
Chiropractors are bullshit - Sujan
https://theoutline.com/post/1617/chiropractors-are-bullshit
======
abatilo
This generalization is insane. I don't go to chiropractors regularly, and my
situation was clearly be anecdotal, but there was one afternoon where any
movement in my back caused me extreme pain. I scheduled a body massage to try
to alleviate at least some of the pain but when I went it didn't help. Then my
fiance suggested trying a chiropractor and I walked in, explained my pain, and
in about 30 seconds it was all gone. I know there are skeezy chiropractors as
well because I have a friend who worked for those kinds of people who swore
they could cure anything. That's bull shit. But this article is a gross over
generalization of a practice. The chiropractor I went to didn't try to sell me
anything afterwards, he didn't promise any mirale weight loss, I just
explained my pain and he fixed it. I respect that.

~~~
enraged_camel
You should read up on the placebo effect.

edit: Just to clarify, there is no scientific evidence that chiro is effective
as anything other than placebo. All evidence provided is anecdotal and hence
useless.

~~~
idanman
OK. So let's say it is the placebo effect. You can pay $50 for a massage that
will manage your pain or better yet get rid of it or you can pay 100's of
dollars and your insurance 1000's to be relieved of the pain with pain killers
and medicine you don't need. For my money I'll choose the $50 and if it
doesn't work then I'll consider other treatment options. Its seems hospitals
are starting to wise up to this too. Here is Rutgers University Hospital Pain
Management Center for example: "We also refer patients for alternative
techniques such as acupuncture, chiropractic care, bio-feedback, and self-
hypnosis."

[http://njms.rutgers.edu/departments/anesthesiology/pain_cent...](http://njms.rutgers.edu/departments/anesthesiology/pain_center.cfm)

~~~
enraged_camel
Not sure what the contention is. We agree.

------
closed
This made me curious about its effectiveness for back pain, so I tried to find
a meta-analysis. Turned up this on plos one. (note, I can't speak for the
article's quality).

> Moderate evidence suggests that chiropractic care for LBP appears to be
> equally effective as physical therapy. Limited evidence suggests the same
> conclusion when chiropractic care is compared to exercise therapy and
> medical care although no firm conclusion can be reached at this time. No
> serious adverse events were reported for any type of care. Our review was
> also unable to clarify whether chiropractic or medical care is more cost-
> effective. Given the limited available evidence, the decision to seek or to
> refer patients for chiropractic care should be based on patient preference
> and values. Future studies are likely to have an important impact on our
> estimates as these were based on only a few admissible studies.

[http://journals.plos.org/plosone/article?id=10.1371/journal....](http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160037)

~~~
arkades
Standard of care for LBP is almost entirely ineffective. So... no surprises
that chiropractic meets that standard.

~~~
themantalope
The current recommendation for LBP is to not treat, unless they have long-
standing radiculopathy.

------
virtualwhys
While I've never realized Nirvana through my chiropractic experiences, they
have been immensely helpful in the short-term.

For example, several years ago I spent the winter on the north shore of Oahu
(Hawaii) surfing. The waves are often perfect and glassy, but pack a serious
punch when you fall. I took a heavy wipeout, which left me as stiff necked as
I've ever been. For a few days I could barely move my head from left to right.
I needed to do something, so went to a chriropractor.

The chiropractor had seen the surfer's whiplash injury many times before;
after some light warmup massage work to loosen up the muscles, a quick jerking
of the head, and crack!!, done. All the tension gone in an instant. Walked out
a new man, was back in the water the next day.

Less extreme, as a computer worker I often find myself in strange/unhealthy
positions while consumed with solving yet another problem. This leaves my back
not feeling all that great. So, 3 or 4 times a year I go to a chiropractor I
know (in Montreal) and get an adjustment. While there's no permanent
realignment, there is most definitely a temporary one, which feels great.

I'd say it depends on the chiropractor (YMMV), and not that the profession as
a whole is a hoax.

~~~
Para2016
>a quick jerking of the head

Please don't ever let anyone do that again. The two vertebral arteries that
supply blood to your posterior brain (occipital lobe, cerebellum, medulla,
pons) are encased in your cervical/neck vertebrae transverse processes. Quick
manipulation of your neck with a "jerk" can injure these arteries and lead to
dissection and infarct of your brain with permanent loss of function or it can
even kill you.

I've survived a vertebral dissection caused by neck manipulation which lead to
permanent loss of vision.

A dissection is injury to the inner lining of a blood vessel leading to clot
formation over the tear. The clot can entirely obstruct the lumen of the
vessel or parts can break off and obstruct downstream vessels leading to
infarct.

Please don't let anyone manipulate your neck in the future.

~~~
gnicholas
I asked my (medical) doctor about the safety risks of chiropractic adjustment,
and he said there are rare cases of permanent injury from neck adjustments. He
said it was less than 1/1000, but enough to be worried about. I have found
that whenever I (infrequently) go in for lower back pain, the chiro always
goes up the back and neck also — especially if his attempts at adjustment
lower down were not successful. I always have to remind him beforehand that I
do not want my neck manipulated.

~~~
Para2016
That's good advice. I'm just a puny resident but I totally agree with your
doctor. I won't comment on chiropractors in general, but just on the neck
manipulation part, which is a risk factor for arterial dissection.

Here's a cohort study supporting your doctor's advice to you.
[http://m.neurology.org/content/60/9/1424.short](http://m.neurology.org/content/60/9/1424.short)

And just for some Pop culture connection - here's a link to an article about a
Playboy model that died after a carotid dissection due to neck manipulation by
a chiropractor. [http://people.com/bodies/playboy-model-katie-may-died-
after-...](http://people.com/bodies/playboy-model-katie-may-died-after-
chiropractor-ruptured-an-artery-in-her-neck-coroner-says/)

------
pfarnsworth
No it is not bullshit, not for back problems. I hurt my back and was suffering
for 2 years. I went to a physiotherapist and they made me do stretches and
other exercises. I took Advil and aleve and both eventually stopped working.
It was debilitating and I desperation I went to a chiropractor. I am a huge
skeptic and thought chiropractors were scams too but I was desperate.

Within 6 weeks the pain disappeared permanently. This was over 10 years ago.
Occsssionally i will tweak my back from carrying my kids on my back and I will
go for s few sessions and I feel great afterwards.

It's not bullshit, at least for back problems. Some chiros say it cures colds
etc which is bullshit. You just need to find a chiro that doesn't deal with
that stuff.

~~~
Geimfari
There only exists two proven methods for stopping back pain: Physical exercise
and rest.

Many things tend to go away by themselves (regression to the mean), back pain
appears to be one of them and we haven't found better ways to treat it.

Chiropractors often make one feel good for a few days but the effect does not
last.

~~~
pfarnsworth
I love how everyone thinks they are an expert. I went to physiotherapy for
over a year. I took medications for longer. Neither worked. I took a short
course of chiro and the pain permanently went away.

~~~
simonbarker87
No, you went to a bad physiotherapist. Most likely you should have gone to a
Physio that actually gets stuck in and manipulates your facet joints and
vertebrae to help get the muscles out of spasm and get the joints comfortable
moving again.

The reason people get relief from chiropractors is manipulating joints is
shown to help free up joints and take muscles out of spasm.

Physiotherapists practice evidence based medicine, chiros try stuff and get
lucky, it happens that there is an overlap in the Venn diagram of those two
fields.

~~~
ovatsug25
Physiotherapists are like programmers—there are good ones and there are bad
ones. I've met better chiropractors than physiotherapists because they are
actually passionate about solving the problem of pain. Because of this
interest, the chiropractors become incredibly interested in the only real,
long-term solution to back pain short of a broken bone: consistent, smart,
exercise specific to the areas in which you experience pain along with a whole
body prime. Their practice is the basis for spinal manipulation and a quick
massage. The only real solution for you as a patient get off your back and
exercise and find the smart people regardless of what it is they are trained
in. Smartness beats education anyway.

~~~
simonbarker87
Agreed, exactly how I recovered from a herneated L5S1

------
Tharkun
I've never seen so many downvoted top level comments. Is the term
"chiropractor" what's causing the problem in this discussion? Can anyone call
themselves a chiropractor where the author of this article is based? It seems
like it's a protected title in many European countries. In Norway & Denmark
for instance the title can only be granted by studying medicine. Over there
chiropractors can prescribe MRIs and some drugs.

It looks like some folks in this thread are talking about quacks who brute
force your back into oblivion, whereas others are talking about physical
therapy spinal manipulation. I'm assuming these are not the same thing?

~~~
gnicholas
In the US, it is not as regulated. My sense, from having tried chiro on
several occasions is that they do quasi-medical things like x-rays when you
first go in, to give the sense that they are on par with medical doctors. But
the diagnosis is always the same — subluxation of the spine.

That said, and even in spite of my strong skepticism toward their practice, I
have to say that it was the only thing that helped my periodic extreme back
pain. I had tried a medical doctor, physical therapist, and massage. Chiro
provided immediate and near-complete relief.

They tried to get me to come in 3x weekly for months (basically maxing out my
insurance contribution), but I only ever needed 2-3 visits to feel 100%.

------
Phlow
I'd like to see a study of the correlation between people that believe
Chiropractics is bullshit and people that believe climate change isn't real.

Seriously, if you've ever been to a chiropractor for back and neck related
problems, you know that it's at the VERY LEAST not bullshit. Claiming it's all
just quack science is completely ignorant.

I do know that chiropractors have long struggled to keep clientele, because
people come when they're hurting, and stop coming when they feel better. So,
some chiropractors have taken to questionable methods to keep people coming
back. The ones on the up-and-up will, quite correctly, tell you that just
cracking your back isn't going to fix your problem, and that you need to do
strengthening exercises of the core muscles that keep your bones in the
correct spots, and to fix your posture problems.

~~~
EpicEng
I went to a chiro for neck and shoulder pain regularly for a couple of months.
I felt nominally better for a couple of hours after each session, but then the
problem came right back. They also told me to stretch, which was obvious.

Took a trip to a doctor and got a useful diagnosis at the first visit. So I
would say no, going to a chiro does not prove it to be more than complete BS.
They stretched out my tight muscles/tendons which gave me minor temporary
relief. Woohoo.

~~~
Phlow
Well, how many people go to doctors and get no useful information or solutions
to their problems? Tons. It doesn't follow that doctors are bullshit. (And I
would argue that a couple hours of nominally feeling better is more than those
people get from a doctor visit, but I digress)

If your problems are spine/neck/etc related, having yourself adjusted will
provide relief, and strengthening, stretching and maintaining good posture
habits will help keep those things from recurring. And, of course, as you age,
the body breaks down... there's only so much that can be corrected.

I will say, strengthening my core made the most difference in my spine/neck
pain. Heavy weight squats, push ups, planks, etc.

~~~
EpicEng
Moving the goal posts a bit here. The doctor ended up solving the issue in my
case.

------
err4nt
Just my 2¢ as a migraine sufferer - although I am wary about getting adjusted
(I fear having too many adjustments would increase the frequency at which I
need adjustments) on more than one occasion, while suffering tremendously with
migraine I've had chiropractors be able to make an adjustment that stops the
migraine like flipping a light switch. (A $40 light switch lol). For me, this
enabled me to drive home from the city where I was visiting (I was there every
week on business and a migraine would have left me stranded unable to drive
home, for hours)

So just be aware that there are real cases where chiropractic, though
expensive, can be insanely (and immediately) effective! There's no room for
doubt in my experience, just what would be a potentially expensive habit if I
kept going.

------
dragonwriter
There's evidence that chiropractic is effective in certain domains, the
problem is that the scope of practice of chiropractic is not limited to those
domains.

It's essentially pseudoscientific alternative medicine that has since had
utility confirmed in some areas. But then, so is much actual medicine, the
problem is that quackery remains more pervasive in churopractic. You can find
chiros that aren't quacks, though; it's not like homeopathy.

------
0xcde4c3db
Just to be clear, the fact that someone bills themselves as a chiropractor
doesn't mean that they exclusively offer chiropractic "treatments". Some offer
quasi-legitimate physiotherapy-like treatment, advice on lifestyle
modification, and guidance on over-the-counter drugs. Any of which might end
up being useless or harmful depending on how knowledgeable and sensible a
given chiropractor is. But the extent to which they do this corresponds pretty
closely to how much they deviate from chiropractic theory and accept proven
understandings of physiology.

------
BooneJS
Sample size 1 observations:

I've been going to chiropractors off and on for a few years. I started with a
lower back injury, saw my primary care physician, went to PT, and after a few
visits she recommended seeing a chiropractor. It took a while before I found a
chiropractor I was comfortable with. Most over-promised and had a ton of halo-
effect services they constantly pushed. I found one that also offered massage
and didn't try to upsell any of their other services and I found that
combination worked for me.

After I moved, I stopped the massage part. I stopped the chiropractor part.
But the back pain hit me again in a big way. I've found that in times of high
stress like I experienced several weeks ago an adjustment lasts for 1-2 days
tops before it returns. My current guess based on this slightly-sensational
article is that the massages help prevent muscles from messing with the entire
system, so that's something I'll need to try.

~~~
aisofteng
Deadlifting and squatting regularly has eliminated my lower back pain.

~~~
BooneJS
I'll give that a shot as well. Sounds like I'll need some equipment to do
that.

~~~
aisofteng
If you've had lower back injury, I strongly suggest you ask a medical
professional first. In my case, it was muscle pain, which was alleviated
(apparently) by making those muscles stronger. I did not have an actual
injury; weight lifting after an injury can cause serious damage.

If you do find it reasonable to try, a gym membership would be best, for at
least a few months, and a couple sessions with a trainer. Poor form with these
exercises can also lead to damage.

------
lwlml
N=1 situation: Found that drinking more water helped the joints of my back
ease and reduced lower-back-pain.

After that, you need to do functional movements and lift-heavy-things, often.
Not too heavy, but enough to prompt your body to improve its capabilities.

------
justinclift
Hmmm, the author doesn't seem to realise there are several different
branches/systems/approaches of "chiropractors".

The bone cracking ones which the author seems to be familiar with I'd
personally agree.

There is a system called NeuroLink though which (in personal experience for
several years) does work:

[http://www.neurolinkglobal.com](http://www.neurolinkglobal.com)

No bone cracking required. :)

------
thescribe
They're totally a scam, and it makes me upset every time a company brags that
their insurance covers Chiropractors. No wonder it costs so much.

------
influnza
I visited a chiropractor in Denmark. It was manual therapy, the doctors were
knowledgeable and used massage and acupuncture in addition to "breaking bones"
\- all was very relieving and made a lot of sense. The one here in the US I
did not trust. I looked more like a waster of money.

------
comstock
This article is pretty long, a lot of it is interesting, but quite a lot is
redundant. All I would really want to see is a summary of a study showing that
chiropractors don't reduce pain. But if even a like to such a study is there,
I didn't see it.

~~~
DougN7
My chiropractor never reduced my pain, but he did point out what was wrong
with my posture, which I corrected myself, and am now pain free. So I'm
grateful for that and don't feel bad about the money spent on treatments.
Having said that, a buddy is a chiropractor and the BS he believes...

------
teilo
This article is bullshit. There is a reason that insurance companies pay for
chiropractic visits but not for faith healers.

------
realworldview
I'll avoid them and stay with good ol' reliable homeopathy.

------
bluedino
Are the okay to go to for back problems?

~~~
Geimfari
It is not recommended. It is recommended to visit a physical therapist, who
will treat you using research-based methods.

~~~
CuriouslyC
I just want to chime in here that physical therapy research is usually not
very good. Thus that "backed by science" guarantee isn't so strong.

The truth is, when it comes to myofascial pain, nobody really understands what
is going on. Empirical techniques (such as ART and Graston) can get results
superior to those achieved by standard physical therapy.

------
kenbaylor
Totally not bullshit.

Hospitals alone kill close to 100,000 Americans alone each year.
[https://www.propublica.org/article/how-many-die-from-
medical...](https://www.propublica.org/article/how-many-die-from-medical-
mistakes-in-us-hospitals)

Chiropractors are good: 1) Personal experience. They have helped my spine
recover multiple times, in record recovery time. 2) Modern medicine consists
of prescribing drugs, or high risk surgeries. Paralysis for life is a real
risk. 3) If you get a great one, they will add years of pain-free time for
your life

Chiropractors are also bad: a) There are some 'religious schools' founded by
'bodies for Christ' aka Maximized Living that make some interesting claims.
Unfortunately these are becoming common b) many new chiropractors have poor
technique. This often goes back to the previous point. c) Unless the person is
really good don't let them mess with your neck. There is a growing link
between neck manipulation and strokes, especially when 'fast techniques' are
involved.
[https://www.researchgate.net/profile/Deanna_Rothwell/publica...](https://www.researchgate.net/profile/Deanna_Rothwell/publication/11997403_Chiropractic_manipulation_and_stroke_A_population-
based_case-control_study/links/540d21960cf2d8daaacaefaa.pdf)

TLDR; This doesn't mean that Chiropractors are bad. There are many many great
ones and it really works.

There are many quacks who drink the cool aid. They are mostly new graduates.

Modern medicine's approach to back and neck pain is utterly subpar and
medieval. There are many quacks there too, and they kill a lot more every
year.

And the medical community also disavowed Surgery as 'quackery' not too long
ago: [http://mentalfloss.com/article/66664/how-uneducated-
butchers...](http://mentalfloss.com/article/66664/how-uneducated-butchers-and-
barbers-became-todays-skilled-surgeons)

~~~
awinder
I don’t know what the more common treatment paths are but im fairly sure that
the first line treatment path from modern medicine is working with a physical
therapist, not surgery.

~~~
kenbaylor
Depends where you are located. First line for me was pain killers. Then
injections of pain killers, then chymopapain. Then surgery. My doctors did not
'believe in' physical therapy by non-doctors.

