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PBS Broadcast Angers Chiropractors
October 1, 2002 1:51 AM   Subscribe

A recent PBS broadcast angered many chiropractors, who called the show "biased, misleading and malicious." Why is chiropractic controversial? Is it really not given a fair shake? Or does its lack of valid scientific theory warrant its dismissal?
posted by sklero (44 comments total)

 
And hey, chiropractic may be rooted in a philosophy that looks like outright quackery, and chiropractors might use some questionable practice building techniques, but look at these cool "ChiroCartoons!"

Maybe Mencken said it best: "This, obviously, is buncombe doubly damned."
posted by sklero at 1:53 AM on October 1, 2002


Now follows anecdotal postings of how it wrekced my couin's friend's spine; or how my aunt's workplacepal was cured when nothing else worked for her intense pain.
Me? I'll stick with blood letting.
posted by Postroad at 3:41 AM on October 1, 2002


I know most doctors turn their nose up at it. A relative of mine works for a orthopaedic surgeon and he considers them a bunch of quacks.
posted by PenDevil at 4:05 AM on October 1, 2002


Chiropractic is a pseudoscience.
posted by jono at 4:38 AM on October 1, 2002


My mother was a chiropractor, so I grew up receiving spinal adjustments on practically a daily basis. They did me no harm that I can detect, and in some cases gave me complete relief from certain conditions almost instantly.

They problem that I have with chiropractic medicine is that it's being applied to areas of human illness where it has no business being. It has distinct benefits for skeleto-muscular problems, but not for much of anything else.

The medical profession should embrace the parts of it that work and reject the rest, just like they do with other alternative therapies.
posted by MrBaliHai at 4:39 AM on October 1, 2002


I think there's a certain "sympathetic magic" element in chiropractic. I have known folks who have seen chiropractors for years and swear by them. So if you believe that it is beneficial to you, it probably is.

When my Dad was a small boy, his asthma was so bad that his parents took him to a chiropractor out of sheer desperation. Dad was too young to appreciate what was being done to him; those visits terrified him, in fact. Naturally, the chiropractor couldn't help my Dad, although he swore to his folks that he could.

I'll pass on the neck adjustments, thanks. But if they help some folks, and as long as the procedures don't injure people (a subject for considerable debate), then I don't see the problem with chiropractic.
posted by tommyspoon at 5:25 AM on October 1, 2002


There is lots of information about chiropractic medicine at one of my favorite sites, QuackWatch.
posted by mmoncur at 5:41 AM on October 1, 2002


Just because it's 'pseudo-scientific' doesn't mean it is necessarily invalid. There are certainly principles of physics and orthopedics (musculo-skeletal function) that have to be considered by chiropractors. Since I'm not a doctor, I'll stop here, and include a link to another such debate, the difference between an MD or a DO.
posted by insomnyuk at 6:05 AM on October 1, 2002


Or maybe I should have just said, "There is but one Science, and Newton is his prophet!"
posted by insomnyuk at 6:06 AM on October 1, 2002


I have known folks who have seen chiropractors for years and swear by them

EXACTLY THE PROBLEM !!

I have been to chiropractor's in the past, who try to get you hooked on some long term heroin addiction. All too often the treatment plans call for a commitment of an extended nature. I think a lot of people go for the massage therapy and cool ultra sound stuff.
I won't dispute that I was helped by them, but I reached a point where I said, ok I feel better, and I stopped going. None of these monthly visits for maintenance. People who do that need exercise. Lose some weight, work out a bit, does the body good.
posted by a3matrix at 6:20 AM on October 1, 2002


When in doubt, go to Oriental massage place for relief! May not help the back or the neck or whatever but ...a good place for adjustments.

Chiropractic took off like a bat out of you know where when it became recognized and accepted for HMO reinbursement...then folks began making weekly trips and it cost them hardly anything so they were repeaters...
Till that time, it was not very much favored. Move on next to homeopathy. Any ideas anyone on this "branch" of medicine?
posted by Postroad at 6:26 AM on October 1, 2002


Hey! Don't be making fun of quackery. I'll have you know that quackery is an established science, dating back to the building of the pyramids...

In a hamfisted attempt to derail this conversation, does anyone else find it wacky that the medical use of magnets has come back into fashion. What's next? Bowel obsession?
posted by jpburns at 6:30 AM on October 1, 2002


As someone who has an RSI in both arms, I can tell you that chiropractic has helped me minimize pain and allows me to continue to work as a software developer. Without semi-regular visits (e.g. when my wrists/arms bother me, I see my chiropractor, when I am feeling OK for weeks or months I don't need to see him) I would be unable to work normally. Whether MDs believe in chiropractic is not my concern, I'd rather seek natural releif from pain rather than mask my pain with prescription drugs.
posted by FullFrontalNerdity at 6:31 AM on October 1, 2002


a3matrix: hammer.nail.bang! People need to stop going to chiropractors when the treatment produces no results or no longer brings them further relief. And chiropractors need to stop pitching these open-ended committments to patients that are not being helped by the treatment.

And your advice about losing weight and exercising is spot-on as well. I had an extremely painful back problem for about 10 years that no amount of treatment, medical, chiropractic, or otherwise could make any inroads with. Since I started a weights/aerobics program 2 years ago, I haven't had a single flare-up.
posted by MrBaliHai at 6:49 AM on October 1, 2002


Old joke:
"How many chiropractors does it take to change a lightbulb?"

"?"

"One, but it takes 20 visits"

My chiropractor told me that; I used him to recover from a back injury (the doctors wanted to operate). Plus I met the woman who became my wife at his office.

Everybody has stories. But what it comes down to is they're less regulated than "real" doctors and it leaves the door open to quick-buck scamsters.
posted by Elvis at 7:12 AM on October 1, 2002


I screwed something up in my neck, pinch nerve possibly. I went in and it helped so I did 3 sessions. Of course then he started pushing monthly visits which I didn't need.
posted by madmanz123 at 7:25 AM on October 1, 2002


it's being applied to areas of human illness where it has no business being. It has distinct benefits for skeleto-muscular problems, but not for much of anything else.

exactly.
insomnia? heartburn? cancer? Go see a MD
Neck problems? See a good dentist first, the real problem 99% of the time is caused by your teeth, if they're not aligned properly and provoke stress to your jaws and neck

BUT: professional athletes in Europe (especially soccer players) use extensively chiropractors for skeleto-muscular stuff (the "star" chiropractor is a Frenchman named Philippe Boixel (in French, LeMonde article) whose patients are some of the best players like France's Zinedine Zidane and Italy's Christian Vieri

You need to take biomechanical tests: then, if you need it, you gotta go see a chiropractor

these guys PBS talked to, they talk about "your well-being", and take x-rays. it's scary. and, their neck technique is NEVER used by less agressive chiropractors (who go very very VERY softly when touching the neck).

in Europe, most chiropractors take a much more minimalist approach. The few very good ones, well, they tell you very clearly what can you expect, and turn you away if they think you don't need them (the way certain good plastic surgeons refuse to do certain procedures they think the patient does not need nor will improve his/her looks)

Probably the majority of patients who see a chiropractor don't really need one, but chiropractors can solve a very narrow, very specific series of muscoskeletal troubles for athletes or persons with certain problems
And of course for some patients there's also the placebo effect: the popping sound CLEARLY makes you think that vertebrae are moving, and you think your spine is fixed
posted by matteo at 7:34 AM on October 1, 2002


The medical profession should embrace the parts of it that work
The medical profession does embrace the parts of it that work; that is a big part of what physical therapy and osteopathic medicine are.

Just because it's 'pseudo-scientific' doesn't mean it is necessarily invalid

No, but the fact that chiropractors have been unable to come up with scientific evidence, especially for their more outrageous claims, is a good sign that it is invalid. Furthermore, most of what they claim as the biological basis for their treatment is nonsense. As far as the difference between MD's and DO's, current osteopathic schools place relatively little emphasis on manipulations, and limit the use of manipulations to certain musculoskeletal conditions. Otherwise DO's are functionally the equivalent of MD's; this has certainly been true of every DO I have worked with. Some countries, however, do not allow osteopaths to function as MD's.
posted by TedW at 7:47 AM on October 1, 2002


Yes, it's an old tired cliché that chiropractors want to push people into regular visits, but name a medical profession that doesn't advocate regular visitation for not only preventative reasons, but maintenance?

People love the idea of the quick cure. Give me a pill when I'm sick so I don't have to come back. Fix my tooth decay after the fact, etc..

Chiropractic has a place both as a preventative in health maintenance, as well as a cure when problems do arise. The same as any other medical profession. Exercise and diet should be the main focus of any healthy lifestyle, but chiropractic shouldn't be discounted as only a cure for problems. A schedule of regular visits can help the skeleto-muscular system retain proper alignment and reduce possible injury. Like any other health profession it can be abused and used in ways that are beyond its scope, but it shouldn't be dismissed because some chiropractors advocate an overzealous visitation schedule.
posted by mikhail at 7:53 AM on October 1, 2002


Elvis, you got it. A big problem with alternative medicine is so many operate on the margins of the law, are completely unregulated. If there was legal recognition, licensing, accreditation for schools, etc, consumers would be better served. I must say, the AMA is a big obstacle to this. They don't want anyone encroaching on their turf. Or like Insomnyuk said (Ha!), there is dogmatic hostility.

By way of contrast, in India, Allopathic (that's your MDs), Homeopathic and Ayurvedic medicine all have government boards, accredited universities, and formal degree programs. The consumer can make an informed decision. Nobody is being well served by the AMA's stranglehold on the system. Something like One in Four Americans spends money on alternative medicine purchases!* That to me indicates a pretty high level of dissatisfaction with the status quo. Unfortunately, most folks have no better source for information than to walk into Whole Foods and ask the stoned health aisle clerk for advice.


Postroad said: when it became recognized and accepted for HMO reinbursement
If people simply had to pay the costs for their own health care, instead of insurance masking true costs, people would rush to alternative healing. At the very least, each system of medicine should be reimbursable. That would at least level the playing field.

I wonder if chiropractors are sued for malpractice more or less than MDs per capita? That would be an interesting study.

*Something like that. There was a survey done a few years back that made the network news. Sorry I couldn't find the link.
posted by BinGregory at 7:57 AM on October 1, 2002


chiropractice - a right pain in the neck.
posted by johnnyboy at 8:02 AM on October 1, 2002


Chiropracty did fix my migraines - especially after years of trying a wide range of medications, some of which were pretty pricey. In fact, after trying so many other things, I wasn't particularly prepared for chiropracty to work and so was pleasantly surprised when it did. I think like FullFrontalNerdity (above) who had RSI, the migraines were probably linked to bad posture etc. when using keyboards and monitors - I get a lot of tension in my shoulders and neck. So maybe it's good for musculoskelatal related stuff.
posted by carter at 8:06 AM on October 1, 2002


each system of medicine should be reimbursable. That would at least level the playing field

No, each system of medicine should not be treated equally. Some are quite frankly bullshit and are a complete waste of money. It is bad enough that people waste their own money on quackery, but I don't want my health insurance premiums to be raised because someone went to thirty different practitioners before their back pain went away (which it probably would have done with little or no treatment anyway).

I wonder if chiropractors are sued for malpractice more or less than MDs per capita? That would be an interesting study

They are sued less, because they do not participate in such things as childbirth or trauma care, which account for a disproportionate share of lawsuits.
posted by TedW at 8:18 AM on October 1, 2002


Here's that link:

Many of these people are looking to other approaches to healing. According to one study, published in the Journal of the American Medical Association in 1998, 42 percent of all Americans are using other than conventional therapies as alternatives or complements to conventional medicine. They are making 200 million more visits to "complementary and alternative health care providers" -- acupuncturists, chiropractors, massage therapists and others -- than to primary care physicians.

On preview - TedW, I'd prefer not to have to pay into a massively bloated health system that I can't use for the treatment I desire. 30% of my compensation is totally wasted on "benefits", and I can't opt out. Restraint of trade is what it amounts to. As I said, if people had to pay for (or even were aware of) the true costs of their care, things would change in a hurry.
posted by BinGregory at 8:32 AM on October 1, 2002


I began seeing a chiropractor a couple years ago when my activities led to a distinct jam in my neck and recurring back and shoulder pain. I don't buy into the idea that chiropractic spinal adjustments can cure everything from sniffles to cancer, so after a series of adjustments I turned to yoga for preventative maintenance.

I have returned to the chiropractor from time to time when an injury leaves something obviously out of whack and impinged, but yoga keeps me so stretched out and conditioned that my daily symptoms of pain, tightness and knots are history.
posted by Tubes at 8:39 AM on October 1, 2002


I would never go to a chiropractor, I think it's all a bunch of baloney. It might be useful for some musculoskeletal conditions, but if I have one of those, I'd just as soon go to a physical therapist. Homeopathy is utterly ridiculous-- they are selling nothing but water. My husband and I have a friend from (UU) church who is into homeopathy. Very nice lady, but not in touch with reality at all. She's lost custody of her kids because of her way-out health beliefs, but she still clings to them... it's pretty sad. As far as DO's go, I did have a DO do some manipulations on me once for a lower back injury and it did help a lot. It wasn't the chiropractor type pressing on the spine stuff, but basically stretches by turning the lower body and raising and lowering legs while lying on the exam table. However, I'd imagine that a physical therapist would do much the same thing.
posted by CoFenchurch at 8:41 AM on October 1, 2002


If they would stick to the physical therapy, i.e. the manipulation of the body, I think there would be more acceptance. The problem is most chiropractors want to branch out and add as much to the bill as possible.

I worked for a chiropractic supply company. We sold every kind of brace imaginable, ointments, pillows, massagers and heating pads. But mostly we supplied them with nutritional supplements. CoEnzyme Q10, Vitamin C with zinc, kelp, tryptophane, you name it-- we supplied it; about 500 different supplements. And the mark-up was astronomical. I know some of the little bottles of vitamins were being sold to the patients as prescriptive drug alternatives but with the prescription drug prices.
posted by Secret Life of Gravy at 8:41 AM on October 1, 2002


30% of my compensation is totally wasted on "benefits", and I can't opt out

Why can't you opt out? Surely you can find a job with fewer benefits, or even become self employed. Although I support universal health care, I think a good first step (or alternative) would be to separate health insurance from employment. There are many people trapped in jobs because they cannot afford to lose their health insurance, and there are others who are denied jobs because prospective employers cannot afford insurance for those with a pre-existing illness. Allowing people to pick and choose among dubious treatments only makes this more difficult because it increases costs (adds bloat) to the entire system by causing money to be spent on worthless treatments as well as delaying effective treatments; think of a woman who finds a lump in her breast and goes to a naturopath or homeopath. If the lump is indeed cancer, by the time she gets to a real physician, what might have been curable with a simple lumpectomy may now require a radical mastectomy followed by radiation and/or chemo; hardly a savings in health care dollars. Free markets are only efficient when everyone has the same information; in this day and age that is not going to happen as there is simply too much specialized information out there for anyone to digest.
posted by TedW at 8:50 AM on October 1, 2002


"Move on next to homeopathy. Any ideas anyone on this 'branch' of medicine?"

Yes. My idea is that those who believe in homeopathic medicine were given, during birth, a homeopathic dose of oxygen, for far too long.

I also have a homeopathic theory involving the "power of dilution" and reverse-osmosis purification. Pure water must be the most powerful homeopathic medicine ever!
posted by five fresh fish at 9:15 AM on October 1, 2002


The National Institutes of Health have a website for their National Center for Complementary and Alternative Medicine, where investigations are going on right now to find out which alternative and complementary practices work and which ones don't. One set of trials is testing the effectiveness of chiropractic therapy.
posted by Alwin at 9:19 AM on October 1, 2002


At the insistence of my mother, when I was in high school, I went to a chiropractor once. I was completely against it, and only agreed to go (and this is going to sound spoiled) in exchange for a mandolin. She agreed; her concern for my (completely unobrusive) scoliosis clouded her judgment.

What was there in the chiropractor's waiting room? Why, pamphlets for Dianetics! And ear-candles! And what was there in the office itself? Charts about acupuncture.

The procedure itself took only a few minutes and did absolutely nothing. I bought an ear-candle, and all my friends and I laughed uproariously about it.
posted by interrobang at 9:59 AM on October 1, 2002


Pure water must be the most powerful homeopathic medicine ever!

"And as human beings, you and I need fresh, pure water to replenish our precious bodily fluids."

-General Jack D. Ripper
posted by MrBaliHai at 10:00 AM on October 1, 2002


I think there's a certain "sympathetic magic" element in chiropractic

And it IS nice to have someone working over your back. People also pay lots of money for massages, and you DO feel better afterward.
posted by HTuttle at 10:34 AM on October 1, 2002


mrbalihai: i'll stick to the vodka, thanks.
posted by escher at 12:08 PM on October 1, 2002


Here's something: why does there not seem to be a real noun form for "chiropractic"? In everything I've read, "chiropractic" is used as a noun. This bothers me. I saw that a couple of posters in the thread used "chiropractice" and "chiropracty."

I like "chiropraxis."
posted by sklero at 1:26 PM on October 1, 2002


I see a chiropractor for problems related to TMJ. It has been the only thing to really help me. My chiro doesn't push frequent visits and only tells me to make another appointment when I'm really having trouble with the TMJ. She says to call her if I need her. I feel very safe with her as she's also an RN and believes in traditional medicine as well. She uses ultrasound and massage, but the adjustments are minimal. She encourages me to continue to do yoga, which is a massive help.

In my opinion, anyone who hasn't been to a chiropractor (as an adult, a teenager doing it to get something they want doesn't count) has no currency commenting on whether or not it is a legitimate health practice. Chiropractic is like any other healing tool, it works on some, not on others. First hand personal experience with it is what counts, not Aunt Susie's, my friend's friend, etc.
posted by Woolcott'sKindredGal at 1:53 PM on October 1, 2002


anyone who hasn't been to a chiropractor...has no currency commenting on whether or not it is a legitimate health practice

Following that logic, one must have been a slave at some point in order to be qualified to condemn slavery. Along the same lines, any surgeon who has not been under the knife himself is not qualified to advise patients on whether or not to have an operation.

First hand personal experience with it is what counts, not Aunt Susie's, my friend's friend, etc.

Actually, your first hand experience is just as anecdotal as everyone else's. A legitimate medical practice does not just work on some but not others apparently at random, it works on a statistically significant number of patients when compared to either a placebo or an alternative treatment in a well-designed study.
posted by TedW at 4:01 PM on October 1, 2002


Slavery? You've got to be kidding. I'm not going to bother to respond to the surgeon comment, that's just lame.

Read my post again, what I said was - "In my opinion..."

Perhaps I was oversimplifying. I should have spoken more generally. Some patients respond to particular treatments more readily than others and chiropractic seems to be one of those that has very different results from individual to individual. No traditional medical treatment or alternative treatment works on everyone.

I didn't say that my experience wasn't anecdotal, I said that I had had chiropractic treatment, therefore I am more qualified to say whether it is worthwhile, than someone who had never had chiropractic treatment. I stand by that opinion.
posted by Woolcott'sKindredGal at 4:29 PM on October 1, 2002


Ad hock fear and rejection of chiropractic (or any other alternative healing method) is very narrow minded, IMHO.

Admittedly - my father was a chiropractor, having received adjustments for most of my natural life, and also having seen and heard all the sides of this argument 100 times.

However, oppositely of the distrust of chiropractic, I grew up with an inherent distrust of MD's and found myself in a very difficult space when I was an adult needing to seek traditional medical care. It's just a difficult from the other side - trusting that an MD is going to treat you properly, is going to give you drugs that will be right for you, hopefully with limited side effects and no long term problems, etc.

It was sort of like having a crisis of faith in a way, submitting the direction of my health into the hands of an MD. Everything went well and I've since gone back for a few small things with equally good results.

Except now I've developed a very balanced viewpoint of what should be used when and have moved to a more central position re: both natural healing and medical healing. They both are healing in the long run, just with different inputs and side effects. And I now decide what balance of those things I would like to have and when. When I get a cold or the flu for instance, I know that it's going to take 7 days to get over it, I treat my body well and it goes away with no visit to the MD. And - luckily for me I have no significant health problems (*knocking on invisible wood*) which I'm not sure is from genetics or having had regular adjustments my entire life - it's very difficult to pinpoint.

Also it's good to keep in mind that many things that work for one person simply do not work for another. There is a great opportunity now in the US to view health and healing from a multitude of perspectives. Just because something does not come in a bottle from a multibilliondollar pharmaceutical company does not mean for sure that it's any less safe or good for you, in moderation of course.

People have been healing themselves via natural means for hundreds of thousands of years, and with the invent of modern medicine, the definition of what is good and helpful has also gone thru wild changes. There are always new things to learn and try and change our minds about. The only think i know for certain is that my body, due to it's own knowledge, knows how to take care of itself intuitively for the most part and i want to do as much as i can to keep that happening.

I think with a more inclusive consideration of all possible treatments we'd all be a lot better off.
posted by nyoki at 5:26 PM on October 1, 2002


I'll second FFN on this - I went to a variety of doctors for help with my RSI and eventually ended up at a chiropractor, who has transformed my condition from constant extreme pain to a very mild annoyance. My chiropractor, OTOH, basically does a lot of stretching and massage [which I can't do entirely by myself because I can't get the proper positioning and leverage on myself]. None of some of the wacky stuff described above. Certainly no spiritual or new-agey theories like the homeopathy crap, just "you need to have good posture and improve your range of motion." Seems pretty solid.

And not all MDs distrust them entirely - my orthopedic surgeon [who has 25 years of experience] sent me to this chiropractor. Admittedly, he basically said "most chiropractors are quacks, but you should try this guy in particular."

In fact, before the chiropractor, I went to a physical therapist who was big into ultrasound, which definitely seems like quackery [sure as hell didn't do anything].

Anyways, I find it surprising that people think that things like stretching and massage are quackery. How could that NOT help with muscular problems [especially posture/activity related ones, like RSI or sports injuries]? Either people are way too skeptical or I've just had a very atypical chiropractor experience.
posted by wildcrdj at 7:51 PM on October 1, 2002


A legitimate medical practice does not just work on some but not others apparently at random, it works on a statistically significant number of patients when compared to either a placebo or an alternative treatment in a well-designed study.

Until another well-designed study comes along to say it doesn’t. Hormone replacement therapy, I’m looking at you.

Wise man say: He who controls the definitions wins the argument. What you have defined is the principle allopathy is based on. This is based on a totally mechanistic conception of human beings, that we are all essentially identical. Most holistic medicine is based on a belief that we are all essentially unique, so what works on one may not work on all. To have a controlled study of the kind you describe for a particular homeopathic remedy, you would need a set of people with the same disease, presenting the same set of symptoms, with the same temperaments, with the same family health history, etc. There may be discrete groups of people who would receive the same treatment for the same disease, but these groups are very small because the diagnostic filter applied to a particular case is exceedingly fine. Still, this is what the good people at the NIH’s CAM center, linked to above, are doing apparently. Randomized Placebo-controlled, Double-Blind Trials are being conducted for homeopathic treatments as well, appearing in peer-reviewed journals. More power to them. It's a shame that, to satisfy the AMA, an older, established, internally consistent philosophy of medicine has to be deconstructed atom by atom and subjected to the standards of an alien upstart system simply to achieve a more inclusive consideration of all possible treatments, as Nyoki said.
posted by BinGregory at 8:51 AM on October 2, 2002


Maybe we should just acknowledge the unproven aspects of chiropractic by re-naming it "chiropractish".
posted by interrobang at 8:56 AM on October 2, 2002


Ugh, that should be Hormone Replacement Therapy

and

Appearing in Peer Reviewed Journals.
posted by BinGregory at 9:56 AM on October 2, 2002


A little late to the dance here, but I'd like to comment on this remark:

The medical profession should embrace the parts of it that work and reject the rest, just like they do with other alternative therapies.

The bottom line is this: If an "alternative" therapy works, then it's not alternative, it's medicine. The problem is, most alternative therapies are really, really hard to prove effective. This may be because their effects are harder to detect, or it may be because they just don't work.

We need to get "alternative" medicines out from behind the beaded doorway and into a research lab. There, we can either adopt the practices into mainstream medicine, or throw them out as superstitious relics.
posted by mikrophon at 12:25 PM on October 23, 2002


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