Chiropractors? Real medicine or quacks?

[rie'smom]

I trust my chiropractor more than any MD except my internist.

 

[Geoff_M]

I believe that good chiropractors help people. Just like with any profession, you have to weed out the charlatans first. I hear plenty of complaints about "real" doctors too.

Without a doubt there are quacks with MDs after their names (I've seen a number of them mentioned in threads on The DIS)... but it's not really two sides of the same coin. The difference is that unlike professional medical organizations like the AMA, often times professional chiropractic organizations and institutions of learning promote and embrace a lot of the quackery. Consider this:

Pediatric Chiropractic Care: Scientifically Indefensible?

In a paper published in 2008, two academic chiropractors offered this observation: “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric health conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions.”

Despite lack of support by the medical and scientific community, chiropractic treatment of children is growing in popularity, and more chiropractors are specializing in “chiropractic pediatrics.”

The International Chiropractic Association offers a post-graduate “Diplomate in Clinical Chiropractic Pediatrics” (DICCP) and publishes a “peer reviewed” Journal of Clinical Chiropractic Pediatrics. The diplomate syllabus is a 30-module, 360+ hours classroom course during weekends over a three-year period. There is no hospital training and no contact with diseased or injured children — only a “mandatory observational/training weekend at a chiropractic center for special needs children under multi-disciplinary care.” A post-graduate certification in chiropractic pediatrics (CICCP) can be earned after 180 hours of classroom instruction.

In a June 2008 joint press release, the American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics and the Council on Chiropractic Pediatrics of the International Chiropractors Association (ICA) announced that the ICA’s Diplomate in Clinical Chiropractic Pediatrics (DICCP) is now recognized by the ACA and its council as the official credential for specialization in chiropractic pediatrics.

Noting increasing public support for chiropractic treatment of children, a January 2009 press release from the American Chiropractic Association made this announcement: “Survey data indicates that the percentage of chiropractic patients under 17 years of age has increased at least 8.5 percent since 1991.…Studies are beginning to show that chiropractic can help children not only with typical back and neck pain complaints, but also with issues as varied as asthma, chronic ear infections, nursing difficulties, colic and bedwetting.”

Is your infant having problems nursing, or is your 6 year old wetting the bed, or suffers from other diseases or medical conditions? No problem! The ACA encourages you to go see a pediatric chiropractor, who may have little actual experience with such children or training in the diseases or conditions themselves, because "studies" are "beginning" to show that spine and neck adjustments are what's needed to return your kid's health. Now can you imagine the AMA promoting such unproven quacktastic woo and associated "quickie" programs?

The above article was written by a man that was actually a practicing chiropractor for 43 years, but he considers himself a traditional "science-based" practitioner. On the topic of "good" vs. "not so good" chiropractors, he also wrote this:

Separating the Good from the Bad

Since the vertebral subluxation theory continues to form the foundation of chiropractic, it seems unlikely that the chiropractic profession will ever abandon the belief that adjusting spinal joints will restore and maintain health. Many chiropractors who say that they reject D.D. Palmer’s subluxation theory simply come up with new terminology that identifies some kind of vertebral joint “dysfunction” that allegedly affects the nervous system, thus interfering with the body’s ability to heal itself. Failure of chiropractic colleges to reject such views and make the changes needed to develop chiropractic into a musculoskeletal back-pain specialty (with commensurate changes in state laws) may simply allow chiropractic to continue as an alternative healing method, such as homeopathy or acupuncture, permitting its practitioners to treat the gamut of human ailments as “primary care providers.” It may then be necessary to depend primarily upon physical therapists for appropriate use of manipulation based on credible research. Chiropractors who can no longer tolerate the controversy associated with chiropractic can retrain as physical therapists, making good use of their training in the use of manipulation. Forty-three states now grant physical therapists direct access to patients; that is, referral from a physician is not needed.

Although I am a critic of chiropractic, I would not hesitate to offer support to a good science-based chiropractor who has separated himself or herself from the herd by expressing views that oppose the implausible treatment methods that are so prevalent among chiropractors. When I was in practice as a chiropractor, I felt an obligation to speak out so that friends, patients, and health-care professionals would not assume that my approach represented chiropractic in general. I worried that a patient who was pleased with my services might assume that treatment by any other chiropractor would be the same. Unfortunately, chiropractic treatment based on the implausible vertebral subluxation theory may be so inconsistent that treatment for any condition may range from an atlas adjustment to a sacral adjustment, all purported to be effective in improving health by removing “nerve interference.” So far, apparently reluctant to bite the hand that feeds them, chiropractic associations in the United States have failed to publicly renounce the vertebral subluxation theory or to condemn the multitude of dubious treatment methods based on subluxation theory.

Today, chiropractic treatment in America is like Forrest Gump’s box of chocolates: “You never know what you’re gonna get.”

The good news that there has been some movement to reign in some of the wild claims of some of the chiropractors. Earlier this year the main chiropractic organization in the UK ordered its members to knock off the promotion of "adjustments" as medical cure-alls and instead concentrate on what can be shown to actually work (like treatment of back and neck pain). And in the US, major insurance companies like UnitedHealthcare and Kaiser are restricting payments to more "traditional" chiropractic treatments.

And as for the comparison to a doctor that prescribes an antibiotic for a viral ear infection... if anything, that's incompetence not quakery. That's also not something promoted by medical institutions.

 

[mill4023]

I think it's like any other profession. There are good ones and bad ones.

No, it's not like any other profession. Yes, there are good and bad doctors, but the difference is that doctors diagnose illness and prescribe treatments based on facts and science, while chiropractors diagnose illness and prescribe treatments based on beliefs and theories that have absolutely NO basis in fact or science.

There is no such thing as an adjustment, because there is no such thing as a subluxation or misalignment in terms of the chiropractic definition of these things.

So the fundamental basis for chiropractic "medicine" is based on completely made up concepts with no evidence to support them.

Can chiropractic treatment help with some back and neck pain? Yes.
In fact, that's the only area where there has ever been any clinical evidence of chiropractic helping.
And it only helps because some of what chiropractors do is similar to what would be done during massage therapy or physical therapy.

Everything about chiropractic "medicine" is a scam and ALL chiropractors are quacks. Some may be less bad than others, but the entire industry is a scam.

 

[Geoff_M]

Can chiropractic treatment help with some back and neck pain? Yes.
In fact, that's the only area where there has ever been any clinical evidence of chiropractic helping.
And it only helps because some of what chiropractors do is similar to what would be done during massage therapy or physical therapy.

I know that anecdotes aren't data, but here's a case in point... Two weeks ago my wife and I spent the weekend in Detroit. My wife had terrible neck pain and said that if she were home, she'd try to go see her chiropractor. We were in a shopping mall in Dearborn and my wife decided to look for a chair massage kiosk. I spotted a small store front that offered chair massages as well as 30 minute clothed table massages. It was traditional massage, nothing fancy, no medical "woo" was being promoted. After 30 minutes on a table, my wife felt great, was smiling, and was fine the rest of the weekend. It was $35 well spent.

 

[declansdad]

No, it's not like any other profession. Yes, there are good and bad doctors, but the difference is that doctors diagnose illness and prescribe treatments based on facts and science, while chiropractors diagnose illness and prescribe treatments based on beliefs and theories that have absolutely NO basis in fact or science.

There is no such thing as an adjustment, because there is no such thing as a subluxation or misalignment in terms of the chiropractic definition of these things.

So the fundamental basis for chiropractic "medicine" is based on completely made up concepts with no evidence to support them.

Can chiropractic treatment help with some back and neck pain? Yes.
In fact, that's the only area where there has ever been any clinical evidence of chiropractic helping.
And it only helps because some of what chiropractors do is similar to what would be done during massage therapy or physical therapy.

Everything about chiropractic "medicine" is a scam and ALL chiropractors are quacks. Some may be less bad than others, but the entire industry is a scam.

Wow, narrow-minded much?

 

[mhsjax]

This is not true.

I saw the same report, they were linking a slightly higher risk of stroke to adjustments. You say not true, fine, but how do you know this?

 

[mhsjax]

And there are studies that say there is not an increase.

http://www.theglobeandmail.com/life/article16388.ece

http://www.iwh.on.ca/highlights/does-chiropractic-care-for-neck-pain-increase-stroke-risk

http://smperle.blogspot.com/2010/04/science-sometimes-stroke-and.html

So these are all studies, so I guess you can't say that it "isn't true" Just a feeling, but are you a chiropractor?

 

[Lisa loves Pooh]

I have a problem with the whole "gotta see me 3x a week for 6 months" nonsense. I saw my PT once a week for 8 weeks after spine surgery and made a full recovery AND it was covered by my insurance.

I'm impressed. (not being snarky!)

I haven't done any PT for any diagnosed by MD problem with prescribed no less than 2x per week at the start. In some cases, I started out at 3x per week.

Just like anything else, our own experiences cannot define how all treatments are. My knee surgery had me in PT for 3x per week at the start. It continued at that pace for prepping a return to training for a half marathon.

Everyone's body is a unique machine and what works for one may not work for another.

I'm shocked that you did well on so little and that speaks well of your PT.

For my knee--people with same surgery are walking no time. My leg was a jello non-supportive blob that stiffed up in an awkward position. So I was on crutches longer than most, but running sooner than most. YMMV and that is true of chiropractic care as well.

I had a terrible PT once who failed to assess me properly for a back condition. She was even consulting a textbook as she was at a loss. I don't blame her in any way--but she just couldn't figure it out. My next therapist was a miracle worker and found the root of the problem and I came out of it a few weeks later the happiest camper in the world. Wish I could be seeing him right now for my shoulder issue.

 

[declansdad]

So these are all studies, so I guess you can't say that it "isn't true" Just a feeling, but are you a chiropractor?

No I am not a chiropractor but I have been helped by a chiropractor after years of doctor visits and physio that were even treating the right problem.

There are many falsehoods out there about chripractors and many of them have been spread by the "traditional" doctors. The problem with there objections are they are mostly based on ancedotal evidence and are used to protect their turf. Many of these same doctors will run down other alternative treatments as well. Traditional Chinese medicine, for example, has been in practice for many more centuries than what we now cal traditional medicine. Seems to me that the Chinese have been around a long time som there must be something to it.

I believe that to maintain your health, there are many people that could be involved and they aren't all MDs.

 

[LisaR]

So for those of you that have had good luck with a chiropractor, what should I look for in picking out one of the good ones? Are there any particular questions I should ask ahead of time? Are x-rays a good thing or a bad thing?

 

[mill4023]

Wow, narrow-minded much?

No. I'm very open minded.
I'm also intelligent, logical, and scientific minded.

I take it you're a chiropractor?

 

[declansdad]

No. I'm very open minded.
I'm also intelligent, logical, and scientific minded.

I take it you're a chiropractor?

No I'm not. I take it you're a MD?

 

[mill4023]

No I am not a chiropractor but I have been helped by a chiropractor after years of doctor visits and physio that were even treating the right problem.

There are many falsehoods out there about chripractors and many of them have been spread by the "traditional" doctors. The problem with there objections are they are mostly based on ancedotal evidence and are used to protect their turf. Many of these same doctors will run down other alternative treatments as well. Traditional Chinese medicine, for example, has been in practice for many more centuries than what we now cal traditional medicine. Seems to me that the Chinese have been around a long time som there must be something to it.

I believe that to maintain your health, there are many people that could be involved and they aren't all MDs.

You're complaining about anecdotal evidence?

All of chiropractic medicine is based on anecdotal evidence.

It kind of has to be since there isn't any scientific evidence (other than some help for back pain, which I already mentioned).

Do you have any evidence that Chinese herbal medicines work? Just because something has been around for a long time doesn't mean it's effective.

Just look at Airborne. It's still on the market and people keep buying it, even though it does absolutely nothing to prevent people from getting sick. Just like chiropractic, it's based on anecdotal evidence.

"Hey, I took Airborne before my last flight and I didn't get sick. See, it works!"

Guess what. I read a newspaper on my last flight and I didn't get sick. Obviously reading newspapers prevents people from getting a cold, right?

 

[mill4023]

No I'm not. I take it you're a MD?

Sorry, you seemed to take a lot of offense to what I said, so I made assumptions. No, I'm not involved in the medical field in any way. As I said, I'm intelligent, logical, and scientific minded. I've also dealt with plenty of bad doctors, so I'm certainly not trying to defend anyone's "turf".

I won't deny that there are chiropractors who are good people and honestly trying to help people. The problem is that the fundamental basis of the profession is based on myth and fantasy, not fact and science. That makes all of them quacks, either intentionally or accidentally.

 

[declansdad]

You're complaining about anecdotal evidence?

All of chiropractic medicine is based on anecdotal evidence.

It kind of has to be since there isn't any scientific evidence (other than some help for back pain, which I already mentioned).

Do you have any evidence that Chinese herbal medicines work? Just because something has been around for a long time doesn't mean it's effective.

Just look at Airborne. It's still on the market and people keep buying it, even though it does absolutely nothing to prevent people from getting sick. Just like chiropractic, it's based on anecdotal evidence.

"Hey, I took Airborne before my last flight and I didn't get sick. See, it works!"

Guess what. I read a newspaper on my last flight and I didn't get sick. Obviously reading newspapers prevents people from getting a cold, right?

Do you have any unbiased proof that these things don't work? Or do only believe studies by the MDs?

From one of the studies:

In this study, the Canadian team looked at nine years of data in Ontario, and found only 818 patients with this kind of stroke. Unlike the previous study in 2001 that investigated the relationship between chiropractic visits and vertebral artery stroke, researchers in this study also studied visits to family doctors that preceded this kind of stroke.
Dr. Silver said researchers were looking for an increased association between chiropractic care and stroke. Although they found this association, they also discovered it to be the same as when patients visited a family doctor.

Seems that one is no better than the other. Should we call MDs quacks and a sham?

 

[rie'smom]

Forgot to mention this in my post:

Our older son had terrible asthma and practically lived on a nebulizer. My dad told me he read about chiropractic treatments helping this. We brought DS and after 3 treatments he was off the nebulizer and the inhaler. That was 20 years ago. He is now 35 and has not ever had another problem.

 

[OceanAnnie]

I don't know quite what to think of chiropractors. It's a big unknown to me. I have had family members that swear by them.

The whole "adjustment" thing is a concept that makes me shudder. I don't have any valid reason for it, it just does.

 

[Geoff_M]

Do you have any unbiased proof that these things don't work? Or do only believe studies by the MDs?

From one of the studies:




Seems that one is no better than the other. Should we call MDs quacks and a sham?

Um, first of all in your links two of them pointed to the SAME study. The third, as far as I tell, didn't point to any specific additional study showing no stroke evidence.

But to your point, "good" doctors often produce studies with incorrect results. The difference between "good" science and "bad" science is that "good" science is repeatable. That's why confirming studies are needed for ANY result. So far, the numbers seem to point at an elevated stroke risk in people that have received neck "adjustments". As additional work is done, the picture will become clearer.

Your third link referred to the decision of a state chiropractic board to decide that there was no stroke risk. Here's another summary of the testimony and decision process in that case.

 

[Geoff_M]

Seems to me that the Chinese have been around a long time som there must be something to it.

Funny thing about that... As the "West" moves to embrace so-called "Eastern" Alt-Med, "Western" medicine is being embraced more and more by the "East". Ironic, no?!?!?

As for traditional Chinese medicine like what we call "acupuncture", that dates all the way back to several decades ago!

 

[rie'smom]

Funny thing about that... As the "West" moves to embrace so-called "Eastern" Alt-Med, "Western" medicine is being embraced more and more by the "East". Ironic, no?!?!?

As for traditional Chinese medicine like what we call "acupuncture", that dates all the way back to several decades ago!

You must have meant several thousand decades:

In actuality, acupuncture may not be as ancient as has generally been assumed. A reconsideration of all extant documents and recent archaeological finds indicates that acupuncture may date back a mere 2100 to 2300 years, first appearing during China's Warring States Period (475-221 BC) and rapidly maturing during the Western Han Dynasty (206 BC-24 AD).