I am a chiropractor. Is chiropractic medicine bullshit, science or both? No holds barred, AMA.

Chiropractic is eligible for the James Randi Million Dollar Challange. Demonstrate this chiropractic for them under proper controlled conditions and they will give you a million dollars.

A quote from the Jame's Randi encyclopedia:

The American Medical Association has referred to chiropractic as “an irrational, unscientific approach to disease causation.” Originated in 1895 by one Daniel David Palmer, it was made into a thriving trade by his son, B.J. Palmer. The major claim of the art is that “subluxations” (misalignments of the spinal column) cause illnesses. The various schools of chiropractic differ in what they claim can be cured by manipulating the spine, some having almost no limit (asthma, bacterial and viral infections, migraine, cancer, AIDS), while others are satisfied to relieve muscle spasms——for which such massage is probably beneficial. Some obviously renegade chiropractors sell their patients on “color therapy” in which applied kinesiology is used to determine the victim's sensitivity to specific colors, and they also use “polarity reversal” in which magnets are used to change the “bioenergy” field of the body. Both systems are perfect examples of expensive quackery, having no basis whatsoever in fact. Chiropractors have been known to bruise and sometimes more gravely injure their customers, but often these people go right back to receive more at the hands of the operator, seeming not to learn from experience. Chiropractors are fond of pointing out that regular MDs are far from perfect, a fact that in no way validates what they themselves are doing and that appears to be only a method of misdirecting the attention of the detractor. While there doubtless is some value to chiropractic in respect to massage relief of strains and muscle spasms, statements made by chiropractors include such howlers as specifying that a subluxation of the sixth dorsal vertebra brings about diphtheria. Such a notion is another classic example of quackery. But having your back rubbed does feel good, and the pops produced by being flexed and stretched do sound impressive.

Claims made for non-MSK at this point have low or no evidence and should be regarded as suspicious. They are studying the effects of manipulation on visceral function though for conditions like irritable bowel sydrome (IBS) and menstrual cramps in women.

I has a dumb... what's MSK?

Musculoskeletal, or related to muscular and skeletal systems.

One of the things that turned me off was that my chiropractor told me to "Make sure I tell my friends about how great my neck feels!" which I've never had any doctor ever say to me. How much marketing/self-promotion is taught in school?

None in the Canadian schools. I have heard that LIFE in the States and other straight schools can bring in marketing guys the 4th year. Lots of DCs must still feel like they're in the "fight" against medicine, although I do recognize the AMA was guilty of trying to contain and eliminate chiropractic (competition in the heath care arena) as recently as 1990. Nowadays the trend is towards integration and collaboration. It's better for the patient and everyone involved.

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A chiropractor is not like a MD or vice-versa. We're primarily muscle and joint specialists, but we apply it in a holistic, whole-body context. I would never tell anyone to ditch their MD for a DC.

OP is verified.

Thanks!

Are you going to reevaluate your career choice if 'bullshit' wins?

I would. I'm not in this for the money or the glory but to help people. My mom was a nurse so I got into healthcare because of her. What's interesting is the shift I'm seeing from bullshit to science;more and more professions want to use adjustments especially the PTs. They claim they are now the trusted and experts at manipulative therapy. Kinda amazing to see something that was once quackery is now being claimed by PT as their expertise. Even vets now are getting into animal chiropractic. But yeah, I'm a health care provider first, and chiro second. Beliefs should never trump science.

Are you aware of the British Chiropractic Association vs Simon Singh court case in the UK? http://en.wikipedia.org/wiki/BCA_v._Singh

Absolutely. A perfect example of how NOT to go about things!

Hmm...that puts a lot of pressure on me. While I ponder how I'm going to vote, what made you pick chiropractic as opposed to say helping people through dentistry?

Well, I love athletics and sports and I got my degree in Kinesiology. It was going to be PT or DC (I can't stand compound fractures and I think a holistic approach is a better view towards medicine than the current reductionist system.

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The hive mind suggests I'm a quack. It's OK, as long as some people can be unbiased and judge me for my quality of answers and information, that's good enough.

How much do you hate Penn & Teller?

Well, it's controversial, and they did their take. It wasn't 'balanced' or 'journalism' but it was TV. They raise good points but they omit the majority of practice: 90% of patients come in for spinal or muscle/joint problems. We're experts in manual therapy and we work primarily in MSK. The older generation doesn't want to limit ourselves to that, but that's the reality. No shame in being an MSK specialist instead of a general physician.

What enraged me was when they showed the back-cracker manipulating an infant, simply because her mom was there for a cracking. This is malpractice, as far as I'm concerned. When I was a small child, my babysitter went to a chiropractor, who offered to manipulate my spine. I had no complaints or symptoms that may suggest such a procedure was necessary. Is this common practice?

Treating infants is not common and should be done with caution and in conjunction with someone from the mainstream side (ie. pediatrician). Most cases are for colicky babies who have tried everything and nothing works. Birthing can be pretty hard on babies if there are vacuums, forceps, caesarians, anything that can tweak a little baby. They're in pain but can't communicate it. There is a developing field of pediatric chiro where those DCs can focus on that population. It's definitely a controversial area, and not one that I practice in.

Why is it ok for an adult and not for an infant? Genuinely curious.

A complex issue but basically: kids and adults all suffer pain and they respond the same way, generally to manual therapy. With babies, everything requires so much more care and precision. Usually there are no adjustments on babies (thrusting) typically is soft mobilizations (sustained pressure with small rhythmic impulses). Babies can't tell you their diagnosis either. Never let a DC or any other holistic practitioner by the sole source for any care, always combine with standard care.

I don't understand where this is coming from. I'm not calling you out or anything, I'm just wondering how you could make a post on this. Did they teach you about treating babies in chiropractor school, or touch on why it should/shouldn't be done? Or are you just coming from multiple angles to piece together what you know about infants and your career to make an educated guess on the matter?

We had a course in pediatrics with the basics for examination. We never had any baby patients for technique class. Pediatric chiro is not very common, nor is it a big patient demographic for DCs. I read the research and form my opinion there. You can also tell what's a reasonable approach from something that's in left field.

P&T will tell you they aren't very balanced, or scientific in any way. They even admit that they're only showing you their side of things. They even did a bullshit on NASA just to prove they could.

Yeah, it was definitely for the entertainment value. Chiro is at the cross roads of mainstream med and alt-med so we are the lightning rod. Alt-med thinks we're selling out, some segments of mainstream med still thinks were quacks. The profession is a hybrid of both, using a holistic approach (manual therapy) but doing so with conventional med (physical therapy modalities, exercises, using mainstream med technologies like MRI, X-ray, blood work, etc.). It's definitely unique in that regard.

And the hard part is there ARE a lot of well meaning but ignorant quacks out there who are slowing down the process of becoming mainstream. Chiros have been split in to two camps, straights and mixers for a long time and no one out outside of the chiro community is really aware of it.

Exactly. The straight/mixer theme though is really more unique to the US though at such an extreme. The mixers are the majority but are kinda like pussies because they're not vocal like the straights who preach against vaccines and only focus on subluxations and eschew other interventions. Pretty lame way to practice and that's why they're high volume, crack crack, goodbye. That's not good medicine in any context.

So... are you a real chiropractor that does adjustments to muscles and bones, or one of those loony toons nut jobs that doesn't believe that germs exist?

Also... how about some proof.

I just sent an email to the moderators so that's awaiting. I'm legit though. I am a recent graduate (2006) that does adjustments, soft tissue manipulation, rehab exercises, acupuncture and nutrition supplementation. I am more geared towards sports-med style of practice but there's quite a range of chropractors out there.

so acupuncture too, why not homeopathy then?

bc homeopathy has no evidence of effectiveness for any condition in the scientific literature. It's bogus.

Acupuncture?

You're a quack.

Acupuncture for pain management is mainstream according to the science. It's actually very well researched. I suppose everyone is entitled to an opinion, but informed ones are preferred.

Acupuncture is no better than placebo.

http://www.sciencedaily.com/releases/2011/03/110324104147.htm

That's from 2011. The reviews I posted were from 2012. Vickers et al. the meta-analysis specifically looks at chronic pain and found it to be more than placebo.

Acupuncture... Well I think I done with this AMA

All acupuncture isn't TCM (the Chinese way). Anatomical acupuncture for pain management is pretty mainstream and has high quality evidence for chronic pain management.

I'm actually going in for my first session of acupuncture this week for some serious nerve pain I have.

I'm not really sure what to expect. Anything I should know going in?

There are different types of techniques. Long needles, short needles, with electricity, without, putting the needles in/around the painful spot, putting the needles in the periphery. So, hard to know exactly. The needles are very thin (nothing like blood work). If there's a needle that's painful after 1 min, get them to reposition or take it out. Shouldn't hurt.

What do you think about claims that acupuncture is nothing more than an elaborate placebo?

I refer them to the scientific literature: http://www.ncbi.nlm.nih.gov/pubmed/?term=acupuncture+mechanism. There are definitely plausible mechanisms of action. Skeptics don't want to admit that the Chinese and 3000 years of tradition were doing something right!

Just for future reference, and I'm not judging you here, saying things like "Skeptics don't want to admit" makes you sound like the type of advertisement my brain automatically ignores.

Agreed.

Plausible mechanisms of action is not the same as proven effectiveness. We would not accept pills that perform as well as the placebo effect to be prescribed by medical doctors, so why is acupuncture different?

Also, to your last sentence, skeptics don't generally subscribe to arguments from antiquity.

Proven effectiveness? High quality levels of evidence such acupuncture is effective for nausea and chronic pain, http://archinte.jamanetwork.com/article.aspx?articleid=1357513, headaches, and may be effective for depression, anxiety, etc. http://www.ncbi.nlm.nih.gov/pubmed/23067573. Also, medical doctors often use placebos. Placebo effect is good. http://www.ncbi.nlm.nih.gov/pubmed/23488251

is what you're referring to also known as "dry needling"?

Some call it that, or IMS. It's still acupuncture though, just not TCM.

My wife, her friend, and her friend's boyfriend all went to the same chiro at different times and with different problems. However, this guy told all of them more or less the same thing and that he wanted to see all of them three times a week for at least six weeks at $75 dollars a session. Exactly how much of your profession is just telling everyone who walks through the door that they have a problem regardless of whether they do or not? Also, how often do you just pop some joints and make people temporarily feel better instead of actually fixing anything? For that matter, do you ever actually fix anything and if so how many "sessions" does it take to make a difference?

That's unethical practice and you should find a different chiropractor. Given that there are 206 bones and 600+ muscles, there's a chance that something isn't moving right. That doesn't mean it's clinically significant though. Fixing the problem is more than just fixing the mechanics, it's fixing the behaviour that leads them to their back pain in the first place. That's the hardest part, hence, the recurrent nature of back pain.

at 25 I went into a chiropractor for the first time after a mild chronic back pain was amplified to severe when i took a hard hit in a mosh pit. x-rays showed what appeared to be a bulged disc and 2 pinched nerves from two vertebrae going in opposite directions. went in after giving it a week to "see if my body would straighten it out" i walked in with my mom and a cane hunched over in pain. came out standing straight and at least half reduction in pain. over the course of maybe 4 more visits i was back to new again.

Yep. Chiropractic care for back pain is completely reasonable and the science suggests it's as effective as standard medical care, physiotherapy, or exercise therapy for chronic low back pain. Not based on some magic or vodoo, but hands on therapy for movement problems of the spine and extremities!

I work in radiology and I have to admit that has colored my opinions on chiropractors. There are a lot of crappy snake oil salesmen out there who take advantage of people in pain. However I had two instructors in college who were freaking knowledgeable as hell.

Do you experience this less in Canada? Is chiropractic covered under the Canadian health plan?

The snake oil salesmen account for roughly 20% of the practicing chiropractors and generate 80% of the headlines. It sucks. The regulatory boards right now are full of the older generation so they're more tolerant of that nonsense, since they graduated in an era where they didn't really know the why and the when and the whole politics or organized med. vs. chiro. Currently the Canadian plan only covers chiro for the armed forces/veterans and natives, however, the national association has a goal of full coverage for every Canadian by 2023. The research is showing that including chiros in hospitals, family health teams, community health centres reduces the health costs for surgeries, imaging and drugs for spinal complaints. I think this is likely to happen, the mainstream of chiro wants this to happen as well.

Can I just say thank you for not being a bullshit doc? My dad graduated from Life and has been in practice over 20 years. My entire life has been "Oh your dad is a chiropractor? I don't believe in it." Or "My cousin/aunt/friend/grandpa saw a chiro once who didn't fix them/hurt them". Just because someone is licensed doesn't mean they know what they are doing, or are even good at it for that matter. I've seen so many people touched by what my dad does and who heal and no longer experience pain. It's pretty cool. Anyway no questions, just a thank you!

Thanks man. Manual therapy has been around for 3000 years, chiro's are just the latest incarnation of manipulative specialists.

Do backpacks actually screw up your back?

If you sling them on one side and they weigh more than 15% of your body weight, your gonna get a repetitive strain injury for down the road eventually

Not really a question but chiropractors have pretty much changed my life. Wall of text, ready go.

I have somewhat mild scoliosis always had really bad lower back and hip pain (starting as young as kindergarten). I went to see bunches of specialists (Children's Hospital Boston ortho, one for hip, one for back, etc.) and had bunches of x-rays, MRIs, and arthrograms done. They poked, prodded, asked questions, noted the scoliosis, noted one of my legs was somewhat longer, noted my restricted range of motion, then said, "Well your hip is falling apart you're going to need a new one before you turn 30. Try to build muscle and take painkillers until you can't deal with it anymore."

Tried to stay in shape but everything hurt (walking hurts, swimming hurts, that elliptical thing hurts, biking hurts...). I was actually really a runner for awhile, but BAM one day the knee totally went and that was that. So I just stayed thin (not always the best ways either but that's a whole other story, even if somewhat related) and was a miserable person because of the pain.

Anyway, flash forward to my early 20s, just out of college, and I'm in chronic pain and pretty willing to try anything so when someone says chiropractor I'm like, why not. The first one I went to for about six months was helpful, not magical but it made it a little better, so I kept going. I got a new job and moved and got a recommendation for a new one in that area.

This guy wanted to see me 3x a week at first and I was skeptical but whatever, sure. He did some of the same stuff, but a lot of different stuff, and not the same thing every time. It FELT different, like it was REALLY moving shit around. Never pain, but that soreness.

One day he's watching me walk (he thinks there should be more progress and is trying to trouble shoot) and then says, hm, I think one of your legs is longer. I said yeah, has been for a long time. He goes out back and comes back with a heel lift for my shoe in the short leg. Wear this, make the legs act the same length.

Two years and multiple height adjustments later to get the right height as my body adjusted, I have no lower back pain, I have no hip pain, no knee pain, things have stopped popping and cracking. I also stopped getting migraines; I was getting 2-3 a month and after I stopped having them, traced it back to a few months after I started with this guy. I see him once every few months now.

After going slow and steady for awhile, I am seven weeks into Couch to 5K, no knee pain, no back pain, just me and my lazy ass who might be a runner again. The first time I jogged for three minutes without my knee hurting I cried (I don't recommend crying at the gym, FYI).

I sometimes get so angry at all of the specialists who noticed my leg length difference and thought it meant nothing, and the 10 years I probably didn't have to be in pain because of it. But, I try to think that I'm pretty damn young still (late 20s) and down the road that decade will be the minority. I have a long way to go but I am hoping to run a marathon before I turn 30 in 2015, simply to be like, "You said I would need a hip replacement, fuck you, I ran a marathon instead."

Like any healthcare provider, there are some shitty chiros in the world, and not everyone is truly helpful for every issue. However, a good one did WAY more for me than some of the top orthopedic specialists in the States, so I think the good ones can probably help a lot of other people, too.

tl;dr: If you say all chiropractors are useless, I will cut you.

[edit for a horrific run-on sentence]

This is what I usually hear. A good combined approach works better than a solo approach. Active care is essential, but so is expert manual medicine.

I work for an insurance company in provider services. We get a lot of chiro cslls and they're always the most difficult. Chiropractors always seem to want every benefit available and I've never understood why. Therapies and modalitIes I understand. But then they ask for 6 kinds of dme and pt/ot/st. Then they'll list off between 5 and 20 codes to verify. Hospitals and private practice are usually way more laid back than the chiro. Can you shed any light on why that is?

I don't really know the insurance industry side of things to be honest. A lot of the rehab clinics, whether owned by a medical doctor, chiropractor or physical therapist tend to be meat markets and they are low quality, high volume. I think insurance companies should do their research too and get some references. It's worth the investment.

They do. Chiropractic credentialing is one of the hardest. Most insurance companies only allow so many in network specialists in an area, and in most areas chiropractors are saturated. There are so many that even with the strict verification, a lot will slip through the cracks. I've had to deal with more than one angry Dr who was trying to do something that he in no way should be billing. Looking back at the older calls, it was clear they were just trying to bill for everything they could. I appreciate that you aren't one of those guys. It's easy to forget I'm usually only dealing with the guys who are trying to play the system. The honest chiros don't usually need to argue.

I agree. I think any clinic that is at the mercy of the insurance companies for revenues is making a mistake. Diversifying the practice so it doesn't really so much on that industry would be a smart business decision IMO.

Can you really tell,when,someone is bullshitting a whiplash injury for a accident lawsuit.

There are 4 types of WAD (whiplash associated disorders) ranging from grade 1-4 (mild sprain/strain to a broken neck). It can get complex, but pre-existing factors such as previous episodes of neck pain, headaches, degenerative disc/joint disease can all negatively affect prognosis. In the end, if it's a grey area, there will be multiple professions doing evaluations. Also, pre-existing psychosocial or mood disorders can make a patient treatment resistant (would need mental health services too) EDIT: Looking at it in a different way, you can definitely tell within the first 4-8 weeks if you're going to be successful with a patient. If no progress, wise to refer out from an ethical, legal and medical POV.

I injured my tail bone while riding a quad, and it hurt so bad that I couldn't sit down or stand straight, it hurt to walk as well. I went to a chiropractor and immediately felt better, no pain at all and I could walk straight again. Every time I go I feel so much better, so I don't really understand what is "fake" about that.

Oy! If it was really the tail bone (coccyx) that was the culprit that's unfortunate Cause the manipulation for that (anally) is something I and most of my colleagues declined to learn a chiro school. It was optional, although it shouldn't be. Palpation class would suck.

Wait a moment.

Are you saying to adjust the coccyx you go though the back door?

To actually adjust the coccyx, yep. Down the dirt road. Not to be confused with the sacroilliac (SI) joint which also can get jammed with a falling injury!

I don't really have an opinion one way or another on the validity of chiropractic therapy. I don't have any personal experience, and haven't done enough research to declare an opinion. I just wanted to apologize for the anti-chiro circlejerk and downvote brigade that has made its way into the thread. You seem to be quite knowledgeable and well-educated, and its a shame that there is so much baggage that goes along with what you're trying to do, which is to just help people. Keep up the good work.

As long as some ppl can see through it, it's worth it. At least you guys now know that good, honest, intelligent chiropractors exist and that we are the silent majority. Except I don't wanna be quiet anymore! ;)

Have you heard of vaginal adjustments for lower back pain? My bosses wife went to a chiro who recommended it a few months ago and I think its complete bs. What's your take on it if it is an actual procedure?

How did I miss this. There is NO such thing as vaginal adjustments for LBP. This is medical malpractice and a definite lawsuit.

I didn't think so. She is getting an attorney and suing but I was just curious. Thanks fir the response!

I can't believe that actually happened. This guy deserves to be behind bars. Sexual assault, professional misconduct. A disgrace to all chiropractors and health care practitioners. Yikes!

Now that my head sits on my neck, not next to it, I no longer have migraines. Thanks to all in your profession.

Glad it helped.

No question but my parents used to travel and go to different chiropractors. I'd tag along. Some were really serious about health and others were bullshit artists who just wanted to scare patients into getting ongoing useless adjustments. The good ones would take a long time to evaluate things, track changes, look at small details, explain what things they were going to be changing and why. The bullshit ones would go "hmm... tap click tap crack ... all done (in 10 minutes) .... let's schedule a year's worth of treatment cause you are going to need it." The hollistic approach is scientifically proven to work well in medicine, but it seems like 90% of chiropractors give the rest a bad name.

So bullshit or science. Same as all fields of medicine. Depends on the person doing the work and whether or not evidence based, scientifically grounded, techniques are used. For years heart doctors recommended statins because "cholesterall=bad!". Bullshit. For decades spine doctors recommended surgery for cases that we now know would be better solved by antibiotics. For years doctors recommended bottle feeding instead of breast milk. Bullshit. For years GI doctors couldn't believe that a bacteria caused ulcers (bullshit) and laughed at those who took kitchen-made medicine that scientists now realize actually acted on the bacteria. I could go on and on and on.

So parts might be bullshit and there might be those who enter your field to make money by abusing the weak. But as long as you use evidence based metrics - I think it will make a difference.

Great reply. Evidence based metrics is why the tide is turning for the profession (outside the US anyways) because there is a commitment to research and data. Manual therapy is a reasonable option for MSK pain management according to the evidence. There is inconclusive, low-levels evidence for visceral conditions. The bullshit of chiro is tag that subluxations will kill you and make you ill. The truth is, uncorrected muscle and joint problems can lead to a lot of pain, disability and even mental health issues (chronic pain and depression, for example). So, yeah, I think more ppl should be paying attention to their bodies and moving well. We spend money for car maintenance, and teeth maintenance, but none for muscle and joint maintenance? It's beginning to change though, people are recognizing the benefits to a holistic approach.

I won't go to a Chiropractor because I'm afraid of something going wrong and having a stroke and/or nerve damage as a result. Should I be?

If you're worried about upper-cervical manipulation, then tell your chiropractor you don't want it done. Maybe it's not even involved in your condition. Always remember, the chiropractor and any professional needs informed consent before they can treat.

Do you care to explain what's involved with that?

The issue that I have is a sharp pain in my back that lines up with the lowest ribs, occasionally pain radiates to my lower right rib cage from back to front. When it occurs I have a difficult time breathing or even moving.

Providing this is a mechanical case (movement related) I would investigate for possible costo-vertebral joint dysfunction or in laymans "popped rib". The muscles over the area will likely be splinted or tight to an extent and rotation, side bending and flexion/extension of the mid back will likely be decreased as well. Treatment would likely consist of adjustments, soft tissue work, stretches, and exercises. A quick test to tell if the ribs are the culprit is to take your hands and brace the side of the ribs when inhaling, if there's reduced pain, then rib mobility is likely the culprit. Get a proper assessment and diagnosis though.

A few questions. What, specifically, made you want to become a chiropractor other than say a physio therapist? What would you say are the fundemental differences between chiropractic and something like physio therapy? Do you follow subluxation theory? Do you believe in so-called innate intelligence or another kind of "life-force"?

Chiropractic is primarily manual compared to PT although there is some overlap (some PTs adjust, some chiros are into rehab) and they both work in the same field (MSK). They're complementary to one another. I chose chiro because it fit more with my kinesiology background and approach to health (holistic). Innate intelligence, life-force are older terms but are considered to be synonymous with homeostasis, and the healing power of nature (when you cut yourself, the body knows how to heal it up). That's part of the holistic background that also separates PT from DC. Subluxation theory, traditionally speaking, is bogus, in the one cause one cure mentality.

I was one of those who would have been loudly screaming "bullshit!". In my eyes, those chiro-quack-ters were a few steps below snake oil salesmen. My opinion changed. Sorry about the wall of text, but here's what happened.
I married a sweet lady with moderate to severe scoliosis. Over the years I watched her health & abilities decline. This woman used to sling lumber in a sawmill, and had no problem arm wrestling me to the ground. I watched as she went from walking normally to depending on a cane. Then she started needing a wheelchair to get through walmart. She was determined not to use it, but soon, almost every time I had to leave her at the back of the store, go fetch her a chair and finish shopping with the wheelchair. I finally bought her a nice electric one of her own. She was becoming more and more dependent on it, due to the back pain. Her doctors would take one look at her spinal x-ray and offer her any pain pill she wanted. Just blew their minds when she'd refuse. I got her to get some just in case. There were days when she really needed them, but it's easier to bathe a cat than get her to take a pain pill, even with her face ashen from pain. A few times I insisted. Wish I had bathed the cat instead..
She should have had a back brace when she was young, but grew up dirt poor in the early 60s. In her early 30s a chiropractor looked at her x-ray and said he wouldn't touch her. The doctors I took her to in her early 40s said even surgery wouldn't help much at her age.
One day she said someone gave her a "coupon" for free exam and x-rays at a chiropractor in a nearby town, and had highly recommended him. Even for a trucker, I got pretty graphic in the language I used to describe chiropractors to her. As most discussions go, however, it ended with me saying "do whatever makes you happy, sweetie". But I was damn sure going with her. Think along the lines of Richard Dawkins meeting the Pope. I straight up told him my opinion of his profession. He responded with a gentle, knowing smile, and proceded to go over her x-rays with us, in minute, painstaking detail. That gave me a little pause, as most doctors I've seen in the last 20 years just rush into the room, barely look up from the chart, mumble something about a presciption then bolt from the room before you can ask any questions. Cornered one once and demanded answers; he told me he was the one with the medical degree he earned from years of schooling and he would know best how to care for her. I just wanted answers. That pissed me off and I fear I wasn't using my indoor voice after that. Still did nothing to improve her care. Blew me away when this kind, soft spoken man was willing to go into detail with us about what he could and couldn't fix. No, he could not straighten her spine. Yes, he could alleviate some of the spots where the vertebrae were pinching nerves, causing her all kinds of pain, headaches, dizzieness, and even reduce a little of the pressure her spine was causing around her heart and lung. No, he couldn't say if she was going to end up wheelchair bound or not. Still I held onto some of my skepticism, because it's served me well in life.
After many weeks of daily treatments, however, she was having less pain. Getting around on her cane again. After a few months, the wheelchair sat, used only on really long outings. Fast forward 10 years. She'd have a hard time finding her cane. The wheelchair? Yep.. Gets used daily. As her computer chair. It's comfy and a great place to store it she says. I apologized to good ol Dr Phil, and dread the day he someday retires. She still has pain, and knows no moderation. When she feels good, she goes all out. Things like pushing a riding mower up onto a trailer to haul to the shop. Then she pays for it by not being able to do squat for a few days. Ol Dr Phil just sighs, tells her to get on the table, while gently admonoshing her not to do that again, pace yourself he says. I just smile, thinking "aint gonna happen".
I'm gone a lot, trucking. I keep her set up for both worlds. Days when she's able... Truck, light trailer, polaris ranger & a zero turn mower. The next few days it's satellite, Netflix, a screamin' gaming rig with 42" tv on her desk, a dozen max level WoW toons.... And wait til the next "good day". To note, Dr Phil is awesome with her. However, he does have fillins sometimes. Two separate occasions, she let them adjust her. One was very rough, and the other just plain HURT her. So yes, there are good and bad. Don't, please DON'T throw the baby out with the bathwater. If it needs a Dr, use one! If it needs a chiropractor, ask around til you get recommended a good one! This chiropractor helped my wife, convinced me, and EVEN HER DOCTOR, who previously stopped just short of calling them witch doctors. So thanks OP, for the ama, and being one willing to take the time to actually TALK about it, explaining and showing tremendous patience.

TL;DR: I was skeptical of chiro-quack-tors, until one changed my wife's life

Used appropriately and in conjunction with medical care, it's a no brainer! Glad to see the wife got her life back on track. Back pain can be very disabling. They shouldn't be discouraged from trying a manual approach.

I see a chiropractor who is great at actual repositioning and correcting things, but he also does this really fishy thing where he asks to hold your arm up at length while he puts pressure down on the wrist while touching different acute areas of the body; he's counting while he does this and takes record of at what "number" the arm weakened when he touched that area. It seems pretty fishy to me. He says he's feeling the body's energy...? Any take on this? Thanks.

I don't think he's looking at the energy, but a concept in Applied Kinesiology called "therapy localization". The basic concept is that a weakened muscle (inhibited) may be the result of a corresponding/neighbouring muscle or group that is too tight or tense (facilitated). If the weakened muscle improves on testing after working out the other area, it suggests it was somehow involved in the dysfunction. It's an interesting idea, but not something that has a lot of research yet, but it's coming.

Hmm, interesting. He even checks himself using other peoples' arm. What is your take on that? In other words, how would his own inhibition in a muscle be readable through someone else's arm?

I have no clue man. Probably just experimenting away. Ask him directly, maybe he can shed some light.

The ideomotor effect.

That would better describe what is occurring in Network practices. But, yep, good find.

A gentleman I study with is a DC and had me come in to his office. He spent about 45 minutes doing different things, and one of things he did involved a tuning fork. He had me hold my left hand out (numbness/tingling occasionally; C3-C6 fusion) and pressed down on it. It pretty much collapsed easily. Then he rang a tuning fork, placed it on my right ear, and no kidding, my left arm was strong like bull when he placed down on it.

What are your thoughts to that?

I really can't explain that. There's a lot out there that medicine (all of it) doesn't about or how it works. It's worth investigating though. Obviously the left hand problem had some kind of inhibition, because it had such a quick response. Hypertrophy (muscle growth) ain't gonna happen in a few seconds. So it's a neurological effect, likely enhanced synchrony with respect to the firing rate of the motor neurons being stimulated. Be interested to see how long this effect last for and if it was just specific to a tuning fork.

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I went to CMCC in Canada. I have a BSc Honours in Kinesiology, so 8 years of school total. No payed customers/patients at the CMCC clinic. The prices for treatment are 50% less than the chiros out + double the treatment time as its interns working on you. So no real need to recruit. That's brutal to hear about your acquaintance. I know some US schools are very traditional and out-of-touch. The DPTs will force them to adapt or they'll become redundant if PTs can master the art and science of manual medicine

Thanks for doing this AMA. What do you think needs to be done to correct the Chiropractic field (prune off all the phonies)? A big international test? Provide better schooling for new comers and wait for the incompetent ones to die off? Also, what do you think of Myofascial release (if you're familiar with it)?

1) Trim the fat. The 20% that adhere to the straight/traditional model really don't want to evolve and they're like a huge weight on the majority's shoulders. This will happen when younger chiros like myself get onto the regulatory boards, etc.
2) The World Health Organization released an international standard for chiropractic education http://apps.who.int/medicinedocs/documents/s14076e/s14076e.pdf. This was (IMO) the tipping point. The next generation of chiros will have it easy compared to us with integration and acceptance. Interns from the chiro school in Canada and now working at major hospital in Toronto. It's happening already. This also weeds off bad behaviours; we are now accountable to other health professions too not just ourselves, patients. 3) Of course! The young DCs are proficient in soft tissue techniques. I use ART, Graston, MET, generic myofascial release.

As a PT, I initially read all of this good ole fashioned reddit hate gleefully, but I have got to give it to you, you are really standing with the punches. While I do not think much of chiropractic medicine, I will say that it is just like any other profession: There are good chiropractors and bad chiropractors. So, here's hoping you are a good one and thanks for doing this. What prompted you to do this AMA? Is this in itself a part of the marketing culture of chiro?

Not really. I was supposed to watch a hockey game tonight and it turns out its on a channel I don't have! So I did an AMA instead. I was surprised it got any traction, I was expecting it to get dismissed out of hand.

I think it's a little of both. Chiropractors are needed for very specific people, not just rich yuppies who use you as a massage. My friend has a disc in her spine that will sometimes slip and pinch a nerve. The only way to get it unpinched is a chiropractor. But sometimes I think chiropractors are just used to temporarily alleviate a more serious problem. So, it's a fine line if both. Just my opinion.

As long as the chiro is telling you that it's for symptomatic relief (which lots of people want, is just relief when other things aren't helping) than IMO, it's not BS, as long as there is transparency.

1. Do 'subluxations' exist, and can they affect the nervous system? I have talked to a chiropractor who basically claimed that the spine 'bends' as I understand them could cause a bunch of symptoms by affecting the nerve transmission.
2. Can chiropractors fix or improve scoliosis?

1) Subluxations is general chiro term for joint dysfunction. Osteopathic physicians call them "somatic dysfunction" PTs call them "orthopaedic dysfunction). They are all the same entity. I.e. a biomechanical spinal lesion/dysfunction where the joint isn't moving properly and it, effects the local muscles and soft tissues. There is evidence that these mechanical spinal problems (i.e. vertebral segments that are either moving too little (adjust) or too much (stabilize).
2) If the scoliosis is functional (i.e. due to muscular imbalances, yes with a combined approach (hands on and exercises). Structural scoliosis, no, but you are looking at helping them reduce symptoms or improve current function (range of motion, strength, endurance, etc...)

I don't understand your question. Are you looking for validation of your profession from redditors?

No validation. I want redditors to ask me anything about chiropractic and I'll tell them what is bullshit and what is truth (i.e. based on science and has evidence supporting it).

When a chiropractor uses the words "science" and "evidence" it reminds me of when deepok choprah says "quantum".

Then seeing DCs with their PhDs (chiropractic scientists) would be an oxymoron. Except not in 2013. http://www.canadianchiropracticresearchfoundation.com/research-chairs--professorships.html Times are a changin'. Research is where it's at for any health profession that wants any credibility.

What kind of work can a chiropractor do for someone who has severe scoliosis? I've had a spinal fusion which keeps me at a decent curvature, but can chiropractors work out some of the kinks related to my condition?

Well, each case is specific. You have to look at the hips and shoulders too (the limbs in general). Also, let's say you had fusion in your low back doesn't preclude the chiro from working in that and other areas of the spine to prevent other pains and issues from occurring. If you're not a candidate for adjustments/manipulations, your chiro should be able to do some soft tissue work and prescribe your an exercise plan to help out. If not, find a different chiro or go see a PT or RMT

Come straight, if I crack my knuckles, back, and neck... hell everything I can crack. How bad is it?

It's not really bad. Specifically, the biomechanics of the spine work like this: there are 24 moveable vertebrae. If some of them get stuck/jammed or don't move smoothly like the other ones, there is a loss of mobility. The vertebrae that are adjacent (next to) the restricted vertebrae, both above it and below it, have to compensate and move MORE, to regain the lost ROM from the jammed segments. So technically, the one's that need the cracking are the stuck ones which and not the loose one's which your popping yourself. I hope this makes some sense!

What's your take on muscle testing? I've found a lot of chiropractors I've visited use this, but I kind of want to call bullshit on it.

Muscle testing for the sake of testing the muscle strength or endurance is legit. Sports MDs, PTs use muscle testing also. Muscle testing for mineral, vitamin deficiency is bullshit.

I went to a chiropractor a number of times when I was younger, the chiropractor would crack my back, thank me for my money and book me another appointment. As an experiment, I popped and twisted my back myself before I went and saw him and he failed to create any pops then remarked how great my back was anger how he must be helping me. I just stopped going. My main problem with my back really was that I was carrying too much belly weight, and he never mentioned that once.

I'm all for alternative treatments that are scientifically provable and evidence based, but I never hear of this sort of peer reviewed proof. If it exists, why isn't that the first thing stated about these treatments?

I agree that a unimodal approach (adjusting) isn't the best one. You have to look at all the factors, including ergonomics, lifestyle, sleep posture, exercise programs (or lack thereof). What specifically are you asking regarding the proof? Evidence of effectiveness?

I have a passion about chiropractic but the money is the only thing keeping me from wanting to go through with it. so I have a few questions.

1. Did you start your own Business or are you working for someone else? and which one usually pays better?

2. Is your income worth going to chiropractic school in your opinion?

The costs for going to a lot of professional schools is becoming prohibitive. I graduated with a debt of 125k and I worked a bit through school. 1) I started my own business. Basic exercise equipment, a table, and low overhead.
2) My current income yes. In the beginning it requires time to build. Easier route would be going to PT from a financial perspective and more instant credibility. That's doesn't mean it's the better route. In the US, it's a tough call. Tuition is getting out of hand.

My friend was recently diagnosed with scoliosis (something like a 30 degree bend). When she was in elementary school, she used to go to the chiropractor twice a week to help with her asthma. Could it have been making her asthma worse?

Most child scoliosis' are structural and above a 20 degree angle should be seen by a specialist for potential bracing. Beyond 45, braces likely won't work. The asthma thing: we try to improve the mechanics of the rib cage through releasing muscle and joint tension so the mechanics of breathing become easier. So, not treating the asthma, but more the resulting movement problems around neck and thorax that can accompany it.

Do you have any positive results for people with inter cranial hypertension? I've been told to try a chiropractor or acupuncture but insurance doesn't cover.

I have no experience nor am I aware of any research. This would be considered experimental. As long as there is informed consent, you know the risks/benefits you may be try it for a bit. The length of time would depend on a lot of variables, but you would need to see them to make that call. Trial periods of 4-8 weeks for chronic issues isn't unreasonable, but there should be some kind of re-evaluation to see if the treatment is doing anything. Metrics.

I dont know if this has been asked, but do you know of something called "military neck" and is it really all that bad?

I've honestly never heard of this, but it probably has a synonym.

cervical kyphosis........ does that sound right?

Yeah, a reversal of the normal curvature of the neck. The SCM muscles (sternocleidomastoids) are the biggest flexor group of the neck so they're likely involved. It's basically a muscle imbalances between the flexors and extensors, so while adjusting can help with the mechanics, it NEEDS to be combined with exercise rehab to fix.

so this is something I should really get fixed?

Well, if you're concerned about it, get it checked out. I know from a mechanical perspective that it's not moving as efficiently as it could and you may be at risk down the road developing neck issues because of that. But I can't tell you online anything specifically. An assessment by a sport-oriented DC or PT would be a good way to go. Make sure there's a manual and exercise component if you decide to proceed.

Hello! I have been suffering from "chronic" (self-diagnosed) lower back pain for many years now, and recently I went to see a chiropractor and she said I needed to go in 3 times a week for two months before I could see results. Every adjustment costed me $45 and lasted for 2 minutes where she used a manual applicator to "fix" my back and shoulders. After 4 sessions I didn't notice any results, and instead I have been feeling more sore than before and my wallet really couldn't justify spending the money. I know every chiropractor's practice is different but I would like to know your opinion on the following:

• How does a manual applicator differ to a hands-on approach? Wouldn't the hands-on approach be better since you can actually feel what you are doing, and apply pressure accordingly?

• How does a 2 minute 'adjustment' cost $45?! I cannot justify spending this amount of money where a small tool pushes my body in various spots.

• How do you fend off people who deduce chiropractic medicine as bullshit? In what way do you defend yourself from all the negative connotations people have towards chiropractors?

• Any advice for my lower back pain problem?

Manual is the most common, preferred and what the research is based on. Activator or instrument adjusting allows you to control the force specifically. LBP: keep active, eat well, sleep well, and maintain your body like you would with your house or your car. Some kind of manual therapy (massage, manipulation, etc.) to help you move and feel better on occasion.

I just wanted to thank you for doing what you do. I saw a chiropractor for a joint injury and he helped me quite a bit. Like you, he was a younger graduate and was very personable.

Still, some of the tools he'd use were freakin' painful but they worked. The thought of one in particular that I forget the name of - it looks like a curved butter knife - still makes me wince.

Unfortunately I was laid off and my insurance went poof but I was able to do a lot of the exercises he recommended and get myself back in more or less working order.

Graston technique. The stainless steel instruments used to soft tissue problems (adhesions in particular). Yeah, it can be uncomfortable but you're not supposed to go bananas on the tissue. No more than 5 min and move to a different area if it's getting too red. It should be followed with ice and stretching for maximal effectiveness. I'd rather have a go with the Graston for carpal tunnel symptoms then immediately hop to surgery.

Can you describe what a typical workday is for you? How many patients, Hours you work, is your schedule full, etc. How much you guys get paid by insurance verses out of pocket in %? Also if you could give rough indication of what your profession makes annually.

Lastly, how/why did you decide to do this as a career?

The practice will vary from one doc to the next. It's all a matter of choice. Some prefer part time practices and some full time, others will be mostly insurance work, others may be 3rd party or out of pocket. I don't usually work for the insurance companies because lawyers get involved and patient prognoses decline. That's a documented scientific fact too. If a lawyer is present in an MVA case, the prognosis for recovery is decreased according to the stats.

Is cracking my neck, back, knuckles good for me (cause it darn feels good) or does it do harm? thanks

There's no evidence to suggest it's bad, but to me, if you can cracks your own spine easily, it likely means that there may be some hypermobility (too much movement) going on in there. Maybe stability exercises might be warranted. Depends on the exam. If you have to crack the knuckles, do it with traction (pulling) rather than bent knuckles, it more mechanically correct and softer on the tissues

How are you treated by MDs and DOs?

The MDs in my area are respectful because I stick to my area of expertise (MSK). They see me more as a non surgical specialist for manual therapy, which is great because that's the gist of my training. We all have to speak the same language which is where some of the confusion comes from.

Do you ever want to go back to school to become a real doctor?

No. I'm as real as a dentist, optometrist or other doctoral professions. I'm not an MD, nor was I trained to be one. DC has their own area of expertise.

I used to go to a chiropractor regularly and now I go occasionally when I have symptoms.

Do you believe there is any benefit to 'maintenance' chiropractic adjustments?

Also, I've been to three chiropractors and they all did pretty much the same routine, although my complaints weren't always the same. Is that normal?

Maintenance treatment has evidence for those who have recurrent, chronic back pain. It's better to have it checked periodically then just letting it go and having a major flare up down the road which will require more therapy in the end. New complaints should be investigated and have their own treatment plan. Tell your chiro to tell you the diagnosis and how they propose to treat it. It should make sense to you. If it doesn't, get a second opinion. Sometimes people can fall into ruts. Ask him/her to be more attentive and that you're concerned about the cookie cutter approach.

What led you to choose a career in chiropractic?

Love of sports, athletics, fitness, rehab. Underlying philosophy of holism. Good with my hands (according to the ex-girlfriends) ;)

I just wanted to say that I stared getting adjustments six months ago, and it has worked wonders for me. When I first started going in, they took an x-ray and my spine was in stage one of decay and just a few weeks ago I got another showing that the natural curve had returned to my neck again. I also feel as though my overall heath has improved.

When you're in less pain, you are healthier. Less pain usually means you can be more active, and the more active and better lifestyle, the better your health. It's a good catalyst for sure.

anything you would particularly recommend for preventing problems, like maybe yoga, stretching, weight training, wearing bare feet etc?

Absolutely. Yoga and a good workout routine can help with strength, endurance, flexibility, balance, stability, etc. Great from a prevention stand point. Just make sure you start at your level, demand cannot exceed capacity or dysfunction occurs.

One thing I learned from a chiropractor that has stuck with me for years: guys should carry their wallet in their front pocket. I had been rearended at a red light one evening about 12 years ago and developed some moderate back pain from it. I got a call from some ambulance chasing chiropractor the next morning asking if I needed help and that the other party's insurance company would cover any charges. I figured I'd do it since it was free. They took some preliminary x-rays and discovered that one vertebra in my lower back was tilted sideways at about a 30 degree angle. (It was definitely a real x-ray - I could see my piercings in it, as well as the cross necklace I was wearing) The first thing the doc said is that the accident didn't cause that, my wallet did, and refused to treat me unless I promised to carry it in my front pocket for the duration of the treatments. The back pain from the accident was muscular, and he used a TENS unit to help with that. He went ahead and billed the insurance for the vertebra as well, saying that it could have been worsened by the accident and treated that with some little spring-loaded device over the course of several visits.

tl;dr: Don't carry your wallet in your back pocket... it'll screw up your back.

Totally. It's like a slow repetitive strain mechanism. Symmetry is ideal

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Cold lasers are a class III and aren't that effective. Class IV lasers, used can help with myofascial pain. No treatment would likely work with just one session though.

I know there are good chiropractors out there (you sound like one) who don't make unreasonable claims or believe in every conspiracy theory about health. Then there are the ones who claim they can cure your cancer or allergies with an adjustment... Are there any tell tale signs to avoid these nuts?

Tell tale signs: claim adjustments are a cure-all, claims subluxations cause disease, discourage you from having medical care, encourage you to pay upfront for a boat load of treatments.

Can chiropractors do anything for plantar fasciitis?

A good bet is to find someone who does myofascial release (or ART, Graston) to the feet, calves and hamstrings. Stretch the posterior chain. Address any lumbo-pelvic imbalances too (functional leg length inequality). Intrinsic foot muscle exercises are important too. Hope this helps.

I always wondered, what sets apart chiropractic modalities from D.O. osteopathic modalities?

great question! Chiropractic is actually a derivative of Osteopathy. Osteopathy though that the circulatory system was the main organ involved in the effects of manipulation, whereas chiropractic thought it was the nervous system. DOs eventually abandoned their stance to medication and surgery and use that waaaay more than manipulative medicine. Modern DOs in the US and almost indistinguishable from MDs although some to retain adjusting. Chiropractic as a whole is the field that has the most training and expertise in manual medicine, specifically in spinal manipulative therapy.

Do you have any self help tricks for those too lazy to visit you? :p

Get exercising. Make sure to include cardio, resistance training, and flexibility. Eat well. Cut of processed foods, preservatives. Try to eat as much real food as possible. Have a good outlook on life, attitude matters.

Hey there, I'm a little late to the party, but I had a question none the less: I visited a chiropractor in February because I have some kinda, pretty serious back issues.

My back doesn't hurt all of the time, but my problem comes when i'm laying down on a hard surface- like doing sit ups on the floor or just laying there flat on my back. my lower back locks up, causing paralyzing pain. I'm talking like.. I can barely breathe from the pain and I have very very limited motion. Once I manage to turtle myself onto my stomach (which can take up to an hour) and stand up, I feel okay. Still a little pain lingering, but I'm not being tortured.

I went to the chiropractor and he told me I had a pinched nerve in my lower, and upper back (I had an S curve), and something in my right hip was locked- that i couldn't move my leg up over my buttcheek or something.. so he did his weird "jack hammer on my spine" routine, which hurt incredibly bad. Only to have an excruciating POP for the spine to go right back into place how it was.

I went back maybe three times, and it was just the same thing. He never really explained exactly what the thing in my lower back is, why it happens only on hard floors (not on beds or couches) and is there anything I can do, other than spend $20 +gas a week for the next 50 years getting spinal adjustments?

p.s. I'm a 23 year old female, who has had a child. Dunno if that helps any. I didn't notice any problems for at least a year and a half after giving birth.. so i don't know if that was the cause.

TL:DR, my back is screwed up and the Chiropractor never explained so I got frustrated and stopped going. Any idea what's exactly wrong with my back? Any at home suggestions to help aid my problems?

Thank you!

Poor communication and a poor assessment will doom any treatment plan. You need to get a good diagnosis on your back. If your pain changes depending on posture or movement, it's likely mechanically related, meaning a DC or PT can help. A good adjustment is clean and fast. You don't need to "muscle it". It's like the martial arts, speed and leverage are essential. Sorry I couldn't help more, but maybe just a bad chiro. Regarding the hard surfaces, try a couple of pillows under the knees which reduces the strain on the low back. Sometimes when we're lying straight on our back it may be a little extended which jams joints and soft tissues back there and can cause pain. Hopefully you get relief soon.

Do you believe in the chiropractoric conceptualisation of vertebral subluxation?

Stripped away from the politics and drama, all professions that use manipulative therapy (mostly by DCs, but some PTs, some MDs and now some veterinarians even) focus on a specific spinal 'target'. The target are vertebral segments that aren't mechanically functioning well. So, joint dysfunction (aka subluxation in chiro talk) is a real entity. Is the cause of all disease. No. Can it produce reflexive changes in the viscera via somato-visceral pathways? Possibly. At least its now being seriously researched as to what the actual significance of dysfunction/subluxation (simple back pain or more complex than that). So far, the research shows a definite effect on the MSK system, beyond that, it's inconclusive. Certain patients certainly do report improved visceral symptoms at times, but we don't know why some ppl and not others, and what conditions may be better affected than others. But there is research into this right now.

How much money do you make?

Not enough to complain but not enough to retire anytime soon.

Is there anything you can suggest for sciatica?

Avoid flexion (bending forward at the spine). Figure out if its from a muscle (piriformis syndrome) a gluteus medius trigger point (pseudo-sciatica) or a disc issue in the lower lumbar spine. No evidence of cortisone injections, so avoid those. Figure out root cause and work with someone trained in rehab to get you on the right track. Can try Mckenzie extension exercises (see you tube). Again, go see a professional for a good diagnosis

I'm conflicted on chiropractic. As a teenager, I developed horrible neck pain and headaches, and based on the TV commercials I had seen, I begged my parents to take me to a chiropractor. Finally, an opportunity presented itself, and the chiropractor adjusted me once and boom, gone.

However, in retrospect, did I have these 'subluxations', or did a just need a damn good neck crack? As a kid, I had seen too many action movies, and was always afraid that if I turned my head too aggressively I'd just snap my neck and instantly be dead. I definitely entertain the possibility that I was just too scared to give myself a good pop.

That chiropractor was a decent guy, and my mom and I saw him every couple of weeks. When I went to college, I looked for a chiropractor near the school, and found a guy who got weird. He had a lot of religious imagery in his office, put me on various machines, and asked to see me three times a week.

After a couple weeks of these 3x weekly visits, my parents asked me "Do you really need to be seeing a doctor three times a week?" Just the question snapped me out of that trance and made me say to myself "Hey, this guy is an asshole." I haven't been to a chiropractor sense.

I never really paid attention to the whole subluxation speil from either doctor. I figured that a healthy spine was part of a healthy body, but I never really thought that you could literally fix, like, a urinary tract issue by making sure your legs were the same length.

So, for me? Chiropractic had some real, immediate physical benefits, not a lot of long-term benefits, and questionable medical advice. I'd advise anybody to see their doctor first, but if you're just sitting at home in pain and don't know what to do? Sure, see a chiropractor, have them adjust you. It'll either work or it won't.

You had mechanical neck pain, and found a mechanical solution (adjustments). So whether you call them a subluxation or joint dysfunction, or any other term, something wasn't moving well and jammed up. Any acute mechanical neck pain or back pain should see significant improvement within 4-6 weeks. If not, get a second opinion.

So what makes a chiropractor, anyway - is it the mechanical motions performed, or the subluxation language?

I've always found it a little silly when people forcibly deny that chiropractic has any effect. Anything that forcefully moves your body could have an effect. Is it positive or negative, does it have anything to do with the chiropractor's intent? That's less clear. But at least something is actually being done that could affect the subject, unlike something like homeopathy.

what makes a DC, is the expertise in manual and manipulative therapy. The subluxation language is unique to chiropractic, but the entity they're describing is not. Joint dysfunction is the generic term is most apt descriptor, IMO

I had a dislocated collar bone from several years ago that never seems to have set correctly - dislocated at the shoulder side. I've always wondered if it would be worth going to a chiropractor to have it popped back in, but didn't know if it was valid or not. I'd be really happy to not have the pain anymore, but it is surrounded in scar tissue...

One adjustment won't solve it. It's chronic, and the tissues have several years of compensations, wear etc. You would need a comprehensive evaluation and a treatment plan for a minimum of 4-6 weeks. Soft tissue techniques like ART and Graston are good for scar tissue reduction as is acupuncture by twirling the needle under the scar tissue like cotton candy (only to be done by a trained health care professional!). If you haven't tried a manual approach, (joint AND soft tissue) who have nothing to lose. Hope it works out well for you.

Reading through this thread makes me miss my old chiropractor. He was awesome. Made an appointment get adjusted and he would say come back if it hurts. My current one wanted to do a bunch of sessions really quickly because it has been so long and he wanted to fix it. I said do it all now, I can take it. He refused but I felt great for months. Sadly due to insurance reasons I cannot go back until june, but I cannot wait! Get all my aches out and life will be great!

Insurance sucks, hopefully one day its a basic universal service (used within reason, of course). A good DC, like a good mechanic or contractor is an awesome asset to the team. You can build a life-long partnership with them bc you trust their work.

Did you go to life?

And what do you think about NUCCA?

No, I'm Canadian, I went to CMCC. Life has a poor reputation academically. NUCCA is not taught in the schools and I don't know too much about it other than Montel said it helped him. Upper-cervical chiropractic is very interesting but also controversial because they posit everything is secondary to C0-1.

I can't speak to the "bullshit" claim that some people make regarding chiropractic treatment, but in my experience it has been the only thing that helps my back pain and stress. I chronically carry stress in my back and neck, and it tightens all my muscles so much I feel like my spine is in a vise grip top to bottom. I saw a chiropractor (after my physician told me they don't recommend it but I can try) and it was amazing. The first day without back pain (without having to take rx pain meds) was absolutely incredible. I felt free and loose and able to MOVE again...and then I left my job and started school and am poor :( so I'm back in pain again. But I know when I am working I will absolutely go back to my chiropractor. He helped me to understand how my daily habits and stresses were affecting me physically, and gave me methods to control it at home. I'm so for chiropractors, but I guess I had an experience with one of the good ones. Nothing works for EVERYBODY, so even if you've had a bad experience I don't think it's fair to call bullshit on an entire profession.

I agree. Don't throw the baby out with the bathwater. That's really the what the thread is kinda about.

Is Thoracic outlet syndrome easy to see in your patients who say they might have it?

I think I might have it, when I raise my left arm all the way up to the ceiling or do a shoulder press motion I have a crackling feeling in my upper left back/shoulder. This could be something else entirely.

Usually TOS involves the ulnar nerve and that innervates sensation wise your ring and pinky finger. The problem lies in the scalenes muscle groups where the brachial plexus emerges. There can be other mechanical compensations elsewhere in the spine or limbs too. You need to go get it diagnosed properly and make sure it's a mechanical problem. Quite frequent in the trades and hairdressers, due to the way they work.

I used to go to what I think was called a satellite chiropractor. I preferred it because I get really uncomfortable when my back or neck cracks. Do you know anything about this specific section of chiropractic medicine? And if so, what do you think about it? Whenever I describe it to someone, they feel like it sounds like hogwash, but it seriously helped my back feel better.

Satellite or network chiropractic? Network isn't even chiro, really, there's no manual manipulation going on. There's no evidence for that, but anytime you can feel relaxed and believe it's a therapeutic experience, the mind is a powerful thing. I don't know too much about it, but I know that it's practiced by a tiny minority of DCs (<1%) and it's not taught in any school anywhere.

I think some chiropractic treatment is valuable in certain cases, but I don't find it the cure-all panacea it's made out to be. When married to my first wife, she was in and out of the chiropractor all the time. When she used it following a car accident they were charging insurance $5000/wk. When that ran out, we called to cancel, but they said that oh, they wanted her to have the treatment and could do it for $500 a week. Left me a little dubious.

My ex also insisted on getting chiro for my son, at that time 4 years old, and I have no understanding of why a perfectly healthy 4 y/o needs chiro, and the chiropractor didn't dissuade her.

So, yeah, I call 15% valid, 85% bullshit.

The validity doesn't have to do with the money spent, but whether or not the chiropractor is treating appropriately and not making bogus claims. Avoid the big money upfront, friends and families types. If the 4 year old wasn't in pain I couldn't justify treating them either.

Chiropracty is bullshit. I used to have back pains all the time so I went to a chiropractor. They took some x-rays, did some adjustments, and told me that my back hurt because one leg was longer than the other and gave me a shoe insert. Well the pain didn't stop so I went to an actual hospital, where, as it turns out, I had to have my gallbladder removed.

No offense but you guys are glorified massage therapists and chiropracty has no business labeling itself as medicine, and no one should ever use chiropractic treatment in place of legitimate medical treatment.

I'm sorry for the evidence suggests otherwise. When used appropriately and skillfully, manual therapy is effective for MECHANICAL (movement-related) back pain. Your pain was referred pain from you gallbladder which often shows up as infrascapular pain on the right side (pain below the shoulder blade on the back). These usually aren't confused though. Gallbladder pain is quite intense, collicky, fever, malaise, abnormal white blood cell counts, difficulty digesting, especially fats. A good DC is a great part of the health care team. And it is a team. Health care is shifting towards multi-disciplinary, collaborative approaches.

You know, despite your title, you don't sound at all receptive to contradictory viewpoints. Every time someone has came in this thread with a chiropractic horror story or account of a swindler, you've been outright dismissive. Oh yeah, [Citation Needed] for your "evidence." Wikipedia seems to think you're full of shit.

I respectfully disagree. Wikipedia is terrible for alt-med and controversial articles, so I stick to pubmed which is a database for all academic peer-reviewed biomedical research. The swindlers are dicks and unethical, but that's doesn't mean that the premise of chiropractic, which is manual therapy is legit intervention for spinal issues, is wrong. It just means they're frauds and crooks. Not the whole profession. That's throwing the baby out with the bathwater.

You're picking and choosing sources that you agree with. That's not how science works. Since you claim to be reasonable and willing to evaluate your beliefs, let's try another tack: what evidence would be adequate for you to agree that chiropractic "medicine" is bullshit?

I'm just picking sources that supports the claim I made. If you can find a source that refutes the studies I presented, great, that's how scientific discourse works. If not, it's all just hot air.
To answer your question, chiropractic medicine would be bullshit if there was no evidence of effectiveness for manual interventions for any condition.

That's now how scientific discourse works. If you were intellectually honest you would spend your own time knowing what the other side says. Purposefully ignoring any information that disagrees with your hypothesis is a form of confirmation bias and is inherently unscientific.

That being said. I find that Chiropractors aren't given enough oversight by any respectable health organization to trust. Combined with a lack of evidence for chiropractic over say, physical therapy and the risk you take by going to an alternative medicine non-doctor I would never recommend a chiropractor. I've gone through several chiropractors and physical therapy sessions overseen by hospitals/doctors and physical therapy has always worked better, faster, and with established results compared to chiropractic.

If you wanted to help people and you are so concerned about being scientific, why didn't you just pursue a career in medical science instead of an unproven alternative medicine?

Edit- I should point out that chiropractors have come to Reddit before, and the threads always go like this. Chiropractor provides their evidence, Reddit provides evidence/articles saying that OP's articles aren't true/misleading and OP ignores them.

You are taking journals and papers that suggest things, or mechanisms, and using them as proof for your practice as a whole while claiming to be scientific while automatically dismissing any evidence that goes against your hypothesis.

I do know what the other side says, research on low back pain is bound to give you a lot of perspectives and results. My specialty is manual medicine. PTs didn't work independently of MDs and were subordinate technicians at the time, now they are more clinicians. A DC and PT were my two choices, I preferred the hands on approach in all honesty.

The citations in the wikipedia page I linked has literally dozens of studies that refute the ones you've cherry picked, but you've chosen to ignore them because they don't support your claim. Thanks for admitting that you were never willing to actually change your position, I guess.

I used to write at WP a long time ago, and I know the process intimately. Feel free to chose a study and we can have a discussion. Otherwise, I'm not going to get baited. Cheers.

And I'll disagree.
8 months ago I was tired of my migraines. Day long, week long, migraines from HELL. Pulsing, vibrating, almost wanted to commit manslaughter type of pain. At this point I was consuming something like 8 excedrin migraine a day easily just to dull the pain (any day w/o was just horrible). I stopped by a chiropractor. He sent me for neck xrays, checked my posture, did a strength test with my fingers and sent me off for the xrays. The migraine came back while I had the xrays done and I could barely drive back to his office, much less hear what he was trying to tell me. He led me to his adjustment bed, threw pressure on my fingers joints, my neck and adjusted my neck. The migraine literally left as he was holding down my pressure points.

Long story short, I've not had more than 5 migraines since I have gone to the chiropractor. He had me doing neck exercise/rehab because of the joint compression and the muscles were literally straining all the time. I have stretches I still do but it was literally a 3x a week process for 3 months.

I've gone 1x or 2x a month since January and the mere thought of realizing how long I've gone w/o a migraine is amazing to me.

There is good evidence of benefit for specific headaches, namely migraines and cervicogenic (headaches arising from the structures of the neck). Here's a quick resource for a more in depth view of migraines and treatment approaches: http://www.umm.edu/altmed/articles/migraine-headache-000072.htm