DOES YOUR CHIROPRACTOR ACTUALLY DO ANY GOOD?
You’ve been to a chiropractor, right? Everyone has.
They’re doctors. More or less. They take the sting out of a backache and they do other stuff too like headaches and such.
Nothing wrong with it.
Here’s the thing though.
They’re not really doctors. They don’t even like doctors. In fact, mostly they’re not big fans of the scientific method that underlies medicine.
Still. They do something, right?
Paul Ingraham, Assistant Editor of Science Based Medicine, at saveyourself.ca, looks at this. He examines the history and the literature of chiropractic; he also looks at what users have to say about their experiences including a Gallup poll.
Chiropractic techniques may make some people feel better for a little while but the evidence for long term benefits is pretty sketchy. The studies that appear to support chiropractic aren’t scientifically sound.Even the members of the profession seem to be locked into some kind of ideological dispute about what chiropractors are good for.
Ingraham is perfect for this role. He’s not a hater. He sometimes uses chiropractors himself and refers others for treatment. He modestly insists that he isn’t qualified to sit in judgment. He’s sharing what he has dug up from his own careful research of the literature. Which is why its harder to dismiss what he has to say.
Ingrham lays out the five “big” questions about spinal manipulation: 1) Do chiropractors oversell their services with distateful and overly agressive tactics? 2) Is the historical idea behind “spinal subluxations” as the cure all for countless disorders and diseases faintly ridiculous in a modern scientific era? 3) Are the possible risks of injury or death from spinal manipulations justified by the insufficient evidence for its efficacy? 4) Now that a major scientific review (2014) has failed to demonstrate a good case for chiropractic treatment of low back pain, does this weaken its most basic appeal? and 5) Should chiropractors be allowed to continue treating children and babies where, say some, the chances for harm to the patient are greatest?
Ingraham says the profession, itself, is divided by its response to these basic questions.
The idea of “subluxations”, so basic to chiropractic treatments since its very beginnings, is rejected, Ingraham says, by many chiropractors as unsupported by science. (If MISTER ScienceAintSoBad gets to chime in here – It sure is!!) In fact, chiropractors fall into categories. The “straight” chiropractors still cling to the original theory of subluxations. If I understand this right, they wouldn’t be shy about fixing gout and liver disease with spinal manipulation therapy.
The “progressives” are called “mixers”. They focus mainly on the spine where even some medical doctors concede that it might at least make sense to find a beneficial effect from SMT.
Ingraham says there’s very little high quality research that supports the idea that chiropractic spinal manipulation therapy works better than other treatments. But, he says, for some people the “joint popping” effect is pleasurable and may even temporarily relieve pain. For others – not so much. He calls attention to a 7 year old Gallup poll that rates chiropractors at the very bottom of the medical profession for honesty and ethics. Considering how unrealistic people are about their expectations for their doctors – how tough they are on them- patients must really think chiropractors are dirt bags! However, I should caution that medicine isn’t all about popular opinion. A single poll shouldn’t be taken out of context.
Paul Ingraham makes a strong case. He’s probably right. Yet chiropractors continue to have their defenders. Many of them.
Maybe a better study will come along. That’s what makes science fun, right?
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The drawing is mine.