On Bashing Chiropractic

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Jorpho
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On Bashing Chiropractic

Postby Jorpho » Fri Oct 29, 2010 2:33 am UTC

You might have heard of this whole Simon Singh business, in which a journalist stirred up a great deal of flak by calling chiropractors out on some of their quackier practices. It came to mind today when I learned that a lower-level politician to whom I am distantly connected has a kinesiology degree which he followed up with a diploma from a chiropractic college.

So, a question: is it right and proper to shun those who go to a chiropractic college? Have they devoted a significant fraction of their lives to studying and propagating filthy unsubstantiated lies by which they shall profit from sick people in need of proper medical care? Or do chiropractic colleges actually teach useful skills based on sound research these days?

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Re: On Bashing Chiropractic

Postby Izawwlgood » Fri Oct 29, 2010 3:52 am UTC

I dunno, my cousin just got a degree in Acupuncture...

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Re: On Bashing Chiropractic

Postby masher » Fri Oct 29, 2010 3:57 am UTC

Depends. I went to a chiropractor for back pain and the only treatment I received was spinal manipulation.

I saw my x-rays, and I had deformed vertebrae. Manipulation help put them into place and helped with nerve pinching and the like in my upper back and neck.

There was nothing in there that I would call quakery.

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Re: On Bashing Chiropractic

Postby sillybear25 » Fri Oct 29, 2010 3:59 am UTC

Izawwlgood wrote:Yes. Give them hell.
Just don't do it in the UK; you'll get sued for libel, even if you have research to back it up as fact.
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Re: On Bashing Chiropractic

Postby Izawwlgood » Fri Oct 29, 2010 4:14 am UTC

I read a cool study a while back wherein they took four study groups of women trying to get pregnant.
A) Did nothing special.
B) Received Acupuncture for fertility.
C) Got 'fake' acupuncture, meaning, they got jabbed with needles randomly instead of pseudo randomly.
D) Lay in a dark room for one hour a day in a clinic and thought about getting pregnant.

Group B and C both equally showed an increase in fertility. Group D showed an increase, but somewhat lesser than B and C.

I imagine the same sorts of studies have shown chiropractors to be as effective as, say, sports massage.
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Re: On Bashing Chiropractic

Postby icanus » Fri Oct 29, 2010 10:06 am UTC

Jorpho wrote:So, a question: is it right and proper to shun those who go to a chiropractic college? Have they devoted a significant fraction of their lives to studying and propagating filthy unsubstantiated lies by which they shall profit from sick people in need of proper medical care? Or do chiropractic colleges actually teach useful skills based on sound research these days?

Easy way to find out - ask their advice about a completely non-orthopedic ailment. If they tell you to see a doctor, they're just an expensive masseuse. If they claim to be able to help then they're lying, murdering scum who will be responsible for the deaths of all the people whose bowel cancer their prodding mysteriously fails to cure.

In the first case, just treat them much as you would treat anyone offering an overpriced, but mostly harmless service. In the second case, treat them like Harry Lyme.

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Re: On Bashing Chiropractic

Postby netcrusher88 » Fri Oct 29, 2010 11:45 am UTC

There is a legitimate field of chiropractic (though I maintain the word "chiropractic" is not a legitimate noun, it ought to be "chiropractice") and legitimate medical science to back it up. Unfortunately it's not very well regulated in many places, so there are a lot of quacks. It doesn't help that the guy who founded the field (and coined its name, go figure) was a quack, though some of his wild ideas were refinable into good medicine.

A good chiropractor is not an expensive masseuse. Massage is less... invasive, in a way. Two of my friends are going to a massage school - a certain number of months of training (I forget how many, but it's <18 I think) and a licensing process (which I assume is similar to other medical licenses) and you are a Licensed Massage Practitioner. Not to demean that at all - it's a pretty intensive program and very heavy on medicine, but it's a very specific type of training and strictly limited in scope. Another friend of mine is going to medical school to be a chiropractor in California (I mention the location because it may have some bearing on regulations - I do not know). From what I understand, when finished he will be an MD - but with a specialization in chiropractic, kind of like an anesthesiologist (they're doctors, yeah? I forget) or podiatrist or what have you.

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Re: On Bashing Chiropractic

Postby Izawwlgood » Fri Oct 29, 2010 2:50 pm UTC

I remain unconvinced that you can call them doctors.
Not only is the field largely unregulated, but I've yet to see any compelling data that indicates a chiropractor does anything useful. Anecdotal data indicates a near 50/50 rate of success.
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Re: On Bashing Chiropractic

Postby SurgicalSteel » Fri Oct 29, 2010 3:01 pm UTC

Izawwlgood wrote:Not only is the field largely unregulated, but I've yet to see any compelling data that indicates a chiropractor does anything useful. Anecdotal data indicates a near 50/50 rate of success.
Which is probably a result of the field being unregulated. You can have "chiropractors" and chiropractors, but both can put Chiropractor on their business card, unlike most regulated fields. Sort of like nutrition. There are actual nutritionists who have studied physiology and such, and who's advice I would trust when they say I should eat more Vitamin B or something, and there are "nutritionists" who tell me to eat more Vitamin B because it's a portal to the spirit world and will release my thetans.
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Re: On Bashing Chiropractic

Postby Izawwlgood » Fri Oct 29, 2010 3:21 pm UTC

But you cannot put chiropractor on a business card unless you're licensed as a chiropractor, and because the licensing process is still, in my mind, akin to differentiating which candidates can read aura's and which cannot, or more fairly, giving a general overview of the spine and some nerves it's attached to, no matter how 'good' of a chiropractor you are, you're still a snake oil peddler.
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Re: On Bashing Chiropractic

Postby SurgicalSteel » Fri Oct 29, 2010 4:25 pm UTC

Ah, so than it's actually more regulated than I thought, it's just not regulated correctly. The basics of my point still stands though, there are chiropractors who know what they're doing and don't claim to be anything they're not (spine adjustment will help you walk better, you'll feel better the same way a massage makes you feel better, etc.) and those who claim to be releasing your aura. Those who think it's some secret of the universe panacea, and those who know it's just another part of physical care and well-being, like orthopedics or taking supplements.
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Re: On Bashing Chiropractic

Postby ImagingGeek » Fri Oct 29, 2010 4:46 pm UTC

Medical research into the validity of chiropracty has not found much in regards of efficacy. For some cases of back pain, people do experience a measurable and reproducible temporary relief from that pain. There is no evidence for long-term gains, nor evidence that chiropracty is better than other methods (i.e. exercise). For example:
http://www.ncbi.nlm.nih.gov/pubmed/20393942
Combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions.
(emphasis mine)

In contrast, there is growing evidence that chiropractic manipulation of the spine may increase the risk of stroke, through damaging the blood vessels that pass into the brain via the same passage in the skull as the spine passes through. For example, in one review:
http://www.ncbi.nlm.nih.gov/pubmed/19444054
The frequency of adverse events varied between 33% and 60.9%, and the frequency of serious adverse events varied between 5 strokes/100,000 manipulations to 1.46 serious adverse events/10,000,000 manipulations and 2.68 deaths/10,000,000 manipulations
(emphasis mine)

Another review, strokes only:
http://www.ncbi.nlm.nih.gov/pubmed/17330693

Long story made short - chiropracty's only measurable benefit is temporary relief of back pain. This relief is equivalent to conventional treatment modalities (OTC medication, exercise, etc), has a high rate of adverse reactions (33-61%), and may kill you via a stroke. Not one of the multitude of chiropractys other claims has ever stood upto scrutiny. The take-home message is if you're going to go with CAM, stick to homeopathy; it won't work, but at least it won't hurt you (directly) either.

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Re: On Bashing Chiropractic

Postby Cloud Walker » Fri Oct 29, 2010 5:09 pm UTC

Helpful link: http://www.skepdic.com/chiro.html

I don't think chiropractors give any more benefits than a good massage.
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Re: On Bashing Chiropractic

Postby Izawwlgood » Fri Oct 29, 2010 6:05 pm UTC

SurgicalSteel, the point is that most chiropractors aren't going to say 'we're releasing your aura', but will rather say 'We're adjusting L6 to release the tension, hopefully removing the pinched nerve'...

That they use words recognized by the medical profession to indicate regions of the body or ways to describe ailments doesn't change the fact that what they do is about as useful as a good massage, and that based on the evidence provided by previous posters, chiropractors are in fact, akin to snake oil peddlers and acupuncturists.
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Re: On Bashing Chiropractic

Postby Garm » Fri Oct 29, 2010 6:10 pm UTC

I'm okay with that temporary pain relief aspect of things. I've had my jaw dislocated or displaced several times while playing basketball and have had it fixed by a chiropractor. He's never claimed that he can fix anything other than structural problems.
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Re: On Bashing Chiropractic

Postby rat4000 » Fri Oct 29, 2010 10:16 pm UTC

If they're akin to acupuncturists, then hell, I'd go to them: http://www.ncbi.nlm.nih.gov/pubmed/17893311

I mean, I've never been to a chiropractor, but acupuncture has helped me several times in life and has apparently been proven to work (mostly people I know saying they've read studies - the link above is the first I could find in Google).

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Re: On Bashing Chiropractic

Postby netcrusher88 » Sat Oct 30, 2010 12:14 am UTC

Acupuncture which could, within a 95% confidence interval, be roughly 3.7% worse than randomly sticking needles into someone ('swhat that study you linked said). I mean if it works for you it works for you, that's cool, but there's no science to back it up.
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Re: On Bashing Chiropractic

Postby jmrz » Sat Oct 30, 2010 12:25 am UTC

I go to a chiropractor quite regularly, because I do have spinal alignment issues which are predominately caused by the fact I spend most of my time sitting in an office chair staring at computers. My chiropractor has never indicated that he can permanently fix me, nor has ever promised me a miracle cure. He merely adjusts my spine and removes the tension and pain. I have noticed a vast improvement in my neck and a sizeable decrease in my headaches. He has explained to me where my pain originates from, but we aren't entirely sure how to fix it beyond trying to strengthen my muscles. Massage also helps, but it's the muscles that are pulling my spine out of alignment, so it still needs to be realigned anyway. It helps me, my medical insurance covers half the cost and I will keep going until I feel I don't need to anymore.

Having said that, there are a number of them that think they can solve all your problems and try a bunch of wacky things to do so. They aren't all like that though!
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Re: On Bashing Chiropractic

Postby rat4000 » Sat Oct 30, 2010 1:27 pm UTC

What I looked at were the study's conclusions which said "Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy."

That 3.7% thing was about differences between two different types of acupuncture, I think. Then again I'm awful at understanding such things and could be misinterpreting it completely, only the conclusion above is pretty clear.

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Re: On Bashing Chiropractic

Postby Jorpho » Sat Oct 30, 2010 2:23 pm UTC

jmrz wrote:Having said that, there are a number of them that think they can solve all your problems and try a bunch of wacky things to do so. They aren't all like that though!
Okay, so the question was: if someone has a diploma from a chiropractic college, can it be assumed that he is or is not like that? Or does it vary from college to college?

(I should add that I find it exceptionally odd that anyone with a kinesiology degree could conceivably go and spend years learning stuff that is seemingly in direct opposition to everything learned in that degree.)

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Re: On Bashing Chiropractic

Postby SlashThred » Sat Oct 30, 2010 2:38 pm UTC

Well, at least in Australia I know you have to have a University degree to put chiropractor on your card. I know this because a close friend of mine, who's 35, is a chiropractor. Accordingly, he attended most of the same classes that physiotherapists attend and many doctors attend. He can name all of my bones/arteries.

Do we expect them to be miracle problem solvers or something and are disappointed when they aren't? Like doctors, most of their field is knowing how to diagnose problems rather than how to prescribe them drugs that fix them.

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Re: On Bashing Chiropractic

Postby netcrusher88 » Sat Oct 30, 2010 9:47 pm UTC

rat4000 wrote:What I looked at were the study's conclusions which said "Effectiveness of acupuncture, either verum or sham, was almost twice that of conventional therapy."

That 3.7% thing was about differences between two different types of acupuncture, I think. Then again I'm awful at understanding such things and could be misinterpreting it completely, only the conclusion above is pretty clear.

"Sham acupuncture" means randomly sticking needles into someone. The 3.7% thing means it is plausibly better than a trained acupuncturist, so the proof is in the study that all that nonsense about placing needles here to make your chi go there or whatever is just that - nonsense.

So the interesting thing from that study is, needles do something. But to say the study supports acupuncture, when its findings support the idea that it's pseudoscience, is a bit disingenuous.
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Re: On Bashing Chiropractic

Postby pollywog » Sun Oct 31, 2010 7:17 am UTC

Temporary pain relief can be a godsend to some poeple, if other forms of pain management aren't working or have adverse effects.

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Re: On Bashing Chiropractic

Postby rat4000 » Sun Oct 31, 2010 8:48 am UTC

And here I was thinking "sham acupuncture" was another school or something.

Darn.

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Re: On Bashing Chiropractic

Postby ImagingGeek » Wed Nov 03, 2010 1:16 pm UTC

netcrusher88 wrote:[So the interesting thing from that study is, needles do something. But to say the study supports acupuncture, when its findings support the idea that it's pseudoscience, is a bit disingenuous.


Not only that, but that is one study of many - most of the others come to the opposite conclusion. A good place to look for well studied and analysed overviews is the Cochrane Review's - these are highly conservative meta-analysis of the medical literature (not politically conservative, but rather in that they have a very high bar in terms of methodology that a stdy needs to meet in order to be considered valid). They have extensively reviewed studies on acupuncture - to the tune of >230 reviews to-date (sample links below). But the long story made short - most acupuncture studies are poorly designed with minimal predictive power. The small minority of acupuncture studies conducted using proper blinding, design and analysis, the results are not good. Doesn't help lower back pain, quitting smoking, schizophrenia, depression, pain in general, autism, MS, GI issues, etc. The Chocrane reviews have given acupuncture a "stamp of approval" for dealing with nausea after surgery (although anti-nausea drugs work better), and have given a tentative thumbs up for dealing with headaches.

Some of the other studies I've mentioned:
http://www2.cochrane.org/reviews/en/ab000009.html
http://www2.cochrane.org/reviews/en/ab005475.html
http://www2.cochrane.org/reviews/en/ab004046.html
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