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Chiropractic Abuse: An Insider’s Lament

chiropractic-abuse

There is a new book critical of chiropractic: Chiropractic Abuse: An Insider’s Lament. The author, Preston Long, DC, PhD, is a chiropractor who says he made a big mistake when he chose chiropractic as a career. He has written an intriguing book explaining his mistake and the experiences that resulted from it during 3 decades as a chiropractor and a critic of chiropractic.

Chiropractic encourages self-delusion, and those who break free of delusion have two choices: to fight or run. Preston Long chose to fight, to keep the baby and throw out the bathwater polluted with pseudoscience and quackery, to try to practice rationally and ethically, and to try to reform chiropractic from within. He soon learned that it was next to impossible for a chiropractor to make a living with a science-based, ethical practice. He eventually found his niche and put his knowledge of chiropractic to good use. He evaluates chiropractic cases for disability and fraud, has worked with the FBI, and has testified at over 200 trials. He has written two previous books, The Naked Chiropractor (2002) and The P.R.E.S.T.O.N. Protocol for Back Pain (2006). This new book tells the story of his life and exposes the delusions and misbehaviors of his chiropractic colleagues.

He reveals “20 things most chiropractors won’t tell you”:

  1. Chiropractic is not based on science
  2. Chiropractors promise too much
  3. Their education is vastly inferior to that of medical doctors
  4. Their legitimate scope is very narrow
  5. Little of what they do has been studied
  6. It’s best to get diagnosed elsewhere
  7. They offer lots of unnecessary services
  8. “Cracking” the back doesn’t mean much
  9. If the first few visits don’t help, more treatment probably won’t help
  10. They take too many x-rays
  11. Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
  12. Neck manipulation is potentially dangerous
  13. Most chiropractors don’t know much about nutrition
  14. If they sell vitamins, they charge too much for them
  15. They have no business treating young children
  16. The fact that patients swear by them doesn’t mean they are actually being helped
  17. Insurance companies don’t want to pay for chiropractic care
  18. Lots of chiropractors do really strange things
  19. Don’t expect chiropractic licensing boards to protect you
  20. The media rarely look at what they do wrong.

The first time I read this list, there was no number 19. I wondered if 19 was the one thing no chiropractor will tell you, not even Preston Long. Turns out it was just an inadvertent omission that was corrected in subsequent copies.

He started to realize his mistake during his first classes in chiropractic school. He wondered why he hadn’t learned about those displaced bones and all the devastating health problems they cause during his undergraduate studies in anatomy, physiology, and biology. He noticed that his teachers never mentioned how hormones help regulate the human body. Despite glaring doubts about this profession, he stayed, simply because he had no other place to go. He has lots of stories to tell about his first adjustment, the cheating he observed, and the inconsistencies in what he was taught.

He covers the history of chiropractic, the imaginary subluxation, the studies evaluating the efficacy of spinal manipulation, the economic abuse of patients, the reasons you should never sign a contract for chiropractic care, the risk of stroke with neck manipulation (with tragic patient stories), insurance frauds and injury mills, upcoding visits, regulatory abuses, and unethical practices of chiropractic boards.

As a practicing chiropractor, he observed many kinds of misconduct among his peers, from cynical marketing techniques to defrauding insurance companies. I got a kick out of the idiotic behavior of chiropractors in several of the cases of sexual misconduct he encountered during his career. One chiropractor

…did rectal exams on all of his female patients and videotaped them. When women complained, investigators found tapes in and near a VCR in a bedroom in his home. He claimed to have done the taping to document the procedures so that insurance companies would pay for them. But he could not explain why they were in his bedroom.

Another chiropractor

…suckled a woman’s breast while doing a breast exam. The woman ran out of his office in her gown only. She contacted police, who asked her to call the chiropractor and record the call. He admitted to it and even asked her to return later that same day. Somehow the chiropractor got wind of the taped call, walked past his receptionist (his wife), locked the clinic door with her still inside, and flew to Colorado where he remains today.

One chapter covers how to protect yourself and what red flags to look for. Another chapter reproduces the Institute for Science in Medicine’s Chiropractic White Paper, authored by our own Jann Bellamy. A final chapter asks if chiropractic can reform. He is not optimistic:

I believe that in order to survive as a profession, chiropractic must adopt the substance of a scientific health discipline and not merely a veneer. This would require abandoning subluxation theory, adopting ethical standards, and clamping down on the wide range of practices that are unproven and lack a scientifically plausible rationale. Unfortunately, having seen little progress in this direction during the past 25 years, I do not believe chiropractic has the ability to reform from the inside.

This book is a very valuable addition to the literature on chiropractic, combining Long’s personal story with everything you never wanted to know about chiropractic. It’s fun to read and packed with information. Even if you think you’ve heard it all before, there are revelations here that will be new to you, that will elicit surprise, indignation, and laughter.

Posted in: Chiropractic

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119 thoughts on “Chiropractic Abuse: An Insider’s Lament

  1. Carl says:

    “He noticed that his teachers never mentioned how
    hormones help regulate the human body.”

    This is my favorite thing to bring up when arguing with people about chiropractors (it shouldn’t be, because it has shockingly little impact). Yes, there are important messages sent to a lot of our organs, but the entire chiropractic profession is based on a flat out wrong idea of how it works. We know how it works, and it simply does not work the way DD Palmer thought.

  2. John says:

    Re: cases of sexual misconduct.

    You can find the same types of misconduct, and far worse, among medical doctors. Every profession has its bad apples.

    1. Egstra says:

      “Every profession has its bad apples.”

      True – now, would you care to address the 20 points the author makes?

      1. 1.Chiropractic is not based on science – the founding premise is the belief in an innate life force which is blocked by ‘subluxation’. It is the former belief which screws it up for us but ironically it was probably what saved the profession from blatant attempts at medical monopolisation. Compare this with ‘religious’ medical professionals. Heck my sister had to work with a group of fundamentalist surgeons off the coast of Africa. So ‘crazy’ people can still partition their minds and perform good clinical work.
        2.Chiropractors promise too much – many do (most never bring it up overtly). The word miracle is popular (as it is in medical fundraising – my friend with breast cancer had to put up with that ‘evangelising’)
        3.Their education is vastly inferior to that of medical doctors – in Australia this is not the case in the field of neuromusculoskeletal disorders, in particular chronic spinal conditions. Be specific. What does vastly refer to?
        4.Their legitimate scope is very narrow – our scope is effectively narrow as are many specialties such as neuropsychology.
        5.Little of what they do has been studied – incorrect. What we ‘do’ is technically diagnosis and conservative management of spine and relayted disorders. Much of my time is spent reading papers (most medical, physio, neuroscience, even ours:))Some of us therefore regularly refer to medical collegues for advanced imaging or interventional proceedures or co-manage.. There really isn’t enough room here to discuss this point (and I’m not sure anyone here is paryticularly interested in discussion anyhow).
        6.It’s best to get diagnosed elsewhere – it depends what the problem is. Diagnosis is an issue within the profession as it is elsewhere. Even ‘believers’ are aware that 3rd party providers and patients demand a tissue diagnosis but it needs to be improved. To take a rare example I had to finish off what was a medical slipup for a patient who’d had a seizure at work. Admitted on a weekend (we all know what that can mean). Anyway we refered him for the scan and his glioblastoma was removed before it killed him. That DOES NOT MEAN medicine is bad. Its just reality. In practice most of my collegues would not have picked it up either. Most people aren’t stupid. They come to us because they suspect their ‘spine’ issue is something more than just a pulled muscle (most common MD ‘diagnosis’) or imbalance (most common PT ‘diagnosis). Many have sought help elsewhere and the benefiyt has ‘not been sustained’. Our job is to see if it can be sustained.
        7.They offer lots of unnecessary services – not an issue in Australia. This appears to be a US health care problem.
        8.“Cracking” the back doesn’t mean much – I’m not sure what this question is asking.
        9.If the first few visits don’t help, more treatment probably won’t help – true for most simple cases however chronic musculoskeletal problems are another issue.
        10.They take too many x-rays – some do. The issue appears to be perception as to what constitutes clinical relevance. eg medical training makes you look for something which can seriously injure. A ‘normal variant’ eg transitional segment however can be clinically significant in spinal cases which are deemed to be best managed conservatively.
        11.Research on spinal manipulation doesn’t reflect what happens in chiropractic offices – question needs to be more specific.
        12.Neck manipulation is potentially dangerous – true as is any procedure. The assumption is that ‘it’s useless anyhow so why risk it’. This is an argument from ignorance.
        13.Most chiropractors don’t know much about nutrition – true.
        14.If they sell vitamins, they charge too much for them – no idea.
        15.They have no business treating young children – why?
        16.The fact that patients swear by them doesn’t mean they are actually being helped – definitely. Again that applies to almost anything.
        17.Insurance companies don’t want to pay for chiropractic care – a US problem (you guys have BIG issues with health care)
        18.Lots of chiropractors do really strange things – shit yes. The dogma of innate intelligence gives credence to many ‘interesting’ approaches. Still we seem to focus onm what the literature calls ‘physically based modalities.’
        9.Don’t expect chiropractic licensing boards to protect you – ?
        20.The media rarely look at what they do wrong – not here they don’t. And good to. We need a good kick up the arse and drop the dogma. There’s too much good we do despite the stupidity. I have to confess the arguments here are not well fleshed out. I’ve yet to meet someone with a strong opinion who bothered to sit down and talk with a few of us before jumping in and holding an extreme view. I’m not an apologist. I often think about abandoning my profession but what for. I perform good work which is evidence based and frankly these days I’d shit all over most diagnosticians within the spine field. Sounds arrogant but it’s because the guys who educate me are that good. Interesting discussion with an interventional radiologist the other day – GP (MD referals) for MS conditions are poor (inaccurate). Specialists very good. No surprise there. Its worth pointing out that the profession will probably survive any attempts to get rid of it.

        Another point – is it logical to assume that an entire profession thinks the same way and offers nothing, that their patients are almost all duped, that my office floor (and those of my collegues) are riddled with the bodies of damaged victims? I’ll take my horns off.

        If people are interested in discussion then please contact me or I can put you onto other sources. If it’s just ranting and absolutist views (like some of my collegues – choke) then leave it. Oh and I’m a cyclist so I’m used to being called one of them. A mate is gay, jewish AND a chiropractor. The flying spaghetti monster clearly didn’t like him. (sorry for the typos)

        DS

        1. WilliamLawrenceUtridge says:

          If you’re annoyed at the way many chiropractors over-promise, why not reconcile your profession with physiotherapists to distinguish from the chiropractors who think they can cure cancer? There are at least two strands of chiropractic – straights, who are loony, and mixers, who are basically physiotherapists specializing in the back. If you don’t want to be mistaken for a profession made up of crazy people, change your profession. Osteopaths did in the US, now they are basically doctors.

    2. Young CC Prof says:

      I would ask two questions:

      1) Are the chiros solidly accused of sexual misconduct still practicing (if they aren’t in prison)?

      2) How many doctors were able to continue practicing following substantiated claims of sexual misconduct?

      If the answers to these questions are different, it proves NOT that there are more perverts in the world of chiropractic care, but that the licensing boards are less effective at protecting patients from those bad apples.

      1. Egstra says:

        The author made 20 points – none of which included sexual misconduct. How about addressing one or more of them?

      2. Harriet Hall says:

        The examples of sexual misconduct involved breast exams and rectal exams. There is no legitimate reason for chiropractors to do either of those exams.

        1. WilliamLawrenceUtridge says:

          Where the “like button” should be.

          1. Carl says:

            Chiropractors aren’t qualified to check on that either.

    3. WilliamLawrenceUtridge says:

      What does that have to do with anything? Because doctors have engaged in misconduct, the same or worse, doesn’t mean chiropractors should get a free pass, does it? Of course every profession has bad apples, it’s up to every professional governing body to protect patients from them. Which hasn’t happened regards chiropractors.

    4. oldmanjenkins says:

      This is not about a “few bad apples.” This is a tree that bears poison fruit. The tree being representative of chiropractic and the “fruit” the “care” they provide. This is also poisoning the well as we are not talking about a science based medical practice with some unethical practitioners. This is an entire industry based upon a lie. Yes there will be some in this “industry” that are more or less unethical. The issue with chiropractors is their philosophy is based upon pre-modern scientific understanding of anatomy/physiology cause and affect.

  3. goodnightirene says:

    I really cannot understand why Mr Long (cannot bring myself to type Dr) didn’t go back to school long ago and become a proper physical therapist or other legitimate health practitioner. How can he make the list you include and still call himself a chiropractor! Why bother to evaluate insurance claims? To sort out the sort-of-fake from the grossly fake? Isn’t this Tooth Fairy science at it’s best (worst?)?

    If chiropractic were “reformed” it simply wouldn’t be chiropractic, so why not take a more realistic position and advocate for a program of re-training and shutting down existing “colleges” of chiro?

    1. Cervantes says:

      I have to agree. Chiropractic has no value at all. To the extent that some maneuvers may make some people feel better, that could be established by RCTs and then physical therapists or massage therapists could provide the service. But chiropractic is pseudoscience and there’s no reason for it to exist.

      1. Jon says:

        I am an actively practicing Chiropractor for 25 years. In short, criminals of any and every kind in any and every profession including Medicine in general taint the wonderful things both M.D’s and other doctors’ do on a day to day basis because they love and care for people. That said, Chiropractic is every bit of science based. The education is exactly the same education exception to surgical rounds and pharmacology. In lieu of those, we learn Nutritiona and spinal adjusting technique.

        The science is based on fact that a healthy functioning spinal segment poses no impingement on it’s underlying nerve in and of itself. That is, when a spinal segment is subluxated or imobile in any one of the normal six ranges of motion, it inhibits normal nerve flow to the organ, tissue it ultimately innervates (feeds neurologically), just as a blood vessel feeds the heart, the “nerve flow” controls the heart. I don’t want to get long winded here but, suffice to say Chiropractors are every bit of professional, Educated and good intending doctors as your ordinary M.D. You see, most people come to me AFTER they had a poor experience with a physical therapist or some other healthcare practitioner. Not because P.T. is bad at all, its just that, it usually isn’t enough to work on muscles tendons and ligaments when the underlying joint remains stuck.
        A great combination is both. Chiropractors “do” P.T. but Physical Therapist DONT do Chiropractic spine manipulation. My advise to all of you naysayers, Get educated before you negatively jawbone your friendly neighborhood Chiropractor.

        1. Harriet Hall says:

          I can’t believe you are still using the “stepping on the hose” fallacy! Nerve conduction is NOT analogous to blood flow through blood vessels. The chiropractic “subluxation” has never been demonstrated to “inhibit normal nerve flow.” And the heart continues to beat when all nerves are severed and it is transplanted into another person’s body. D.D.Palmer got it wrong. Today we can measure nerve conduction. When there is localized pressure on a nerve, as in carpal tunnel syndrome, the conduction is slowed across the compressed portion but is normal proximal and distal to that portion. That can be demonstrated by nerve conduction studies to confirm the diagnosis.

          I explained why chiropractic is not a science here: http://www.sciencebasedmedicine.org/science-and-chiropractic/

          1. Chelsea says:

            The heart continues to beat outside the body because it has it’s own electrical conduction system. It is fairly self regulating. That being said, the Central and Peripheral Nervous Systems also contribute to the normal function of the heart, ie. sympathetic nervous system speeds it up, parasympathetic slows it down.

            Whether or not there is actual research indicating that there is no altered conduction distal to compression at the Carpal Tunnel, patients who suffer from this condition experience paresthesia and difficulty with everyday tasks involving gripping, especially. Since muscles move bones and nerves stimulate muscles do perform these tasks, CLEARLY it is a nervous issue stemming from COMPRESSION OF THE NERVE. Inflammation of the synovial sheath in the Carpal Tunnel causes stenosis of the tunnel and therefore shrinks the space the Median nerve would normally have to travel. The nerve becomes compressed and the information it sends back to the brain is altered. Therefore, the brain interprets it falsely, and delivers a false impulse back down the Median nerve. This can also occur more proximally at the Pronator Teres muscle, as the Median nerve comes through the muscle at the volar aspect of the forearm. Again, in this case there is expression of the neurologic deficit distal to the site of compression. When this occurs, it is Prontator Teres Syndrome, not Carpal Tunnel Syndrome (a common misdiagnosis). Where did I learn all this? From my shitty, medically-inferior Chiropractic college.

            Onto my last point. I read the article you posted and I cannot even begin to dive into that. In summary, I would like to say that Chiropractic in it’s early days was admittedly rough, and founded on very little science due to the fact that the technology just wasn’t available. As with all Medical models, Chiropractic has since come a long way and evolved into a more scientifically sound practice. You cannot compare Chiropractic to allopathic medicine because they are different things. Both desire the same outcome, however. Our goal is to help people and trust me, I’ve seen it happen more times than not with Chiropractic. Don’t bash what you do not know.

            1. WilliamLawrenceUtridge says:

              As with all Medical models, Chiropractic has since come a long way and evolved into a more scientifically sound practice.

              Depends which chiropractic you are talking about. If you are talking about the “physios with a twist”, then yes – spinal manipulation has finally been tested after more than a century and it was found to be effective, so now physiotherapists are using it. If you are talking “spinal manipulation can cure cancer”, then that is the branch of chiropractic that tried to sue Simon Singh and lost – because they couldn’t produce any evidence their claims were backed by science. That was what, last year? So no, no science to support chiropractic claims beyond “we can help acute back pain”. Which again, you are now redundant to physiotherapists since they are becoming trained with this modality now that there is evidence for it.

              You cannot compare Chiropractic to allopathic medicine because they are different things. Both desire the same outcome, however. Our goal is to help people and trust me, I’ve seen it happen more times than not with Chiropractic. Don’t bash what you do not know.

              You certainly can’t compare the two. One has evidence, the other doesn’t. One is at best a reasonable way of helping wth pain in the musculoskeletal system. The other can, collectively, address most of the common causes of death for humans across the entire world.

        2. Chris HIckie says:

          Care to cite any real scientific references on how to “get educated”? I bet you won’t, just like the chiropractor in Dr. Hall’s 2008 SBM article did not either.

          As a pediatrician with a doctorate in neuroscience, I cannot stand the nonsensical (at best) and dangerous (at worst given your group is antivaccine) “techniques” of chiropractic.

        3. WilliamLawrenceUtridge says:

          Chiropractors “do” P.T. but Physical Therapist DONT do Chiropractic spine manipulation.

          Are you sure about that? Because aside from that position paper, there’s also this systematic review, and this is from a world-symposium of physiotherapists.

          If your focus is on spinal manipulation why do you learn about “nutritiona” (I’m assuming you mean “nutrition”)? You would have to have a pretty frank nutritional deficiency before you would see impingement on the spine, and that’s assuming that your claim of nerve impingement is even valid, at which point I would think the patient would have a whole lot more problems than mere mechanical back dysfunction that can be remedied with spinal manipulation.

        4. a PT says:

          I can assure you that chiropractors DO NOT do physical therapy. We are a group of professionals highly skilled in managelent of joint pathology, including mobilizations and manipulations (in some states). I can also assure you that a PT worth his time will ALWAYS normalize joint mobility during therapy treatments. We also provide home programs so patients can maintain normal joint mobility, which allows progression to stability and controlled mobility. How many chiro’s out there provide patients with a comprehensive program? None that I have heard of.

          1. William says:

            @ a PT
            Don’t fool yourself chiropractors CAN and DO do physical therapy.
            I run a physical therapy suite and get to boss a PTA around all day. All
            with an Orthopod’s blessing. All I had to do was learn to write evaluations and treatment plans( because thats what insurance companies want) like you do. Only Medicare won’t allow a DC to “be a PT” so the MD does
            the evals and guess who writes them? The MD would rather not even have the PTA but you know the insurance rules and regulations.
            Oh, and there’s no PTs in Indiana I know doing manipulations, and I have resources. Funny, that up until July of this year a PT couldn’t do PT unless they had an order from an MD,DO, DPM or I hate to tell you this: a DC. Many insurance companies still adhere to that policy despite your new access laws.
            So would you rather not try to get along with us?

            1. windriven says:

              “Don’t fool yourself chiropractors CAN and DO do physical therapy. I run a physical therapy suite and get to boss a PTA around all day. All with an Orthopod’s blessing.”

              F*** you. You get to “boss around” a PT? Double f*** you, you crude, loathsome, sanctimonious poseur. Just because you found an orthopedic surgeon with the poor judgment to hire you doesn’t make you remotely competent. Your attitude about relationships with subordinates says everything there is to say about you … which is very nearly nothing.

              I own a couple of manufacturing companies and I don’t hold the attitude that I “got to boss around” even the newbiest employee. You strut like a peacock but have the credentials of cow and the integrity of a weasel.

              Pray tell us who your orthopod is. I’ll bet s/he would be honored for the world to know that you are in their employ.

      2. Wow says:

        Cervantes, what would you say to the person who had been down every option available but was still suffering, visited a chiro office, and finally after years experienced relief? Now, answer this without the “Placebo” cop-out. Who is this really about. The patients or the fragile medical egos? Just a thought.

        1. windriven says:

          @Wow

          Josef Stalin is reputed to have said something along the lines of: “one death is a tragedy, a million deaths is a statistic.” In the instance that you posit, one good outcome is a nice anecdote, but it takes thousands of good outcomes in a carefully structured study to even begin to define a useful therapy.

          You will always be able to find people who have benefited from every kind of nonsense you can imagine. Most often it is regression to the mean. Sometimes it is placebo. Sometimes it is simply inexplicable. But as you doubtless understand, correlation does not imply causation. Maybe it was the reiki. Maybe it was the new fabric softener. Without careful scientific study you really don’t know.

          Chiropractic is a fossil, a tradition based on a totally flawed understanding of physiology. Do chiropractors occasionally do some good? Of course. But Wow, even a blind squirrel occasionally finds an acorn.

          As to fragile medical egos – you must be kidding. MDs save 2kg premies, resect ballooning aortas, transplant failed kidneys, cure tuberculosis and peritonitis and a huge range of other infectious diseases; they cure some cancers and extend the lives of many more cancer patients, they excise brain tumors, replace failed heart valves and are beginning to unwind the genetic foundations of life. And their egos should be bruised my people who believe in subluxations???? You’d have to be drunk or mad to believe that.

          Just a thought.

          1. WilliamLawrenceUtridge says:

            We must be careful to not overstep though. Chiropractic is terrible, probably worse than nothing, for nearly every condition. But I will recognize their effectiveness at treating low back pain – equal to or better than most conventional treatment options. That’s why physiotherapists are adopting it as a mainstream practice.

          2. windriven says:

            @WLU

            You said:
            “But I will recognize their effectiveness at treating low back pain”

            I said:
            “Do chiropractors occasionally do some good? Of course.”

            But chiropractors call themselves chiropractors, not lowbackpainologists. Further, their effectiveness in treating lower back pain is unrelated to their foundational belief in subluxations.

          3. WilliamLawrenceUtridge says:

            Ah, fair enough. And I agree on all points. Not to mention, now that spinal manipulation has been validated scientifically, a genuine science-based practice is adopting it (physios, and I wouldn’t be surprised to see osteopaths doing so as well).

    2. Carl says:

      goodnightirene says:
      October 29, 2013 at 10:06 am
      Why bother to evaluate insurance claims?

      I think a lot of state laws require insurance companies to pay for chiropractors. Separating the real fake medicine from the fake fake medicine can save a lot of money.

  4. Jonathan says:

    I feel that the space allotted in this article to the tales of sexual misconduct—and Harriet Hall’s apparent glee in recounting them (“I got a kick out of [them]“)—detract from its message rather than add to it. Was the point to argue that chiropractic enables this kind of misconduct more than other professions? But that argument is not seriously made. As someone who wasted money on chiropractic in the past, I was enjoying the article up to that point, but surely the issues are too serious for this kind of point scoring?

    1. windriven says:

      @Jonathan

      “I feel that the space allotted in this article to the tales of sexual misconduct—and Harriet Hall’s apparent glee in recounting them (“I got a kick out of [them]“)—detract from its message rather than add to it.”

      Deep breath, buddy. Dr. Hall’s mention of sexual misconduct amounts to 100 or so words in a long post. Besides, where does one find a subluxation in the anus? I thought that was a bone thing. There are no bones in my anus. Same with breasts. Maybe this particular chiro believed he could taste subluxations?

    2. Anna says:

      I agree. I don’t know how anyone can “get a kick” out of tales of sexual assault. The dissonance there was jarring to me!

      1. Andrey Pavlov says:

        To be honest the wording threw me off guard as well as I first read the article. Then when I read the quoted section it become clear to me as I was first appalled and then chuckled at the stupidity of the chiros involved. I agree that it is not clear that Dr. Hall is referring to that aspect of the story rather than the actual sexual misconduct and based on the sentence structure it does seem to be the other way around. However, it is nothing more than poor sentence structure in someone who can certainly be given the benefit of the doubt here and any reasonable person should be able to figure out as they chuckle at the guy trying to explain why he had the videos in his bedroom and the other one locking his wife in an office.

        1. Harriet Hall says:

          I corrected the faulty sentence structure to make my intent clearer.

  5. stan says:

    20 Things about chiropractors that don’t add up to anything, really!

    Chiropractic is not based on science
    So what? science is not the holy grail.

    Chiropractors promise too much
    Got some peer-reviewed study on this?

    Their education is vastly inferior to that of medical doctors
    Different, yes. Inferior In some areas, but not across the board. But they’re not medical doctors or pretending to be one. If they are, steer clear.

    Their legitimate scope is very narrow
    So what? just use them for what they’re good for

    Little of what they do has been studied
    so what

    It’s best to get diagnosed elsewhere
    OK, you can do this before seeing one

    They offer lots of unnecessary services
    Anyone in any service business does this. The patient can decide what’s “necessary”

    “Cracking” the back doesn’t mean much
    Nothing at all – it’s just a euphemism

    If the first few visits don’t help, more treatment probably won’t help
    OK, try a few and see if they help. You’ll know.

    They take too many x-rays
    Unlike hospitals… Liability issues.

    Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
    So what?

    Neck manipulation is potentially dangerous
    Any medical or physical procedure is potentially dangerous.

    Most chiropractors don’t know much about nutrition
    …and your doctor does?

    If they sell vitamins, they charge too much for them
    you can buy supplements they recommend somewhere else. It’s a legit business practice to mark up products.

    They have no business treating young children
    No more than doctors who overprescribe ADHD drugs

    The fact that patients swear by them doesn’t mean they are actually being helped
    No, but it doesn’t mean they aren’t. Don’t underestimate the patients.

    Insurance companies don’t want to pay for chiropractic care
    they don’t want to pay for anything, really. Watch Michael Moore’s “Sicko”

    Lots of chiropractors do really strange things
    Wow.

    Don’t expect chiropractic licensing boards to protect you
    …or the AMA.

    The media rarely look at what they do wrong.
    The mainstream media is completely lame about all subjects.

    1. James says:

      Chiropractic is not based on science
      So what? science is not the holy grail.

      Science is never the expected to be the holy grail.

      It is the road to the grail.

      Science allow us (humans) to understand the twist and turns to the path to the “holy grail”.

      Science when applied properly also allows us to realize when we are going down the wrong path.

      Science allow us to find the shortcuts also.

      Since Chiropractic is a fixed set of knowledge it will never evolve from it amoebic state.

      This is the truly sad part because of this it forces mostly well meaning naive Chiropractors to evolve into parasites that feed on the unsuspecting host in order to survive.

    2. WilliamLawrenceUtridge says:

      Stan, here is a more substantial elaboration of these points as a bonus page.

      So what? science is not the holy grail.

      Agreed. The Holy Grail is an illusory religious preoccupation that has no objective existence. Science is merely the most effective means of determining whether a medical treatment is effective or not, responsible for the doubling or tripling the life expectancy of humans in a little less than two centuries. At its heart it’s relatively common sense – very carefully keep track of how well at least two similar groups do if given different treatments, and publish the results.

      No Holy Grail, merely the best way we have discovered to determine if an effect is real or not.

      Got some peer-reviewed study on this?

      Here is a starting point. Here’s another, and another and another and another, but feel free to explore the entire category. While not direct links to the specific peer-reviewed studies, Dr. Ernst’s articles do contextualize the citations and link directly to the pubmed articles, as well as addressing their strengths and shortcomings. You’re welcome.

      Different, yes. Inferior In some areas, but not across the board. But they’re not medical doctors or pretending to be one. If they are, steer clear.

      Such claims are actually rather common. The education and training of chiropractors are decidedly inferior, in terms of quantity but mostly in terms of quality. Chiropractors, even the “mixers” who don’t think they can cure cancer, still believe in the nonexistent subluxation. At best they are equipped to deal with musculoskeletal complaints. In which case, their education is inferior to physiotherapists.

      But I agree, the chiropractors who think they can be doctors are lunatics.

      So what? just use them for what they’re good for

      That ain’t much, basically back pain. And many argue they can be primary care providers.

      Little of what they do has been studied
      so what

      So what? So why are they permitted to practice? How would you feel about Pfizer selling drugs with equivalent evidence base?

      Anyone in any service business does this. The patient can decide what’s “necessary”

      Unless the patient is systematically misinformed by, say, their chiropractor. There’s a reason the state imposes laws and regulations to manage the issue of unequal information. It’s a pity the state has cast of its burden of care for its citizens by permitting chiropractors to practice essentially unregulated and without restraint.

      They take too many x-rays
      Unlike hospitals… Liability issues.

      The x-rays taken by hospitals are useful, they have diagnostic utility. Chiropractors take x-rays for no reason, they certainly don’t support the central dogma of chiropractic (subluxations).

      Any medical or physical procedure is potentially dangerous.

      Yes, but real medical procedures are accompanied by evidence of benefit; there is an explicit and implicit risk-benefit calculation. What benefit is there to cervical manipulation? If there is none, then it’s all risk – patients risk tearing their arteries and throwing clots into their brains for no reason whatsoever.

      Most chiropractors don’t know much about nutrition
      …and your doctor does?

      Three things:
      1) Yes
      2) How does doctors being ignorant about nutrition (they aren’t) justify chiropractors being ignorant about nutrition? Isn’t the rational response that chiropractors should stop giving nutritional advice?
      3) Doctors don’t sell expensive, unnecessary vitamins directly out of their office. Chiropractors do. There is a systematic incentive to exaggerate and fearmonger about nutritional deficiencies.

      you can buy supplements they recommend somewhere else. It’s a legit business practice to mark up products.

      See my above point, the sale of vitamins is predicated on fearmongering, not honesty.

      No more than doctors who overprescribe ADHD drugs

      The sins of doctors do not justify the sins of chiropractors. And further, the use of drugs to treat ADHD, though problematic, does have an evidence base. And further – if doctors overprescribe drugs based on the evidence, then doctors need to adjust their prescribing habits. That doesn’t mean that chiropractors are magically more effective. You can’t keep complaining about doctors as if it justified chiropractors being bad at their jobs. Perhaps you might try improving chiropractic care and opposing their attempts to be real doctors.

    3. Moderation says:

      I ignored everything you said after your first two comments. Your inconsistency is astounding. First you say that science isn’t the holy Grail, and in the very next comment you asked for peer-reviewed articles.

      You are right about one thing. Science is not the holy Grail, it is not an end point, it is a process.

    4. Zoe says:

      Wow. Literally cannot believe how ignorant this comment is – come and work in the UK where if you can’t prove that you’re keeping up with the latest research (i.e. your elusive ‘science’) then you’ll be struck off.

      Hardly any of the reasons you give in answer to the author’s points are relevant and they appear to be just speculation. If you gave an answer where you could actually back up your points I think that people would value what you were saying but seeing as you don’t care much that a health professional doesn’t use researched techniques, I don’t suppose that you’ll bother to give evidence either.

      ‘It’s a legit business practice to mark up products’ – this is somebody’s health and quality of life. It disgusts me that people have to pay to keep what should be a right. The NHS may not have got everything right but at least everybody is entitled to have free healthcare.

    5. Simply Will says:

      I’m a Soon to be physical therapy graduate…being said, This is absolutely my favorite reply.

      Some of these “truths” are wow, others are evident in all fields of practice, most important element here is perspective.

      Overall, healthcare needs an overall. In the 70s like minded PT and Chiros attempted to blend their professions. I think it was along the lines of “physiopractic” or “osteopractic”…. Can’t remember exactly, but I think such a move would be more beneficial for sports/ortho/manual focus/outpatient practitioners of chiro/physio.

      We can then distance ourselves from the kooks.

    6. Calli Arcale says:

      They offer lots of unnecessary services
      Anyone in any service business does this. The patient can decide what’s “necessary”

      Service business? SERVICE BUSINESS??? And here, I thought Chiropractic was considered a medical practice. They certainly make medical claims. Huh. I guess I was wrong. According to Stan, it’s in a completely different industry. It should be compared to spas and hotels, not doctors.

      So who cares about science and proof? Who cares about whether or not their education is comparable? It’s all in whether the customer is happy, and as their experience is entirely subjective, perhaps they are more comparable to a sommelier, who also undergoes industry-specific training but is principally concerned with making the customer satisfied with their very expensive purchases.

      This is medicine, Stan, not hoteliery or something like that. If you want someone who will just tell you how great you are while rubbing your back and relieving you of some cash, go to a spa. That’s what they’re for. If you want medical care, go to a doctor. This is also what creeps me out about the concept of boutique medical care. This isn’t the service sector.

      1. Wow says:

        And medical practice isn’t a business? Have you seen the size of our “medical clinics”? Its the biggest business in our country. As for research it has been shown that 34% of medical researchers have practiced questionable research practice, remember vioxx. If you are really concerned about patient health, read this: http://www.ourcivilisation.com/medicine/usamed.htm

        I’m sure most of you won’t. You do not want facts. You want your opinions to be supported.

          1. Wow says:

            This is the problem. You want facts and studies but when presented with them all of a sudden they are idiots. This is the medical response to anything “different”. Put it down and criticize it in order to attempt discredit it. Overall, I think your answer was pretty good though.
            The commets on this site are not talking about improving anything that needs improvement. They are just severely criticizing Chiropractic. As usual nothing constructive or even psuedointellectual.

          2. Wow says:

            BTW: I feel that “medicine has it’s flaws” is insulting to the American people when medical mistakes is the number one cause of deaths in our country. This info is coming from the medical profession. Again, who is this debate about. Patients or egos?

            1. devo-T says:

              [M]edical mistakes is the number one cause of deaths in our country

              [spit-take]

              First of all, senescene (biological aging) is far and away the leading cause of death. But for the sake of argument, let’s look at the data — credible data, not the kind found on OurCivilization, which espouses such time-tested classics as “global warming is a myth”and “HIV doesn’t cause AIDS” to new favorites like “smack kids or child monsters will erode public order”.

              So, then, the number of iatrogenic deaths in the US is estimated at anywhere from 210,000 to over 400,000. Even if you assume the upper limit, it still only ranks 2nd in both natural and preventable causes of death.

          3. WilliamLawrenceUtridge says:

            You didn’t present facts and figures though, you presented webpage with an article co-authored by Gary Null. That’s not a citation, that’s a polemic. By a lunatic. Medicine responds to evidence, Gary Null doesn’t have any. Even Null’s citations are stupid – I prefer mine newer than 1986 for instance. Not to mention, he is citing discussions by the very medical system he decries. Then he’ll make a statement like this:

            Medicine is not taking into consideration the following monumentally important aspects of a healthy human organism:

            (a) Stress and how it adversely affects the immune system and life processes
            (b) Insufficient exercise
            (c) Excessive caloric intake
            (d) Highly processed and denatured foods grown in denatured and chemically damaged soil
            (e) Exposure to tens of thousands of environmental toxins.

            With nary a citation. A, B and C are naught but regular medical recommendations, D and E are assertions, not proof. He also treats any link with a pharmaceutical manufacturer as proof of malfeasance rather than a reason for caution. Holding a grant from Big Pharma does not mean you are automatically evil and compromised.

            Not to mention, you are still doing nothing but repeating the same fallacy – “medicine is flawed” does not address the core issue raised by this blog post, that chiropractic is far, far worse. Chiropractic needs to improve, but the reality is, if they actually become science-based, they would be physiotherapists. Chiropractic practice is not substantiated by scientific research except for spinal manipulation for low back pain, which physiotherapists are now adopting (more evidence that medicine is not prejudiced against chiropractic – they are prejudiced against any practice that is nonsensical and unproven). Chiropractic needs to be criticized, it puts people’s health at risk with no evidence of efficacy, as well as wasting resources and discouraging pursuit of genuinely effective treatment. Any finger pointing chiropractors make about medicine and greed compeltely ignores the fact that chiropractors do not dispense services for free and are strongly motivated to exagerrate their effectiveness and distract from the fact that almost nothing they do can be justified by the scientific literature.

            BTW: I feel that “medicine has it’s flaws” is insulting to the American people when medical mistakes is the number one cause of deaths in our country. This info is coming from the medical profession. Again, who is this debate about. Patients or egos?

            Well, I’m not really debating – I’m merely pointing out that comments such as yours are irrelevant to the matter at hand. Even if 100% of deaths were due to medical mistakes, even if medicine weren’t engaging in a decades-long drive to reduce medical error and improve practice, that still wouldn’t justify chiropractic. Chiropractors need to get off their asses, stop whinging about the flaws of another discipline, and take some responsibility for their own failings.

            Shitty medicine does not justify even shittier chiropractic care, and if you can’t see why this is, you need to think about it a little more.

            And again, Gary Null is a mendacious loon out to sell you unnecessary vitamins. Perhaps take his commentary with a grain of salt (and check his references before trusting them).

      2. Wow says:

        And medical practice isn’t a business? Have you seen the size of our “medical clinics”? Its the biggest business in our country. As for research it has been shown that 34% of medical researchers have practiced questionable research practice, remember vioxx. If you are really concerned about patient health, read this: http://www.ourcivilisation.com/medicine/usamed.htm

        I’m sure most of you won’t. You do not want facts. You want your opinions to be supported.

        1. Carl says:

          It doesn’t matter that medicine is a business, it matters that medicine is an expert profession which implies a special area of knowledge. It is ridiculous for you to imply that a medical professional has no more input on what the patient needs than the guy at a sandwich shop.

          Should I get mustard? -I dunno, whatever you want.
          Should I get an x-ray and a spinal fusion? -I dunno, whatever you want.

          You and Stan can’t possibly be that stupid.

          1. Wow says:

            Just the type of ignorant answer I expected. How about an intellectual response “Carl”. Thanks for making my day and proving my point. Oh, and I know you are going to reply “whats your point”, to which I will reply…exactly.

          2. Carl says:

            Not a single thing you just said had anything to do with the topic.

  6. DevoutCatalyst says:

    Chiropractors have no business doing breast or rectal exams.

    1. DevoutCatalyst says:

      My comment was addressed to Jonathan, written before Harriet’s comment appeared above his. Damn this comment system.

  7. goodnightirene says:

    Chiropractic is not based on science
    So what? science is not the holy grail.
    YES IT IS

    Chiropractors promise too much
    Got some peer-reviewed study on this?
    CHECK ARCHIVES OF THIS BLOG

    Their education is vastly inferior to that of medical doctors
    Different, yes. Inferior In some areas, but not across the board. But they’re not medical doctors or pretending to be one. If they are, steer clear.
    THEY ARE LOBBYING TO BECOME PRIMARY CARE PROVIDERS–BECAUSE THEY THINK THEY ARE DOCTORS. THEIR EDUCATION (SEE PALMER COLLEGE WEBSITE) IS NOTHING AT ALL LIKE MEDICAL SCHOOL

    Their legitimate scope is very narrow
    So what? just use them for what they’re good for
    THAT WOULD BE LOWER BACK PAIN–TRY A PT OR MT AND SKIP THE CHIRO NONSENSE

    Little of what they do has been studied
    so what
    YOU CAN’T BE SERIOUS

    It’s best to get diagnosed elsewhere
    OK, you can do this before seeing one
    HOW DOES THE AVERAGE PERSON KNOW THIS?

    They offer lots of unnecessary services
    Anyone in any service business does this. The patient can decide what’s “necessary”
    NOT TRUE AT ALL–SOME MAY, BUT SUCH A STATEMENT IS RIDICULOUSLY INCLUSIVE.

    “Cracking” the back doesn’t mean much
    Nothing at all – it’s just a euphemism
    THIS COMMENT ADDS NOTHING

    If the first few visits don’t help, more treatment probably won’t help
    OK, try a few and see if they help. You’ll know.
    YOU WON’T KNOW IF IT WAS THE ‘CRACKING’ OR JUST A COINCIDENCE OR IF YOU GOT BETTER BY SOME OTHER MEANS.

    They take too many x-rays
    Unlike hospitals… Liability issues.
    SEE MULTIPLE ENTRIES IN THE ARCHIVES

    Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
    So what?
    YOU CANNOT BE SERIOUS!

    Neck manipulation is potentially dangerous
    Any medical or physical procedure is potentially dangerous.
    THERE IS NO COMPARISON AS NECK MANIPULATION IS COMPLETELY UNNECESSARY AS PRACTICED BY CHIROS

    Most chiropractors don’t know much about nutrition
    …and your doctor does?
    YOUR DOCTOR KNOWS PLENTY ABOUT BIOCHEMISTRY–THE BASIS OF NUTRITION

    If they sell vitamins, they charge too much for them
    you can buy supplements they recommend somewhere else. It’s a legit business practice to mark up products.
    THEY MARK UP WAY MORE THAN THE LOCAL DISCOUNT STORE

    They have no business treating young children
    No more than doctors who overprescribe ADHD drugs
    APPLES AND ORANGES

    The fact that patients swear by them doesn’t mean they are actually being helped
    No, but it doesn’t mean they aren’t. Don’t underestimate the patients.
    WHY NOT UNDERESTIMATE PATIENTS WHO HAVE LITTLE KNOWLEDGE OF SCIENCE OR THE FOUNDATIONS OF CHIROPRACTIC?

    Insurance companies don’t want to pay for chiropractic care
    they don’t want to pay for anything, really. Watch Michael Moore’s “Sicko”
    TOO SILLY TO BOTHER COMMENTING ON

    Lots of chiropractors do really strange things
    Wow.
    AGREED

    Don’t expect chiropractic licensing boards to protect you
    …or the AMA.
    THE AMA IS NOT A LICENSING BOARD, BUT RATHER A PROFESSIONAL ORGANIZATION

    The media rarely look at what they do wrong.
    The mainstream media is completely lame about all subjects.
    ANOTHER SWEEPING NON-STATEMENT

  8. lizditz says:

    I am exasperated with chiropractors who claim to have a magic cure for dyslexia (I’m looking at you, Phyllis Brooks, ADHD (I’m looking at you, American Chiropractic Association and/or autism (I’m looking at you, Robert Melillo.

    They and the thousands of other chiropractors like them are preying on desperate parents and providing no benefit to struggling children. They are a disgrace.

  9. sad chiro says:

    I wish I could afford to go back to medical school. I try to be as ethical as I can in my practice. I actually DO tell patients several of the things on that list. I don’t practice in the US so the perspective is a little different. I love what I do and I hope/think/whatever I’m helping people, though probably more through mechanisms similar to PT/Massage therapy. Anyway. Thought I’d throw it out there that Chiros who agree with Preston Long do exist, though we’re few and far between, and I appreciate that he puts his voice out there.

  10. Jesse Goldswain says:

    I would like to attempt a response to these 20 points. I am a chiropractor and I am aware of the factions in the profession. I am in favour of a scientifically methodical approach to chiropractic.

    1. Chiropractic is not based on science
    - The original idea that spinal misalignments are the cause of all disease is not based on science. Chiropractic is a profession that uses manual therapy to improve the well being of patients. The treatment of choice for most chiropractors is spinal manipulative therapy – a treatment based purely on scientific methodology i.e. that proprioceptive input from a joint maintains normal function of that joint and the rest of the neuro musculoskeletal system it relates to.
    2. Chiropractors promise too much
    Absolutely correct. I cannot fault you there. Too many chiropractors fail to meet expectations either because expectations are set too high or the treatment is inappropriate.
    3. Their education is vastly inferior to that of medical doctors
    I have an undergraduate masters of chiropractic degree from a first class university in the UK accredited to the standards imposed by the WHO. I speak on behalf of European chiropractors when I say that the level of knowledge and training we receive in neuro-musculoskeletal medicine is second to none. I have no problem discussing co-morbidity with general practitioners.
    4. Their legitimate scope is very narrow
    Chiropractors should have a limited scope to neuro-musculoskeletal disorders. To say that is limited, however, is without an appreciation for the scale of such disorders. Chiropractors should be well versed in primary care differential diagnosis and make appropriate referrals.
    5. Little of what they do has been studied
    True. Relatively little has been trialled through randomised controls. More work needs to be done to understand explicitly the dynamic of treatments used by chiropractors. There is however evidence supporting a limited scope of practice.
    6. It’s best to get diagnosed elsewhere
    By the standards of which most “principled” chiropractors examine patients you would be best to seek an orthopaedic consult. However a competent chiropractor has every skill to differentially diagnose neuro-musculoskeletal disorders or refer for a second opinion.
    7. They offer lots of unnecessary services
    The practices of which you speak are businesses within the healthcare sector. The definition of a business is not how many patients you get better, it is the turn of profit. Naturally these offices obey the principles of supply and demand however unethical. Here is where regulatory bodies should act to conduct clinic audit and facilitate a board of complaints brought against such chiropractors.
    8. “Cracking” the back doesn’t mean much
    Cracking backs for the sake of cracking backs is not the desired outcome of spinal manipulative therapy. There is a mechanism of spinal stability described quite eloquently by Panjabi which dictates that the desired outcome of “cracking backs” is a sensory input to allow for normal joint function through the active and neural control of a motion segment through sensory motor integration.
    9. If the first few visits don’t help, more treatment probably won’t help
    Depends on the chronicity of the case, but I would agree with that. If there is no response in 2/3 treatments, seek an alternative intervention.
    10. They take too many x-rays
    Some more drastic chiropractic approaches require x-rays for every patient. This is contrary to IRMER guidelines and is against most standards of practice.
    11. Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
    I don’t know how to respond to this statement because I dont understand the point it is trying to make.
    12. Neck manipulation is potentially dangerous
    True. We know there are risks associated with spinal manipulation (not just to the neck I might add). That risk is elevated in populations with a predisposition to vascular complication. Diagnostic triage is a vital component of clinical practice that reduces the risk of such events. It would be negligent to assume that any intervention is without due risk. That risk has been evaluated to be significantly lower than other treatment modalities for the same diagnosis.
    13. Most chiropractors don’t know much about nutrition
    Nutrition is not emphasised in the chiropractic curriculum (several modules I remember). Chiropractors should stick to their scope of practice, after all there are professional nutritionists who can co-manage patients. I believe any dietary advice given by the chiropractor is in light of general health advice. It is possible to obtain continuous professional development within the purview of nutrition.
    14. If they sell vitamins, they charge too much for them
    Same point as number 7.
    15. They have no business treating young children
    This is completely false. I can’t think why you would withold treatment from young children. Assuming the chiropractor has undergone adequate training in the examination and care of infants, that child has just as much right to chiropractic care as an adult.
    16. The fact that patients swear by them doesn’t mean they are actually being helped
    By definition they are being helped. Even if your outcome is subjective does not detract from the fact that it is an outcome measure.
    17. Insurance companies don’t want to pay for chiropractic care
    You are speaking of the USA I presume. I treat the employees of my local US embassy. They all receive reimbursement for treatment. (by the way I think you’ll find that insurance companies don’t want to pay for anything if they can find a way not to)
    18. Lots of chiropractors do really strange things
    Yes. I will simply agree with that. And we are probably talking about the majority :(
    19. Don’t expect chiropractic licensing boards to protect you
    I can’t answer that as I do not practice in the US.
    20. The media rarely look at what they do wrong.
    That’s quite clearly not true. Every month I read a similar headline to “chiropractor breaks baby’s neck” in the global media. There is a media frenzy around anything controversial, and chiropractic is regularly targeted in such a way.

    1. sad chiro says:

      Thank you, this was great :) There should be a club…

    2. Blue Wode says:

      Jesse Goldswain wrote in response to point 3: “I have an undergraduate masters of chiropractic degree from a first class university in the UK accredited to the standards imposed by the WHO.”

      Would that be the University of Glamorgan which offers the degree course(s) at the Welsh Institute of Chiropractic? If so, you might like to read this post by a neuroscientist:
      http://sciencedigestive.blogspot.co.uk/2010/06/email-to-university-of-glamorgan.html

      I suspect that the revelations in that link would be much the same for the University of Bournemouth which offers chiropractic degree(s) through the Anglo European College of Chiropractic.

      Jesse Goldswain wrote in response to point 6: “By the standards of which most “principled” chiropractors examine patients you would be best to seek an orthopaedic consult.”

      How would a member of the public know to seek out an evidence based chiropractor in the first place? And if they did know to seek one out, to what source could they refer to look one up?

      Jesse Goldswain wrote in response to point 12 re neck manipulation being potentially dangerous: “True. We know there are risks associated with spinal manipulation (not just to the neck I might add). That risk is elevated in populations with a predisposition to vascular complication. Diagnostic triage is a vital component of clinical practice that reduces the risk of such events. It would be negligent to assume that any intervention is without due risk.”

      But you should know that there are no reliable methods available to screen for patients who might be predisposed to suffering a vertebral artery dissection from neck manipulation. You should also know that the risks of neck manipulation outweigh any perceived benefits. Where is your cautious attitude?

      Jesse Goldswain wrote in response to point 15 re chiropractors having no business treating young children: “This is completely false. I can’t think why you would withhold treatment from young children. Assuming the chiropractor has undergone adequate training in the examination and care of infants, that child has just as much right to chiropractic care as an adult.”

      Here are several reasons why you should withhold chiropractic treatment from children (read to the end, and also click on the ‘Safe for children?’ link at the top):
      http://www.ebm-first.com/chiropractic/treating-children.html

      Jesse Goldswain wrote in response to point 19 about not expecting chiropractic licensing boards to protect you: “I can’t answer that as I do not practice in the US.”

      If you practice in the UK, then you should know about the General Chiropractic Council’s desperate response to the 600+ complaints it received during the British Chiropractic Association’s (unsuccessful) attempt to sue the writer and broadcaster, Simon Singh, for libel. See here:
      http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1205-general-chiropractic-council-wants-to-waive-the-rules-.html

      1. Jesse Goldswain says:

        Thank you, Blue Wode, for your topical dissection.

        I have read that aforementioned blog some years back. It is a critique of the information provided on a website assuming the person who writes the website has any knowledge of the degree. Be as it may, you are welcome to question the reputation of my degree, but I challenge you to a match of medical debate. I will select 2 of my colleagues who will go head to head with 3 of any practicing medical doctors with similar qualification i.e a medical degree. We will be quizzed on our recall of anatomy, phyioslogy, neurology, orthopaedics, biochemistry, molecular biology, embryology, radiology, any subject you like except pharmacology and surgery.

        I promise this is no empty challenge. I have taken this challenge before with general practitioners, for fun as it were, and needless to say it was slightly embarrassing on behalf of GPs.

        A member of the public would be well advised to consult a chiropractor based on referral or recommendation. All of my patients come from referrals, and usually not because one person has recommended me, but several people. I take pride in my reputation, as would any chiropractor working to a high standard. I could quickly tell you which physiotherapist/dentist/podiatrist/orthopaedist to see and which to avoid based on how they conduct their practice. I would hope that the successful practices are the ethical practices. Alas society measures success by financial gain and not the results of clinic audit.

        You should know that certain individuals within a population have an increased risk of vascular accident. You should also know that no one suffers a CVA because of neck manipulation. There are complications weaken the intima lining of the vertebral/carotid artery, or thrombus formations within the lumen which is the mechanism of CVA with neck manipulation. If neck manipulations caused CVA, don’t you think there would be a LOT more strokes after neck manipulation? I’m talking about 1 a day at least. Clearly the patients who suffer as a result of neck manipulation have underlying pathology.

        I have a 6 month old son whom I adjusted at 2 weeks because he presented with an inability to latch to my wife’s left breast. I have sufficient post graduate training to do such things. You really think I would take any undue risk of injuring my own child if I didn’t think he would benefit? No problem suckling after the treatment by the way (not that you think that matters as you consider this anecdotal evidence).

        That GCC incident was regarding the advertising standards of 600 (20%) of it’s members and not complaints concerning the safety or competence of it’s members. I can appreciate your concern on what certain chiropractors are advertising – but this is the reason we are having this discussion.

        1. Andrey Pavlov says:

          You really think I would take any undue risk of injuring my own child if I didn’t think he would benefit?

          Your thought that it would benefit means nothing about whether it actually benefits. And yes, children die quite regularly because their parents believe in nonsense.

          We will be quizzed on our recall of anatomy, phyioslogy, neurology, orthopaedics, biochemistry, molecular biology, embryology, radiology, any subject you like except pharmacology and surgery.

          Funny how your challenge is all about the things furthest removed from actual patient care. Why not have a challenge as to interpretation of various findings, diagnosis of disease, and actual management of disease? Probably because chiropractors have no idea about those things, but any undergraduate who can blindly and stupidly memorize a list can regurgitate those kinds of facts.

          You should also know that no one suffers a CVA because of neck manipulation. There are complications weaken the intima lining of the vertebral/carotid artery, or thrombus formations within the lumen which is the mechanism of CVA with neck manipulation. If neck manipulations caused CVA, don’t you think there would be a LOT more strokes after neck manipulation?

          Wow. And topping it off with the argument from incredulity. Just because it doesn’t happen as often as you think it should happen means it doesn’t ever happen. You even almost got yourself to the actual answer – certain people have weakening of the intima or other subtle underlying pathology and then neck manipulation rips the intima! But of course it wasn’t the neck manipulation that did it. The intima was already weakened. Never mind that if that person didn’t have the neck manipulation the artery never would have dissected. Mind boggling how chiros will hold tooth and nail that their precious neck cracking can’t lead to CVA, ever even when they themselves offer up the mechanism!

          1. William says:

            @ Andrey
            You said
            Funny how your challenge is all about the things furthest removed from actual patient care.

            Physiology (and abnormal physiology),Ortopaedics,Neurology
            and Radiology have nothing to do with actual patient care?

          2. Andrey Pavlov says:

            @william:

            Since when does “furthest removed from actual patient care” equate to “nothing to do with patient care”?

            Of course those have to do with patient care. But those are the things that one must learn to then actually apply to a patient in order to care for them. Why do you think that PhD’s in human physiology would not be able to actually act as a physician? Do you think an anatomist can take care of a pneumonia? Or a biochemist?

            That was my point – those basic subjects are necessary but not sufficient for actual patient care. But there is a reason why the basic sciences – which is what those subjects are – are at the bottom of the hierarchy of evidence in medicine. We here at SBM agree with that, but we also take it one step further and say that those sciences give us the Bayesian prior to inform higher order studies rather than discard them when poorly done studies conflict with well established basic sciences.

            It is also the reason why translational research is extremely difficult and why most bench research doesn’t actually pan out into clinical benefit.

            So yes. Many people could best me in those topics – all of them in fact – and still be abysmal at actual patient care. Plus, my smartphone will trump everyone on those topics and be an even worse physician. Goldswain’s challenge is thus rather inane.

        2. Blue Wode says:

          Jesse Goldswain wrote: “I will select 2 of my colleagues who will go head to head with 3 of any practicing medical doctors with similar qualification i.e a medical degree. We will be quizzed on our recall of anatomy, phyioslogy, neurology, orthopaedics, biochemistry, molecular biology, embryology, radiology, any subject you like except pharmacology and surgery.”

          That would be a waste of time. The fact remains that the robust scientific data are increasingly revealing that spinal manipulation for low back pain (what ‘chiropractic’ might be beneficial for) is no better than taking OTC medication and/or doing exercises. That said, the precautionary principle tells us that spinal manipulation, as administered by chiropractors, cannot be recommended for low back pain sufferers due to the appalling lack of standardisation within the profession – i.e. many chiropractors continue to manipulate their low back pain patients’ necks based on the false belief that such ‘adjustments’ act as a panacea.

          Jesse Goldswain wrote: “A member of the public would be well advised to consult a chiropractor based on referral or recommendation.”

          Are you being serious? That is the worst type of advice (unless, or course, the referral or recommendation came from an MD or other science-based healthcare professional, and even then it should be treated with great caution).

          Jesse Goldswain wrote: “You should know that certain individuals within a population have an increased risk of vascular accident. You should also know that no one suffers a CVA because of neck manipulation.”

          Not true. http://www.ebm-first.com/chiropractic/risks.html

          Jesse Goldswain wrote: “There are complications weaken the intima lining of the vertebral/carotid artery, or thrombus formations within the lumen which is the mechanism of CVA with neck manipulation. If neck manipulations caused CVA, don’t you think there would be a LOT more strokes after neck manipulation?”

          Yes, I would, but since there are no reliable chiropractic adverse event reporting systems in place anywhere in the world, the complications that we do already know of are likely to represent only the tip of a very large iceberg.

          Jesse Goldswain wrote: “I have a 6 month old son whom I adjusted at 2 weeks because he presented with an inability to latch to my wife’s left breast. I have sufficient post graduate training to do such things.”

          Do you have any robust scientific evidence to support using that intervention other than “sufficient post graduate training”?

          Jesse Goldswain wrote: “You really think I would take any undue risk of injuring my own child if I didn’t think he would benefit?”

          Not wittingly, but I would suggest that you get up to speed on risk/benefit assessments.

          Jesse Goldswain wrote: “That GCC incident was regarding the advertising standards of 600 (20%) of it’s members and not complaints concerning the safety or competence of it’s members.”

          If promoting claims not supported by scientific evidence isn’t a competence issue, then what, in your opinion, is it? BTW, the UK General Chiropractic Council apparently has an almost complete disregard for the “competence” of its registrants (and please note that it also has no adverse events reporting system in place):
          http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1827-alliance-of-uk-chiropractors-october-2010-newsletter.html

          Also see here:
          http://www.ebm-first.com/chiropractic/uk-chiropractic-issues.html

        3. Harriet Hall says:

          “You really think I would take any undue risk of injuring my own child if I didn’t think he would benefit? ”

          Of course you wouldn’t do it unless you “thought” he would benefit. Just like the chiropractor in my area who “thought” spinal manipulation was a better treatment for his child’s meningitis than antibiotics. The child died because of his father’s false beliefs.

        4. WilliamLawrenceUtridge says:

          A member of the public would be well advised to consult a chiropractor based on referral or recommendation.

          What distinguishes you from a physiotherapist? Why are chiropractors superior given the similarity of their focus?

          If you had to choose your career anew, would you still be a chiropractor? Or would you be a physiotherapist?

          Clearly the patients who suffer as a result of neck manipulation have underlying pathology.

          Are your beliefs justified by reference to the appropriate clinical literature? Or is that purely based on your professional judgement? How do you defend against the innate human tendency to be self-serving in the face of challenges to one’s self-concept (i.e. that you are a professioanl healer, not someone who damages their patients)?

          1. WilliamLawrenceUtridge says:

            Clearly the patients who suffer as a result of neck manipulation have underlying pathology.

            I should also note that this is a “no true Scotsman” fallacy.

    3. WilliamLawrenceUtridge says:

      3. Their education is vastly inferior to that of medical doctors
      I have an undergraduate masters of chiropractic degree from a first class university in the UK accredited to the standards imposed by the WHO. I speak on behalf of European chiropractors when I say that the level of knowledge and training we receive in neuro-musculoskeletal medicine is second to none. I have no problem discussing co-morbidity with general practitioners.

      You’re basically agreeing with this point then – doctors learn a whole lot more than MSK conditions. And there are chiropractors who don’t limit themselves to just MSK, they claim to treat a host of other problems like allergies, asthma, etc. I’m glad you’re not one of them.

      15. They have no business treating young children
      This is completely false. I can’t think why you would withold treatment from young children. Assuming the chiropractor has undergone adequate training in the examination and care of infants, that child has just as much right to chiropractic care as an adult.

      How do you feel about adjusting the neck of an infant?

      By definition they are being helped. Even if your outcome is subjective does not detract from the fact that it is an outcome measure.

      How do you feel about homeopathy? How do you feel about giving patients saline instead of real medicine? How do you feel about replacing doctors with witchdoctors who invoke spirits rather than bacteria and viruses? How do you feel about placebo improvements that could mislead patients into abandoning effective medications? I question purely subjective improvements as a valid patient outcome.

      But overall it seems like you’ve got a lot of work to do to separate the valid, science-based practice from the invalid, nonsense-based, Palmerian ones. I think this would be incredibly valuable, some way of officially noting that you’re basically physiotherapists who specialize in the back.

  11. pmoran says:

    I agree with those who see little future for “chiropracty” within any mature medical system. (Chiropractors hate this old terminology but it does put the field in its rightful place as something of a medical anachronism.)

    Spinal manipulation was never an exclusively chiropractic modality, so that chiropracty remains forever defined and characterised by its embarrassingly naive medical theories as to the role of the spine in illness.

    To the extent that spinal manipulation is a reasonably legitimate resort for one or two conditions it could be, and often is, quite comfortably incorporated into physiotherapy and orthopaedic practice.

  12. elden says:

    “I got a kick out of the several cases of sexual misconduct he encountered during his career.”

    If you get your kicks reading about cases of sexual assault, that’s probably something you should keep to yourself — the many victims of sexual assault by medical providers are probably not going to appreciate your amusement. Seriously, is there no limit to Dr. Hall’s tone-deafness on women’s issues?

    1. Harriet Hall says:

      “Dr. Hall’s tone-deafness on women’s issues” ??!!??!!

      For the record, I don’t get kicks out of sexual assault. I get kicks out of the idiocy of the chiropractor who kept incriminating tapes in his bedroom and the one who inadvertently locked his wife in the clinic when he fled.

      If anyone thinks I am unaware of women’s issues, I would urge them to read my book “Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon.” My whole life story is about overcoming the many “women’s issues” I had to face.

  13. le sigh says:

    16. The fact that patients swear by them doesn’t mean they are actually being helped
    By definition they are being helped. Even if your outcome is subjective does not detract from the fact that it is an outcome measure.

    Um. I think SBM covers this topic in every other blog post. Placebo medicine is not ethical.

  14. bananaomelets says:

    16. The fact that patients swear by them doesn’t mean they are actually being helped
    By definition they are being helped. Even if your outcome is subjective does not detract from the fact that it is an outcome measure.

    I think SBM covers this in literally every other post. Placebo medicine is unethical.

  15. William says:

    First of all if statement one is true, then the other nineteen are unnecessary to list.
    Second, dd any of the scientists here exam Preston long’s credentials:

    His “PhD” comes from an online university, Walden University. Need I say more?

    Do notice his Linkedin,com ” Skills and Expertise” which happen to include,
    Nutrition,Supplements,Wellness,Wellbeing

    I’m sure he learned that at Walden though, not at Cleveland Chiropractic College in 1984

    I’m sure he’s donating a majority of his book’s profits to chiropractic stroke victims

    1. WilliamLawrenceUtridge says:

      I’m sure he’s donating a majority of his book’s profits to chiropractic stroke victims

      Whether he is or is not in no way validates his critique.

  16. Larry Livingston says:

    Funny….most of these apply to medical doctors as well.
    1. Medicine is not based on science, the promote the illusion that it is.
    2. Medicine promise too much and then hand you a script
    3. Their education is vastly inferior to that of medical doctors – learning how to prescribe is a superior education? Or learn from the drug rep…
    4. Their legitimate scope is very narrow – do they even know how to erform an orthopedic test?
    5. Little of what they do has been studied – outside of medicine there has always been conflict regarding the legitimacy of the allopathic model…study the history of the AMA.
    5. It’s best to get diagnosed elsewhere – ALWAYS get a second opinion…see how often they are the same!
    6. They offer lots of unnecessary services – hmmm ever heard of cosmetic surgery, 485000 spinal surgeries in the US last year they propose 8 out of 10 were unecessary? WTF!
    7. “Cracking” the back doesn’t mean much – Antibiotics, flu shots have been basically proven ineffective or indifferent to conservative management for the majority of cases of flus, viruses… etc
    8. If the first few visits don’t help, more treatment probably won’t help “if it doesn’t get any better come back and see me” Okay so you’re doing nothing now…what will you do then?
    9. They take too many x-rays – Oh you can see through skin? Maybe MRI’s, CT’s mammogram etc are better?
    10. Research on spinal manipulation doesn’t reflect what happens in chiropractic offices. What’s different in an MD’s office? Which research…being very broad
    11. Neck manipulation is potentially dangerous – So are drugs and surgery
    12. Most chiropractors don’t know much about nutrition – either do MD’s – they get even less nutrition education than chiros check the hours.
    13. If they sell vitamins, they charge too much for them – what’s different from a GP or nutrition store…they all do and most are junk.
    14. They have no business treating young children – Opinion – Keep your kids away from a GP unless you want to start them on drugs early
    15. The fact that patients swear by them doesn’t mean they are actually being helped – Placebo right – kind of like “come back and see me if it doesn’t get any better” Subjective versus objective…show some proof
    16. Insurance companies don’t want to pay for chiropractic care – they don’t like to pay for anything – what’s your point?!
    17. Lots of chiropractors do really strange things – so do lots of people? again…what’s your point?!
    18. Don’t expect chiropractic licensing boards to protect you – when is the last time a medical board prosecuted anyone for a vaccine reaction or botched surgery or prescribed medication addiction or overdose? Give it a rest! your reaching now…
    20. The media rarely look at what they do wrong. Are you kidding me…they constantly bash the profession … pharmaceuticals are the biggest advertiser they control the media. Don’t think so check it out yourself.

    1. windriven says:

      @Larry Livingston

      Let’s stop at 1. You said: “Medicine is not based on science, the(sic) promote the illusion that it is.”

      Shall we start with the germ theory of infectious disease or would you like to start at the other end of the time scale and talk about genetic sequencing and positron emission tomography? Medicine is thoroughly based on science and if you had the slightest clue how science works you wouldn’t make such a glaring ass of yourself.

      Medicine continually studies and refines and implements new findings and discards old ones found to be imperfect. Then you have quacks who haven’t changed jack since their delusional founders drew their last breath. Subluxations? You make me laugh. Homeopathy? Only someone with a bronze age understanding of physical chemistry could believe it. And then we have reflexology and reiki and acupuncture with its imaginary lines.

      Medicine prevents smallpox, repairs diseased blood vessels, restores fertility to many of the infertile, saves 2kg premature babies, cures tuberculosis, and replaces failed kidneys. And what does your particular brand of bullshit offer, Slick?

    2. Sawyer says:

      Larry, next time please read the content of the article instead of posting a pre-written screed. Or I suppose the absence of #19 is a huge coincidence, right?

      1. Carl says:

        Well, he does win a point on #19 even without saying it. Chiropractic licensing boards are about as likely to protect you from bad MDs as they are to protect you from bad DCs

    3. Calli Arcale says:

      I’ll just answer one of yours, okay? Kinda busy today. ;-)

      20. The media rarely look at what they do wrong. Are you kidding me…they constantly bash the profession … pharmaceuticals are the biggest advertiser they control the media. Don’t think so check it out yourself.

      Pharmaceuticals are the biggest advertiser, and they control the media? Hah! Nonsense. The entire health sector consistently comes out near the bottom in a breakdown of advertising by industry. Do you want to know what sorts of industries spend the most and consequently have the most influence in the media? Retailers. Target, Kohls, Home Depot, Fleet Farm, Best Buy, TJ Maxx, Macy’s, Menard’s, Walmart, Walgreens, CVS, Barnes & Noble, JC Penny, Sears, Bloomingdales, Nordstrom’s, Herberger’s, GameStop, Microcenter, Tractor Supply Company, Dick’s Sporting Goods, REI, KMart, , AutoZone, Holiday, Superamerica, BP, Shell (yes, these last few are oil companies, but they *fight* over business to their convenience stores), Slumberland, Hom Furniture, IKEA, Men’s Warehouse, DSW Shoe Warehouse, Famous Footwear, Payless Shoes, Foot Locker, GAP, and so on. Just walk through a random mall, one you’ve never been to before, and you’ll probably recognize at least 75% of the store names because of their saturation advertising. Drive through a typical suburb’s retail district, and you’ll likely recognize nearly all of the big box retailers.

      It’s not like this in medicine. Grab a random person off the street and ask them if they’ve heard of Sam’s Club. Now ask them if they’ve heard of GlaxoSmithKline. Your odds are good that they’ll say “yes” to the first and “no” to the second.

      Now, this is not for want of trying on GlaxoSmithKline’s part. But the retailers are far too well established as the big players of advertising, and retailers do not need to spend anywhere near as much money on research and pretty much none on manufacturing. Their budget is spent on buying stock, maintaining their stores, and inducing customers to come in and buy. Here in Minnesota, we have some big players in the medical industry — yet none of our sports facilities are named for them. Target has naming rights on both the basketball arena and the ballfield (Target Center and Target Field, respectively). The football stadium, the Metrodome, is now the Mall of America Field at the HHH Metrodome (rather a mouthful, but it’s a long story). An energy company has its name on the professional hockey arena (the Xcel Energy Center in St Paul, affectionately called “the X”). A local bank has its name on the University of Minnesota’s stadium, TCF Stadium. (Twin Cities Financial has strong ties to the U of M in any case.) Retailers, a power company, and a bank. And this is fairly consistent with what you see nationwide. Stadiums get named for retailers, airlines, banks, energy companies, insurance companies . . . indeed, the closest thing you’ll find to a professional sports stadium named for anything in the healthcare industry is Blue Cross Arena — and Blue Cross isn’t a provider, it’s an insurance company.

      The biggest money isn’t in healthcare. It’s in . . . well, money.

    4. Kultakutri says:

      Erm, well, define necessity.

      Would a surgery be necessary if it saves life? You would probably agree on this one.

      Would a surgery be necessary if it improves quality of life physically, like, say, a procedure to fix someone’s wonky spine? Probably so. At this point, we could debate whether a certain surgery is the best option to achieve a certain outcome. This was discussed at SBM some time ago and the article concluded that indeed, in some cases, less invasive procedures could provide the same results but some doctors are plainly conservative and want to follow the surgery route because they are used to it. Huh, chiropractics hasn’t changed their paradigms despite scientific progress so blaming medicine for the same thing is a bit unfair.

      Would a surgery be necessary if its purpose is patient’s emotional well-being, say, doing something about an ugly scar on one’s face?
      Is it necessary to fix something that Gawd or Mother Nature intended to be but the patient finds it annoying, such as breasts too large or too small or asymmetry of the face for which the person got ridiculed…

      We could discuss first world problems, beauty ideals, media influence or mental issues but I fail to see anything inherently wrong with cosmetic surgery. As far as I am aware, the surgeons often do both elective aesthetic surgery and treatment of injuries or congenital malformations so the ability of the surgeons isn’t wasted and if the hospital earns a bit of extra money on someone getting a nose job and can spend it on improved services in the children’s oncology ward, why not. It may be not necessary by a strict definition but I can’t see it as wrong or condemnable.

  17. oldmanjenkins says:

    Lets not also forget chiropractic is very very very expensive. As it is a disproved methodology, it is not prudent to continue paying one more aksi/birr/chervonets/denier/ekwele/franc/gulden/hwan/inca/krone/lira/mark/nahar/ora/perper/qiran/rand/shekel/tala/vatu/won/yen/zaire on a system created to perpetuate a “need” to come back over and over and over again.

  18. CHRIS BRUNO says:

    I would imagine that Preston Long is a fairly old bitter individual who just did not make the correct decisions on his own life. Years ago, at that time there was no way to have an academic discussion regarding the science that did support chiropractic or the merits of its practice, but this has surely changed over the past 10 years. Dr. Long is one of several in our profession that has made a significant living (I would expect) from professing to being our professions “conscience”, when actually he doesn’t offer solutions, just criticisms. In spite of that our humble profession does continue to help patients, has grown worldwide and has generated a reasonable amount of supportive evidence for what we do…in spite of our detractors. “Illegitimi Non Carborundum!”

    1. Harriet Hall says:

      I have no interest in hearing what you “imagine.” And personal speculations about the author do nothing to refute the content of his book. It would be more helpful if you could cite some of that “supportive evidence” that you “imagine” Preston Long and those of us on SBM are not aware of. I don’t think you can come up with anything significant that we have not already seen.

    2. WilliamLawrenceUtridge says:

      You may imagine Dr. Long to be whatever you want – but that doesn’t make it so. He would probably agree, however, that “did not make the correct decisions on his own life”. Dr. Long would probably have preferred he go into a science-based profession that is based on how the body actually works – not how a 19th century huckster imagined it worked.

      Years ago, at that time there was no way to have an academic discussion regarding the science that did support chiropractic or the merits of its practice, but this has surely changed over the past 10 years.

      Are there any peer-reviewed references to support your point? Beyond spinal manipulation for back pain, I don’t believe that any chiropractic intervention is supported by the medical literature, and as I pointed out above, not that it has been proven to improve care for low back pain, it is being adopted by physiotherapists. So what does chiropractic add that can’t be found in a physiotherapist’s office?

      Also, searching pubmed for review articles, with a date range of 10 years and a subject of “chiropractic”, found 242 articles. Most are pretty negative and often are low quality and are in ghetto journals. Last one..

      Tell me again about the excellent evidence base for chiropractic care? That list seems like a litany of “there is no evidence”, or “the evidence is weak”, or “the trials were poorly conducted”, or blatantly self-serving.

      Your profession isn’t particularly humble, it appears to promise the moon on very shaky evidence – very far from the “reasonable amount” that you allege exists. It’s easy to get trapped in a circle-jerk of chiropractors citing chiropractors citing chiropractors, what is there on pubmed? Where are the original studies? Not that we really need them since the systematic reviews are pretty much universally negative bar back pain.

    3. Carl says:

      “he doesn’t offer solutions, just criticisms.”

      Oh, those poor helpless chiropractors, with nobody to tell them how to stop BSing.

      The critic does not have to offer solutions. If the supposed profession of chiropractic is full if quacks practicing nonsense (and it is), they are responsible for their own behavior. Until someone offers me a solution to my problems, I’ll just keep on stealing wallets…

  19. Stephane says:

    Indeed – you can stop reading Larry Livington’s dim-witted-half-ass comment at #1 and pretty much grasp his absence of knowledge of the real world around him.

    I actually had to turn my computer screen around so that I would not be seen reading some nonsense.

    And, sadly, this is what they teach in our universities. Medicine is bad. It kills people. lol. Even here in Quebec with a rigorous curriculum, they get the same, unevolving, unproven (actually disproven), dogma

  20. Chris Hickie says:

    Chiropractors have absolutely no damn business touching children, let alone infants. But since their arrogance and sadly incorrect hubris precedes them, here is the next bizarre chiropractic “book” on “treatment” to be published: http://www.russell-media.com/titles/available-titles/baby-designed-by-god

    The premise of this book is that only a chiropractor is good enough to care for something created by a deity. I think there are many levels of stupid in that premise.

    1. Egstra says:

      OMG! And their website is simply ludicrous. The mission statement? “To serve God by helping His people express more of their God given innate health potential through principled chiropractic care.”

      “principled chiropractic care” Is that an oxymoron?

  21. 1.Chiropractic is not based on science- the 110 yr old concept that manipulation heals all is not based on science. Science does indeed show that manipulation is effective for neck and back pain, headaches and other conditions IF caused by a spinal problem irritating the nervous system.

    2.Chiropractors promise too much- absolutely true. Philosophy based DCs absolutely still have some of that “cure all” mentality. Avoid!

    3.Their education is vastly inferior to that of medical doctors- lol This makes me laugh. The courses of study are similar with MDs getting into pharmacology and DCs getting into manipulation as treatment tools. MDs are better at diagnosing medical issues. DCs are much better as diagnosing musculoskeletal issues. So are PT docs.

    4.Their legitimate scope is very narrow. The scope is non surgical musculoskeletal treatment and nutritional and lifestyle advice.

    5.Little of what they do has been studied- Nonsense. Spinal manipulation has been studied extensively. The “cure all” claims have not, nor has Applied Kinesiology” a tool used by perhaps 30% of DCs to diagnoses disease.

    6.It’s best to get diagnosed elsewhere- If it is an infection, or metabolic disorder, MDs are better at diagnosing. DCs are much better at dx of muscoloskeletal dx. Almost ALL DCs regularly refer to MDs. MDs almost never refer to DCs. Nice huh?

    7.They offer lots of unnecessary services- No question about it. Many DCs treat for too many treatments because they need to “keep the patients” because MDs won’t refer, making grandiose claims and never ending treatment the best way to build their practices.

    8.“Cracking” the back doesn’t mean much- An ignorant statement. The crack or “release” as a joint is manipulated causes nerve endings to be reset so the associated muscles spasm subsides. ( put very simply )

    9.If the first few visits don’t help, more treatment probably won’t help- This is true about 90% of the time.

    10.They take too many x-rays- They used to until X rays were proven of minimal value in treating most back and neck pain.

    11.Research on spinal manipulation doesn’t reflect what happens in chiropractic offices- It does in mine but sure, many make absurd claims. Perhaps if MDs referred to scientific DCs the wacky DCs would have an incentive to change.

    12.Neck manipulation is potentially dangerous- Really? Then why is my 3 million malpractice ins cost $1200 whereas a family MD who does no surgery pays 12 THOUSAND?

    13.Most chiropractors don’t know much about nutrition- They don’t but some learn in post grad education and seminars. MDs know even less.

    14.If they sell vitamins, they charge too much for them- Yes they do and so do holistic MDs who sell vitamins. The mark up is generally 100%.

    15.They have no business treating young children- There is some science supporting the treatment of some young kids but the science is weak.

    16.The fact that patients swear by them doesn’t mean they are actually being helped- The fact that someone swears by anything means nothing scientifically.

    17.Insurance companies don’t want to pay for chiropractic care- Almost all do because patients want it AND in some studies it saves money.

    18.Lots of chiropractors do really strange things- A vague statement not worthy of comment

    19.Don’t expect chiropractic licensing boards to protect you- Correct and don’t expect medical boards to protect your from bad MDs.

    20.The media rarely look at what they do wrong.- The media constantly bashes DCs usually with the help of MDs. That’s why the AMA lost a antitrust suit in 1987 filed against them by DCs for restraint of trade.

    Who am I and what do I know? I am a chiropractic orthopedist ( 3 yrs extra training) and have an MS degree in nutrition. I am a college professor of anatomy and physiology. I also review DC’s records and treatments for AMI, a quality control organization for insurance companies. I know more than you so don’t even try to argue with me:)

    1. Chris Hickie says:

      21. They are antivaccine almost to a T, which in and of itself shows a complete lack of any true medical/scientific training and understanding.

      There…fixed it for you.

    2. Calli Arcale says:

      3.Their education is vastly inferior to that of medical doctors- lol This makes me laugh. The courses of study are similar with MDs getting into pharmacology and DCs getting into manipulation as treatment tools. MDs are better at diagnosing medical issues. DCs are much better as diagnosing musculoskeletal issues. So are PT docs.

      Physical therapists do not call themselves doctors unless they actually are doctors. They understand what you do not, that a degree that can be obtained with the equivalent of an associates degree is not equivalent to a degree that requires, at minimum, the equivalent of a master’s degree plus additional training just for the bare minimum. You can be a DC without a college degree. You cannot even begin training for an MD without already having a college degree. There is no way to call DC training comparable without some very creative accounting.

      4.Their legitimate scope is very narrow. The scope is non surgical musculoskeletal treatment and nutritional and lifestyle advice.

      I would consider a chiropractor’s nutritional advice comparable to that of my coworkers. They are not dieticians.

      6.It’s best to get diagnosed elsewhere- If it is an infection, or metabolic disorder, MDs are better at diagnosing. DCs are much better at dx of muscoloskeletal dx. Almost ALL DCs regularly refer to MDs. MDs almost never refer to DCs. Nice huh?

      Ah, so your real irritation is that they don’t give you enough business? You feel there should be reciprocity? Yet far more conditions are treatable by MDs than by DCs (by your own admission), so why would you expect it to be equitable? Meanwhile, I would not go to a DC for all musculoskeletal complaints. Their training is in the spine. A great deal of the skeletal system is not the spine. Carpal tunnel, for instance, is musculoskeletal, yet DCs are not qualified to diagnose that. They might think they are, just as many feel they are qualified to diagnose asthma or ADD as spinal problems.

      8.“Cracking” the back doesn’t mean much- An ignorant statement. The crack or “release” as a joint is manipulated causes nerve endings to be reset so the associated muscles spasm subsides. ( put very simply )

      This is an extraordinary claim that I have never seen validated. This is the *claim* upon which most chiropractic care is based, but you’re stating it as a fact. Please, show me the evidence. Because what I’ve read make it very implausible to me.

      10.They take too many x-rays- They used to until X rays were proven of minimal value in treating most back and neck pain.

      Given that many chiropractors do not change their practice in accordance with science, I think this is a naive statement.

      11.Research on spinal manipulation doesn’t reflect what happens in chiropractic offices- It does in mine but sure, many make absurd claims. Perhaps if MDs referred to scientific DCs the wacky DCs would have an incentive to change.

      See above. You are extrapolating yourself to the whole of the profession, and then allowing yourself to vent a little resentment.

      12.Neck manipulation is potentially dangerous- Really? Then why is my 3 million malpractice ins cost $1200 whereas a family MD who does no surgery pays 12 THOUSAND?

      Ah, it’s all about money, is it? Besides, people have actually died due to neck manipulation. It’s probably not very common (though as lousy as many chiros are with bookkeeping, it’s hard to tell), but that doesn’t mean there are no risks in neck manipulation. There is a risk. Doctors have to advise patients of small risks of death associated with procedures; surely chiropractors should too. Do you disagree?

      13.Most chiropractors don’t know much about nutrition- They don’t but some learn in post grad education and seminars. MDs know even less.

      Yes, chiros have the option of going to some seminars or continuing education. It is not required. The people you really want to see for nutritian are dieticians. That is the field with expertise in nutrition. Meanwhile, whether your claim that “MDs know even less” is true (and I doubt it, given that chiros are not actually required to take any nutrition training at all, so if they have any it’s purely out of the goodness of their hearts), it really doesn’t matter — you can’t say “well, they suck!” as an argument for why you’re great.

      17.Insurance companies don’t want to pay for chiropractic care- Almost all do because patients want it AND in some studies it saves money.

      Yes, it does save money; it’s a cheaper way of treating the worried well than MRIs and such. This is also why Mao introduced acupuncture; it allowed him to meet his promise of free health care for all.

      Who am I and what do I know? I am a chiropractic orthopedist ( 3 yrs extra training) and have an MS degree in nutrition.

      You are the exception, not the rule, yet you want us to take your experience and generalize it to the entire profession? I think not.

      1. William says:

        @ Calli Arcale
        Unless you’re a dietician defending the profession, I think you’ll find many non-chiropractors disagree about how superior dieticians are.

        1. WilliamLawrenceUtridge says:

          Well, most of the non-dieticians tend towards low-value degrees, prescribe a lot of quacky supplements and vitamins (as opposed to dieticians, who go with “food” as the best source of macro and micronutrients, in the absence of frank dysfunction), and generally think diet can treat diseases rather than being, at best, preventive for some.

        2. Calli Arcale says:

          William — I am a software engineer. About as far from a dietician as one can be, as we live on Mountain Dew and pizza. :-D Dieticians definitely have their flaws, but they seem to be the closest thing there is to a real nutritional specialty.

    3. WilliamLawrenceUtridge says:

      DCs are much better as diagnosing musculoskeletal issues. So are PT docs.

      I would agree with much of your commentary so far, but this point prompts me to ask – what is therefore the difference between a science-based chiropractor, and a physiotherapist? Doctors acknowledge that they are poor at treating musculoskeletal complaints (bar frank dislocation, which they are trained to replace), that’s why they refer to PTs. What do you add? Why not simpy be a PT?

      The scope is non surgical musculoskeletal treatment and nutritional and lifestyle advice.

      Given much of your training is musculoskeletal, what qualifies you to give nutritional advice? Registered dieticians have specific and explicit training in diet and health. Do you have anything comparable? Why would you not refer to a dietician? Why grasp at this added responsibility and scope of practice? What do you offer that a doctor can’t (given they take biochemistry and learn the individual molecular pathways and metabolic loops throughout the body), or that you are unqualified for and must refer to a dietician? Why not stick to bones and muscles?

      MDs almost never refer to DCs. Nice huh?

      Blame your own profession, which has a reek of lunacy. Yes, there are “mixers”, the redundant “physiotherapists with a twist” brand of chiropractors, but you are “mixed” with the “straights”, who think that cancer can be caused by back cracking. Is there any wonder that doctors are reluctant to refer? Have you considered cleaning up your own profession, and distinguishing yourself from your lunatic peers? Or, perhaps simply retraining as a physiotherapist? Your profession resembles used car salesmen – while there are certainly honest, conscientious ones, the people who make news, make waves and advertise are hucksters prone to exagerrated rhetoric and false claims. Why is being wary of them a flaw amongst doctors?

      The crack or “release” as a joint is manipulated causes nerve endings to be reset so the associated muscles spasm subsides. ( put very simply )

      [citation needed]

      Yes they do and so do holistic MDs who sell vitamins. The mark up is generally 100%.

      And the solution is to persuade patients that these supplements are unnecessary, they should get their vitamins from a balanced diet rather than pills. Doctors and chiropractors both shouldn’t sell vitamins.

      Correct and don’t expect medical boards to protect your from bad MDs.

      Actually, we very much do expect medical boards to protect patients from bad MDs. The boards often fail at this, to our disappointment. Which again, doesn’t justify bad chiropractic care.

      I am a college professor of anatomy and physiology. I also review DC’s records and treatments for AMI, a quality control organization for insurance companies. I know more than you so don’t even try to argue with me

      Two points:

      1) Which college? Is it a chiropractic college?

      2) Despite your argument from authority, I’ve made some points. What do you think of them?

  22. statchison says:

    What I find most compelling about Preston Long’s thesis for his latest book is that it essentially boils down to the confession of “I was simply wrong about everything.”
    “Everything” being that initial impetus that drives us at a young age to choose a career path and get mentally prepared to devote our life’s work to a discipline in the hope that we will be able to make a meaningful contribution. Sadly, after 120 years there is no such thing as a meaningful contribution to be made anywhere to the chiropractic profession. During all of that time, chiropractic has amassed no important body of knowledge, or managed to prove the claims regarding this treatment that DD Palmer had initially made.

    How is it possible that someone who is as clever and thoughtful, as Preston Long appears to be, become attracted to the idea of becoming a chiropractor in the first place? Chiropractic is nothing if not an accomplished advertiser of it’s own exaggerated merits. Based on their rhetoric, it sounds as though there must be something substantial going on. Especially if you do not have the critical thinking skills to figure out what is really going on. Over the years, plenty of smart people have been suckered into joining this cult like profession, and it does take some of them many years to figure out that everything they had worked for and put their time and energy into was only a mirage.

    1. Sawyer says:

      Blame the Shruggies. At no point in my first 25 years of life did anyone ever utter a word to me about chiropractic medicine being nonsense. No teacher, doctor, nurse, scientist, lawyer, author, professor or politician felt it necessary to inform me the questionable standards this field employed. Chiropractors were treated as being on par with, if not above, all other MDs in the town I grew up in.

      I don’t think cult is the right term to describe them, because it suggests that they are isolated from the real world. My experience has been the complete opposite. Chiropractors benefit tremendously from casual acceptance and intellectual laziness of their community rather than isolation and secrecy.

  23. susan-jillian smith says:

    Chiropractors and migraine are a truly horrible mix. There are several incidence of people with chronic migraine that had a stroke within a few hours of a “neck adjustment”. I am always warning people with this condition to stay away from Chiro’s. They are not real Dr’s and since migraine is a complex condition – a simple neck adjustment is not the answer. I have chronified pain that is managed by a neurologist. Stigmatized, misunderstood Illness’ like mine that are easy targets for homeopaths, even over the counter drugs, etc, use the word migraine like it is a throw away meaningless word. In fact there are variations that should be taken serious – and managed by Dr’s that understand. It breaks my heart to know the abuse that this illness is open to.

  24. Don says:

    Well – having had doctors inject things and prescribe pills multiple times – to the effect of often EXACERBATING the issue – I have found that in multiple scenarios, the chiropractor has had far better results. You, of course will say that this is anecdotal – but I notice that to this day, painkillers and muscle relaxers seem to be de rigour for so many types of injury – and they rarely even provide much temporary relief – much less contribute to any permanent solution. I admit to being VERY skeptical at first – but when “modern medicine” failed utterly – this “quackery” seems to succeed. I felt the same about acupuncture (and I still don’t really want to do it), but even that seems to have some actual basis – if the results of the few times I have allowed it to be done are worthwhile.

    I don’t generally go for all the new-age mumbo-jumboey stuff, but in this case… a fairly impressive number of failures (or worse) from paid, educated physicians stand across the table from a number of successes from chiropractic (at a fraction of the cost, even considering my chiro fees are NOT insurance covered… they still are less than the deductibles and copays I have paid for the educated failures…

    1. WilliamLawrenceUtridge says:

      Yep, you’re right – this is anecdotal. I’m working through my own bout of back pain right now. It’s a lot better than it was three weeks ago, when I could barely walk. You know what I did? Nothing. Not quite true, I saw a physio who assessed me, gave me some easy, low-impact, low-stress exercises, did not adjust my back, and it has been gradually getting better. All without any risk of cervical artery dissection.

      Since your practices have generally not been studied, how do you know your patients aren’t simply getting better simply because most injuries tend to get better over time? How do you know that the quackery isn’t simply giving patients something do do while they heal, irrespective the intervention? The exception is that chiropractors have some evidence for spinal manipulation being helpful for back pain (that’s why physiotherapists are adopting it), but even there – the assistance is acute. Over the course of months, the differences between those treated with usual care (pain relief and mild activity) and spinal manipulation narrow and eventually vanish.

      Evidence can be a pesky thing.

  25. Disgruntled-Aus-Chiro says:

    As an Australian chiropractor, i’d like to respond to the 20 points, as I somewhat agree with a lot of them.

    1. Chiropractic is not based on science
    Partially true, although there is a lot of research coming out. We don’t fully understand how we the targe
    2. Chiropractors promise too much
    100% agree, a lot of marketing/sales person tactics involved
    3. Their education is vastly inferior to that of medical doctors
    Agree. Basic sciences are almost the same. The difference is clinical exposure. In Australia, chiropractic students get 8 hours a week patient exposure (~ 350 patients in final year – around 7 patients a week – of which majority are the same patients). You can go through the year without seeing an acute disc, neural signs or the majority of orthopaedic cases that we learn about in the theory component. Compare this to medical students who spend 30+ hours per week in the final 2 years of their medical degree – whom get practical exposure to real patients
    IMO, chiropractic students are not clinically competent when they finish because they have not seen the majority of patient presentations.
    4. Their legitimate scope is very narrow
    Agree. Based on evidence for manipulation – acute LBP, neck and some forms of headaches
    5. Little of what they do has been studied
    100% agree. The weekend conferences of different techniques has very little study behind it. It’s all about marketing.
    6. It’s best to get diagnosed elsewhere
    Depends on the diagnostic capabilities of the chiropractor. Some are very good and detailed. Others just give a vague diagnosis.
    7. They offer lots of unnecessary services
    Depends on the clinic.
    8. “Cracking” the back doesn’t mean much
    For acute patients it can be good. For a so called “maintenance” patient, it doesn’t mean much
    9. If the first few visits don’t help, more treatment probably won’t help
    100% agree
    10. They take too many x-rays
    Depends on the chiropractor. Some techniques such as Gonstead require every patient to have an x-ray – totally unnecessary and against the evidence
    11. Research on spinal manipulation doesn’t reflect what happens in chiropractic offices
    Some what. There just hasn’t been enough research
    12. Neck manipulation is potentially dangerous
    Potentially, it can happen – as the research shows – even if it is 1/6 million.
    13. Most chiropractors don’t know much about nutrition
    In Australia, chiropractors are educated quite well on nutrition at university – more so than medical students
    14. If they sell vitamins, they charge too much for them
    100% agree
    15. They have no business treating young children
    100% agree. Should only diagnose at most, then refer
    16. The fact that patients swear by them doesn’t mean they are actually being helped
    100% agree
    17. Insurance companies don’t want to pay for chiropractic care
    Not sure about this in Australia
    18. Lots of chiropractors do really strange things
    100% agree. From not even touching the patient to adjusting the whole body for no clinical reason
    19. Don’t expect chiropractic licensing boards to protect you
    Unsure
    20. The media rarely look at what they do wrong.
    In Australia it is the opposite over the past few years. The medical community has been having a real dig. A lot of it is legitimate imo, although they should also mention the positives at times

    My biggest concern with chiropractic is the wellness/maintenance model. The truth is that running a pain based clinic where you treat for 6-8 sessions and discharge the patient is not economically viable. (I had a lecturer at uni who said he was changing his clinic from pain based to wellness – for financial reasons). There just is not enough patient turnover. There is no evidence out there that suggests the maintenance model reduces the risk of developing long term complications or even reduces the chances of acute injuries – even though this is what their spiel is based on. It is all about marketing and locking in the patient (or client or customer in some cases) long term.

    I will look to purchase this book, should be an interesting read!

    1. WilliamLawrenceUtridge says:

      In Australia, chiropractors are educated quite well on nutrition at university – more so than medical students

      How do you know this? Doctors are generally educated on the molecular and biochemical pathways that nutrients move through as part of their undergraduate and med school training. This claim is thrown around a lot, but I would be very curious to know the source of it. And what kind of training? I took a semester-long nutrition class, is it more than that? Further, registered dieticians are the professionals who are responsible for designing nutritionally adequate diets, and they take years to achieve this designation. Is it comparable to dieticians, or should you be referring? And for that matter – why? Why do chiropractors, who are at best physiotherapists with a twist, feel they need to learn about nutrition? I understand thtat for the crazy, “back cracking can cure cancer” ones it is hubris and lunacy, but why the non-crazy “I can help with muscle pain” chiropractors believe this as well is a little confusing to me.

      20. The media rarely look at what they do wrong.
      In Australia it is the opposite over the past few years. The medical community has been having a real dig. A lot of it is legitimate imo, although they should also mention the positives at times

      My standard response to points like this, by chiropractors like yourself who don’t think you can cure cancer and allergies, is to ask – why not merge with physiotherapists? Why not undertake what American Doctors of Osteopathy did, to essentially become science-based practitioners of musculoskeletal treatments? Why not undertake grandfathering into the discipline?

      My biggest concern with chiropractic is the wellness/maintenance model. The truth is that running a pain based clinic where you treat for 6-8 sessions and discharge the patient is not economically viable. (I had a lecturer at uni who said he was changing his clinic from pain based to wellness – for financial reasons). There just is not enough patient turnover.

      It sounds a bit, somewhat ironically given the chiropractic profession’s frequent criticisms of the medical profession, like the state of American doctors before the Flexner report. Medical schools were for-profit enterprises, with no appreciation of or care for students coming into or graduating from the schools. Their incentive was the profit motive, the more students they pushed through, the more money they made. I don’t know if there was a comparable glut of doctors as there appears to be of chiropractors – and hence the massive drive towards marketing and “trapping” of patients.

      1. Harriet Hall says:

        Perhaps it would help to have the chiropractic apologists give us examples of cases where their knowledge of nutrition improved a patient’s clinical outcome and involved something MDs typically don’t know.

  26. Disgruntled-Aus-Chiro says:

    How do you know this? Doctors are generally educated on the molecular and biochemical pathways that nutrients move through as part of their undergraduate and med school training.
    In Australia to be registered as as a chiropractor you have to have done biochem at undergrad. We also have 2 subjects worth of nutrition over 2 semesters. Medical students in Aus have only a few lectures on nutrition – which is frequently mentioned by Dr Karl (a science broadcaster and he also has a med degree).
    I agree with you though about why chiropractors should need to have such a big emphasis – should be left to nutritionists. I prefer just to stick to musculoskeletal.

    My standard response to points like this, by chiropractors like yourself who don’t think you can cure cancer and allergies, is to ask – why not merge with physiotherapists?
    This would be great f it happened. Although too many chiropractors in the past have stuffed things up and we are made to look like quacks. Physio don’t need to merge, they are already going strong.

    Note in some physio schools in Australia – they are starting to teach manipulation.

    Medical schools were for-profit enterprises, with no appreciation of or care for students coming into or graduating from the schools. Their incentive was the profit motive, the more students they pushed through, the more money they made.
    This is happening in Australian universities. They have increased the number of students dramatically over the past 5-10 years, the reason = they get more funding from the uni once they have a certain number of students enrolled.

    There market is already flooded with chiropractors in Australia, there will be a big problem in years to come with a large number of unemployed chiropractors.

    1. WilliamLawrenceUtridge says:

      Biochemistry and molecular biology are part of a standard medical school curriculum, part of learning how drugs affect and are processed by the body. Here is the Stanford University medical school curriculum, but from what I know, it’s hardly a disputed fact. Stanford’s curriculum also includes an explicit section on nutrition. Quackwatch also discusses this. Do doctors need more? People think so, but I think that idea is a little questionable. In my mind, a doctor spending time counseling a patient about the nitty-gritty details of diet, the role more of a dietician, is akin to asking a PhD-holding researcher in chemistry to teach grade eight students about the states of matter.

      But I’m glad we agree that chiropractors learning nutrition doesn’t make much sense. Perhaps you could be a leader of the push to merge physios and non-crazy chiros. Somebody needs to do it.

      Good luck to you.

  27. Dave says:

    Would you please give an example of what dietary advice you give that is different than what most doctors recommend for most patients (I’m not talking about people with celiac disease, lactose intolerance, PKU, etc) which is to eat a large variety of vegetables and fruit, limit red meat and replace it with fish, nuts, olive oil etc, and veryy inportantly reduce the portion sizes? I think the Mediterranean diet has been correlated with lower heart disease, and it’s known that 7th day Adventists, who are vegetarian, outlive their neighbors, but there are so many confounding factors contributing to outcomes that more specific advice is hard for me to give. Most of the studies I’ve seen on supplemental vitamins, other than folic acid for women of childbearing age or thiamine for alcoholics in withdrawal, have shown little if any benefit and some harm.

    Example: I read one study on a group of very healthy individuals who were on average 5’9″ in height, average weight less than 130 lbs, and consumed most of their calories from ungali, a corn based food, with almost 25% of their calories from refined sugars mostly used to sweeten tea. The confounding factor? These were elite Kenyan distance runners, who ran more than 70 miles a week (I came across this study because I’m a distance runner myself and was interested in what these men, who win almost all the world’s major marathons, ate.) I would certainly not recommend this diet to my patients or family and although it provided calories for these guys to train like they do I doubt it’s the best for longevity.

  28. windriven says:

    Hey everyone, there’s some douchebag chiropractor sliming this book over at Amazon. Gish Gallop. Straw men. Ad hominems. The whole playbook of the witless.

    It would be nice if a few of us went over and balanced the dialogue.

  29. Victor says:

    The crack or “release” as a joint is manipulated causes nerve endings to be reset so the associated muscles spasm The crack or “release” as a joint is manipulated causes nerve endings to be reset so the associated muscles spasm subsides. ( put very simply ). ( put very simply )

    ANSWER
    UTTER TRASH. COMPLETE BS. NONSENSE. DELUSIONAL.

    IN FACT NONE OF THE ABOVE IS REMOTELY REAL

    THE CALIM IS FRAUDULENT OR PSYCHOTIC.

    Think about spinal manipulation.

    Some thoughts – Take a gymnast:

    After a workout every joint in the body in a gymnast will SURELY be out of place and need at least a weeks chirp-gyro. How many gymnasts have a travelling chiro-gyro as part of the team. How many gymnasts are in agony after daily 3 to 4 hour practice. Any?

    Take the same gymnast. After a chirp-gyro manipulation the gymnast returns to practice and after 10 somersaults on the matt and back flips, has now surely undone all the chirp-gyro-phoney-pscyho-FRAUDULENT- manipulations? So what should she do now. Go back to “dr” Gyro and have every subluxation of every facet joint placed back in place? Then after bending down to tie her shoe laces all the joints in her spine have moved – AGAIN – and are out of place. So more chiro is required to reset these facet joints. Right? When does this nonsense stop? When does this drivel end? When do people stop talking to psychos expecting a logical answer? Do you carry on talking to a schizophrenic and expect insight? So why do people here entertain these clowns and even debate the absurdity that the chiros espouse? It shows lack of insight on the part of the science based crowd i.e. trying to point out the deficiencies in chiro-gyro. It is itself delusional to expect a logical answer from a deluded person. Think of a “profession” that has its birth and continuous belief in a slap on the back? A back slapping action that started a cultish pseudo science belief system that exists to this day. How stupid is the average person to believe this?

    The spine needs minute subluxations every moment of every day so that one can achieve the incredible mobility that we all have as humans. If there was someone who could increase the subluxation of the spine that may well be of benefit. By causing thousands of subluxations after a 3 hour DAILY training session, every gymnast should be on mega doses of morphine because they have literally subluxated every joint in the body every day during every training session

    So a chiro gyro should be running after the gymnasts and manipulating their spines after ever twist, backflip and somersault. Last time I looked there were thousands of chiros on the matt manipulating the spines of gymnasts. Surely everybody has noted this activity.

  30. statchison says:

    If we could be given the opportunity to go back in time to evaluate the very first chiropractic graduating class in Davenport Iowa, close to the turn of the 20th century, we would most certainly discover that these first individuals to be called Doctors of Chiropractic as close to being illiterate as is possible yet still meet the minimum standard required to pass a course devised by an uneducated, although enterprising Canadian grocer who had appointed himself to be the first “Doctor” of chiropractic.

    Similarly, if we could look into the state of medicine during that same era, we would no doubt find some significant deficiencies. However Medicine has been continuously reworked and reformed over time. Unafraid to work with constructive criticism.

    In his writings, BJ Palmer actually celebrated the simple minded individual who chose to faithfully apply his chiropractic principles of healing. For example, he wrote: “Give me a simple mind that thinks along single tracts, give me 30 days to instruct him, and that individual can go forth on the highways and byways and get more sick people well than the best, most complete, all around, unlimited medical education of any medical man who ever lived.”

    Has chiropractic done enough to reform itself into a scientifically legitimate profession, since those early days of the profession? There are plenty of apologists out there who will try to claim that it has. What all of these apologists have in common is that each one has made a very significant investment in becoming a chiropractor. It is understandable that they will try just about anything to defend their position, so that they can go on doing chiropractic things while believing that they made a sound and justifiable decision about their career path.

    In the earlier days of the internet, chirobase and quackwatch were about the only sources of skeptical views about chiropractic. Even on chirobase, you could find the odd example of attempting to give chiropractors the benefit of the doubt, when they added an article about how to chose an evidence based chiropractor. Implying to the reader that there were good chiropractors out there who completely understood the criticism of questionable practises in chiropractic and had managed to reform themselves. Clearly, despite the best intentions, even chirobase got this wrong. The idea of chiropractic reform is little more than a distraction, to keep enough people busy in the hopes that nobody will not realize that real progress is impossible.

    Can a former chiropractor be an unbiased and trustworthy source of information regarding what is wrong with the chiropractic profession? Preston Long, DC, PhD states that while he was practising, he gave it his best shot to try to do his work in an evidence based manner. One of the clues that this wasn’t working out for him was that he was not able to build a profitable operation. We could try to imagine a different scenario in which Preston Long did manage to do better financially with his “evidence based” chiropractic, and find a higher level of satisfication, subjectively, with the profession. The problem would be that he would still be essentially wrong, only he would not have realized it, and this book would still need to be written by somebody else. Ideally we would have more skeptics, who are not former chiropractors, interested in taking a closer look at and recognizing what is wrong with chiropractic. However it is still a very minor concern in the overall scheme of things.

  31. Adam says:

    This is post will most likely be ignored by everyone here that has chiropractic all figured out but here goes.

    My answers reflect things as they are today in the USA only. I make no claims to know what goes on in other countries or their specific laws governing practice.

    1. DD Palmer’s chiropractic philosophy was wrong based on current anatomy and physiology knowledge. So wasn’t the allopathic philosophy of the exact same time in history in the USA. Anyone that still holds his philosophy literally today is also wrong. I know many chiropractors that don’t. His patient care philosophy of treating the cause of disease instead of symptom and starting conservative care first wasn’t wrong and definitely wasn’t shared by the allopathic doctors of the time.

    2. Some do, but not all. I’ve never promised to cure cancer or any other chronic disease. You want pure anatomy and physiology rationale for treating asthma as a chiropractor? Here goes; costovertebral joint mobility, inspiratory and expiratory muscle strength & diaphragm activation. I can directly affect all of these things. Chiropractic is not limited to only spinal manipulation. It’s only one tool.

    3. Don’t know what college the author went to or what year he graduated in, but I did my internship in hospitals, long term care facilities, and multidisciplinary offices. I was asked to show a primary care resident how to do a comprehensive ankle sprain evaluation without the use of diagnostic imaging because she didn’t know where to start. She also had no idea what to do about it for home care or follow up.

    4. My legitimate scope is the entire neuromusculoskeletal system. Last time I checked, it’s a rather large percentage of our body mass. See #2 above. To say that because I’m a chiropractor and I do exercise, stretching, deep tissue work, nutrition and health education aimed at preventing chronic disease makes me really something else (physical therapist, massage therapist or nutritionist) indicates some sort of monopoly on the therapeutic intervention. However, now that there’s evidence to support the efficacy and validity of the one tool most commonly associated with chiropractic, others want to learn it too. I like physiotherapits, massage therapists and other healthcare providers. For me, chiropractic isn’t just a single intervention method, it’s a way of looking at disease. What the cause is, what isn’t doing its job right and why instead of what symptoms I need to control.

    5. I have as good sized stack of research backing all of the interventions that I use in my office. Show me a research article backing off label prescription use, long term efficacy (15+ years) of any medication currently employed to control chronic disease for that period of time or longer, I’ll even settle for a high success rate for the most commonly performed spinal surgeries for chronic pain without severe neurological deficit instead of asking for cost effectiveness.

    6. Misdiagnosis of carpal tunnel without comprehensive testing of the other brachial plexus entrapment points leading to unnecessary carpal tunnel surgery that results in no subjective improvement in neurological symptoms despite positive NCV study? Are you really sure you want to have the comprehensive exam after the failed surgery?

    7. I don’t know what unnecessary services that you are referring to but I have documented clinical rationale for every service I recommend and provide as well as layman’s terms explanations of exactly what they should accomplish in objective terms.

    8. I tell people all the time that the cavitation means nothing. Good joint mobility however is important as the synovial fluid exchange is affected by intra-articular pressure which is governed in part by joint position and range of motion. Joint manipulation temporarily decreases the intra-articular pressure of the joint which pulls more synovial fluid into the joint thereby increasing joint lubrication. It stimulates mechanoreceptors which down regulates nociceptive signals to the brain.

    9. I always give a cutoff for subjective and objective improvement, however the timeline for improvement varies depending on mechanism of injury, tissues involved and acute or chronic status among a long list of other factors. I tend to see subjective and objective within 2 visits but I’ll let it go to 4 with a more chronic condition.

    10. I don’t take any and I rarely order any myself.

    11. I’m not sure I follow but before doing any intervention (manipulation is only one that I use) I first have to identify and document need as well as establish objective measures of progress.

    12. As is every therapeutic intervention in existence. However lets talk risk benefit ratio instead. Risk/benefit ratio of using “safe” OTC medications to control chronic pain, using prescription pain medication, surgery, injections etc. Manipulation may not be 100% without risk but it has a very reasonable risk/benefit ratio when compared with alternatives and efficacy studies put it as beneficial as any of the above mentioned standard interventions. Incidence rate of VBAI which is I’m certain what this refers to is drastically lower than the fatal side effects incidence rates seen with prolonged use of NSAIDs.

    13. I won’t argue this point. I will add that most primary care providers, most physiotherapists and most “insert healthcare profession here” don’t either. In the USA, formal nutrition training is lacking in most professions that would benefit from it. I do my own reading on this as part of my professional development and I start with public health studies. Your mileage may vary.

    14. I won’t argue this point. I will add that almost every place that does sell vitamins charges too much. It’s an addiction that gives a false sense of security. Instead I talk to patients about eating a healthy diet and exercising routinely. It seems that most of their primary care doctors don’t have time to explain what a healthy diet actually is.

    15. I will argue this point unless you believe that mechanical injury to joints, ligaments or tendons isn’t possible until adulthood. Sports injury alone starts as early as 6 years old. See comments above about spinal manipulation not being my only treatment method. I personally won’t treat until a child is fully weight bearing and I don’t ever manipulate a joint without dysfunction. That being said, a child in my office is rarely too young to benefit from stretching, exercise and neuromuscular training. These are all in my scope of practice and I make full use of them.

    16. Not going to argue this one either, that’s why I use objective functional measures.

    17. Insurance companies in the USA don’t want to pay for anything. Every provider that I talk to from every field of healthcare complains about reimbursement. This sounds like whining from a former chiropractor that didn’t know how to document condition, treatment and objective improvement accordingly. We get reimbursed well enough.

    18. Lots of (insert name of group here) do really strange things. If you don’t understand the recommendations, reasons, expected outcomes etc of a provider then just get a second opinion. I know plenty of chiropractors in the USA that don’t do a lot of really strange things.

    19. Don’t expect any government agency to do your thinking for you. Ask questions and use that squishy thing between your ears to decide whether it makes sense or not. My nephew went into the pediatrician’s office with the symptoms of a sinus infection. The pediatrician did a limited history, no exam and sent my sister-in-law home with a diagnosis of allergies and 3 prescriptions without even requesting an allergy test. This level of laziness from a profession that is claimed to have drastically better education levels and clinical practices. No one ever gets treated in my office for anything without a comprehensive history and exam.

    20. The media looks for news stories that sell commercial slots. It just so happens that the American public cares more about what celebrity had naked photos of them leaked on the internet than about public health or safety. The only time a medication recall is heavily publicized is when there is a class action law suit involved.

    For all of you skeptics saying that chiropractic is full of quacks, I say no it isn’t. For every person that will follow my post with a why don’t you change from chiropractic to this, that or the other healthcare title instead: money. The way the US education system works, I’d not be allowed to test out of courses I’d already taken to earn advanced standing and complete my degree sooner. I could become an osteopath and be forced to retake courses that I already have done so that they can earn their tuition dollars. The same thing applies to medical doctor or doctor of physical therapy. I could become a physiotherapist and work under an even more restrictive license in the US than the one I already have just so the name on my degree was something more culturally appealing to everyone else, but I won’t. I do believe that it is possible to practice ethically and employ every one of the interventions allowed under my scope of practice which if I haven’t spelled it out yet is significantly more than just spinal manipulation. I do believe it is possible to reform the profession over and over again just like the medical profession claims to have done. My patient care philosophy isn’t wrong. I look for the root cause of the health problem, no matter what that cause is and work with it accordingly. When you go back far enough, do you know what the real cause of most disease is? It’s ignorance about how to take care of yourself. People don’t know what a healthy diet is anymore, they don’t get routine physical exercise, the do repetitive tasks daily, they live sedentary lifestyles, they pollute themselves and their environments and then wonder why they got sick. The most powerful tool I have and the reason I can have a positive impact on every disease is evidence based health education which I just so happen to give to every patient at every visit. That is why I will remain a chiropractor and I will force the bad apples of my profession out little by little through any means morally available until chiropractic skeptics don’t have anything left to complain about.

    Adam

  32. Tom S says:

    OK folks, I am suppose to believe, Mr. Long took 30-yrs in the chiropractic field to find out he made a mistake?

    Now, right a book and make money over what he has learned and to warn us all?

    COME ON MAN !!!!!

    The bottom line is, Mr. Long knew what he was doing, and probably made good money as a chripractor and couldn’t leave the luxury of the life and money he made in the field.

    I don’t believe Mr. Long thinks everything is wrong with the chiropractic field, just that he disagrees with some of the practices, schooling, and that there are lot of things that are either still pseudo-science or quackery, but anyone reading this post or the guys book can figure for themselves that if chiropractic care was ALL wrong, then there is no way in hell States would license folks as DC’s, nor would they authorized to bill our insurance companies for services, even if insurance companies don’t like it.

    In the end, this guy Mr. Long got sick and tired of being a chiropractor and has decided to lash out at the entire chiropractic profession for all the 30-yrs he has been involved in it and apparently has figured out that he should have never became a DC in the first place. That was his choice and he could have left years ago, instead of trying to make money and write a book.

    1. windriven says:

      “OK folks, I am suppose to believe, Mr. Long took 30-yrs in the chiropractic field to find out he made a mistake?”

      It didn’t take 30 years. Long has been speaking out for some time.

      “The bottom line is, Mr. Long knew what he was doing, and probably made good money as a chripractor and couldn’t leave the luxury of the life and money he made in the field.

      “[I]f chiropractic care was ALL wrong, then there is no way in hell States would license folks as DC’s, nor would they authorized to bill our insurance companies for services, even if insurance companies don’t like it.”

      Really? Some states license naturopaths, acupuncturists, and other quacks. Quacks lobby state legislatures because licensure gives them the appearance of legitimacy. Legislatures pass licensing bills because it gives them some control over activities that are already taking place. It is a devil’s bargain but it happens all the time.

    2. Harriet Hall says:

      @Tom S,
      You owe Preston Long an apology. You have no right to make unfounded assumptions when you have not read the book. He realized he had made a mistake during chiropractic school but was in a situation where he had to bite the bullet. He thought he could do the “good” things without the “bad.” He struggled to eke out a living doing only evidence-based treatments as he watched colleagues making money hand over fist by unscrupulous practices. He only survived because of his wife’s income. He NEVER made “good money” as a chiropractor because he was unwilling to compromise his principles. And he HAS been speaking out for most of his career. He published “The Naked Chiropractor” in 2002 and a book on evidence-based treatment of back pain in 2006. His history is very similar to that of Samuel Homola, who also realized early on that chiropractic education was a farce, but who graduated, did his best to treat patients with evidence-based treatments only for short term treatment of musculoskeletal pain, struggled to make a living, and made enemies out of other chiropractors for revealing what went on “Inside Chiropractic.” It’s easy to say he
      “could have left” but not easy to do when you have no training for other jobs and need a source of income.

  33. Tom S says:

    Sorry for typos on my post, I mean to say “Write a book”.

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