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Issues with Chiropracty
EmperorSeth
Registered User regular
Registered User regular
My gym apparently has some advertising or affiliation with ChiroOne, a nearby chiropractic office, as they are there once a week or so, offering chiropractic evaluations for a relatively cheap $20 instead of their usual $400 fee. Since I get occasional back injuries, I decided to try it out. Well, I got the X-rays back this week. According to them, I not only have an unbalanced hip, but also a much too straight neck. They want me to go in for three months of adjustments. What worries me is the price. They originally gave me a figure of $8,280, which after insurance was down to about $4,500. Then the doctor said she was willing to remove most of the uninsured cost, bringing the total to about $1,500. That's reasonable and within my means, but it also makes me worried. Is this or the original 8K price at all right for this kind of work? And why would the doctor agree to remove so much of the price?
You know what? Nanowrimo's cancelled on account of the world is stupid.
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It sounds like the chiropractor is trying to make money off of you, and off of your insurance.
My experience with chiropractic adjustments invovled a maximum 15 minute appointment, during which he would use a little pressure jabby thing to tap various parts of my back. No lie, it made me feel a hell of a lot better, but I was still feeling sort of ripped off at the cost of 33$ or so per adjustment. I realize some of that is him making back his investment in offices, equipment, and paying for his secretary, but who would really turn down 120-150$ per hour?
Because a lot of what they do is simple manual pressure, they don't have a lot of outgoing cost, so I assume they have a lot of flexibility on price while still making it profitable for them. At that point, they'll probably agree to whatever price cut they think necessary to bring you in, especially if it's in some sort of contractual format and they can bang your insurance on top of it.
If I were in your shoes, I'd talk to a real doctor about it first, and if you still want to go ahead, don't sign any sort of contract. Make sure you can stop at any time. For me, since I was on an appointment to appointment basis, I was able to take my weekly visits, turn them into two weeks, then three, then finally cease them all together.
How many adjustments are we talking per week? And what's involved in an adjustment?
Disclaimer: I'm from Canada, so some or all of this may not apply to you.
Look for a chiropractor who openly states that his or her practice is limited to the treatment of neuromusculoskeletal problems that have a mechanical origin. If you want to know if your practicioner is full of crap, here are the key words to avoid: Contact Reflex Analysis, subluxation, Applied kinesiology (AK), straight chiropractic, NUTRI-SPEC, NutraBalance, Morter HealthSystem, nutritional blood analysis / live cell analysis, enzyme replacement system.
Remember that properly performed spinal manipulation is always done by hand.
Do not mess with the neck: this is just dangerous.
Some further reading:
http://www.chirobase.org/07Strategy/goodchiro.html
http://www.quackwatch.org/01QuackeryRelatedTopics/chiroasst.html
http://www.quackwatch.org/01QuackeryRelatedTopics/chirovisit.html
http://www.quackwatch.org/01QuackeryRelatedTopics/chiroinv.html
http://www.quackwatch.org/01QuackeryRelatedTopics/chirosub.html
http://www.quackwatch.org/04ConsumerEducation/BookContents/homola.html
http://www.quackwatch.org/04ConsumerEducation/BookContents/cv.html
The origins and "theory" of Chiropractic are 100% completely bogus. I cannot stress this enough. Traditional Chiropractic teaches that most human diseases are caused by spinal misalignments or "subluxations" (a made-up word that doesn't really mean anything) and can be fixed through adjustments or "manipulations." I'm not talking back-pain diseases, I'm talking about things like Asthma and the common cold. There is no real evidence to back this up.
However, modern Chiropractic has been seen to be reasonably effective in the treatment of back pain, particularly lower back pain. Clinical trials are hard to do, but the evidence seems to indicate that there is some usefulness to adjustments even if the mechanism isn't well-understood (even by practitioners). The AMA has cautiously endorsed it for this purpose.
However, quackery and insurance fraud still abounds. There are some good critical articles here, and you should be very, very wary. Sure, you may have found a Chiropractor that really helps, doesn't make plausible-sounding but medically ridiculous claims, and isn't going to try to get you or your insurance company to pay out thousands of dollars for specious procedures. Or maybe you found a huckster.
Since you mentioned the name of the place, I did some Googling. Is this the same outfit? Based on your location and the location of their practices, I'm guessing it is. If so, read that page carefully. It's still talking about "subluxations" and the like. This is mumbo-jumbo in the highest degree. They claim that there's a direct causal link between your spinal "alignment" and your body's immune system. I would be shocked to find any medical (that is, supported by scientific evidence) studies that confirmed this. They also, if you click a few more links, sell videos about "THE SECRET TO BACK PAIN RELIEF THAT THE MEDICAL PROFESSION DOESN'T WANT YOU TO KNOW ABOUT." That's right up there with this joker. These are major, major, can't stress enough how major, red flags. Seriously, please, please stay away from these particular people.
If you are going to seek Chiropractic care, please take some time and effort to find an ethical, scientifically-minded chiropractor. (This may be hard to do, the Chiropractic 'training' that these 'doctors' receive is probably biased against it). Get a referral from a trusted M.D., for your (and your wallet's) sake.
Fristle's post on how to find an honest chiropractor was very, very good. I'll also point out that limited application of chiropractic techniques applied to certain conditions (like osteoarthritis) can have a beneficial effect when done under the supervision of a physician. A good chiropractor will work with your doctor. A bad one won't.
the "no true scotch man" fallacy.
Be careful with chiropractors anyway. My aunt went to a chiropractor once and he dislocated a disk in her back. She had to go through surgery to correct it. Not pleasant.
But I concur with those that tell you to take the X-Rays to an actual M.D. and get his/her opinion. And tell your doctor about the back injuries, too.
However, I gotta say every other chiropractor I've seen has seemed a bit quacky, so use the above tips. I had one that barely did anything and kept wanting me to come back every week. And my own chiropractor has on occasion lamented the quackery in his profession. He has his own stories almost exactly like Dalboz's aunt.
That said, if the X-rays are remotely accurate, seeing a real MD seems reasonable. They didn't give me a copy of the X-rays at the meeting, but I should be able to get a copy by asking for them, right? How much, given usual health insurance, would a regular doctor's vist be from there? I mentioned my back pain when I went in for some pain medication the last time my back started hurting, but the physician in question (I belong to Dreyer, a standard medical clinic/group) said they don't handle that sort of thing in-clinic? Would a good next step be to call Dreyer and ask for a referral?
Yes. There may be a small fee involved with that.
If they give you any flak about it, just say that HIPAA (pronounced 'hip-pah') says that they're required by law to give them to you (for a reasonable fee.)
Only your health insurance company can answer that. It could be anywhere from free to $300 depending on your insurance and the doctor.
They may have rules about giving out pain medication, due to fears about abuse and addiction. Yeah, call Dreyer and ask for referrals.
the "no true scotch man" fallacy.
The $8000 reduced to $1500 sounds like the chiropractor is pulling the same kind of nonsense a scummy used car salesman might. There is no damn way these services are worth anything near $8000, especially if they're being "reduced" to $1500. It sounds like the $8000 figure is quoted to make the $1500 one sound good.
Lime'd for truth. I read an article in the Skeptical Enquirer (It's a skeptic's magazine, not a tabloid) a few years ago that really emphasized this.
I'll point out here that hospitals and clinics do this a lot. It has to do with the negotiation process with insurance companies; medical practitioners set their fees a lot higher than what they would need to make a profit, because the insurance companies will only pay a portion of those fees. Then if somebody who is uninsured or underinsured walks in, they'll reduce the patient's fees for that person.
I'm not defending chiropractors with this. I'm just pointing out that slashing fees on a procedure is not an unusual practice or a red flag.
That said, $8000 for chiropractic services is a red flag. That's astronomical.
the "no true scotch man" fallacy.
My first chiropractor was a crook big time. He never said when he wanted to see you but I had a generally fucked up back so I went about weekly or so. I used to ask him for stretches or ways to help my back but he just said "be active" but I don't wanna be active if my back is hurting and being active may just fuck it worse. He spent no more than 3 minutes a session with me or anyone from what I could see. He'd snap me and kick me out of the office. He also does ART and when I found out what that was I was pissed off because I remember telling him about some golfers elbow I had and he never suggested he could do some ART on it...
My second chiropractor was amazing for the first two months or so and he told me upfront he wanted to see me as little as possible when I'd come in too much. He refused to be all cracky with me because the adjustments wouldn't hold if the muscles weren't strong enough to support them. He gave me plenty of exercises and everyone commented on how amazing my posture was. I felt amazing, stronger and more pain free than ever. Then things just started going down hill, I complained to him about some issues I was noticing with exercises like how I could row 35lbs with my right side easily for reps but still struggled with 10lbs for reps on the left side. I kept struggling away at the problem but it never got better. Eventually I hurt my hamstring or pissed off my sciatic nerve or something. I spent 4 months of weekly adjustments to ease the pain of it but the exercises he gave me never helped much until I researched it myself and gave myself exercises it got better in days. At this point he became useless and I would tell him my problems and he'd tell me to keep being active basically again... I tried rehabbing myself for a year still seeing the chiropractor to tell him what I was doing and he'd tell me to keep it up but despite my efforts problems kept getting worse or stagnating, never really improving much. There was a missing piece to the puzzle and the chiropractor wasn't up on how to solve it.
I've been seeing a physiotherapist for 4 weeks or so and its been nothing but amazing. Hes confirmed everything I've tried to tell my chiroprator to try to fix but he picked up on it without me telling him. The sessions are like being at the chiropractor sometimes the way he'll crack my back and adjust me all over but he explains how we can keep me from needing to be cracked to feel relief. He even showed me how to get someone to crack me on a foam roller(feels as good as chiro). My back has never felt better than it does lately.
I'm not to say all chiropractors are crooks like my first or underknowledged like my second but they've steered me clear. Also the chiro my dad saw a couple times was insane, saying adjustments cure all diseases and he needs to see my dad for a life time of adjustments for him to live a longer less disease filled life...
************
Long story short:
Goto physio therapy for pain management.
I figure it's just a psychological tactic to sucker you into giving them money - if they can make you feel like there's something wrong with you, your first instinct is to have it fixed, and because their offices are made to look like those of real doctors, there is a lot of subconscious tendency to take them at their word.
http://www.thelostworlds.net/
That's bizarre. Shows how messed up the US medical system is, in any other country (and I'll bet any other business in the US) getting quotes like that is a surefire sign you are getting conned.
Secondly, blindly trusting doctors is just like blindly trusting chiroprators (or any other kind of doctor). A chiropractor is a spine and joint specialist, just like a dermatologist is for the skin. I'm gonna tell you a little story. My dad once had a patient come into his office with a bad knee - not exactly close to the spine, but still. He had been to several doctors, none of which had managed to treat him properly. My dad did an x-ray, and after examining it, discovered that the guy had cancer. Though he had to amputate his leg, he survived. Creepy stuff.
Secondly, I've also been treated with instant relief. I was suffering from lower back pains after a day of track and field stuff. My dad told me to walk normally away from him while he was watching me. I took five paces, and he said there was a kind of dislocation in my lower back. Five minutes later, he had snapped in back in a violent maneuver that involved twisting my upper and lower body in opposite directions. Sounds crazy, huh? Hey, it worked!
Again, though, I can't speak for everybody. Chiropractors have been regarded as quacks for a long, long time, but my experience with them has shown me the opposite.
I firmly believe it's bullshit of the "herbal life" caliber.
When I went a few times, him just popping my back felt pretty good. the man can pop a back like a champ. All the wierd stuff, though, just made me feel shitty afterwards. So I stopped going.
That said, the guy I was going to was a pretty nice guy, and believed in his practice. So much that he'd drop the price to next to nothing just to get you in the door. He'd keep the price there, too.
The point of that last part was that 8k is bullshit. I'd stear clear of that place.
In general, a physio will do some of the same work as a chiro such as forcing the spine back into place. The main difference is that the chiro will stop there and tell you to come back next week, while the physio will work with you going over exercises and stretches to keep the problem from coming back. After the treatment cycle, the physio will tell you not to come back.
I spent some time with a physiotherapist after a car accident, and I've never been to a chiropractor since.
If you ever need to talk to someone, feel free to message me. Yes, that includes you.
Violent manipulations, i.e. sudden and fast twists -- make me very uncomfortable in concept. It seems impossible to do something both violently and precisely, and by nature anything done violently has the potential to damage something.
My belief is that it's theatrics. Much like faith healers or acupuncture, the theatrics of the "treatment" are the cure, because they activate a powerful placebo response. The placebo response is very much real, but if it requires scamming the patient to activate it, then I'm not on board with that.
As for accupuncture .. my dad thought it was all bullshit-o too... until the pain in his shoulder that he has had for years (that his many doctors before had told him he just 'had to live with') got so bad that he couldn't move his arm. He on a whim popped into a place, and after 45 min, was swinging his arm around.
He never said the mpain was completely gone... it was still there , just 'in the background'. But the shear difference in a man walking stiff to swinging his arms all over is pretty telling. He didn't get into 'chi' or any life force stuff.. just sticking needles in him and stimulating...
Librarians harbor a terrible secret. Find it.
This is not precisely true. A spine and joint specialist is called an 'orthopedist,' although it would be more accurate to say that the medical profession most analogous to the chiropractor is the osteopath. (Orthopedists tend to have a more surgical focus, while osteopaths are typically trained in manual manipulation.) Orthopedists and osteopaths base their practice on objective medicine, which is in turn based on the scientific method. If an orthopedist or an osteopath (or any other medical doctor) makes decisions that repeatedly go against mainstream scientific understanding, the state can revoke their license to practice. This is not true of chiropractors, who are expected to follow a separate discipline that is not based on the scientific method.
I agree wholeheartedly but I'm afraid that's a discussion for another thread.
the "no true scotch man" fallacy.
My understanding is that it's more like cracking your knuckles - it does make them feel better and more flexible right away, but it's a superficial effect that in the long term causes problems. That fits in well with what I know of people who go to a chiropractor - they go on a regular basis because they feel stiff or whatever if they don't.
Manipulating the lower back especially seems like a load of crap to me, because if you look at the human spine, the lower part is made of pieces that lock together. They literally cannot be out of alignment unless it's so far that your spinal cord would have a multi-inch break in it.
http://www.thelostworlds.net/
I was treated once, and never experienced any trouble after it.
Chiropractors really will help you feel better. Until one day after you stop going to see them regularly. Then you're right back where you started from, minus $$$.
Every so often I go to chairo (once or twice ever 4-6 months) and it is amazing. I am a pretty active guy so i figure all the exercise does keep most of it in check, but every so often it catches up to me. One time i went i really didnt know i had a problem, but when my back was realigned it honestly felt like i had taken some rediculous drugs. I walked home and stared at the wall (seriously) all night because it felt so good. I hadnt realized how badly i needed to go until i was taking a leak and saw stars.
I find that I feel better after going. Maybe it is a placebo effect, but I highly doubt it.
I am also really fortunate that I go to a chairo at the university I attend where a session costs me only $15.
I have had good experiences with them, but at the same time for substantially less money then they are talking about with you. I would say talk to a real doctor and see what they think about it.
"If I ever woke up with a dead hooker in my hotel room, Matt would be the first person I'd call."
www.PatriceOneal.com
This just isn't true. Although blindly trusting anyone is a bad idea, I'd put my trust in a doctor of medicine over chiropractor any day.
An actual doctor goes through a decade of training, and practices using guidelines based on empirical evidence. On the other hand, most chiropractors actually believe that 'spinal subluxation' plays a role in every illness.
Chiropracty is 'alternative medicine', which is the same as 'unproven medicine'. That's not to say that all alternative therapies are bad. Even if it is just a placebo effect - if it makes you feel better and you're not paying through the nose, why not? However, $1500 seems like a ridiculously high price, and $8000 is just insane.
This really can't be overstated. Doctors spend their entire lives studying, keeping up on new developments, and working very hard, working many more hours than most people. Chiropractors can get their "degree" from mail-in degree mills, and maybe take a week long class or something. I'd rather have someone with no understanding of medicine at all help me than a con man who lies and takes advantage of people. There is absolutely no scientific evidence none at all, ever supporting chiropractics (and plenty against, including countless injuries and deaths). Absolutely every argument for it is circumstantial. And a good deal of the reason people think chiropractics works is because they get confused between chiropractics and real doctors like physical therapists.
In fact, the AMA once tried to forbid any doctor from recommending anyone a chiropractor, and declared chiropractics to be unethical and quackery. The government, because they're idiots and fuck things up, said they couldn't do that, when the chiropractors leveled an antitrust suit against the AMA.
Quackwatch's http://www.chirobase.org/ lists a bunch of stuff about chiropractics.
once being the key word
She'd have the students do stuff to her regularly and she swears by it.
She encouraged me to go too.. I did.. cost $15 a session and it made me feel good.
Most of the time.. The guy I saw did Active Release Therapy (ART).. kinda like a very painful massage.
This guy inflicted some pretty bad short term pain during these sessions.. But in the end it seemed to help.
Also, I let the guy play with my neck.. In the hands of a trained professional you have nothing to worry about.
The problem is that the field had been(is?) without a great deal of regulation... Just like the massage therapy field.. you can go to a guy who's got some valid credentials or you can go to a rub'n'tug parlor.
A Spine and Joint specialist is an orthopedist. And Orthorpedist, dermatologists, ear nose and throat...ologist, all have to go to med-school.
Chirpractors study alignment and and simple kinesiology.
I, personally, would be more apt to trust a spine and joint specialist who also had to pass med school before letting them touch me.