What's wrong with chiropractors?

Feral

darkmayo wrote:

The problem I have seen with people buying into the pseudo-science over actual proven treatment is that the pseudo science practitioners have more time to give the patient the warm fuzzies, to explain in detail why there homeopathic wombat extract will cure them of there whatever. They can sell it better, they can spend the time gaining the trust of the patient, meanwhile your GP has 5 minutes to visit you before he has to go to his next patient.

http://www.acsh.org/healthissues/newsID.656/healthissue_detail.asp

Chiropractic has thrived¬despite its self-destructiveness and despite vigorous opposition from the medical establishment in the U.S.¬because American physicians as a whole have nearly abandoned a large segment of the patient population. In terms of frequency of patient reporting to physicians, musculo-skeletal pain is second only to respiratory infections. The best treatment by far for most cases of musculo-skeletal pain is conservative¬more specifically, outpatient treatment that features physiotherapy (physical exercise and noninvasive manual and related methods). Musculoskeletal complaints have never had prestige in the medical sphere. Primary care physicians often respond to patients' reporting of back pain, for example, not with curiosity and concern but rather with annoyance or frustration¬at worst, with disdain.

Physicians are not well trained in the management of common musculoskeletal complaints. In a study published in The Journal of Bone and Joint Surgery in 1998, researchers found that 82 percent of new medical residents had failed what was considered a basic competency examination in musculoskeletal medicine. The researchers concluded that medical-school preparation in such medicine was inadequate. The specialists who have been adequately trained in musculoskeletal medicine¬neurologists, orthopedists, physiatrists, and rheumatologists¬are relatively scarce and inaccessible, can be expensive, focus on cases more exotic than those of ordinary aches, and tend to treat musculoskeletal problems aggressively.

From a thread we had about a year ago:

Feral wrote:

General practitioners in private practice have to see 18-24 patients per day to stay afloat. (Again, feeling kind of lazy about digging up links...) If the GP is filling out forms, handling basic business management tasks, and working reasonable hours, that's not a whole lot of face time per patient. And of course medical offices aren't the most relaxing of environments. Going to the doctor can feel like a dehumanizing experience even with the best bedside manner.

I think an effective alt medicine practitioner is more likely to sit down, take the time to talk to you, make sure you feel relaxed. And some of the alt medicine practices I've seen seemed more like spas or masseurs than doctors' offices. Who wouldn't want to go someplace that feels a little bit more like pampering? And if your complaints are at all affected by the placebo effect - if they're stress or depression related, with vague symptoms like 'fatigue' or 'aches and pains' - I can see how a more attentive holistic approach could be efficacious in a way that a strict medical approach would not be.

Preacher

Look one of the best competitors on American Gladiators ever was a chiropractor. I think that defeats a lot of science bs!

darkmayo

Feral wrote:

darkmayo wrote:

The problem I have seen with people buying into the pseudo-science over actual proven treatment is that the pseudo science practitioners have more time to give the patient the warm fuzzies, to explain in detail why there homeopathic wombat extract will cure them of there whatever. They can sell it better, they can spend the time gaining the trust of the patient, meanwhile your GP has 5 minutes to visit you before he has to go to his next patient.

http://www.acsh.org/healthissues/newsID.656/healthissue_detail.asp

Chiropractic has thrived¬despite its self-destructiveness and despite vigorous opposition from the medical establishment in the U.S.¬because American physicians as a whole have nearly abandoned a large segment of the patient population. In terms of frequency of patient reporting to physicians, musculo-skeletal pain is second only to respiratory infections. The best treatment by far for most cases of musculo-skeletal pain is conservative¬more specifically, outpatient treatment that features physiotherapy (physical exercise and noninvasive manual and related methods). Musculoskeletal complaints have never had prestige in the medical sphere. Primary care physicians often respond to patients' reporting of back pain, for example, not with curiosity and concern but rather with annoyance or frustration¬at worst, with disdain.

Physicians are not well trained in the management of common musculoskeletal complaints. In a study published in The Journal of Bone and Joint Surgery in 1998, researchers found that 82 percent of new medical residents had failed what was considered a basic competency examination in musculoskeletal medicine. The researchers concluded that medical-school preparation in such medicine was inadequate. The specialists who have been adequately trained in musculoskeletal medicine¬neurologists, orthopedists, physiatrists, and rheumatologists¬are relatively scarce and inaccessible, can be expensive, focus on cases more exotic than those of ordinary aches, and tend to treat musculoskeletal problems aggressively.

From a thread we had about a year ago:

Feral wrote:

General practitioners in private practice have to see 18-24 patients per day to stay afloat. (Again, feeling kind of lazy about digging up links...) If the GP is filling out forms, handling basic business management tasks, and working reasonable hours, that's not a whole lot of face time per patient. And of course medical offices aren't the most relaxing of environments. Going to the doctor can feel like a dehumanizing experience even with the best bedside manner.

I think an effective alt medicine practitioner is more likely to sit down, take the time to talk to you, make sure you feel relaxed. And some of the alt medicine practices I've seen seemed more like spas or masseurs than doctors' offices. Who wouldn't want to go someplace that feels a little bit more like pampering? And if your complaints are at all affected by the placebo effect - if they're stress or depression related, with vague symptoms like 'fatigue' or 'aches and pains' - I can see how a more attentive holistic approach could be efficacious in a way that a strict medical approach would not be.

Better written than what I said.

Bagginses

Feral wrote:

Bagginses wrote:

darkmayo wrote:

bowen wrote:

That's what I thought they meant by it, though that energy flow stuff is lolerific. These guys are medical professionals?

well.. professionals in there own field, which they might say is medical. In all honesty if you really have back problems, go a real doctor who will likely refer you to a physiotherapist, who may have chiropractor certifications as well.

What about problem with the nervous system running through the spine? Neurologist?

Probably.

That's the crux of the problem with chiropractic. Some conditions are caused by pinched nerves; some complaints can be treated by manual manipulation of the joints or spine.

However, chiropractic as a school of thought believes that completely unrelated conditions can be treated this way. At best, it's a harmless waste of money; at worst, they can make existing spinal problems worse.

It does kind of make sense, though, when signal disruption (aka pinched nerves) is the most likely for a mysterious, unexplained problem. Back issues is basically the best guess you give instead of "fuck if I know," which can lead to a rapid inflation of its use.

shryke

Man, some of this shit is crazy. My GF's family goes to a Chiropractor on a infrequent but regular basis and they never hear anything like this.

From what I've seen, they were basically a combination physiotherapist and masseuse.

override367

In 9.5 out of 10 cases they aren't actually doing anything though, and what they are doing is probably harmful

Toldo

Not exactly sure how I can add to this conversation, but my father has worked as a chiropractor for the past forty years. He established a clinic in a small town after finishing his education at Palmer College of Chiropractic and has since been able to build some great relationships with local doctors and other medical professionals. Since he is a licensed radiologist, he is able to take care of some of the spillover from the local hospital.

My father does not believe spinal correction can cure any kind of disease--he only treats neck and back pain. Neither does he treat small children. He does perform acupuncture, however.

I have responded positively to the times when he has treated me, but I guess that is all I can say.

mrt144

Looking at my chiropracter's web site, looks like he thinks that he's only really good for relieving back pain imminently and helping people build healthier backs through muscle strengthening.

Taramoor

Bagginses wrote:

darkmayo wrote:

bowen wrote:

That's what I thought they meant by it, though that energy flow stuff is lolerific. These guys are medical professionals?

well.. professionals in there own field, which they might say is medical. In all honesty if you really have back problems, go a real doctor who will likely refer you to a physiotherapist, who may have chiropractor certifications as well.

What about problem with the nervous system running through the spine? Neurologist?

I had numbness in my left hand and some back pain.

I saw a chiropractor my Dad recommended, who took x-rays and did some kind of heat reading of the different part of my spine. Then he had me come in for regular sessions. It continued to get worse.

Once my insurance informed me that these would be $55 each because, and I quote the BCBS rep here "your coverage doesn't include magic." I never went back.

Then I went to a nerve specialist who stuck with electric needles and showed me how my nerve conduction speed was low, who directed me to a neurologist who looked at my spine and said "if you see that chiropractor again you'll permanently lose the use of your hand".

The neurologist operated on my arm to unpinch my ulnar nerve. And I haven't had a problem since unless I lift over 250 lbs.

Then I saw the episode of Bullshit! About chiropractors.

I hate them.

durandal4532

Chriopractors are bullshit artists who rely on the fact that people get defensive about sunk costs.

"But not my guy! I'm not dumb!" Yes yes, you're a genius, the guy who snapped your back "into alignment" is still a charlatan.

Who, sometimes, will kill you by accident! Because he's not a doctor so much as a man who plays one as a hobby.

It's only because back pain is so prolific that people can keep these assholes in business. Everyone thinks their crippling back pain is shocking and terrible and any feeling of relief is prioritized. But it's actually something that the majority of humanity will deal with because our backs were built to fail.

Edit: But Taramoor!

MY guy didn't almost cripple me for life!

Captain Carrot

durandal4532 wrote:

Chriopractors are bullshit artists who rely on the fact that people get defensive about sunk costs.

"But not my guy! I'm not dumb!" Yes yes, you're a genius, the guy who snapped your back "into alignment" is still a charlatan.

Who, sometimes, will kill you by accident! Because he's not a doctor so much as a man who plays one as a hobby.

It's only because back pain is so prolific that people can keep these assholes in business. Everyone thinks their crippling back pain is shocking and terrible and any feeling of relief is prioritized. But it's actually something that the majority of humanity will deal with because our backs were built to fail.

Occupy Spine!

durandal4532

1% of my body tissue can paralyze the other 99%, it isn't right.

DoctorArch

I could go on and on about this and all other pseudo-scientific magical medical thinking for days. If you want to read about Chiropractic Medicine 2.0 (a new century of magic medicine) look up Craniosacral therapy.

spool32

However, chiropractors are often high on their own supply. They often believe they are helping people!

Toldo

Several European countries recognize chiropractic treatment as a valid form of treatment, and require chiropractors to be authorized and hold licenses in order to practice. Are they wrong?

mrt144

The biggest knock I have against chiropractors is that if they're actually helping you in the long term, why do you have to see them so goddamn much? I've rarely seen a chiropractor state that their goal is to have to out of their office for good in 2 weeks or less.

Captain Carrot

The UK's NHS funds homeopathy, which doesn't stop it from being a load of shit. Yes, those countries are wrong.

Toldo

mrt144 wrote:

The biggest knock I have against chiropractors is that if they're actually helping you in the long term, why do you have to see them so goddamn much? I've rarely seen a chiropractor state that their goal is to have to out of their office for good in 2 weeks or less.

What about long-term physical therapy?

spool32

Captain Carrot wrote:

The UK's NHS funds homeopathy, which doesn't stop it from being a load of shit. Yes, those countries are wrong.

They most certainly are wrong.

durandal4532

Toldo wrote:

Several European countries recognize chiropractic treatment as a valid form of treatment, and require chiropractors to be authorized and hold licenses in order to practice. Are they wrong?

Absolutely.

mrt144

Toldo wrote:

mrt144 wrote:

The biggest knock I have against chiropractors is that if they're actually helping you in the long term, why do you have to see them so goddamn much? I've rarely seen a chiropractor state that their goal is to have to out of their office for good in 2 weeks or less.

What about long-term physical therapy?

See a physical therapist?

Toldo

mrt144 wrote:

Toldo wrote:

mrt144 wrote:

The biggest knock I have against chiropractors is that if they're actually helping you in the long term, why do you have to see them so goddamn much? I've rarely seen a chiropractor state that their goal is to have to out of their office for good in 2 weeks or less.

What about long-term physical therapy?

See a physical therapist?

What I meant was that physical therapists often work with people over long periods of time to rehabilitate them.

DoctorArch

Physical therapy is the result of scientific testing that has proven significant long-term results with the application of certain procedures.

The crux of pseudo-science is that it never produces a "cure" or actual remedy but only a temporary solution that requires the patient to subject themselves to the temporary solution repeatedly. There is never a determinable endpoint.

darkmayo

DoctorArch wrote:

Physical therapy is the result of scientific testing that has proven significant long-term results with the application of certain procedures.

The crux of pseudo-science is that it never produces a "cure" or actual remedy but only a temporary solution that requires the patient to subject themselves to the temporary solution repeatedly. There is never a determinable endpoint.

Not that I disagree with your statement, but there is quite a lot of actual medical treatments that are temporary solutions as well, or solutions that only work as long as you take the meds.

AngelHedgie

Toldo wrote:

mrt144 wrote:

Toldo wrote:

mrt144 wrote:

The biggest knock I have against chiropractors is that if they're actually helping you in the long term, why do you have to see them so goddamn much? I've rarely seen a chiropractor state that their goal is to have to out of their office for good in 2 weeks or less.

What about long-term physical therapy?

See a physical therapist?

What I meant was that physical therapists often work with people over long periods of time to rehabilitate them.

Physical therapy is built on science, not bullshit.

Bagginses

spool32 wrote:

Captain Carrot wrote:

The UK's NHS funds homeopathy, which doesn't stop it from being a load of shit. Yes, those countries are wrong.

They most certainly are wrong.

I thought the UK yanked it last year.

Dropping Loads

Another thing is that not all placebos are created equal. A doctor can give a patient a sugar pill and say "This will help relax your back, which will make it easier to do your stretches every night." A chiropractor will give you a long consultation, perform an alignment, and then say the same thing. There's a certain personality that is much more willing to believe the chiropractor than the doctor in this case, and because of this, will actually do the stretches because the chiropractor told them to, but would blame the doctor for the pill not working. It's another example of sunk cost/personal investment.

(I'm not saying that chiropractors are doing a good thing. I'm saying that human psychology plays a known role in treatment outcomes.)

mrt144

darkmayo wrote:

DoctorArch wrote:

Physical therapy is the result of scientific testing that has proven significant long-term results with the application of certain procedures.

The crux of pseudo-science is that it never produces a "cure" or actual remedy but only a temporary solution that requires the patient to subject themselves to the temporary solution repeatedly. There is never a determinable endpoint.

Not that I disagree with your statement, but there is quite a lot of actual medical treatments that are temporary solutions as well, or solutions that only work as long as you take the meds.

And in the case of something like schizophrenia, it's accepted that pharmaceutical therapeutics is the end point of treatment, for now. And in the case of mental illness there is a formal diagnosis progress going on

Pi-r8

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

Captain Carrot

You mean Communism. Better dead (of an easily preventable disease) than red.

The Ender

The mom of a friend of my mother was nearly killed by a chiropractor / homeopath. She had been going to the doctor and getting medication for about 6 months to deal with some stomach pain, and the pain continued to worsen even though she was taking the medication as prescribed.

So one day her daughter (my mom's friend) just asks to see what kind of medication the doctor had been giving her... and sees that it's some kind of Lavender extract. This doesn't sound like medicine to her, so she goes down to the clinic to see the family doctor about what was up with the meds. Family doc says he hasn't seen the daughter's mom come in for years, takes a look at the 'medicine', and tells her that her mom must be going to see some homeopath, and that the 'medicine' is actually just a bottle of water.

Daughter immediately runs home, grabs her mom, drags her to the family doctor, and the mom is diagnosed with diabetes. She'd have almost certainly died in a few weeks if she had continued to see the homeopath.


The story as to how / when she decided to go and see the local homeopath was never really told to me, but from what I gather, she went in on a lark one day and decided that the old guy seemed real sweet & smart, and his office looked so much more vibrant than the doctor's office, and she got fed a load of bullshit about how normal doctors poison people with toxic 'unnatural' medication.

Neaden

Pi-r8 wrote:

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

My impression is that Chiropractors are mostly seen by people with insurance, it's not really a money thing.

override367

What insurance covers chiropractors? I've never had insurance that did (and rightly so).

thehumandignity

I always kind of assumed that chiropracty was hand-waving and bullshit just because of the sheer volume of people that say it is, so when I got the opportunity I told a chiropractor about this back pain I used to get whenever I ran. I say "used to" because, after asking me some questions and having me stand up straight against a wall to examine my posture, he did an adjustment, right there on the spot, and it's never happened again. I am aware that the placebo effect can occur even when you don't expect the placebo to be effective but this was a pain that would occur literally every single time I would run and hasn't happened again, ever, since then, about three years ago.

I know there are some crackpots like the anti-vaccers mentioned in the OP but all this tells me is that chiropractors, like every other profession, are composed of people.

Julius

Neaden wrote:

Pi-r8 wrote:

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

My impression is that Chiropractors are mostly seen by people with insurance, it's not really a money thing.

I think there is a group of people in any society who will seek out bullshit-remedies. It's not like these industries don't exist in Europe. Shit, usually these remedies are more expensive than normal doctors.

The stuff mentioned by Thanatos in the OP is more a result of the US just being very big and a curious aspect of the politics in the US. I doubt it has anything to do with the lack of socialized medicine, and if it does it's probably just a small part.

Pi-r8

Julius wrote:

Neaden wrote:

Pi-r8 wrote:

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

My impression is that Chiropractors are mostly seen by people with insurance, it's not really a money thing.

I think there is a group of people in any society who will seek out bullshit-remedies. It's not like these industries don't exist in Europe. Shit, usually these remedies are more expensive than normal doctors.

The stuff mentioned by Thanatos in the OP is more a result of the US just being very big and a curious aspect of the politics in the US. I doubt it has anything to do with the lack of socialized medicine, and if it does it's probably just a small part.

I doubt that it's anywhere near as big a problem in Europe. Over here, you have people saying "fuck, my back is killing me, and I can't take time off my job. But I can't go to a real doctor because it's too expensive." Guess I'll just go to a chiropracter/acupuncturist/faith healer instead, or maybe just pop some aspirin or drink some alcohol. And thanks to the magic of the placebo effect, sometimes that does make them feel better. But it bites us in the ass long-term,so we end up paying vast amounts through medicare to try and reverse decades of damage from lack of preventative care. And even then, we still end up behind almost all of Europe in life expectancy.

Bagginses

Pi-r8 wrote:

Julius wrote:

Neaden wrote:

Pi-r8 wrote:

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

My impression is that Chiropractors are mostly seen by people with insurance, it's not really a money thing.

I think there is a group of people in any society who will seek out bullshit-remedies. It's not like these industries don't exist in Europe. Shit, usually these remedies are more expensive than normal doctors.

The stuff mentioned by Thanatos in the OP is more a result of the US just being very big and a curious aspect of the politics in the US. I doubt it has anything to do with the lack of socialized medicine, and if it does it's probably just a small part.

I doubt that it's anywhere near as big a problem in Europe. Over here, you have people saying "fuck, my back is killing me, and I can't take time off my job. But I can't go to a real doctor because it's too expensive." Guess I'll just go to a chiropracter/acupuncturist/faith healer instead. And thanks to the magic of the placebo effect, sometimes that does make them feel better. But it bites us in the ass long-term,so we end up paying vast amounts through medicare to try and reverse decades of damage from lack of preventative care. And even then, we still end up behind almost all of Europe in life expectancy.

From what I've seen, chiropractors tend to charge boutique prices, more than real doctors.

override367

But it takes less time and is easier to get in

Pi-r8

Bagginses wrote:

Pi-r8 wrote:

Julius wrote:

Neaden wrote:

Pi-r8 wrote:

As long as proper health care remains way too expensive for most people in America, I guess it's inevitable that we'll have these pseudo-doctor loosely-regulated cottage health industries like chiropractors (and to a lesser extent acupuncturists, although at least they can't do any harm to you). Yet another problem that would be solved by socialized medicine.

My impression is that Chiropractors are mostly seen by people with insurance, it's not really a money thing.

I think there is a group of people in any society who will seek out bullshit-remedies. It's not like these industries don't exist in Europe. Shit, usually these remedies are more expensive than normal doctors.

The stuff mentioned by Thanatos in the OP is more a result of the US just being very big and a curious aspect of the politics in the US. I doubt it has anything to do with the lack of socialized medicine, and if it does it's probably just a small part.

I doubt that it's anywhere near as big a problem in Europe. Over here, you have people saying "fuck, my back is killing me, and I can't take time off my job. But I can't go to a real doctor because it's too expensive." Guess I'll just go to a chiropracter/acupuncturist/faith healer instead. And thanks to the magic of the placebo effect, sometimes that does make them feel better. But it bites us in the ass long-term,so we end up paying vast amounts through medicare to try and reverse decades of damage from lack of preventative care. And even then, we still end up behind almost all of Europe in life expectancy.

From what I've seen, chiropractors tend to charge boutique prices, more than real doctors.

What about compared to getting surgery at a hospital?

Apothe0sis

There are three camps within the "Chiropractic" industry - the splitters, who want to reform the industry into a medically based back cracking and massage field, the traditionalists who are all about subluxations being the cause of your UTI and the accommodationists who try to bridge the two positions.

Skeptoid did an episode on the "Chiropractic" - he goes through the different camps -> Whacking, Cracking, and Chiropracting

My main complaint is that 'Chiropractic' totally violates English morphology - nouns don't use the suffix "-ic" you turds.