I’m allowed to call a cult leader “God” and I’m allowed to call the idiots at the apple store “geniuses” but I’m not going to devalue those words either.
Generally agree with this, but one time when I was little landed on my back on the edge of a trampoline and really hurt my back. After some back and forth my parents took me to a chiropractor who fixed my pain, saying I probably moved a disk onto a nerve or something like that.
So I think pain caused by physical movement of the spine like my injury is totally legit as a reason to go to one
Glad they worked for you. One thing I would add: Maybe make sure they’re actually skilled/qualified and not a chiropractor-in-training using you as a test dummy.
Yes, there are. But there also some clinics that have chiropractors in training who aren’t as qualified to do chiropractic as experienced chiropractors. I know a place where they use chiropractors who are still in training and developing experience, and lots of people say to avoid it and go to more professional chiropractors.
There are literally some clinics that have chiropractors in training who aren’t as qualified to do chiropractic as experienced chiropractors. I know a place where they use chiropractors who are still in training and developing experience, and lots of people say to avoid it and go to more professional chiropractors.
I will be more clear. The skills and qualifications of a chiropractor are nothing. If I were more charitable, I’d say that their treatments do not work the way they say they do. It’s based on assertions that are at odds with reality and so far in testing, reality has always won. You can not be skilled at a thing when that thing is not real so a chiropractor and chiropractor-in-training are six of one and half a dozen of the other.
You can study fantasy for years and interact with people who play along with your fantasy. Pretending that fantasy is medicine is dangerous and unconscionable.
Astrology works the same way. Anecdotal evidence is really effective but the data clearly show you’ll get more consistent relief with real doctors and real physical therapists.
I don’t doubt whether you and your parents believe that going to a chiropractor fixed your pain. Can’t exactly zip around with a time machine and see what would have happened in that scenario if you’d gone to a doctor, done some stretching on your own, or just gone about your day ignoring it (among other options). Anecdotes like yours suggest that there’s a helpful effect from going to chiropractors but when it’s studied by competent professionals, those benefits disappear because chiropractic practitioner beliefs and performances are not constrained to the narrow limits of reality.
If someone is injured beyond the simple stuff like cuts that you can slap a band-aid on or sprains/strains to be treated with RICE (Rest, Ice, Compress, Elevate), go to a doctor. Head, neck or back injuries in particular are not something to gamble on but I’m glad your case turned out okay.
Laws and accreditation don’t change how the human body works (and, importantly in the case of chiropractic performances, doesn’t work). No energy lines to unblock, your humors or bile aren’t unbalanced, a wheatstone bridge can’t detect alien ghosts and some distant planet’s apparent motion from the Earth’s perspective isn’t causing your misfortune. We’re just meat machines no matter which map lines you’re inside and a medical professional who can’t keep their mysticism and fantasy out of the workplace can not be trusted to maintain their patients’ physical or mental health.
Chiropractors and osteopaths only exist in such large numbers because they bill less to insurers than actual doctors & hospitals. So of course insurers are going to promote these quacks because it’s cheaper than somebody going to an actual physiotherapist for treatment.
There should really be legislation that requires insurers to cover science & evidence based treatments. If someone wants woo it should be at additional expense to them, not part of a standard policy.
You’ve got it in reverse. See that “possible exception for back pain”? Chronic pain related to joint issues is ALL chiros do, insurance used to cover that when you had a back injury or whiplash, things it works for. Then insurance stopped covering that, pretty sure it’s because they favor you getting a prescrip for pain killers but that’s conspiracy on my part, and a lot of chiros started to turn to less savory things, as they did that more and more snake oil types who claim chiropractic work is some fuckin miracle come out of the woodwork.
I’ve worked with these issues a lot in representing injured workers, including litigating coverage of chiro treatment. In my experience, insurers will always cover chiropractic if it is under the direction of a doctor. A lot of orthos send their patients to chiros for treatment. Insurer is fine approving eight or twelve sessions as ordered by the treater. Where they have a problem is when it’s the chiropractor directing the care. You know, if you get hurt and you just go straight to the chiropractor, they will say they need to treat you indefinitely, twice a week or something.
As for efficacy, it’s undeniable that chiropractic care feels good. If it feels good and the patient believe it’s working, that’s enough to make it work for real. No doubt, there are plenty of studies that bear out improvements of objective functional capacity and subjective pain ratings after chiropractic care. The mechanism is that the “adjustments” affect the autonomic, sympathetic, and parasympathetic nervous systems, and prompt the release of neuroendocrine factors such as serotonin and dopamine. For some people that is enough to feel better and even heal. For insurers, many of them are happy to pay for a course of chiro care because doing so may save them from having to pay for continued Ortho followups, skilled PT, guided injections, or even surgical interventions.
On the other hand, chiropractic education and practice is highly subjective, and the entire field lacks consistency and validity, and IMO is inadequate for the forces it exerts on the most sensitive part of the human body: the cervical spine. Cervical manipulations are highly dangerous. It can severe arteries, cause strokes, cause stroke-like symptoms from nerve palsy, and can break vertebrae; this can easily paralyze or kill a patient, and the chiro cannot know these forces are likely safe for a patient unless they’ve reviewed prior imaging of the cervical spine and know for sure there are no preexisting stress fractures, lesions, or neural impingement.
At this point the industry is so large and powerful that the medical industry and regulatory structure has decided that patients may decide to bear these risks for themselves.
This comment is a hot mess of personal experience and fatalism wrapped in the vaneer of scientific authority. Chiropractor bad … Unless doctor say go. Then bad not bad anymore.
Just my medicolegal experience. Not sure what you mean by fatalist or veneer of scientific authority, though medicolegal science is a thing, I said up front I wasn’t a scientist and that my experience was in resolving and litigating coverage disputes or how you’d simplify my conclusions into such a slogan. I clearly said the entire art suffers from inadequate validity and training that ends up getting people seriously injured or killed.
Oh, it’s fatalist of me to say the law and insurance industry say patients may elect that risk? I suppose, that’s the way it is right now. Certainly doesn’t have to be. The political will of regular people is too distracted by culture wars and disinformation to be hopeful that Congress is going to step in and regulate chiropractic. We have serious challenges like maintaining democratic governance to be so focused on this. You want to regulate something that maims and kills people, I have about twenty other things way more urgent before we get to chiropracty. If you want to spend all your political capital in this one place, have at it. I hope you’re right and chiropractic medicine is the most imminent of our problems; is that fatalist?
So, DO’s in many of not most states in the US have the same licensure and practice limitations as MDs and charge/are reimbursed similarly. I’m many cases they actually attend the same residency programs as allopathic/MDs. Most I’ve worked with drop 99% of the Osteopathic manipulation stuff soon as they graduate. Naturopaths on the other hand…
If I pay for a business to make me a chocolate milkshake under the same health code regulations and standards as the place across town, I don’t want them finishing it off by stirring in a spoonful of shit with the ice cream as a bonus. Even if >99% of what’s in the cup is not shit, it isn’t somewhere I’ll go and I’ll make an effort to discourage people from going there too.
Osteopaths, chiropractors and all those other flavors of cargo cult imitation medical quackery differ only by the proportion of ingredients. Making a distinction between them is meaningless, it just lets the less-obvious liars get a foot in the door.
(Additional note because this is the internet: This is a “spherical cow in frictionless vacuum” scenario and ignores things like accidental contamination as well as the narrow range of illnesses where an appropriately-prepared and administered fecal transplant (which this is not) may be indicated.)
I think you’re misunderstanding what most of them keep practicing. It’s not the kooky cranial/cervical manipulation(you can make an argument that them having to learn that stuff in the first place is BS and a waste of time), but most do pick up a few muscle pressure point tricks and stretches that are essentially the same as what PT instructs patients on how to do. Is it bullshit? No more so than most medicine that’s practiced(the data behind the vast majority of what your average physician does is at best all over the place, the truly “settled” clinical questions are few and far between). In my book though, anything that keeps you from having to prescribe a scheduled drug (read as:narcotic or muscle relaxer) to get someone functional from something like severe trapezius tightness or piriformus syndrome is a heck of a tool to have at your disposal in a primary care or urgent care setting.
A broken clock might be right twice a day but that doesn’t mean you should rely on it for timekeeping. If something works, we study it in search of why, how and other details that may not be immediately obvious but could have an impact on patient outcomes. From what their product quality shows, chiropractors and their snake oil salespeople colleagues appear to be some combination of less diligent, less motivated and less capable when it comes to doing that sort of evaluation. Trying to blend that part of the market into the realm of legitimate evidence-based medicine is bad for almost everybody involved. Might as well start having the nurse follow the vitals check with a palm reading if the standard of “has a basis in reality” is too onerous for modern medicine.
We’re constantly making bigger and brighter lights to shine out into the darkness of what we don’t yet know while the Supplementary, Complementary and Alternative Medicine crowd sprints for the first patch of darkness to plant a flag and hide. You’re right that there are a lot of unanswered questions but an answer is not a valid substitute for a correct answer.
I think this depends on the kind of chiropractic work. If they are just there to pop bubbles for that crack, then nothing is happening. I got into a car accident and my insurance sent me to a chiropractor that never cracked my back. Instead he gave me physical therapy, got me MRI images to check for an cracks on my spine or hernias in my discs, and gave me some equipment to help relax my back muscles and provide support to my bacl. I feel like this kind of work actually does provide benefit. I don’t go anymore since all of that stuff is cleared up now, but I would trust that guy with my back again if I needed it.
I’ve seen a couple ‘chiropractors’ that are just giving good physio work and advice but taking chiro insurance money. Scammy maybe, but if they’ll put me back together I’ll take it.
Some chiropracters are more or less “bootleg” physical therapists that use the same treatment. Of course, there is no guarantee that a given chiropractor will use effective and proven treatments like a licensed PT practitioner.
I mean, all they’re really doing is rubber stamping a form so insurance will pay. You can go to your hospital and give them cash to have an MRI done without a doctor being involved.
I’m not sure you could go to most hospitals and get an MRI just because. Diagnostic tests still carry risks, especially MRIs given how strong the magnetic field is and that you can’t easily turn them off.
This is one of those things, like acupuncture, that I will not fault anyone else for engaging in. There’s no hard evidence that they are effective, but if it helps you with your problem (even if it’s all in your head), then it was worth it, was it not?
I know people who have had their lives improved and their mobility restored thanks to chiropractors. I also know one or two who swear they got scammed for years because the pain always comes back really quickly.
I may not personally recommend a chiro to someone as a solution to their back or neck pain, but I won’t discourage them from going if they are considering it.
There’s a difference though. Doctors are trained professionals so when they kill someone it’s by accident (hopefully), but quack doctors are not professionals, when they kill someone it’s 3rd degree murder.
There’s a difference between making stuff up and an unsuccessful medical procedure, but the only way to tell the difference is if the person has a reasonable chance of actually being successful I.e. a medical professional.
That’s why surgeons don’t commit assault. But some random person coming at me with a knife does even if the end result is still my chest cavity being opened up.
I guess my point is that it doesn’t really matter if their practice is backed up by hard science or not if some people still experience tangible benefit from doing it. Is it still a scam if the scammer provided you the product that you paid for?
Like I said, I would never advocate for someone to go see a chiropractor, an acupuncturist, a homeopath, a shaman, or whatever alternative treatments that might be out there over going to a real doctor or therapist, but if they’re already going to one and claiming that it’s working for them, why bother trying to convince them otherwise? You can tell them it’s pseudoscience until the cows come home, they’re not going to be inclined to listen.
This was news to me too not long ago, but acupuncture is legit and used in western medicine. I found this out because a friend of mine in the military received acupuncture to treat his back pain. Like a white dude named Brad that went to med school put 3 or 4 pins in his ear and his back pain was gone for the day.
Acupuncture is quackery too. At the very least it should not be part of any public health service, or insurance policy, and people gullible enough to go for it should have to pay out of their own pocket.
Do you mean the network of collagen fibers and fluid-filled spaces that underlies the skin and surrounds the gut, muscles, and blood vessels? Calling that an “organ” is a ginormous stretch.
It makes up 20% of your body weight, that doesn’t seem inconsequential. It has signaling functions, and that’s just the start of what we know about it. We also discovered it’s how cancer can end up so far away after it’s undergone metastasis.
Ok, I’ll admit that I learned something today - so that’s a win - but did you even read the article you linked?
The researchers are calling this network of fluid-filled spaces an organ—the interstitium. However, this is an unofficial distinction; for a body part to officially become an organ, a consensus would need to develop around the idea as more researchers study it, Theise told Live Science. The presence of these fluid-filled spaces should also be confirmed by other groups, he added."
So, ya know, it’s not being called an organ by anyone but this group of researchers…
I am glad you read it, this subject matter fascinates me.
It’s essentially almost like a new discovery from only 5 years ago. I think we are about to learn much more about the different roles this system (organ) plays.
I am not going to debate about whether some groups have declared it an organ or not. I believe it will be in time anyway.
The research surrounding this is interesting because you have so many people jumping into it that some people are simultaneously saying things like “I think this could be a way cancer moves around the body” and another being like “Yeah, I basically proved that already. I am attempting to figure out how to stop it”
I am actually really torn about this one, on one hand I had one episode of back pain that lasted nearly a year, swearing up and down the whole time that chiropractors were basically witch doctors and that I would never go to one. However, when I finally caved and went to one he fixed my issue after two sessions. On the other hand, my more recent back pain was not helped after I saw my chiropractor four times. In addition, I work as a nurse and have now seen at least three patients come in with vertebral dissections, essentially a stroke, that occurred literally right after they had seen a chiropractor for neck pain. Anecdotally, I would say it isn’t worth the risk. Had I done physical therapy and used bought a tens unit the first time I’m sure it would have also fixed it without the chiro, but I was lazy
That’s the thing. Chiropractic could be considered a manual treatment which is a therapeutic modality. PTs do manual therapies that are less traumatic and are one component of the musculoskeletal issues that contribute to pain that chiro claims to heal. For most situations of acute back pain they resolve in 4 to 6 weeks so even the ineffective treatments appear to help- it’s just like treatments for the common cold.
I could share anecdotal evidence, and we know what that’s worth. But the idea that they’re all witch doctors rings false. Just as the notion that a certified physical therapist is just dandy.
All told, I’d shy away from chiropractors, especially these days.
The whole chiropractor field is based on the conjuration of a dead guys spirit to learn the techniques required to heal every disease and ailment…so ill go ahead and say every chiro is essentially a witch doctor
The adjustments cause a sympathetic nervous response that produces dopamine and seratonin. They can feel great. That’s documented and undisputed. Also undisputed is that such response is enough to heal certain injuries for certain people. The placebo effect is real. If the patient believes it works, that’s enough sometimes.
The risks of chiropracty out weigh the benefits, IMO.
Someone who knows what they’re doing, and knows the limits of what they can do, can benefit certain physical conditions you may have. But they’re not doctors. They have no prescribing power. A lot of people go there thinking that they can also prescribe them a medication, which is not the case. But there’s no standards for being a chiropractor, so each one is different and some may do little to help you or even hurt you or name you and in some rare cases, kill you
Not only can they not prescribe anything (because they are play doctors not real ones) but they have no access to the medical equipment (other than xrays which can literally only tell you if you have a broken bone) so they have Zero ability to diagnose whats really wrong with you, or your back, or anything really. Its all guesswork for them and the few people on here who say “quackocracked hepped me!!” is the one time they get it right out of 10 or 20 failures.
I’m a radiologist and I too have seen multiple cases of vertebral artery dissections and stroke immediately following chiropractic manipulation. Absolutely no chance I would ever suggest someone see a chiropractor.
This is the entire problem with quackocrackers, they have no ability to diagnose any illness or disease. So people who think they just have a back ache and go to a quackcracker instead of a real dodctor are delaying getting a proper diagnosis, so then if they happen to have something more serious like cancer, they’ll essentially be sacrificing their own life by going to quackocracker instead of finding out whats really wrong.
I’m 100% on board with science and evidence based therapies but I’ve had a similar experience with back pain. I won’t let them manipulate my neck at all though.
I’d say the science is clear: humans don’t understand what makes them sick and they don’t understand why they get better. We value our own anectdotal evidence over actual research almost every time, and we keep making the wrong conclusions. I’d go so far as to say that you can’t be “on board” with both science and with your own conclusions based on anectdotal evidence. It’s one or the other.
It’s because what they’re doing can sometimes provide temporary relief and when it works, it works fast. An underlying cause has made some inflammation, they stretch things out, relieve some pressure in places that shouldn’t have pressure. But they’re not fixing anything, just letting your body get back up to barely functioning until the underlying cause rears it’s head again. Messed up discs are their bread and butter, but they’re just resetting the house of cards you call a back.
Actually fixing the problem is a big, expensive, scary, painful deal and (US) chiros let insurance companies off the hook for a long time.
If you have spinal or neck pain, see a licensed physiotherapist. If you have a toothache, do you go to a toothiologist to have your teeth punched? Or do you go to a doctor of dental medicine?
I mean, if you want to re-shape your nose you can either go to a cosmetic surgeon, or run full speed ahead into a brick wall. Either method would accomplish the mission. One is cheaper, one is more predictable, both are potentially lethal.
PCP is the one who makes referral to other physician specialists, like a pain and rehabilitation medicine physician. the PM&R’s attempt to identify the pain generators through a series of different types of injections sometimes accompanied w/ PT, OT, MT, and possibly chiro.
when those fail (conservative treatment), the Pt is referred to either a neurosurgeon or orthopedic surgeon.
Worked for my ex-wife. 6 treatments and he sent her home, fixed for good. The bad stories may outweigh the good, but let’s not pretend all practitioners are dumbasses.
For people who point to certifications and education, I’ll remind them that plenty of doctors and nurses smoke and are anti-vax. It ain’t a perfect world.
They are not practitioners. They hold no medical degree and you should not trust them with any medical care. Treat them for what they are, glorified back crackers who peddle pseudoscience and may kill you by accident.
en.wikipedia.org
Hot