What's the current establishment opinion of chiropractic?

In My Humble Opinion
1

I was at a wellness expo last week and got roped by a chiropractor. She offered an initial consultation, including x-rays, for only $20, and the $20 would be donated to such-and-such. My girlfriend, being a chiro-goer, told me that was a great deal and I should do it. So I did.

I went in yesterday morning and they took x-rays, and the chiro poked around my back and neck and listed off some gobbledygook for her assistant to write down. I went back tonight for the follow-up. It was preceded by some propoganda about why chiro is good and how we go to dentists before there’s a problem, so why not go to chiropractors for the same reason. She also listed off some other stuff, which I think I’ll be formulating a question to put into GQ as it sounded sketchy and a bit flakey.

Then in the actual follow-up – a fairly short consultation where she tells me that she’s glad I came in and shows me my x-ray – she ends with, “so do you want to heal yourself”? And my answer was, “Well, that all depends upon what my additional research tells me. I need to go to some additional sources to find out more about what you do and whether I think I need to engage your services. No offence, that’s just how I make my decisions.” And she encouraged that and asked me to get back to her either way.

So, of course, SDMB is one of my sources. What is the current state of opinion on chiro? It seems to be that in the past they’d been considered a wee bit quackish by the medical establishment, but I’m wondering if general opinion has changed any. Is chiro generally seen as helpful, harmful, or useless?

It may be important to note that I don’t suffer back pain, neck pain, limited mobility, or any of the many other things that I’ve heard they can help with. However, in my x-ray, my neck (the spine) does indeed look like a broomstick rather than a supply, curvacious spine, and she did show me what she claims to be early (I’m 35) degeneration around my hips, which she claims she can help.

2

IF she has offered to cure/relieve/fix only what you’d expect physical manipulation to cure/relieve/fix, and hasn’t offered to cure/relieve/fix anything that it would seem patently absurd for physical manipulation to cure/relieve/fix (such as the flu, or asthma, or AIDS, or general bodily illness usually caused by pathogens, or (Og forbid) spiritual miasmas of any sort), then she’s probably one of the good chiropractors.

If she’s been offering to cure/relieve/fix things that seem too good to be true, then, as with all things that seem such, it probably is.

3

Such as, curing/relieving/fixing back pain?

I personally say that if you’re not in any sort of pain, experiencing any discomfort, etc, there’s really no reason to get it fixed.

4

No, actually. I’d consider back pain well within the expected focus of treatment for chiropractic. You might even say that it’s the condition most effectively treated by chiropractic. I’d hardly call that too good to be true, considering that there is plenty of evidence that it IS true.

5

Gah. Read the above as “back pain that doesn’t exist.” I blame it on the NyQuil…

6

Heh. Gotcha. Yeah, I have to admit that the “we can prevent problems” thing seems slightly suspicious, but not completely outside of the bounds of possibility. If the x-rays show signs of the beginnings of a misalignment or something like that, it could very well be beneficial to have things cracked back where they belong.

7

General rule for telling the good chiropractors from the quacks: Listen to the pitch. If they only talk about bones (vertebra, etc.) then they’re probably a good chiropractor. If they even MENTION energy (as in “your energy isn’t flowing right” or “we can free up the energy flow in your spine”), walk away.

Bonus buzzword: Subluxation. If they mention subluxation, walk away.

8

See http://www.chirobase.org/ from the same folks who bring you http://www.quackwatch.org/

9

The whole “we can prevent x, y, or z” pitch is something to be cautious of. I know folks who get chiropractic treatments all the freakin’ time, not because they have any particular problem, but just because…uh…well, I honestly don’t know why. If you add up the money they’re spending, it’s a huge amount. If you’re looking to prevent back problems, your health care provider should be able to suggest excercise or lifestyle changes that may help. If they suggest you come in frequently for “adjustments,” think “scam.”

You may also want to ask your chiropracter what medical certifications they have. A lot of places don’t require any sort of medical background or knowledge to be a chiropracter.

And, as other posters have said, if they mention “energies” or “chi” or any ability to fix problems not related to the musculoskeletal system, they’re a quack.

10

I’ve been going to a chiropracter more off than on for my neck and lower back. I can tell a definite difference (positively) and really tell a difference (negatively) when I don’t go for a while. It is recognized as complementary medical treatment by the NIH, I was actually referred to my first one by my MD, and is exactly as much quackery as the practitioner.

I haven’t had anybody mention energy to me though I’m aware they exist. I did have a problem with one that I went to always wanting to sell me products like she was a Mary Kay agent on crystal meth (“you have to use this pillow or your neck will never heal” and “BioFreeze is the only mentholated rub that’s good for you”) so I dropped her. She was a bit irritated with me by then anyway because she’d said “Regular doctors would want to write you out five prescriptions, but we chiropracters don’t believe in that” and I responded “That’s good, seeing as how you’re legally unable to”, and she didn’t appreciate it.

But the one I go to now is a good ol’ boy who’s in the business of helping back pain, carpal tunnel and the like and makes no pretenses of being able to prevent Alzheimer’s or allergies (actual claims I’ve heard chiropracters make).

Another gauge of whether you have a good one or a quack: find out what’s the youngest patient they will see without a physician’s referral. If they’re willing to perform an adjustment on a 2 year old without a doctor’s say-so, they’re a quack.

11

Ayup, there was some mention of energy. And subluxation. And she said that the reason that the left arm hurts during a heart attack is because it’s governed by the same nervous system tissue as the heart. The first and last above most certainly struck me as a little on the flakey side for my liking.

But at this point I’m wondering whether I ought to be having someone deal with this broomstick neck. If it’s not curvy like other people’s necks, can this cause me a problem? How the hell do I know whether I need preventative maintenance, who the hell can fix me, and whether any of it is even real?

12

Can somebody point me to some large, randomized, double blinded clinical studies that show that chiropractice, in any form, works?

Thanks,
threemae

13

Your body is very good at telling you when something isn’t right. No body needs to be “adjusted.”
Subluxation is a medical term meaning the vertebra have been pulled apart. It is a medical emergency. When someone is hanged, the injury that causes death is a subluxation of C-1/C-2 The first and second vertebrae are violently pulled apart, interupting the spinal cord.
There are a few cases every year where in a person walks into a chiropractor’s office, for an adjustment, and wheels out as a quad.
It may have its place, I’m not convinced, but if it does, I can assure you, that place, is very, very narrow.
My opinion.

14

Cherkin DC, Deyo RA, Battie M, et al. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. N Engl J Med. 1998;339:1021–1029.

“There are few data on the relative effectiveness and costs of treatments for low back pain. We randonly assigned 321 adults with low back pain that persisted for seven days after a primary visit to the McKenzie method of physical therapy, chiropractic manipulation, or a minimal intervention (provision of an educational booklet).”

“Conclusions For patients with low back pain, the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving the minimal intervention of an educational booklet. Whether the limited benefits of tese treatments are worth the additional costs is open to question.”

Mind you my anecdotal experience is that I receive great relief from chiropractic manipulation for both lower back and neck problems.

15

Have you heard of this “broomstick neck” condition from anyone other than this chiropractor? If you want the straight dope about the condition of your neck and whether there’s any need for treatment, you need medical advice – my advice is to get the opinion of an MD of the appopriate specialty. Sounds to me, though, like you’re not experiencing any real symptoms from it. Also, for nearly any phsyiological function or anatomical arrangement, normal is a range that you may be well within. Is the D.C. showing you some idealized picture, then asserting you have some serious problem because you’re neck doesn’t look exactly like it?

16

You beat me to it. It doesn’t make sense to conclude that this person is a quack but still believe the X-rays. Get a second opinion of them before taking any action based on what they show.

Here’s how my family got a recommendation for a good chiropracter - My dad asked the orthopedic surgeons he knew. They’d say the party line about chiropractic being no good - then supply him with the name of the person they used.

If you have musculoskeletal pain - it doesn’t hurt to go to one and see if it provides relief. If you don’t - don’t.

Preventative health has more to with life style issues such as diet/excercise than premature manipulations.

17

I used to work at the American Academy of Orthopaedic Surgeons. Those guys hated chiropracty, likening it to just a slight improvement over witch-doctoring. Which isn’t surprising, since chiropractors directly compete with orthopaedists.