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.
I'm in Germany and the two chiropractors I've dealth with have all been orthopedist (which is tightly regulated and requires a 72 months education) also.
My anecdotal experience has been similar. The orthopedist I occasioanlly go to use chiropractic methods only sometimes. Other times he just tells me to take some pain medicine and to rest. Besides, I don't have back pain often anyway (luckily).
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.
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."
Could very well have been a pinched nerve or super tight muscle that needed to be tweaked a certain way to release. I've been there, although didn't see a chiropractor to fix it.
I say this as a long time skeptic of chiropractic; my dad, in fact, had a terrible moment in his youth where he had lower body paralysis for 2 days after a chirp visit... My partner has ahhh unusual wrist physiology and when we moved to a new city (near where she grew up), she wanted to go visit her old chiropractor to get her wrist looked at (the same guy had looked at it 30 years ago). I bit my tongue and didn't say anything. His advice: you need to get X-rays and I'll schedule you to see a (mainstream MD) specialist.
I'm still skeptical, but it gives me a little faith that in spite of whatever quackery exists, some of them do at least recognize problems that are the domain of conventional medicine.
Almost all signal can have most of it's information expressed as a sine wave, but it's the jitter in the wave that has all the 'important' information. There's a fallacy where getting the majority of certain types of information leaves you blind to the important but "smaller" types. I think medicine and personal health is one such domain where this fallacy is abundant.
The weakness of heuristics is that they don't turn into reusable models but vice versa models can leave you blind. The constant disdain for heuristics is a huge weakness of many scientifically minded people IMO.
this the silliest misinterpretation of Fourier analysis I've ever seen and I'm not going to try refute it except to say that with the clarity you're implying Fourier decomposition applies only to periodic signals (ie saying that a signal that has a continuous time FT "has most of its information expressed as a sine wave would be an egregious exaggeration so you must talking about series expansion and that only applies to periodic signals [and I'm at a loss for how to interpret info about chiropractors as periodic]).
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.
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.
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.
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.
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.
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.
They're dangerous pseudo science pushers, with no evidence to back up their core basis to operate.
Go to a physio therapist. Their medicinal practices are based on good, solid scientific evidence based medicine.
lastly.. here is quite possibly the most ridiculous thing you'll ever see, a Chiro doing an "adjustment" on a snapping turtle... https://www.youtube.com/watch?v=693MsUkQzsA
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.
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.
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.
Don't know why people are downvoting the above comment. Yes It's anecdotal, yes it contradicts the articles argument but It's still an interesting personal account.
That's the problem with anecdata: Whenever I had muscle or joint pain, physiotherapy and massages helped massively in easing them. Who of us is right now?
I had a problem with my shoulder, for which doctors recommended surgery. Decided to try a chiropractor and the problem went away permanently after a few sessions.
According to hacker news, unfortunately you are misinformed anti-science idiot, and your anecdote doesn't count. Prepare to be downvoted by armchair experts.
You know that thing about anecdotes. There are a lot of explanations for your situation getting better concurrently with chiro, but not because of chiro. For example, regression to the mean, placebo effect, etc.
That said, I had been under the impression that chiro is about as effective for lower back pain as evidence-based physical therapy. But that doesn't mean it is effective. It could equally well mean that we don't know of many good treatments for lower back pain, and thus that physical therapy is only good as a placebo (chiropractic).
Lots of science-only hecklers here. Seems to me to be a bit arrogant to think science holds all the answers and that holistic treatments are devoid of value?
Should we ideally strive for scientific rigour in everything we do? Yes. Does quantum mechanics prevent us from predicing anything to arbitrary precision? Yes. Are we currently unable to model any three body interaction analytically? Yes.
Right at the atomic level, our science is built on top of approximations and concessions to rigour. The second you get to anything remotely murky like biological systems, it all gets a bit hand wavey anyway.
This is not to discount the scientific method or years of evidence based research, but if chiropractors and Chinese medicine, and even homeopathy can have an effect on people then who are we to tell them they're wrong?
Even if it is just a placebo, until we can in precise terms explain the pathways of the placebo effect, then various healing methods in their various cultural contexts still have their place in the world imho, provided they are not known to be causing harm.
> You only need anecdotes to prove that it's not bullshit.
Oh dear. No. That's not true at all. Suppose I have back pain. Then I eat some dirt. Then I feel better. Then I start claiming that dirt ingestion cures back pain. Someone would be well within their rights to call that bullshit, despite my anecdote. Even if I could find a dozen people who had the same experience, it would still be bullshit.
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?
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%.
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.
Chiropractors are like physical therapists but with tradition and intuition instead of evidence-based medicine. It doesn't mean they can't help you, but they're not your best or safest option if you can see a real physical therapist.
Are you suggesting that belief in the efficacy of chiropractic correlates with belief that climate change isn't real, or the reverse?
It seems to me that skepticism of the medical establishment and skepticism of mainstream environmental science would go hand-in-hand, but I also think chiropractic is bullshit (and I've been to a chiropractor for back and neck related problems).
I'm rolling my eyes and guessing there's a significant positive correlation between people that believe chiropractics is bullshit and people that believe climate change isn't real.
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.
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.
Did they recommend any exercises? And did you follow them?
The pain coming back is hardly a surprise if neither of those things occurred. Same with physio.
I've been lifting weights since I was 14, so no exercise recommendations. I did the stretches, but I was doing that prior to seeing them anyway.
In my case, the problem was something called weight lifter's shoulder. Not something that can be fixed by a chiro, but they were happy to take my money for two months while providing no diagnostic value.
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.
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.
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.
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.
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.
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.
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.
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.
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...
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.
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...
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.
Placebos don't help. At best they provide temporary relief; on some people they don't even work. A placebo is like you car engine making a funny noise and the mechanic telling you to turn the stereo up so you won't hear it. Or, to make the analogy more appropriate, it's like the mechanic telling to come back twice a week so he'll turn the stereo on for you, while charging you $10 each time. Meanwhile the shop across the street charges $100 but actually takes a look at your engine.
The effect of heroin is real, and it won't help if you have, say, a bacterial infection.
If you have for example a nerve caught in a joint, a placebo may make you believe you're getting better and eliminate the pain of a while, same as an analgesic, but the nerve will still be caught in that joint. That's what I mean when I say it doesn't help. It doesn't actually make the ailment go away. Sometimes the ailment will go away on it own while the patient is under the placebo effect, but that's not the same as the placebo actually doing anything.
> In fact if placebo didn't work then it would be pointless to use it in clinical trials for new drugs.
You do realize that a drug being found to have an effectiveness at treating X equal to placebo is considered a failure, right? It means the drug has no effect on X, positive or negative. That's one of the reasons homeopathy is considered bullshit (the other being that its founding principles are false), that on clinical trials it's been found time and again to be as effective as a placebo.
Yes that's exactly the point! If a drug is only as effective as placebo then it's a failure. That's exactly why they don't just compare the drug to the control group who doesn't get any medication at all!
In a hypothetical but semi-realistic case let's say 300 people are taking part in a trial.
100 will be the control group that gets nothing. Maybe 20 people will get better on their own.
Next is the placebo group, who think they are getting some awesome new meds. Out of 100 people maybe 40 will get better on their own.
Next is the group that actually gets the medication. Now if only 40 out of 100 get better than they know the medicine is no better than placebo and doesn't actually do anything.
Notice that if there wasn't a placebo group people would assume that the drug actually helps people because it performs better than the control group.
You seem to be confusing placebo with someone randomly getting better (the 20% of the control group).
The whole idea of placebo is that you're more likely to "randomly get better" when you think you're going to get better (the 40% compared to the 20%). The implications of this is that somehow the brain is involved in healing the body.
Sure the brain is involved: folks who feel someone cares about them, will attend to their own health better. Take all the medicine; do the exercises; stay rested and eat right.
A more accurate car analogy would be to take 3 race car drivers trying to improve their lap times around the Nürburgring. You tell two of them they will be getting special tyres that allow them to go faster, but you only actually give special tyres to one of the two.
The driver who gets the special tyres improves their performance, while the control driver performs as usual.
The placebo effect is when the driver who thinks he has the special tyres improves his time even though he hasn't received any special tyres.
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.
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.
Modern medicine; you realize that just means it's new, right? From personal experience I can almost guarantee that the physical therapist would be just as clue-less as the rest of the white-coats. Their main task isn't to solve problems, it's to generate profits; and you don't generate maximum profits by solving problems.
