Why are chiropractors scam artists?

[Pheidippides]

Okay, since we're all into the n=1 back pain cures, here's my story.

I have ankylosing spondylitis. Forgive the spelling. Diagnosed at 20 on my mission, which is early. Genetic markers, X-rays, etc. all back this up.

I cannot even begin to describe the pain. Took me at least an hour every day to get out of bed.

Use to be that I would have flare ups roughly every spring and fall when seasons change. Debilitating.

Then I lost weight, started exercising, got strong, and used NSAIDs. No problems since. Minor stiffness.

The chiro treating my dad for 30 years didn't help him at all. But he loses some weight and starts exercising, and no more problems.

Losing weight and exercise are the two things that are under prescribed and that I think are pretty much cure-alls.

[San Juan Sun]

You then attacked me for an unrelated post in another thread.

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.

I didn't feel the need to respond to your other thread, as Cardiac did a nice job in saying what I was thinking. I would not characterize myself as upset either. If you felt attacked, well, you should know that your germane comments outside a thread but within a forum may be introduced as evidence for the defense.

If you would like to take the discussion of the other surgeon back to that thread, I understand. I believe that someone asked you to further elaborate on why he was out of his depth. I would appreciate it if you could do so. I have a pretty significant experience with open and endovascular AAA repair for my level of training, as well as experience with reps, and would be very interested to hear why this surgeon was unsafe. I would also like to hear about what you did regarding the situation. Did you discuss the issue with the surgeon? Did you discuss it in your departmental meetings or with your hospital's Risk Management or Medical Executive committee meetings? I know each institution has different processes, and I'd be very interested to hear about how yours works.

Also, I'm still waiting for you to tell me how I'm wrong about LBP. Perhaps it went over the head of this simple surgeon. Upon reflection however, I think we may be talking about different patient populations. If you do a lot of pain management, wouldn't it be safe to say that you don't see the run of the mill LBP, the kind that never makes it to your office because they get better?

[SoonerCoug]

Losing weight and exercise are the two things that are under prescribed and that I think are pretty much cure-alls.

The corollary to this is that if you want someone's health to really tank, order a motorized wheelchair for them. I got lots of experience doing this and filling out disability paperwork in my residency. There is even a crazy guy who cuts off cars with his motorized wheelchair to beg for money at an intersection by my home.

That said, there are plenty of skinny people with horrible inflammatory arthritis that does not improve with lifestyle modification.

[Joe Public]

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

Wait, they don't ask you the "happy ending" question? What kind of crap chiropractor are you going to?

[Northwestcoug]

Here's my n=1 and apochryphal stories.

I had bad asthma as a kid. Effective treatment wasn't as well recognized as it is now, so my mom was at her wit's end. She tried everything, including a chiropracter who was more than willing to try to help me. For some reason, the chiropracter also did accupuncture on me. We went for about a month of procedures. Of course, nothing he did helped.

My aunt went to one for bad back pain. Her chiropracter had her lay on her back while he examined her. She abruptly stopped the exam after he put his finger in her belly button and started sensing her energy.

I'm curious about the licensing body of chiropractry. Every month my state's licensing body publishes a list of physicians/PAs who are disciplined for unethical or dangerous behaviour. There are about 20 names each month. I wonder how vigilant chiropractry is with their docs.

[ERCougar]

I've mentioned my experience a few times in different threads. I experienced what I believe is a fairly common injury (herniated disk causing sciatica) and had what I believe to be a fairly common experience of frustration dealing with health care professionals who all take different approaches and no one seems to know what to do. The docs here on this board I would include in my generalization of professionals who don't appear to really understand the issue.

Sorry docs.

There's a big difference between understanding the issue and being able to fix it.

I also don't know how you're defining "health care professionals" or who you're seeing. There is a very defined treatment protocol to treating lumbar disc radiculopathies. Sure, it can be improved and tweaked, but I would guess that 90% of legitimate "health care professionals" follow it. And it's pretty successful (some of that stems from the fact that this is usually a self-limited condition anyway). Sure, there will be refractory cases, but that doesn't mean we don't know what's going on.

[doctorcoug]

Most chronic back pain is bone and nerve, yes. Pain is a required part of my specialty and although I didn't do a fellowship in pain I have probably personally performed 100+ interventional procedures in the last 18 months.

You have fallen into the trap of defining the prevalence of disease based upon what you see in clinic. You should have said, "Most chronic back pain PRESENTING TO AN ANESTHESIOLOGIST is bone and nerve". The actual fact is pretty much what SJS summed up.

Let me take a page from your book...I see about 10 patients a day with back pain. I've sent 1 to an "interventionalist" in the last month (the only patient that got an MRI due to red flag symptoms). Only one patient due to "bones and nerves". Everybody else was muscle/connective tissue.

Lots of NSAIDs, reasonable amount of PT, fair amount of trigger point injections (hey, sooner, saline works just as well as lidocaine here), fair amount of OMM (for the acute back pains), no narcotics, and...NO x-rays! And...they all seem to get better; it is amazing what the tincture of time will do

[jay santos]

You have fallen into the trap of defining the prevalence of disease based upon what you see in clinic. You should have said, "Most chronic back pain PRESENTING TO AN ANESTHESIOLOGIST is bone and nerve". The actual fact is pretty much what SJS summed up.

Let me take a page from your book...I see about 10 patients a day with back pain. I've sent 1 to an "interventionalist" in the last month (the only patient that got an MRI due to red flag symptoms). Only one patient due to "bones and nerves". Everybody else was muscle/connective tissue.

Lots of NSAIDs, reasonable amount of PT, fair amount of trigger point injections (hey, sooner, saline works just as well as lidocaine here), fair amount of OMM (for the acute back pains), no narcotics, and...NO x-rays! And...they all seem to get better; it is amazing what the tincture of time will do

Just fyi, when I herniated my disk, I initially went to my family doc. He diagnosed me with a muscle strain, gave me a prescription for a muscle relaxant and sent me on my way. I didn't go back to him to tell him he diagnosed me wrong.

[doctorcoug]

Just fyi, when I herniated my disk, I initially went to my family doc. He diagnosed me with a muscle strain, gave me a prescription for a muscle relaxant and sent me on my way. I didn't go back to him to tell him he diagnosed me wrong.

Did you notice that I don't prescribe muscle relaxants? I treat those with OMM and they do come back, almost all of them, mainly to say "thanks".

[San Juan Sun]

Did you notice that I don't prescribe muscle relaxants? I treat those with OMM and they do come back, almost all of them, mainly to say "thanks".

"Give me my Soma and Percocets, dammit!"

Glad to see you back DC, I hope all is well.

[Mrs. Funk]

This might sound like a dumb question, but I have no background in this. Osteopath's are MDs, right? Is it better to see an osteopath than a chiropractor? I would think the osteopath would probably be more expensive, but like I said no background.

[SoonerCoug]

"Give me my Soma and Percocets, dammit!"

Glad to see you back DC, I hope all is well.

Where do you live? The only people I have ever seen on Soma live way out in the sticks.

[SoonerCoug]

This might sound like a dumb question, but I have no background in this. Osteopath's are MDs, right? Is it better to see an osteopath than a chiropractor? I would think the osteopath would probably be more expensive, but like I said no background.

Osteopaths are not MDs. Osteopaths are DOs. Osteopaths learn the same things that MDs learn in medical school, so they are licensed physicians. Chiropractors do not learn medicine.

[Mrs. Funk]

Osteopaths are not MDs. Osteopaths are DOs. Osteopaths learn the same things that MDs learn in medical school, so they are licensed physicians. Chiropractors do not learn medicine.

I see. I guess alternative medicine junkies (which I am not) would argue that it doesn't matter that chiros don't learn medicine. I would imagine the practice of an osteopath and a chiropractor would be very different as to modality and philosophy.

[San Juan Sun]

Osteopaths are not MDs. Osteopaths are DOs. Osteopaths learn the same things that MDs learn in medical school, so they are licensed physicians. Chiropractors do not learn medicine.

Pretty much what Sooner said, except that DOs get some training in musculoskeletal medicine that MDs usually don't get in medical school. Of course, my humble opinion is that DOs/MDs really need a good residency or fellowship to practice any kind of manipulation.