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Chiropractors are bullshit (theoutline.com)
124 points by michaelmachine on May 15, 2021 | hide | past | favorite | 133 comments



A reminder that the national organisation in the UK tried disastrously to censor articles like this through the libel laws:

https://www.wikipedia.org/wiki/British_Chiropractic_Associat...

The author they tried to bankrupt was Simon Singh, author of Fermat's Last Theorem.

https://www.wikipedia.org/wiki/Simon_Singh

A "furious backlash" to the lawsuit resulted in the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24-hour period, with one national chiropractic organisation ordering its members to take down their websites, and Nature Medicine noting that the case had gathered wide support for Singh, as well as prompting calls for the reform of English libel laws


Simon Singh has a YouTube video on Fermat's last theorem that is a masterpiece of mathematical communication. As someone who is an engineer with a bit of math education (lots of calculus, linear algebra...etc), and who likes applying math, but does not intuitively get it at all to understand what mathematicians talk about, I found he communicated it to where I got the concepts and he fuzed it with the history in a splendid fashion. Great stuff.


FWIW, after spending a year seeing some doctors and getting not even a friggen correct diagnosis for my in-the-end-not-actually-a-"back"-issue, I saw an osteopath (of all things, and he did, in fact, come off like a quack) who suggested I had what I had originally self-diagnosed myself with before seeing the doctors who convinced me otherwise--a sacroiliac joint dysfunction--and then (after wasting some thankfully-small amount of time with even more doctors again) finally went to see a chiropractor to get the specific adjustment all the studies I was reading (sadly, while lying on the floor of my apartment watching BoJack Horseman wishing I were dead as the pain had gotten so bad I could barely even sleep anymore) would simply immediately fix that kind of issue (but which was going to take ridiculously long to convince a physical therapist to do... like, I had even already done months and months of PT) and it was almost like night and day... I only needed to see him like three times over the course of a week (to let the inflamed tissue slowly start to heal correctly while I wore a sacroiliac belt to sleep) and I was essentially fixed. So, I totally appreciate chiropractors have a lot of woo-woo to them (mine included: he seemed to worship a bone in your neck that I am pretty sure doesn't do shit all), but frankly: doctors suck too and chiropractors ain't that bad :/. Like, seriously: I was diagnosed with mild scoliosis of my spine when I was a kid, and the chiropractor I saw was the only person who cared enough--even with my explicitly bringing up that hint--to figure out if I was standing crooked (which he admittedly did with a silly iPad camera app ;P)... shouldn't that be "table stakes"? It turned out I was (and that that fits the pattern of sacroiliac joint dysfunction). Had I just gone to see the chiropractor in the first place--as has been recommended by my (honestly also a bit woo-woo ;P) friends, and which I had turned my nose up at, as being anti-chiropractor is "cool"--I would have likely saved myself a year of pain and a number of secondary effects I accumulated (such as a ton of weight gain from being increasingly unable to move for a year), as I am very confident he would have just done that adjustment on me as a matter of course, and if not he definitely would have noticed how I was standing a bit crooked immediately (unlike any of the three doctors I saw ;P).


I'm just gonna quote the last paragraph in the article (which really should have been the first for folks unwilling to read the whole thing);

> I get it, you’re going to occasionally hear a friend say that chiropractic helped him de-clutter his alcove or do 87 sun salutations… but that’s an anecdote, and data is more important, and trustworthy than anecdotes. The data on chiropractic supports that the practice is nothing more than a collection of broken promises and fake medicine.


The problem is that that doesn't actually mean "chiropractors are useless"--as it is too focused on what they are claiming to sell rather than what they are capable of--nor certainly does it mean "doctors are effective" (and, if you actually look at the studies, most of the interventions performed by orthopedic surgeons are apparently at best no better than just getting physical therapy and at worst ridiculously horrible: they are mostly short-term hacks that cause long-term tradeoffs... which might sound familiar ;P). I spent a ton of time avoiding the chiropractor because I had been indoctrinated into the world of "chiropractors are useless hacks selling snake oil" until I realized that I specifically needed to get a "grade 5 lumbopelvic mobilization" and it suddenly occurred to me "I bet a chiropractor knows how to do that!"... it turns out they do, and are a lot easier to "manipulate" (pun absolutely intended ;P) into getting what you want than physical therapists.


> The problem is that that doesn't actually mean "chiropractors are useless"

That's true. A blind pig does find an acorn from time to time. :)

Look, you found a chiro that basically did physiotherapy for you for a problem you were experiencing. Great! I'm glad it worked out!

But that doesn't change the fact that the profession at large is 1) founded on a fundamentally pseudo-scientific basis that has no grounding in reality, 2) is absolutely riddled with charlatans who claim to cure basically every human ailment, and 3) the professional associations actively defend those who make these claims rather than insisting on rigorous, evidence based, ethical standards of care.

If chiropractors want to be taken seriously, it's pretty easy: expose your treatments to the rigors of the scientific method, only support those treatments that have demonstrable benefits, and take away the licenses from the fraudsters who prey on those who are desperately suffering and looking for a way out.


I'm trying not to roll my eyes at some mumbo-jumbo pseudoscience.

Get an inversion table, a strong masseuse, sublingual CBD tincture, some shots of vodka, and a scrip for baclofen. Problem solved without snakeoil.


Mmmhmm.

Selective data collection and interpretation can say pretty much anything you want it to, can't it.


Which is why we have the scientific method. Shame that the chiropractic "profession" refuses to use it.


That doesn't mean that no chiropractors use it.

And even the quackiest quack's “I've seen this problem before, this fixed it” is better than the best doctor's “I've never seen this before, but I can guess what might help”. You can have empiricism without science.


Uhuh.

So the associations who ostensibly regulate this "profession" allow chiropractic practicioners to make absurd claims about curing asthma or hearing loss.

But there's good chiros out there so that makes it all fine!

Got it.

Should we just jump to the No True Scotsman thing, now, or should we go back and forth a bit first?


My attempt at nuance wasn't intended as a rebuttal. I'd pick a random doctor over a random chiro any day.


It's not like they need data, when they can recruit plenty of satisfied customers to go sing their praises on the Internet with powerful anecdotes.

Placebo is a hell of a drug, most especially when it comes to nebulous and subjective pain.


Let me start by saying that I agree that doctors do suck. They are people and that should be enough to understand them. But all self regulating industries with a financial incentive to lie suck. I realize this topic treads deeply into quasi-religious territory so forgive me in advance, but couldn't this just be the placebo effect? Mixed with the healing effect of someone caring about you?

Maybe your physio actually got you on the way to recovery. And the chiropractor is simply taking credit.

Also what actually does an 'adjustment' do?

Just thinking out loud here.


Not OP, But I've also had some success with chiropractic. There is some wackiness to avoid out there (the ones who treat it like a spirituality), but the one I go to currently takes a disciplined approach. They only target a few specific places based on thermal scans on the spine.

Their argument is that subluxations (misalignment of the vertebrae) impair nerve function, kind of like having a kink in a hose. Misaligned vertebrae press on nerves and make them less able to deliver signals from the brain. Those signals trigger healing, so by relieving the pressure, the body becomes more able to heal itself.


> Their argument is that subluxations (misalignment of the vertebrae) impair nerve function, kind of like having a kink in a hose.

And this "theory" is--pardon the expression--complete horseshit that's unsupported by any scientific evidence.

The article actually covers this topic at some length, including the fact that this "theory" regarding subluxations was discovered through the very scientific practice of seance...


I've had to think hard about engaging with you, because I don't think you're engaging in good faith. I didn't say that chiropractic is a science, nor did I use the word "theory."

In fact, it's not scientific, and that's why I consider it valuable. It can see things that science misses.

Science is often the best method we have, but it's far from infallible. And the idea that there must be a total disconnect between science and mysticism is simply false. Many of the best scientists have had a mystical bent (Einstein, Newton, Bacon).


Thank god someone else has some sense. I'm trying to not double facepalm at all the flat earthers' voluminous, glowing reviews of osteopathic "medicine" and chiropractic, both of which are pseudoscience medical equivalents of Scientology, which itself abuses the word "science."


No: I had stopped seeing my physical therapist months earlier for various reasons, including that I was experiencing setbacks that I found emotionally demoralizing.

What a "grade 5 lumbopelvic mobilization"--what all the medical science people (online) were saying I needed to get done (like, I was at the point where I was watching talks from conferences on lumbar spine radiculopathy issues)--does is it takes the ilium and the sacrum in one's pelvis and separates them slightly, essentially stretching the sacroiliac joint a bit (which is hard to do and requires enough directed force to make it really hard to do to yourself... that joint "normally" barely moves at all: it is at best a shock absorber) and then allowing it to go back to a maybe-more-normal position in the case that they have accidentally gotten locked into a bad place and ended up with some tissue (or even a nerve) getting pinched. Physical therapists will also do this, but as far as I can tell--after starting to try to get an appointment with a new one at around the same time (but unable to get one for weeks out)--they are way more addicted to following only the pathologies that have actually been determined by the doctor who prescribed you to see them (as that's how they work: the doctor give a you a prescription).


Fwiw I have no dog in this fight, but I am personally very skeptical of chiropractors. Nevertheless my doctor said he might actually prescribe me to see one for a long term (decade+) back and neck issue. His exact words were "normally I would never send anyone to a chiropractor, but one thing they are great at is getting dislocated things back into place." Which sounds like the kind of thing you were dealing with.


You seem to me to be barking up the wrong tree by lionizing osteopathy, which is junk science, with "doctor" skill. (DOs are poser MDs from the STEM equivalent of Scientology.)

I saw two otolaryngologists. One was an arrogant prick who said I had allergies despite having an extreme left lateralization Weber test, the other found what I suspected from research: SCDS visible on a CT scan requiring forthcoming invasive brain surgery to repair it. It has nothing to do with MD, DO, or RN but the skill, wisdom, and professionalism of a specific provider.


There are definitely bad doctors out there. However, this is, at best, personal anecdote about a single case and hardly evidence of systemic failure of modern medicine nor evidence that chiropractic is effective.


I've lived both sides of this. I once went to a chiropractor for back issues and he made me seriously worse and it took months to recover because what he thought just needed to be put in was actually a herniated disc.

Fast forward more than a decade and I have an amazing chiropractor. Every time I go there, I walk away feeling better, walking straighter, and in less pain. My daughter also goes there and the chiropractor has helped her tremendously with various issues.

If anything I think it's a shame that the quacks and the Good Guys can share the same title. But it's the same in any profession, isn't it?

It reminds me of the joke: What do you call a med student that graduates at the bottom of his class?

Doctor.


> Every time I go there, I walk away feeling better, walking straighter, and in less pain.

So what is your chiro fixing, if you have to keep going back for ten years?


There is no correlation between 10 years ago and the more recent visits. They are unrelated. Usually my hip is out of place and my lower and upper back are out. I only go in when I feel like I need it, I don't visit regularly.


If anything I think it's a shame that the quacks and the Good Guys can share the same title. But it's the same in any profession, isn't it?

No. Chiropractic medicine is pseudo-scientific, so inevitably the percentage of quacks will be far greater than in a scientific-based medicine.

So not remotely the same.


And I have quite literally watched PhD's ignore science and go based on their feelings- making [incorrect] diagnosis without even standing within 5 feet of the patient. If that isn't pseudo-scientific, then I don't know what is.

So yes, it is remotely the same.


You are confusing anecdotal observations of outlier instances (bad docs in medicine) with a general approach (the pseudo-science of chiropractic "medicine"), which is essentially restating your initial comment.


Everyone claims to be "Science based", yet there is an element of faith that one's worldview is the only correct true worldview while other worldviews are "pseudoscience". It's almost is if fundamentalist religions, with priesthood, are claiming to be "Science based" as a way to have authority over the audience's critical thinking.

If you claim to be "Science based" you have to prove it with your actions. Words are not enough...Vitriolic rants only make you look like the kook...


> If anything I think it's a shame that the quacks and the Good Guys can share the same title. But it's the same in any profession, isn't it?

I actually agree with most of your post, but want to comment on this: yes, it's the same in any profession, but the profession itself also matters. Some are grounded in science, some aren't, and this matters. People are going to be people, but the foundations of their jobs matter.


Every time you go? That doesn't sound effective.


Think of it like taking aspirin for a headache. It works. Then later, you get another headache, so you take more aspirin. To expect more than that for any treatment is as unreasonable.


This article is full of weak proof and elitism. If one is to go back to the 1900s to critize how the practice is formed one must remember the state of medicine. He references this but only to cast a negative light chiropractors by linking them to a time when medicine practices lack the scientific base we have now.

This statement? "Who the hell peddles (real) medicine out of a kiosk"

It is so elitist it out of touch. Most chiropractors are not in mall kiosks.

My eye doctor is located in a mall.

He may be right but this rant didn't address that.


A friend of mine went to one of the best chiropractic schools. She said 30% of her instructional time was business classes. That told me a lot about the field.


How is 'best' quantified here? =)


Debatably, as with all rankings.

Here it means highest-ranked/best-known based on trade publications.


Is your eye doctor an ophtalmologist, optometrist or other (or both)?

In Spain ophtalmologist, like physiotherapist has studied medicine and specialized. But optometrists has not and maybe you are comparing a chiropractors (without medicine title) with optometrists.


This is true in America too.


In America:

Ophthalmologist = Medical Doctor (MD) that specializes in the eyes. 4 years of medical school followed by an internship and residency like any other MD.

Optometrist = Doctor of Optometry. 4 year professional degree post Bachelors.

There's a lot of overlap between the two, but there are some things Ophthalmologists can do that Optometrists can't, like eye surgery and prescribing drugs.

Optician = Not a medical professional at all. Some states require an Associates Degree, many just require a certificate. Basically the person at a mall kiosk who helps you pick out eyeglass frames, puts the lenses that an Ophthalmologist or Optometrist prescribed into the frames, and fits them to your head.


I don't think labelling the argument as elitist really addresses the issue.


The historic scientific basis for chiropractors is total BS. The idea that everything stems from the spine, and if you get the spine and alignment, everything else will follow. Literally, a belief that you could, for example, cure cancer, by aligning the spine.

That’s no better than energy healing, and the idea that you have energy flows that get interrupted and need to be corrected by using a certain crystal.

Having said that, chiropractors can fix muscular skeletal issues, that the typical medical community often ignores.

My chiropractor anecdote is this: I was in college and I had a bad pain in my neck and jaw. It came out of nowhere, and lingered as an annoying pain. I went to the student health clinic, where the doctor promptly prescribed me antibiotics for 30 days. I took the antibiotics, and things sort of improved. But the pain never went away.

I went to a chiropractor, who gave me one, single adjustment. When he adjusted my neck, it hurt like heck. 24 hours later the pain was greatly diminished. 24 hours after that, the pain went away and I never felt it again.

There was no infection; the antibiotics did nothing. The relief I felt over 30 days was merely the healing of the body on its own. There was still something incorrect in my neck and jaw, and who knows if it ever would have resolved. The chiropractor fixed it in literally 30 seconds.

So, it’s a mixed bag. And certainly, I hope everyone criticizing chiropractic care is similarly critical of Western medicine, and dumb doctors like the one who simply threw antibiotics at me and sent me on my way.

One more thing, I’m a lawyer who does the occasional personal injury work. A lot of that industry is based on chiropractic care. And there are some over billing charlatans making bank doing that chiro care. I guess the bottom line is that I’m not willing to completely toss out chiro cares potential, but there are lots of bad actors.


I dont want to be the devils advocate. Usually in those cases you would be better consulting another doctor, just in case.

Doctors are also human.

I had a friend who had eye problems suddenly, and the first doctor told him that he would become blind in some more years. Then he told him to put some eyedrops to ease pain meanwhile.

He was devastated. Imagine being in your 18s and then become blind...

Then, he went to another doctor because the eyedrops werent very effective. That new doctor saw again his symptoms and told him that "it was just an hormonal thing, it will be no more when it stabilizes with adult developtment" and gave him more appropiate eyedrops.

Since then he has good health.


Just a side note but in a place like the UK you don't get to "see another doctor" for a second opinion (unless you go private) without moving to a different surgery altogether. Usually if you even so much as question the opinion of your GP you will get ostracized and mocked. Asking to see a different one in the same surgery will leave you getting questioned by the receptionist as to why you would ever want to do that and if you do somehow manage to get an appointment with a different GP they will likely have been informed that you've moved to them from another GP in the practice and will treat you like a nagging hypochondriac.

I have an endless number of terrible experiences with UK GPs and few good experiences.

When I was 8 I started getting headaches. These headaches got worse and worse until I was hitting my head against the wall and the metal bedposts of my bed to give me pain to distract from the headache. My mother took me from GP to GP getting a record at the local surgery for being quite a pest trying to get a GP who would do something about it instead of claiming that it's normal for an 8 year old kid to get debilitating headaches and that I was just acting or that I just needed to get given paracetamol.

A year or two later I had flat feet which caused me immense pain while walking long distances. Going to the GP it took my mother's begging and another GP change before they decided to give me a referral to a specialist (previously one GP said that I just needed to take paracetamol and if that didn't work take ibuprofene as well, which my mother tried until I started getting pains in my abdomen which I assume must have been my liver or stomach complaining). The specialist immediately noticed that I did in fact have flat feet and needed inserts in my shoes to correct this. The inserts immediately stopped the pain from happening and a few months later I could walk without inserts.

When a lot of front-line doctors (at least in my experience) avoid taking on the responsibility of making any kind of diagnosis or even getting you to a specialist I can totally see why people who privately go directly to someone who has at least a little bit of specialization find the results to be a lot better.


> Literally, a belief that you could, for example, cure cancer, by aligning the spine.

I can assure you that 99% of chiropractors would never claim that they can cure cancer.


I agree. But the original basis for chiropractic care would make claims like this. They would blame the cancer on spinal issues. And that’s what I’m saying is bogus. I agree that most chiros now would not say that because it’s ludicrous.


The original basis for pretty much all medical treatment was nonsense. Some people noticed some things worked, that got passed down and added to over time, somebody spotted patterns and built up an elaborate theory and then that got passed down as gospel.

The classic example is Hippocrates' theory of the Four Humours. Galen, world-renowned physiologist, elaborated on this by ascribing psychological temperaments to each Humour… To cut a long story short, he taught us that the Central Nervous System controlled the body, and was in turn controlled by the brain (or, at least, the voice was); and that cataracts can be removed with a needle; and that blood provides life-giving energy and nutrition to the body (specifically, heart-generated blood provides energy and liver-generated blood provides nutrition, and blood passes between the chambers of the heart via a blood-permeable interventricular septum); and that men have more teeth than women.

Medicine has moved on since then. If Chiropractors haven't, that's a good argument, but “Chiropractors used to be quacks” isn't a particularly strong argument that they are now.


Men have more teeth than women goes back to the Greeks, and Galen wasn't the only person to run with the idea. (cf. Jews having more teeth than non-Jews, etc)


> Men have more teeth than women goes back to the Greeks

Men on average have more teeth than women (since hyperdontia is twice as common in men.)

But that's obviously not what the Greeks were referring to.


I come from a long lineage of chiropractors (although I’m not one).

I’ve never been a big believer in the practice, and yes there are very rare cases where a chiropractic adjustment can lead to a stroke but again, it’s extremely rare. (Perhaps less rare if you’re going to the guy at the mall kiosk..)

I’d like to see some scientific studies proving chiropractic adjustments are harmful.

A lot of physical and mental health has to do with simply having awareness and being conscious of your body. For some people, going to a chiropractor monthly gives them 20 minutes in a room where their doing nothing but thinking of their body and talking about their body with the chiropractor.

Again, I’ve never been a big believer of the science behind it. But I am a believer that any activity that makes you sit down and think about your body and what you could be doing differently to reduce your aches/pains is likely to have some degree of positive outcome.

There are lots of links in the article and I didn’t click them all. But if there are actual studies showing damage (aside from 1 in a million adjustments causing a stroke), I would love to read them.


Same lineage here. Great grandpa was a chiro. His boys all chiros. One of those was my grandpa, and all his boys chiros. None of the next generation took up the mantle. I’m a lawyer.

If the care is outright harmful, we all must have dodged a bullet.

And I have at least one or two anecdotes where the treatment genuinely brought me near-instant, lasting relief for an ache or pain.


> I’d like to see some scientific studies proving chiropractic adjustments are harmful.

The burden of proof lies very much in the other direction.


No, that's not how burden of proof works. The default assumption is that a given event has zero effect. If you want to assert that it's actively harmful then the burden is on you to show that.


Which is why we let people sell anything they want as medicine until someone proves it's harmful...

Oh wait that's the opposite of how it works. Medical procedures have to go through a rigorous approval process to prove they are safe, or at least better than no treatment.


The “supplement” industry has entered the chat.


“First do no harm”


Here's a few cases of chiro doing harm: http://whatstheharm.net/chiropractic.html (ignore the site header at the top, that statistic is for all topics totaled)


As long as the evidence shows chiropractic results in more strokes and also isn't more effective than doing nothing, then that's all the evidence you need.

I have a ~30 year old friend who had a stroke shortly after seeing a chiro; it was not officially recorded as due to the adjustment, but I suspect it was. How many more strokes are not properly attributed?


> I’d like to see some scientific studies proving chiropractic adjustments are harmful.

This is really not at all how science works. On the contrary, chiropractors should be able to prove that their methods work to a community of extremely skeptical scientists, using double-blind tests as is standard practice.

At the end, it is likely mostly harmless, just like homeopathy. It may be even positive, in that receiving regular soothing attention from a bullshitter may have a good effect on your mental health (unless it is used as a replacement for real medical care when there are serious issues).


> It may be even positive, in that receiving regular soothing attention from a bullshitter may have a good effect on your mental health

This is why I would be more interested in seeing studies showing harm than studies showing efficacy.

If it’s harmless and helps people in psychosomatic/indirect ways, I’m all for it. Especially when the alternative is going to an orthopedic doc and getting pain meds, over-eagerly prescribed surgery, etc.


> I’m all for it.

Not me. I abhor pretty lies, even when the knowledge of the truth proves to be harmful.


Sure it is, he's addressing a specific question that is theoretically testable.

This is the same question that gets asked of drug developers as well - There's the efficacy question AND the harmful question. Does it work? (not what he's asking) and Does it break something? (this is the question)

This is a valid scientific endeavor.


I think it makes more sense when you rephrase it and drop the ask for proof to something like 'I would be interested in some scientific studies on the safety...' (at least I would, having considered visiting a chiropractor recently for back pain).

Medlife Crisis has a good video talking about the placebo effect and the promotion of pseudoscientific treatments that's really worth a watch:

https://www.youtube.com/watch?v=jQw2B0vCPYo

tl;dr In the video, he captures my concerns perfectly about the whole thing, "by mainstreaming and legitimising practices outside proven science it increases acceptance of things that don't work, and regular people can be harmed through neglecting effective therapies"


> I get it, you’re going to occasionally hear a friend say that chiropractic helped him de-clutter his alcove or do 87 sun salutations… but that’s an anecdote, and data is more important, and trustworthy than anecdotes. The data on chiropractic supports that the practice is nothing more than a collection of broken promises and fake medicine.

Anecdata doesn't matter is such a bleak worldview. Technocracy has huge gaps, from how people view, understand, and interpret data to collection and sorting practices. Anecdata helps tell the story of why things don't work or what we missed that does work. It helps us recognize gaps and improve. Technocracy and anecdata are a marriage you cannot rid yourself of because the human worldview, no matter how data rich is fallible.

This author takes issue with holistic medicine. I've heard this argument time and again about chiropractics due to its wonky history and some outlier practitioners. I've rarely run into chiropractors that have told me stuff that aligns with junk. On the other hand, I have ran into a number of Chiros that are more like DOs in the holistic things they ascribe to. I have run into chiropractors that were determined to remedy my issue (I have a crack in my lower column around my sciatic nerve). When the VA started prescribing me pills and couldn't find the crack after numerous MRIs and X-rays I found a chiropractor. When my leg would go numb and I would get shooting pain that put wells of tears in my eyes, he did x-rays, found it, cracked my back and alleviated enough pressure that I could walk. I knew and he reminded me that I had to lose weight, I had to increase my core strength, and I needed to take pride in living again.

I've had numerous people argue with me about what it is that they think he did that helped where the VA fell short and thought palliative care or spinal fusion was their only option. I speak to you with no spinal fusions, and I don't know the science of what he did, but I'm shocked at the audacity that people have to chalk all Chiros up as lunatics and snake oil salespeople.

My point is, it's important to speak concisely about problems, and I know it is difficult to in the moment, but "Chiropractors are bullshit" is on par with someone who has experienced the worst ends of technocracy saying, "Technocracy is bullshit".


Chiropractors frustrate me because they tend to treat symptoms - not root causes. You can get 'adjusted' a million times but if you have a muscle imbalance or perpetual tightness that is pulling something out alignment you will always fall back into that state.

For instance, if you sit for hours in the same funny position on your couch every night. Or if you tend to sit on one leg constantly. Or if you sleep in the same funny position all the time and create tightness in your neck.

I would love to have a practitioner look at my entire musculoskeletal system in order identify the specific areas that need work - the linchpin in the entire imbalance. There is a concept called referred pain - which means that sometimes pain in one part of your body is actually caused by an issue somewhere completely different.


> For instance, if you sit for hours in the same funny position on your couch every night.

For what it’s worth, good chiropractors will dig in and give advice like “don’t drive with your wallet in your back pocket because you’ll sit crooked”

Chiropractors tend to be more holistic in their thinking in my experience compared to regular doctors who ignore lifestyle issues.


My extreme prejudice against chiropractors notwithstanding, that wallet advice is good. And I believe there's lots of similarly low-lying fruit.

I told a nurse once about my grandmother's extreme spinal hunch. She responded that the tragedy of that particular illness is that usually it can be prevented by regularly exercising your back's range of motion in every direction, and not perpetually hunching over.


    I would love to have a practitioner look at my entire musculoskeletal system in order identify the specific areas that need work ...
What you are looking for is a Physiatrist ( https://www.spine-health.com/treatment/spine-specialists/wha... ). I learnt about them when I asked a doctor to refer me to a good neurosurgeon for my back pain (which I suspected was because of a nerve being pinched). He told me that if I went to a surgeon the treatment plan offered would be surgery and instead referred me to a Physiatrist who diagnosed my issues correctly and suggested Physiotherapy to treat it. That worked out great for me.


Dealing with this shit right now with muscle imbalances in my back on one side, chiro obviously didn't help more than 30 minutes after a session so I dropped it. Physio is a little better but it still feels very symptomatic in approach. Gonna' see if I get get an MRI scan in a third world country because nobody will afford you one in the West if it's just a wee pain with 'no cause.'


This is a technique used by a lot of athletes but I personally believe it is one of the most helpful body maintenance tools for any human.

https://performanceforhealth.com/8-mobility-ball-exercises-t...

After spending 30 minutes with a lacrosse ball I can feel my entire body relax. Using it on your ass cheeks will do wonders especially if you sit constantly. Your muscles will bind up and kinda stick together - the ball helps loosen up knots and tightness.

It is not pleasant for the faint of heart ... but if you can push past it the first few times you will eventually learn to appreciate the relief more than the torture of doing it. A lot of times you will physically feel pain melt away.

I got nothin better to do on this Sat morning so I am gonna get mine out right now and do some mobilizing.

Psoas release is also very helpful for those of us who are sitting all the time: http://recoveryourstride.blogspot.com/2012/05/this-works-flo...


Pain is systemic. There are lot of studies collecting data and showing that people with the same physical abnormalities experience varying degrees of pain.

For example, my spine has lost its natural lordosis and is completely flattened yet I experience no pain. My mother has several disc hernias and disc protrusions along with degenerative changes due to age, no pain. She had shoulder pain and the physical issue was calcification of tendon. There are people with calcified tendons, no pain.

My father had massive back pain issues with degenerative changes of spine that don’t cause any pain to some. The moment he started fixing a systemic issue of the back being weak and sensitizing the tissue he started experiencing less pain.


You may want to try the trigger point therapy workbook. It's basically a guide for massaging yourself effectively.


> look at my entire musculoskeletal system in order identify the specific areas that need work

a Physiotherapist does that. Ok, they won't look at the "entire muscle-skeletal system" but the low-hanging fruit is usually obvious to them.


Some anecdotal evidence: I went to a chiropractor when I was first starting out as a programmer because the base of my neck was in a lot of pain from staring at the monitor. I didn’t get the whole “adjustment“ thing but putting me on a tens unit with a hot compress really did the trick.


A lot of what chiros do now is basic physical therapy. When used in conjunction with typical chiro manipulation, it’s quite helpful for the aches and pains of life.

That’s why I hesitate to completely agree with an article like this. I’ll be the first to admit chiropractic limitations. However, there are real benefits when used appropriately. The problem is when the chiropractors get out over there skis, and start talking about solving all of the bodies problems through alignment alignment of the spine.


The (completely false) theory underlying chiropracty says that it can do .. basically everything. That's supposed to be a feature.

The 'problem' is not chiropractors failing to stay in their lane - If they follow the theory, their lane includes everything.

The problem is that the theory is still being taught, despite being trivially disproven since the invention of the x-ray.


So go to a physiotherapist. Not someone that also serves a dose of magic woo.


I had a friend who had back pain. Went to a chiropractor. He took xrays and did adjustments. For about a year and a half he did this. The doctor continued to take x-rays to show that he was improving internally!

Then one day, he was in such severe pain his wife called an ambulance who took him to the ER. He had lung cancer that had metastasized. The chiropractor completely missed the very obvious cancer on the xray which the ER spotted quickly.

He died a few months later. It was too late for any realistic attempt at treatment.

Always see a real MD first.


For a good laugh, check out the Wikipedia talk page where people contest whether 'chiropractic' deserves to be called pseudoscience. [0] I particularly enjoyed someone pointing out that These are in-universe sources.

For all Wikipedia's flaws, it does a good job of talking straight about this kind of thing.

[0] https://en.wikipedia.org/wiki/Talk:Chiropractic


We should invent the name for the aspects that are not bullshit, then. Some of the things they do are objectively helping some people in some cases. Gatekeeping medicine is important, but it can also become just that, gatekeeping


> We should invent the name for the aspects that are not bullshit, then.

We did: Physiotherapy.


What are HNers thoughts about public chiropractors that record and publish their treatments and results?

I still remember Ian Rossborough (even though he got suspended after adjusting a baby) and his famous video

https://www.youtube.com/watch?v=YpNcnM0FkTM

making a boy walk straight in 10 days.

Honest question, is this a stunt? Scam? Fake? Magic? Bullshit?


> is this a stunt? Scam? Fake? Magic? Bullshit?

Hard to pick just one.

The "got suspended after adjusting a baby" line is -- you have to admit -- a bit of a red flag.


I watched until he asks about continuing the first correction and then after the kid agrees he whacks him in the back from the other side of the the body. He can’t even fully see where he’s is striking. Like some sort of magic martial artist. I’d call it bullshit.


Is that on 2:40?

Isn't that just a strike on kid's lower vertebra, where he holds his fingers beforehand?


Why wouldn't you adjust his back to be facing you where you could accurately strike? Instead he does a reach-around strike which would be less accurate and would reduce the effectiveness and efficiency of said "fix". It's things like this where injuries probably stem from a person who is "trained to punch you in the lower back", considering this person doesn't have doctorate or nearly the extensive training to use physical abuse to fix someones back.


I almost wanted to share that video over here too, but I Ctrl+F "Ian" and saw that you did that first

The channel name is Chiro Core by Dr Ian

1. https://www.youtube.com/c/ChiroCore/videos


Bottom line for me is that a chiropractor does aid short term in my experience. After a few sessions, I feel much more mobile and flexible and less stiff. Does this hold out in the long run? No. Is this placebo and the "feel good" sensation just makes me thing it helps? Probably. Does that "probably" actually make a noticeable difference to me? Yes.

I've only done it for about 6-9 sessions at a time, and with years between revisits. It's the same effect, for me, as a massage therapist. For a while after the therapy, I feel great.

I don't look at chiropractors or massage therapists as a cure for anything. It's just an experience that feels good and has short term lasting effects that have been worth the cost to me.

I work a hands on job involving climbing, crawling, pulling or lifting up to 150kg or 330lbs, and various other physically strenuous activities, as well as sitting at a desk. So the benefits may greatly differ for me than that of an average person.


I play a lot of hockey and in my younger more competitive years I took a very hard hit to my shoulder that severely dislocated my AC joint.

After seeing a couple doctors, they told me I had many months of recovery ahead, probably surgery to fix it. It made no sense to me, no one would touch this huge bump on my shoulder unless they went to cut me open, which would be significant healing time.

I went to a local myopractor on a recommendation, not quite a chiropractor, but along the same vein. They massaged my upper back and shoulder and set my shoulder in first visit, then scolded me for waiting so long to do it in the first place. They had me come back a few more times to monitor it and reset it if need be, and I was back on the ice in 4 weeks.

That was 20 years ago, I weekly see a myopractor now, and I credit them for keeping my adrenaline junky banged up 40 year old body together in good enough condition to keep doing the crazy stuff.


If you see them weekly, did they really fix anything? If anything, it sounds like they hooked you in for repeat business. When I see a doctor to fix an ailment, it's one and done.


Depends on the type of chiropractor you go to. Obviously the "I can cure IBS by re-aligning your spine" types are bullshit, but some of them are basically a combination of a masseuse and physical therapist. People I knew in the military were regularly referred to chiropractors as part of recovering from an injury.


All the comments here simply show the very poor state of science education.

Everyone should read this book and then reevaluate comments about chiropractors.

The Demon-Haunted World: Science as a Candle in the Dark

https://www.amazon.com/dp/0345409469/ref=cm_sw_r_cp_awdb_imm...

And I’m not throwing shade. It’s not any single persons fault or a comment on character. I really do believe there’s a systemic problem with our education system. The reason chiropracty causes this to stand out is that it very successfully flaunts the scientific method and is still accepted at large (for reasons I won’t start going into, but most of which are covered in the book)


I knew an osteopath in Tulsa. I asked him about the popping thing and he gave me a straight answer (I think). He said you have a fluid sealed into your joints and like all fluids in your body, there are gases dissolved in it. If you distort the joint enough these gases will pop out of solution, like opening a can of soda or a bottle of champagne. This pop is quite forceful and stimulates nerve endings around the joint which produces (temporarily) localized muscle relaxation and a mild analgesic effect. That's why it feels better. And it takes time for the gases to be reabsorbed which is why you have to wait before you can pop the joint again. And yes, the rest is essentially bullshit...


I hurt my back moving a friend, went to a chiropractor for two weeks. Im not sure if it wad a pinched nerve or what but the pain was excruciating when transitioning from standing to sitting and vice versa. On my 4th visit the pain was still there but the chiropractor put me on the table positined me on my side with my arms arcross my chest and knees bent and amazingly he pushed down and the pain dissapeared instantly.

So I might be an outlier but can attest that a chiropractor fixed my back pain, I was 100% pain free and never needed to go back.


Lots of people have this kind of experience. If you did a survey asking people whether chiropractors are useful for musculoskeletal problems, you would get a strong response that yes they are. But self reported experience, even through a broad survey is not evidence because people can't be trusted to accurately report what they feel.

I personally think the problem is that the practice has over-medicalized what it does, and medicine does indeed require a high burden of objective evidence, which they can't meet. But there are plenty of things that people do where "do people like it?" and "is it safe enough?" are high enough bars.

I do think the question of "is it safe enough?" is the interesting one with respect to chiropractic adjustments, and I wish that were better separated from the (in my opinion) more tedious debate about whether it is generally BS.


>because people can't be trusted...

I suppose that is true, where I live chiropractic visits are subsidized by a government run medical system and because of that, there is a detailed record of treatment. Positive and negative outcome inference should be possible with such a record so trusting people is not required.

In other words, if enough people visited chiropractors and then later visited doctors for pain medication and or surgery then there would be a reasonable argument against funding chiropractic treatments. I can only assume the opposite is also true, hence the reason they are currently and have been funding chiropractor treatments for the last three decades.


The alternative in past observed experience was going to a doctor for back pain and being prescribed pills that turned you into a pill addict that needed to be weaned off of them.

Personally, I know the adjustments work, but I’ve seen the alternative scenario with guys I’ve played hockey with they were hurt, and even if it were all in my head, it’s still a far superior outcome frankly. I’m pain free and drug free.


Please watch this video of a guy with severe kyphosis that modern medicine would perhaps not have much of a solution except PT and maybe a permanent back brace:

https://m.youtube.com/watch?v=oObKPX8beeM

Then watch part 2:

https://m.youtube.com/watch?v=b_vu96FNLZs


That's been obvious to me since I was about 14 yo, roughly 30 years. They're like fortune tellers, financial advisors, osteopathic "medicine" DO's, faith healers, life coaches, water diviners, cryogenics, solar freakin roadways, and "alternative" medicine.

People will believe in anything, especially false hope for the impossible, saving a buck, or a shortcut.


I am personally mesmerized by the aligment youtube videos. It is touching to see someone barely able to walk and after a series of adjustments able to walk normally. I didn't even knew there was a sentiment that these adjustments were 'pseudoscience'. The guys doing it seemed pretty knowledgable with X-Rays and stuff. I always thought of it as a complementary medicine.


my bff is a chiropractor which made me realize that not all of them are shills. he grew up in athletic training and sports medicine and is adamant that he shouldn't be seeing patients for more than a visit or two to mainly make sure the patient is not ignoring something that needs an ortho surgeon and to teach home rehab exercises for recovery...

but.. i live in chiropractor hell in northern indiana.. the number of chiropractors here are absurd. and one of the things they utilize is a body heat imaging scan to determine if patients have: cancer, colitis, celiac's and a world of other stuff.. that they cant actually detect.. this has raised a generation of women that won't get mammograms because of the evil radiation.

on the other hand, my wife is a breast cancer surgeon and business is good here.


NFL/NBA uses chiropractors; that's enough testimonial for me.


NFL doesn't have a very good track record on the medical front. https://www.pbs.org/wgbh/frontline/film/league-of-denial/ If chiro provides cheap short term care at the expense of the player, that sure does sound like a great deal for the business that is the NFL/NBA.


You're just making things up. It's not "at the expense of the player" These players are in peak physical fitness. If they want to go to any kind of doctor they can as they have medical insurance and they are all multi-millionaires.


Did you watch the documentary? It would be them that re making things up.


Documentary is about concussions, I saw it years ago. Has nothing to do with the player's preference for chiropractic.

Player likes chiropractic because he believes it makes him perform more optimally, you inserted/made up this concept of the NFL pushing chiro to save money "at the player's expense".

Pro-athletes preferring chiro is a strong counter-signal these "skeptic" articles.


At best, Chiropractors are bullshit. At worst, they kill or paralyze people.

Their manipulations offer temporary pain relief because they forcefully mobilize the joint/bone structure. The only way to fix this long term is by correcting the muscle imbalances through physical therapy. Most people would rather get immediate pain relief vs months of therapy and exercise, so they have a constant supply of victims.

Chiropractic care should be outlawed as snake oil or health plans should stop covering it.


Some chiropractors do have the education and experience to operate as physical therapists. When I was doing competitive weight lifting, I saw a chiro who had a masters in sports medicine and had spent years as a college football trainer. He ran his office like a rehab clinic, and a lot of his clients were high school, college, and amateur athletes like me. He wasn't just popping some bones and moving on, he was working to keep his patients healthy through identifying weaknesses and imbalances and making training recommendations to correct them. Being a chiro got people in the door who didn't understand what their problem was to begin with, just that they needed relief.

I realize the industry is full of snake oil practitioners, but some of them are actual professionals.


Then the not snake-oil subset should abandon the label of chiropractor. Otherwise they're just giving cover to the charlatans.


This is unfortunately a common pattern for bullshit pseudomedicine. They make up something random that looks like treatment and has some limited, short-term effect. By doing so they gain followers, who keep repeating the standard story.

It's scary effective.


When I read a sentence like your first one, it sounds to me like somebody saying, "at best, massages are bullshit", which just strikes me as odd. At the very least it's clear that lots of people self report feeling better after partaking in their services, in both cases.


What about Osteopaths?


Not to be confused with a Doctor of Osteopathic Medicine in the U.S:

> There is a distinction between osteopathic physicians trained within the United States and those trained outside of the United States. Osteopathic physicians, or DOs, currently have unlimited practice rights in roughly 74 countries, with partial practice rights in many more; DOs have full practice rights in all 50 US states. As of 2018, there were more than 145,000 osteopathic physicians and osteopathic medical students in the United States.

https://en.m.wikipedia.org/wiki/Doctor_of_Osteopathic_Medici...


In the USA there are real doctors with an osteopathic medicine degree. https://sciencebasedmedicine.org/osteopathic-medicine-what-i...

> Essentially we need to distinguish between osteopathic medicine, which is mostly equivalent to standard medicine, and osteopathic manipulation, which is pure pseudoscience akin to straight chiropractic.

> The fact that any individual physician is a DO rather than an MD really tells us nothing. However, osteopathic medicine really should ditch the manipulation based on quaint notions of vitalism. They should also stop selling themselves as “holistic” or pretending that they invented preventive medicine.


This is the first I've heard about osteopaths of imaginary medicine. Osteopaths were always DOs to me.


Or homeopathic medicine.


Very useful as a supply for a large number of differently named placebos.


Might want a (2017) tag on this.


I had an interesting run-in with a chiropractor. Toward the end of winter 2017 there was a freak snow storm in the north east. 2 feet of heavy snow fell in 24 hours. I had an undiagnosed shoulder injury I was compensating for from hard falls downhill biking and 20 years of drumming. I didn't realize at the time as I ran the snow blower pushing and lifting it, I was doing critical damage to my spine. C5, C6 & C7 were bulging and getting herniated, impeding on nerves that control my left back arm and hand.

Over the next two weeks my left back shoulder forearm and hand would vary in sensation from complete numbness to random spasms to extreme pain like fire or bursting open. I lost muscle and my back shoulder and arm began to atrophy.

In NYC it's tough to get to see a doctor without an appointment unless you're loaded. I'm not but I was willing to bleed my life savings to get some relief. I went to lots of doctors, paying cash, just to get someone to help. They barely looked at me and never touched me. An x-ray showed no broken bones so they prescribed muscle relaxers. Nothing they did would address the underlying issue or actually do anything beyond postponing even worse bigger issues to deal with later.

I started going to acupuncture. $200 dollars a pop. Laying on the table was excruciating. I couldn't feel the needles at all. The acupuncturist eventually would push needles all the way through various muscles with no effect. Then we tried "cupping", it looked awesome/gruesome. Since the needle pokes weren't working she recommended chiro.

This is were things get interesting. I'm on the chiro table, he walked in and takes one look at me "Whoa, what did you do?!" He could see my shoulder was not aligned. I felt so relieved that someone finally could see my injury and immediately. I thought I was in good hands. He started to manipulate me. "Did you have a previous injury? Your shoulder has partial subluxation. Your c5,c6,c7 are out of alignment. That's strange." Then he said he was going to fix my shoulder. "You'll feel a lot of pressure. That's weird it popped out again. You may should go to the ER." I now I realize I went in to shock. Everything after was a blur. I remember him saying things but I don't know what. I ended up in NYU ER. My entire arm felt like was opened and dissected and lit on fire. It was a busy day and the waiting room had a triage tent setup. I wasn't dying and blood was flowing to my arm so I sat there for three hours. They finally gave me a valium. The pain stopped. As I left, the ER staff begged me to stay. I got in a taxi and went home. The valium made me feel great, like a cloud; soft and fluffy. (BTW that ER visit "not a bill" was for $5,500... I never saw specialist or got any imaging. Just a valium.) The day after I felt like I lost a fight and got my left side kicked in. Weeks later I saw a neurologist, I had an MRI, It turns out my c567 were in fact bulging. But the chiro should not have manipulated me without imaging.

This is my back in May of that year. https://imgur.com/a/LA1emY8

I worked with PT and regained 100% use and strength even better than pre-injury, however as of today my thumb, index and middle finger are numb, I presume due to the extreme manipulation in the chiropractors office.


This is more an indictment of the US medical economy than chirpractic. If an actual MD didn't do a physical exam for someone with that history ("was snow blowing and then for two weeks I've had numbness and extreme pain") they should be sued for malpractice.

Same for the ER a) giving you valium without a physical exam, and then b) begging you to stay without saying why.


Do they even exist outside of north America?


In India, there have been traditionally "bone setters" who literally do just that. Did you fall down the stairs and twisted your arm? Or shoulder or leg? Well they did that.

I saw once at a hospital a kid who had fallen off a bike. There were like 4 men pulling and twisting his pelvis like crazy. I shuddered at the sight. These were actual doctors so yeah.

About the bone setters, they just fixed your twisted limb or foot or something. Over the past many years now they have fallen out of fashion so your nearest bone and joint hospital is where they treat you.

Rest of therapy and stuff is now delegated to physiotherapists.


That's slightly different. Bone setters exist(ed) almost everywhere.

Chiropractors have this weird fixation on vertebrae.


yeah. my own back is a mess because i did it. i can lay flat on my back and crack my way from the top of the neck to the lower back. then while standing up, i can push out with my hands on just above the pelvis and i hear this huge pop. then, to top it off, i sometimes when i have stood up for a long time or did some manual physical work, i ask my little brother to stand on my pelvis and at the right place, there is just super nice feeling and once i stand, the strain on my back is lifted. i crack my fingers, feet, knees, neck, ankle, pelvis, back, elbows, wrists...... shit


Unfortunately, yes.


I've had whiplash twice. A chiropractor did pretty good at straightening that out.

Do I trust the new-age-ish stuff that they offer? No. Do I trust them to straighten my spine? Yes. At least, I trust the one I have.


I hadn't heard of the term 'chiropractors' until our family moved into the suburban parts of the US. The other fancy shops that surprised me by their existence were these healing crystal stores and astrologers and whatnot. Eww.

I mean it is downright unacceptable these days.


Magical thinking is quite prevalent in the US.


You mean illiteracy?

Thank you for trying to turn it into something positive with great words though.


Of course chiropractors are bullshitters. That’s obvious to anyone with any training in science. And also most of psychology/psychiatry is bullshit, especially the pharmaceutical side. In general, humans wanting to believe that all serious problems have medical/pharmaceutical solutions leads to a large amount of bullshit in the minds of people who have the education to do better.


Jumping from chirpractic to psychiatry is a leap.

Lumping psychology and psychiatry together is also a leap.

One is about magical theories on how our minds and emotions work, the other is about biochemistry.


Aren't psychiatrists the people who prescribe children and teenagers drugs for imaginary "medical conditions" that are in fact complex and nebulous emotional/behavioral/mood issues that we have no understanding of at a biochemical level and indeed doubtless can never be fully characterized at a biochemical level due to the complexities of the human mind?

It's lovely that you think of psychiatry as concerned with biochemistry, but that is the problem that I am referring to.


The author uses the fact that Chiropractic was started with inspiration from the spiritual world as evidence of quackery and says they are surprised that chiropractors are allowed to practice. And yet ... We allow many organisations which specifically say that taking directly to non-physical beings will solve your problems. So this bullshit is far less surprising than the direct and common bullshit we tolerate every day.


"We" don't allow them. I take issue with lots of forms of quackery and faith based "let's pretend we're science" organizations. So I agree there are others practicing quackery besides chiropractors out there.




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