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That’s so Chiropractic

Alien autopsy (Wikimedia Commons), by Flickr user Jim Trottier

Alien autopsy (Wikimedia Commons), by Flickr user Jim Trottier

Old bad studies: Fantastical autopsy results

I found the following quote at “Chiropractic care can treat more than just bad backs” (FYI. Chiropractic can’t):

Luse references a study published in The Medical Times authored by Dr. Henry Windsor [sic], M.D. that showcases the correlation of spinal health to overall wellness. Windsor dissected 75 human cadavers to investigate their causes of death. The study showed that 138 of the 139 diseases of the internal organs that were present were in connection to the misalignments of the vertebrae.

But I was intrigued. So I went to the video tape. Well, the PDF.

It is an interesting read by a physician who was looking for an association between curvature of the spine and visceral pathology.

He had 50 corpses, age unknown, that he dissected, looked at the spine for curvature and then looked for pathology in organs in the same distribution of sympathetic nervous system as the level of the spine curvature.

It would be important to know the age and co-morbidities of the patients, since curvature of the spine is a natural result of aging and can be found in normal people and those with nutritional and other metabolic problems.

More importantly, there is no description of the definition of what constitutes a curvature of the spine beyond the obscenity definition: He knows it when he sees it. In fact he finds curvatures where:

such a curve would have been considered normal by many.

He found the curves then found internal pathology then lined up the diseases with the curvature and found associations. 50 cadavers, 105 curvatures of which 100 were ‘minor’ and of these 105 curvatures, 96:

showed evidence of disorders in some of the structures supplied by that portion of the sympathetic system coming from the vertebral segments of the curvature.

Why only some? What was minor? Why are not all the organs in the sympathetic distribution diseased? Um. Because it is an imaginary association?

Or reversing the process of thought, 221 structures other than the spine were found diseased. Of these, 212 were observed to belong to the same sympathetic segment as the vertebrae in curvature

And when there wasn’t an association, it was due to the levels one vertebrae up or down; close enough, right?

Without knowing how abnormal curvature is defined and how the spines were examined, as far as I can tell this is a massive example of confirmation bias. He saw what he wanted to see.

There were a hodgepodge of problems discovered: infections, tumors and cirrhosis, that, as he philosophically notes, are:

the ordinary diseases of adult life

It is curious that diseases with radically different pathophysiologies were thought to be perhaps due to spine curvature and involvement of the sympathetic nervous system. I can think of no reality-based physiology that would result in cancer and infection from interference with the sympathetic nervous system, and we have no way of knowing if the sympathetic nervous system was even impaired in these cadavers. It is a hypothesis, not a conclusion, from his studies, and an awful one at that.

Some of the processes do not seem to be diseases at all: one small bladder, one unduly large bladder, eight large and seven small red kidneys, one degenerated pancreas, whatever that is, one groin wound, four dilated stomachs, seven large and five atrophic spleens. So many subjective findings. It seemed as if when there was no pathology he found some anyway.

This is as curious an example of presuming causation from association as I have ever seen.

It is fun to read old studies (this study was from 1921), in part due to the style of speech used and in part to see the complete lack of rigor in how information was measured and reported. By modern standards this was a truly awful study. This report would be a nice example for students on how not to do a study for if a mistake could be made, it was.

He concludes that children and dogs like to curl up to sleep because it:

[relaxes] the sympathetic nervous system, induces contraction of the great vessels [and empties] the cerebral vessels.

A unique explanation of sleep: depriving the brain of blood by curling up. The report was from the 1920′s so I suppose we can cut the author a little slack for his unique hypothesis of sleep physiology.

And how this fanciful study applies to the equally fanciful adjustments of subluxations of the spine performed by chiropractors is uncertain as:

All curvatures and deformities of the spine were ridged, apparently of long duration: irreducible by ordinary manual force: extension, counter-extension, rotation, even strong lateral movement failed to remove them or even cause them to change their relative positions.

Nothing there a chiropractor could alter, unless they used a hammer. Or perhaps a spring-loaded rod.

Modern bad studies: Frightening autistic children

Hope for Autism” reads the title. From a chiropractor. I thought, I’m skeptical. I can’t see how the manipulation of the spine to correct fanciful subluxations could do anything for autism . So I went looking for the original paper, which is in a journal so obscure, J. Vertebral Subluxation Res., it is not on PubMed. But the original, “Clinical Efficacy of Upper Cervical Versus Full Spine Chiropractic Care on Children with Autism: A Randomized Clinical Trial,” is available for download.

Their introduction is humorous, although I suspect not deliberately:

Since the primary problem in autistic children is neurological, it is prudent to research the efficacy of chiropractic care in these children.

Since at its heart chiropractic has nothing to do with neurology, or reality.

They decide to answer the question as to:

which is the recommended chiropractic technique in these cases of autism?

I would wager none.

It is every bit as methodologically horrible as you could predict: 14 patients, no randomization or blinding, no control, short follow-up and outcomes based on parents observations and the Autism Treatment Evaluation Checklist. Any results, given the zero prior plausibility of chiropractic, are going to be due to bias. The study, and its results, are best described as garbage.

If the study was approved by an IRB it is not mentioned in the methods nor is there any mention of informed consent. The study mentions how stressful it was for these autistic children, and all for no valid reason.

A few of the children displayed aggressive behavior such as pushing, falling, flaying arms in the air, and kicking. These actions were usually momentary. Chiropractic care was resumed when he child was able to continue… X-ray examination proved to be the most difficult procedure for autistic children…Light from the collimator bulb either scared or fascinated the children.

They used the percussion adjustment instrument of the Atlas Orthogonal technique on these poor children:

The patient is placed on his side with head support at four inches below the mastoid. A metal stylus is placed between the mastoid and the ramus of the mandible. An adjustment, an impulse imparted to the stylus by a plunger that excites a compressional wave in the stylus, is then delivered to the patient. At the patient-stylus interface, a portion of the wave energy is transmitted to the patient and a portion is reflected back to the plunger. The former portion of energy is enough to direct the atlas vertebra to move to its normal orthogonal position.

No wonder they thrashed about in terror, being held down so a rod could thump them behind the ear like a mob execution. There is zero literature on the PubMeds to support the use of Atlas Orthogonal technique and the patter used to justify its use sounds science-y, but, as one chiropractor recognizes, it:

is an outdated, unproven, unsubstantiated technique system.

The kids also received an unhealthy dose of useless radiation:

To attain this, the technique recommends four pre-adjustment cervical x-rays and two post-adjustment x-rays be taken immediately after the first adjustment in the cervical area.

X-rays are not a benign diagnostic modality (although the data is from CT scans, ionizing radiation should not be given as part of tooth fairy science without IRB approval and informed consent):

Risk estimates are derived for paediatric head computed tomographies (CTs) as well as for brain tumours in adults. On the basis of estimates for Germany about the number of head scans, the annual rate of radiation-induced diseases is calculated. About 1000 annual paediatric CT investigations of the skull will lead to about three excess neoplasms in the head region, i.e. the probability of an induced late effect must be suspected in the range of some thousands.

The scant literature on the topic of autism and chiropractic summarized by the “Hope for Autism” authors is also horrible:

Our systematic review of the literature revealed a total of five articles consisting of three case reports, one cohort study and one randomized comparison trial. The literature is lacking on documenting the chiropractic care of children with ASD…However, given the ineffectiveness of pharmaceutical agents, a trial of chiropractic care for sufferers of autism is prudent and warranted.

The ‘since airplane design has flaws, flying carpets should be used’ argument.

A worthless study that only served to scare and irradiate autistic children and proved nothing about the efficacy of chiropractic for autism. If it had been approved by an IRB, they ought to be ashamed for allowing autistic children to be frightened and irradiated without good reason.

Chiropractors, primary Care and vaccines

Some chiropractors want to become primary care providers. Jann Bellamy and Harriet Hall have written about this fantasy. There are several issues with having chiropractors function as if there were knowledgeable and competent physicians.

The first is that their education in school is woefully inadequate to diagnose and treat common medical problems.

The second is that their practical training is even less adequate. I have yet to meet a new medical school graduate who is even barely competent to take care of patients. It is why they have a residency. Most of the real meat of medical training occurs during the 3 to 7 years after medical school. Chiropractors do not have any meaningful post graduate training.

And third, they do not want to participate in the key concepts that make up primary care. Part of primary care is to diagnosis and treat acute and chronic medical problems and they have no training for this. But another part is health maintenance: doing the testing and treatments for the prevention of diseases such as colonoscopy, mammograms and vaccines.

Vaccines are a key part of health maintenance and arguably the most important intervention to improve human health. Maybe fresh water and flush toilets were more important. Part of health maintenance is making sure your patients are up to date in their vaccines.

And chiropractors are often loudly and proudly against vaccines: Immunizations by Colorado DCs: Really?

Are You Prepared to Vaccinate?

Did no one in Colorado get the memo? Based on the feedback I’ve received from previous columns, not many doctors of chiropractic support prescriptive injectables2 and precious few would be willing to give immunizations to infants.

and

In my opinion, providing risky immunizations to Colorado babies for the purpose of accomplishing a pro-drug agenda is much like a betrayal of those infants for “30 pieces of silver.”

Chiropractors do not subscribe to the reality that vaccines have been and are one of the key tools in the prevention of infections.

A greater than 92% decline in cases and a 99% or greater decline in deaths due to diseases prevented by vaccines recommended before 1980 were shown for diphtheria, mumps, pertussis, and tetanus. Endemic transmission of poliovirus and measles and rubella viruses has been eliminated in the United States; smallpox has been eradicated worldwide. Declines were 80% or greater for cases and deaths of most vaccine-preventable diseases targeted since 1980 including hepatitis A, acute hepatitis B, Hib, and varicella. Declines in cases and deaths of invasive S pneumoniae were 34% and 25%, respectively.

Chiropractors ‘heck no’ antagonism is further evidence against them being responsible for primary care.

Are you willing to administer all of those vaccinations to your infant, adolescent and adult patients so you can meet the accepted standard of a primary care physician? I suspect the majority of you will not just say, “No,” but will say, “Heck no!” So, if we are not willing to do that, then maybe it’s time for us to stop trying to be something we don’t want to be and trying to obtain authority to do things we don’t want to do…However, I do not think the majority of the chiropractic profession believes that primary care – when it includes the medical “Holy Grail” of vaccinations – is the right course to follow.

It is not an isolated opinion but part of the chiropractic world view.

Anti-vaccination attitudes till abound within the chiropractic profession. Despite a growing body of evidence about the safety and efficacy of vaccination, many chiropractors do not believe in vaccination, will not recommend it to their patients, and place emphasis on risk rather than benefit… But this puts the chiropractic profession outside the greater healthcare community and may contribute to its continued marginalization and small market impact.

And it disqualifies them as primary care providers. One would think that to practice primary care people would need to understand the concepts behind primary care and this chiropractor has the correct conclusion for his field. They have no business being in primary care.

Chiropractic, stroke and patient safety

I learned early in my career that even simple interactions can lead to harm. I had a patient as an intern who had an out-of-hospital cardiac arrest. In the field they placed an IV for resuscitation. The IV site became infected, she became bacteremic, the infection went to her aortic valve, which blew out acutely and she died.

It is why I roll my eyes when people say the first rule of medicine is to do no harm. Everything you do in medicine has the potential for harm, including doing nothing. All actions and all inactions can have bad consequences.

The real rule of medicine is that the odds of providing benefit should be greater than the odds of doing harm. There is also a fudge factor for the disease being treated. I once took care of a patient who died of acute liver failure due to medication she was taking for toenail fungus. I always mention this to patients when they ask for terbinafine. There is a low likelihood of death to treat a trivial problem but most people find the risk/benefit unacceptable when I mention my case. And there are other, less toxic, therapies for nail fungus.

If the disease, like leukemia, offers certain death, patients are more likely to accept the risk of serious complications from chemotherapy or a bone marrow transplant since the potential payoff, life, is worth the risks for the treatment. Risks and benefits are variable and deciding what to do is complex calculus filtered through patients’ expectations and values that is not done justice by the simplistic phrase ‘Do no harm.’

The issue with most of the pseudo-medicines is they do nothing, they alter no physiologic process, and so any side effect is not acceptable. If the benefit is zero, the risk should also be zero.

Cervical manipulative therapy has little real proven indication, especially if being used to fix mythical subluxations. Chiropractors are remarkably adamant that their adjustments are safe and do not cause stroke from vertebral artery dissection (VAD). They love to point to “Risk of Vertebrobasilar Stroke and Chiropractic Care Results of a Population-Based Case-Control and Case-Crossover Study” as evidence that chiropractic is safe and suggest patients are seeking chiropractic care for their prior VAD. In point of fact the study confirms the risk of stoke following CMA.

I noted at SBM:

A passive hanging (no drop) gives about 686 Newton’s of force around the neck for a 70 kg human. In chiropractic, “the mean force of all manual applications [is] 264 Newton’s and the mean force duration [is] 145 milliseconds”. So a chiropractic neck manipulation, for a short period of time, can provide 38% the force of a hanging. And a bad hanging at that.

Neck injuries are not that frequent because the muscles of the neck prevent injury by preventing sudden, disastrous, movement. If you want to increase the chance of injury from relatively minor trauma, have the person relax. If the muscles are relaxed because the person is not expecting the trauma, the chance of injury goes up. It is why whiplash can occur after minor injuries. Chiropractors often have their patients relax just before the coup de grace, I mean manipulation, helping to maximize the chance of injury despite having less force applied to the neck than a noose and gravity.

Given the above, to claim that the [vertebrobasilar artery stroke] occurred before the patient had chiropractic neck manipulation is like saying the hanging victim had a broken neck, but it occurred on the steps up to the scaffold.

There is now a position paper “Cervical Arterial Dissections and Association With Cervical Manipulative Therapy” from the American Heart Association/American Stroke Association and discussed by Dr. Novella.

They review the literature and anatomy/physiology of stroke and CMA. The money quote:

Although current biomechanical evidence is insufficient to establish the claim that CMT causes CD [Cervical artery dissections], clinical reports suggest that mechanical forces play a role in a considerable number of CDs and most population controlled studies have found an association between CMT [cervical manipulative therapy] and VAD [vertebral artery dissection] stroke in young patients. Although the incidence of CMT-associated CD in patients who have previously received CMT is not well established, and probably low, practitioners should strongly consider the possibility of CD as a presenting symptom, and patients should be informed of the statistical association between CD and CMT prior to undergoing manipulation of the cervical spine.

In epidemiology, Hill’s Criteria provides a framework for considering whether association is causation and is helpful when there are no definitive studies. We will never have a prospective trial of cervical manipulation to see if it can induce a stroke and given the rarity of the event will have to rely on less definitive data. Hills Criteria are:

  • Strength: A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal.
  • Consistency: Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect.
  • Specificity: Causation is likely if a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.
  • Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay).
  • Biological gradient: Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence.
  • Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge).
  • Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that “… lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations”.
  • Experiment: “Occasionally it is possible to appeal to experimental evidence”.
  • Analogy: The effect of similar factors may be considered.

Hill’s Criteria has been applied to the concept of Chiropractic subluxation and the reality of subluxation was found wanting.

There is a significant lack of evidence to fulfill the basic criteria of causation. This lack of crucial supportive epidemiologic evidence prohibits the accurate promulgation of the chiropractic subluxation.

For stroke causation, Hill’s criteria are modestly met. The preponderance of information points to CMT as a risk for dissection and stroke and there is certainly plausibility for what is fortunately a rare event. The case reports of stoke immediately after CMT give one pause; they may reach the level of parachute evidence.

I have spent a significant part of my career in infection control and quality, where we strive apply the literature to maximize patient safety and to good effect.

To date the only pseudo-medical quality initiative that led to an increase in patient safety of which I am aware is the use of sterile disposable acupuncture needles, an intervention they work hard to subvert by ignoring all other infection control interventions like gloves. A hallmark of pseudo-medicines is they do no change because of data.

In real medicine we recognize the potential for harm and strive to reduce it. In my institutions we try to always put patient safety first. The question is the response by the chiropractic community to the position paper. I predict denial rather than changes in practice to increase the safety of their clients.

Well what do you know? From the American Chiropractic Association

The largest and most credible study, Cassidy et al., found that a patient is as likely to have seen a primary care medical doctor as a doctor of chiropractic prior to experiencing a cervical arterial dissection (CD).

Neck manipulation is a safe, conservative treatment option for neck pain and headache. The evidence presented in the AHA paper fails to show that neck manipulation is a significant risk factor in CD. In addition, the paper fails to put into context risks associated with other neck pain treatments such as neck surgery, steroid injections and prescription drugs.

And leading scientist Christine Goertz DC

In an Aug. 8 speech, Christine Goertz, DC, PhD, vice chancellor for research and health policy at Palmer College of Chiropractic, explained that medical doctors and doctors of chiropractic need to be vigilant in assessing patients who may be in the early stages of vertebral arterial dissection (VAD). It’s also extremely important that the data regarding the risk of VAD is presented to patients in an accurate manner.

“The facts are that VADs are very, very rare events, and there’s absolutely no research that shows a cause-and-effect relationship between chiropractic care and stroke,” Goertz said.

We have very rare events in real medicine as well. We used to use the antibiotic trovafloxacin at the rate of 300,000 prescriptions a month, but there were 6 deaths and handful of severe liver failures from the medication.

And now? We no longer use it because we have safer therapies with equal efficacy. And unlike cervical manipulation for neck pain, an intervention that has no benefit, trovafloxacin was an effective antibiotic.

To use massive understatement, the pharmaceutical industry has not always been forthcoming about the risks of their products. But when they are discovered by physicians, we respond in a way to maximize patient safety. The President of the Infectious Disease Society of America doesn’t give a speech release saying

The facts are that liver failure are very, very rare events, and there’s absolutely no research that shows a cause-and-effect relationship between trovafloxacin and liver failure

or

trovafloxacin is a safe, conservative treatment option for infection. The evidence presented fails to show that trovafloxacin is a significant risk factor in liver failure.

In medicine we balance the risk and the benefit of an intervention and try to do what is in the best interest of the patient by changing practice. When in doubt we try and maximize patient safety

Chiropractic is more interested in keeping their business model active than changing to decrease patient risk. But that is the case for all pseudo-medicines.

Lets increase the chance of more strokes

A while back I mentioned a study that wasn’t a study by the British Chiropractor Association that suggested that texting could kill you.

Their completely unsubstantiated theory is that texting, by causing the head to lean forward, would lead to hyper-kyphosis, restrictive lung disease and death. This idea has no basis in the medical literature I can find.

However, the English need some entrepreneurial sprint because it took

Dr. Dean Fishman, a chiropractor (to) create and trademark the phrase “text neck.”

Hereby referred to as TN.

He has an Android app ($2.99 and free version) to let you know if you are using your phone at a dangerous angle. Why might you do this? Because TN, according to the Text-Neck Institute:

… IS A GLOBAL EPIDEMIC! ‘Text Neck’ is a world-wide health concern, affecting millions of all ages and from all walks of life. Widespread overuse of handheld mobile technology is resulting in a harmful and dangerous physical condition on the human body, which is known as Text Neck.

that will lead to:

Flattening of the Spinal Curve, Onset of Early Arthritis, Spinal Degeneration, Spinal Misalignment, Disc Herniation, Disc Compression, Muscle Damage, Nerve Damage, Loss of Lung Volume Capacity, (and) Gastrointestinal Problems.

TN is based on almost no data and/or wild extrapolation as the search term “text neck” has no hits on PubMed.

I do not doubt a stiff neck and tension headache may occur from prolonged use of a mobile device in an awkward position. I certainly get a sore neck at the computer, especially as the screen is not at bifocal level.

But disc herniation? Loss of lung volume? Gastrointestinal problems? Color me skeptical.

He quotes “Roentgenographic findings of the cervical spine in asymptomatic people” as:

FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage, and early arthritis.

The abstract from 1986, long before cell phones and texting, concerns normal changes in the neck with aging:

The purpose of this study was to determine the incidence and severity of degenerative changes seen on lateral roentgenograms in 200 asymptomatic men and women in five age groups with an age range of 20-65 years and to determine the normal values of cervical lordosis and spinal canal sagittal diameters and their relationship to degenerative changes. It was found that by age 60-65, 95% of the men and 70% of the women had at least one degenerative change on their roentgenograms. A small sagittal diameter correlated with the presence of degenerative changes at the same disc level, and the strongest correlation was with the size of the posterior osteophytes at C5-6 (r = 0.52). Cervical lordosis measurements did not relate to degenerative changes except for subjects over age 50 with moderate or severe intervertebral narrowing. It is important to realize that although roentgenographic abnormalities represent structural changes in the spine, they do not necessarily cause symptoms.

He conveniently ignores the association between cervical spine curvature and neck pain which suggests:

In conclusion, we suggest that when so-called “abnormalities” of the sagittal profile are observed in the older patient with neck pain they must be considered coincidental, i.e. not necessarily indicative of the cause of pain. This should be given due consideration in the differential diagnosis of patients with non-specific neck pain.

In the Cephalalgiaarticle, used as a reference,

the study demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients.

Was in a whopping 24 patients.

Not the most robust of literature to support the concept of TN.

But the biggest concern with making TN a worry to people is the ‘solution’ to the problem. Somehow I suspect the treatment will be chiropractic manipulation of the neck.

And that could lead to an increase in strokes. Great.

Posted in: Chiropractic, Clinical Trials, Energy Medicine, Science and Medicine

Leave a Comment (86) ↓

86 thoughts on “That’s so Chiropractic

  1. Badly Shaved Monkey says:

    So I did check the paper to which Dr Crislip linked, and no he did not create a typo of his own. The chiros really did say;

    A few of the children displayed aggressive behavior such as pushing, falling, flaying arms in the air,

    It must be a particularly vigorous chiro manipulation actually to flay the patient. I thought merely fleecing them was their intention.

    1. Windriven says:

      They flay them first. It makes the fleecing easier.

    2. kaitch says:

      Yes, I thought the flaying of arms was a behaviour of real concern, whether or not it occurred in the air.

  2. What’s up friends, how is the whole thing, and what you
    want to say on the topic of this paragraph, in my view its really
    amazing in support of me.

    1. Windriven says:

      Assh0le. Eat sh!t and die.

    2. Jopari says:

      Eh, don’t get what Cartier Bracelet is getting at.

      But even if it was something stupid, Windriven, I think that was uncalled for.

      1. brewandferment says:

        i bet cartier is a spambot

      2. Windriven says:

        Jopari, this is a spambot, not a person. It’s only purpose is to drive morons like me to the linked site to either drive traffic metrics or to sell something.

        You will wait a long time for me to apologize to a bit of noxious code or, for that matter, to the slime that wrote it.

        1. Jopari says:

          Be that as it may be, your response was unwarranted, and some would misconstrue as rather childish.

          It really doesn’t matter if it’s a piece of code or a real person. That’s my opinion, though in this case, I suppose what’s done is done.

          I suppose I don’t actually want you to apologize, just not do that, it paints a rather bad image for people at first glance.

          1. WilliamLawrenceUtridge says:

            Don’t worry about Windriven, he’s got plenty of opportunities beyond first glance for people to form opinions.

            I’m surprised he replied though, normally he forwards the presence of spam to Paul for deletion…

            1. Windriven says:

              Paul leaves them unless they are clearly selling sCAMs. It disgusts me that these jerks litter discussion boards with their digital detritus. That said, I agree with Jopari. It was a childish response. I do those on occasion and generally on Fridays and almost always unapologetically. It’s my inner 12 year old demanding to be heard.

              1. Thor says:

                Two things: I didn’t see your comment, plus I meant to post under WLU’s 1:52 comment, not here, though it doesn’t really matter.

              2. goodnightirene says:

                I guess I have to agree a bit with Jopari here. This blog is growing and gets new people who (like me) never heard of a “spambot” (although I get it) and might not take away an impression of our comments section that encourages them to come back if they read your concise retort.

                Can we not just ignore the spambot? I used to not get “trolls” either and replied to them, but was quickly told to ignore them.

                Please feel free to educate me on all this.

            2. Thor says:

              Can’t speak for Windriven, but I’m continually tempted to express myself like that when witnessing CAMsters and religionists. For me, it’s exasperation, and a necessary venting.

              Like you said, just peruse the comments on most posts to see what W’s really all about. And, still funny to blast a bot like that (sure doesn’t hurt anybody’s feelings). Admittedly, some are certainly offended (like my dad used to be) by certain ‘cuss’ words and (pseudo) violent expressions. Then again, some don’t mind – especially knowing from whom they come.

  3. That has inspired me to do autopsy studies on my dental patients. I suspect and hypothesize that every cavity I find postmortem can be traced back to a cranial nerve, showing conclusively that tooth decay is not an infectious process like THEY want you to think, but a neurological one.

  4. Chris Hickie says:

    There is no way to get good (let alone reproducible) spinal xrays of a child that is struggling to get free like I am certain those children with autism were.

  5. Jann Bellamy says:

    I have a recent “pediatric chiropractic” textbook which teaches how to detect “subluxations” with x-rays. The book is full of x-rays of children, many marked to show the location of the “subluxation.”

    1. Nick J says:

      interesting. if the marking were removed, would a trained physician see anything?

      1. Jopari says:

        Probably not, because they’re not “experienced enough” to detect it, and need to go through “extensive training”.

      2. WilliamLawrenceUtridge says:

        Nick, you just described a good clinical trial that could be done to test whether all the certainty regarding the detection and identification of subluxations are warranted or not. Studies done to date have not been promising.

  6. goodnightirene says:

    That’s it! No more neighborhood parties! They won’t read this blog (which I print and offer them) because they “don’t read much” and instead get their news from The Mighty Oz and Diane Sawyer (who they do not believe has had “work”). Flying carpets indeed.

    1. Windriven says:

      Ah, Irene, go to the parties, drink the wine, and keep your conversations limited to religion and politics. A good time will be had by all. ;-)

      1. goodnightirene says:

        WD: Religion and politics I can handle, but the woo it burns me! And I have to bring my own beer because they only offer Miller Lite. They go on about not putting “poison” into their bodies, but swill cheap booze day in and day out by the gallon.

        Honestly, they natter on for hours about their chiros and needlers and (seriously) ghosts! No redeeming social value at all.

        1. Windriven says:

          Irene, you have only one choice. Move!!!

          I think it was Horace Walpole who opined: God created 90% of the people so you’d want to be with the other 10%.

          1. goodnightirene says:

            You are right of course, but tell me where it’s better? Well, at least in the hippy-dippy Wootowns I used to live in, they offered better food and drink!

            Mr. Goodnight will retire in a few years (he is my toyboy) and we will definitely relocate, but I am open to suggestions for affordable, woo-free communities.

            1. Windriven says:

              Hmmm… Affordable is pretty easy. Woo-free cuts down the possibilities considerably. I think there might be an old Nike missile silo available out in the Nebraska plains. ;-)

        2. mouse says:

          I usually change the topic to pets, children, harmless neighborhood gossip or gardens when the topic turns to chiro or the like at a neighborhood party. But Miller Lite, Dr Oz and long discussion about foods as “poison” (which kinda suggests the food’s no better than the beer)? That sounds boring as hell.

          I do enjoy a good ghost story, though, Even though I don’t believe in ghosts.

        3. mouse says:

          If it helps at all, I’m slated for an all day annual party today, where the prescribed arrival time is 1:00pm, but the hosts typically don’t put any food out until 4-6pm. The host tends to drinking to much and making racial or sexist jokes.

          Going to get a tray of humus, baba ghanoush, olives and pita now.

          1. goodnightirene says:

            Thanks for both of those comments Mouse. I, too, like a ghost story, but “story” is the key. These people BELIEVE. Your annual party sounds like the one’s around here–only they tend to be weekly. I’m pretty sure I won’t be asked back to most of them as I have the habit of saying something in response to sexist and (especially) racist jokes or comments. One guy at the last party here asked me point blank if we were thinking of moving because he is worried about “certain people” who seem to be moving in “around here”! I asked what he meant by “certain people” and he explained in clear and offensive language. I left–but no one else did. The next day I was told by the hostess that I need to be more “tolerant”.

            I wish I could say that woo is correlated to racism/politics/class, but as I said above, it is everywhere I’ve lived, so I guess I will simply stop attempting to socialize with these people.

            1. mouse says:

              Turns out the party was actually rather pleasant. I took a large tray of hummus, baba ghanoush, pita, salami, olives and some cherry tomatoes from the FM mixed with basil, olive oil and fresh mozzarella and put it down were everyone sits and complained about the blind spot in my van*. That gave everyone something to chew on for awhile.

              The usual suspects seemed to remained relatively sober and there were no racists or sexist comments to be heard.

              *Maybe this is not a big conversation starter outside of the Detroit metro area, I don’t know.

        4. egstras says:

          I find myself able to “rise above” many forms of ignorance/obliviousness but the woo drives me nuts.

      2. WilliamLawrenceUtridge says:

        Finding a party where you can discuss religion and politics comfortably is a thing to be treasured. Among the most interesting discussions about the most interesting topics one might find outside of a specialist conference. I’ve managed to do it on rare occasions, sometimes even when sober!

  7. Becky says:

    A little help please! An acquaintance is pushing HARD for us to take out 12 year old daughter to a chiro that practices the Gonstead technique to treat scoliosis. She has a 60 degree curve in her lumbar. This person acts as if it would be borderline child abuse for us to get the spinal fusion surgery that has been recommended by the doctor. Our conversations go in circles.
    He says “Spinal fusion caused me more problems than it fixed.” I say ” Really how do you know you wouldn’t be in more pain with out it?” blank stare.
    He says “This guy has really helped my pain.’ I say “That’s nice but what does that have to do with my daughter?” blank stare
    He says “My chiro can cure your daughters curve.” (I haven’t provided any details about her curvature to him)
    I say “How can you diagnose my kids problem without any medical training whatsoever?” blank stare
    I find it very disconcerting that anyone would think that twisting a kid into a pretzel would have any long term effect on such a bad case of scoliosis.
    My husband and I are doing our due diligence here, researching pubmed and JAMA, second opinion ext. I need some guidance on studies that compare the outcome of spinal fusion surgery versus no surgery in curvatures over 50 percent.

    1. Becky says:

      Oh and any info on this Gonstead technique would be helpful.

      1. Kiiri says:

        I would be VERY hesitant to take a child to chiropractor to fix a severe scoliosis. There techniques are not evidence based at all. I would get a second opinion on surgery from doctors you trust and proceed as advised. As Dr. Crislip notes above nothing in medicine is without risk, and while your daughter might have long term problems after surgery her problems could well be worse without it. Best of luck and good wishes to your family. I hope your daughter the best and a speedy recovery.

      2. Jann Bellamy says:

        The Gonstead Technique is quackery. It is one of several techniques used by chiropractors to “detect” and “correct” the non-existent chiropractic subluxation and it is quite popular among chiropractors. One of the methods used to find these supposed subluxations is the full-spine x-ray, which will subject the patient to unnecessary radiation. The chiropractor may manipulate the cervical spine, which carries a risk of vertebral artery dissection and stroke. You can see a youtube video of a cervical manipulation using the Gonstead technique here: https://www.youtube.com/watch?v=v-Xl-VOAfS0. You can read about the chiropractic subluxation in any number of posts on this blog, including this one written by a chiropractor: http://www.sciencebasedmedicine.org/subluxation-theory-a-belief-system-that-continues-to-define-the-practice-of-chiropractic/ Here’s another he wrote about pediatric chiropractic: http://www.sciencebasedmedicine.org/pediatric-chiropractic-care-scientifically-indefensible/ Dr. Steve Novella, who is a neurologist, recently wrote about the risk of stroke after manipulation here:
        http://www.sciencebasedmedicine.org/a-statement-on-cervical-manipulation-and-dissections/.

        Frankly, I am curious as to why you care what this acquaintance thinks or why you think you need to explain yourself to him. We don’t give medical advice on this blog and I am not a doctor, but as one parent to another, I suggest you get a second opinion fro another orthopedic surgeon if you are not sure about your current physician’s advice and that you ignore any advice that your child should be treated by a chiropractor.

        1. Becky says:

          Thanks for the references, some I read a few months ago. I’ll reread them. So far we have seen her pediatrician and a pediatric orthopedic surgeon. We have an appointment with another surgeon after some tests for a second opinion. We have no plans to take her to a chiro.

          “Frankly, I am curious as to why you care what this acquaintance thinks or why you think you need to explain yourself to him.”

          Good question , I don’t care, I just like to be prepared with facts instead of an epic eye roll…. or maybe I’ll use both. In particular I’m interested to see if there are any studies that compare the outcome of spinal fusion surgery vs no surgery.

          1. Jann Bellamy says:

            Becky, please see comment 12 from an orthopedic surgeon. Hope that helps.

    2. Peter S says:

      Have you seen or considered seeing a physiatrist as well as a surgeon? My thought was that perhaps there are non-surgical options that such a doctor might be in the best position to review. I wouldn’t go near a chiropractor, personally, for anything potentially serious.

      1. Chris says:

        I don’t think that a spine that is physically curved (60%!) would benefit much from psychiatry:
        http://en.wikipedia.org/wiki/Scoliosis

        By the way, King Richard III was depicted by Shakespeare as having a hump back, but his skeleton revealed he had severe scoliosis:
        http://www.le.ac.uk/richardiii/science/spine.html

      2. Chris says:

        AAAGh! You wrote ” physiatrist.” My bad, I am sorry.

        Goes and looks it up (never seen the word, I obviously read it as something more familiar). I see that you posted a valid option, though it may have already been brought up for Becky’s child.

        Again, sorry. And thanks for introducing me to a new word and type of specialty.

      3. mouse says:

        Also called Physical Medicine and Rehabilitation (PM&R). This was the specialist who diagnosed and guided treatments for my cervical nerve root pain. I never knew they were call physiatrists.

    3. Sarah Southon says:

      I don’t think you’ll find that exact study (patients won’t generally accept randomization into surgery vs. no surgery) but there are many long-term studies of untreated scoliosis and spinal instrumentation patients that can be compared.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475645/
      Some things to be aware of: 1) some older natural history studies grouped patients with all different types of scoliosis together (neuromuscular, congenital, juvenile, idiopathic) and found negative long-term results however when you separate out the adolescent idiopathic scoliosis patients (most common type) the long-term outcomes are very good- normal life expectancy, good quality of life- even without any treatment. http://www.uiortho.com/braist/uofi/AIS%20JAMA.pdf
      2) The pain issue- People with untreated scoliosis do have a higher rate of back pain later in life than the general population but so do people who have had scoliosis surgery (about equal risk).
      3) The more modern spinal instrumentation systems with titanium rods and pedicle screws have only been around for about 25 years. Prior to this the Harrington rods had much higher complication rates.
      https://www.spinemd.com/assets/uploads/files/CRG_Spring_2010.pdf
      This article provides a summary of long-term studies on post-operative patients.
      http://www.scoliosisoman.com/Adolescent%20Idiopathic%20Scoliosis%20-%205-Year%20to%2020-Year%20Evidence-Based%20Surgical%20results.pdf
      As you see from the above article, surgery for adolescent idiopathic scoliosis can correct the cosmetic effects and improve the patient’s body image. This is not done without risk though and I believe each family should consider these carefully. This guide can help:
      http://www.aboutkidshealth.ca/En/ResourceCentres/Scoliosis-Parents/Treatment/ImmediateRisksOfSurgery/Pages/Cons-of-Having-or-Not-Having-Surgery.aspx
      Consider also that without surgery, her curve is likely to progress 0.5-1 degree per year throughout her life (based on the natural history studies). If you choose to proceed with the surgery there is no benefit to waiting. Hope this info is helpful to you!

      1. Sarah Southon says:

        Oh and sorry I forgot to mention I agree there is NO evidence that supports chiropractic treatment can do anything to improve the curves in patients with scoliosis.

  8. JustaTech says:

    Are chiros at least trained to recognize menegitis? I’ve always heard that a sudden stiff neck and headache are symptoms of menegitis, and you should get the person to the hospital ASAP. Would a chiro know to be concerned about that?

    1. WilliamLawrenceUtridge says:

      Ha, even if they recognized it, they’d probably suggest the problem could be treated with adjustments to “boost the immune system”.

      1. Calli Arcale says:

        I recall a while back a study wherein a group of chiros were asked to fill out questionnaires. Included were hypotheticals about people with strong symptoms of meningitis. Only one even suggested getting medical attention, and none recognized the potentially life-threatening nature of the symptoms. Of course, it’s just a survey, with all the limitations of a survey, so make of it what you will. It certainly didn’t fill me with confidence in chiropractors.

        1. NOBS says:

          Calli-
          Will you/can you, please cite your “study/survey”? Thank-you

          1. Calli Arcale says:

            It was a long while back that I read about it, but if I can find it, I will. Do remember, it’s just a survey, and it’s not really a fair assessment since they were just presented with a brief list of symptoms — I had meningitis when I was a kid, and I was pretty obviously sick, which I’m sure no chiropractor will fail to notice. I mean, not only did I have a blinding headache and a very stiff neck with a lot of neck pain, but I was also hot to the touch, hallucinating, experiencing tunnel vision, and was only intermittently responsive to people trying to get my attention. I kinda don’t think that would get missed in practice. I brought it up, though, to illustrate how chiropractors often do not take seriously symptoms of infection, which logically cannot be treated by adjusting any kind of subluxation.

  9. Kiiri says:

    We should organize SBM parties but sadly I doubt we are anywhere near each other. oh well, perhaps hubby and I will succeed in finding some gamers to hang out with. But perhaps we should consider a social SBM meeting at some point. I am sure it would be more fun that a TMR drinking party. Better booze and conversation for sure.

    1. Mark Crislip says:

      we hope to have an SBM meeting in a year or two, with extra hoppy beer

      1. Lawrence says:

        IPAs are the bomb, particularly anything from the West Coast!

      2. Windriven says:

        “with extra hoppy beer”

        I’ll bring my own beer.

        1. Missmolly says:

          What, you don’t like drinking earwax? Philistine :)

        2. Mark Crislip says:

          For Windriven? If we should ever meet I will treat you to the all non-judgemental beers of your choice even if it be miller light for all the pleasure your comments have provided.

      3. goodnightirene says:

        I am happy to hear the news! I am leaving next week to head West, so maybe I could visit the “headquarters”? :-))

  10. Chris says:

    Dr. Crislip, have you stopped doing the sfsbm podcasts? Because the podcast feed, http://sfsbm.org/sfsbmpodcast/sfsbm.xml. is blank. I see nothing there.

    By the way, I avoid itunes. But even when I check iTunes (which I hate) I see the last one listed was from Aug. 7th.

    Thanks in advance.

    1. Mark Crislip says:

      dropped a ‘<‘ in the rss feed. they are so finicky. Will be fixed in a few hours.

      1. Chris says:

        Thanks.

        I remember when I would submit a long program that did lots of fun engineering analyses, only to have it fail due to one type.

          1. Chris says:

            See what I mean? That is obvious evidence I can’t type.

  11. Stephen H says:

    Unfortunately, one has to install the TN app before reviewing it:(. On the bright side, for some reason the (free) version didn’t install correctly to my phone, and while it was trying to do so I was able to write the necessary review. I encourage others to take the effort to review-bomb this crazy app – https://play.google.com/store/apps/details?id=com.textneckbeta.gui .

    You can also report the app as “inappropriate” from the Store on your Google device.

    As someone who has lived with undiagnosed Asperger’s for most of my life, I would not have been happy to be subjected to quackery by my parents. One wonders what legal options those children might have later in life, regarding physical abuse by some quack.

    Finally, I am interested in the “how can you test it?” question. Have Chiroquacktors ever tried running randomised control trials with animals? There are lots of things that you are permitted to do with animals that would result in big trouble were they applied to human patients. Do mice live longer if they receive regular neck cracking?

    How about a trial in which one group of patients receives “best of medical care” while the other receives best of quackery – chiropractic, acupuncture, homoeopathy, reiki, maybe a bit of training in mouse meditation…? 500 or so animals on each side of the test, and results to be measured on objective wellbeing – blood pressure, disease and treatment response, longevity, etc. Oh, and probably another 500 as the control group. Call it “The great quack challenge” – they can front up and show the world how good they are, or they can tear down their institutions of “learning” and burn all those misguided “textbooks”.

    James Randi, feel like throwing down a challenge?

    1. Chris says:

      “James Randi, feel like throwing down a challenge?”

      He already has, at least for homeopathy:
      https://www.youtube.com/watch?v=SMukj31qw1U

    2. MadisonMD says:

      @Chris: Homeopathy already failed the Randi challenge. But the story is quite amusing.

      I like Stephen’s challenge because it is all-encompassing. However, after quackery fails, the quackmasters will certainly justify the failure. It was done wrong because the Voodoo doll’s head was facing northeast rather than north-northwest.

  12. ray bellamy says:

    Regarding proper treatment of scoliosis.
    Many smaller curves let’s say 20 degrees or less in adolescents will not progress or get worse, so any treatment can claim “success” in that the curve did not worsen. Chiropractic treatment is worthless of course in affecting the outcome.
    The curve you describe, Becky, of 60 degrees is probably quite serious and in some significant danger of progression (worsening). Disc spaces tend to become permanently deformed in time and ligaments stretch out, allowing the curve to increase. Surgery is usually considered in cases above 30 degrees or predicted to get past 30 degrees.
    Exercise is good for almost everyone but does not have an effect on scoliosis outcome. Get as many opinions regarding the surgery as you like and can afford, but the opinions should be from orthopedic surgeons. Pediatric orthopedic surgeons and spine surgeons particularly.

    1. Becky says:

      Thanks, this confirms what I we have been told by our pediatric orthopedic surgeon. The more I read the more I am confidant surgery is our best , if only option.

  13. Frederick says:

    Yesterday evening, me and my wife were drinking a beer outside of a bar around here, she spoke the a fourth persone with us about how she just went to see the Chiro, ( STUDENT chiropractor, yes Trois-Rivieres , my town, have the only Chiropractic school in Quebec), He cracked her back and her Neck Hard and fast she said, but it was ok because he did it fast… Me and my wife looked at each other with desperate look, She made me that look ( don’t say anything!), I did say in a low voice, they do it despite the risk of stroke. She also said that they saw that she had a Subluxation between X and Y vertebras ( well I don’t remember which one she said).

    Since those subluxation does not exist, what are they seeing? How do they conclude that?
    I’m curious to know if you go see a Chiropractors to get a “diagnosis” and then go see couple of them without being “treated”, will their diagnosis be more or less consistent with each other? I doubt it.

    1. MadisonMD says:

      To your questions, this may be of interest to you, Frederick.

    2. NOBS says:

      To your questions, Frederick, THIS may be of interest to you:
      http://www.westhartfordgroup.com/index.htm

    3. Frederick says:

      Thanks MD, that was a interesting read. CAM provider always want you to go multiple time to Maintain your health, or buy supplement on regular basis and stuff like that. It is funny that sCAM advocate always accused real medicine of being greedy, but if you not sick you don’t have to see you doctor or after a check up, if you have no problem, The doc won’t say “come once a month to maintain you body balance” or Buy this supplement. On the other hand, you always have to go multiple time to Cam, and always have to buy stuff.

      As for the WHG, at least they are not anti-vaccine, but it is still Chiropractic.

      1. Thor says:

        WPG: a nice effort to put a legitimate face on chiropractic. You just know that most of what it is really all about is not being said. Digging deeper one would invariably find that “subluxation” and vitalism is the basis of their approach. That is, unless they are truly that rare breed, like Sam Homola, who are, indeed,
        putting the nonsense behind them. I really doubt it, though.

        1. Frederick says:

          yeah, At first I thought they were really No non-sense Chiro, but you dig deeper and you find that they still have such non-sense. I agree with you that it is a effort in the good direction, With All respect due to Sam Homola, I Agree with Dr. Novella, they are just glorified Physical therapist, The part that Chiropractors do that have any effects are basically PT. In a Way Chiro like M. Homola should just stop calling it Chiropractic, and just do PT.
          But it is my juts my opinion.

          1. Peter S says:

            And when they go beyond what is essentially physical therapy, look out!! Here is the website of a chiro in my area. Except for quantum physics I think it hits every CAM trope there is. My favorite is the “web-like interconnections,” that makes me want to make an appointment pronto.

            “What Makes Us Different?

            Our approach to holistic health and wellness (reflecting Dr Bonnie’s balanced background in Chiropractic Care, Functional Medicine Nutrition & Hormonal Balance, and Energetic Medicine) – that works with your body’s natural healing processes to achieve an overall more effective program of prevention and treatment of the precursors to chronic disease before it compromises your life span and your quality of life.

            A Revolutionary, Holistic Approach to Healing

            We believe in a personalized approach to health that deals with primary prevention and underlying causes instead of symptoms for serious chronic disease. As such, we utilize many of the precepts from Functional Medicine – a science-based field of health care that is grounded in the following principles:

            · Biochemical individuality describes the importance of individual variations in metabolic function that derive from genetic and environmental differences among individuals.

            · Patient-centered medicine emphasizes “patient care” rather than “disease care,” following Sir William Osler’s admonition that “It is more important to know what patient has the disease than to know what disease the patient has.”

            · Dynamic balanced assessment of both internal and external factors or stressors that can trigger physiological dysfunction (precursors of chronic disease).

            · Web-like interconnections of physiological factors – an abundance of research now supports the view that the human body functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other. For example, we now know that immunological dysfunctions can promote cardiovascular disease, that dietary imbalances can cause hormonal disturbances, and that environmental exposures can precipitate neurologic syndromes such as Parkinson’s disease.

            · Health as a positive vitality – not merely the absence of disease.

            · Promotion of organ reserve (life force) as the means to increasing your body’s capacity to handle unforeseen daily stressors – whether physical, chemical, or emotional – as a way to enhance health span and overall quality of life.

            Functional medicine is anchored by an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma are processed by one’s body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs. The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation. The core clinical imbalances that arise from malfunctions within this complex system include:

            · Hormonal and neurotransmitter imbalances
            from cellular membrane function to the musculoskeletal system

            · Oxidation-reduction imbalances and mitochondropathy

            · Detoxification and biotransformational imbalances

            · Immune imbalances

            · Inflammatory imbalances

            · Digestive, absorptive, and microbiological imbalances

            · Structural imbalances

            Imbalances such as these are the precursors to the signs and symptoms by which we detect and label (diagnose) organ system disease. Improving balance – in the patient’s environmental inputs and in the body’s fundamental physiological processes – is the precursor to restoring health and it involves much more than treating the symptoms. Through effective application of functional medicine, we are dedicated to improving the management of complex, chronic disease by intervening at multiple levels to address these core clinical imbalances and to restore each patient’s functionality and health.”

            1. Frederick says:

              WOW, what does Chiro don’t do? oh yes… Science.

            2. Frederick says:

              Yeah, You wish the Boards were less Cranks oriented, at least, but.. no This is for the “what is chiropractic” from “L’ordre des Chiropraticiens du Québec” :

              Chiropractic is a natural approach to health care that responds perfectly to Quebecers’ increasing concerns about health and quality of life.

              The word CHIROPRACTIC comes from the Greek kheir, meaning “hands” and praktikos, meaning “do” or “practice.”

              Chiropractic is a health care discipline that relies on the body’s inherent ability to keep itself healthy and heal itself without drugs or surgery (homeostasis). Chiropractic interventions focus on the relationship between structure (primarily the spine) and function, as coordinated by the nervous system.

              Chiropractic treatment is both preventive and curative, i.e., it is intended to provide relief as well as prevent the development of symptoms or pain associated with improper functioning of the spine or other joints. To achieve this, the chiropractor uses primarily chiropractic adjustments, a specialized form of joint manipulation.

              A chiropractor is your partner in restoring and maintaining your health. He is trained to give you the best advice to help you optimize your health and prevent the emergence of health problems.
              And of course, The research chair in Chiropractic his in my town! https://oraprdnt.uqtr.uquebec.ca/pls/public/gscw030?owa_no_site=722

              And there’s a Chiropractors at every corner here.

  14. Woo Fighter says:

    There’s a chiropractor who advertises very heavily in the Montreal media. She buys those “advertorial” ads in local community newspapers that look like real content but are part of an advertising package. Right next to her “column” (ad) is a large display ad for her services. Quel coincidence!

    It drives me crazy to hear her mislead and lie in her ads. She calls a subluxation a “pinched nerve”:

    Misalignment (pinched nerve or subluxation) of the vertebrae can interfere with the normal functioning of these nerves. Misalignments can be caused by accidents, injuries, falls, bad posture, poor sleeping habits, gravity, stress, and even in the birth process, for both mother and child. This misalignment is called “subluxation.” Sitting is as devastating to the spine as sugar is to the teeth. Subluxation is painless at the beginning, similar to cavities in your teeth. The only time you feel pain is when the subluxation is there for too long compared to having a root canal that causes pain. The position of the spine literally charges your brain battery. If for example you do not have a good input in your computer system, can it give you good output? It is similar with the spine. If your spine is misaligned, your body cannot function properly. Chiropractic is a journey, the longer and higher you climb the healthier you become.

    Her website claims that chiropractic can address these conditions (among others, but these are the dubious ones):

    Digestive Difficulties
    Dizziness, Vertigo and Light Headedness
    Ear Infections
    Sweaty Hands Treatment and Relief

    While it’s not on her website, I could swear in one of her recent “columns” she claimed chiropractic is also good for asthma.

    1. Frederick says:

      Yeah, I saw her, somewhere. On local Radio around here ( heard that on the radio at work, I don,t tune to those channels), there’s a Chiropractor giving Health advice. I mean, anybody sane enough can give sound health advice. But I heard him once talking about balance stuff, and subluxation. Right on the radio!

      But the one that creeps me out the most is “Docteur” Robidoux with his “méthode sans douleur”. He has a mad scientist look in his tv Adds and seem to have overkill high tech chiropractic machines. It is scary.
      https://www.youtube.com/watch?v=M42r3NTAppA

      his website : http://www.donotlink.com/bao4

    2. simba says:

      The asthma thing terrifies me. Potentially deadly illness, where the symptoms (but not the actual problem) respond well to placebo, which most people regard as fairly harmless anyway?

      I know people who will happily have their small child’s triggers in the house, because all that happens is they wake up and cough repeatedly in the middle of the night, every night. It’s just a bit of a cough, it doesn’t actually affect his asthma.

      When I think of the people I know who are using Buteyko, homeopathy, herbalism for a child’s asthma. Then there’s the one where they tried repeatedly to get the teenager to sit in an oxygen chamber whenever they got an asthma attack, because one go in the oxygen chamber in high oxygen would ‘cure’ their asthma forever.

  15. Ausduck says:

    I wear a health safety/quality hat professionally, and posed several questions to a chiro’s comment (in response to a negative online news article) ‘chiro is 100% safe, and we always get the informed consent of our clients, or their parents’. I asked a) Did they have an adverse event report/review system, b) If not, how did they know chiro was 100% safe, and c) since they couldn’t know the actual risks involved with chiro by not examining adverse events, how did they obtain informed consent?
    You can imagine how that discussion went. Even to the whine of ‘but who pays for all of this?’ by the chiro.
    I agree with Mark Crislip -there is no concept of safety/quality, the focus is not on safe patient outcomes utilising quality treatments (heck, with ‘wellness visits’ signed up for much like gym memberships, any patient outcome is not high in the list imo). The emphasis seems to be business modelling and building client base. One has to be very wary of a profession where there are no consistent standards of care, and where anyone who graduates can start practicing on any and all in the animal kingdom without extensive further study or accreditation.

    1. Mark Crislip says:

      “One has to be very wary of a profession where there are no consistent standards of care, and where anyone who graduates can start practicing on any and all in the animal kingdom without extensive further study or accreditation.”

      LOL. I do love clever use of language above all else. I plan to steal, er, borrow, er pay homage to the animal kingdom quote in the future.

      1. Ausduck says:

        I’m a well trained bureaucrat if nothing else, Mark :)
        Steal away.

  16. Kevin says:

    I am a college premedical student currently looking outside of traditional medicine for health care related carers. I recently started examining the chiropractic field.

    With two sides to the same coin on whether chiropractic works or not, it is hard to discern what to believe, especially since I have no formal medical education.

    Perhaps someone could reply with articles about the ‘scientific evidence’ behind the subluxation theory, which I have yet to find. I should mention that I’ve shadowed two chiropractic offices. An overwhelming number patients report less to no pain and overall better health. But it still leaves me in doubt. What about the patients for whom chiropractic does not work?

    1. Harriet Hall says:

      There is NO scientific evidence behind the subluxation theory. Even science-oriented chiropractors have rejected the concept. See http://www.sciencebasedmedicine.org/the-end-of-chiropractic/
      Patients report improvement, but controlled studies don’t bear that out. Patients reported improvement from Medieval bloodletting, and every quack has testimonials from patients who were “cured” by his brand of snake oil. The only way to tell if a treatment is truly effective is to do controlled scientific studies.

      Why not go to a conventional medical school? You would learn to do much more for your patients and if you decided you wanted to learn spinal manipulation techniques you could do that too.

    2. Andrey Pavlov says:

      @Kevin:

      I was in your shoes once, sort of. In my undergrad I got a degree in medical anthropology. They taught me that all this alternative medicine stuff was legit and even told us that “Western BioMedicine” was good for acute illnesses and injuries but for chronic diseases and “wellness” it sucked. I totally bought it. Until I really started digging deep and learning about both real medicine and CAM.

      Read the overview on chiropractic here at SBM. And peruse all the rest of the posts as well. You will find them well referenced and logically laid out. Follow the links provided, read the primary source documents, take the time to learn how to read those documents, and put it all together for yourself. Read other sources out there. This will be a lot of work. But this is not just your life and entire career we are talking about, but also any other people you interact with on a professional level (i.e. your patients) at stake as well. You should do your due diligence.

    3. WilliamLawrenceUtridge says:

      Kevin, chiropracitic care (specifically spinal manipulation, the one service they offer that is relatively unique to them) has been proven effective for exactly one thing – low back pain. That’s why physiotherapists are now training themselves on how to provide safe spinal manipulations limited to single vertebrae (generally lumbar).

      Subluxations are delusions, upon testing no two chiropractors have succeeded in identifying the same subluxations for the same group of patients. Further, the claims made by the more extreme chiropractors (“straights”) are dangerous nonsense – that subluxations (which don’t exist) cause cancer, or diabetes, or hypertension, or impair immunity. Even “mixers” who are less extreme are still making bold claims about their treatments when really it basically comes down to a musculoskeletal manipulation (that again, physiotherapists are now providing). And then there’s their tendency to oppose vaccination, pretend they are dietitians, sell you supplements, support homeopathy, and try to coerce you into multiple unnecessary weekly “maintenance adjustments”.

      I would suggest, in addition to this website, you peruse quackwatch, read the books produced by Sam Homola, and if you’re going to go on just my word, simply avoid chiropractors in general.

    4. MadisonMD says:

      Perhaps someone could reply with articles about the ‘scientific evidence’ behind the subluxation theory, which I have yet to find.

      We haven’t found it either.

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