this post was submitted on 05 Dec 2023
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"Systematic reviews of controlled clinical studies of treatments used by chiropractors have found no evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[8] A 2011 critical evaluation of 45 systematic reviews concluded that the data included in the study "fail[ed] to demonstrate convincingly that spinal manipulation is an effective intervention for any condition."[10] Spinal manipulation may be cost-effective for sub-acute or chronic low back pain, but the results for acute low back pain were insufficient.[11] No compelling evidence exists to indicate that maintenance chiropractic care adequately prevents symptoms or diseases.[12]"

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[–] [email protected] 340 points 11 months ago (49 children)

Anything a chiropractor can do that will actually help, a PT can do better. They'll also teach you what exercises to do to prevent needing to see them again.

A chiropractor will just tell you to come to them more often, and take more of your money over time.

[–] [email protected] 156 points 11 months ago (9 children)

You can save a lot of money by just going to a masseuse instead of a chiropractor. People attribute the positive feeling they get from attention to well being improvements, and pseudoscience practitioners certainly achieve that at a premium price. If it's attention you want, get a massage, otherwise go to a PT and get some real help.

[–] [email protected] 65 points 11 months ago (20 children)

Also I think a massage therapist will tend to be more educated on the muscles and how they work together than a masseuse

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[–] [email protected] 140 points 11 months ago (3 children)

its not just not helpful, it can be deadly/dangerous.

strokes are triggered by these idiots.

[–] [email protected] 90 points 11 months ago (3 children)

Strokes, but also broken necks.

And some of these quacks do "adjustments" on children and infants.

[–] [email protected] 27 points 11 months ago

Saw that on episode of Bullshit with Penn and Teller. Anyone who would do that to a baby should be imprisoned for life.

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[–] [email protected] 31 points 11 months ago* (last edited 11 months ago) (2 children)

https://www.ahajournals.org/doi/full/10.1161/01.str.32.5.1054

Thank your pointing this out. It's not just any stroke too, it's primarily vertebral/basilar artery distribution strokes. Those supply the brain stem which includes such necessary functions as control of breathing and consciousness. You don't want a stroke anywhere, but particularly not there.

Some chiropractors might swing back that, you've only showed correlation not causation. Well, when we have no clear evidence of chiropractic neck manipulation being helpful for anything, and we have a likely very dangerous correlation, the clinical parsimony is just not there. So no one is going to run that study (give a large amount of people neck manipulation, a large amount of people no neck manipulation, and compare rates of stroke that occur afterwards), it would be very unethical, no institutional review board would ever approve that study as ethical to perform.

And it makes a lot of sense too, the vertebral artery is encased in the neck vertebrae, so violent movements of the neck vertebrae can stretch and tear those arteries. Those tears, called a dissection, can sometimes obstruct blood flow all on their own, but more often create a spot for blood clots to form that then move onward into the brain and basilar artery (since there's turbulent blood flow and a defect in the smooth artery wall that normally prevents your blood from clotting). So please, no violent neck movements for any reason, chiropractor or otherwise.

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[–] [email protected] 105 points 11 months ago (2 children)

But boy, oh boy. Say this to a believer and get ready to loose an afternoon.

[–] [email protected] 78 points 11 months ago

loose an afternoon

That’s alright. A chiropractor can tighten up that afternoon for ya.

[–] [email protected] 41 points 11 months ago (11 children)

Indeed. I’ve got a chiropractor in my family, and I actively avoid talking to them about their work because I’ve always been convinced that it causes more harm than good. I think they finally got the hint after the 1000th time I refused their offer of an adjustment. They do some genuinely bizarre stuff beyond the standard adjustments, and talk about it like it’s proven science.

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[–] [email protected] 83 points 11 months ago* (last edited 11 months ago) (5 children)

People should also be aware of the growing number of alternative mental therapists popping up everywhere due to the shortage in actual psychologists.

They are nothing more than life coaches with a six-month certificate in whatever-the-fuck, most of which are disguised as Masters qualifications from wherever-the-fuck.

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[–] [email protected] 70 points 11 months ago* (last edited 11 months ago) (10 children)

Chiropractors and osteopaths only exist in such large numbers because they bill less to insurers than actual doctors & hospitals. So of course insurers are going to promote these quacks because it's cheaper than somebody going to an actual physiotherapist for treatment.

There should really be legislation that requires insurers to cover science & evidence based treatments. If someone wants woo it should be at additional expense to them, not part of a standard policy.

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[–] [email protected] 66 points 11 months ago (15 children)

I am actually really torn about this one, on one hand I had one episode of back pain that lasted nearly a year, swearing up and down the whole time that chiropractors were basically witch doctors and that I would never go to one. However, when I finally caved and went to one he fixed my issue after two sessions. On the other hand, my more recent back pain was not helped after I saw my chiropractor four times. In addition, I work as a nurse and have now seen at least three patients come in with vertebral dissections, essentially a stroke, that occurred literally right after they had seen a chiropractor for neck pain. Anecdotally, I would say it isn't worth the risk. Had I done physical therapy and used bought a tens unit the first time I'm sure it would have also fixed it without the chiro, but I was lazy

[–] [email protected] 57 points 11 months ago

That's the thing. Chiropractic could be considered a manual treatment which is a therapeutic modality. PTs do manual therapies that are less traumatic and are one component of the musculoskeletal issues that contribute to pain that chiro claims to heal. For most situations of acute back pain they resolve in 4 to 6 weeks so even the ineffective treatments appear to help- it's just like treatments for the common cold.

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[–] [email protected] 58 points 11 months ago (2 children)

If you see a youtuber calling themselves Dr. and giving out medical advice, 99% they are a chiropractor.

[–] [email protected] 50 points 11 months ago (12 children)

I met one of these in an airport bar! He introduced himself as a doctor then when I asked what specialty, he said he's a chiropractor. "Ohhhh, so not a doctor doctor."

He was not impressed.

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[–] [email protected] 58 points 11 months ago (4 children)

If you have spinal or neck pain, see a licensed physiotherapist. If you have a toothache, do you go to a toothiologist to have your teeth punched? Or do you go to a doctor of dental medicine?

[–] [email protected] 25 points 11 months ago

I mean a chiro would pop your back for your toothache.

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[–] [email protected] 57 points 11 months ago (4 children)

It does take an entire weekend of school to get certified though.

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[–] [email protected] 48 points 11 months ago (22 children)

I know people that swear by it which I can kind of understand if you have pain and they "pop" something and you feel better. But is it really helping if you have to keep going back?

[–] [email protected] 25 points 11 months ago (6 children)

I wonder if it's a placebo effect. Like I go for a back massage every month or so and feel good for a few weeks but I'm fully aware it's just muscle pain relief and not some permanent fix.

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[–] [email protected] 46 points 11 months ago (2 children)

One of my best friend’s fathers was an MD before retiring.

The cadaver he used in med school: broken neck during an “alignment” at a chiropractor’s office.

Anecdotal evidence for sure, but definitely a story that I think of whenever someone talks about going to a chiropractor.

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[–] [email protected] 43 points 11 months ago (3 children)

Don't "patients" like die from this all the time/randomly?

[–] [email protected] 57 points 11 months ago (1 children)

They never complained afterwards.

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[–] [email protected] 43 points 11 months ago (3 children)

That image feels designed to look like porn at a passing glance.

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[–] [email protected] 40 points 11 months ago (2 children)

Quick reminder that Physios and Chiros outside America face different rules for accreditation, and may not warrant similar judgement.

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[–] [email protected] 37 points 11 months ago* (last edited 11 months ago) (9 children)

If chiropractic was legit people wouldn’t have to keep going back for more “treatment”.

If you’ve got a bad back, watching your posture and doing some core strength training is more effective.

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[–] [email protected] 36 points 11 months ago (8 children)

I think this depends on the kind of chiropractic work. If they are just there to pop bubbles for that crack, then nothing is happening. I got into a car accident and my insurance sent me to a chiropractor that never cracked my back. Instead he gave me physical therapy, got me MRI images to check for an cracks on my spine or hernias in my discs, and gave me some equipment to help relax my back muscles and provide support to my bacl. I feel like this kind of work actually does provide benefit. I don't go anymore since all of that stuff is cleared up now, but I would trust that guy with my back again if I needed it.

[–] [email protected] 64 points 11 months ago

Yeah, If the chiropractor doesn't use chiropractic methods, it's definitely preferable.

[–] [email protected] 43 points 11 months ago (3 children)

Did you maybe go to a physiotherapist? That doesn't sound at all like a chiropractor, especially the MRI and actual treatment part.

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[–] [email protected] 39 points 11 months ago (1 children)

That's just a physiologist right?

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[–] [email protected] 35 points 11 months ago (1 children)

A good chiropractor is one that doesn't use chiropractic "treatment"

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[–] [email protected] 32 points 11 months ago (4 children)

it's an interesting decision to exclude

with the possible exception of treatment for back pain.

and

Spinal manipulation may be cost-effective for sub-acute or chronic low back pain

from the title here

[–] [email protected] 46 points 11 months ago (4 children)

A massage never killed anyone, unlike chiropracty. Just get a massage.

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[–] [email protected] 27 points 11 months ago (2 children)

Physical therapy will always be the better route.

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[–] [email protected] 26 points 11 months ago (1 children)
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