What do chiropractors do?

Scot Dutchy · **#121** by **Scot Dutchy** » Dec 30, 2011 6:38 pm

The quack I went to had American qualifications. He never kept notes on the treatment he was giving.
He had a machine that made a lot of noise when he was "correcting" my back.
Luckily my health insurance covered the charges he made. He had no effect what ever. After six months I stopped.
My caeser therapist had me right in a month.

starr · **#122** by **starr** » Dec 30, 2011 6:51 pm

Templeton wrote:.....
Furthermore, was it not you Mr. Samsa that extolled the virtues of Osteopaths in a previous post, and was it not you that stated that Osteopaths should be the physician doing spinal manipulations? Why would you suggest such a thing if there was no benefit to spinal manipulation? Curious

....

I didn't read Mr.Samsa's post as extolling the virtues of Osteopaths. I think you might be remembering Mr.Samsa's comments earlier about physiotherapy being a valid evidence-based treatment.

Mr.Samsa wrote: ...

In a nut shell, if you're extremely lucky, you'll get a chiropractor who has also trained in an actual medical field (like physiotherapy or general medicine) and they will apply standard treatments that have nothing to do with chiropractic.

If you see a standard chiropractor, then you'll get someone with a fairly poor understanding of human anatomy and who has been taught some basic evidence-based physio treatments (but without the safety precautions that should go along with it), and they'll make a few references to "subfluxations".

...

EDIT for clarity

Pebble · **#123** by **Pebble** » Dec 30, 2011 8:14 pm

Just reading this post, I realise you are a hopeless case. Mr Samsa was kind enough to do what you should have done before uncritically pasting tripe - analysed the quality of the evidence. He did this in a dispassionate and even handed manner, and because your sources were crap - you take umbridge.

Templeton wrote:This is something akin to the Dark Ages, and my dear Irrational Skeptic you are the voice of the ignorant masses. Health is something everyone can aspire too, not just the favored few - You've drunk the koolaid of the clerics who would have you believe that only they know the vast mysteries of the body electric. Why next I would suspect you to start spouting about in Latin ---- Pie Jesu Domine, dona eis requiem. Whack !

So checking the evidence is in your mind evidence of ignorance?

Templeton wrote:
Every organ in the body is connected to the nervous system, therefore every organ has a correlating nerve - Every nerve passes through the spinal column. Basic anatomy tells us that each vertebra, and the nerves that pass through them correlate with each and every organ in the body, one might consider gaining a basic understanding of a subject before one ridicules. Furthermore, was it not you Mr. Samsa that extolled the virtues of Osteopaths in a previous post, and was it not you that stated that Osteopaths should be the physician doing spinal manipulations? Why would you suggest such a thing if there was no benefit to spinal manipulation? Curious

The Vagus nerve (or indeed any of the other 11 cranial nerves)? Anyway - so what - every organ in the body is connected somehow to everything else, it does not follow that massaging the toes will cure cancer.
Further Mr Samsa has pointed out on a number of occasions now that spinal manipulation has an evidence base for efficacy - limited to low back pain, though even that is not impressive. Second he has pointed out that many of the other spurious claims made for and by chiropracters have been properly investigated - why don't you look up some of those studies?

Templeton wrote:
Indeed a simple Cut and Paste was what I did, only to show you that the information is out there should you, or anyone else care to investigate further. You might want to brush up on your web surfing skills ole bean if you are unable to find the reports listed in my previous post. Your attempts to misdirect by stating you couldn't find them or they were observational studies is weak and a sign of poor debate. What do you want, blood work for pain relief? That's not how it works my good man. The method by which Chiropractic functions is to relieve misaligned vertebra that hinder the proper function of the nervous system. One method to record the results is by 1st person observation. (This happens to be used regularly in medical studies) ah do I sense a segue?

Just because there's a lot of shit on the internet does not mean it is quality material. As to studies with subjective endpoints - e.g. pain relief - there randomisation and blinding are absolutely pivotal. Where this is not present there is no evidence of cause and effect only of associations, which may or may not merit further investigation, but not conclusions of the type you are making.

Templeton wrote:

You miss the mark - from the 1st person perspective - which is what I stated, and every patient, ourselves included, subscribe to this form of experimentation. If the remedy makes us feel good - what do you do? Continue to take it, even while patients continue to take medications that have adverse side effects because they find relief from their initial dis-ease? There is evidence for relief therefore we continue with the treatment. A 1st person inquiry is the initial diagnosis for all doctors.

Would they ask if it was irrelevant?

No it is not Mr Samsa who is missing the mark, you are however missing the entire barn. If your only goal is symptomatic relief, with no interest whatsoever in the cause of the symptoms or the likley future outcome, then as an individual one may certainly choose to use an approach such as this. It is still not evidence of cause and effect.

Templeton wrote:
Mr. Samsa, How do you feel?

Having read your response to the work he put into assessing your post, and efforts to be calm and even handed, somewhat pissed I imagine.

Mr.Samsa · **#124** by **Mr.Samsa** » Dec 31, 2011 12:30 am

Templeton wrote:This is something akin to the Dark Ages, and my dear Irrational Skeptic you are the voice of the ignorant masses. Health is something everyone can aspire too, not just the favored few - You've drunk the koolaid of the clerics who would have you believe that only they know the vast mysteries of the body electric. Why next I would suspect you to start spouting about in Latin ---- Pie Jesu Domine, dona eis requiem. Whack !

Come on, Templeton. How could you compare my actions and behaviors to those of the dark ages and ignorant masses? I took the "citations" you gave me, which may well have been crayon scribblings on toilet paper, and I spent at least an hour of my time going through each one, reviewing the methodology and conclusions, then reporting back here with my opinions on them.

Incidentally, it was you who was ignorant of the research you were presenting and clearly hadn't read through any of references you produced. You cheered the "New Zealand commissions report", even though the only way you could have read it is if you had flown to NZ and then read one of the few remaining hard copies in the dark basement of some library. Instead, you take it on faith that the interpretations presented by chiropractors (who obviously haven't read it either) are correct.

And you accuse me of ignorance and blind faith? You fucking presented one reference which refuted chiropractic, and another one that only looked at physiotherapy! Not to mention you listing one of the references twice.

If ignorance and blind faith is defined as diligently researching the evidence presented to back up claims, and fairly assessing the quality of those studies before reaching an even-handed and balanced conclusion, then I'd happily be an "irrational skeptic", because the alternative appears to be to blindly accept claims made by charlatans without question.

Templeton wrote:Every organ in the body is connected to the nervous system, therefore every organ has a correlating nerve - Every nerve passes through the spinal column. Basic anatomy tells us that each vertebra, and the nerves that pass through them correlate with each and every organ in the body, one might consider gaining a basic understanding of a subject before one ridicules.

Every part of the body is also connected by various tissues, veins, arteries etc, but there still remains no evidence that "adjusting" the spine can fix a problem with the liver. I have a basic understanding of anatomy, and whilst I'm no medical expert, I'm pretty sure that releasing the synovial fluid in someone's lower back won't cure someone of cirrhosis.

But by all means, prove me wrong. I will happily change my position if you present some evidence.

Templeton wrote:Furthermore, was it not you Mr. Samsa that extolled the virtues of Osteopaths in a previous post, and was it not you that stated that Osteopaths should be the physician doing spinal manipulations? Why would you suggest such a thing if there was no benefit to spinal manipulation? Curious

As Starr kindly pointed out for me, I haven't mentioned osteopaths.

Physiotherapists, however, do perform manipulations because there exists some evidence that they can be effective for some conditions. However, these conditions are purely musculoskeletal - importantly, they do not "realign" vertebrae, they don't "unpinch" nerves, and they certainly don't cure organ damage by cracking a neck. These manipulations are also done in conjunction with various other methods and are not used for conditions which have no supporting evidence.

As I've said throughout this thread, I have less issues with chiropractors who are essentially poorly trained physiotherapists. My only complaint is that they should go back to school and get their full training, rather than endangering the lives of their patients and inducing strokes.

Templeton wrote:Indeed a simple Cut and Paste was what I did, only to show you that the information is out there should you, or anyone else care to investigate further.

That's called "plagiarism". And seriously, if you thought that was the best evidence for chiropractic then that's just sad. Even I, as someone who doesn't accept the validity of chiropractic, could provide you with a couple of links which are more convincing than those are.

Templeton wrote:You might want to brush up on your web surfing skills ole bean if you are unable to find the reports listed in my previous post.

Perhaps so - feel free to provide the links then. If you don't, then I'll take that as an implicit acceptance that such papers cannot be found with the limited information provided.

Templeton wrote:Your attempts to misdirect by stating you couldn't find them or they were observational studies is weak and a sign of poor debate.

Why would I need to "misdirect" you or other people here? I annihilated your references. The fact that I couldn't find the links to a couple of them was inconsequential, given that most of the ones I couldn't find were related to LBP.

As for pointing out that they were observational studies being a "sign of poor debate", that's just ridiculous. We're in the science forum, we don't accept observational studies because they (by their very nature) cannot establish causation - which is the meat and bones of science. I could link you to "observational studies" demonstrating that Power Balance bracelets can increase your speed and strength, but it doesn't mean shit.

Templeton wrote:What do you want, blood work for pain relief? That's not how it works my good man. The method by which Chiropractic functions is to relieve misaligned vertebra that hinder the proper function of the nervous system. One method to record the results is by 1st person observation. (This happens to be used regularly in medical studies) ah do I sense a segue?

Why would I want blood work? No, I want scientific studies. I'm sorry if I wasn't clear before, but I want studies where we can eliminate confounds and reliably establish causation. More simply, I want a study which rules out all/most other possibilities which leads us to the inevitable conclusion of: "The positive effect was caused by chiropractic". I'll accept that maybe you're not well-versed in scientific debate and this is why you keep suggesting observational studies are valid, so to help you out I can tell you that I'm looking for a study with an appropriate statistical design (this will usually be an RCT).

Note that no medical studies use 1st person observation as their primary outcome measure, especially when no blinding or controls have been used. Such an example of that would be a case study, which in medicine is treated as an anecdote. It might direct our research into a valid avenue of investigation, but it is not treated as evidence in itself.

Templeton wrote:Mr. Samsa wrote:
Anecdotal reports are not "evidence". You can't have empirical evidence without experimentally adjusting some variables, as "evidence" is that which helps us establish a causal relationship between claims and conclusions. And, obviously, when all we have is a subjectively reported case study, we have no way of judging what variables produced the outcome (or whether the outcome as reported even occurred).

You miss the mark - from the 1st person perspective - which is what I stated, and every patient, ourselves included, subscribe to this form of experimentation. If the remedy makes us feel good - what do you do? Continue to take it, even while patients continue to take medications that have adverse side effects because they find relief from their initial dis-ease? There is evidence for relief therefore we continue with the treatment. A 1st person inquiry is the initial diagnosis for all doctors.

Doctors are not scientists. This is getting ridiculous now.

Templeton wrote:Would they ask if it was irrelevant?

Would who ask who if what was irrelevant? A scientist looking at whether a treatment is working would view a patient saying "I feel better" as irrelevant, yes, because it is. When such an outcome is treated as secondary, in an appropriately controlled and blinded study, then the outcome can be useful but obviously not evidence in itself.

Notice how physiotherapists, who deal with similar problems and have some overlapping techniques with chiropractors, don't use subjective outcome measures in order to judge the validity of their field? Notice how they assess the range of mobility, extension, functional measures, etc, and chiropractors don't? Why don't chiropractors? If disorders are caused by subluxations, or hips being "out of place", then why not perform a study to shut up the people who doubt them? Take an X-ray before the treatment, showing the hip to be out of place, and then take an X-ray afterwards where the hip is now in place.

Why rely on entirely subjective measures that are prone to psychological manipulation and are often not even correlated with whether the treatment works or not?

Templeton wrote:Mr. Samsa, How do you feel?

Pebble wrote:...somewhat pissed...

The_Metatron · **#125** by **The_Metatron** » Dec 31, 2011 5:15 pm

Fuckin' science.

Mr.Samsa · **#126** by **Mr.Samsa** » Dec 31, 2011 11:20 pm

The_Metatron wrote:Fuckin' science.

Paul G · **#127** by **Paul G** » Jan 04, 2012 12:45 am

Mr. Samsa and Pebble, thank you for all the posts in this thread, I've learnt a great deal.

Mazille · **#128** by **Mazille** » Jan 05, 2012 10:58 am

!

GENERAL MODNOTE
Templeton,
This post of yours is directly copied and pasted from other websites. Furthermore you have failed to offer any sources.
Not only is this frowned upon here for reasons of scientific ethics, it is also in contravention to copyright laws and our FUA. Please, in future, ensure that you provide sources for your quotes as well as that you don't copy whole articles, but rather the first couple of sentences, while providing a link to the rest. This will make sure you stay well within the law and our FUA.

Mazille

P.S.: Please, don't discuss moderation in this thread. If there are any questions contact the staff or open a thread in the Feedback forum.

Lance · **#129** by **Lance** » Jan 08, 2012 7:56 am

Chiropractors can achieve some success with certain lower back pains.
http://www.ncbi.nlm.nih.gov/pubmed/16517383

However, when they start talking of subluxations, or treating conditions other than back pain, then beware!
There are a vast number of claims made by chiropractors that are out and out swindles.
http://www.quackwatch.com/01QuackeryRel ... chiro.html

If you think that chiropractors are responsible medical care givers, just take a look at their views on immunisation.
http://www.ncbi.nlm.nih.gov/pubmed/2233 ... t=Abstract

There are a few, a very few, good chiropractors, who will limit their practise to those conditions where they can help. Sadly, there are a whole lot more who will do far more harm than good.

mcan · **#130** by **mcan** » Mar 30, 2012 11:58 am

im a natural born skeptic. however i just went through 5 months of lower back pain that started mild, got worse to the point of being nearly unable to walk. i saw three different physios over a period of 3 months, countless massages, and paid big bucks to see a sports physician who took bone scans, mri etc only to continue getting worse. these guys with all the muscle manipulation, physical therapy, pain killers couldnt reverse my clearly poor progress. I finally gave in a saw a chirpractor and was 50% pain free after 5 days (2 treatments), and 100% pain free within 2 weeks (4 treatments total).

So what should i be thinking? I dont believe a single word of this chiropractors explanation of my problem no do i really think he understands what the hell he is doing. This became apparent to me after the hundreds of physiology articles about the spine and hip I had read over many months. If I questioned him and used some of my "knowledge" I got a ridiculous answer. That being said im sure ancient Chinese chiro equivalents also have had "crazy" theories and explanations.

Fact is though, chiro is a very old profession. It may not be back up by modern science however to me at the end of the day evidence speaks, and some of that evidence has been gathered over a very old time.

Will I go back to a chiro, hell yes, will I see him 10 times a year as he wants, hell no and I will use the advice provided by physio to maintain my back. They are dodgy as hell but they are obviously able to fix (at least temporarily) conditions that other professions cant.

back to the question, what do chiros do?...I have no idea.

Mr.Samsa · **#131** by **Mr.Samsa** » Mar 31, 2012 4:44 am

mcan wrote:im a natural born skeptic. however i just went through 5 months of lower back pain that started mild, got worse to the point of being nearly unable to walk. i saw three different physios over a period of 3 months, countless massages, and paid big bucks to see a sports physician who took bone scans, mri etc only to continue getting worse. these guys with all the muscle manipulation, physical therapy, pain killers couldnt reverse my clearly poor progress. I finally gave in a saw a chirpractor and was 50% pain free after 5 days (2 treatments), and 100% pain free within 2 weeks (4 treatments total).

So what should i be thinking? I dont believe a single word of this chiropractors explanation of my problem no do i really think he understands what the hell he is doing. This became apparent to me after the hundreds of physiology articles about the spine and hip I had read over many months. If I questioned him and used some of my "knowledge" I got a ridiculous answer. That being said im sure ancient Chinese chiro equivalents also have had "crazy" theories and explanations.

Fact is though, chiro is a very old profession. It may not be back up by modern science however to me at the end of the day evidence speaks, and some of that evidence has been gathered over a very old time.

Will I go back to a chiro, hell yes, will I see him 10 times a year as he wants, hell no and I will use the advice provided by physio to maintain my back. They are dodgy as hell but they are obviously able to fix (at least temporarily) conditions that other professions cant.

back to the question, what do chiros do?...I have no idea.

Say we gathered together a large group of people with your problem and got chiropractors to work on them, and suppose we got another large group of people with your problem but only gave them a fake chiropractic treatment (i.e. they do nothing at all). Suppose our results found that some people in the first group improved, and suppose our results found that some people in the second group also improved. We look at the numbers and find that there is no difference in the success rates of both options.

Question 1: What would you conclude based on that evidence?

Now imagine that we pick one person out of that first group who showed an improvement, and he tells us about how he had tried everything before and nothing worked, but after just a couple of visits to the chiropractor he is now cured. And now imagine we take someone from the second group (that received no treatment) and he tells us the exact same story.

Question 2: How willing would you be to accept the first person's story?

Sciwoman · **#132** by **Sciwoman** » Mar 31, 2012 5:48 am

We can trade anecdotes until the sun boils away the oceans. Anecdotes prove nothing overall. However, for my low back pain caused by arthritis, a herniated disk, degenerating disks, and sacroiliitis, I went with the treatment recommended by my doctor which was ice/heat as needed, pain killers as needed, six weeks of physical therapy, and moving to another department at work where I could sit down. Right now, I continue with exercises the physical therapist showed me how to do, walking, and other joint friendly exercises. I wonder if there have been long term studies following groups who opted for chiropractic treatment vs those who went the route I took and their outcomes over several years.

(I know this was a bit back in the thread, but, I think Skinny Puppy's doctor was rather neglectful in not recommending physical therapy.)

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