I am often asked my opinion of chiropractic care. My usual answer (based on evidence) is that it can be somewhat helpful in the treatment of low back pain. That’s it. Any further claims are complete and utter bullshit. Many chiropractors practice ethically, and recognize the correct scope of their abilities…many do not.
Adapted from RationalWiki
Chiropractic is the theory and practice of correction of “vertebral subluxation processes” to treat and cure disease. It was developed in the late 19th century, just before the development of modern medical education in the United States.
Chiropractors subscribe to the theory of “vertebral subluxation”. This differs from the medical definition considerably. An orthopaedic (real) subluxation is a painful partial dislocation of a vertebral body. A “chiropractic subluxation” is an asymptomatic misalignment or a “vertebral subluxation complex” thought to be a cause of disease. The mechanism posited is usually the blocking of nerve impulses from spinal roots, or some such nonsense. Such a subluxation has never been proven to exist.
Lest you think that this unproved hypothesis has died away, in July 1996, the Association of Chiropractic Colleges issued a consensus statement that:
Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation. A subluxation is a complex of functional and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.
This hypothesis has never been tested, and ignores significant anatomical reality, such as the fact that much of the nervous system does not pass through “subluxations” in any way. This especially applies to the autonomic nervous system that “influences organ system function”.
According to the American Chiropractic Association:
The ACA Master Plan, ratified by the House of Delegates in June 1964 (Amended June 1979, June 1989, July 1994 and September 2000), and will govern future policies of ACA as quoted:
“With regard to the core chiropractic principle, which holds that the relationship between structure and function in the human body is a significant health factor and that such relationships between the spinal column and the nervous system are highly significant because the normal transmission and expression of nerve energy are essential to the restoration and maintenance of health.
That’s basically a re-statement of subluxation theory without the “s” word. It’s also patent bullshit.
So the chiropractors haven’t given up the absurd theory behind their “profession”—but does it work despite the poor theory? After all, outcomes are what count.
For back pain, there is evidence that chiropractic therapy may be as effective back exercises plus anti-inflammatory medications. Chiropractic has also been found to be slightly more effective than simply handing a patient a book about back care. In some studies, chiropractic did cost more overall. Specifically, a study comparing outcomes of acute low back pain treated by orthopedic surgeons, primary care physicians (PCP), and chiropractors found similar outcomes, but less cost from PCPs.
While 50-60% of patients who seek chiropractic care do so for back or neck pain, a significant number are treated for other problems. There is no evidence to support the use of chiropractic outside the realm of minor musculoskeletal complaints. Chiropractors who make any claims beyond low back pain are either dishonest, ignorant, or both. There is some evidence that (rarely) chiropractic care can cause stroke, carotid artery dissection, and other life-threatening problems.
Chiropractic may have a place in the treatment of low back pain—or it may not. Chiropractors are basically glorified massage therapists—except many massage therapists have better training, and know the limits of their profession. Chiropractors who discourage real medical care, vaccinations, and medications, or sell herbs and other potions out of their offices should be ashamed of themselves.
But of course, they have no shame.
————
References
March 18, 2008 at 4:25 pm
How can something be bullshit yet at the same time be “as effective as medicine plus exercise” for acute lowback pain?
March 18, 2008 at 4:39 pm
Because dangerous chiros pretend they have significantly more biological and medical training than they really have. This leads to chiros bellowing bullshit like vaccines are useless and that chiros can treat allergies and that ‘manipulating’ infants is safe, etc– Behaviors that are not discouraged by major chiro organizations.
March 18, 2008 at 4:47 pm
You are an expert on chiropractic training?
March 18, 2008 at 5:00 pm
Apparently more of an expert than you.
http://www.chirobase.org/06DD/chiroimmu.html
March 18, 2008 at 5:02 pm
Peter is back to the one thing that chiros do that can be useful, then hoping it justifies everything else. It does not, nor is spinal manipulation uniquely chiropractic. Many health professionals (PTs, DOs, etc.) do it too. In fact, masseurs can do as well in many cases.
“Chiropracty” is not effective for low back pain, “manipulation and massage,” sometimes provided by chiros, are what work.
March 18, 2008 at 5:05 pm
All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident. Arthur Schopenhauer
March 18, 2008 at 5:09 pm
You have now succumbed to the Galileo Fallacy. To wear the mantle of Galileo, it is not enough to be persecuted; you must also be right.
March 18, 2008 at 5:10 pm
@Peter
You appear to have failed to read the post properly. PalMD stated that: “My usual answer (based on evidence) is that it can be somewhat helpful in the treatment of low back pain. That’s it. Any further claims are complete and utter bullshit.”
So don’t attempt to frame his argument as “all chiropractics are talking bullshit”.
Martin
March 18, 2008 at 5:11 pm
Joe: since we are taking about training how many hours of spinal manipulation instruction did you recive in PT school? How many hours do they get in DO school?
March 18, 2008 at 5:12 pm
*gets popcorn, sits back to watch Peter’s “debate” unfold*
March 18, 2008 at 5:13 pm
Peter, I can’t have sex with Antarctic Krill, nonetheless I can do a very good job researching how successful they are.
March 18, 2008 at 5:16 pm
So come on Peter, what training do you have? Do you think chiropractors can cure allergies? Can you give us the results of a study that proves it?
March 18, 2008 at 5:28 pm
Peter wrote “Joe: since we are taking about training how many hours …”
Don’t make it personal. Stick to data. Do chiropractors spend FOUR years in school just learning how to massage people with low back pain?
Why not take this over to:
http://www.skeptics.org.uk/forum/forumdisplay.php?f=6
where you can try to argue with Blue Wode, and me, without wasting PalMD’s time and space. On that forum, you can post a claim for chiro, and the best support for it, and see what happens.
March 18, 2008 at 7:05 pm
No,no, this is fun…
March 18, 2008 at 7:59 pm
PalMD writes “No,no, this is fun…” Very well, I did not want to hijack your blog; but, I am not doing you a favor if I am not suggesting something that you wish.
Thanks for your blog, Pal, I visit few forums/blogs; but yours in on my regular list, now.
March 18, 2008 at 8:15 pm
I write, as most writers do, to satisfy ego, so responses feed that. However, I also write to educated, and the discussion fulfills that purpose.
March 18, 2008 at 9:02 pm
Is Peter your resident troll, or is this just his thing?
Peter, no I am not an expert on chiro training. Im an expert on viruses (please see my blog). The anti-vax movement is rife with chiros.
And, DOs are not a relevant comparison. DOs must pass the same boards and do the same residencies as MDs (in ADDITION to their extra training). If they fail at one of those steps, they fail as a physician. Chiros do not man local ERs or family medicine clinics. They cannot do what physicians do. They cannot do what PhDs do. Yet dangerous DCs try to pretend that they are >MD+PhD.
Why would you defend that?
March 18, 2008 at 9:45 pm
This is cross-posted from SBM, but it’s relevant. These are 2 experiences that I have had in my life where chiropractic worked when the “real doctors” were complete idiots.
When I was about 3 (or so I was told), I suddenly couldn’t walk. I couldn’t put pressure on one leg. It’s a condition that many people have, though I don’t if there’s a specific name (probably just bursitis), but basically my hip needed to “pop.” It still happens occasionally now. However, I was too young to know what was wrong, so my parents took me to a doctor. They wanted to do surgery to draw off the fluid. My dad said, “I don’t think so,” and took me to a chiropractor who popped my hip, and I ran down the hall back to the waiting room.
Then, about 3 years ago, I was having a strange headache from the right side of my forehead to the base of my skull after making a 12 hour drive. It had lasted for weeks. I ended up in the ER for what turned out to be cough syncope (my first time fainting, and it freaked me out), and asked the doctor about it, worried that they might be related. He wasn’t interested in figuring it out.
Then I went to the Student Health Center just for the headache, telling them that I was taking 1000 mg of ibuprofen and tylenol and neither was even touching it, and the NP wrote me a prescription for….800 mg of ibuprofen. W…T…F? I made a second appointment, asking to see a real doctor, but in the meantime, went to see a chiropractor. My experience with sciatica led me to believe that it could be a pinched nerve, and I was quite pissed with the medical establishment’s unwillingness to find out the problem instead of writing a prescription and sending me on my way. He said he thought it was my C1 vertabra, popped my neck, and it was like someone took my headache and drove a spike through it. The next day though, the headache was gone. I went for the appointment and told the doctor that story and then what I thought of his colleagues. They took x-rays and found nothing of course, but I didn’t care. My headache was gone thanks to the chiropractor.
Now, who were the hacks in those cases? I admit that most chiropractic is woo, and that they’re not doing themselves any favors by continuing in ignorance (I heard the chiropractor that fixed my headache talking about someone having “stomach influenza”), but many SBM practitioners aren’t doing themselves any favors either by being shown up by a chiropractor and then saying that chiropractic is all crap.
March 18, 2008 at 11:39 pm
I’m afraid I side with the scientific evidence here - and anecdote, whether fascinating or not, is simply of lower evidence than randomised controlled trial. Especially double-blind RCT. So the stories from Egaeus are lovely, but unconvincing.
From memory, the chiropractic manipulation recognised as having some evidence supporting its use in acute low back pain for the first six weeks only, is low velocity thrust. There are a number of other health professionals such as physiotherapy and even some manual medicine medical doctors who are trained to deliver this technique. However, that is as far as it goes for evidence to support the use of manipulation of any type for acute low back pain. And most chiropracters and osteopaths recognise this, it’s just those that would like to expand their practice to areas outside where the evidence has been demonstrated that I get qualms over…
What is recommended for ALBP? Good analgesia, assessment to ensure red flags are identified and managed appropriately, appropriate temporary modification of activities, and gradual return to normal activity. Medics and other health professionals can assist by providing appropriate reassurance.
And that is that. No magnetic underlays, no laying on of hands, no copper bracelets, no coloured lights, no electricity, nothing. It gets better gradually, grumbles away for ages, returns very often, and is normal. As normal as a tension headache, or dehydration headache.
March 19, 2008 at 8:13 am
The plural of anecdote is not data, as somebody once said and I love repeating.
Having said that, anecdotes like the above are often revealing in other ways. For example, one of the points noted in the recent antidepressant meta-study was that roughly 50% of the effect of pain-killers is accounted for by the placebo effect. Now, headaches and back pain often have a strong psychological component to them, so if you’re already convinced a treatment won’t work, it probably won’t.
I don’t see what on earth popping the neck would have, clinically, to do with a headache. But in terms of psychology, if it feels like the chiropractor has done something major, the patient is more likely to feel a placebo effect. I’m sure the procedure probably also causes a bit of a rush - my hands always feel good when I click my fingers.
In that respect, it seems a bit like the current “Cupping” and blood-letting craze in Iraq (http://layscience.net/?q=node/62).
Going further into the psychology, the “I don’t think so” comment in relation to what you can hardly call surgery is telling, as it implies the parent had an irrational fear of medical treatment. No doubt that can be passed down to impressionable children.
Regarding hip “popping”, bursitis is an inflammation of tissue in the joint, leading to a massive accumulation of fluid, leading to a prominent lump. “Popping” a joint would have precisely zero effect on it. If anything, it would aggravate it. If you had bursitis, anti-inflammatory drugs and fluid drainage would be the way to go. Ultimately though, you have no idea what happened when you were 3 years old.
March 19, 2008 at 10:07 am
I don’t know what the condition is called. I am not a doctor. However, I am probably wrong about the bursitis, since my shoulder bursitis is unaffected by any popping that goes on. I simply know that it STILL HAPPENS. Did you read that part? Infrequently something goes “wrong” and I can’t put pressure on my leg until the hip pops. It happens on both sides, and is quite painful, but it doesn’t require surgery to fix.
A 2-month headache in one area of the head is not going to be affected by a placebo when most of a large bottle of ibuprofen has failed. I have sciatica. I know what a “pinched” nerve feels like. When my neck popped, something in my neck (not my head) moved, and the pain was magnified intensely. I was regretting it until the pain was gone the next morning.
I am not a believer. I don’t believe in god, UFOs, ghosts, bigfoot, *or* homeopathy. I’ve taken a few SSRIs for moderate depression in the past and the only effect I noticed was an upset stomach (except for Lexapro, which worke). I’m not prone to the placebo effect.
I am sure that there was a perfectly evidence-based way of fixing the problem in my neck that was causing the headache. However, a series of incompetent and/or uncaring evidence-based practitioners made me look elsewhere.
Don’t think I’m singling out doctors. I just thing that most of the ones that I’ve been to are just as incompetent as the rest of the population. It’s not just those incidents. How about the NP who thought my reported wheat-induced diarrhea was due to fiber (an MD corrected him and sent me to a gastroenterologist who diagnosed celiac disease)? Or the ER doctor who stitched up my cut finger, poked around, and said, “I don’t see any tendon damage.” I had mallet finger because the top tendon was completely severed. It took 2 *additional* doctors to look at it before I finally got sent to a hand specialist, who needed about 15 seconds to diagnose what I had been telling the doctors. Shall I go on?
Doctors are body mechanics. This is not an insult, but a simple statement of fact. Unfortunately the machine is very complicated and is still being figured out. It takes some shopping around to find a good one, and I *think* I have finally succeeded.
And again, don’t worry, I’m not singling out one profession except to the extent that my well-being depends on them, and I’ve been exposed to them reasonably often. I’m an electrical engineer and saw plenty of people get out of school and get great jobs who couldn’t tell the difference between voltage and current. It’s the human condition, and unfortunately, doctors are not immune.
I also don’t think that chiropractic has all the answers (or many at all), but sometimes they are right, even if they don’t really know why. I would prefer that doctors would have fixed my neck/head problem, but they just wanted to give me a prescription for something that I had already tried with zero results.
March 19, 2008 at 11:33 am
Let’s talk about the chiropractors who cause carotid artery dissections (potentially fatal) by their “adjustments” of the neck.
I, too, will grant that their manipulations can sometimes relieve pain for individuals. Unfortunately, anyone who tries to treat metabolic problems or other systemic illnesses with manipulation of the spine is a major quack, pure and simple.
To me, chiroproactors drive repeat business for themselves by doing the very thing that makes someone a habitual knuckle-cracker. Sure, there is relief in getting one’s back “popped/adjusted/cracked” - they’ve basically created an addict. How is that a professional service?
March 19, 2008 at 12:35 pm
If they stick to what their own Society states that they do best (helping people through ACUTE low back pain), everything would be fine.
Who wouldn’t want a good stretch and “adjustment” when the back is in spasm?
Leave the treatment of allergies, high blood pressure, asthma and infections to others.
March 19, 2008 at 1:27 pm
Why do people expect doctors to know exactly what’s wrong with them and fix it immediately the first time they see one? And if that doesn’t happen the doctor is somehow an “idiot” or a “quack.” Are doctors somehow infallible because they went to med school and completed a residency?
March 19, 2008 at 2:16 pm
If you actually read what I wrote, it wasn’t the lack of diagnosis, it was the lack of sense, and the lack of trying to find a diagnosis.
A patient walks in, says, “I have had a headache for 2 months in a specific spot on my head. I’m taking 1000 mg of ibuprofen every 4 hours, but it doesn’t help at all.” Is a prescription for 800 mg ibuprofen appropriate?
A patient walks in and says, “I’ve tested it methodically, (describe test diet), and every time I eat wheat, I get the runs. I think I might have some kind of wheat allergy.” Is “it’s probably the fiber” an appropriate response?
A patient walks in with a clean slice across the knuckle about 1/3 of the way through. Is it not expected that a severed tendon should be noticed and/or expected? Afterward, is mallet finger that hard to diagnose? “Look, doc, I nearly cut my finger off, and now I can’t bend the tip of my finger back. I think I might have a severed tendon” How freaking difficult is that?
I’m not asking that doctors and NPs be magicians and be able to diagnose every single condition immediately. I’m smart enough to know that’s impossible. I’m also smart enough to recognize basic competence, and those 3 anecdotes (simply the worst of my experiences) are the opposite of that.
March 19, 2008 at 4:24 pm
You are taking a critical look at alternative claims - I just wish you would have the same critical look at conventional medicine!
I am not a friend of chiropractice (I hate the popping sound and the feel!), but in Germany (where I am originally from) chiropractors are a respected part of the health profession. Patients can use that modality and don’t have to fear their doctor ridicules them for it.
Don’t the many studies contradicting each other, scores of unhappy patients, the 100.000 patients who die each year of medications, the 20.000 that die of surgery (rough numbers only - don’t cite me for that!) give you a break thinking?
I prefer natural herbs and handed-down cures from my grandmother over many conventional ones. And I am, like you, a board-certified internist.
Alexa Fleckenstein M.D.
March 19, 2008 at 4:46 pm
Even M.D.’s can be immune to reality. What you (or I) “prefer” doesn’t really matter. What the evidence shows does.
For colds, bubbie’s advice goes a long way. For hypertension and diabetes, not so much.
See this.
March 19, 2008 at 6:25 pm
Alexa … where to begin…? The reason you know the numbers harmed by medicine is because health professionals are studying and reporting the problems in the hope they can be corrected.
Is there any similar program in the CAM community? (Hint- No). When we became aware that chiros cause strokes- they vigorously denied it. When ephedra was known to cause heart attacks and stroke, the manufacturers denied it (while paying wrongful-death suits so they could continue to profit from the “natural” product).
Also, keep in mind that the medical profession sees, and treats, the really unhealthy segment of the population. If they only treated the worried-well, as quacks tend to do, their record would be better.
Unhappy patients are not necessarily poorly-served, they are just unhappy. People may be happier seeing a quack; that does not mean they are healthier.
Are “natural” herbs different from herbs? The term “natural” is for marketing, it does not really mean anything. You should read the book “Natural Causes”
http://www.amazon.com/Natural-Causes-Politics-Americas-Supplement/dp/0767920422/ref=sr_1_1?ie=UTF8&s=books&qid=1205968247&sr=1-1
The title refers to people who were harmed (even, seriously dead) from taking “natural” products.
Yeah, even MDs can be immune to reality. Maybe, you can do better.
March 20, 2008 at 5:39 am
@ Alexa Fleckenstein M.D.
“I am not a friend of chiropractice (I hate the popping sound and the feel!), but in Germany (where I am originally from) chiropractors are a respected part of the health profession. Patients can use that modality and don’t have to fear their doctor ridicules them for it.”
In view of the following, it’s surprising that German chiropractors command that level of respect.
From an open letter published in Dynamic Chiropractic, 17th December 2005:
“My name is Gordon Janssen. I am a chiropractor in my home country of Germany. As many probably know from previous articles, chiropractic is not considered a profession, but a type of therapy in Germany. Therefore, lay practitioners and medical doctors, with minimal training in chiropractic techniques, are allowed to legally practice “chiropractic.”"
http://www.chiroweb.com/archives/23/26/15.html
From a thread posted at Chirotalk on 6th August 2007:
“Germany is one of those countries in Europe which has yet to pass legislation to recognize and regulate the practice of chiropractic. Our colleagues in the GCA (German Chiropractic Association) are fighting to achieve that goal, in the difficult environment where many lay practitioners and medical doctors are claiming to provide chiropractic services.”
“…Gordon Janssen, DC, a Palmer graduate and a board mem-ber of the German Chiropractors’ Association…insists that to become a lay practitioner in Germany, a person only needs to “finish the 9th grade in school, have no infectious disease, have committed no crime in the past and he/she must pass a test to show they are not a ‘threat to public health.’”
http://chirotalk.proboards3.com/index.cgi?board=leadership&action=display&thread=1186385194
March 26, 2008 at 1:42 am
Sometimes anecdotal evidence counts more than traditional scientific evidence when it comes to healthcare. PalMD can criticize the subluxation theory as there is little scientific evidence to support it (which doesn’t mean there is some truth to it). What matters is whether or not the patient is experiencing benefit whether it comes in the form of less pain, less frequent pain or other symptoms, improved movement and so on.
The majority of chiropractors (me being one) are quick to refer patients out for medical tests when the situation warrants it; for example signs of aneurysms, cancer, MS, fracture, etc. The fringe chiros are the ones who are more likely to overlook dangerous conditions.
When criticizing chiropractic or other forms of alternative healthcare it’s best to look at the big picture. The fact of the matter is that medical care has serious limitations, and is much more dangerous than chiropractic. And it can be argued that much of medical care is NOT scientifically based. Sure, drugs are designed in a “science lab” using standard scientific equipment and calibrations, but what about the drug’s effect on a disease process? It’s a hit and miss. The “side effects” of drugs are in fact effects. Antibiotics are routinely prescribed by MDs for viral infections. Vaccines are guesswork; viruses mutate making them useless. And that’s just the tip of it. Here’s a link that supports what I’m saying:
Death by Medicine
Here’s an exerpt from it:
“The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is an astounding 783,936 per year. It is now evident that the American medical system is the leading cause of death and injury in the US. (By contrast, the number of deaths attributable to heart disease in 2001 was 699,697, while the number of deaths attributable to cancer was 553,251.5)”
March 27, 2008 at 1:54 am
Yo Dan,
Can you tell us what your ilk do (that is useful) that cannot be done by a masseuse, or a real health professional?
March 27, 2008 at 9:54 am
In the realm of feelings, yes. In the realm of evidence, no.
I think the fact that 1. There is virtually no biological plausability for subluxation theory and 2. That there is very little scientific evidence to support it kind of precludes it from having even “some truth to it”.
I think you’d be hard-pressed to find anyone disagreeing with you, but given the paucity of evidence, there is very little reason to believe that chiropractic is of benefit except in the case of lower back pain. You can dress the profession up with pretty anecdotes, but I think I’ll trust the numbers more than pretty words.
I’m glad you’re not one of “those” fringe chiros. I’ll hold out judgment on whether you are actually fringe or not.
1. It would behoove you to explain what those limitations are. And be careful, because I bet much of what you say will be grounded in misconception and fallacy.
2. Given that nearly all medicine is at least grounded in the cumulative knowledge of human biology and physiology, I would certainly say it’s more scientific than chiropractic.
Please clarify this.
I think this is obvious to anyone with half a brain. It’s why physicians have pharmacology training, you know?
I think you’ll find many an MD decry this, also. This is hardly a black mark against medicine.
If you’re talking about the influenza vaccine, it’s not “guesswork”. It may not protect against all strains, but it does protect against some. I hardly think that’s useless by any means. As for other vaccines, I would suggest that you provide an academic source.
This is perhaps an example of twisting “statistics” to prove a pre-conceived bias. Just looking at the article’s statistics (which is prettily sourced to make it look legitimate), there are several glaring flaws. Forgive me if I don’t look at all of the sources individually. I don’t have time.
Problem 1: Nearly all of the numbers come from different studies. It does not seem to take into account the differences in categorizing cause of death across studies or how the data was collected.
Problem 2: Given the previous problem, not all of the causes of death are mutually exclusive. For instance, separating out “bedsores” from “infection” is problematic given that the reason people die from bedsores is because of infection. Separating “medical errors” from categories such as “adverse drug reactions”, “surgery-related”, and “outpatient” would be rather hard, further calling into question their count. I could go on and on and on dissecting their table (perhaps you didn’t see it?), but I think you get the point.
Problem 3: In saying medicine “kills more people”, what’s the alternative? “Conventional” medicine as a whole takes care of much sicker patients than you will ever see, Dan. You won’t even see a chiropractic ICU, where I would guess a significant portion of nosocomial infections come from. And, if this number were true, one would have to compare the price of not treating the various conditions “conventional” medicine treats to the price of iatrogenic effects.
Problem 4: I find it very telling that at the top of the page, it says this: “Life Extension is a global authority on health, wellness and nutrition as well as a provider of scientific information on anti-aging therapies. We supply only the highest quality nutritional supplements, including minerals, herbs, hormones and vitamins.” Conflict of interest? I think so.
March 27, 2008 at 10:02 am
Okay, I’m going to fix my previous comment. I used “<” to delineate quotes, so they ended up being swallowed up.
Sometimes anecdotal evidence counts more than traditional scientific evidence when it comes to healthcare.
In the realm of feelings, yes. In the realm of evidence, no.
PalMD can criticize the subluxation theory as there is little scientific evidence to support it (which doesn’t mean there is some truth to it).
I think the fact that 1. There is virtually no biological plausability for subluxation theory and 2. That there is very little scientific evidence to support it kind of precludes it from having even “some truth to it”.
What matters is whether or not the patient is experiencing benefit whether it comes in the form of less pain, less frequent pain or other symptoms, improved movement and so on.
I think you’d be hard-pressed to find anyone disagreeing with you, but given the paucity of evidence, there is very little reason to believe that chiropractic is of benefit except in the case of lower back pain. You can dress the profession up with pretty anecdotes, but I think I’ll trust the numbers more than pretty words.
The majority of chiropractors (me being one) are quick to refer patients out for medical tests when the situation warrants it; for example signs of aneurysms, cancer, MS, fracture, etc. The fringe chiros are the ones who are more likely to overlook dangerous conditions.
I’m glad you’re not one of “those” fringe chiros. I’ll hold out judgment on whether you are actually fringe or not.
When criticizing chiropractic or other forms of alternative healthcare it’s best to look at the big picture. The fact of the matter is that medical care has serious limitations, and is much more dangerous than chiropractic. And it can be argued that much of medical care is NOT scientifically based.
1. It would behoove you to explain what those limitations are. And be careful, because I bet much of what you say will be grounded in misconception and fallacy.
2. Given that nearly all medicine is at least grounded in the cumulative knowledge of human biology and physiology, I would certainly say it’s more scientific than chiropractic.
Sure, drugs are designed in a “science lab” using standard scientific equipment and calibrations, but what about the drug’s effect on a disease process? It’s a hit and miss.
Please clarify this.
The “side effects” of drugs are in fact effects.
I think this is obvious to anyone with half a brain. It’s why physicians have pharmacology training, you know?
Antibiotics are routinely prescribed by MDs for viral infections.
I think you’ll find many an MD decry this. This is hardly a black mark against medicine.
Vaccines are guesswork; viruses mutate making them useless.
If you’re talking about the influenza vaccine, it’s not “guesswork”. It may not protect against all strains, but it does protect against some. I hardly think that’s useless by any means. As for other vaccines, I would suggest that you provide an academic source.
And that’s just the tip of it. Here’s a link that supports what I’m saying:…
This is perhaps one of the best examples of twisting “statistics” to prove a pre-conceived bias. Just looking at the article’s statistics (which is prettily sourced to make it look legitimate), there are several glaring flaws. Forgive me if I don’t look at all of the sources the article uses individually. I don’t have time.
Problem 1: Nearly all of the numbers come from different studies. It does not seem to take into account the differences in categorizing cause of death across studies or how the data was collected.
Problem 2: Given the previous problem, not all of the causes of death are mutually exclusive. For instance, separating out “bedsores” from “infection” is problematic given that the reason people die from bedsores is because of infection. Separating “medical errors” from categories such as “adverse drug reactions”, “surgery-related”, and “outpatient” would be rather hard, further calling into question their count. I could go on and on and on dissecting their table (perhaps you didn’t see it?), but I think you get the point.
Problem 3: In saying medicine “kills more people”, what’s the alternative? “Conventional” medicine as a whole takes care of much sicker patients than you will ever see, Dan. You won’t even see a chiropractic ICU, where I would guess a significant portion of nosocomial infections come from. And, if this number were true, one would have to compare the price of not treating the various conditions “conventional” medicine treats to the price of iatrogenic effects.
Problem 4: I find it very telling that at the top of the page, it says this: “Life Extension is a global authority on health, wellness and nutrition as well as a provider of scientific information on anti-aging therapies. We supply only the highest quality nutritional supplements, including minerals, herbs, hormones and vitamins.” Conflict of interest? I think so.
March 31, 2008 at 11:02 pm
Rick,
I’ll try to address your responses, but I have little time.
I’d say that “subluxation” is a model that simply suggests a relationship between structure and function in the human body; and in chiropractic terms, structure refers to the spinal column. An extreme example is childhood scoliosis which can hinder respiratory function. Now, can spinal adjustments help asthma and ear infections? Maybe in some cases. Sure there may not be many double blind studies, but you will find a substantial amount of case studies in the literature.
Regarding vaccines, I’ve come across studies (by MD researchers) that:
1) the vaccine did NOT increase the patient’s antibody count post-vaccination (it’s a study recently done in Japan, you can look it up in PubMed), and
2) vaccines may be linked to excitotoxins and neurogenerative disease (Dr. Rosedale, anti-aging specialist).
My understanding of vaccine manufacturing is that a consortium of infectious disease experts across the world attempt to guess which viral strain will be most prevalent for a particular flu season. Once the strain is “decided” by consensus, the vaccine is made. I’ll admit that I haven’t researched this personally, but it seems to make sense.
I’ll give you the arguments about the stats in the Death by Medicine article. I believe you are arguing that some cases were counted more than once (bedsores, infections). But even if 1/3 of this number were double counts, the # of deaths from medicine are still staggering. Let’s not forget the cases that were missed in this count, too, which by interpolation could be tens of thousands more.
The problem I have with medicine is that there is a conflict of interest between the pharmaceutical companies and physicians. Big Pharma funds many drug research projects; or their lobbyists and consultants sit on the FDA board and influence a drug’s FDA clearance. Such is the case of Vioxx, which was shown to have an unacceptable adverse reaction rate (heart failure). Now we have the drug lobbyists trying to get the FDA to make cervical cancer vaccines mandatory for young girls! We’re seeing that statin drugs damage heart tissue by depleting CoQ10 stores, and may also be causing neurodegenerative disease (cholesterol is key component of cell membranes– take too much away and you have problems). It’s best to avoid having to take medicine in the first place by making changes in lifestyle habits, but there’s no money in that.
April 2, 2008 at 9:34 pm
Dan,
In response to your defense of chiropractic:
You can cite case study after case study after case study, however, the biological plausability of many of the “structure-function” claims that chiropractic makes is virtually nil. Just because you say chriopractic “can” help (without any cited proof, I might add) with asthma, etc. does not mean it justifies chiropractic’s use as a comprehensive health system when “conventional” medicine already has the pathophysiology and treatment down pat.
As far as your scoliosis example is concerned, the respiratory defect associated with scoliosis is not due to “subluxations”. Due to the spine being laterally curved (not subluxated, curved), this affects the shape of the chest, resulting in a restricted pulmonary function by hindering lung expansion.
Now, to address the two studies:
1) The only study I found that matched your criteria was in Vaccine, and it addresses the immunogenticity of the flu vaccine in infants and further states that the flu vaccine has been known to have poor immunogenticity in children anyway. Not to mention this was only one type of the flu vaccine.
2) I wasn’t able to find your second study in pubmed. Some superficial research on Ron Rosedale seems to paint him as a “diet guru”. This already brings him into suspect. For some reason, I doubt that this “study” was peer-reviewed.
I’ll give you the arguments about the stats in the Death by Medicine article. I believe you are arguing that some cases were counted more than once (bedsores, infections). But even if 1/3 of this number were double counts, the # of deaths from medicine are still staggering. Let’s not forget the cases that were missed in this count, too, which by interpolation could be tens of thousands more.
The number is staggering, yes, but
1) I cannot begin to trust the article as it was written for a website that hawks nutrition supplements. Conflict of interest much?
2) This was not peer-reviewed.
3) Again, the “funny” statistics calls into question the entire basis of this “article”. It looks like they just looked up a whole bunch of studies, pulled numbers and added them up. They give no indication of whether or not the studies are compatibile with being added in such a way, which were estimates, etc. Without the peer review process, I cannot begin to even trust that they considered this.
It’s also rather convenient how many articles it cites because it discourages fact-checking. I wouldn’t be surprised if they distorted the data in the articles.
Lastly, you can complain about “death by medicine”, however, again, what’s the alternative? What would happen if we completely get rid of “convential” medicine? Of those who died from surgery complications, what proportion required the surgery to keep living? Of course, this is completely ignoring the fact that the number is in all likelihood horribly distorted.
The problem I have with medicine is that there is a conflict of interest between the pharmaceutical companies and physicians.
And you don’t think we haven’t thought about this? I was recently at an AMSA conference in Houston, and there is a huge movement of medical students who want to remove this conflict of interest. Not to mention the large number of physicians supporting this cause. We even had an editor from JAMA speak about this, and she is heavily against this conflict of interest. I consider myself pharm-free.
This is not a problem with medicine per se. I could point out plenty of conflicts of interest within the “alternative” health field, but, then again, this seems to be ignored.
Big Pharma funds many drug research projects
Again, this has been talked about ad nauseum. And, again, this is a problem. Does this make medicine worse than using unproven and implausible methods? No. While the conflict of interest is troubling and there should be a way to mediate it (like laws giving researchers independence to publish negative studies and the inability of drug companies to screen papers before allowing them to be submitted). However, where else would the money come from?
or their lobbyists and consultants sit on the FDA board and influence a drug’s FDA clearance
See prior comments.
Such is the case of Vioxx, which was shown to have an unacceptable adverse reaction rate (heart failure).
Of course, this isn’t a failure of “conventional” medicine. This is a failure of regulation and honesty within the pharmaceutical industry. And, frankly, the whole Vioxx story is a lot more complicated than what you presented.
Now we have the drug lobbyists trying to get the FDA to make cervical cancer vaccines mandatory for young girls!
I don’t like the conflict of interest, either, but that doesn’t mean it’s a bad idea. HPV isn’t really a virus of “whores” or those who are promiscuous.
We’re seeing that statin drugs damage heart tissue by depleting CoQ10 stores, and may also be causing neurodegenerative disease (cholesterol is key component of cell membranes– take too much away and you have problems).
Cite reputable references, please.
It’s best to avoid having to take medicine in the first place by making changes in lifestyle habits, but there’s no money in that.
And how is this the sole domain of CAM? This is ignoring the glaring assumption that conventional medicine doesn’t address this.
June 16, 2008 at 1:03 pm
At some point we need to be honest and demand the same measure of effectiveness applied to supplements as to drugs - which would likely crush the supplement industry. Similarly the same standard of effectiveness should be applied to “alternative” practitioners (whether in physical or mental health fields).
The market would quickly sort out the wheat from the chaff and our overall provision of healthcare to the populace would improve.
July 5, 2008 at 5:05 pm
Wait, so it doesn’t improve immune function? I want my $35 bucks back.
July 25, 2008 at 5:49 pm
I’ve been a chiro for 30 years now and have come to one realization about the medical profession. They seem to know a lot about disease and nothing about health. Who trains you people anyway? We could probably train a monkey to hand out analgesics, antidepressants and statins and get the same results. God forbid they had to actually counsel patients on why they have these conditions rather than throw the new meds at them. No offense but what would you possibly offer a patient besides a ticket to Walgreens? It amazes me we survived on planet earth without drugs for millions of years. Our healthcare system is rated #30 and yet is the most expensive and cancer will soon be the #1 killer in America. Type 2 diabetes is growing expotentially and I have yet to meet a patient where thier MD suggested they limit the carbs. Drugs are about conveinence in a pathetically weak culture and you certainly know how to hook them. I watch those commercials where they list the 15 side effects for statins and I wonder if the population can even read any more. Did IQ’s just fall off sharply? Medicine is great with critical care, joint replacement and several other life saving surgeries. As far as general health you would be safer to go to a witch doctor.
Pick on chiros all you want because I will tell you there are many that are a waste of time. Parenthetically, I have NEVER massaged a patient in my career as it’s got nothing to do with chiropractic. If you just want something palative stay on drugs and let the condition progress. The spinal adjustment remains one of the few treatments that actually corrects a condition. Half my practice is medical failures so I have seen and heard what they call “treatment” for 30 years. Even the lazy, fat, brain dead public is beginning to realize a drug does nothing to correct. If the word ever really gets out, you guys are in big trouble. (laughing).
Whenever I have an MD question me on the “safety” of the spinal adjustment I simply ask him how much he pays in malpractice. In my area a family practice doc pays arounf $40,000 a year. I pay $1,500. The insurance companies are bright people and they understand true risk. So really, who is hurting who?
I had a fireman come in a few years back with a complaint of persistant nocturnal back pain. He was under the care of a local internist that was well thought of. He had treated him for over a year and never once thought to x-ray him let alone order a CT or MR of the area of complaint. Nocturnal pain that wakes you up at night is a huge red flag and I ordered a full spine MR on the first visit. tHE RADIOLOGIST CALLED THE NEXT DAY WITH THE GREAT NEWS; Full spine cancer that had spreAd almost everywhere. When I called the internist he was arrogant on the phone and seemed a little irritated I even called him. When I told him what I had found he instantly transformed into a scared little boy. what a pussy. As I was told the next day he even lied to the patient telling them they were not sure what his problem was. The patient died three months later. So don’t EVER tell me medical doctors are safe. I could list my experiences for hours on all the things you miss. If I cut an artery or go into cardiac arrest I’m glad you exist. Past that you really have nothing to offer but a pill to placate me.