28 year old Georgia woman cannot walk, talk, eat, or breathe on her own.
August 17, 2022 11:24 PM Subscribe
My daughter went for a routine chiropractor appointment. Now she’s paralysed. “Our main form of communication right now is, we’ll go through the alphabet, and she’ll let me know when I’ve gotten to the right letter, and I just spell everything out. She can also nod and thumbs up, and she can mouth things; sometimes I can get it, sometimes not. Really, right now, [we are] spelling everything out. Thankfully, she’s a very good speller. But, yeah, we just spell everything out painstakingly.”
“I had never heard of anything like this happening. I didn’t know it could happen. So it just wasn’t on my radar.”
“I think people should just avoid neck adjustments, for one thing, If they are really insistent and they think they need a neck adjustment, then a good chiropractor will do X rays. There should be an MRI done, there should be extensive tests done first, before they ever touch your neck with any sort of adjustment.
“And truthfully, I just think chiropractors should not do them at all."
~~~~~
One hell of a story, perhaps more common than expected. Any simple search will bring up horror stories, also stories of people getting real help, and of course people saying that driving a car is dangerous also. As it's a post I'm putting up I'm not taking a position, nor giving any of my experience.
“I had never heard of anything like this happening. I didn’t know it could happen. So it just wasn’t on my radar.”
“I think people should just avoid neck adjustments, for one thing, If they are really insistent and they think they need a neck adjustment, then a good chiropractor will do X rays. There should be an MRI done, there should be extensive tests done first, before they ever touch your neck with any sort of adjustment.
“And truthfully, I just think chiropractors should not do them at all."
~~~~~
One hell of a story, perhaps more common than expected. Any simple search will bring up horror stories, also stories of people getting real help, and of course people saying that driving a car is dangerous also. As it's a post I'm putting up I'm not taking a position, nor giving any of my experience.
Of course chiropractic is bullshit quakery, just like homeopathy, supplements, acupuncture, and a million other fake cures.
posted by ryanrs at 12:40 AM on August 18, 2022 [60 favorites]
posted by ryanrs at 12:40 AM on August 18, 2022 [60 favorites]
It's kinda intense that chiropractors believe the shtick sold to them. I mean, if as a chiropractor I had paralysed someone for life - I would go into a pretty deep funk. Probably reassess what I thought I knew.
In my own experience: bodies are weird, the way it feels to live in them is (at times) weird and chiropractors work that angle. I've been to chiropractors, been 'adjusted', a couple times and it was funny but for me pointless.
posted by From Bklyn at 1:09 AM on August 18, 2022 [1 favorite]
In my own experience: bodies are weird, the way it feels to live in them is (at times) weird and chiropractors work that angle. I've been to chiropractors, been 'adjusted', a couple times and it was funny but for me pointless.
posted by From Bklyn at 1:09 AM on August 18, 2022 [1 favorite]
A friend of mine in high school was badly injured by a chiropractor - all of her shoulder muscles in one shoulder got torn. She had pain and limited functionality for A YEAR. :(
She was being treated for migraines, and had no existing muscle injuries when she went in.
posted by carriage pulled by cassowaries at 2:10 AM on August 18, 2022 [3 favorites]
She was being treated for migraines, and had no existing muscle injuries when she went in.
posted by carriage pulled by cassowaries at 2:10 AM on August 18, 2022 [3 favorites]
A few years back, on Ask Metafilter, someone asked about chiropractic and got this answer:
"I'm a grad student in neuroscience at a major hospital. My adviser is a MD PhD neurologist. Every week, there's a morning case conference where all the neurology attendings and residents get together and present all the new cases that have come in in the past week.
Every single week with little or no exception, one of those cases is someone who died or became a paraplegic due to the actions of a chiropractor."
posted by i_am_joe's_spleen at 2:12 AM on August 18, 2022 [112 favorites]
"I'm a grad student in neuroscience at a major hospital. My adviser is a MD PhD neurologist. Every week, there's a morning case conference where all the neurology attendings and residents get together and present all the new cases that have come in in the past week.
Every single week with little or no exception, one of those cases is someone who died or became a paraplegic due to the actions of a chiropractor."
posted by i_am_joe's_spleen at 2:12 AM on August 18, 2022 [112 favorites]
From 17 May 2016: Melbourne chiropractor who cracked back of baby temporarily banned from treating children
A Melbourne chiropractor who cracked the back of a newborn baby in a video that went viral is temporarily banned from treating children.
posted by carriage pulled by cassowaries at 2:12 AM on August 18, 2022 [2 favorites]
A Melbourne chiropractor who cracked the back of a newborn baby in a video that went viral is temporarily banned from treating children.
posted by carriage pulled by cassowaries at 2:12 AM on August 18, 2022 [2 favorites]
From 20 Jan 2016: Chiropractors who claim ability to prevent caesareans and cure cancer referred to health regulator
Chiropractors around the country have been making claims they can prevent caesarean births, treat diabetes, cure cancer and even fight the flu. The ABC has obtained a list of the 10 chiropractic clinics which were the subject of complaints to the regulator by a public health expert.
posted by carriage pulled by cassowaries at 2:13 AM on August 18, 2022 [5 favorites]
Chiropractors around the country have been making claims they can prevent caesarean births, treat diabetes, cure cancer and even fight the flu. The ABC has obtained a list of the 10 chiropractic clinics which were the subject of complaints to the regulator by a public health expert.
posted by carriage pulled by cassowaries at 2:13 AM on August 18, 2022 [5 favorites]
Here's a story about a man who suffered a vascular event during neck manipulation by a chiropractor.
Mr Halloran died in the Royal Adelaide Hospital two days later from a heart attack.
posted by carriage pulled by cassowaries at 2:15 AM on August 18, 2022
Mr Halloran died in the Royal Adelaide Hospital two days later from a heart attack.
posted by carriage pulled by cassowaries at 2:15 AM on August 18, 2022
Of course chiropractic is bullshit quakery, just like homeopathy, supplements, acupuncture, and a million other fake cures.
Harmful practices absolutely deserve all the accountability that is coming to them, however it's not a bad idea to be more aware of the history of the othering of diverse therapeutic pratices, as recently discussed (regarding TCM) by the Conspirituality team - they also did an episode on chiropraxy itself (accompanying article here).
posted by progosk at 3:02 AM on August 18, 2022 [9 favorites]
Harmful practices absolutely deserve all the accountability that is coming to them, however it's not a bad idea to be more aware of the history of the othering of diverse therapeutic pratices, as recently discussed (regarding TCM) by the Conspirituality team - they also did an episode on chiropraxy itself (accompanying article here).
posted by progosk at 3:02 AM on August 18, 2022 [9 favorites]
An acquaintance from uni days is a Chiropractor. No way would I ever go see him for treatment. I asked him what he thought of a particular vaccine and he got offended and said "is this because I'm training to be a chiropractor?" I had no idea it was a sore point, I was just asking his opinion.
Of course, older wiser me who also lived through 2021 has learned a lot about how vaccine opinions are a useful proxy for other beliefs.
Physiotherapy exists and is part of the accepted medical establishment.
posted by freethefeet at 3:23 AM on August 18, 2022 [19 favorites]
Of course, older wiser me who also lived through 2021 has learned a lot about how vaccine opinions are a useful proxy for other beliefs.
Physiotherapy exists and is part of the accepted medical establishment.
posted by freethefeet at 3:23 AM on August 18, 2022 [19 favorites]
Oh that poor mother- "we're responsible people who don't cancel at the last minute" so her daughter decided to keep the appointment.
posted by freethefeet at 3:29 AM on August 18, 2022 [4 favorites]
posted by freethefeet at 3:29 AM on August 18, 2022 [4 favorites]
"My chiropractor helped me," is the equivalent of , "I got Covid and it wasn't that bad."
posted by 3.2.3 at 3:43 AM on August 18, 2022 [25 favorites]
posted by 3.2.3 at 3:43 AM on August 18, 2022 [25 favorites]
Well, a chiropractor did help me. But the exact issue was relatively mild and far away from my neck (I threw my back out pretty bad once, he found a curve in my back that I never knew about that was a weak point, and was focusing on that), and some sessions with him helped; although, the next time my back went out I had two sessions of massage therapy instead and that worked just as well.
This is not a defense of chiropracty as such, and anecdota is not data, absolutely. I think it's more like, chirorpacty falls into a huge gray area, and I just happened to be dipping one toe into the "good" side and got out and so I was fine. But I can't help but think that maybe some further study into why it sometimes does work, to clear up "here's why this works sometimes" and "what are the things you shouldn't do," may be an interesting idea - it would be much clearer for the patient suffering from pain to know whether "okay, it would be safe in this instance since it's just the lower back" vs. "yeah, no, anything around the neck is a super-bad idea, lemme do something else".
Also, yeah, I did get a case of Covid but it was mild, but I attribute that to having been vaxed and boosted and to just having good luck, and what happened to me is not true of everyone and I still think people should take Covid serious, for the record.
posted by EmpressCallipygos at 3:53 AM on August 18, 2022 [9 favorites]
This is not a defense of chiropracty as such, and anecdota is not data, absolutely. I think it's more like, chirorpacty falls into a huge gray area, and I just happened to be dipping one toe into the "good" side and got out and so I was fine. But I can't help but think that maybe some further study into why it sometimes does work, to clear up "here's why this works sometimes" and "what are the things you shouldn't do," may be an interesting idea - it would be much clearer for the patient suffering from pain to know whether "okay, it would be safe in this instance since it's just the lower back" vs. "yeah, no, anything around the neck is a super-bad idea, lemme do something else".
Also, yeah, I did get a case of Covid but it was mild, but I attribute that to having been vaxed and boosted and to just having good luck, and what happened to me is not true of everyone and I still think people should take Covid serious, for the record.
posted by EmpressCallipygos at 3:53 AM on August 18, 2022 [9 favorites]
P'shaw - chiropractic only works when Pluto's in retrograde; everyone knows that.
posted by whatevernot at 4:24 AM on August 18, 2022 [4 favorites]
posted by whatevernot at 4:24 AM on August 18, 2022 [4 favorites]
Osteopathic physicians in the United States are trained to provide osteopathic manipulation therapy (OMT), which to a lay person looks a lot like chiropractic adjustment. Except they are actually physicians who have received exactly the same training as an MD physician.
posted by adoarns at 4:37 AM on August 18, 2022 [19 favorites]
posted by adoarns at 4:37 AM on August 18, 2022 [19 favorites]
This is horrific. I didn’t have any real opinions about chiropracty except for thinking it was sort of quack-y, and seeing the comments here so far has been really eye-opening. I just found it (yet again) flabbergasting that in the middle of all the godawful issues she’s now facing, they’re also having to run a GoFundMe charity begathon to pay for it all. Which is likely to be necessary to get her through years of treatment - and I’m sure it’s a lot harder to get pledges for the crucial but (PR-wise) boring rehab she’ll need 3 or 5 years down the road.
Everything about this story is awful.
posted by Mchelly at 4:39 AM on August 18, 2022 [4 favorites]
Everything about this story is awful.
posted by Mchelly at 4:39 AM on August 18, 2022 [4 favorites]
Part of what I do for my job is going through local papers for healthcare news and ads, and it always amazes me how many chiropractics will go to absurd lengths to avoid admitting, when they put an ad in the paper, what they are. The aim is always to make themselves seem like a legit medical practice while skating right up to not quite saying that.
posted by Halloween Jack at 4:47 AM on August 18, 2022 [6 favorites]
posted by Halloween Jack at 4:47 AM on August 18, 2022 [6 favorites]
I was going to mention osteopaths, too. Both osteopathy and chiropractic emerge from the same sort of 19th century pseudoscientific nonsense and took these diverging paths and I'd be curious to understand how that happened.
My understanding is that there's not a whole lot of evidence for OMT and a lot of DOs don't actually practice it.
posted by hoyland at 4:56 AM on August 18, 2022 [8 favorites]
My understanding is that there's not a whole lot of evidence for OMT and a lot of DOs don't actually practice it.
posted by hoyland at 4:56 AM on August 18, 2022 [8 favorites]
A few years ago, I went to a chiropractor once or twice, for a really awful lower back pain.
I mostly went because the alternative would have been go to the ER, or wait for an appointment with a PCP, get a scan, go to a "specialist", take heavy meds, etc. ...I think my co-pay then was $250 bucks for ER, $60 for a specialist, $35 for the PCP visit, $50 for a scan...so it all adds up and takes time.... A massage would have been over a hundred bucks. The chiro was 40 bucks, and could see me right away, so there I went......
I don't know how the process could really fix anything, but the pain did subside and eventually go away. (Since then, I've learned some good floor stretches that I can do on my own that (thankfully) alleviate any pain.)
A mother of my friend went for years. She had chronic back pain, and she seemed caught in a loop of "I'm in pain, I need this treatment" "Still in pain, still need the treatment". The chiro never encouraged home stretching, light exercise, or anything to this woman, he just kept treating her and taking her money.
My spouse went on and off for a while, said it really helped, but I always thought it more a placebo effect.
Then, last year, my spouse caught covid from his chiropractor!!!!!. Spouse did not ask she (the chiro) wear a mask, but for god's sake shouldn't she have had one on? Spouse was in the hospital for a week, and months later, is still recovering.
...No more chiropractors in our lives....
posted by rhonzo at 4:57 AM on August 18, 2022 [8 favorites]
I mostly went because the alternative would have been go to the ER, or wait for an appointment with a PCP, get a scan, go to a "specialist", take heavy meds, etc. ...I think my co-pay then was $250 bucks for ER, $60 for a specialist, $35 for the PCP visit, $50 for a scan...so it all adds up and takes time.... A massage would have been over a hundred bucks. The chiro was 40 bucks, and could see me right away, so there I went......
I don't know how the process could really fix anything, but the pain did subside and eventually go away. (Since then, I've learned some good floor stretches that I can do on my own that (thankfully) alleviate any pain.)
A mother of my friend went for years. She had chronic back pain, and she seemed caught in a loop of "I'm in pain, I need this treatment" "Still in pain, still need the treatment". The chiro never encouraged home stretching, light exercise, or anything to this woman, he just kept treating her and taking her money.
My spouse went on and off for a while, said it really helped, but I always thought it more a placebo effect.
Then, last year, my spouse caught covid from his chiropractor!!!!!. Spouse did not ask she (the chiro) wear a mask, but for god's sake shouldn't she have had one on? Spouse was in the hospital for a week, and months later, is still recovering.
...No more chiropractors in our lives....
posted by rhonzo at 4:57 AM on August 18, 2022 [8 favorites]
I'm an osteopath in Britain, and this is a whole complicated subject!
Osteopaths in the UK and America started from the same point, with a magnetic healer and travelling preacher called AT Still, who put together a whole philosophy of how everything in the body would work better if the various fluids in the body moved around smoothly. Some of it was surprisingly accurate - lots of things about the functioning of the lymphatic system, and ways into it. He founded a college and started teaching. A lot of it wasn't perfect, but in an era with mercury cures, general health, good diet, cleanliness etc. was pretty effective by the standards of the time.
Quick digression - an oft-cited bit of trivia is that the osteopathic hospitals had better outcome measures than mainstream ones during the flu pandemic. We suspect that this is more about overall cleanliness and ventilation, and lack of other, more potentially harmful treatment than the osteopathic manual care, but there is definitely room to think that waggling chests around could help with breathing.
One of Still's students was a guy called Palmer, who decided that the most important thing was nerves rather than fluids, and that the best way to impact the nervous system was spinal adjustments. He went on to found his own school, the college of chiropractic.
The American osteopaths (DOs) were increasingly everywhere, but wanted to also be able to have the same recognition (and access to additional techniques) as the MDs. At this point, they had to take on similar tests of competence, which meant similar educations, and gradually over time this evolved into a parallel profession. There is still an element of manual therapy in an American DO education, but it can be pretty minor, depending on the university.
In the meantime, some of the other early students went to Britain, where they did more manual stuff. A few decades ago, there was a move to become a regulated profession, which means a masters degree, minimum 1600 hours of supervised treatment, codes of conduct, guarantees of quality, CPD, a governing body with a responsibility to the public etc. I don't know so much about the history of chiropractic in the UK, but they are now also a regulated profession. They were historically controversial for their overuse of diagnostic x-ray to justify treatment, but most chiropractors (in the UK) no longer do this.
posted by fizban at 5:12 AM on August 18, 2022 [50 favorites]
Osteopaths in the UK and America started from the same point, with a magnetic healer and travelling preacher called AT Still, who put together a whole philosophy of how everything in the body would work better if the various fluids in the body moved around smoothly. Some of it was surprisingly accurate - lots of things about the functioning of the lymphatic system, and ways into it. He founded a college and started teaching. A lot of it wasn't perfect, but in an era with mercury cures, general health, good diet, cleanliness etc. was pretty effective by the standards of the time.
Quick digression - an oft-cited bit of trivia is that the osteopathic hospitals had better outcome measures than mainstream ones during the flu pandemic. We suspect that this is more about overall cleanliness and ventilation, and lack of other, more potentially harmful treatment than the osteopathic manual care, but there is definitely room to think that waggling chests around could help with breathing.
One of Still's students was a guy called Palmer, who decided that the most important thing was nerves rather than fluids, and that the best way to impact the nervous system was spinal adjustments. He went on to found his own school, the college of chiropractic.
The American osteopaths (DOs) were increasingly everywhere, but wanted to also be able to have the same recognition (and access to additional techniques) as the MDs. At this point, they had to take on similar tests of competence, which meant similar educations, and gradually over time this evolved into a parallel profession. There is still an element of manual therapy in an American DO education, but it can be pretty minor, depending on the university.
In the meantime, some of the other early students went to Britain, where they did more manual stuff. A few decades ago, there was a move to become a regulated profession, which means a masters degree, minimum 1600 hours of supervised treatment, codes of conduct, guarantees of quality, CPD, a governing body with a responsibility to the public etc. I don't know so much about the history of chiropractic in the UK, but they are now also a regulated profession. They were historically controversial for their overuse of diagnostic x-ray to justify treatment, but most chiropractors (in the UK) no longer do this.
posted by fizban at 5:12 AM on August 18, 2022 [50 favorites]
The problem seems to be a lot of chiro consider themselves the equivalent of a full MD. Indeed a lot of them go by title of "DC" (Doctor of Chiropractic) nowadays, and they will gladly offer advice that are OUT OF THEIR EXPERTISE from everything to nutrition (okay, usually not a problem there) to sham nutrition (apple cider vinegar cures X) to vaccines are deadly (WTF?!) and they want to be treated as MD including ability to prescribe medicine, get paid by Medicare in the US, and so on.
Then the problem becomes... Why should you not believe them, when they give themselves titles like "the Drugless Doctor" (real Youtube Chiro) when you, through one reason or another, distrusts the whole medical system?
posted by kschang at 5:14 AM on August 18, 2022 [4 favorites]
Then the problem becomes... Why should you not believe them, when they give themselves titles like "the Drugless Doctor" (real Youtube Chiro) when you, through one reason or another, distrusts the whole medical system?
posted by kschang at 5:14 AM on August 18, 2022 [4 favorites]
I got cornered by one at a party recently and man, did I get a earful of the persecution complex. Did you know they do more study than an MD does? Whatever. Then get the MD degree. But then I suppose you're held to pesky things like licensing standards and review boards.
posted by JoeZydeco at 5:23 AM on August 18, 2022 [7 favorites]
posted by JoeZydeco at 5:23 AM on August 18, 2022 [7 favorites]
IIRC, modern Osteopaths, or DOs are considered the same as MDs as they go through virtually the same education.
But modern chiros can't even agree on standard practices. They have different schools on how to diagnose things, different schools on how to treat things, and so on.
Yet they want to be your PCP. In fact, in the US, they sued American Medical Association for having rules on the books that referring patients to chiros is considered unethical. They sued it as an antitrust unfair competition lawsuit. They got a partial victory and such rules were removed from the AMA.
Famous British skeptic Simon Singh, back in 2008, called spinal adjustment for children as treatment for conditions like ear infection and asthma, "bogus". The British Chiropractic Association sued him for libel, and was forced to withdraw the lawsuit 2 years later when it's clear it became a true PR disaster for them. Two years later, BCA still called SImon Singh a "legal bully" in an article published by the Guardian.
This is one of the cases where Canada is ahead of the US. Many chiros have made statements that chiro treatment can PROTECT you from COVID, at least back in 2020, that are still easily found on the web. While I do recall an instance where a provincial chiro body in Canada issued a warning to its members to stop claiming chiro can help prevent catching COVID.
NOTE: Correction, American Chiropractic Association did release a statement that there is no quality evidence to support that spinal adjustments can imrpove immunity to COVID.
posted by kschang at 5:33 AM on August 18, 2022 [1 favorite]
But modern chiros can't even agree on standard practices. They have different schools on how to diagnose things, different schools on how to treat things, and so on.
Yet they want to be your PCP. In fact, in the US, they sued American Medical Association for having rules on the books that referring patients to chiros is considered unethical. They sued it as an antitrust unfair competition lawsuit. They got a partial victory and such rules were removed from the AMA.
Famous British skeptic Simon Singh, back in 2008, called spinal adjustment for children as treatment for conditions like ear infection and asthma, "bogus". The British Chiropractic Association sued him for libel, and was forced to withdraw the lawsuit 2 years later when it's clear it became a true PR disaster for them. Two years later, BCA still called SImon Singh a "legal bully" in an article published by the Guardian.
This is one of the cases where Canada is ahead of the US. Many chiros have made statements that chiro treatment can PROTECT you from COVID, at least back in 2020, that are still easily found on the web. While I do recall an instance where a provincial chiro body in Canada issued a warning to its members to stop claiming chiro can help prevent catching COVID.
NOTE: Correction, American Chiropractic Association did release a statement that there is no quality evidence to support that spinal adjustments can imrpove immunity to COVID.
posted by kschang at 5:33 AM on August 18, 2022 [1 favorite]
I can't help but think that maybe some further study into why it sometimes does work, to clear up "here's why this works sometimes" and "what are the things you shouldn't do," may be an interesting idea -
Total anecdata, but when I had nasty lower back problems about 15 years ago I made a few visits to a chiropractor. Sometimes it helped, sometimes it didn't. Eventually I realized my back issues weren't going to go away by themselves, so I went through the whole expensive complex process of actually visiting doctors, and wound up spending a couple of months having weekly sessions with a physical therapist at a sports injury clinic.
Whereupon it became clear that the chiropractor was liberally borrowing accepted sports medicine techniques and treatments. Like, just for one example, both places gave me paperwork outlining stretches and exercises to relieve and prevent my kind of lower back problems, and they were virtually the same. (The actual cure involved techniques that the chiropractor did not have access to.)
So there's one answer - sometimes it works because they're treating things that can actually be treated by muscular/skeletal manipulation using methods not at all unique to chiropractic.
Of course, part of the reason I tried a chiropractor first was that I could almost always book an appointment within 36 hours of my call, and it never cost me more out of pocket than my $20 insurance co-pay. Which was . . . not the case with getting treated by the more legit medical system. So, yeah, I have no doubt whatsoever that chiropractic can flourish when it's the cheap, fast, and easy alternative to the US' totally fucked up health care system.
posted by soundguy99 at 5:38 AM on August 18, 2022 [18 favorites]
Total anecdata, but when I had nasty lower back problems about 15 years ago I made a few visits to a chiropractor. Sometimes it helped, sometimes it didn't. Eventually I realized my back issues weren't going to go away by themselves, so I went through the whole expensive complex process of actually visiting doctors, and wound up spending a couple of months having weekly sessions with a physical therapist at a sports injury clinic.
Whereupon it became clear that the chiropractor was liberally borrowing accepted sports medicine techniques and treatments. Like, just for one example, both places gave me paperwork outlining stretches and exercises to relieve and prevent my kind of lower back problems, and they were virtually the same. (The actual cure involved techniques that the chiropractor did not have access to.)
So there's one answer - sometimes it works because they're treating things that can actually be treated by muscular/skeletal manipulation using methods not at all unique to chiropractic.
Of course, part of the reason I tried a chiropractor first was that I could almost always book an appointment within 36 hours of my call, and it never cost me more out of pocket than my $20 insurance co-pay. Which was . . . not the case with getting treated by the more legit medical system. So, yeah, I have no doubt whatsoever that chiropractic can flourish when it's the cheap, fast, and easy alternative to the US' totally fucked up health care system.
posted by soundguy99 at 5:38 AM on August 18, 2022 [18 favorites]
I am focussing on osteopathy, because that is my main expertise, but certainly in the UK, physiotherapists, chiropractors and osteopaths can all do the manipulation part. There is a tendency to think of chiropractors as mainly doing joint-clicking, physiotherapists mainly giving exercise, and osteopaths being a bit more joint-waggly/massage-y, but all of the professions do all of this and other things as well. We all do additional training in areas of interest, but there is inevitably a lot of focus on the musculoskeletal system, something which is dealt with very poorly by GPs for all sorts of other reasons. The neurophysiology of pain is complex and not well understood in general, but I believe that teaching patients about it is the most important (and most effective) part of the job - I'm going to skip that digression for now.
In the UK, most musculoskeletal care on the NHS is physiotherapy, but this is mainly an artefact of how the NHS was formed and what was going on at the time. Osteopaths do practice in the NHS, doing treatment, triage, and as part of multidisciplinary teams. I must admit I don't know about chiropractors in the public healthcare setting.
The mechanism of a manipulation is pretty well understood - it is like clicking knuckles, changing the pressure in a joint through applying pressure leading to a sudden release of gas in the joint, and a sudden neurological release with nerves that surround the joint. This causes temporary reset of pain sensitivity, and also relaxation of surrounding muscles. Because the spinal joints surround the nerves which supply everything in the periphery, it sometimes seems to give a reduction in sensitivity to these areas as well. It also can help things go from being "stuck" to "moving", although people disagree about what either of those things might mean. It's important to note that joints can't be "out" or "put back in" (at least without dislocation, which is a whole other thing).
The problem with manipulation, at least as far as I am concerned, is that if you make things feel better, move better, be more relaxed, but then the person goes away and does whatever they had been doing for the previous six weeks which lead to the tension/pressure/stuckness/whatever, all we have done is apply brief release. Because of this, education, provision of exercises, changing habits etc. is just as important, especially if we want to make a long term difference.
There is a negative stereotype of chiropractors, and I believe it is more true in the US, that they will tend to see you as a patient and then "keep" you, coming once or more times weekly, sometimes indefinitely, and there are arguments about whether repeated manipulation in the same area leads to joint laxity, increased sensitivity, and so on. It definitely leads to dependence which is a pretty unhealthy state, although good for the practitioners pockets.
We see vanishingly few serious injuries from manipulation in the UK, and when we do it is a huge deal. There was one chiropractor in Scotland who fractured an elderly patients neck 3 years ago, who did go on to die. We spend a lot of time looking for signs that would contraindicate the manipulative treatment, and it often sounds like the cases in America where it goes wrong, the chiropractor has not done any proper screening. There was one relatively recently where they did a load of manipulation, the patient felt loads of neurological symptoms after, in all four limbs, and so they called them back the next day and did it all again. Completely bizarre, and unethical. I also have the perception that maybe they are doing it in an ungentle way? The actual process is just moving joint surfaces away from one another, so there is really no reason for it to cause damage*, but it seems like people like to do things in much more powerful ways.
I am happy to say more if you want, but this is already a bit of a lecture!
*There is one big exception - vertebrobasilar insufficiency. It tends to be older, frailer ladies who have this, and there are orthopaedic tests to look out for it, but the tests themselves are provocative enough that they could cause the damage on their own - looking all the way up to the ceiling, turning and bending the neck to the side, completely. Instead, if we have a patient who talks about getting dizzy when they look up, or when having their hair washed at the hairdressers, we tell them to speak to the doctor and do gentle massage type treatment, keeping their neck very still...
posted by fizban at 5:39 AM on August 18, 2022 [14 favorites]
In the UK, most musculoskeletal care on the NHS is physiotherapy, but this is mainly an artefact of how the NHS was formed and what was going on at the time. Osteopaths do practice in the NHS, doing treatment, triage, and as part of multidisciplinary teams. I must admit I don't know about chiropractors in the public healthcare setting.
The mechanism of a manipulation is pretty well understood - it is like clicking knuckles, changing the pressure in a joint through applying pressure leading to a sudden release of gas in the joint, and a sudden neurological release with nerves that surround the joint. This causes temporary reset of pain sensitivity, and also relaxation of surrounding muscles. Because the spinal joints surround the nerves which supply everything in the periphery, it sometimes seems to give a reduction in sensitivity to these areas as well. It also can help things go from being "stuck" to "moving", although people disagree about what either of those things might mean. It's important to note that joints can't be "out" or "put back in" (at least without dislocation, which is a whole other thing).
The problem with manipulation, at least as far as I am concerned, is that if you make things feel better, move better, be more relaxed, but then the person goes away and does whatever they had been doing for the previous six weeks which lead to the tension/pressure/stuckness/whatever, all we have done is apply brief release. Because of this, education, provision of exercises, changing habits etc. is just as important, especially if we want to make a long term difference.
There is a negative stereotype of chiropractors, and I believe it is more true in the US, that they will tend to see you as a patient and then "keep" you, coming once or more times weekly, sometimes indefinitely, and there are arguments about whether repeated manipulation in the same area leads to joint laxity, increased sensitivity, and so on. It definitely leads to dependence which is a pretty unhealthy state, although good for the practitioners pockets.
We see vanishingly few serious injuries from manipulation in the UK, and when we do it is a huge deal. There was one chiropractor in Scotland who fractured an elderly patients neck 3 years ago, who did go on to die. We spend a lot of time looking for signs that would contraindicate the manipulative treatment, and it often sounds like the cases in America where it goes wrong, the chiropractor has not done any proper screening. There was one relatively recently where they did a load of manipulation, the patient felt loads of neurological symptoms after, in all four limbs, and so they called them back the next day and did it all again. Completely bizarre, and unethical. I also have the perception that maybe they are doing it in an ungentle way? The actual process is just moving joint surfaces away from one another, so there is really no reason for it to cause damage*, but it seems like people like to do things in much more powerful ways.
I am happy to say more if you want, but this is already a bit of a lecture!
*There is one big exception - vertebrobasilar insufficiency. It tends to be older, frailer ladies who have this, and there are orthopaedic tests to look out for it, but the tests themselves are provocative enough that they could cause the damage on their own - looking all the way up to the ceiling, turning and bending the neck to the side, completely. Instead, if we have a patient who talks about getting dizzy when they look up, or when having their hair washed at the hairdressers, we tell them to speak to the doctor and do gentle massage type treatment, keeping their neck very still...
posted by fizban at 5:39 AM on August 18, 2022 [14 favorites]
I think focusing on osteopathy in a thread about chiropractors is liable to accidentally lend credibility where none is due. Osteopaths and chiropractors are not the same.
If this were a thread about traveling hucksters shilling patent medicines, bringing up the legitimacy of pharmacists would be a distraction at best, and dishonest at worst.
Chiropractors are charlatans who borrow from, but are not, osteopaths and physical therapists. If they wanted to be legitimate, they'd have followed the proper education, licensure, and ethical guidelines of those professions, but instead, they're chiropractors.
posted by explosion at 5:48 AM on August 18, 2022 [24 favorites]
If this were a thread about traveling hucksters shilling patent medicines, bringing up the legitimacy of pharmacists would be a distraction at best, and dishonest at worst.
Chiropractors are charlatans who borrow from, but are not, osteopaths and physical therapists. If they wanted to be legitimate, they'd have followed the proper education, licensure, and ethical guidelines of those professions, but instead, they're chiropractors.
posted by explosion at 5:48 AM on August 18, 2022 [24 favorites]
My own take on this is that chiros are quacks until individually proven otherwise.
The whole basis of chiropracty as laid out by DD Palmer is pure non sense that he pulled out of his ass and you never know how much of that cool aid chiros will still be drinking.
I'm sure it sometimes help due to placebo, coincidence, dumb luck and the fact that sometimes poking at the back helps when you have back pain.
Personally, I'd rather see a physiotherapist who'll actually look at how you move and give you exercises to strengthen your muscles and try to help fix the core issues.
posted by WaterAndPixels at 5:53 AM on August 18, 2022 [11 favorites]
The whole basis of chiropracty as laid out by DD Palmer is pure non sense that he pulled out of his ass and you never know how much of that cool aid chiros will still be drinking.
I'm sure it sometimes help due to placebo, coincidence, dumb luck and the fact that sometimes poking at the back helps when you have back pain.
Personally, I'd rather see a physiotherapist who'll actually look at how you move and give you exercises to strengthen your muscles and try to help fix the core issues.
posted by WaterAndPixels at 5:53 AM on August 18, 2022 [11 favorites]
If you were referring to the Lawler case, that happened in 2017.
TL;DR -- Lawler, 80 went to York chiro practice by Arleen Scholten for a leg injury. Minutes into the treatment, he screamed and said, "You are hurting me. I can't feel my arms." after a "drop-table" maneuver. Instead of immediately summon paramedics and inform them there may be neck / spin injury, Arleen dragged the patient off the table into a sitting position and administered rescue breaths. THEN asked her receptionist to summon 999. When paramedics arrived, Arleen told them the patient may have suffered a stroke. It was only at the hospital and x-ray did they find that his neck was broken, as apparently no c-collar was used by the paramedics. Lawler was declared a quadriplegic and died a day later.
Worst part? The Chiro council ruled it an accident, and gave her license back.
posted by kschang at 5:58 AM on August 18, 2022 [6 favorites]
TL;DR -- Lawler, 80 went to York chiro practice by Arleen Scholten for a leg injury. Minutes into the treatment, he screamed and said, "You are hurting me. I can't feel my arms." after a "drop-table" maneuver. Instead of immediately summon paramedics and inform them there may be neck / spin injury, Arleen dragged the patient off the table into a sitting position and administered rescue breaths. THEN asked her receptionist to summon 999. When paramedics arrived, Arleen told them the patient may have suffered a stroke. It was only at the hospital and x-ray did they find that his neck was broken, as apparently no c-collar was used by the paramedics. Lawler was declared a quadriplegic and died a day later.
Worst part? The Chiro council ruled it an accident, and gave her license back.
posted by kschang at 5:58 AM on August 18, 2022 [6 favorites]
From anecdotal conversations with friends/colleagues about lower back pain (ain't getting old fun!), the good chiros look more like physios than chiros....
posted by WaterAndPixels at 6:00 AM on August 18, 2022 [4 favorites]
posted by WaterAndPixels at 6:00 AM on August 18, 2022 [4 favorites]
That’s the one - it was in the news again in 2019, maybe a lawsuit or something. And yes, it sounds dreadful. I don’t have any experience with the drop couches, either, but I think they speed up the movement? Definitely a more intense version of the same thing.
I mention osteos just because I know us, but the actual technique, or at least the end of it, is the same!
posted by fizban at 6:01 AM on August 18, 2022
I mention osteos just because I know us, but the actual technique, or at least the end of it, is the same!
posted by fizban at 6:01 AM on August 18, 2022
I dunno about the profession at large, but I had a very good experience with a chiro about a decade ago.
I had terrible lower back pain stemming from a previously torn ligament, on top of a connective tissues disorder, exacerbated by my wildly sedentary lifestyle as a grad student (not that I knew this at the time). I couldn’t sleep, couldn’t move, was in pain constantly, didn’t know why (other than the old injury) & nothing I did made it better.
Over the course of about a year I’d sought help from the university medical center, where the doc shrugged & gave me a 2-pill muscle relaxer Rx, and both urgent care & the ER, where I was told that since I didn’t have nerve symptoms it wasn’t an emergency & I should go back to my doc … and when I did, the doc at the university medical center looked at me suspiciously over his glasses, said ‘I already gave you muscle relaxers, I dunno what more you want of me’ & sent me home.
I ended up going to a chiro out of desperation, despite the fact that I am firmly anti-woo & it felt woo as hell to even consider it. I was impressed, though; the chiro got a diagnostic X-ray, pointed out that the minor scoliosis I knew I had was a bit worse than I thought it was, found the scar tissue from the previously torn ligament before I told him about it, and described how my connective tissue disorder was throwing my biomechanics out of whack & causing most of my pain. No mention of chakras or essential oils or apple cider vinegar at all.
He put together a course of treatment that started with mild adjustments & deep tissue massage, both with the goal of increasing my range of motion & reducing pain enough to get me to the point where I could start targeted PT, which was then folded into the routine; the massage therapists & physiotherapists were employees who worked in the chiro’s office, & collaborated with him on the specifics of my treatment plan. He was very clear that his goal was to heal me enough that he wouldn’t have to see me again.
It took several weeks to see significant improvement, and in the long run it was definitely the PT & relearning how to move correctly that produced the most long-term benefits, but I could not have even contemplated starting PT from where I was initially - I was in too much pain, it would just have been impossible - if any of the docs I saw had even referred me to PT. And my subsequent experiences with PTs for other issues leads me to believe that going straight to PT would not have worked for me at all; none of the PTs I’ve met outside the chiro’s office were equipped to deal with a patient as immobile & in as much pain as I was initially.
So, yeah. My experience isn’t data, and I clearly any chiros who claim to realign chakras, cure cancer or the flu, replace standard medical care or whatever are bullshit artists (mine was pro-science, pro-vaccine, offered no other medical advice & made no claims about anything but back pain)….but there’s at least one chiro out there who has done some good.
posted by wind_up_horse at 6:15 AM on August 18, 2022 [6 favorites]
I had terrible lower back pain stemming from a previously torn ligament, on top of a connective tissues disorder, exacerbated by my wildly sedentary lifestyle as a grad student (not that I knew this at the time). I couldn’t sleep, couldn’t move, was in pain constantly, didn’t know why (other than the old injury) & nothing I did made it better.
Over the course of about a year I’d sought help from the university medical center, where the doc shrugged & gave me a 2-pill muscle relaxer Rx, and both urgent care & the ER, where I was told that since I didn’t have nerve symptoms it wasn’t an emergency & I should go back to my doc … and when I did, the doc at the university medical center looked at me suspiciously over his glasses, said ‘I already gave you muscle relaxers, I dunno what more you want of me’ & sent me home.
I ended up going to a chiro out of desperation, despite the fact that I am firmly anti-woo & it felt woo as hell to even consider it. I was impressed, though; the chiro got a diagnostic X-ray, pointed out that the minor scoliosis I knew I had was a bit worse than I thought it was, found the scar tissue from the previously torn ligament before I told him about it, and described how my connective tissue disorder was throwing my biomechanics out of whack & causing most of my pain. No mention of chakras or essential oils or apple cider vinegar at all.
He put together a course of treatment that started with mild adjustments & deep tissue massage, both with the goal of increasing my range of motion & reducing pain enough to get me to the point where I could start targeted PT, which was then folded into the routine; the massage therapists & physiotherapists were employees who worked in the chiro’s office, & collaborated with him on the specifics of my treatment plan. He was very clear that his goal was to heal me enough that he wouldn’t have to see me again.
It took several weeks to see significant improvement, and in the long run it was definitely the PT & relearning how to move correctly that produced the most long-term benefits, but I could not have even contemplated starting PT from where I was initially - I was in too much pain, it would just have been impossible - if any of the docs I saw had even referred me to PT. And my subsequent experiences with PTs for other issues leads me to believe that going straight to PT would not have worked for me at all; none of the PTs I’ve met outside the chiro’s office were equipped to deal with a patient as immobile & in as much pain as I was initially.
So, yeah. My experience isn’t data, and I clearly any chiros who claim to realign chakras, cure cancer or the flu, replace standard medical care or whatever are bullshit artists (mine was pro-science, pro-vaccine, offered no other medical advice & made no claims about anything but back pain)….but there’s at least one chiro out there who has done some good.
posted by wind_up_horse at 6:15 AM on August 18, 2022 [6 favorites]
"Every single week with little or no exception, one of those cases is someone who died or became a paraplegic due to the actions of a chiropractor."
I think a lot of chiropractic is quackery and nonsense, but this seems very unlikely.
50 people per year just at one hospital are dead or paraplegic due to a chiropractic manipulations? If these kind of statistics were true, we'd be seeing tons of ads from lawyers trying to find clients. I see ads daily about class action suits for people who drank the water at Camp Lejeune. Surely, that's a much smaller number than the tens of thousands of corpses and paraplegics that the chiropractic industry supposedly produces every year.
posted by jonathanhughes at 6:17 AM on August 18, 2022 [6 favorites]
I think a lot of chiropractic is quackery and nonsense, but this seems very unlikely.
50 people per year just at one hospital are dead or paraplegic due to a chiropractic manipulations? If these kind of statistics were true, we'd be seeing tons of ads from lawyers trying to find clients. I see ads daily about class action suits for people who drank the water at Camp Lejeune. Surely, that's a much smaller number than the tens of thousands of corpses and paraplegics that the chiropractic industry supposedly produces every year.
posted by jonathanhughes at 6:17 AM on August 18, 2022 [6 favorites]
From anecdotal conversations with friends/colleagues about lower back pain (ain't getting old fun!), the good chiros look more like physios than chiros....
My experience with chiros is that some of them are a lot better than others, and you can tell the good ones by how little they'll claim to be able to help you with. If they claim to cure everything from joint pain to cancer, they are quacks. If they claim that weekly visits nigh unto the end of time will keep your body functioning smoothly and avoid a host of problems, they are quacks. If, on the other hand, they think if you come in a couple few times, they might be able to get your hip to loosen up, they are probably okay. It has gotten much, much harder to find the third type. Probably still best to avoid that thing where they whip your neck around, though.
These days, I tend to see a registered massage therapist where I might have seen a chiropractor before. A physiotherapist would probably be better yet, but I don't really know what's necessary to see a physio -- private practice physio that you can just go through without getting referred after a a major injury seems like a relatively new phenomenon to me. I don't remember all those clinics just existing when I was younger.
The most helpful body work therapist I ever saw was an RMT who did some manual joint manipulation as part of his massage and gave out a lot of stretching advice.
posted by jacquilynne at 6:30 AM on August 18, 2022 [1 favorite]
My experience with chiros is that some of them are a lot better than others, and you can tell the good ones by how little they'll claim to be able to help you with. If they claim to cure everything from joint pain to cancer, they are quacks. If they claim that weekly visits nigh unto the end of time will keep your body functioning smoothly and avoid a host of problems, they are quacks. If, on the other hand, they think if you come in a couple few times, they might be able to get your hip to loosen up, they are probably okay. It has gotten much, much harder to find the third type. Probably still best to avoid that thing where they whip your neck around, though.
These days, I tend to see a registered massage therapist where I might have seen a chiropractor before. A physiotherapist would probably be better yet, but I don't really know what's necessary to see a physio -- private practice physio that you can just go through without getting referred after a a major injury seems like a relatively new phenomenon to me. I don't remember all those clinics just existing when I was younger.
The most helpful body work therapist I ever saw was an RMT who did some manual joint manipulation as part of his massage and gave out a lot of stretching advice.
posted by jacquilynne at 6:30 AM on August 18, 2022 [1 favorite]
Vertebral artery dissection is a well-known complication arising from chiropractic adjustments.
…
I recall going to a chiropractor once about 25 years ago as a form of moral support to a friend of a friend who had recently opened his practice. Three things I recall from the experience:
1. He told me that one of my legs was longer than the other, by “straightening” my legs out and eyeballing where my ankles supposedly didn’t meet. He said this could be corrected by regular adjustments. I’d seen this bullshit trick done before by quacks I’d encountered in my martial arts training days. It made him look like a dime-store charlatan to have such a weak game.
2. He x-rayed my back and told me to elongate my neck as much as possible during the process. I’ve always been very flexible, and was able to nearly completely flatten my neck vertebrae against the post behind me. When the x-ray came back, he pointed out the straightness of my neck as a deformity that would need some work to correct.
3. On the way out of his office, I saw a framed quote on the wall that said “If germ theory were real, then everyone in the world would already be dead.”
Quackery, bullshit, and dangerous ignorance…all for only $35.
The last I checked, he’s still in business.
posted by darkstar at 6:32 AM on August 18, 2022 [15 favorites]
…
I recall going to a chiropractor once about 25 years ago as a form of moral support to a friend of a friend who had recently opened his practice. Three things I recall from the experience:
1. He told me that one of my legs was longer than the other, by “straightening” my legs out and eyeballing where my ankles supposedly didn’t meet. He said this could be corrected by regular adjustments. I’d seen this bullshit trick done before by quacks I’d encountered in my martial arts training days. It made him look like a dime-store charlatan to have such a weak game.
2. He x-rayed my back and told me to elongate my neck as much as possible during the process. I’ve always been very flexible, and was able to nearly completely flatten my neck vertebrae against the post behind me. When the x-ray came back, he pointed out the straightness of my neck as a deformity that would need some work to correct.
3. On the way out of his office, I saw a framed quote on the wall that said “If germ theory were real, then everyone in the world would already be dead.”
Quackery, bullshit, and dangerous ignorance…all for only $35.
The last I checked, he’s still in business.
posted by darkstar at 6:32 AM on August 18, 2022 [15 favorites]
Next verse, same as the first:
They call it "alternative medicine" because if it worked, they'd just call it "medicine."
Chiropractor is one of the great evils of the world, and the attempts to whitewash it are appalling. At least with homeopaths it's possible that some patients get relief, because most people are chronically dehydrated.
posted by Mayor West at 6:32 AM on August 18, 2022 [10 favorites]
They call it "alternative medicine" because if it worked, they'd just call it "medicine."
Chiropractor is one of the great evils of the world, and the attempts to whitewash it are appalling. At least with homeopaths it's possible that some patients get relief, because most people are chronically dehydrated.
posted by Mayor West at 6:32 AM on August 18, 2022 [10 favorites]
I was a bit afraid that I would get some heat for my earlier comment, but I didn't, so thank you.
I actually think it's telling that even though there is a lot of evidence to suggest chiropracty is kinda loosey-goosey, you still have people going to see chiropractors anyway. To me, this doesn't suggest anything either way about the validity of chiropracty - rather, it suggests that there are a lot of people suffering from chronic pain, and more traditional medicine is not able to fix that - and they are desperate.
So maybe the longer-term solution is for the traditional medical community to take chronic pain and pain management way the hell more seriously. From what I know, even though we've come a long way, there is still a hell of a lot we don't know about pain management - and maybe it's time to start thinking outside the box a little and studying other techniques. Look at why chiropracty helps some people - is it a muscular thing? How exactly does that help, and is there some way to recreate those affects a different way? Or cryotherapy - how and why does that work for some people? Are there any pharmaceuticals that aren't opiods that would help? How exactly does pain work? And what is it about chronic pain that is making it chronic? Is it that the pain receptors just got stuck "on", or is there some underlying cause that just hasn't been discovered yet?
Another thing that might help would be for doctors - and, honestly, for insurance companies - to support a patient without holding them against a timetable. When I broke my knee, my health insurance covered my physical therapy - but only to a point. They would only cover 30 sessions per calendar year, they said; so for most of last year I was paying out of pocket because after the first 30 sessions of 2021, I still couldn't walk down stairs because my knee was still that messed up. But that didn't mean it would always be that messed up, I just needed more work on it. But as far as my insurance company was concerned, my not seeing full recovery after 30 sessions meant it was "a chronic problem" and it was therefore my own problem. I'm now able to walk down stairs, thanks to my therapist and thanks to my continuing to work on it - but no thanks to my insurance company. I finally ran out of the money to pay out of pocket longer term and keep working on a gym twice a week, but I'm largely unsupervised for that and I'm sure it's slowing me down as a result.
Sometimes some people's recovery takes time. But it seems like the medical industry is reluctant to expend energy on the people whose recovery is a little slow, and it seems like they just say "okay, yes, maybe it still hurts sometimes, but can you live with that? Then you're good enough." And ongoing pain shouldn't be "good enough", and so it shouldn't be any surprise that people experiencing it feel like they've been abandoned by more traditional doctors and are turning to alternative methods.
People who see chiropractors aren't doing so because they have been hornswaggled by quacks. They're doing so because the "real doctors" are telling them that "meh, you just gotta deal with it, sucks to be you I guess" instead of helping them.
posted by EmpressCallipygos at 6:46 AM on August 18, 2022 [32 favorites]
I actually think it's telling that even though there is a lot of evidence to suggest chiropracty is kinda loosey-goosey, you still have people going to see chiropractors anyway. To me, this doesn't suggest anything either way about the validity of chiropracty - rather, it suggests that there are a lot of people suffering from chronic pain, and more traditional medicine is not able to fix that - and they are desperate.
So maybe the longer-term solution is for the traditional medical community to take chronic pain and pain management way the hell more seriously. From what I know, even though we've come a long way, there is still a hell of a lot we don't know about pain management - and maybe it's time to start thinking outside the box a little and studying other techniques. Look at why chiropracty helps some people - is it a muscular thing? How exactly does that help, and is there some way to recreate those affects a different way? Or cryotherapy - how and why does that work for some people? Are there any pharmaceuticals that aren't opiods that would help? How exactly does pain work? And what is it about chronic pain that is making it chronic? Is it that the pain receptors just got stuck "on", or is there some underlying cause that just hasn't been discovered yet?
Another thing that might help would be for doctors - and, honestly, for insurance companies - to support a patient without holding them against a timetable. When I broke my knee, my health insurance covered my physical therapy - but only to a point. They would only cover 30 sessions per calendar year, they said; so for most of last year I was paying out of pocket because after the first 30 sessions of 2021, I still couldn't walk down stairs because my knee was still that messed up. But that didn't mean it would always be that messed up, I just needed more work on it. But as far as my insurance company was concerned, my not seeing full recovery after 30 sessions meant it was "a chronic problem" and it was therefore my own problem. I'm now able to walk down stairs, thanks to my therapist and thanks to my continuing to work on it - but no thanks to my insurance company. I finally ran out of the money to pay out of pocket longer term and keep working on a gym twice a week, but I'm largely unsupervised for that and I'm sure it's slowing me down as a result.
Sometimes some people's recovery takes time. But it seems like the medical industry is reluctant to expend energy on the people whose recovery is a little slow, and it seems like they just say "okay, yes, maybe it still hurts sometimes, but can you live with that? Then you're good enough." And ongoing pain shouldn't be "good enough", and so it shouldn't be any surprise that people experiencing it feel like they've been abandoned by more traditional doctors and are turning to alternative methods.
People who see chiropractors aren't doing so because they have been hornswaggled by quacks. They're doing so because the "real doctors" are telling them that "meh, you just gotta deal with it, sucks to be you I guess" instead of helping them.
posted by EmpressCallipygos at 6:46 AM on August 18, 2022 [32 favorites]
@jonathanhughes wrote: "50 people per year just at one hospital are dead or paraplegic due to a chiropractic manipulations? If these kind of statistics were true, we'd be seeing tons of ads from lawyers trying to find clients...
Well... that hospital may be where people end up going after being passed around other trauma centers, I assume.
A statistical analysis of cases in Ontario Canada found 582 "vertebrobasilar accidents" with NO history of stroke as of event date. And billing records confirm prior use of chiropractor vs those who don't. The statistics are VERY disturbing. Those who did have a stroke are 5x as likely to have visited a chiro... and visited one MULTIPLE TIMES.
And you can just imagine what sort of reaction this would generate from the chiros, now that "Fake News" prez and antivaxxers have shown them the way to be truth deniers, if anyone want to spend money doing such studies in the US.
posted by kschang at 6:55 AM on August 18, 2022 [3 favorites]
Well... that hospital may be where people end up going after being passed around other trauma centers, I assume.
A statistical analysis of cases in Ontario Canada found 582 "vertebrobasilar accidents" with NO history of stroke as of event date. And billing records confirm prior use of chiropractor vs those who don't. The statistics are VERY disturbing. Those who did have a stroke are 5x as likely to have visited a chiro... and visited one MULTIPLE TIMES.
And you can just imagine what sort of reaction this would generate from the chiros, now that "Fake News" prez and antivaxxers have shown them the way to be truth deniers, if anyone want to spend money doing such studies in the US.
posted by kschang at 6:55 AM on August 18, 2022 [3 favorites]
I’ve heard it said that chiropractic manipulation causes pain and minor injury which in turn causes the body to release endorphins which then make the patient feel good and assume the treatment has been beneficial. Don’t know how much truth there is in that.
(Is ‘chiropracty’ an accepted term, btw? Never come across it before.)
posted by Phanx at 7:01 AM on August 18, 2022
(Is ‘chiropracty’ an accepted term, btw? Never come across it before.)
posted by Phanx at 7:01 AM on August 18, 2022
Is ‘chiropracty’ an accepted term, btw? Never come across it before.
I was kinda guessing?
posted by EmpressCallipygos at 7:11 AM on August 18, 2022
I was kinda guessing?
posted by EmpressCallipygos at 7:11 AM on August 18, 2022
People who see chiropractors aren't doing so because they have been hornswaggled by quacks. They're doing so because the "real doctors" are telling them that "meh, you just gotta deal with it, sucks to be you I guess" instead of helping them.
EmpressCallipygos--this is so true!
I think it bears repeating, though, that the '"real doctors" route can be prohibitively expensive. Not to mention the pace of getting appointments, approvals, etc.. I think that is a huge reason for the success of the chiro industry.
People who don't have a PCP, for whatever reason, can quickly and (relatively) cheaply, get a person to attend to them. That alone can be a very positive experience.
posted by rhonzo at 7:16 AM on August 18, 2022 [4 favorites]
EmpressCallipygos--this is so true!
I think it bears repeating, though, that the '"real doctors" route can be prohibitively expensive. Not to mention the pace of getting appointments, approvals, etc.. I think that is a huge reason for the success of the chiro industry.
People who don't have a PCP, for whatever reason, can quickly and (relatively) cheaply, get a person to attend to them. That alone can be a very positive experience.
posted by rhonzo at 7:16 AM on August 18, 2022 [4 favorites]
I went to a chiro once for an aggravating kink in my shoulder but what actually helped me was that he had this awesome massage table that accommodated boobs properly and just laying on it allowed that muscle to relax. He messed about a bit but it was all that table.
He then tried to tell me I needed to come every week and that I had one leg longer than the other.
I did not fall for that.
I have gone to massage therapists since who did not have good boob accomodation on their tables and I think of that guy every time and his awesome table. He'd have done more good as a masseuse. But probably made less money.
posted by emjaybee at 7:26 AM on August 18, 2022 [11 favorites]
He then tried to tell me I needed to come every week and that I had one leg longer than the other.
I did not fall for that.
I have gone to massage therapists since who did not have good boob accomodation on their tables and I think of that guy every time and his awesome table. He'd have done more good as a masseuse. But probably made less money.
posted by emjaybee at 7:26 AM on August 18, 2022 [11 favorites]
Anything helpful that chiropractors accidentally do can be done by a regulated, trained, and certified physical therapist. Because they are practicing physical therapy without the regulation and certification.
I went to a university that was associated with an osteopathic medical school, and for years I had easy access to DOs for my PCP and they were the best doctors I've ever had. They listened, they had thoughtful recommendations (for example, for managing chronic sinusitis with various preventative precautions instead of just waiting until I got another sinus infection like my childhood doctor did) AAAAND referred me to physical therapy when it was appropriate. None of them every manipulated any of my parts. Until today I had assumed they were the same as UK osteopaths, but now I think I understand that's not true and the UK falls somewhere in between a chiropractor and DO in the US.
posted by Lyn Never at 7:38 AM on August 18, 2022 [4 favorites]
I went to a university that was associated with an osteopathic medical school, and for years I had easy access to DOs for my PCP and they were the best doctors I've ever had. They listened, they had thoughtful recommendations (for example, for managing chronic sinusitis with various preventative precautions instead of just waiting until I got another sinus infection like my childhood doctor did) AAAAND referred me to physical therapy when it was appropriate. None of them every manipulated any of my parts. Until today I had assumed they were the same as UK osteopaths, but now I think I understand that's not true and the UK falls somewhere in between a chiropractor and DO in the US.
posted by Lyn Never at 7:38 AM on August 18, 2022 [4 favorites]
Is ‘chiropracty’ an accepted term, btw? Never come across it before.
It appears to be chiropractic.
posted by spindle at 7:38 AM on August 18, 2022 [1 favorite]
It appears to be chiropractic.
posted by spindle at 7:38 AM on August 18, 2022 [1 favorite]
Fun fact: my husband's hometown is the birthplace of Daniel David Palmer, who's probably the most to blame for the existence of chiropractic. They have a large bust of him on the high street there. We make fun of it when we visit his parents.
(Well, technically he was born in Pickering but raised in Port Perry)
posted by Kitteh at 7:44 AM on August 18, 2022 [2 favorites]
(Well, technically he was born in Pickering but raised in Port Perry)
posted by Kitteh at 7:44 AM on August 18, 2022 [2 favorites]
A few years ago, I went to a chiropractor once or twice, for a really awful lower back pain.
ditto for me. And I always felt better after a visit. However (from fizban's comment above) ...
The problem with manipulation, at least as far as I am concerned, is that if you make things feel better, move better, be more relaxed, but then the person goes away and does whatever they had been doing for the previous six weeks which lead to the tension/pressure/stuckness/whatever, all we have done is apply brief release. Because of this, education, provision of exercises, changing habits etc. is just as important, especially if we want to make a long term difference.
This is also true of my experience. What finally worked for me (and it really has worked) was finding a movement expert (background in pilates, Feldenkreis and more) who set me up with some stretching/strengthening routines. I still get occasional lower back issues but they always respond to my getting serious again about the stretching and strengthening (ie: hard work on my part).
So yeah, TLDR: chiropractic worked for me but only as a short term solution. Beware of golden bullets and the quacks who offer them and that part of yourself that sorta kinda maybe believes in them.
posted by philip-random at 7:50 AM on August 18, 2022
ditto for me. And I always felt better after a visit. However (from fizban's comment above) ...
The problem with manipulation, at least as far as I am concerned, is that if you make things feel better, move better, be more relaxed, but then the person goes away and does whatever they had been doing for the previous six weeks which lead to the tension/pressure/stuckness/whatever, all we have done is apply brief release. Because of this, education, provision of exercises, changing habits etc. is just as important, especially if we want to make a long term difference.
This is also true of my experience. What finally worked for me (and it really has worked) was finding a movement expert (background in pilates, Feldenkreis and more) who set me up with some stretching/strengthening routines. I still get occasional lower back issues but they always respond to my getting serious again about the stretching and strengthening (ie: hard work on my part).
So yeah, TLDR: chiropractic worked for me but only as a short term solution. Beware of golden bullets and the quacks who offer them and that part of yourself that sorta kinda maybe believes in them.
posted by philip-random at 7:50 AM on August 18, 2022
The problem with manipulation, at least as far as I am concerned, is that if you make things feel better, move better, be more relaxed, but then the person goes away and does whatever they had been doing for the previous six weeks which lead to the tension/pressure/stuckness/whatever, all we have done is apply brief release. Because of this, education, provision of exercises, changing habits etc. is just as important, especially if we want to make a long term difference.
Yeah, that was what ultimately helped me with the issue I had.
I saw a chiropractor after throwing my back out real bad while working on a play (and HOO BOY do I ever have a whole lot of stories about THAT play, but I'll spare y'all), and so this was a workers' comp thing, and it was one of the actresses who recommended her chiropractor to me because she had had the same problem and swore by him. He was the one who ascertained, through x-rays, that I'd had some spinal curvature because one of my legs was indeed a wee bit shorter than the other, and my hips had just tried to compensate. (emjaybee, I know you're dubious, but I saw the x-ray - and honestly, after a few sessions, I was about an inch taller. Legs being a tiny bit asymmetrical is not uncommon, it's just that most of us don't ever notice it.)
Ultimately, though, it was the exercises he gave me and the simple awareness that "oh, okay, that's a weak point I should be cognizant of" helped me longer term. Prior to my back going out, I'd been lugging around huge heavy furniture set pieces twice a day as we set up for rehearsal and cleaned up after, and this was just how I learned that that was too much for me to handle. (I shouldn't have been doing that anyway as a stage manager, but that's one of those whole other stories.) A couple I know also helped a lot - she is a massage therapist, and he also has similar back issues, so they also both visited to offer double-teamed advice (she was telling me "here's why your existing mattress sucks and what you should do instead, and here are some other stretches that can help" and he was telling me "honest to God do this because HOLY SHIT it helped me").
My back only went out one time after that - when I moved into my last apartment, and was trying to do a little more of the lifting than I should have done. That time, I went to a really good massage therapist instead, and did some daily stretching and that took care of it. These days I just am very careful to not overstress my back, and I am very quick to speak up and admit that "okay, yeah, this thing is too heavy for me to handle, I'mma need some help." And one of the stretches my friend showed me is my magic bullet for lower back pain.
At the end of the day it was something else that helped me longer term, but the information I got from that chiropractor initially did shed some light. So that's why I'm not inclined to dismiss it as total nonsense - but it's not the magic bullet either.
posted by EmpressCallipygos at 8:04 AM on August 18, 2022 [1 favorite]
Yeah, that was what ultimately helped me with the issue I had.
I saw a chiropractor after throwing my back out real bad while working on a play (and HOO BOY do I ever have a whole lot of stories about THAT play, but I'll spare y'all), and so this was a workers' comp thing, and it was one of the actresses who recommended her chiropractor to me because she had had the same problem and swore by him. He was the one who ascertained, through x-rays, that I'd had some spinal curvature because one of my legs was indeed a wee bit shorter than the other, and my hips had just tried to compensate. (emjaybee, I know you're dubious, but I saw the x-ray - and honestly, after a few sessions, I was about an inch taller. Legs being a tiny bit asymmetrical is not uncommon, it's just that most of us don't ever notice it.)
Ultimately, though, it was the exercises he gave me and the simple awareness that "oh, okay, that's a weak point I should be cognizant of" helped me longer term. Prior to my back going out, I'd been lugging around huge heavy furniture set pieces twice a day as we set up for rehearsal and cleaned up after, and this was just how I learned that that was too much for me to handle. (I shouldn't have been doing that anyway as a stage manager, but that's one of those whole other stories.) A couple I know also helped a lot - she is a massage therapist, and he also has similar back issues, so they also both visited to offer double-teamed advice (she was telling me "here's why your existing mattress sucks and what you should do instead, and here are some other stretches that can help" and he was telling me "honest to God do this because HOLY SHIT it helped me").
My back only went out one time after that - when I moved into my last apartment, and was trying to do a little more of the lifting than I should have done. That time, I went to a really good massage therapist instead, and did some daily stretching and that took care of it. These days I just am very careful to not overstress my back, and I am very quick to speak up and admit that "okay, yeah, this thing is too heavy for me to handle, I'mma need some help." And one of the stretches my friend showed me is my magic bullet for lower back pain.
At the end of the day it was something else that helped me longer term, but the information I got from that chiropractor initially did shed some light. So that's why I'm not inclined to dismiss it as total nonsense - but it's not the magic bullet either.
posted by EmpressCallipygos at 8:04 AM on August 18, 2022 [1 favorite]
A young friend of mine had a blood vessel in his neck broken by a chiropractor, he went into a stroke. He nearly died and has had to relearn how to walk and talk. I was shocked, I had no idea that could even happen, let alone how common it is.
posted by LarryC at 8:07 AM on August 18, 2022 [1 favorite]
posted by LarryC at 8:07 AM on August 18, 2022 [1 favorite]
I was thinking there was a chiropractor in Congress, but I may have been thinking of opthalmologist Rand Paul or Paul Gosar, D.D.S. There are some chiros in statewide office, though.
Why are most of the physicians in Congress Republicans?
posted by box at 8:07 AM on August 18, 2022
Why are most of the physicians in Congress Republicans?
posted by box at 8:07 AM on August 18, 2022
@box - My guess is Republicans doctors are more likely to be in it for the money, and then they realize the money is far easier in Congress. I'd bet if you look at their backgrounds, they were all in high income specialties, and not GPs or Pediatricians trying to get by on $150K a year.
posted by COD at 8:10 AM on August 18, 2022 [1 favorite]
posted by COD at 8:10 AM on August 18, 2022 [1 favorite]
Rocky Mountain Raga
... sounds lovely, doesn't it?
There will never be any more music from that artist, because he died on a chiropractor's table.
posted by scruss at 8:12 AM on August 18, 2022 [3 favorites]
... sounds lovely, doesn't it?
There will never be any more music from that artist, because he died on a chiropractor's table.
posted by scruss at 8:12 AM on August 18, 2022 [3 favorites]
Chiropracty got oversold big time by the guy who originated it, but there are a number of treatments from it tested and approved by the general health community. The VA supports it, you can get insurance to cover your practice, and millions of people use it.
There are over 360 million chiropractic appointments every year.
Two years ago I would’ve said that a bunch of people sitting around on the Internet trading anecdata about how their pet peeve is a horrible deadly thing was all in good fun, but with the sheer number of deaths caused by misinformation recently it has started to take on a much more sinister tone.
If chiropracty didn’t work for you then go ahead and say that. If it harmed you then go ahead and say that. But 35 million people use chiropractors every year and the widespread harm one would expect from reading the people in this thread who have "done their own research" just doesn’t exist.
500,000 deaths, a lot of them caused by medical misinformation. There is now a higher standard for banging on your pet drum. Please honor it.
posted by Tell Me No Lies at 8:17 AM on August 18, 2022 [4 favorites]
There are over 360 million chiropractic appointments every year.
Two years ago I would’ve said that a bunch of people sitting around on the Internet trading anecdata about how their pet peeve is a horrible deadly thing was all in good fun, but with the sheer number of deaths caused by misinformation recently it has started to take on a much more sinister tone.
If chiropracty didn’t work for you then go ahead and say that. If it harmed you then go ahead and say that. But 35 million people use chiropractors every year and the widespread harm one would expect from reading the people in this thread who have "done their own research" just doesn’t exist.
500,000 deaths, a lot of them caused by medical misinformation. There is now a higher standard for banging on your pet drum. Please honor it.
posted by Tell Me No Lies at 8:17 AM on August 18, 2022 [4 favorites]
There is now a higher standard for banging on your pet drum. Please honor it.
So, curious, does the account posted by the OP meet this standard we now need to adhere to?
posted by WatTylerJr at 8:25 AM on August 18, 2022
So, curious, does the account posted by the OP meet this standard we now need to adhere to?
posted by WatTylerJr at 8:25 AM on August 18, 2022
People who see chiropractors aren't doing so because they have been hornswaggled by quacks. They're doing so because the "real doctors" are telling them that "meh, you just gotta deal with it, sucks to be you I guess" instead of helping them.
Another thing, I've known a couple of doctors (MDs) who semi-regularly went to the same chiropractor. Probably one of the less quacky ones, based on what I knew about the doctors in general. I don't think they ever referred a patient to a chiropractor, so I'm not sure if they felt it was a real help or just a placebo that they found effective for whatever general back ache they were experiencing.
posted by ghost phoneme at 8:42 AM on August 18, 2022
Another thing, I've known a couple of doctors (MDs) who semi-regularly went to the same chiropractor. Probably one of the less quacky ones, based on what I knew about the doctors in general. I don't think they ever referred a patient to a chiropractor, so I'm not sure if they felt it was a real help or just a placebo that they found effective for whatever general back ache they were experiencing.
posted by ghost phoneme at 8:42 AM on August 18, 2022
if we're piling on with anecdotes, the one time I frequented a chiropractor's office I only returned to take advantage of the therapeutic massage.. the fellow (not the same person as the chiropractic practitioner) had been an oilfield worker, he lost his vision in a workplace accident and retrained for massage therapy, my god he was amazing. Every time I paid the bill on the way out I got to stare at the assortment of Scientology texts on display at the reception counter, and that is my lasting impression of chiropractic.
posted by elkevelvet at 8:47 AM on August 18, 2022 [1 favorite]
posted by elkevelvet at 8:47 AM on August 18, 2022 [1 favorite]
chiropracty is not evidence-based.
posted by blairsyprofane at 8:55 AM on August 18, 2022 [3 favorites]
posted by blairsyprofane at 8:55 AM on August 18, 2022 [3 favorites]
But 35 million people use chiropractors every year and...
But you know what? The number of people they don't kill or injure is a lot less interesting than the number they do, right? There's a reason this sort of logic is usually deployed in defense of guns, cops, etc. You know 99% of cops never kill anyone? I guess we can all stop worrying about police violence!
But you know what else doesn't kill many people? Prayer. Homeopathy. Tarot cards. If a "treatment" confers no proven benefit, you'd at least hope that it doesn't hurt anyone either.
posted by klanawa at 9:04 AM on August 18, 2022 [16 favorites]
But you know what? The number of people they don't kill or injure is a lot less interesting than the number they do, right? There's a reason this sort of logic is usually deployed in defense of guns, cops, etc. You know 99% of cops never kill anyone? I guess we can all stop worrying about police violence!
But you know what else doesn't kill many people? Prayer. Homeopathy. Tarot cards. If a "treatment" confers no proven benefit, you'd at least hope that it doesn't hurt anyone either.
posted by klanawa at 9:04 AM on August 18, 2022 [16 favorites]
Back pain is an incredibly common problem, extremely debilitating and often it self resolved or patients just give up and live with chronic pain. Some of the actions they perform on their patients may have a therapeutic benefit but mostly not because of their diagnosis, because the diagnosis is based on sham science. Generally you are probably more likely to benefit from a massage from a licensed massage therapist or from seeking physical therapy after a consult with an actual doctor.
posted by interogative mood at 9:07 AM on August 18, 2022 [1 favorite]
posted by interogative mood at 9:07 AM on August 18, 2022 [1 favorite]
As others have mentioned there seems to be a big correlation between adjustments and strokes in middle aged folks. Happened to a friend last year. One of the first questions asked when he went to the ER was if he had had an adjustment recently.
I’m a rock climber and manage to injure my body a lot. Lots of minor annoying things. I’ve tried many chiros and it has never done anything for me. I’m sure there are some good ones out there but the ones I’ve seen were all junk.
posted by misterpatrick at 9:08 AM on August 18, 2022
I’m a rock climber and manage to injure my body a lot. Lots of minor annoying things. I’ve tried many chiros and it has never done anything for me. I’m sure there are some good ones out there but the ones I’ve seen were all junk.
posted by misterpatrick at 9:08 AM on August 18, 2022
The very first patient I saw as a clinical medical student was a middle-aged man who had had a vertebral dissection and posterior circulation stroke due to chiropractic manipulation. He survived long enough to make it to the hospital; many don't. He was a great dude, and actually excited to teach students about his his textbook lateral medullary syndrome, which up to that point I'd had a sneaking suspicion was just something my neuroanatomy professor made up to torture us on exams. That patient was the spark that led me into neurology. (Before that I was going to become a general pediatrician!)
Since then, I have had hundreds of patients maimed by chiropractors. Many of them young and otherwise healthy, just like this woman in Georgia. Massage is great. Physical therapy is great. But some dude cracking and wrenching your neck? No thanks.
posted by basalganglia at 9:09 AM on August 18, 2022 [37 favorites]
Since then, I have had hundreds of patients maimed by chiropractors. Many of them young and otherwise healthy, just like this woman in Georgia. Massage is great. Physical therapy is great. But some dude cracking and wrenching your neck? No thanks.
posted by basalganglia at 9:09 AM on August 18, 2022 [37 favorites]
It certainly seems telling that the "best" chiropractors mentioned in this thread are the ones who perform the fewest actions that differentiate chiropractic from massage or physical therapy.
Keep in mind also that the damage "alternative medicines" do isn't just direct damage. It's also the misdirection that fails to lead a patient to proper care. For example, homeopathy won't cause cancer, but it sure will mislead a cancer patient from obtaining timely, proper care.
The inaccessibility of medical care in this country is a huge problem, and one that absolutely must be addressed. But those filling in the gaps by preying on the desperation of the underserved are still immoral.
posted by explosion at 9:18 AM on August 18, 2022 [10 favorites]
Keep in mind also that the damage "alternative medicines" do isn't just direct damage. It's also the misdirection that fails to lead a patient to proper care. For example, homeopathy won't cause cancer, but it sure will mislead a cancer patient from obtaining timely, proper care.
The inaccessibility of medical care in this country is a huge problem, and one that absolutely must be addressed. But those filling in the gaps by preying on the desperation of the underserved are still immoral.
posted by explosion at 9:18 AM on August 18, 2022 [10 favorites]
If chiropracty didn’t work for you then go ahead and say that. If it harmed you then go ahead and say that. But 35 million people use chiropractors every year and the widespread harm one would expect from reading the people in this thread who have "done their own research" just doesn’t exist.
I guess now’s as good a time as any to introduce you to the concept of the hazard ratio. Vertebral artery dissection is an incredibly rare event, with an incidence of around 1-1.5 per 100K. You seem to be setting up a national mass casualty event as a bright line for public safety, with anything less than that indicating relative safety, but that would indicate an increase of VAD risk by four or five orders of magnitude. I don’t know how you’d ever see something like that without chiropractors actually trying to kill people.
Tripling the risk of a rare form of death doesn’t mean everyone dies — just twice as many as wouldn’t have died otherwise. And as other have said here, for a pseudoscience which provides no more benefit than massage to have any iatrogenic risk is utterly unconscionable.
posted by Coda at 9:25 AM on August 18, 2022 [22 favorites]
I guess now’s as good a time as any to introduce you to the concept of the hazard ratio. Vertebral artery dissection is an incredibly rare event, with an incidence of around 1-1.5 per 100K. You seem to be setting up a national mass casualty event as a bright line for public safety, with anything less than that indicating relative safety, but that would indicate an increase of VAD risk by four or five orders of magnitude. I don’t know how you’d ever see something like that without chiropractors actually trying to kill people.
Tripling the risk of a rare form of death doesn’t mean everyone dies — just twice as many as wouldn’t have died otherwise. And as other have said here, for a pseudoscience which provides no more benefit than massage to have any iatrogenic risk is utterly unconscionable.
posted by Coda at 9:25 AM on August 18, 2022 [22 favorites]
I have no dog in the chiropractic fight (nobody is going to ever crack my back or neck, thank you very much), but these threads are always so depressing in that right out of the gate there's a piling on of folks who seem more bent on demonstrating their super rationalist SCIENCE! credentials with jokes about astrology or religion and taking an absolutist know-it-all stance that it all just feels really self-satisfied and smarmy. Any real conversation feels immediately shut down beyond just reconfirming over and over again the dominant stance taken right out of the gate. Clearly some folks out there must like chiropractic approaches . . But it doesn't seem like we'll hear from many of them if they're instantly ridiculed right at the start. Being respectful or I dunno, open to discussion, doesn't have to mean endorsement.
posted by flamk at 9:28 AM on August 18, 2022 [8 favorites]
posted by flamk at 9:28 AM on August 18, 2022 [8 favorites]
But 35 million people use chiropractors every year
And get some semi-amateur physical therapy they could have been getting from physical therapists, and back rubs they could get from massage therapists. This is like saying 35 million people use veterinarians every year and also don't get rabies, it's not the correlation you're trying to say it is.
posted by Lyn Never at 9:30 AM on August 18, 2022 [3 favorites]
And get some semi-amateur physical therapy they could have been getting from physical therapists, and back rubs they could get from massage therapists. This is like saying 35 million people use veterinarians every year and also don't get rabies, it's not the correlation you're trying to say it is.
posted by Lyn Never at 9:30 AM on August 18, 2022 [3 favorites]
> But 35 million people use chiropractors every year
And get some semi-amateur physical therapy they could have been getting from physical therapists, and back rubs they could get from massage therapists.
Then maybe we should be looking into whatever it is that the chiropractor is giving them that their doctor, their physical therapist, and their massage therapist isn't able to, and address that.
This is like saying 35 million people use veterinarians every year and also don't get rabies, it's not the correlation you're trying to say it is.
35 million people is still an awful lot of people, and if that many people are falling through a crack in the system, it sounds like it's a mighty big crack and maybe we should figure out where it is and how to fix it.
posted by EmpressCallipygos at 9:38 AM on August 18, 2022 [2 favorites]
And get some semi-amateur physical therapy they could have been getting from physical therapists, and back rubs they could get from massage therapists.
Then maybe we should be looking into whatever it is that the chiropractor is giving them that their doctor, their physical therapist, and their massage therapist isn't able to, and address that.
This is like saying 35 million people use veterinarians every year and also don't get rabies, it's not the correlation you're trying to say it is.
35 million people is still an awful lot of people, and if that many people are falling through a crack in the system, it sounds like it's a mighty big crack and maybe we should figure out where it is and how to fix it.
posted by EmpressCallipygos at 9:38 AM on August 18, 2022 [2 favorites]
There's a chiropractor in my extended, non-related family.
Over the past 10 years, we have argued about:
*vaccines (me: PRO, him: rabidly CON)
*diet drugs (he partnered with a skeezy local MD to get prescriptions)
*training (he did a dual bachelor's & DC degree in 5 years...that's his total training)
*science (For a while, I hired undergraduate science instructors for a huge online program and, when I told him that I rejected applicants with DC degrees without looking at their resumes, he actually attempted to file an EEOC complaint against me. He lost, of course.)
*subluxations (it's their catchall term for anything they want to convince you needs chiropractic "treatment")
*the long-standing connections between chiros and Scientology
posted by yellowcandy at 9:44 AM on August 18, 2022 [10 favorites]
Over the past 10 years, we have argued about:
*vaccines (me: PRO, him: rabidly CON)
*diet drugs (he partnered with a skeezy local MD to get prescriptions)
*training (he did a dual bachelor's & DC degree in 5 years...that's his total training)
*science (For a while, I hired undergraduate science instructors for a huge online program and, when I told him that I rejected applicants with DC degrees without looking at their resumes, he actually attempted to file an EEOC complaint against me. He lost, of course.)
*subluxations (it's their catchall term for anything they want to convince you needs chiropractic "treatment")
*the long-standing connections between chiros and Scientology
posted by yellowcandy at 9:44 AM on August 18, 2022 [10 favorites]
One of those weird employment-path determining tests in high school, the one administered by the armed forces, suggested that I pursue a career as a chiropractor. Or an astrophysicist. I knew that the test mainly was designed to propose jobs that the army needs folks for, but I was surprised that the government should actually endorse the field in such a straightforward way.
posted by St. Oops at 9:46 AM on August 18, 2022 [1 favorite]
posted by St. Oops at 9:46 AM on August 18, 2022 [1 favorite]
yellowcandy's link includes part of the explanation of why the VA covers chiropractic:
The case cited in the article is Wilk v American Medical Association (1990), in which a group of chiropractors won a decision based on the Sherman Antitrust Act that the AMA was attempting to contain and eliminate the chiropractic profession. What Scientology omits is that the decision was not based on the merits of chiropractic. Judge Getzendanner wrote:
The case cited in the article is Wilk v American Medical Association (1990), in which a group of chiropractors won a decision based on the Sherman Antitrust Act that the AMA was attempting to contain and eliminate the chiropractic profession. What Scientology omits is that the decision was not based on the merits of chiropractic. Judge Getzendanner wrote:
The plaintiffs [chiropractor group] clearly want more from the court. They want a judicial pronouncement that chiropractic is a valid, efficacious, even scientific health care service. I believe that the answer to that question can only be provided by a well designed, controlled, scientific study… No such study has ever been done. In the absence of such a study, the court is left to decide the issue on the basis of largely anecdotal evidence. I decline to pronounce chiropractic valid or invalid on anecdotal evidence.posted by spamandkimchi at 10:12 AM on August 18, 2022 [5 favorites]
I was warned away from chiropractic for years by my parents for most of the reasons given above. Then I started having upper back spasms and neck stiffness, to the point of being unable to ride a bike and practice some specific forms of meditation. Through a physical therapist friend who was unable to resolve some of the muscular issues at work, I was recommended to a chiropractor in the Seattle north end. He turned out to practice a very different form that I've not seen mentioned here, the activator method.
He never adjusted my neck manually, but used a little gun that would pulse/tap on specific places on my back and neck to help guide the vertebrae back to a neutral position. I was struck by some other techniques that he would use to "QA" his work, having me resist certain pushes or pulls he was doing to my arms or legs. I always left feeling better, and he was good about encouraging exercises to address some of my lifestyle choices in tech/cycling/accordion. When I was first diagnosed, I went 3 or 4 times over a few months. I had some stiffness two or three years later I went back to him to address, and the last time I went was about 18 months ago.
At one point when I needed some help, and he had gone on a long vacation, so I reached out to friends and got a couple of recommendations. The guy I went to did the manual adjustment process, and I was shocked at how dangerous it felt. Still helped, but it didn't last. At all. And when the other guy returned, I went back to him.
I've now moved from Seattle, and reached out to him to ask what keywords to use to find an appropriate chiropractor using the same techniques he used. He was completely unhelpful and suggested I look for physical therapists' recommendations. So I think there are issues with some inconsistency of technique application, and maybe some underlying awareness of the spine that is hard to teach, and a lot of sketchiness in terms of how practitioners market themselves. The sense I get is that even "the activator method" is no guarantee that the chiropractor will know how to apply the device, meaning I could still be injured. Frustrating.
posted by SoundInhabitant at 10:18 AM on August 18, 2022
He never adjusted my neck manually, but used a little gun that would pulse/tap on specific places on my back and neck to help guide the vertebrae back to a neutral position. I was struck by some other techniques that he would use to "QA" his work, having me resist certain pushes or pulls he was doing to my arms or legs. I always left feeling better, and he was good about encouraging exercises to address some of my lifestyle choices in tech/cycling/accordion. When I was first diagnosed, I went 3 or 4 times over a few months. I had some stiffness two or three years later I went back to him to address, and the last time I went was about 18 months ago.
At one point when I needed some help, and he had gone on a long vacation, so I reached out to friends and got a couple of recommendations. The guy I went to did the manual adjustment process, and I was shocked at how dangerous it felt. Still helped, but it didn't last. At all. And when the other guy returned, I went back to him.
I've now moved from Seattle, and reached out to him to ask what keywords to use to find an appropriate chiropractor using the same techniques he used. He was completely unhelpful and suggested I look for physical therapists' recommendations. So I think there are issues with some inconsistency of technique application, and maybe some underlying awareness of the spine that is hard to teach, and a lot of sketchiness in terms of how practitioners market themselves. The sense I get is that even "the activator method" is no guarantee that the chiropractor will know how to apply the device, meaning I could still be injured. Frustrating.
posted by SoundInhabitant at 10:18 AM on August 18, 2022
IME chiropractic is a career for ethically-challenged people who want to make MD money without the continuous study or hard work that would entail. When I was young and desperate I used to work for a chiropractor. The professional “journals” they get address only one topic: how to make more money. The dude I worked for insisted on being addressed as “Dr.” while fleecing the vulnerable and gullible through neverending repeat visits and massive amounts of overpriced supplements. He spent his downtime watching porn in his office. When I quit I basically had to hold his office hostage to make sure he gave me the money he owed me. He shared the office with a massage therapist and a couple psychologists and I’m not gonna lie, it felt really good to publicly humiliate him in front of them and his patients.
posted by Jess the Mess at 10:40 AM on August 18, 2022 [5 favorites]
posted by Jess the Mess at 10:40 AM on August 18, 2022 [5 favorites]
Clearly some folks out there must like chiropractic approaches . . But it doesn't seem like we'll hear from many of them if they're instantly ridiculed right at the start.
There are some things in this world that are already-proven scams, if not outright evil.
There are people who like MLM schemes, Scientology, fascism, conversion therapy, et cetera. That some people are satisfied with these things does not make them valid or deserving of immunity from ridicule.
Chiropractic is not a sidelined or overlooked indigenous medical practice like the best of "alternative medicine." It is in line with homeopathy and other western scam medicines.
"Hearing both sides of the argument" is how these evils thrive. Metafilter does not need to be open to "both sides" of the chiropractic conversation any more than it needs to be open to "both sides" of other readily disproven scams and evil ideologies.
posted by explosion at 11:08 AM on August 18, 2022 [21 favorites]
There are some things in this world that are already-proven scams, if not outright evil.
There are people who like MLM schemes, Scientology, fascism, conversion therapy, et cetera. That some people are satisfied with these things does not make them valid or deserving of immunity from ridicule.
Chiropractic is not a sidelined or overlooked indigenous medical practice like the best of "alternative medicine." It is in line with homeopathy and other western scam medicines.
"Hearing both sides of the argument" is how these evils thrive. Metafilter does not need to be open to "both sides" of the chiropractic conversation any more than it needs to be open to "both sides" of other readily disproven scams and evil ideologies.
posted by explosion at 11:08 AM on August 18, 2022 [21 favorites]
but these threads are always so depressing in that right out of the gate there's a piling on of folks who seem more bent on demonstrating their super rationalist SCIENCE! credentials with jokes about astrology or religion and taking an absolutist know-it-all stance that it all just feels really self-satisfied and smarmy.
Trump. This is how you end up with Trump. This attitude of "uhg, you leftists always complaining about patriarchy and white supremacy and religion and corporations and bitcoin and plastic" attitude is how we end up with Trump.
One in five Americans don't have a single covid shot. One in five Americans aren't sure the moon landings happened. It's not being a smarmy "know-it-all" to say that these people are completely, utterly, tragically, ridiculously wrong.
I'm not sorry that I don't consider this to be normal.
I get it. I'm upset when obnoxious atheists and edgelords misuse "rationality" and "science." But I also get upset when chiropractors misuse "medicine" and "treatment."
posted by AlSweigart at 11:20 AM on August 18, 2022 [21 favorites]
Trump. This is how you end up with Trump. This attitude of "uhg, you leftists always complaining about patriarchy and white supremacy and religion and corporations and bitcoin and plastic" attitude is how we end up with Trump.
One in five Americans don't have a single covid shot. One in five Americans aren't sure the moon landings happened. It's not being a smarmy "know-it-all" to say that these people are completely, utterly, tragically, ridiculously wrong.
I'm not sorry that I don't consider this to be normal.
I get it. I'm upset when obnoxious atheists and edgelords misuse "rationality" and "science." But I also get upset when chiropractors misuse "medicine" and "treatment."
posted by AlSweigart at 11:20 AM on August 18, 2022 [21 favorites]
Also just because there are problems with the legitimate health care system doesn’t mean that charlatans attempting to take advantage of that should be entertained as a practical solution.
posted by Selena777 at 11:22 AM on August 18, 2022 [14 favorites]
posted by Selena777 at 11:22 AM on August 18, 2022 [14 favorites]
This article is from way back in 2001, but it explains the two different "schools" of chiropractic. There's one school - the "straights" (no idea if this is still current terminology or not) that believe spinal manipulation can cure anything, and the "mixed" school is more in line with physical therapy-like treatments. I think this is partly why people who have seen chiropractors have had such different experiences.
At the suggestion of a well meaning friend I saw a chiropractor for some nagging mid-back pain; I realized some sessions in that he belonged to the "straight" school and I noped out of the practice soon after. I also later found out that the nagging back pain was referred pain from a stone-filled gallbladder and wasn't actually musculoskeletal in origin.
posted by sencha at 11:23 AM on August 18, 2022 [2 favorites]
At the suggestion of a well meaning friend I saw a chiropractor for some nagging mid-back pain; I realized some sessions in that he belonged to the "straight" school and I noped out of the practice soon after. I also later found out that the nagging back pain was referred pain from a stone-filled gallbladder and wasn't actually musculoskeletal in origin.
posted by sencha at 11:23 AM on August 18, 2022 [2 favorites]
"Every single week with little or no exception, one of those cases is someone who died or became a paraplegic due to the actions of a chiropractor."
I think a lot of chiropractic is quackery and nonsense, but this seems very unlikely.
Funny your gut is telling you this is unlikely, as it mirrors the second paragraph of this post's description:
“I had never heard of anything like this happening. I didn’t know it could happen. So it just wasn’t on my radar.”
posted by AlSweigart at 11:43 AM on August 18, 2022 [2 favorites]
I think a lot of chiropractic is quackery and nonsense, but this seems very unlikely.
Funny your gut is telling you this is unlikely, as it mirrors the second paragraph of this post's description:
“I had never heard of anything like this happening. I didn’t know it could happen. So it just wasn’t on my radar.”
posted by AlSweigart at 11:43 AM on August 18, 2022 [2 favorites]
I have no dog in the chiropractic fight (nobody is going to ever crack my back or neck, thank you very much), but these threads are always so depressing in that right out of the gate there's a piling on of folks who seem more bent on demonstrating their super rationalist SCIENCE! credentials with jokes about astrology or religion and taking an absolutist know-it-all stance that it all just feels really self-satisfied and smarmy.
Agreed, and one of the things that bum me out is that various 'alternative' healing stuff is often discussed as if it's on an opposite pole from medicine or Western Medicine or whatever, which... I dunno, but I've had a look around the good old USA, and it's hard for me to feel that the medical system here is evidence-based, health-based, or care-based.
It seems to me that any practice in the health/wellness/care/healing realm exists somewhere on a spectrum of scam to care, and any one practitioner might be located more toward one side or more toward another but the patterns we think we know about, the biases that we have about what types are more one than the other... well shit, all of that just feels like internalizing the authority of a field that's cornered a lot of it and doesn't always have a lot to show for it in aggregate.
posted by entropone at 11:50 AM on August 18, 2022 [3 favorites]
Agreed, and one of the things that bum me out is that various 'alternative' healing stuff is often discussed as if it's on an opposite pole from medicine or Western Medicine or whatever, which... I dunno, but I've had a look around the good old USA, and it's hard for me to feel that the medical system here is evidence-based, health-based, or care-based.
It seems to me that any practice in the health/wellness/care/healing realm exists somewhere on a spectrum of scam to care, and any one practitioner might be located more toward one side or more toward another but the patterns we think we know about, the biases that we have about what types are more one than the other... well shit, all of that just feels like internalizing the authority of a field that's cornered a lot of it and doesn't always have a lot to show for it in aggregate.
posted by entropone at 11:50 AM on August 18, 2022 [3 favorites]
I've had quite bad care from a chiropractor who also claimed to be a Naturopath, and heard chiropractors claim to be able to treat all manner of illness well outside what should be their limited scope. It's sham, quackery, and can cause harm. Take whatever bits of it have any proven merit, train people to do that plus good massage and physical therapy. I think part of what people badly need and get from chiros is touch. Touch that is intended to be therapeutic. At least in the US, people live at a distance both physical and emotional and it's not good for us.
posted by theora55 at 11:51 AM on August 18, 2022 [3 favorites]
posted by theora55 at 11:51 AM on August 18, 2022 [3 favorites]
Seconding the benefit of being touched by someone you believe wants to help you. Some lonely years that significantly increased the chance of letting the angry muscle relax. (Massage therapists, and even a few hairdressers.)
posted by clew at 12:11 PM on August 18, 2022 [3 favorites]
posted by clew at 12:11 PM on August 18, 2022 [3 favorites]
but used a little gun that would pulse/tap on specific places on my back and neck to help guide the vertebrae back to a neutral position.
I think you will get similar relief if you find a qualified, licensed massage therapist who uses a therapy gun. No need for a chiropractor.
posted by interogative mood at 12:24 PM on August 18, 2022 [1 favorite]
I think you will get similar relief if you find a qualified, licensed massage therapist who uses a therapy gun. No need for a chiropractor.
posted by interogative mood at 12:24 PM on August 18, 2022 [1 favorite]
I grew up with multiple chiropractors in the family, and through them met quite a few others over the years. Many times, I heard them say things like "Chiropractic can cure everything." As a kid, it is easy, normal even, to trust your parents and relatives to tell the truth, so I bought into it. Sometimes I even fantasized about being a chiropractor when I grew up.
Then, when I was around 12 I started wondering why I still had health problems, if chiropractic supposedly cures everything. I had been under near-constant chiropractic care for my whole life, so why was I sick? I started to doubt. When I was in seventh grade I started having such severe lower back pain that I could barely move without being in extreme agony. This lasted for a few months, during which the cure was. . . more chiropractic. I couldn't even tie my own shoes for a couple of weeks, it was so excruciating. I started having serious doubts then when I considered that I was the only kid in my class that was under chiropractic care, and the only kid in class that was incapacitated with back pain.
A lot of the "anecdata" shared by other posters sounds uncannily familiar to me. I won't go into details which you can read about above, but some trends I noticed in the chiropractic community (as far as I was exposed to it) were: magical thinking (as in, "healing hands"), science skepticism (as applied to medicine in particular and scientific thinking in general), extreme/fanatical anti-vax bias (e.g. "Vaccines are lie from the pit of hell, and that is where they belong!"), gullability when it comes to other forms of snake oil (especially over-the-counter supplements), and a cult-like mentality (e.g. idolization of Palmer).
I suppose there are some ethical chiropractors that actually help their patients. I think they are the minority, but I'm sure they exist. Of the chiropractors I have met personally, some were more studious than others, though one of them I would describe as semi-literate. One wonders how a "college" could matriculate someone with so little academic ability, who was openly disdainful of study. The intellectual spectrum among US chiropractors is quite broad, which raises questions for me about the quality of any formal education and training they receive.
Personally, I found much better success with a combination of yoga and physical therapy. No way would I ever voluntarily set foot in a chiropractor's office, or allow any of my relatives to manipulate my spine.
posted by abraxasaxarba at 1:10 PM on August 18, 2022 [15 favorites]
Then, when I was around 12 I started wondering why I still had health problems, if chiropractic supposedly cures everything. I had been under near-constant chiropractic care for my whole life, so why was I sick? I started to doubt. When I was in seventh grade I started having such severe lower back pain that I could barely move without being in extreme agony. This lasted for a few months, during which the cure was. . . more chiropractic. I couldn't even tie my own shoes for a couple of weeks, it was so excruciating. I started having serious doubts then when I considered that I was the only kid in my class that was under chiropractic care, and the only kid in class that was incapacitated with back pain.
A lot of the "anecdata" shared by other posters sounds uncannily familiar to me. I won't go into details which you can read about above, but some trends I noticed in the chiropractic community (as far as I was exposed to it) were: magical thinking (as in, "healing hands"), science skepticism (as applied to medicine in particular and scientific thinking in general), extreme/fanatical anti-vax bias (e.g. "Vaccines are lie from the pit of hell, and that is where they belong!"), gullability when it comes to other forms of snake oil (especially over-the-counter supplements), and a cult-like mentality (e.g. idolization of Palmer).
I suppose there are some ethical chiropractors that actually help their patients. I think they are the minority, but I'm sure they exist. Of the chiropractors I have met personally, some were more studious than others, though one of them I would describe as semi-literate. One wonders how a "college" could matriculate someone with so little academic ability, who was openly disdainful of study. The intellectual spectrum among US chiropractors is quite broad, which raises questions for me about the quality of any formal education and training they receive.
Personally, I found much better success with a combination of yoga and physical therapy. No way would I ever voluntarily set foot in a chiropractor's office, or allow any of my relatives to manipulate my spine.
posted by abraxasaxarba at 1:10 PM on August 18, 2022 [15 favorites]
Something I'd like to address, as I see it continuing to come up:
I think you will get similar relief if you find a qualified, licensed massage therapist who uses a therapy gun. No need for a chiropractor.
Do medical insurance companies cover massage therapy? I know that some cover some chiropractic visits. Maybe that is one reason people opt for visiting chiropractors despite "no need for a chiropractor".
Again, to make clear: I personally think that while there certainly are problematic chiropractors, the lack of access to proper health care is an even bigger problem, which is driving some people to take a gamble this way ("Well, yeah, some chiropractors are probably bad, but some might be okay, and at least they might be able to do something since the insurance cut me off everything else and my knee is still shot....")
If people were able to get the care they needed elsewhere, they might not be turning to chiropractors in the first place. That seems like a bigger problem.
posted by EmpressCallipygos at 1:54 PM on August 18, 2022 [6 favorites]
I think you will get similar relief if you find a qualified, licensed massage therapist who uses a therapy gun. No need for a chiropractor.
Do medical insurance companies cover massage therapy? I know that some cover some chiropractic visits. Maybe that is one reason people opt for visiting chiropractors despite "no need for a chiropractor".
Again, to make clear: I personally think that while there certainly are problematic chiropractors, the lack of access to proper health care is an even bigger problem, which is driving some people to take a gamble this way ("Well, yeah, some chiropractors are probably bad, but some might be okay, and at least they might be able to do something since the insurance cut me off everything else and my knee is still shot....")
If people were able to get the care they needed elsewhere, they might not be turning to chiropractors in the first place. That seems like a bigger problem.
posted by EmpressCallipygos at 1:54 PM on August 18, 2022 [6 favorites]
Yeah, part of the problem is that chiropractors are simply more accessible than doctors are in my area. Most of the chiro offices that I have seen welcome walk-ins, cost less, and are often members of the community they serve. If conventional medicine has already dismissed you or if you feel uncomfortable with doctors in general, chiropractic probably starts to look pretty good. Especially if they spend time talking with you and provide some reassurance that they can help.
posted by corey flood at 2:26 PM on August 18, 2022 [5 favorites]
posted by corey flood at 2:26 PM on August 18, 2022 [5 favorites]
When my kids were really little, there was another new mom in my circle who was huge into chiropraxy, and kind-of fell into the anti-vax granola mommishness of the era (2010ish, so Wakefield was just being finally debunked, and pro/anti-vax hadn't really polarized yet). She decided not to vaccinate her baby, which her husband was like, "This seems dumb to me, but I guess we can wait until she's six months."
Then the infant started getting repeated ear infections and mom made a chiropractor appointment. Dad said, "Um, how would cracking her back cure a bacterial infection in her ear? Can babies' backs even crack? They're like squid, all floppy." Mom was like, "He's cured me of a bunch of things and SWEARS he can cure her ear infection better than antibiotics, those are poison!"
Dad was not convinced, googled, became alarmed, and said he flatly refused to have her seen by a chiropractor. Mom insisted. The whole thing escalated, and dad ended up getting a restraining order against both the chiropractor and against his wife, forbidding her from taking the baby to anyone but an MD. Eventually he got a court order to have the baby vaccinated. THEY REMAINED MARRIED, which was the weirdest part of the whole thing to me!
posted by Eyebrows McGee at 3:16 PM on August 18, 2022 [23 favorites]
Then the infant started getting repeated ear infections and mom made a chiropractor appointment. Dad said, "Um, how would cracking her back cure a bacterial infection in her ear? Can babies' backs even crack? They're like squid, all floppy." Mom was like, "He's cured me of a bunch of things and SWEARS he can cure her ear infection better than antibiotics, those are poison!"
Dad was not convinced, googled, became alarmed, and said he flatly refused to have her seen by a chiropractor. Mom insisted. The whole thing escalated, and dad ended up getting a restraining order against both the chiropractor and against his wife, forbidding her from taking the baby to anyone but an MD. Eventually he got a court order to have the baby vaccinated. THEY REMAINED MARRIED, which was the weirdest part of the whole thing to me!
posted by Eyebrows McGee at 3:16 PM on August 18, 2022 [23 favorites]
I have long wished that physical therapy worked more like psychotherapy, in which regular, preventative care is encouraged. I don’t know why it’s necessary to have an egregious injury to get PT covered by insurance in the U.S. I presume preventative care would save a lot of money on avoided surgeries. This need is one thing that drives people to chiropractic.
posted by Comet Bug at 3:21 PM on August 18, 2022 [8 favorites]
posted by Comet Bug at 3:21 PM on August 18, 2022 [8 favorites]
Comet Bug, to be fair, preventative psychotherapy isn't really legitimately covered by insurance either, unfortunately, at least not as well as it should be. Everyone must be diagnosed with some medical affliction. God forbid we just admit that sometimes folks just need a few hours of a one-sided, non-judgmental human connection to manage living under capitalism. But you raise a really good point that I hadn't considered regarding PT! Like, let me spend $200 bucks now to save you $90000 later!?
posted by flamk at 3:50 PM on August 18, 2022 [6 favorites]
posted by flamk at 3:50 PM on August 18, 2022 [6 favorites]
tl;dr but as someone who's endured exactly one session with a chiropractor I must say I'm not surprised. Doesn't feel right what those guys do, at least what that one did to me. Especially the head-twisting business at the end, reminded me of Sleeper.
posted by Rash at 5:04 PM on August 18, 2022
posted by Rash at 5:04 PM on August 18, 2022
I was once a juror on a case where a guy was suing someone for a back injury, and his lawyer called up a chiropractor to demonstrate how the guy could no longer raise his arms over his head. He demonstrated this by holding up a posterboard with a clock face on it behind his patient and showing how his arms could only go to "two o'clock". We on the jury were dumbfounded and in deliberations kept asking each other why the guy didn't consult an actual doctor. So we found against him. Afterwards, the lawyer trailed me out of the courtroom and asked me why the jury voted the way it did. I told him the jury found Chiropracty shady. He told me his client's insurance would only cover a chiropractor visit. So then I felt bad for the guy but thought the lawyer should have taken him to a real doctor.
posted by acrasis at 5:35 PM on August 18, 2022
posted by acrasis at 5:35 PM on August 18, 2022
Most of the chiro offices that I have seen welcome walk-ins, cost less,
Well, yeah. Fake medicine is often cheaper than real medicine.
posted by AlSweigart at 5:58 PM on August 18, 2022 [8 favorites]
Well, yeah. Fake medicine is often cheaper than real medicine.
posted by AlSweigart at 5:58 PM on August 18, 2022 [8 favorites]
I've had back issues since a fall down some stairs in my first year of college. Two micro-discectomies (car accident in my senior year ripped apart the scar tissue and the same disc popped). Twenty some years later, I'm dealing with the slow degradation of my lower back, and am receiving treatment for stenosis. It sucks, but there's not a lot I can do, so, oh well.
The thing is, my college was in the Quad Cities, across the river from Davenport, Iowa, home to Palmer "College" the birthplace of the whole chiropractic concept. The four cities are flooded with the offices of chiropractors. It's always seemed like some magical sort of quick fix, if I just go and see one, they'll be able to fix all the shit going wrong in my back.
That is, until, post surgery, I met my physical therapist. We talked a lot during my therapy appointments. I mentioned going to school near Palmer, and asked about it. He had been stretching my legs out, and set my leg down, took a breath, and said, "stay away from those butchers." He was a very nice, kind man who could get a little intense at times, but damn, the anger I saw in his face was real. He took a breath, and then went back to stretching my legs, and spent the rest of the session explaining the difference between what he was doing, and how much study and training was required, backed up by research and study, and the outright quackery and woo of chiropractic "medicine."
I've never been, but I can't say the appeal of a magic back cracking that suddenly heals the nerve damage in my leg is there. Then again, so is the idea of the tooth fairy.
posted by Ghidorah at 6:52 PM on August 18, 2022 [6 favorites]
The thing is, my college was in the Quad Cities, across the river from Davenport, Iowa, home to Palmer "College" the birthplace of the whole chiropractic concept. The four cities are flooded with the offices of chiropractors. It's always seemed like some magical sort of quick fix, if I just go and see one, they'll be able to fix all the shit going wrong in my back.
That is, until, post surgery, I met my physical therapist. We talked a lot during my therapy appointments. I mentioned going to school near Palmer, and asked about it. He had been stretching my legs out, and set my leg down, took a breath, and said, "stay away from those butchers." He was a very nice, kind man who could get a little intense at times, but damn, the anger I saw in his face was real. He took a breath, and then went back to stretching my legs, and spent the rest of the session explaining the difference between what he was doing, and how much study and training was required, backed up by research and study, and the outright quackery and woo of chiropractic "medicine."
I've never been, but I can't say the appeal of a magic back cracking that suddenly heals the nerve damage in my leg is there. Then again, so is the idea of the tooth fairy.
posted by Ghidorah at 6:52 PM on August 18, 2022 [6 favorites]
Just wanted to highlight this comment from upthread:
“having me resist certain pushes or pulls he was doing to my arms or legs”
This is also one of those highly abused diagnostic techniques used by all kinds of quacks to demonstrate the need and efficacy of their nostrums. I’ve personally seen and experienced it used by peddlers of copper bracelets, magnets in the shoes, crystal healing, chi balancing, and a couple of other so-called therapies that are highly woo-dependent. We used to get all kinds of this stuff in the martial arts school, back in the day.
That’s not to say that testing mobility or muscle strength isn’t a potentially legitimate thing — legitimate physicians and physical therapists might indeed do it. But the test can easily be gamed with a variable manner of grip, angle, force, and initial impulse used in the push, the ability of the patient to subconsciously brace better for the second push, as well as the simple power of suggestion.
I have vivid recollection of a guy who would have you hold your arm out in front of you, push down on your hand to demonstrate musculoskeletal weakness, and then wave his hands in front of a certain chi meridian, and re-test. Lo and behold, the arm couldn’t be pushed down the second time!
The technique has such a long history of use among quacks that it’s use by anyone to show an immediate, miraculous response to some therapeutic intervention — short of actually putting a joint back into place, etc. — is a huge red flag.
posted by darkstar at 7:52 PM on August 18, 2022 [5 favorites]
“having me resist certain pushes or pulls he was doing to my arms or legs”
This is also one of those highly abused diagnostic techniques used by all kinds of quacks to demonstrate the need and efficacy of their nostrums. I’ve personally seen and experienced it used by peddlers of copper bracelets, magnets in the shoes, crystal healing, chi balancing, and a couple of other so-called therapies that are highly woo-dependent. We used to get all kinds of this stuff in the martial arts school, back in the day.
That’s not to say that testing mobility or muscle strength isn’t a potentially legitimate thing — legitimate physicians and physical therapists might indeed do it. But the test can easily be gamed with a variable manner of grip, angle, force, and initial impulse used in the push, the ability of the patient to subconsciously brace better for the second push, as well as the simple power of suggestion.
I have vivid recollection of a guy who would have you hold your arm out in front of you, push down on your hand to demonstrate musculoskeletal weakness, and then wave his hands in front of a certain chi meridian, and re-test. Lo and behold, the arm couldn’t be pushed down the second time!
The technique has such a long history of use among quacks that it’s use by anyone to show an immediate, miraculous response to some therapeutic intervention — short of actually putting a joint back into place, etc. — is a huge red flag.
posted by darkstar at 7:52 PM on August 18, 2022 [5 favorites]
I think you will get similar relief if you find a qualified, licensed massage therapist who uses a therapy gun. No need for a chiropractor.
You think so huh? Well feel free to recommend someone, know-it-all. My story started with a licensed physical therapist who was unable to help me, and offered this as a way out. And it worked. To EmpressCallipygos' point, the therapist wasnt covered, the chiropractor was. Even if it wasnt, it did what it claimed. I didn't post it to prove everyone else wrong, just to add color to this discussion. A specific technique that didn't feel as dangerous as Danny Aiello pulling Tim Robbins through the Bardo.
I endured a year plus of debilitating back spasms. Like lay down on the floor in my cubicle for a half hour debilitating. It stopped after three treatments. If you've got evidence of the invalidity of my experience please drop it in the chat.
posted by SoundInhabitant at 8:14 PM on August 18, 2022 [3 favorites]
I think that you might want to try searching for McTimoney chiropractic, which is the group that use the adjustment gun. If people reading haven’t experienced it, it is really nothing at all a massage gun, it does gentle clicks. I can’t speak for the underlying neurological mechanism, but I’ve treated plenty of people who mention good experiences with it in the past, and at worst said it was ineffectual.
This conversation has ended up focussing on the sharp practice, under training, or whatever of chiropractors, but the strange thing for me is that the neck clicking is not at all specific to them (or me!).
In India, it’s apparently not uncommon to have barbers do it as part of the service. In Japan, there is seikotsui, in Ireland lightning bone setters… I was at a martial arts seminar where they showed us how to do it (although I thought that was a pretty bad idea). I even ended up giving some classes to a couple of Irish Physical Therapists (distinct from physiotherapists) because they had already “learnt” the techniques and were insured to practice, but wanted me to help them be a bit more delicate and safe!
But somehow the talk is all about chiropractors - is it really just that they are so badly trained in the US that damage is so common?
posted by fizban at 1:42 AM on August 19, 2022
This conversation has ended up focussing on the sharp practice, under training, or whatever of chiropractors, but the strange thing for me is that the neck clicking is not at all specific to them (or me!).
In India, it’s apparently not uncommon to have barbers do it as part of the service. In Japan, there is seikotsui, in Ireland lightning bone setters… I was at a martial arts seminar where they showed us how to do it (although I thought that was a pretty bad idea). I even ended up giving some classes to a couple of Irish Physical Therapists (distinct from physiotherapists) because they had already “learnt” the techniques and were insured to practice, but wanted me to help them be a bit more delicate and safe!
But somehow the talk is all about chiropractors - is it really just that they are so badly trained in the US that damage is so common?
posted by fizban at 1:42 AM on August 19, 2022
But somehow the talk is all about chiropractors
This is a thread about chiropractors. You're the one who keeps attempting to drag it back to osteopaths and other practitioners.
And yes, once again, we are focusing on the dangerous and extreme aspects of chiropractic, because a chiropractor who does none of those things is an unlicensed massage therapist.
The fact that you're a self-described osteopath but you keep defending chiropractic rather than distancing yourself from it is making me dubious that you are actually an osteopath. You're coming across entirely as a chiropractor who's taking umbrage at his profession being maligned.
posted by explosion at 4:29 AM on August 19, 2022 [9 favorites]
This is a thread about chiropractors. You're the one who keeps attempting to drag it back to osteopaths and other practitioners.
And yes, once again, we are focusing on the dangerous and extreme aspects of chiropractic, because a chiropractor who does none of those things is an unlicensed massage therapist.
The fact that you're a self-described osteopath but you keep defending chiropractic rather than distancing yourself from it is making me dubious that you are actually an osteopath. You're coming across entirely as a chiropractor who's taking umbrage at his profession being maligned.
posted by explosion at 4:29 AM on August 19, 2022 [9 favorites]
Crikey! If you wish, I can share my registration details, clinic and so on, but I don’t normally do that sort of thing online. In fact I rarely comment, as I don’t feel like I have much expertise, but since I do, for once, I was interested in sharing some of it.
I’m just interested in manual therapy as a whole. I’m sorry if I come across as defending American Chiropractic, as a lot of their practices seem pretty indefensible. I just think that the manipulation discussion is wider than just them, and as it’s something I sometimes do, and read research on, I wanted to talk about it.
posted by fizban at 6:22 AM on August 19, 2022
I’m just interested in manual therapy as a whole. I’m sorry if I come across as defending American Chiropractic, as a lot of their practices seem pretty indefensible. I just think that the manipulation discussion is wider than just them, and as it’s something I sometimes do, and read research on, I wanted to talk about it.
posted by fizban at 6:22 AM on August 19, 2022
OK, let me better explain my position through analogy:
In the US, one can represent oneself in court. It's not advisable, but it's allowed. People are generally not allowed to give legal advice if they're not attorneys, but sometimes people might say "I encountered a similar situation, here's what I did", usually while also advising to speak with an attorney.
And then there are sovereign citizens, who have their own "understanding" of what the law is, and they advise others with dubious legal practices. Their advice is not only incorrect, but also likely harmful to the recipient. To be clear, these sovereign citizens still do 95% of the correct stuff. They appear in court. They file motions. They use the English language, and cite law and precedent. It's just that last 5% that is incredibly wrong and makes the difference, much like how we share 99% of our DNA with chimpanzees, but we're different.
So in this analogy, we've got a thread on Metafilter about sovereign citizens (chiropractors) in which a UK solicitor (osteopath) is coming in and saying that he sees that the sov-cits seem to be observing mostly good practice, and he's incredulous that they're so mocked in the US.
The reason I'm dubious is because I'd expect an osteopath to jealously guard the reputation of his profession, and to distance himself from quackery. Not to dignify the practice. It may just be that you have failed to fathom just how ridiculously unregulated medicine is in the US, because chiropractors are, every single one, badly trained by definition. If they were well-trained, they'd be licensed as something else instead.
posted by explosion at 7:26 AM on August 19, 2022 [1 favorite]
In the US, one can represent oneself in court. It's not advisable, but it's allowed. People are generally not allowed to give legal advice if they're not attorneys, but sometimes people might say "I encountered a similar situation, here's what I did", usually while also advising to speak with an attorney.
And then there are sovereign citizens, who have their own "understanding" of what the law is, and they advise others with dubious legal practices. Their advice is not only incorrect, but also likely harmful to the recipient. To be clear, these sovereign citizens still do 95% of the correct stuff. They appear in court. They file motions. They use the English language, and cite law and precedent. It's just that last 5% that is incredibly wrong and makes the difference, much like how we share 99% of our DNA with chimpanzees, but we're different.
So in this analogy, we've got a thread on Metafilter about sovereign citizens (chiropractors) in which a UK solicitor (osteopath) is coming in and saying that he sees that the sov-cits seem to be observing mostly good practice, and he's incredulous that they're so mocked in the US.
The reason I'm dubious is because I'd expect an osteopath to jealously guard the reputation of his profession, and to distance himself from quackery. Not to dignify the practice. It may just be that you have failed to fathom just how ridiculously unregulated medicine is in the US, because chiropractors are, every single one, badly trained by definition. If they were well-trained, they'd be licensed as something else instead.
posted by explosion at 7:26 AM on August 19, 2022 [1 favorite]
I met my physical therapist. We talked a lot during my therapy appointments. I mentioned going to school near Palmer, and asked about it. He had been stretching my legs out, and set my leg down, took a breath, and said, "stay away from those butchers."
When I was a kid, my dad had an injury and went to a chiropractor a few times and told me to never ever go to a chiropractor.
(When I was about 10, a friend showed me her knuckles on both hands. She was like "I crack the knuckles on these hands, and I don't crack the knuckles on these hands." The hand with the knuckles she popped were all notably larger.)
I'm in the US and hypermobile, and last year I had a physical therapist tell me never to go to a chiropractor because they could kill me.
posted by aniola at 5:18 PM on August 19, 2022 [4 favorites]
When I was a kid, my dad had an injury and went to a chiropractor a few times and told me to never ever go to a chiropractor.
(When I was about 10, a friend showed me her knuckles on both hands. She was like "I crack the knuckles on these hands, and I don't crack the knuckles on these hands." The hand with the knuckles she popped were all notably larger.)
I'm in the US and hypermobile, and last year I had a physical therapist tell me never to go to a chiropractor because they could kill me.
posted by aniola at 5:18 PM on August 19, 2022 [4 favorites]
I guess I’m trying to get at a distinction between manipulating joints - bad, and chiropractors - bad, but perhaps you are right and they really are just such a shower of shot in the US that there’s no point me thinking about it.
I do want to emphasise that the arbitrary divisions into physio, physical therapist, sports therapist sports massage therapist etc etc are really unhelpful much of the time, but that is just another argument for trusting individuals and individual recommendations, and that is depressing, because I believe strongly in the importance of research, and it’s really hard to do effectively in manual therapy.
It feels important because lots of people say, don’t go to a chiropractor, you should only see a …, but those guys are fairly loosely regulated as well!
I’ll step back, now.
posted by fizban at 1:41 AM on August 20, 2022
I do want to emphasise that the arbitrary divisions into physio, physical therapist, sports therapist sports massage therapist etc etc are really unhelpful much of the time, but that is just another argument for trusting individuals and individual recommendations, and that is depressing, because I believe strongly in the importance of research, and it’s really hard to do effectively in manual therapy.
It feels important because lots of people say, don’t go to a chiropractor, you should only see a …, but those guys are fairly loosely regulated as well!
I’ll step back, now.
posted by fizban at 1:41 AM on August 20, 2022
"It feels important because lots of people say, don’t go to a chiropractor, you should only see a …, but those guys are fairly loosely regulated as well!"
I tell people to go to an orthopedist rather than a chiropractor.
Orthopedists aren't loosely regulated.
posted by yellowcandy at 11:15 AM on August 20, 2022 [1 favorite]
I tell people to go to an orthopedist rather than a chiropractor.
Orthopedists aren't loosely regulated.
posted by yellowcandy at 11:15 AM on August 20, 2022 [1 favorite]
I went to see a physical therapist after a car accident. They worked with a chiropractic clinic down the street. They asked if I had interest in seeing anyone there. I said, 'no.' My insurance company, Kaiser, will cover chiropractic visits as well as acupuncture. I've never availed myself of that so I don't really know of what extent. My parents (RN, MD) were horrified to hear that Kaiser offered this. A dear friend went with me to a yoga retreat. She had back pain and on the way there she told me of all the acupuncture, chiropractor visits and cranial sacral therapy she was doing. She's under-insured and terrified of expensive medical visits. I don't blame her. She couldn't participate in the yoga and I gently told her that it was time to get an MRI and that with this pain, even her state-sponsored health insurance provider would agree. Turns out, bulging disc (or discs). I don't really know how many visits she invested in the alternate care but nothing they could offer would help with those. The acupuncture may have helped temporarily with some of the pain. The last time I brought up my neck pain with my doctor, he gave me a pamphlet about necks and suggested that my neck locking up while driving my car was "not really that bad, right?" I thought he was joking but he didn't laugh. He said that I could go see a PT for it but that's a minimum $500 deductible up front to get unlimited with the PT, with co-pays once I had met the deductible. It's almost like they want you to go get fleeced rather than provide the medical care that they deem the most competent.
posted by amanda at 1:26 PM on August 20, 2022
posted by amanda at 1:26 PM on August 20, 2022
You think so huh? Well feel free to recommend someone, know-it-all. My story started with a licensed physical therapist who was unable to help me, and offered this as a way out. And it worked.
You asked for advice from the internet and I replied. If you want treatment and have moved to a new city start by getting a new primary care physician and then get referrals from there for a physical therapist or other specialist. Your insurance or work health savings plan may be able to reimburse massage therapy if it has been prescribed by a PCP or specialist.
posted by interogative mood at 2:41 PM on August 20, 2022 [1 favorite]
You asked for advice from the internet and I replied. If you want treatment and have moved to a new city start by getting a new primary care physician and then get referrals from there for a physical therapist or other specialist. Your insurance or work health savings plan may be able to reimburse massage therapy if it has been prescribed by a PCP or specialist.
posted by interogative mood at 2:41 PM on August 20, 2022 [1 favorite]
I also later found out that the nagging back pain was referred pain from a stone-filled gallbladder and wasn't actually musculoskeletal in origin.
I had nagging back pain that turned out to be reflux-related. I only learned this when I started taking omeprazole and modifying my diet. I'd had several possibly-unnecessary nerve ablations to relieve the pain. Referred pain is a fascinating thing.
posted by Well I never at 7:06 AM on August 21, 2022
I had nagging back pain that turned out to be reflux-related. I only learned this when I started taking omeprazole and modifying my diet. I'd had several possibly-unnecessary nerve ablations to relieve the pain. Referred pain is a fascinating thing.
posted by Well I never at 7:06 AM on August 21, 2022
I've been really lucky with chiropractors, in that they wanted to make sure they lost my business. One I went to for foot drop (after I went to my doc) and she was able to adjust my spine to alleviate the pressure on the nerve. BUT She also told me that if it happened again, I should go to my doc again and not straight to her or any other chiropractor, because if it happened again it needed to be addressed by something beyond chiropractors.
The other chiropractor identified what I thought was neck pain as TMJ issues. He taught me stretches I could do on my own, and they work! I only saw him the once. I'd been dealing with this pain literally for decades. He didn't pop my neck, he didn't even touch me. Just taught me the stretches and had me do them in front of him to be sure I was doing them right.
I don't know if I live near an actually science-based chiropractic school that's part of the university or if I just got really lucky.
posted by tllaya at 2:23 PM on August 21, 2022
The other chiropractor identified what I thought was neck pain as TMJ issues. He taught me stretches I could do on my own, and they work! I only saw him the once. I'd been dealing with this pain literally for decades. He didn't pop my neck, he didn't even touch me. Just taught me the stretches and had me do them in front of him to be sure I was doing them right.
I don't know if I live near an actually science-based chiropractic school that's part of the university or if I just got really lucky.
posted by tllaya at 2:23 PM on August 21, 2022
I went to a chiropractor as a kid. I had gone off and on since, maybe 6 years old. My mom also went as did my sister. We've survived, and I've had some bad experiences (strangely it seems that my chiro did better earlier in the early 80s or maybe I was pliable enough complications/stiffening didn't happen as much) Anwyays, I did notice as time went on that it didn't seem as effective as I thought. Then I had a few where it actually made it more painful in my 20s (different city, different chiros). In the end, I realized this is not for me, and I think it may have also been around that time that I heard about paralysis from this (which you know, kinda obvious on reflection)
But yeah. All the pain and issues I've had for better or worse has been dealt with by MD's and PTs in rehab since then.
Also? I had a spinal abscess that required 3 weeks of PT after being hospitalized for nerve impingement in my lower back.
I shudder to think what would have happened had I went to a chiro first. Can you imagine if the abscess exploded and infected everything?
posted by symbioid at 2:39 PM on August 21, 2022
But yeah. All the pain and issues I've had for better or worse has been dealt with by MD's and PTs in rehab since then.
Also? I had a spinal abscess that required 3 weeks of PT after being hospitalized for nerve impingement in my lower back.
I shudder to think what would have happened had I went to a chiro first. Can you imagine if the abscess exploded and infected everything?
posted by symbioid at 2:39 PM on August 21, 2022
One last thing, I guess - these are the symptoms of vertebrobasilar insufficiency, so if you feel them, especially after looking up, or over your shoulder, consider talking to a doctor, and definitely don't let someone click your neck!
Loss of vision in part or all of both eyes
Double vision
Vertigo (spinning sensation)
Numbness or tingling
Nausea and vomiting
Slurred speech
Loss of coordination, dizziness or confusion
Trouble swallowing
A drop attack — sudden generalized weakness
You'd think that most of those things would prompt anyone to do something about it, but especially with the confusion, people sometimes just shrug the whole thing off.
posted by fizban at 7:31 AM on August 22, 2022
Loss of vision in part or all of both eyes
Double vision
Vertigo (spinning sensation)
Numbness or tingling
Nausea and vomiting
Slurred speech
Loss of coordination, dizziness or confusion
Trouble swallowing
A drop attack — sudden generalized weakness
You'd think that most of those things would prompt anyone to do something about it, but especially with the confusion, people sometimes just shrug the whole thing off.
posted by fizban at 7:31 AM on August 22, 2022
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I am ignorant of the precise theories by which chiropracty operates, so I do not know if this is simething the profession can reform on, and thus have a continuing role in society for whatever actual good they provide, or whether this is part and parcel of their form of "medicine" and as such, chiropractors should be discouraged from peddling their skills, and regulations imposed to ensure patients desperate to go to them anyway have a *true* informed consent of the actual risks and benefits of these procedures, based on data known to the government, and not left to the profession to come up with.
I have a much greater tolerance to alternate forms of medicine that may not be too well supported with research, but do not tend to actually CAUSE new problems. Things like supplements, or biofeedback, or neurofeedback, all of which have some supported use cases, and many unsupported ones they are also promised to help with, but aside from a few supplements, their failure modes are much less severe than chiropractors.
(I do also have moderately severe back pain, so someome promising help for that and the like but actually just making things much worse for some of their customers rubs me particularly badly)
posted by Wotron at 12:16 AM on August 18, 2022 [28 favorites]