In 2006, a Gallup poll discovered that the field of chiropractic care was rated as the least ethical and honest subset of health-related professionals. Since you’re reading this, you’re likely interested in the controversy surrounding this field.
First, let’s establish what the field of chiropractic care entails.
Chiropractic care was invented by D.D Palmer around 1890. The main concept behind this field is that spinal “misalignments” cause a large amount of health problems and disease. This was given the special term of “subluxations” by adherents to chiropractic beliefs. This idea has never been shown to be true and, in fact, the chiropractic definition of subluxations has been repeatedly shown to not exist. The medical term that most closely describes what a chiropractor calls a subluxation is just a partial dislocation. A study published in 2009 says as much:
There is a significant lack of evidence in the literature to fulfill Hill’s criteria of causation as regards chiropractic subluxation. No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.
Related to that, the entire field of osteopathy is devoted to curing of diseases by way of joint manipulation. That’s what they believe, at least. They genuinely believe that what amounts to a back rub can, quite literally, cure a bacteria or virus based illness. Regardless of the fact that they don’t actually exist, subluxations are treated by manual adjustment of the spine. Though this is dangerous, many people still flock to chiropractic clinics every week for their regular “adjustment.”
Why do people go? They generally believe that their bones have somehow drifted out of place and that this is causing some type of nervous system problem. They also believe this can be fixed by the person that has informed them that the bones are no longer where they are supposed to be. Some people go in all the way and believe that this will restore chi flow or something similar. No, chi/ki/qi/et. al are not known to exist. No, you can’t throw ki-fireballs. I was disappointed too.
Though the primary underpinnings of chiropractic care are known to be false, chiropractors do see results through two primary means: placebo effect and massage therapy. Everyone has a friend that swears by their weekly chiropractor visit. Let’s look at why.
First, let’s examine the placebo effect. Most commonly this term refers to using something like sugar pills as a control in an experiment to determine the effectiveness of a drug. The control group usually, believing that they are taking the actual drug, will exhibit psychosomatic effects related to the drug. The mind plays tricks on the body. How does this relate to chiropractors? Simple. You go to a clinic expecting to feel better after you leave. You’re seen by a “doctor” in a lab coat who prescribes an elaborate care routine for you. The procedure is done either in a clinical, professional manner or is done in a personal, relaxing setting. Either way, the illusion is complete. You pay a substantial sum of money for this high quality care. Afterwards, you feel much better since you were treated by someone in a lab coat (or yoga pants with incense, depending on the flavor of office).
Next, we’re going to consider massage therapy. Typically, people go to a chiropractor to get aches and pains fixed. Most chiropractic care routines involve either physical therapy-style movement or therapeutic massage. Guess what? This stuff actually works! Granted, you’re not seeing a licensed massage therapist or physical therapist but you’re often getting some of the same treatment that a real physical therapist would prescribe. In this circumstance, chiropractors can actually be helpful. However, that doesn’t justify a major problem that this creates:
You may be asking yourself what’s the harm in seeing a chiropractor. First, glance up at the featured image at the top of this article. Note the location of the spinal cord. Consider the impact of forcing vertebrae beyond the limits of natural body motion. The spinal cord is between 6 and 13mm thick. Severing it will render everything below that point paralyzed. Scary? Yep.
Now let’s look at this case as a prime example of what you do not want to have happen:
In this case, an individual experiencing neck pain went to a chiropractor. The chiropractor performed an x-ray but performed no form of soft tissue scans (specifically cited for not doing an MRI). The chiropractor diagnosed the patient with “mild spasm” based on X-ray scans of the patient’s bones. The chiropractor then performed his normal spinal and neck manipulations. The patient reported increasing pain after each treatment. After the third treatment, he was left as a quadriplegic. The chiropractor never performed a CT or MRI scan. This is not an isolated incident. There are dozens if not hundreds of documented cases of this exact problem. That is why you should go to a licensed physical therapist.
Here’s a quote from Dr Stephen Barrett, MD, from Quackwatch.com:
“Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked by a clot as a result of being stretched. The injury often results from extreme rotation in which the practitioner’s hands are placed on the patient’s head in order to rotate the cervical spine by rotating the head… The vertebral artery … is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection…
“Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the risk of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won’t reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.”
Still not convinced? In 1992, there was a study by Stanford where 486 members of the American Academy of Neurology were asked how many patients they had seen that had suffered a stroke within 24 hours of a chiropractic adjustment. Among that group, 55 patients were discovered that fit the criteria of chiropractic induced stroke.
Just in case that wasn’t enough, enjoy some further reading:
Questions? Comments? Feel free to leave a comment below.