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Chiropractors, a thread:
Of all the things in alternative medicine, Chiropractic is probably the most widely accepted. Despite this, CHIROPRACTORS ARE NOT DOCTORS. Chiropractic is a PREscience belief system. It's not based on neurology, anatomy, or physiology it's based on myth.
Of all the things in alternative medicine, Chiropractic is probably the most widely accepted. Despite this, CHIROPRACTORS ARE NOT DOCTORS. Chiropractic is a PREscience belief system. It's not based on neurology, anatomy, or physiology it's based on myth.
Chiropractic is not a science, it was created by a single individual in 1895 all by himself in a single day. This individual, D.D. Palmer, was not a scientist or physician. He thought a bone was out of place in a deaf janitor's back.
He pressed on the janitors back and thought he had replaced the bone and immediately the janitor said he could hear again (according to Palmer). Nevermind that the nerves for hearing are in the head. He took this 1 case and stated it was the reason for all disease.
This is the myth of "Chiropractic subluxation"; that disease is caused by bones being out of place (mostly in the spine) causing impaired nerve signals. Palmer thought there was a force called "Innate" that restored health via alignment of bones and nerves. Again, this is 1895.
In reality, subluxation is a medical term for a partial dislocation. These are seen on x-rays, but the Chiropractic definition is not despite their claims. If you show an x-ray to a chiropractor three of them will likely see their "subluxation" at different places.
Chiropractic schools have been repeatedly challenged in the past to produce sample teaching x-rays showing their definition of subluxation. None have been able to do so.
When a chiropractor creates an audible "pop" in your back, they may tell you it is the sound of the bone popping back into place.
This is not true. It's the same sound you would get when you crack your knuckles. It's produced by gas rushing into a joint space to fill a vacuum.
This is not true. It's the same sound you would get when you crack your knuckles. It's produced by gas rushing into a joint space to fill a vacuum.
When you pull bones apart, the ligaments stretch and the pressure inside reduces which makes room for a gas bubble to fill a space and this tiny bubble makes a BIG sound.
Chiropractors originally believed in BOOP, or bones out of place. When that couldn't be demonstrated on x-ray it was justified by saying things such as "there is a displacement but it's too small to be seen on x-ray". Eventually this theory had to be given up on.
The current definition that chiropractors use for subluxation, is, "a complex of functional and/or structural/pathological articular changes the compromise neural integrity and may influence organ system or general health". This is intentionally vague.
A disease like Diabetes is defined so that every doctor who evaluates a patient gets the same diagnosis. Chiropractors have intentionally made their definition vague to interpret it a million ways. It amounts to a pretext; an excuse to treat anyone the chiropractor wants to.
Some chiropractors are now rejecting the subluxation concept entirely. However, the law still defines Chiropractic in terms of the subluxation and the word is still very much in common use.
The second part of Chiropractic theory is nerve impairment. Palmer thought all body functions were governed by nerves from the spine. They aren't.
Palmer didn't know about cranial nerves and he didn't know about hormones. He also apparently didn't know that some spinal nerves exit through the sacrum which cannot be manipulated.
Today we know with organ transplants that you can sever all the nerves to an organ and transplant it into another person's body still works just fine.
True subluxation may not even affect nerves. You can have a subluxation without nerve impairment and nerve impairment without subluxation.
In spondylolisthesis, true subluxations have occurred that are seen on x-ray but may not cause any pain or impairment unless advanced.
In spondylolisthesis, true subluxations have occurred that are seen on x-ray but may not cause any pain or impairment unless advanced.
And in these cases the pain is usually MSK pain and not nerve pain.
One condition that can cause nerve pain is a ruptured disc. When a disc ruptures, the disc material breaks through the fibrous annulus and puts pressure on the nerve.
One condition that can cause nerve pain is a ruptured disc. When a disc ruptures, the disc material breaks through the fibrous annulus and puts pressure on the nerve.
In this instance, there is NO displacement of the bone.
Chiropractic claims that pressure on a nerve impedes flow of messages through the nerve like stepping on a garden hose. Today we know that's false. Nerve impulses don't flow like water. They are electrical impulses.
Chiropractic claims that pressure on a nerve impedes flow of messages through the nerve like stepping on a garden hose. Today we know that's false. Nerve impulses don't flow like water. They are electrical impulses.
Today we can actually measure nerve conduction speeds.
In carpal tunnel syndrome, the median nerve is compressed at the wrist. We make the diagnosis by showing that the nerve conduction is normal above and below the wrist and slowed only at the area of compression.
In carpal tunnel syndrome, the median nerve is compressed at the wrist. We make the diagnosis by showing that the nerve conduction is normal above and below the wrist and slowed only at the area of compression.
The third part of Chiropractic theory is innate. This is a mystical power that it maintains Health. It is a semi-religious concept. D.D. Palmer actually thought of making Chiropractic a religion at one point.
Weird right? That's because Chiropractic is not science. It's a philosophical position called "Vitalism".
Vitalism is the idea that some unmeasurable, undefined, undetectable life energy invests material bodies. There is no objective evidence that any such force exists.
Vitalism is the idea that some unmeasurable, undefined, undetectable life energy invests material bodies. There is no objective evidence that any such force exists.
Like many myths this one has a grain of truth behind it. The idea that the body heals itself and medicine just makes it easier.
But healing isn't accomplished by any mystical force.
Healing occurs through physiological processes that can be detected and studied.
But healing isn't accomplished by any mystical force.
Healing occurs through physiological processes that can be detected and studied.
Chiropractic manipulations can cause harm. Neck manipulations cause strokes by damaging the vertebral arteries.
Normally arteries are very elastic and turning your own head is fine. But imagine a joint being forced beyond it's normal ROM. This can cause a tear in the artery.
Normally arteries are very elastic and turning your own head is fine. But imagine a joint being forced beyond it's normal ROM. This can cause a tear in the artery.
Sometimes this causes immediate damage from bleeding, but sometimes the tear is temporarily sealed with a clot which breaks loose later on and travels to the brain, clogging an artery and causing a delayed stroke as much as several days later.
How often does that happen? It's estimated that 20% of basilar strokes are due to spinal manipulation, or around 1300 a year. Patients under the age of 45 were five times more likely then controls to have visited a chiropractor within a week of the event.
Chiropractic strokes are underreported. This is because of the potential delay between Chiropractic manipulation and the appearance of a stroke. With this delay the connection may be missed.
A famous case that comes to mind is that of Sandra Nette, a healthy 40 y/o woman who was feeling fine who went to her chiropractor for a maintenance adjustment that she thought would keep her healthy. When the chiropractor manipulated her neck she suddenly felt dizzy and unwell.
When she complained to the chiropractor didn't recognize it was an emergency. His only response was to sell her massage services. He let her drive herself home and she only made it part way.
Doctors found tears in both of her vertebral arteries, one of them 3 in long.
As the stroke progressed she developed locked-in syndrome; an intact mine locked in a paralyzed body.
As the stroke progressed she developed locked-in syndrome; an intact mine locked in a paralyzed body.
She was in pain, unable to eat or breathe on her own and could only move one arm just enough to type on a special keyboard. She sued.
The chiropractor later admitted to the court that when he learned he was getting sued he forged Sandra signature on an informed consent form.
The chiropractor later admitted to the court that when he learned he was getting sued he forged Sandra signature on an informed consent form.
Chiropractors have tried to defend themselves by saying the patients who had strokes came to them with neck pain and were already in the early stages of a stroke.
Sandra had no neck pain. Neither did Laurie Jean Mathiason who, at age 20, had neck manipulation for tailbone pain.
Sandra had no neck pain. Neither did Laurie Jean Mathiason who, at age 20, had neck manipulation for tailbone pain.
With her neck manipulation she went into convulsions on the chiropractors table. His only response was to try and revive her by slapping her face. She died in a coma three days later.
Even if patients do have neck pain if chiropractors can't identify patients in the early stages of a stroke they have no business manipulating their necks.
We don't know the actual risk of stroke from neck manipulation because the appropriate studies haven't been done.
We don't know the actual risk of stroke from neck manipulation because the appropriate studies haven't been done.
Strokes are undoubtedly rare, but if a drug had the same small risk of stroke and so little demonstrable benefit it would be taken off the market.
Undesirable effects of manipulation include local discomfort, headache, tiredness, radiating discomfort, broken bones, herniated discs, disability, paralysis, and death.
Some chiropractors deny that there is a risk of stroke but in 2002, 9% of claims paid by major chiropractic insurance companies were for strokes. This isn't proof that they were caused by manipulation but is proof that the insurance companies know there is a problem
Chiropractors are quack magnets. They adopt every new idea that might increase their patient count no matter how crazy. They even use quack methods after they've been disproven.
A notable example is Moire Contour Analysis which claims that it can map the surface of the body and find asymmetries that help locate disease areas. It doesn't work.
For about a century chiropractors have been using a device called a Nervo-scope. It allegedly picks up temperature differences to pinpoint subluxation. The needle in the scope also moves when you press harder.
For patients who don't like the idea of having their back forcefully cracked, there exists the "activator adjusting instrument". It's patent application states the device is "tunable" to the natural frequency of a human spine and can be adjusted to as light as a fingertap.
The Atlas Adjustment tool is used by chiropractors to focus on the top two cervical vertebrae. It taps specific spots on the Atlas which allegedly fixes the entire spine.
The concept of Applied kinesiology is a pseudoscientofic physical exam method that 43% of American chiropractors use to diagnose allergies and other conditions. They believe it even works by proxy (diagnose a disease in a child by testing the strength in their moms arm).
Toftness device have the operator rub their fingers on a detection plate and claim to feel a stickiness when the device is positioned over a subluxation. It was banned by the FDA in 1980 but it is still being used by chiropractors around the country.
Chiropractors used to routinely take full spine x-rays that were mostly out of focus because of the different thickness of the body at different levels. They would then repeat these x-rays over and over despite the reality that chiropractic subluxation are not seen on x-rays.
Continuing medical education, or CME for chiropractors amounts to courses in practice management to boost their patient count. They often engage in unethical advertising.
Some put blind ads in newspapers but not reveal they are chiropractors even though the practice is prohibited by the ethical guidelines of their own organizations. They will offer to email new medical reports for back pain or ruptured disc cures with no need for surgery.
There are no new discoveries just minor variations on old techniques and they have to sneak this to you by mail or email by request because the FTC would not allow them to make false claims in direct advertising.
A common free exam is a double scale test where you are told you are lopsided because your weight is uneven when you stand with one foot on two scales. Just try standing on two scales on your own and getting them to register the same weight.
These exams are guaranteed find "subluxations" in everyone and chiropractors will tell you that everyone needs routine adjustment in order to treat them.
Chiropractors are notorious for poor advice because of their lack of actual medical training. Many are against vaccinations and water fluoridation. Many will offer diet advice based on unsubstantiated theories and will sell diet supplements and vitamins out of their own office.
Many will try to convince their patients to avoid conventional medical care claiming that it is always harmful.
This has led to chiropractic scope creep where some will try and act as a family physician despite having no actual medical training.
This has led to chiropractic scope creep where some will try and act as a family physician despite having no actual medical training.
In one case study, a patient went to a chiropractor complaining of the symptoms of an MI. Instead of rushing him to the ED they all offered him Chiropractic adjustments for his pain.
In another case study chiropractors fail to recognize a high fever in an infant was an emergency
In another case study chiropractors fail to recognize a high fever in an infant was an emergency
Most just offered to adjust the infant's spine.
Many chiropractors create a chiropractic neuroses by adjusting patients and convincing them that every symptom they get, every sniffle or itch, is a reason to run back to the chiropractor because their last adjustment has slipped.
Many chiropractors create a chiropractic neuroses by adjusting patients and convincing them that every symptom they get, every sniffle or itch, is a reason to run back to the chiropractor because their last adjustment has slipped.
On the topic of children, they are most commonly brought to chiropractors for ear pain. There is NO evidence that chiropractic works for ear infections or any other pediatric condition.
Chiropractors can get away with claiming that it does because most ear infections will go away on their own without treatment.
Occasionally they will miss an ear infection in a child that does require antibiotics and complications like mastoiditis can occur.
Chiropractors claim that colic is caused by subluxation. This is simply untrue.
Chiropractors claim that colic is caused by subluxation. This is simply untrue.
Manipulating children has been considered scientifically indefensible even by some chiropractors. It puts children at risk for brain bleeds and paraplegia. It also delays diagnosis of treatable illnesses like cancer and meningitis.
Chiropractors come in different types. There is the ICA, International chiropractors Association and the ACA, American Chiropractic Association.
The ICA is for "Straights", or chiropractors that limit their practice to Chiropractic adjustments only.
The ACA is for "Mixers" who may add anything from massage to voodoo.
The ACA is for "Mixers" who may add anything from massage to voodoo.
There is also a small amount of practitioners called the National Upper Cervical Chiropractic Association (NUCCA) who exclusively work on the top vertebrae in the neck. Most other chiropractors are hesitant to associate with them due to the danger of what they do.
Nucca practitioners follow the hole-in-one Theory; which is the idea that if you adjust the Atlas vertebra the rest of the spine will somehow magically fall into alignment.
A notorious practice for them is to draw lines on x-rays from before and after.
A notorious practice for them is to draw lines on x-rays from before and after.
They will make the lines on the after images straighter in order to feign that there is Improvement after they have manipulated the neck
NUCCA claims they can treat everything from allergies to Multiple Sclerosis and epilepsy by adjusting the Atlas.
There is an infamous NUCCA chiropractor in Seattle called the "No-touch chiropractor" known for putting one hand over the other on the neck and making a crack in her own wrist while remaining about an inch away from the patients skin.
The biggest thing that chiropractors seem to do well with is keeping patients entertained until their symptoms resolved naturally and supporting patients who are dissatisfied with conventional medicine and thus providing psychological support.
Chiropractors have their own journals but these journals published poor quality study is designed to SHOW that it works rather than to ASK if it works. The studies are often poorly designed and don't usually have controls.
Scientific applications of conventional medicine show progress.
There has been no real progress in Chiropractic in over a century.
Science gives up in effective treatments.
Chiropractic has never given anything up.
There has been no real progress in Chiropractic in over a century.
Science gives up in effective treatments.
Chiropractic has never given anything up.
There exists now over a hundred different Chiropractic adjustment techniques. They have not been tested to see if some are more effective than others they just keep adding more so that they can provide any treatment they want.
A commonly issued textbook in Chiropractic schools is titled "Somatovisceral aspects of Chiropractic" by Charles and Marion Masarsky. It is about treating in other parts of the body instead of just the spine.
The book claims that chiropractic can treat asthma, colic, ear infections, endocrine disorders, menstrual pain, and a host of other internal disorders.
The textbook claims it is an evidence-based approach but provides nothing that could be claimed as evidence based or science based medicine. Their concept of evidence is anecdotal reports, uncontrolled studies, and poorly designed studies that have never been replicated.
Sometimes chiropractors do help people feel better, but this is mostly psychological and they often cause more harm than good.
Ultimately, chiropractic is a pre-scientific belief system that has tried to establish scientific credibility for over a century and failed.
Ultimately, chiropractic is a pre-scientific belief system that has tried to establish scientific credibility for over a century and failed.
I will add sources here in a little bit. Apologies.
Please note that some statements contained with (like the Chiro textbook) are a reflection of the actual study itself.
Please note that some statements contained with (like the Chiro textbook) are a reflection of the actual study itself.
Sources:
History of Chiro
https://chiro.org/Plus/History/Persons/PalmerDD/PalmerDD's-Lifeline-chrono.pdf
Chiro Practical Theory and "Subluxation"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185558/
Chiro and Xrays
https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf
Chiro and Vitalism
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101456115-img
Chiro and Stroke Risk / Dissection
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506737/
History of Chiro
https://chiro.org/Plus/History/Persons/PalmerDD/PalmerDD's-Lifeline-chrono.pdf
Chiro Practical Theory and "Subluxation"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185558/
Chiro and Xrays
https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf
Chiro and Vitalism
https://collections.nlm.nih.gov/catalog/nlm:nlmuid-101456115-img
Chiro and Stroke Risk / Dissection
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506737/
Chiro and Patient Demographics for Stroke
https://www.jmptonline.org/article/S0161-4754(08)00347-3/fulltext
Case Study #1: Sandra Nette
https://quackwatch.org/wp-content/uploads/sites/33/quackwatch/casewatch/mal/nette/claim.pdf
Case Study #2: Laurie Mathiason
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2051302/pdf/aco111-017c.pdf
Chiro and Stroke Legal Fees
https://pubmed.ncbi.nlm.nih.gov/26085925/
https://www.jmptonline.org/article/S0161-4754(08)00347-3/fulltext
Case Study #1: Sandra Nette
https://quackwatch.org/wp-content/uploads/sites/33/quackwatch/casewatch/mal/nette/claim.pdf
Case Study #2: Laurie Mathiason
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2051302/pdf/aco111-017c.pdf
Chiro and Stroke Legal Fees
https://pubmed.ncbi.nlm.nih.gov/26085925/
Chiropractic Techniques - All
https://web.archive.org/web/20060728105451/http://www.amerchiro.org/pdf/PDR/H-Chiropractic%20Techniques.pdf
Chiro - Practice Out of Scope (Nutrition/Allergies/etc)
https://quackwatch.org/related/Tests/ak/
Chiro and Children
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794701/
Chiro Textbook (w/ Out of Scope advice)
https://www.chiroweb.com/archives/22/12/25.html
https://web.archive.org/web/20060728105451/http://www.amerchiro.org/pdf/PDR/H-Chiropractic%20Techniques.pdf
Chiro - Practice Out of Scope (Nutrition/Allergies/etc)
https://quackwatch.org/related/Tests/ak/
Chiro and Children
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794701/
Chiro Textbook (w/ Out of Scope advice)
https://www.chiroweb.com/archives/22/12/25.html
