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Chiropractic gimmickry

[Editor's Note: Today, we have a guest post from Sam Homola, who, as you recall, practiced as a chiropractor until he ultimately realized that there is no evidence that subluxations exist. Since then, he's discussed in various places, including, we are pleased to say, SBM, his skepticism regarding chiropractic. Enjoy!]

Much has been written (and published on this site) about the implausibility of chiropractic vertebral subluxation theory which proposes that a vertebral subluxation complex or a spinal joint dysfunction “may affect organ system function and general health.” Associated chiropractic gimmickry that might be harmful as well as a waste of time and money should be also be brought to the attention of concerned consumers. As a chiropractor (retired) who has renounced subluxation theory, it might be helpful to share my concerns about some dubious chiropractic methods that are foisted upon an unsuspecting public, unchallenged in the market place.

The Neck Curve Pitch

I often receive mail expressing concern about treatment or services provided by a chiropractor. One of the most common concerns comes from chiropractic patients who have been told that they have a flattened or reversed cervical curve that portends dire consequences if the normal cervical curve is not restored. The patients are informed that failure to undergo a treatment program to realign the cervical vertebrae will allow degenerative changes to occur, progressing to “Stage 4 degeneration” that will trigger the development of life-threatening illness. Frightened by such scare tactics, these patients are usually persuaded to undergo a long course of neck treatment, which may involve use of a special traction harness to force hyper extension of the cervical spine.

It is not unusual for some individuals to have a straight cervical spine or some reversal of the normal cervical curve and have no symptoms at all. Such deviations from normal may be structural in nature, usually cannot be changed, and are not often significant. A cervical curve can be temporarily altered when neck muscles are in spasm, but the curve (or lack of curve) that is normal for the individual returns when the spasm subsides. When there is no pain or loss of mobility in the neck or cervical spine, no treatment is needed. Any attempt to “restore the normal cervical curve” by using manipulation or forced cervical extension is unnecessary and may subject the patient to risk of injury to vertebral arteries.

Stretching the Truth

One of the most popular forms of treatment currently being offered by chiropractors is a form of motorized computer-controlled traction called “decompression therapy.” It is an expensive form of axial or longitudinal traction provided by machines that cost up to $125,000. While any form of traction might be helpful in relieving some types of back pain, promoters of decompression therapy claim that using a computer-driven table to control the level of disc decompression will rehydrate and restore a disc structure by pulling nutrients into ruptured or degenerated disc cartilage. Advertisements promoting decompression therapy often suggest that surgery for a herniated disc can be avoided by using decompression therapy to “restore the disc.” There is no credible evidence to support this contention.

Expensive decompression therapy is unlikely to be any more effective that simple mechanical or manual manipulative traction in the treatment of back pain or disc herniation. According to a current Aetna Bulletin (No. 0180) dealing with vertebral axial decompression therapy, “…there is no adequate scientific evidence that proves that vertebral axial decompression is an effective adjunct to conservative therapy for back pain. In addition, vertebral axial decompression devices have not been adequately studied as alternatives to back surgery.”

Consumers should beware of testimonials extolling the miracle cures of decompression therapy, and they should refuse to pay for a course of traction treatments that may cost several thousand dollars. Patients are often enticed into paying for such treatment in advance in order to reduce the cost of the treatment.

When there is no progressive neurological damage caused by disc herniation, disc surgery is rarely needed or indicated. With time, the disc protrusion will be absorbed and the ruptured disc cartilage will degenerate, with or without treatment, as it would normally do after disc surgery. While a degenerated disc can cause some chronic or recurring back pain, nerve root encroachment rarely occurs unless there is spur formation or bony overgrowth near the intervertebral foramen (where a spinal nerve passes between two vertebrae).

Locating Imaginary Subluxations

Many chiropractors maintain that they can use fingertip palpation to locate vertebral subluxations. Some use computerized instruments that combine thermography with surface electromyography to measure skin temperature differentials and electrical activity in muscles claimed to be associated with vertebral subluxations. A hand-held scanning device is moved up and down the spine, in contact with the skin, measuring electrical activity or skin temperature on each side of the spine. The results appear on a screen that displays graphic bar colors alleged to indicate the location of subluxated vertebrae. Even when there are no physical or neurological symptoms, such testing may be used to persuade a patient to undergo treatment for correction of multiple vertebral subluxations in order to prevent the development of symptoms.

While surface electromyography (not to be confused with needle electromyography) testing might be helpful in evaluating the function of muscles, and thermography might be helpful in detecting the symptoms of such things as reflex sympathetic dystrophy (an autonomic disturbance affecting blood flow to the skin), it is an oxymoron to suggest that either of these tests can locate a chiropractic subluxation that has never been proven to exist. Thermography and surface electromyography are considered to be experimental and investigational with no established validity as diagnostic techniques.

Needless to say, computerized instruments used to locate subluxations that “cannot be detected any other way” can be an effective gimmick for selling chiropractic adjustments to asymptomatic patients who have imaginary vertebral subluxations.

Space-Age Subluxation Correction

Once “subluxations” have been located, an attempt is usually made to correct them by manually adjusting the spine. In many cases, however, instruments may be used to “tap the vertebrae into alignment.” The most common instrument used is a hand-held spring-loaded rubber-tipped stylus that delivers a tap to the offending vertebra. Other variations, some electrically powered, deliver a rapid succession of taps, or a tap with a torque. A special table-top machine designed exclusively to deliver a stylus tap to the atlas, the uppermost cervical vertebra, is sometimes used by chiropractic “upper cervical specialists” who maintain that a misaligned atlas is the primary subluxation causing most ailments.

One “NASA-inspired” instrument uses a piezoelectric sensor to locate and correct vertebral subluxations. A hand-held device shaped like a tuning fork is placed on the spine (straddling the spinous processes). The instrument delivers a vibratory force that measures movement in a spinal segment, which is graphically displayed on a computer screen to indicate the degree of movement or fixation of a vertebra. It is claimed that correction of the subluxation or fixation can be made by using the same hand-held instrument to deliver an oscillating force to restore normal movement, as determined by the piezoelectric sensor. This instrument is used as both a diagnostic instrument and a therapeutic instrument.

If there were any scientific evidence to support the contention that use of adjusting instruments to realign the vertebrae would improve health, such “space-age” instruments would be used in hospitals around the world; at the present time, they are used almost exclusively by chiropractors. FDA approval of the use of instruments for chiropractic adjustment of the spine does not mean that the instruments have been proven to be effective.

Patients who are fearful of back-cracking spinal manipulation (especially the elderly who may have fragile bones) are often subjected to instrument adjusting to correct imaginary subluxations that are alleged to be the cause of back pain and a multitude of other ailments. Some subluxation-based chiropractors treat all of their patients with adjusting instruments.

Paying in Advance for Unnecessary Treatment

One of the most disturbing complaints I hear comes from chiropractic patients who have paid thousands of dollars in advance for a course of treatment lasting several months─after succumbing to a high-pressure sales pitch involving scare tactics. These patients have usually opted to discontinue treatment because symptoms have either worsened or disappeared. Most have signed a contract, however, that does not allow a refund, even if the treatment regimen was not completed. Some have used a chiropractic “health care credit card” to borrow the advance payment from a loan company, leaving the patient legally bound to repay the loan.

It’s never a good idea to pay for chiropractic services in advance. Treatment should be discontinued if symptoms have worsened after one week of treatment or have not improved after two to four weeks of treatment. In many cases of neck or back pain, symptoms will often resolve after a few weeks, eliminating the need for further treatment. Patients who have signed a contract for discounted long-term treatment that involves correction of vertebral subluxations, however, may be told that subluxation-detection instruments indicate that they still have subluxations that need to be corrected to prevent a recurrence of symptoms. Treatment may then be continued as a preventive-maintenance measure, even in the absence of symptoms─all in keeping with subluxation theory which proposes that correction of vertebral subluxations will “restore and maintain health.” Such unnecessary treatment is a needless expense, and it poses a risk that outweighs benefit, especially in the case of neck manipulation which is potentially dangerous.

It is generally considered to be unethical to ask for contracted payment in advance for long-term treatment of a health problem, since such an agreement is tantamount to a guarantee that the treatment will be effective. There is no way to determine if chiropractic treatment might be effective or how many treatments might be needed. I generally advise chiropractic patients to pay for treatment per visit on an as-needed basis and only for treatment of mechanical-type back pain and related problems. A “free exam” or a request for payment in advance should raise a red flag. Few consumers are aware that a diagnosis of “subluxations” in a chiropractor’s office is in itself a red flag.

To smite all humbug, however big; to give nobler tone to science; to set an example to abstinence from petty personal controversies; and of toleration of everything but lying; to be indifferent as to whether the work is recognized as mine or not, so long as it is done.

Thomas Henry Huxley, 1856

(A personal note: Science-Based Medicine has evolved to become one of this nation’s most respected blog sites. Journalists, lay persons, and health professionals who are seeking reliable information about health-related subjects are visiting this site on a daily basis. A new post, published daily by health-care professionals who are authorities in their fields, covers a different subject each day, ranging from quackery to controversial issues in science-based medical care. These blogs are written in a reader-friendly fashion that allows readers at every level to understand and benefit from what they have read. An occasional argumentative response to critical analysis of a pseudoscientific healing method often provides a good example of how someone can be adversely influenced by indoctrination into a belief system, further illustrating the need for an informative site like Science-Based Medicine where there is no reluctance to “smite all humbug, however big.”)

Posted in: Chiropractic

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54 thoughts on “Chiropractic gimmickry

  1. ARE YOU A DOCTOR OF CHIROPRACTIC? If so, then you need the LATEST and GREATEST in SPINAL DECOMPRESSION! With the new DOC 2000 table your patients will experience the ULTIMATE in SUBLUXATION ELIMINATION TECHNOLOGY! The new DOC 2000, from EUROTECH, will find and eliminate every single SUBLUXATION in your patient’s body. The new DOC 2000 is only $150,000, and yes, layaway is available, as is ultra cheap 19% APR financing!

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  2. DevoutCatalyst says:

    From Google University,

    “Finally, before starting your neck pain treatment, your chiropractor will do a general medical examination, checking your blood pressure, look for swollen lymph nodes, listen to your lungs, and perhaps even do a breast exam.”

    Chiropractors say the darndest things. When they’re not scheming to get the bra off, they may be hypothesizing about vitamin C as a treatment for suspected rabies exposure in lieu of standard care. You can peruse chiropractic sites and find endless nonsense heaped upon nonsense. The simplest advice would be to avoid all things chiropractic. Run! Especially if you’ve been bitten by a potentially rabid animal! Or encounter a rabid chiropractor!

  3. Oh my, sadly this isn’t made up:

    http://chirocity.com/nervo-scopenervoscope.aspx

        The Nervo-Scope is used and respected for its efficient, informative and accurate results. These instruments are the most sensitive temperature measurement products available today. All of the competitive products compare themselves to the Nervo-Scope because, after 50 years, it still sets the standard for accurate and reliable results.         

      Used and trusted by thousands of chiropractors, Nervo-Scope has proven to be extremely valuable in patient assessment, reliably detecting and measuring minute heat differences in the tissues along the spine.Nervo-Scope can be used comfortably and reliably for both pre and post adjustment assessment enabling the capability to produce information as used by the most successful clinics, universities and colleges. The electronic circuits in these instruments amplify the temperature differentials which are viewed with a large meter scale with a fluorescent pointer, thus making even the smallest temperature changes easy to see.

    The Analagraph Recorder, when used in conjunction with the Nervo-Scope ETS-7 or ETS-8, provides a permanent record to log and chart the amount of existing heat differences indicated from your Nervo-Scope readings. The Analagraph Recorder is a valuable and efficient tool in documenting patient assessments and providing a pattern reference for pre and post check of patients. This information indicates any change of reading, thus establishing a pattern which may assist in determining the frequency of adjustments.

  4. Haha, here’s the link to the activator Sam mentioned:

    http://chirocity.com/activator1.aspx

    Now with BlueTooth! :) I don’t want to spam SBM with all the chiropractic quackery, because it may fill up the site’s MySQL database. But just look around on that website. So many thousands and thousands of dollars of complete quackery equipment. That is so damn sad.

  5. Janet Camp says:

    Chiropractic gained respectability through successful lobbying for insurance reimbursement, a tactic now being used by the rest of alt, complementary, integrative “medicine”. Reimbursements to chiros should cease and their “colleges” should be shut down. They are not “doctors” of anything at all–not even in the academic sense. It is the worst kind of “see the Emperor’s beautiful new clothes” imaginable.

    It would set an example for the rest of woo-dom if chiropractic could be shut down. I know someone who is not at all well off who uses her social security for “wellness” adjustments from a chiropractor. She thinks it will prevent cancer, an idea the “doctor” does nothing to dispel.

  6. tgobbi says:

    Sam mentions payment in advance. Just 2 weeks ago I had an experience that was new to me. (Please forgive me if this is a repeat of something I already wrote about)!

    Responding to a blurb in the local newspaper I went for a free chiropractic exam at an area YMCA. Chiro One Wellness Centers, a franchise operation with offices in various parts of the U.S. sent someone (not a DC or, as far as I could tell, a person with any training other than what he had been taught by rote) to the “Y” along with the ubiquitous chiro spine chart. He asked me a number of questions, eyeballed my posture and told me that, yes, I had some of those pesky subluxations. The office was offering a special reduced-price exam and consultation, along with two x-rays, at a substantial discount. Normally $400.00 I could sign up RIGHT NOW for only $40.00!

    So far there’s nothing unusual about any of the above; I see it all the time. What floored me was that they demanded payment on the spot, right there at their table at the YMCA! Credit cards and checks are acceptable. Maybe I’m naive but this struck me as a new low, even for the chiropractic “profession” which is about as low as one can get.

    One wonders how many suckers they snared…

  7. Scott says:

    It’s quite hard to see how chiropractic is practiced and not come to the conclusion that practicing as a D.C. should be considered prima facie evidence of criminal fraud.

  8. Grant Ritchey says:

    Thank you for an excellent article, Sam. In dentistry, we are seeing a rapid growth in chiropractic philosophies, especially as it pertains to treatment of TMD (jaw joint issues). One school of thought places a huge emphasis on the alignment of the atlas in the overall general and dental health of the individual. (Example: http://www.itsmn.com/symptoms/). We are also seeing an upswing in methodologies such as cranial manipulation (Example: http://www.chirodontics.com/), which promises to cure whatever ails you. (See also Steve Hendry’s and my article in SBM: http://www.sciencebasedmedicine.org/index.php/cranial-osteopathy-in-dentistry/) All of these are either unproven or proven to be ineffective in the literature, but their practice continues to grow.

    Grant Ritchey

  9. mattyp says:

    Are you fair dinkum? Analograph recorder?
    Makes me think of Arrested Development… This I’ve never heard of before.
    Dear God no wonder…

  10. @JanetCamp,

    Ouch! I 100% agree with you! Well said! It is bizarre that these psychopaths are allowed to continue “practicing.”

  11. Sam Homola says:

    Thank you Grant Ritchey. The October 17, 2011, SBM article “Cranial Osteopathy in Dentistry” by you and Steve Hartley was a valuable contribution and a good example of the critical thinking that exemplifies the mind set of a true scientist.

    Steve Hartman, a faculty member of an osteopathic college, wrote a similar article, “Cranial Osteopathy: it’s fate seems clear,” for an online journal titled “Chiropractic & Manual Therapies,” in which he concluded:
    “Until outcome studies show that these techniques produce a direct and positive clinical effect, they should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”

    http://chiromt.com/content/14/1/10

    I am always amazed to see practitioners with advanced degrees subscribe to such nonsense as osteopathic craniosacral manipulation or chiropractic atlas adjustments. I suspect that these practitioners simply lack inherent critical thinking skills, a quality not assured by an academic degree.

  12. Linda Rosa says:

    I was taken hundreds of times to a chiropractor as a child in the 50s and 60s. This guy probably was using one of the infamous Ruth Drown machines, though I’ve never seen anything exactly like it in photos. After a crackdown by authorities, the machines was moved to a crawl space under the chiropractor’s house where it continued to be used. The chiropractor claimed the machine could not only diagnose and heal, but also tell him when people would die.

    The craziest gadgetry this chiro used was actually maneuver involving a “concentrated liver pill.” He would place the pill along my spine where he suspected there was a subluxation. Then he had three seconds to click my heels together. (I had to be wearing shoes with leather soles – and be naked, of course – for this to work.) If he was right about the location of the subluxation, then, as he predicted, one of my legs would shorten, while the other lengthened. It was a simple trick to play on my mother who watched on the first time. But while I couldn’t see what was happening, I could feel this guy tugging on my legs as he banged my feet together. My mother refused to believe it was a trick.

  13. DevoutCatalyst says:

    Would chiropractors of today still insist on having young girls naked for their little leg growing off-Broadway carnival act? Perhaps? Too bad the statutory of limitations has run out for this particular fetid coprolite.

  14. lizditz says:

    Thank you Dr. Homola for another informative article.

    My personal bêtes noires are the “chiropractic neurologists” and any chiropractor claiming to be able to “help” autism, ADHD, and learning disorders such as dyslexia.

    I recently ran across one new to me, a scamster named Bob de Maria. He claims to be able to heal ADHD. This one has the claim that chiropractors aren’t neck and back doctors, they are nervous system doctors

    He is anti-vaccine.

    Yerk.

  15. Chiroraper. Absolutely disgusting and sadly not surprising. These scumbag pieces of garbage need to be escorted off a cliff.

  16. rwk says:

    @Skepticalhealth
    Why don’t you lead them off the cliff and go away with them yourself. We want you gone!

    SBM, here is your hero:

    http://twitter.com/SkepticalHealth

    A true professional. I’d bet your patients, your hospital and state boards would be proud of you.
    And your parents.

    Be gone!

  17. lol :) You post my twitter, which is the same as my user name, and is the same as a website I recently abandoned. My username here used to link to it! So lets get things straight. I cuss a lot on Twitter, and you defraud innocent sick people out of hundreds of thousands of dollars each year, all the while providing minimal if any treatment, while putting them at risk for stroke, paralysis and death. You partake in a quack practice that is regularly linked with everything from rape to death, is founded upon a disproven religion, and promotes anti-medicine and anti-vaccination viewpoints. Yeah, I should be ashamed…

  18. rwk says:

    @skepticalhealth,
    you actually don’t know what I do, right scientist? But you do make stupid assumptions based upon what you see
    on the internet and you say things that are so unbecoming of a doctor that if your public knew they’d be going to someone else. And I’d love for them to know. But I’m not going to waste my time on you. Go away from this site, you add nothing.

  19. Badly Shaved Monkey says:

    rwk

    Please tell me, are you a chiropractor?

  20. @rwk, any input on chiropractic itself? Any input on the fact that chiropractors use these completely fraudulent devices to “diagnose” and “treat” people? And if you are going to say that “it wasn’t taught in my school!”, then how does practcailly every chiropractor end up doing the same garbage? Why are these websites considered “chiropractic supply houses!”, and why do they build very expensive, yet completely fake, equipment and target it for use directly by chiropractors? And what mental deficiency exists in these people that allows them to believe a table like that will treat back pain, or that those ridiculous pneumatic tools will find and treat “subluxations”? Or that you can hook someone up to a computer and it can magically detect all these back problems. How can they believe such stupid things?

    Oh, and in the other chiropractic post here on SBM, the one that demonstrated the occurance of vertebral artery dissection occuring after manipulation of the cervical spine, do you advocate that technique? Do you think that cervical spine manipulation is uniquely effective (ie, greater than teaching someone a few exercises, greater than simply giving a pain pill and waiting, and greater than apparently randomly putting tape on someone’s neck) to warrant its use in spite of the fact that it can cause stroke, paralysis, and death?

    Also, I’d like your input comparing your profession to PT. In my naive view, and when I look at the curriculi (curriculums?), it seems that the chiropractic curriculum spend lots of time on so many things that are not related to treatment. You guys learn the basics of running an office, marketing, you learn how to do an x-ray machine (it’s amazing that you learn it sooo much faster than a legitimate x-ray tech, who spends years in schools learning how to harness ionizing radiation), the history of chiropractic, subluxations, quackery, etc. I just checked the PT curriculum for the PT school in my state, and it only had 1 three-hour class devoted to “business admin and marketing.” So chiropractors are less competitive students, less science based, and receive less training. How is it that chiropractors can consider themselves superior to a profession that they are in fact in every way inferior to?

    I’m genuinely intereted in hearing your answers to these questions.

  21. tgobbi says:

    SkepticalHealth: “… it seems that the chiropractic curriculum spend lots of time on so many things that are not related to treatment. You guys learn the basics of running an office, marketing, you learn how to do an x-ray machine (it’s amazing that you learn it sooo much faster than a legitimate x-ray tech, who spends years in schools learning how to harness ionizing radiation), the history of chiropractic, subluxations, quackery, etc…”

    Which, if true (and I have no doubt that it is), corroborates my view that chiropractic is not a healthcare profession; it’s an elaborate marketing scheme!

  22. Sure, just have a look at almost any chiropractic college’s admissions information:

    http://www.nuhs.edu/academics/college-of-professional-studies/chiropractic-medicine/curriculum/trimester-by-trimester/

    They partake in rigorous courses such as “the fundamentals of natural medicine and historical perspectives”, “business principles”, “whole health concepts and philosophies”, “botanical medicine”, “marketing”, “communication”, more “business planning”, a second “botanical medicine” class, “clinical natural medicine”, etc. And then these schools offer electives where you can learn any of a number of absolutely ridiculous, shameful techniques like cranio-sacral, NUCCA, etc. It’s just pure garbage.

    It is funny reading over their curriculum, as it seems like some of the classes have legitimate scientific-sounding names. But these are the same people that tell their patients to not get vaccinations, that bacteria don’t exist, put them on pure protein diets, and tell them they can cure them with whatever magical garbage they bought off of a website. Oh yeah, and they also invent diseases. I wonder if they have, in their classes, presentations that say “Oh, those stupid medical doctors don’t know about this disease, it’s called ileocecal therapy, and we just manipulate the ileocecal valve and it will cure any symptoms! But they’re too stupid to know about this!!!!”

  23. mousethatroared says:

    rwk – “SBM, here is your hero”

    LOL – I’m not aware that anyone appointed SkepticalHeath our hero. Did I miss the memo? If I were to pick a SBM hero it would probably be Harriet Hall with several other extremely close seconds.

    Don’t be silly. If you don’t like SH’s posts either dispute them or ignore them, but don’t try to act like one voice can be generalized to a whole group of people with diverse backgrounds and interests.

    And, by the way, As much as I’d like to thwack SH upside the head 90% of the time, If I was sick, I’d still seek his care as an MD over that of a chiropractor. When one looks closely, one can see that he is actually thinking about using the science and evidence to find the most likely way to improve people’s health. This differs from many chiroprators who seem to start with a therapy then look for a way to convince people that it may do them some good.

  24. Yeah, that was a really weird comment for him to make. Chiropractors on this blog have done everything from calling me a communist to accusing me of having been molested as a child. Is it it any wonder I post anonymously?

    @rwk, I’d really be interested in you answering the questions I posted above.

  25. lilady says:

    Hmmm, did someone mention spinal decompression machines? Here, from a chiro discussion board, is an in-depth discussion of those machines:

    http://chirotalk.proboards.com/index.cgi?board=fraud&action=print&thread=2929

  26. lilady says:

    Hmmm, did someone mention craniosacral therapy? How about this article about an infant who died in Holland after undergoing craniosacral therapy?

    http://anaximperator.wordpress.com/2009/05/07/infant-dies-after-craniosacral-therapy/

  27. mousethatroared says:

    SH “Is it it any wonder I post anonymously” – Ummm, well – even if we put all the anti-CAM stuff aside, I can’t see how the needs anger management, wing nut aspects of your online persona would be an appealing feature on your resume.

    Unless you are applying to be the Drudge Report personal physician. Oh wait, no, I think I’ll send the chiropractors over that for that job. ;)

  28. BillyJoe says:

    Harriet,

    In the article you link to above, the link to your article in the Skeptical Inquirer seems to be broken.

  29. BillyJoe says:

    Michelle, are you suggesting that SH posts his professional views here anonymously in order to protect his professional reputation which would otherwise be harmed by the manner in which he expresses those professional views here?

    I am much more direct here than in real life. In real life, I am still pretty firm about putting right the mistaken views of others, but I go about it in a much more congenial way. I am not an ‘accommodationist’ though. But, no matter how you go about it, at the end of the day, people are still offended when you take down their heart felt beliefs.

  30. BillyJoe says:

    ….in the above, I was referring to obviously mistaken views.
    (ie when there is so much evidence against that view for it to be taken seriously and where the person holds that view either in ignorance of the evidence against it, or in spite of it)

  31. mousethatroared says:

    @BillyJoe – I’m referring to political, social views, here and on his twitter feed, not his professional views.

    It’s common for folks with more adament political, social views to post (vent) anonymously, since potential employers or other professional contacts may frown upon a colorful or politically controversial online presence.

  32. ConspicuousCarl says:

    #RWKfail

  33. DevoutCatalyst says:

    I was wondering if a chiropractor ever gave a TED talk, I mean, TED sometime set the bar a bit low, Rick Warren, for example, but NO, there are no chiropractors giving talks that are amazing, inspiring, jaw subluxating, life-changing, etc. Instead there are over 1100 entries of spam (in individual community profiles) by chiropractors advertising their practices.

    TEDCred score: 0 TEDCred reflects your contribution to the TED community.

  34. DavidRLogan says:

    Great taste in comedy, Skeptical Health! Actually that may explain a bit of your online persona…

    tssss you’re an MD? what were they outta other letters or sumthin’? tsss tss

    Relevant to the post, thanks Sam! I sent this to a close family member who’s interested in some of the exact same gizmos/treatments. She thanked me so I’m thanking you…

    -David

  35. morris39 says:

    Commenters here seem to suffer from a collective delusional affliction i.e. if you show someone else is mistaken, you must be correct and beating a dead horse is a good thing. It does not require a great deal of knowledge to conclude that the broad chiropractic claims are not supported by evidence or by known theory. It is also common knowledge that people often turn to chiropractors for help with back issues because help from conventional medicine is unavailable or ineffective (not controversial). I have suffered from tolerable lower back pain for decades, managed mostly by exercise and helped by lean bodyweight. Even so one or twice a year I needed and got effective help from a chiropractor (incidentally an employee of a fitness clinic owned by a now infamous MD in GTA) who massaged and stretched the spastic muscle. Belatedly I discovered that in my case the back pain is correlated with connective tissue problems in general. I have managed to make significant and improbable improvements over a 2 year period to my back, neck and gums mainly through dietary changes. And, this starting at age 71. I will not describe any of this as you would no doubt reject the claims (with zero evidence to the contrary) and it makes no difference to me. What makes you so sure of your opinions? I say this in general not just this particular post.

    1. Harriet Hall says:

      @morris39,

      “What makes you so sure of your opinions? I say this in general not just this particular post.”

      We are not categorically rejecting manipulation. There is evidence that manipulation is effective in relieving certain limited types of lower back pain. There is no good evidence that it is superior to other treatments for low back pain. We are not “so sure of our opinions” but rather we are aware of how opinions based on personal experience can go wrong. If you think you have made significant improvements through dietary changes, that claim needs to be examined just like any other claim. The whole of medical history shows that untested claims are more likely to be false than true. We are not categorically dismissing people’s personal experiences, but we are asking for credible evidence based on scientific testing before we accept their interpretations of those experiences as true. A good scientist forms hypotheses and tests them. A good scientist does not express “opinions” but provisional conclusions based on the currently available evidence or lack thereof, and is never so “sure” of provisional conclusions that he is unwilling to change those conclusions when better evidence surfaces.

  36. BillyJoe says:

    morris,

    “one or twice a year I needed and got effective help from a chiropractor who massaged and stretched the spastic muscle

    You were treated by a chiropractor but, instead of using chiropractic treatments, he used physiotherapy.
    So how exactly is this support for chiropractic?

  37. morris39 says:

    @BillyJoe
    You have not read my message. Of course that was physiotherapy and effective. My point is that you seem to be beating a dead horse. I don’t like the tone of this (whole) blog even though I do not disagree with the bare facts which for the most part are trivial or self serving in my opinion. I was feeling cranky and you people claim to know better. In hindsight, my post was a waste of time as I still feel cranky.

  38. Thats cute they have internet access at nursing homes :)

  39. Haha, wow I did not mean to hit submit on that one. Ok, so you don’t like the anti-quackery tone of this blog. You posted to tell us how we are all wrong about chiropractic, but it was a (worsely trained) chiropractor treating you with physical therapy that had some type of effect on your perception of your pain. Thank you.

  40. morris39 says:

    No, it is you who does not understand that recognizing quackery is a very small feat indeed and not worth the self-congratulatory tone displayed ad nauseum. I did not defend chiropractic, if you actually read what I said. Good bye

  41. weing says:

    @morris39,

    “What makes you so sure of your opinions? I say this in general not just this particular post.”

    Confirmation bias has a lot to do with it. Certainty is a sensation. Check out ‘On Being Certain: Believing You Are Right Even When You’re Not’ by Robert Burton.

  42. george_seifert says:

    You state that “FDA approval of the use of instruments for chiropractic adjustment of the spine does not mean that the instruments have been proven to be effective.” Now I’m not defending these instruments in any way, but I think FDA approval means that the product is proven to be safe and effective. So if this thing really is FDA approved, then somebody at the FDA messed up.

  43. Sam Homola says:

    The FDA has issued clearance for use of chiropractic adjusting instruments for “chiropractic adjustment of the spine and extremities.” There is no proof, however, that instrument (or manual) adjustment of the spine will “restore and maintain health,” as proposed by chiropractic vertebral subluxation theory. Such subluxations have not been proven to exist.

    Whatever other benefits might result from use of adjusting instruments, there is no reason to believe that they are effective for the reason they are used most often by chiropractors, that is, to adjust vertebral subluxations to restore and maintain health.

  44. Sam, thank you for explaining that. I tried looking it up on the FDA’s website, but the answer they gave was very ambiguous.

  45. george_seifert says:

    So FDA approval is pretty much meaningless anymore. That’s really infuriating that they would approve something like this. Especially considering all the billions spent by legimate companies to get real therapies approved. Is there a special classification that these “instruments” get approved under?

  46. What is infuriating to me is that chiropractors take advantage of the publics ignorance of what “FDA approved” means to try to lend legitimacy to their quackery.

  47. DevoutCatalyst says:

    FDA approval got you feeling down? Don’t forget the Space Foundation and chiropractic,

    http://www.spaceref.com/news/viewpr.html?pid=18731

  48. Harriet Hall says:

    See http://www.chirobase.org/06DD/activator/K973506.pdf for how the FDA approved one activator as equivalent to a previous one (510K approval) and for use to correct subluxations.

  49. lilady says:

    See http://www.accessdata.fda.gov/cdrh_docs/pdf2/k023462.pdf for how the FDA approved (2003), another activator as equivalent to several previous ones (510K approval) and for use to correct subluxations.

    See Page 5 for diagrams of the activator and the various attachments including a “Cervical Dual Stylus Attachment”.

    Figure 2. Measurements of the adjusting instrument (left) and stylus attachments (right).

  50. youralldumb says:

    Your all Dumb… I want to tell you a story… My father was a chiropractor and for years i listened to everybody tell me either how great he was or how bad chiropractic was… I listen to them all and when i went to college i decieded i wanted to be a real doctor, a doctor of medicine… someone that people would respect and see as trust worthy… so i went to medical school, i graduated, and i practiced for 10 years… do you know what i discovered? i discovered how much i hated “western medicine.” it was horrable… for 10 years it was nothing but listening to all the sickly people saying i have a stomach ache, my back hurts, i cant sleep, I cant work, my kid fell down… My father never said anything about me being and MD and he never tried to give me any of his “Philosophy”… MY turning point in the medical profession is when my friend brought his son into see me… he told me my father informed him that vaccination could be harmful to the child… i told him that it was safe and nothing would happen… he took the child to be vaccinated with in a week the child started haveing major problems and a few years later i decided to diagnose him with autism… i dont know if it was the vaccination or not but i decided it was time for me to get rid of the stupid pharmisitical ran and dictated phylosopy of pill pushing… everyone patient i had was on something… i felt like a drug dealer… I asked my father how he delt with all the patients and he said someting to me that made sence… he said i do my best to get people better…
    You people that put all your anti chiropractic comments are just retarted… If you hate it that bad go be an MD, go be a DO, go be a PT OT RN NP what ever you believe in and deal with sick people every day…. The chiropractic Philosophy is the best… eat right, exersize, and take proactive steps to being WELL… If you dont want to get adjusted then dont… but dont criticise chiropractors because they tell you to gett of your fat butt, get away frome the computer, and go run a mile and eat an apple… your all so dumb

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