NeedAnswers wrote:
That's not really how it works, my friend. Not exactly. If you have a 30% chance of getting back pain, and the treatment reduces that % to 15%, then that's a decrease of 15% possibility that you will get back pain. Getting back pain is not 100%, you still only had a 15-30% chance to get it. .

That is exactly how it works. If you do a study of 5000 people and in the sham treatment group over say 5 years 750 of the 2500 people report back pain, while in the treatment group 375 of 2500 get pain - we have a useful result.

If you choose to do a study of N=1 (i.e. anecdote or personal experience) there are only two possible outcomes - you get pain (1 person out of 1 trial got pain = 100%) or you don't (0/1 = 0%) there are no other possible outcomes - and the results either way are entielry meaningless.

NeedAnswers wrote:

What would be more helpful to research is people like me, who have an ailment (scoliosis since birth) that gets progressively worse as you grow up (but doesn't impede me from doing anything and doesn't have significant cosmetic value). To experience that pain without treatment, and then get the treatment and be without pain means that the treatment worked in my opinion. I know my body, I'm aware of the type of "placebo effect" that positive thinking and a few other alternative medicines or metaphysical things can do for me because I've tried them and used them (with moderate success over the years). Going to the chiropractor was pure physical success for me. Popping my back was always successful, not always with my neck even though it seemed to feel less tense at night when I was receiving that treatment.

I'm not saying every chiropractor is good or credible, I'm saying don't judge the whole of the group by the actions and words of some of the group, especially if you don't have any firsthand experience. It's totally fine to sit back in your chair and read books or other people's comments about what something is, but without some anecdotal evidence you are lacking something that I am not : firsthand experience and evidence gained from actually being in the office and receiving the treatment.

The plural of anecdote is still not data. This approach is how miracles are supported. It is an entirely meaningless way of investigating anything. Whatever the outcome in one individual you cannot generalise from there, take a hundred such individuals, blind procedures adequately analyse outcomes objectively and fairly - then you begin to have some data.

Pebble wrote:

NeedAnswers wrote:
That's not really how it works, my friend. Not exactly. If you have a 30% chance of getting back pain, and the treatment reduces that % to 15%, then that's a decrease of 15% possibility that you will get back pain. Getting back pain is not 100%, you still only had a 15-30% chance to get it. .

That is exactly how it works. If you do a study of 5000 people and in the sham treatment group over say 5 years 750 of the 2500 people report back pain, while in the treatment group 375 of 2500 get pain - we have a useful result.

If you choose to do a study of N=1 (i.e. anecdote or personal experience) there are only two possible outcomes - you get pain (1 person out of 1 trial got pain = 100%) or you don't (0/1 = 0%) there are no other possible outcomes - and the results either way are entielry meaningless.

NeedAnswers wrote:

What would be more helpful to research is people like me, who have an ailment (scoliosis since birth) that gets progressively worse as you grow up (but doesn't impede me from doing anything and doesn't have significant cosmetic value). To experience that pain without treatment, and then get the treatment and be without pain means that the treatment worked in my opinion. I know my body, I'm aware of the type of "placebo effect" that positive thinking and a few other alternative medicines or metaphysical things can do for me because I've tried them and used them (with moderate success over the years). Going to the chiropractor was pure physical success for me. Popping my back was always successful, not always with my neck even though it seemed to feel less tense at night when I was receiving that treatment.

I'm not saying every chiropractor is good or credible, I'm saying don't judge the whole of the group by the actions and words of some of the group, especially if you don't have any firsthand experience. It's totally fine to sit back in your chair and read books or other people's comments about what something is, but without some anecdotal evidence you are lacking something that I am not : firsthand experience and evidence gained from actually being in the office and receiving the treatment.

The plural of anecdote is still not data. This approach is how miracles are supported. It is an entirely meaningless way of investigating anything. Whatever the outcome in one individual you cannot generalise from there, take a hundred such individuals, blind procedures adequately analyse outcomes objectively and fairly - then you begin to have some data.

I'm not talking about random people who may or may not experience back pain already. I'm talking about people who DO experience back pain, receive treatment, and feel better. As I said, you don't have to like or accept anecdotal evidence. You can sit in your computer chair and read up on chiropractors as much as you like and become an "expert" on them. I have back pain, I saw a chiropractor, no more back pain. Nothing else that I had ever done was so effective. I tried several other methods that would be considered "alternative" to medicine because there is no medicine for scoliosis.

If you're talking about preventative methods for people who are not already disposed to get back pain, or may only get back pain at 30% of a chance if they don't see a chiropractor, then no you can't expect to have good results. That's now how it should be done, and the chiropractor that I saw did not claim to see babies or super young children to prevent them having back pain.

Taking a shot to prevent you from getting the flu does not work at a 100% chance, but it reduces the chances of you getting the flu and millions of people get flu shots every year. So then if a chiropractor could lower your chances of getting back pain or suffering whatever he or she claims, then why is that not on par with a flu shot? 15% better results is fairly significant.

reddix wrote:

Mantisdreamz wrote:But if something seems to work for you and others too, then what's the big deal?

You can read up on it and yes, come across the possible dangers or the fact that it's not proven to work. But, isn't experiencing something yourself the best way to go about it? That way you can make your own judgement call. (Especially if beforehand, it is confirmed by many others that you know that it benefits them).

Personal experience and anecdotal stories are not reliable methods of obtaining evidence. This is partly because it is very difficult, if not impossible sometimes, to filter out one's own cognitive biases. For example, it is possible that certain details may have been misinterpreted as an experience that did occur when the real cause of the experience was something entirely different. Also, since other people receiving the information do not have access to the exact details, they cannot adequately review the information to ascertain what really happened and what is the truth of the matter. Rigorous peer review helps to filter out the biases, leaving a more accurate approximation of the truth. I think.

Until this is done adequately, I personally would hold claims of chiropractic efficacy in doubt.

I know what you mean. And I know that other's people's words and pro opinions on something can influence you. But when it comes down to it, if something apparently worked for you, does that mean you cannot even trust yourself?

Truthfully, I don't really think that much on it. On the surface, I see that I was benefited (pain relieved), and I'm okay with accepting that, without looking at all the if ands and buts or the notion that I could have maybe possibly tricked my own mind into thinking it worked. Maybe that's a stupid or simple thing to say. But, I'd rather just look at the results, rather than sit there speculating and distrusting myself.

Pebble wrote:
Personal experience is fine if you can deal with you cognitive biases, regression tot the mean, natural variation, placebo effects etc.

How do you apply personal experience to preventative measures? If you have a 30% chance of getting back pain and a treatment reduces this to 15%, then you as an individual either get back pain (100%) or do not (0%) - how can you assess if the treatment helped?

In this case though, I really don't know about preventative measures by going to chiropractors. That seems like you are skipping a step by doing that. And not the right way to go about preventative measures for back pain.

Also, I think that someone should really try everything they can before just running into a chiropractor's office... and that's even if they want to try that route.

I think it's fine that many people are not convinced by them, or skeptical about them... being that it is true that it's not scientifically proven. I'm not trying to convince anyone. Just stating my personal experience.

Mantisdreamz wrote:
I know what you mean. And I know that other's people's words and pro opinions on something can influence you. But when it comes down to it, if something apparently worked for you, does that mean you cannot even trust yourself?

Truthfully, I don't really think that much on it. On the surface, I see that I was benefited (pain relieved), and I'm okay with accepting that, without looking at all the if ands and buts or the notion that I could have maybe possibly tricked my own mind into thinking it worked. Maybe that's a stupid or simple thing to say. But, I'd rather just look at the results, rather than sit there speculating and distrusting myself.

Okay. Well, it's good that you like it then.

I guess my beef is that I think personal experience is irrelevant in a thread in a science forum asking whether a treatment does anything or not.

reddix wrote:
I guess my beef is that I think personal experience is irrelevant in a thread in a science forum asking whether a treatment does anything or not.

That's a good point. The way I see it... is that first and foremost you get the scientific verdict on it.... and then you can go from there and take input from others (or along with personal experience) to add to it. And then perhaps try to correlate the 2.

So you've got the studied facts on it... and you also have the experience of others. If they contradict... well, that's where you have to start questions on why that might be so. Whether it be that the people who have taken part in it are cognitively biased or whether it might be that in some cases, there is some truth to it and it really does help. I think that both scenarios should be taken into consideration.

NeedAnswers wrote:


I'm not talking about random people who may or may not experience back pain already. I'm talking about people who DO experience back pain, receive treatment, and feel better. As I said, you don't have to like or accept anecdotal evidence. You can sit in your computer chair and read up on chiropractors as much as you like and become an "expert" on them...

If you're talking about preventative methods for people who are not already disposed to get back pain, or may only get back pain at 30% of a chance if they don't see a chiropractor, then no you can't expect to have good results. That's now how it should be done, and the chiropractor that I saw did not claim to see babies or super young children to prevent them having back pain.

Taking a shot to prevent you from getting the flu does not work at a 100% chance, but it reduces the chances of you getting the flu and millions of people get flu shots every year. So then if a chiropractor could lower your chances of getting back pain or suffering whatever he or she claims, then why is that not on par with a flu shot? 15% better results is fairly significant.

I respect of the first point I refer you back to my previous answer - do it in 100 people we have something to discuss, anecdotes remain anecdotes.

In respect of the second, vaccination is trialled in large scale populations and are proven to work - accepted that 60 years ago the evidence base on which vaccine programs were initially rolled out was imperfect by today's standards subsequent large scale registries have put the matter beyond question, and that while flu vaccination has been proven in clinical trials to work, the benefit is more modest than we might hope and the changing nature of the virus means that this years batch will not undergo formal trialling etc. Nevertheless this means that the up sides and downsides are known and one can state with a high degree of certainty what you are paying for.

With chiropracty there is no evidence base, the studies that have been done do not show consistent superiority to placebo/sham - there are no studies of 'preventative' chiropracty - so the figures 15% and 30% are purely imaginary and have nothing to do with chiropracty. I provided those figures to illustrate what a preventative intervention (unspecified) might look like. So jumping to conclusions that this might suggest chiropracty is like vaccination is madness.

Pebble wrote:

NeedAnswers wrote:


I'm not talking about random people who may or may not experience back pain already. I'm talking about people who DO experience back pain, receive treatment, and feel better. As I said, you don't have to like or accept anecdotal evidence. You can sit in your computer chair and read up on chiropractors as much as you like and become an "expert" on them...

If you're talking about preventative methods for people who are not already disposed to get back pain, or may only get back pain at 30% of a chance if they don't see a chiropractor, then no you can't expect to have good results. That's now how it should be done, and the chiropractor that I saw did not claim to see babies or super young children to prevent them having back pain.

Taking a shot to prevent you from getting the flu does not work at a 100% chance, but it reduces the chances of you getting the flu and millions of people get flu shots every year. So then if a chiropractor could lower your chances of getting back pain or suffering whatever he or she claims, then why is that not on par with a flu shot? 15% better results is fairly significant.

I respect of the first point I refer you back to my previous answer - do it in 100 people we have something to discuss, anecdotes remain anecdotes.

In respect of the second, vaccination is trialled in large scale populations and are proven to work - accepted that 60 years ago the evidence base on which vaccine programs were initially rolled out was imperfect by today's standards subsequent large scale registries have put the matter beyond question, and that while flu vaccination has been proven in clinical trials to work, the benefit is more modest than we might hope and the changing nature of the virus means that this years batch will not undergo formal trialling etc. Nevertheless this means that the up sides and downsides are known and one can state with a high degree of certainty what you are paying for.

With chiropracty there is no evidence base, the studies that have been done do not show consistent superiority to placebo/sham - there are no studies of 'preventative' chiropracty - so the figures 15% and 30% are purely imaginary and have nothing to do with chiropracty. I provided those figures to illustrate what a preventative intervention (unspecified) might look like. So jumping to conclusions that this might suggest chiropracty is like vaccination is madness.

Madness isn't the term I'd use seeing as people who have had chronic back pain are actually benefiting from Chiropracty, regardless of it being scientifically tested or not. Seriously, anecdotal evidence is all I have to offer, and if that means I have to step away from the phenomenon then that's fine as I received what I needed already and I have no bones in whether or not other people trust a chiropractor in the future. I do, however, feel that there is a growing amount of cases in which anecdotal evidence is no longer evidence at all. I don't think people should alienate themselves from what other people say, think, and feel and try to absorb everything in life through the scientific method alone. If you want to do that and it's comfortable for you then I won't try to stop you, but you're limiting yourself because not every enjoyable or beneficial thing in life has been scientifically peer reviewed.

A question for you : If you had found that chiropracty was able to reduce back pain in at least 60% of patients, or that 60% of patients had reported less back pain after seeing a chiropractor, would that make a significant difference in your mind? I mean if you went to the chiropractor yourself with back pain and left without it, would you still doubt it because you hadn't peer reviewed yourself and you felt biased or something?

NeedAnswers wrote:Madness isn't the term I'd use seeing as people who have had chronic back pain are actually benefiting from Chiropracty, regardless of it being scientifically tested or not. Seriously, anecdotal evidence is all I have to offer, and if that means I have to step away from the phenomenon then that's fine as I received what I needed already and I have no bones in whether or not other people trust a chiropractor in the future. I do, however, feel that there is a growing amount of cases in which anecdotal evidence is no longer evidence at all. I don't think people should alienate themselves from what other people say, think, and feel and try to absorb everything in life through the scientific method alone. If you want to do that and it's comfortable for you then I won't try to stop you, but you're limiting yourself because not every enjoyable or beneficial thing in life has been scientifically peer reviewed.

A question for you : If you had found that chiropracty was able to reduce back pain in at least 60% of patients, or that 60% of patients had reported less back pain after seeing a chiropractor, would that make a significant difference in your mind? I mean if you went to the chiropractor yourself with back pain and left without it, would you still doubt it because you hadn't peer reviewed yourself and you felt biased or something?

Madness? This was in reference to the comparison to vaccines, not all your points.


The 'placebo effect' demonstrated with surgery and other invasive procedures frequently is seen in 50 - 70% of patients, the 'benefits' can last upto 18 months. With medicines - say for example antidepressants 30 - 50% is not unusual.

I put placebo in quotes because this is really a mix of many things natural variation in symptom burden etc. So to answer your question directly - I would put alsmost no weight on such an experience and so would not use it to suggest to others that they too might like to try out a given approach.

If I may bump this thread...

I'm aware some of the joint manipulation chiropractors do can be effective for relieving pain. I accept that. I'd rather those manipulations be performed by a medical professional though which is why I see a physiotherapist trained in spinal manipulation who doesn't engage in any of the snapping and cracking and popping theatrics of chiropractics (although it does feel good and a lot of people think the relief from symptoms when chiropractic is used is faster than when physio is used. I get immediate relief from physio so I don't understand that.)

Anyways, someone recently approached me and insisted life-long chiropractic treatment for a specific condition was a reasonable treatment option. To me, that is completely absurd. Persistent issues that a chiropractor can't fix in a handful of appointments might require surgery or physical therapy. Having to return to the chiro every week or two does not sound like the effective management of a musculoskeletal problem to me. It leaves a very bad taste in my mouth that any chiropractor would suggest to a client that a reasonable source of treatment was seeing them routinely for the rest of their life.

The person who told me this used all kinds of BS chiropractic jargon, insisting his condition could be summed up as bones becoming loose in joints and the chiropractor putting them back in the joint. They were not describing a real condition that could be effectively treated with chiropractic. They also told me naturopathy treats MRSA as effectively as evidence-based treatments. I don't believe for a second that I'll convince them they're wrong nor will I try. I am curious if I'm the only person who considers life-long chiropractic treatment for a musculoskeletal condition unreasonable.

Rachel Bronwyn wrote:If I may bump this thread...

I'm aware some of the joint manipulation chiropractors do can be effective for relieving pain. I accept that. I'd rather those manipulations be performed by a medical professional though which is why I see a physiotherapist trained in spinal manipulation who doesn't engage in any of the snapping and cracking and popping theatrics of chiropractics (although it does feel good and a lot of people think the relief from symptoms when chiropractic is used is faster than when physio is used. I get immediate relief from physio so I don't understand that.)

Anyways, someone recently approached me and insisted life-long chiropractic treatment for a specific condition was a reasonable treatment option. To me, that is completely absurd. Persistent issues that a chiropractor can't fix in a handful of appointments might require surgery or physical therapy. Having to return to the chiro every week or two does not sound like the effective management of a musculoskeletal problem to me. It leaves a very bad taste in my mouth that any chiropractor would suggest to a client that a reasonable source of treatment was seeing them routinely for the rest of their life.

The person who told me this used all kinds of BS chiropractic jargon, insisting his condition could be summed up as bones becoming loose in joints and the chiropractor putting them back in the joint. They were not describing a real condition that could be effectively treated with chiropractic. They also told me naturopathy treats MRSA as effectively as evidence-based treatments. I don't believe for a second that I'll convince them they're wrong nor will I try. I am curious if I'm the only person who considers life-long chiropractic treatment for a musculoskeletal condition unreasonable.

Chirporacters can be divided into a number of groups.
1. Those who accept that there is little evidence for any benefit - in the limited sphere of back pain and muscloskeletal wear and tear/ minor injury problems, their treatments fare no worse than conventional therapies - basically because all therapies tried to date are pretty poor - short of some types of surgery (e.g. hip replacement). The only difference between chiropracty and physiotherapy is that the physiotherapists study treatments and discard those shown no to work.

2. Believers group 1. Think that the autonomic nervous system provides magical links to the internal organs and that a host of conditions benefit from chiropractic interventions. Such people will recommend treatment for infantile colic and asthma - in the latter case sometimes advising against life saving medical therapy. There are neural connections - but there is no evidence they can be harnessed in the ways suggested.

3. Believers group 2 (the mad men/women). Think that everything is down to mythical spinal alignment problems and that world peace and nirvana would ensure if only everyone's spines could be kept in proper alignment.

Pebble wrote:The only difference between chiropracty and physiotherapy is that the physiotherapists study treatments and discard those shown no to work.

Well, that's not true at all. There is some cross-over between manual therapy used by physical therapists and chiropractors but physio encompasses an entire body of treatments that chiropractic never touches upon.

Rachel Bronwyn wrote:

Pebble wrote:The only difference between chiropracty and physiotherapy is that the physiotherapists study treatments and discard those shown no to work.

Well, that's not true at all. There is some cross-over between manual therapy used by physical therapists and chiropractors but physio encompasses an entire body of treatments that chiropractic never touches upon.

Please provide an example of a chiropractic practice, that had been evaluated, found ineffective and discarded!

I don't understand what you're getting at. I never claimed the chiropractic industry had a great record for discarding practices that are found ineffective.

Some individual chiropractors and chiropractic associations will do so. What constitutes chiropractic will never change though and there will always be practitioners who believe in the efficacy of chiropractic in it's entirety.

You claimed there was only a single difference between physical therapy and chiropractic, which isn't true because, while these is some cross-over in manual therapy, they're very different disciplines consisting of very different practices.

Rachel Bronwyn wrote:I don't understand what you're getting at. I never claimed the chiropractic industry had a great record for discarding practices that are found ineffective.

Some individual chiropractors and chiropractic associations will do so. What constitutes chiropractic will never change though and there will always be practitioners who believe in the efficacy of chiropractic in it's entirety.

You claimed there was only a single difference between physical therapy and chiropractic, which isn't true because, while these is some cross-over in manual therapy, they're very different disciplines consisting of very different practices.

I see, not making myself clear - this was in the context of describing the only vaguely sensible group of chiropracters, those who restrict their practice to MSK problems. Of course they approach the 'treatment' differently. They are not called spine crackers for nothing. The pivotal difference (as opposed to only) is that chiropracty is like religion - stuck in its past, physiotherapy tries to find the most effective approach using empirical methodology - unfortunately this has not led to signigicant advances yet, but has led them to discard many treatment approaches that are complex but ineffective.

Bolero wrote:What do chiropractors do?

Take your money.

That's all I have to add.

theye1 wrote:

That's all I have to add.

The shit some people will swallow! If only he stopped when he got to the statement 'I don't know what to do' rather than proceeding to demonstrate that he is just a con artist.

Pebble wrote:

Rachel Bronwyn wrote:If I may bump this thread...

I'm aware some of the joint manipulation chiropractors do can be effective for relieving pain. I accept that. I'd rather those manipulations be performed by a medical professional though which is why I see a physiotherapist trained in spinal manipulation who doesn't engage in any of the snapping and cracking and popping theatrics of chiropractics (although it does feel good and a lot of people think the relief from symptoms when chiropractic is used is faster than when physio is used. I get immediate relief from physio so I don't understand that.)

Anyways, someone recently approached me and insisted life-long chiropractic treatment for a specific condition was a reasonable treatment option. To me, that is completely absurd. Persistent issues that a chiropractor can't fix in a handful of appointments might require surgery or physical therapy. Having to return to the chiro every week or two does not sound like the effective management of a musculoskeletal problem to me. It leaves a very bad taste in my mouth that any chiropractor would suggest to a client that a reasonable source of treatment was seeing them routinely for the rest of their life.

The person who told me this used all kinds of BS chiropractic jargon, insisting his condition could be summed up as bones becoming loose in joints and the chiropractor putting them back in the joint. They were not describing a real condition that could be effectively treated with chiropractic. They also told me naturopathy treats MRSA as effectively as evidence-based treatments. I don't believe for a second that I'll convince them they're wrong nor will I try. I am curious if I'm the only person who considers life-long chiropractic treatment for a musculoskeletal condition unreasonable.

Chirporacters can be divided into a number of groups.
1. Those who accept that there is little evidence for any benefit - in the limited sphere of back pain and muscloskeletal wear and tear/ minor injury problems, their treatments fare no worse than conventional therapies - basically because all therapies tried to date are pretty poor - short of some types of surgery (e.g. hip replacement). The only difference between chiropracty and physiotherapy is that the physiotherapists study treatments and discard those shown no to work.

2. Believers group 1. Think that the autonomic nervous system provides magical links to the internal organs and that a host of conditions benefit from chiropractic interventions. Such people will recommend treatment for infantile colic and asthma - in the latter case sometimes advising against life saving medical therapy. There are neural connections - but there is no evidence they can be harnessed in the ways suggested.

3. Believers group 2 (the mad men/women). Think that everything is down to mythical spinal alignment problems and that world peace and nirvana would ensure if only everyone's spines could be kept in proper alignment.

I don't know how it is anywhere else in the world but this post is beautiful and sums up the situation in the states. The vast majority of trained chiros believe view "1" however their goal is to get their subject's views to be that of view point "3" (for obvious financial reasons). I worked at a pain clinic for nearly 5 years during my undergrad and the results were pretty split between those that said their back pain had improved and gotten worse.

Just some basic info (2002) that brings it together well for me:

http://www.pbs.org/saf/1210/forum.htm, particularly:
"The segment did not claim that chiropractic is fraudulent and did not attempt to prove or disprove that chiropractic 'works,' but it does state that chiropractic has no basis in science.… The one area where there is significant published evidence of chiropractic benefit is in treating back pain. Valid studies have shown that chiropractic can be of benefit to back pain sufferers. However, chiropractic success rates were no greater than conventional approaches like physical therapy and exercise."

They also address the issue of neck adjustments and strokes — which was news to me before I read some of the discussion in this forum. Good to know.

Also, the wiki seems pretty well-balanced overall (though I've not yet read it all in detail):
http://en.wikipedia.org/wiki/Chiropractic

Sorry if this is old hat here on the verge of 2012. I've only just now found rationalskepticism.org as I was doing some research into chiropractic.