Posted by: Ticktock | December 29, 2008

Chiropractic Failure?

My wife’s ear was drowning in an infection.  She went to the doctor, who offered her a Z-pak antibiotic treatment, which didn’t immediately work.  Instead of going back to the doctor, my wife decided that she would switch gears and try the chiropractor.  I tried to warn her that she was wasting money, but my wife is strong-willed and independent.  She makes her own decisions, and I do not attempt to influence her other than some occasional teasing.

I told her to watch out for the word “subluxation” because that meant that her chiropractor would likely be applying treatments based on nonsense.  Sure enough, when she was in the waiting room, she noticed a poster saying something about subluxation and children.

The chiropractor saw my wife and did the appropriate adjustments, but my wife’s infected ear fluid didn’t suddenly pop or drain into her neck like she was imagining.  In fact, she didn’t notice any change at all.  After the treatments, the chiropractor had the nerve (and the common sense) to encourage her to visit an Ear Nose & Throat doctor, but of course, he would need to see her for more treatments also.

I told my wife that all my skepticism is rubbing off on her, and that placebos are ineffective on her now.  Then she punched me in the arm.

So, what is the deal with subluxation?  Why am I such a downer against back whackers?  Let’s start at the very beginning with the guy who made up the concept.  Yes, I’m talking about the uneducated grocer Daniel David Palmer, who created chiropractic medicine in 1865 after he claimed to cure a man’s deafness just by manipulating his spine.  Dr. Palmer believed in all kinds of funny treatments, including mesmerism, which had long since been debunked by Benjamin Franklin, and phrenology, which would soon be debunked by Mark Twain.

Palmer imagined the chiropractic theory around the same time that Louis Pasteur was making important scientific discoveries about germ theory.  We, of course, now know that many diseases come from germs, but at the time, the average doctor (grocer) was in the dark on most health problems.  So, Daniel David Palmer can be forgiven for believing that subluxations (spinal displacements) were the cure to 98% of all diseases.  That was a long time ago.  We can forgive him, and his abused son BJ, for making up such a silly concept.

But wait, many of today’s chiropractors believe the same nonsense.  They deny germ theory, they decry modern medicine, and they defy logic.  In fact, chiropractors are known to object to vaccination, and their objections are based on the archaic imaginings of a self-taught grocer who was put in jail for practicing without a license.

Most chiropractors still believe, without any scientific evidence, that subluxations are the root cause of most disease.  Ask them to scientifically explain how pinched spinal nerves cause disease, and they will probably sidestep the answer.  And yet, these chiropractic “doctors” are more ubiquitous than Starbucks.  I have at least three chiropractors within a five mile radius of my house.

The subluxation theory of disease is complete nonsense.  You would think that people with scoliosis would be terminally ill.  Or that terminally ill patients would have multiple pinched nerves in their spine.  And yet, there is nothing to show this to be true.  In fact, BJ Palmer had an extremely distorted spinal chord, and he was the early leader of chiropractic medicine.

Does that mean that all chiropractors are quacks?  No, I truly think they believe in the treatment, and a quack is someone who purposefully administers a treatment they know doesn’t work.  Chiropractic has been validated as a mode of treatment by our system of medicine, and many doctors will come here to point out that they are legitimate in the eyes of society.  However, that doesn’t change the fact that the concept is based on unscientific ideas such as subluxation and innate intelligence.  It also doesn’t change the fact that most chiropractors claim to cure problems that they can’t cure.  However, chiropractors will point out that they do help people with back pain and joint problems, and that many of these people feel relief and come back again for more treatment.

There are chiropractors that have separated themselves from the taint of the Palmer’s.  They do work that is more in common with physical therapy than complementary alternative medicine, and they call themselves “mixers”.  The chiropractors you want to watch out for are called “straights”.  There are a few warning signs to watch out for (located here) when choosing the best chiropractor.  The worst offenders are those “straights” that argue against fluoridation, vaccination, and pasteurization.   You may find some decent chiropractors at quackwatch’s referral directory, but in my opinion, you would just be better off seeing a physical therapist.

As always, I welcome any chiropractors whom I may have misrepresented to correct any mistakes I made against their character to leave comments.  They deserve to defend themselves if they can.

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Responses

  1. The Medical Profession have a few iatrogenic problems with antibiotics.

    http://www.herbdatanz.com/death_by_meds.htm

    Pastuers Germ Theory was brushed under the medical necropolis carpet a few years ago.

    ! in 4 American kids cant breath properly .. I wonder why?

    • The benefits of the medical profession far outweigh the risks. Dr. Novella answers this objection better than I could.

      I have no idea what necropolis carpet you are talking about, but if you are saying that there are no such things as germs than you have to work up a better argument than that.

      You wonder why kids can’t breath properly. What does that have to do with anything besides air quality? I’m sure you have a theory to enlighten us all. Be sure to prove it before you come back.

  2. Finally someone has written an article about the quackery of Chiropractic. The problem is that most humans are so ignorant that they can’t evaluate these types of things for themself and thus they fall prey to the back poppers and that ilk. Of course, the comments that will appear here will, for the most part, be from that great ignorant mass out there. Good article.

  3. Uhh…you mention some antiquated stuff from 113 years ago. Chiropractic has come a long way since then. Remember MD’s. sold snake oil. Surgeons were low level technicians. Don Pointer obviously is misinformed. He doesn’t really know about mechanoreceptors, golgi tendon organs and the like. How sad that this highly educated man is so close minded and critical about something he knows nothing about.
    Dr. Laureen Longo

    • My problem is with the chiropractors that believe in subluxation and those who deny the existence and influence of germs. You won’t find M.D.s who still sell snake oil, but you will find chiropractors that believe that most maladies can be cured by adjusting the spine.

  4. Very good point. It’s not that some of us deny the existence of germs, it’s that just because you come in contact with a particular germ doesn’t mean you’ll get the disease or infection attributed to it. The body does have an inate ability to heal itself in most instances, and we do have immunity. If this were not the case, doctors would get ill every time they came in contact with a patient with an illness. Some of us are genetically predesposed to certain illnesses. Spinal adjusting allows the body to concentrate on fighting illness, rather than focusing on battling the pain caused by inflammation, muscle strain, etc. Also, thoracic spine adjusting, alleviates muscle spasm, allowing the diaphragm to move more freely. This allows asthma and allergy sufferers to breathe better. It also improves exhalation, allowing the body to rid itself of inhaled toxins.
    Dr. Laureen Longo

  5. I tried to explain the truth behind chiropractics to my mother, a believer. I told her about the law of the regression towards the mean and how she has no way of knowing if her pain would have gone away in 4 weeks without treatment when she chose 4 weeks of treatment because she has no control for the experiement. Then she hit me with “well it works for me.” And that’s when I gave up because that’s the final retort I hear in discussions on prayer.

  6. If it were a viral infection then the antibiotic wouldn’t have any affect on it, would it?

  7. If you look at current research regarding back pain (search for author’s Tim Flynn, John Childs, et al. http://www.annals.org/cgi/content/abstract/141/12/920) most of the valid current research looks to the implementation of a clinical prediction rule to determine the best practice for addressing low back pain. This research that is published, is often published by a group of physical therapists.

    Spinal manipulation is a valid approach to address acute low back pain…however as the clinical prediction rule demonstrates a patient does not respond within 2-3 manipulations, they are considered a non-responder and treatment should progress with an exercise stabilization approach.

    This is one of the main downfalls of chiro’s…their attempt to manipulate a “specific” subluxation to correct a problem and feeling that only regular “maintenance” adjustments will ensure a healthy individual. Manipulation of the spine is a general approach without the ability to truly isolate individual segments. (blog.evidenceinmotion.com/evidence/files/does_technique_matter.doc)

    Next time a friend or family member decides they need to have their back looked at by a chiropractor, suggest an evidence based physical therapist (you can find a PT at http://www.apta.org) Specifically look for a physical therapist who specializes in manual therapy.

  8. You’r totally confusing two concepts. One that the spine get’s out of alignment from time to time, especially with trauma, and it can be pushed back into place making you feel, walk and move much better (absolute 100% true)with the airy fair chiropractic “cures all” stuff (not true). It’s almost as if you intentinally confuse the two just so you can dismiss all.

    Love your blog but you guys seem to almost fall into the fundamentalist category, it’s just that your fundamentalism is “science”.If you applied the same rigor to the stuff you like, most of it wouldn’t pass muster either. The world just doesn’t “test well”, meaning not all of life’s experiences can measured in a double blind study.

    If you had the experience of your right arm not moving full range for two months (I’m an athlete so I really notice these things)and you go to your chiropractor and she moves a few upper vertebrae and suddenly full range comes back you’d understand the undeniable logic and validity of it.

    To say if your bones are out of alignment it has no effect on your body movement it to deny everything we know about mechanics.If you car shimmied because of poor wheel alignment who you refuse to take it to those “quack mechanics” who thinks they can fix your car. I would hope not. That’s all that legitimate chiropractic does. It just get’s you back into place.

    Oh, and by the way, I from time to time tell my chiropractor to find whats wrong without giving her any clues. Just to test her. She tells me what she finds, moves the bones, and fixes my problem. She can do this because her decisions aren’t based upon “feelings” or what I tell her, but on measurable differences.

  9. Fundamentalists refuse to change their mind. We’re not fundamentalists because we are more than willing to change our minds, depending on the evidence presented.

    We use science and reasoning, so if something hasn’t (or can’t) be tested by science, we will apply reasoning and logic to the claim. If you have a better way to assess claims than scientific reasoning, you should share them with the class. Personal anecdotes neither prove nor disprove a claim.

    I think if you’ll look closely at this article, you’ll see that I do not condemn them with sweeping generalities, but I do say that they make claims that are not only unproven, but are consistently disproved. Let’s put it this way, I would not want to get my car fixed by mechanics that think cars are run on magic and that inflating my tires will fix my windshield wipers via this magic. It doesn’t matter to me if they can inflate my tires and change my oil properly if they still believe that my automobile runs on magic, and they claim to manipulate this magic to cure other things that they can’t actually cure.

    • Good analogy. I to believe the scientific method is the best overall method for finding truth. But it is also hindered and filtered through current assumptions, prejudices, cultural norms and the limits of technology. So what we prove to be right today may turn out to be completely wrong tomorrow. The two most recent examples are ulcers being caused by bacteria and a common cervical cancer being caused by a virus. This is quite shocking. So for decades people doctors have been treating ulcers completely wrong. Now they’re talking of immunizations against cervical cancer for young girls. Who knew? This is the self correcting results of the scientific method. It’s also why I take all science with a grain of salt.

      Only recently have scientists discovered antioxidants and how they affect cellular integrity. So what do people do with this information? They buy antioxidants extracts. Huh? Just eat the food. It also turns out that the supplements are largely useless because there are yet undiscovered properties in whole foods that allow us to use its full nutrient profile. You can’t just break apart the entire universe into little pieces and expect to find the truth about everything. Why do we laugh? Why do we think a Les Paul through a Marshal stack sounds warm? Why do we try to convince each other of our point? We simply don’t know and may never know. This however doesn’t negate these truths. Our collective experiences can create a narrative in which to describe the world.

      Personal experience are valid. Kick me in the shin and it hurts me. I don’t need it validated by a third party.

      Do calling people horrible names hurt their feelings? Most of the time, yes. But can you prove it. No. How can you prove your feelings are hurt. MRI?

      What I mean by fundamentalist is the total reliance on one methodology or line reasoning to explain everything. You can be a scientists and very logical and still be blinded by your allegiance to your methodology. I’m an atheist, for lack of a better word, but I don’t have any allegiance to it at all. It’s more of the sum of my experiences than any ideology. It doesn’t have any value to me.

      That’s all I’m saying.

      I just think your writing group sometimes drift into scientific fundamentalism. This is totally normal. I’m known to have my reactionary moments as well. When you discover that so many major decisions in the world are made from a place of prejudice and superstition and have little reasoning behind them it’s kind of unnerving.

      Anyway, love your blog. If I agreed with everything you said I’d be suspicious.

      Thanks

  10. Suppose chiropractors effectiveness relies on the same principles as all other forms of alternative medicine, the placebo?

    Suppose the chiropractors today are no longer trained in the art of healing but just the art of popping and snapping joints?

    We all know that placebo is difficult to explain and a major role in all alternative form of medicine.

    Suppose someone took all the gimmicks out of medicine and focused on perfecting the art of placebo in a manner that can stimulate an actual response consistently?

    I have developed such a method. I can’t explain it very well but I can prove it with ease. I can prove a person can cure themselves of any disease in a very short time frame even as little as two weeks.

    What form of science is their to validate my claims? Is there anyone or any group that researches claims of cures?

    I’m posting here to see if any of you are aware of any faction of science who is actually investigating claims of cures or at least interested in cures?

    Alternative Medicine is going to become less and less effective unless someone decides to investigate the truth. The truth is we are all designed to heal and cure diseases and again I can prove it without any products, any sales, any fees, any bills and most of all without any medicine.

    Anyone have any ideas on who I would contact to have cures validated?

  11. Straight Dope Dad:

    I wish I could find your chiropractor. Sometimes my back hurts, and someone else twisting, stretching, and rubbing it will make it feel a lot better. Massagers will do the rubbing, but not the manipulation. All but one of the physical therapists I’ve gone to don’t do any rubbing or manipulation- they have me do excercises, which do help, and I do them at home, but they aren’t always sufficient. I once found a chiropractor who did just what I needed- took x-rays, showed them to me, showed what was out of whack, did some adjustments, told me to come back in 3 days or so, and told me if 2 or 3 treatments didn’t do it then a different approach was warranted. Alas, he went out of business (probably from not overselling himself), and so now my back just hurts longer when I injure it.

    I wouldn’t fault this blog for throwing spinal manipulations for pain relief in with claims of chiropractic cures of infectious disease. It’s the chiropractors who do that. Or almost all of them. Which is a real pity, because skillful manual adjustment can (in my subjective experience) provide quick, cheap, effective pain relief. Or at least be a quick, cheap, effective placebo, and when my back hurts, I actually don’t care if it’s a placebo, as long as it’s effective. I can’t placebo myself.

  12. Speaking as someone who was a pre-chiro college student and firm believer at one time, I have seen every concept unique to chiropractic exploded simply by studying the field carefully. There is no science behind any chiropractic theories and philosophies, and it is harmful in that what little good a chiropractor can do in a few limited circumstances, ban be better practiced by medically educated professionals.

    Speaking as the husband of a woman who’s chance to return to work after many traumas to her spine were destroyed by a chiropractor, before my own eyes, I warn anyone who will listen that chiropractors are ineffective as health care “professionals”, and can be dangerous in their ignorance of anatomy, physiology, the disease process and sciences in general.

    Chiropractic schools stress to their students the importance managing a practice, and attracting and keeping clients returning, supporting and perpetuating the advancement chiropractic propaganda and the schools that depend on their success.

  13. My mother’s family has always been very into chiropractics, so I gave it a try. I immediately realized that it is just as reliable as prayer.

    I left in more pain, was told it would improve with time, and then when it just got worse and worse I was told that I needed to have regular treatments to make it better. LOL


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