathy, and others. There is no acceptable evidence that chiropractic can improve the many other health problems it claims to benefit, from colic to asthma. There is no evidence to support the practice of adjusting the spines of newborns in the delivery room or providing repeated lifelong adjustments to maintain health or prevent disease."*

11

There is a benefit to having someone pay attention to you, listen to your problems, and sincerely wish for you to get well. There’s also a benefit to having someone place there hands on your body. It comforts and reassures the patient, makes them feel loved, gives them hope, and stimulates oxytocin.

You can get the same benefit from a hug as you get from a chiropractor.

Charging $150 for hugs and calling it medicine is quackery.

12

The fact is if chiropractic didn’t work insurance wouldn’t pay for it.

13

It is reality that insurance pays for it. That does not make it a fact that it works.

14

Nonsense. Insurance pays for all sorts of stupid stuff, especially if it replaces or puts off more expensive treatments. See also: acupuncture, B12 shots, “therapudic touch,” and homeopathic/naturalist treatments, all of which are often covered by insurance.

15

So if our chiro only charges $20, then he’s not a quack?

16

Actually, that might be decided by state statute. People who vote go to chiropractic clinics and some legislators may also be chiropractic patients too. In fact, this paper states that 45 states mandate insurance to cover chiropractic care.

17

The problem I have with chiropractics is the complete lack of evidence and the complete lack of blind studies to demonstrate any effectiveness.

The basic theory of chiropractics is full of what is obviously non-scientific based ideas of disease and physiology. As mentioned in the Straight Dope article, chiropractics states that most disease is the result issues with nerve flow. That the body has innate intelligence to heal itself, and this intelligence is transmitted by the nerves, and that this nerve flow can be blocked by misaligned vertebra. Even many chiropractors don’t believe it. This is why there’s a big fight between the straight (the true believers), and the mixers who believe that other treatments are necessary to help chiropractics work.

Even most patients don’t believe in chiropractic theory. 60% of the visits to chiropractics are for skeletal muscle pain. Another 39% go for maintenance. Few go for diseases such as flu or cancer which chiropractic theory claims to also treat. (The article linked is very boastful of this fact, and crows about the *evidence based medicine[/] report. However, the report doesn’t go into the effectiveness of the treatment, only why people are going).

And, it’s not like chiropractics in benign. Many adjustments are actually quite dangerous. Neck manipulation is extremely dangerous and has been linked to strokes.

I will admit that maybe there might be something to chiropractics, even if the theory is all wrong. However, the way to show this is with a good double blind study. And, the two treatments must be equal in value to the patient. One study that showed moderate effects of chiropractics involved one group of patients being treated by chiropractors while the other group filled out a survey.

And, don’t give me that bogus big medicine won’t do a study. Hospitals now have chiropractic units (they’ll do anything to make a buck). Chiropractics is a 14 billion dollar industry. It’s big medicine. That’s more than Norvartis’ income in 2012 (9.6 billion). Chiropractics is a big industry and could sponsor a few good studies to prove its effectiveness.

18

No, just a lower class of quack.

19

Going down the row…

Quoting anything from sciencebasedmedicine.org is not stating any facts, but just opinions of Steven Novella and David Gorski. They may be doctors but so are 800,000 others that don’t share their opinions. While not chiropractic yet, the Integrative Medicine at Yale University, where Dr. Novella is a professor, teaches Acupuncture. I might be wrong but I believe Novella once said if acupuncture worked then studies would be published. When confronted with the fact that 1000s are published in China annually, he replied that they aren’t good studies because they prove Acupuncture works. Circular logic, I would say.

As to insurance companies paying chiropractors, yes maybe you can claim that doesn’t prove anything…but what about state college sports programs, government run hospitals, and the VA system? Why do we accept Chiropractor services with tax payer money…could it be they have proven their worth with the consumer? The NBA, NFL, and the MLB also use them, are you assuming that jocks are so stupid they can simply be talked out of their pain?

Lastly, mentioning an Australia study of 99 patients is questionable. While I have never been to a chiropractor myself, I know many that have…including doctors. I might not make a chiropractor my first choice for the everyday flu, from what I have heard from other people, they would be my first choice for any back problems. I might check with an African Witchdoctor before I went to MD, as I have never heard a good result from someone coming back from a doctor’s visit. :slight_smile:

20

Nonsense. People whined hard enough to make it happen. As mentioned, chiropractors got lawmakers to write laws forcing coverage.

One doesn’t have to be stupid to fall for the placebo effect.

There is some benefit to spinal adjustment in easing back pain. It is similar in function to stretching and exercising and massage.