Why are chiropractors scam artists?

[jay santos]

There is not any good evidence that it helps, but I've heard several people share their testimony about it.

Here's why it seems viable to me.

A couple things that seemed to have helped me and seemed to have help others, as I do research and study on the internet.

1. McKenzie exercises
2. Traction therapy

Each of these, the design is to decompress your spine, ie pull it apart where it is now compressed, pinching the nerve.

The inversion table seems like it works on the same principle, so it seems legit to me.

[SoonerCoug]

The inversion table seems like it works on the same principle, so it seems legit to me.

Go to pubmed.gov and show me a quality study on inversion therapy. There are all kinds of things that might seem theoretically good that don't actually work or even cause harm.

There was a time when anti-TNF medications were expected to save lives in sepsis since they saved lives in animal models. Anti-TNF medication ended up killing more people in trials than they saved. The principle made a whole lot of sense, but it didn't help in practice.

You can't rely on a principle or opinion when it comes to medicine. You have to rely on legitimate, high-quality studies if you want to know the truth.

I know there is some good evidence that certain exercises and physical therapy can help some patients, so I have no problem referring people to physical therapy.

[HuskyFreeNorthwest]

There is not any good evidence that it helps, but I've heard several people share their testimony about it.

In the mouth of two or three witness shall all things be established.

[San Juan Sun]

I'd say that there is plenty of crap in allopathic medicine too, especially when it comes to back pain and injections, but at least real doctors usually don't blatantly make shit up.

I'm not sure what you're referring to. My student experience was with a large group of allopathic PM&R guys in Phoenix. Of course, they injected almost everyone. They called is "liquid gold", referring more to the reimbursement and less to the results. They also had their techs do a lot of ultrasonic massage, which was charged at 15 minute intervals I think.

On the other hand, they had a whole lot of patients that came into their clinic in wheelchairs and left walking. They never wrote for narcs, ever. And they taught a lot, and even let me stick some people. Heady stuff for a 4th year medical student. (Also, they only made me work 2-3 days a week, always going home by lunchtime. It was a great month. )

[SoonerCoug]

On the other hand, they had a whole lot of patients that came into their clinic in wheelchairs and left walking. They never wrote for narcs, ever. And they taught a lot, and even let me stick some people. Heady stuff for a 4th year medical student. (Also, they only made me work 2-3 days a week, always going home by lunchtime. It was a great month. )

Putting a needle into someone can make them feel a lot better. There is no doubt about that. A lot of this stuff is just placebo effect, but it's still voodoo.

[San Juan Sun]

Go to pubmed.gov and show me a quality study on inversion therapy. There are all kinds of things that might seem theoretically good that don't actually work or even cause harm.

I did not know this until recently, but the FDA does not require manufacturers to prove that their devices offer efficacy. They only have to prove a lack of harm. Not exactly a comforting feeling, and it obviously leaves a lot of room for fraud.

[jay santos]

Go to pubmed.gov and show me a quality study on inversion therapy. There are all kinds of things that might seem theoretically good that don't actually work or even cause harm.

There was a time when anti-TNF medications were expected to save lives in sepsis since they saved lives in animal models. Anti-TNF medication ended up killing more people in trials than they saved. The principle made a whole lot of sense, but it didn't help in practice.

You can't rely on a principle or opinion when it comes to medicine. You have to rely on legitimate, high-quality studies if you want to know the truth.

I know there is some good evidence that certain exercises and physical therapy can help some patients, so I have no problem referring people to physical therapy.

Would you include McKenzie exercises and traction therapy also in the same boat as stuff that doesn't help?

[Green Monstah]

I have gone to chiros fairly frequently for minor back pain. However, recently I realized that stretching and going for a brisk walk will usually get me straightened out and relieve pain just as well. I may try the massage route too (although it will likely cost more than my visits with a chiro).

Note: I've had good luck avoiding the quacks. Of the two I've seen the last five years, both are reasonable and provide great core-building advice and focus on stretching and deep tissue massage.

My wife went to one, however, that was off his fucking rocker. He gave her a free diagnostic exam, then called and said he needed to see both of us immediately. We were petrified. We went in and noticed we were in a room of other couples. He gave his spiel, talked about how MDs killed his father by giving him conflicting meds, and then focused on the arch in your cervical vertebrae, and how if it straightens out, you'll die. He then showed us my wife's cervical vertebrae and said she was 6 degrees from death, and tried to get us to prepay $1500 for 9 months of treatment. Dude was whacked, but I've been lucky otherwise.

[Indy Coug]

I have gone to chiros fairly frequently for minor back pain. However, recently I realized that stretching and going for a brisk walk will usually get me straightened out and relieve pain just as well. I may try the massage route too (although it will likely cost more than my visits with a chiro).

The upside of going to a chiro instead of a masseuse is being able to avoid the inevitable "happy ending" question.

[Donuthole]

The upside of going to a chiro instead of a masseuse is being able to avoid the inevitable "happy ending" question.

Wait, they ask you beforehand? What kind of crap masseuse are you going to?

[TexTechCoug]

I don't agree with your etiology for most back pain, and neither do most interventionalists. It is far more complex and still the etiology is often unclear.

Not up for writing an essay but arthropathy and foraminal stenosis are often considered culprits as is non-impinging discogenic pain. While your description sounds reasonable, it certainly shouldn't be considered authoritative.

Here is my initial post where I said I disagreed and used the strong wording, shouldn't be considered authoritative. You then attacked me for an unrelated post in another thread. Even in the initial post I offered an explanation of more common causes of back pain.

I am sorry if you found something objectionable in my statement that I don't agree with you.

Why you are so upset about me saying I worked with a surgeon who was out of his depth is beyond me.

[Mrs. Funk]

Count me in with those who had good experiences with a chiro. I went monthly while I was pregnant with Lil' Funk and sometimes weekly towards the end. It made a huge difference in the back and hip pain I experienced. He was the traditional "crack your bones" type (see Eddie Izzard clip below), no fancy machinery or laser beams or infrared magnets or those clicky ArthroStim devices or whatever. No gimmicks and no pressure. Well, every 6 months or so I get a postcard from their office reminding me to schedule my adjustment, which I haven't done because I haven't had pain.

[YOUTUBE]mUwnkTnHrtI[/YOUTUBE]

[Jeff Lebowski]

Here is my initial post where I said I disagreed and used the strong wording, shouldn't be considered authoritative. You then attacked me for an unrelated post in another thread. Even in the initial post I offered an explanation of more common causes of back pain.

I am sorry if you found something objectionable in my statement that I don't agree with you.

Why you are so upset about me saying I worked with a surgeon who was out of his depth is beyond me.

Can you guys knock off the sideshow and get back to the technical part of the back pain debate? I am really enjoying and interested in that part. TIA.

[SoonerCoug]

Would you include McKenzie exercises and traction therapy also in the same boat as stuff that doesn't help?

Here is part of a review article that summarizes some of the evidence regarding McKenzie exercises:

Pain:

Generic back exercise compared with usual care or no treatment (acute low back pain of <6 weeks' duration) We don't know whether exercise is more effective at improving pain as we found insufficient evidence (very low-quality evidence).

Generic back exercise compared with non-exercise interventions (acute and subacute low back pain) We don't know whether exercise is more effective at improving pain as we found insufficient evidence (low-quality evidence).

Generic back exercise plus CBT compared with no exercise or CBT alone Neuromuscular training plus CBT may be more effective at reducing pain intensity at 7 days (low-quality evidence).

Generic back exercise compared with CBT plus exercise We don't know whether generic back exercise plus CBT is more effective than generic back exercise alone at improving pain or severity at up to 6 months' follow-up in people with subacute low back pain (low-quality evidence).

Specific back exercise compared with passive treatments McKenzie treatment may be more effective than a combined analysis of educational booklets, bed rest, ice packs, and massage at reducing pain at 7 days (low-quality evidence).

Specific back exercise compared with advice to stay active McKenzie treatment is no more effective at reducing pain intensity at 12 weeks (moderate-quality evidence).

Specific back exercise compared with flexion exercises We don't know whether McKenzie treatment is more effective at reducing pain at 8 weeks as we found insufficient evidence (low-quality evidence).

Specific back exercise compared with back school McKenzie treatment may be more effective at improving pain at 1 year (low-quality evidence).


Functional improvement

Generic back exercise compared with usual care or no treatment (acute and subacute back pain) We don't know whether exercise is more effective at improving function as we found insufficient evidence (very low-quality evidence).

Generic back exercise compared with non-exercise interventions (acute and subacute low back pain) We don't know whether exercise is more effective at improving function (low-quality evidence).

Generic back exercise plus CBT compared with no exercise or CBT alone Neuromuscular training plus CBT may be no more effective at improving disability at 12 months' follow-up (low-quality evidence).

Specific back exercise compared with passive treatments McKenzie treatment may be more effective at reducing disability at 7 days but not at 4 weeks compared with a combined analysis of educational booklets, bed rest, ice packs, and massage (low-quality evidence).

Specific back exercise compared with advice to stay active McKenzie treatment seems to increase disability at 12 weeks (moderate-quality evidence).

Specific back exercise compared with flexion exercises McKenzie treatment may be more effective at improving disability scores at 5 days (very low-quality evidence).

Specific back exercise compared with spinal manipulation McKenzie treatment may increase disability at 5 days and at 4 weeks (low-quality evidence).

Specific back exercise compared with NSAIDs We don't know whether McKenzie treatment is more effective at 3 months at improving short-term disability as we found insufficient evidence (low-quality evidence).

[San Juan Sun]

Can you guys knock off the sideshow and get back to the technical part of the back pain debate? I am really enjoying and interested in that part. TIA.

I would like to, but he started it.