Sorry to ask such an ignorant question, but I hear about people going to them, and I've a vague idea they're not legit doctors... Can anyone help me out with an explanation?

I mainly ask because this woman at my work said her chiropractor told her to take out her bellybutton piercing becuase it was hooked right through a chi line (?) on her body, and if she didn't take it out, she'd get cancer. She said she took it out immediately. After all, "When a doctor says these things, you listen."
I'm thinking Chi line? Take out your piercing or you'll get cancer? Doctor?

There's a thread on it in the Pseudoscience section here: Chiropractic.

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".

If you see the worst case chiropractor, then you'll get someone who is fully committed to the idea of subfluxations, which are supposed displacements of the spine which leave no physical trace and cannot be seen in any known scan we currently have available, but these displacements can cause anything from back pain, to acne, cancer, AIDS, pneumonia, asthma, etc...

The first case will generally give you a poor-to-average physical therapy session, as they have the knowledge from their education in other areas but their effectiveness tends to be diluted by their tendency towards wooness. The latter two, however, will be completely ineffective and more expensive, with Cochrane reviews (official high quality meta analyses) concluding that people would be better off just going to a masseuse. The biggest problem with these last two groups is that due to their sub-standard education, they have a tendency to rip the arteries in people's necks and cause a significant chance of stroke.

Basically: There is no evidence at all for any effectiveness in the field and the best case scenario is that you don't die after seeing one. If you have back pain, then go to someone who is educated in evidence-based treatment of back pain, like physiotherapists.

Bolero wrote:I'm thinking Chi line? Take out your piercing or you'll get cancer? Doctor?

No, not legitimate doctors...but they often use the title and it's misleading because it then gets assumed they've had medical training. In fact, it's the chiropractors that could cause cancer as they often use x-ray imaging for "diagnostic" purposes, but if it's looking for imaginary subluxations they are exposing patients to an unnecessary test that has some quantifiable risk. I'm not surprised about the statement about the Chi line, the basis of it is the outdated principle of vitalism and "innate intelligence" and that sort of thing would fit right in.

I think that for lower back pain, there might be some modest effect but it's no better than seeing a physiotherapist or doctor in terms of effectiveness. That's not enough to justify it being a stand alone practice IMO, you could teach the basics to a legitimate health professional and they could add it into the arsenal to use if needed. As for the rest of the claims made about chiropractic, there's no evidence that it's effective for any other condition.

Hemlock wrote:I think that for lower back pain, there might be some modest effect but it's no better than seeing a physiotherapist or doctor in terms of effectiveness. That's not enough to justify it being a stand alone practice IMO, you could teach the basics to a legitimate health professional and they could add it into the arsenal to use if needed. As for the rest of the claims made about chiropractic, there's no evidence that it's effective for any other condition.

And the main reason that chiropractic has shown some minor efficacy in that area is that lower back pain is one of the most nebulous forms of symptom that anyone can have. It has multiple different causes, affects a wide range of people, lasts for varied amounts of time, etc, and essentially waving a dead chicken over it whilst chanting the lyrics to a Bon Jovi song would probably show some mild effect.

Sounds like that chiropractor upholds beliefs pertaining to points and meridians usually associated with accupuncture.

Lots of chiropractors are hardline alties who subscribe to way more alternative "medicine" beliefs than just "subluxations".

I know of one chiropractor whose entire career in based on manipulating the spine in order to relieve pain (nothing else and certainly nothing about "chi lines") who genuinely seems to fix people without hurting them. I'm still too frightened to see him knowing the damage he could cause me and that chiropractic treatment is not gentle and involves a lot of "violent" movements and popping and cracking and snapping.

My "chiropractor" is fantastic. He's a physiotherapist who abandoned chiropractics for physiotherapy. The first time I took my partner to see him due to a misaligned ribcage he came out saying "Gordon really doesn't like chiropractors, does he?" He starts most of his sessions with new patients by saying "I will not be doing anything chiropractic." I do think some small amount of the knowledge he accumulated as a student of chiropractics and a chiropractor has made him a better physiotherapist. Occassionally he does do something to my spine that results in a pop followed by relief. The majority of chiropractics is garbage though.

Irresponsible chiropractors have a really bad habit of causing strokes as well.

Rachel Bronwyn wrote:My "chiropractor" is fantastic. He's a physiotherapist who abandoned chiropractics for physiotherapy. The first time I took my partner to see him due to a misaligned ribcage he came out saying "Gordon really doesn't like chiropractors, does he?" He starts most of his sessions with new patients by saying "I will not be doing anything chiropractic." I do think some small amount of the knowledge he accumulated as a student of chiropractics and a chiropractor has made him a better physiotherapist. Occassionally he does do something to my spine that results in a pop followed by relief. The majority of chiropractics is garbage though.

Whilst your therapist might be quite knowledgeable (and he must be fairly smart, since he gave up a quack profession for an evidence-based one), I just have to point out that the "popping" sound means abso-fucking-lutely nothing. It's a trick they're taught in chiropractic school because patients feel that a "popping" sound is evidence of a successful manipulation, when in reality it doesn't mean anything.

In physiotherapy school they usually teach people this by getting a test subject to lie face down and they simply rest their hands on their shoulder and crack their own knuckles. So they apply no manipulation, and no pressure so they don't even get a massaging effect, and often the patient will say something like, "Oh yeah, you really nailed it that time!". Then the physiotherapist will actually perform a manipulation (one backed by scientific evidence), but without cracking their own knuckles, and they'll get a response along the lines of, "Oh you didn't quite get it that time...".

In other words, this just demonstrates that people know fuck all about their bodies.

Is there a large difference in what they do based upon where they are practicing.

Here they pretty much seem to fall into the category of massage and general twisting you about. I can't recall anyone i know who has been to one (Admittedly only a couple but they have each been to more than one) mentioning anything other than that. Other places it seems they are rather more involved in mythical energies and allsorts of woo.

Mr.Samsa wrote:
Whilst your therapist might be quite knowledgeable (and he must be fairly smart, since he gave up a quack profession for an evidence-based one), I just have to point out that the "popping" sound means abso-fucking-lutely nothing. It's a trick they're taught in chiropractic school because patients feel that a "popping" sound is evidence of a successful manipulation, when in reality it doesn't mean anything.

Oh, I don't question that at all. It does feel good though. If I thought popping had anything to do with the efficacy of manipulation I'd be highly displeased with Gordon's care. Popping is very uncommon in our appointments and never occurs anywhere near Gordon's hands or the area of my back he's working on. It's just sometimes a side effect of something else he's doing. He never intentionally pops any of my joints (though one of the things he does to the back of my ribcage involves a quiet but extremely pleasurable crunching sensation and noise. I always giggle deliriously after it.) It's not part of the treatment.

Rachel Bronwyn wrote:Oh, I don't question that at all. It does feel good though. If I thought popping had anything to do with the efficacy of manipulation I'd be highly displeased with Gordon's care. Popping is very uncommon in our appointments and never occurs anywhere near Gordon's hands or the area of my back he's working on. It's just sometimes a side effect of something else he's doing. He never intentionally pops any of my joints (though one of the things he does to the back of my ribcage involves a quiet but extremely pleasurable crunching sensation and noise. I always giggle deliriously after it.) It's not part of the treatment.

That's good

I assumed that it wasn't his main tool or whatever given that he'd have physiotherapy training, but it's a common claim made by chiropractic patients so I figured I'd piggyback onto your post to make my point.

I always thought chiropractors were very highly trained in procedures to get your money into their pockets while doing nothing.

Mr.Samsa wrote:

Hemlock wrote:I think that for lower back pain, there might be some modest effect but it's no better than seeing a physiotherapist or doctor in terms of effectiveness. That's not enough to justify it being a stand alone practice IMO, you could teach the basics to a legitimate health professional and they could add it into the arsenal to use if needed. As for the rest of the claims made about chiropractic, there's no evidence that it's effective for any other condition.

And the main reason that chiropractic has shown some minor efficacy in that area is that lower back pain is one of the most nebulous forms of symptom that anyone can have. It has multiple different causes, affects a wide range of people, lasts for varied amounts of time, etc, and essentially waving a dead chicken over it whilst chanting the lyrics to a Bon Jovi song would probably show some mild effect.

Not quite, the research I was thinking of (and can't be bothered digging out right now because it's late for me) compared it head to head with doctors care and physiotherapy. They all stacked out up about the same, with the effect for all equally modest. That doesn't mean that manipulation for lower back pain or the other interventions should be discarded though, if there is some evidence that it may help, it can be used (keeping in mind of course, that for chiropractic all the rest of it is a waste of time). It's correct though that there's pretty much not much that is effective for lower back pain other than analgesics, keeping moving and trying to educate in preventing it happening in the first place or at least not making it worse.

Rachel Bronwyn wrote:Sounds like that chiropractor upholds beliefs pertaining to points and meridians usually associated with accupuncture.

Lots of chiropractors are hardline alties who subscribe to way more alternative "medicine" beliefs than just "subluxations".

I know of one chiropractor whose entire career in based on manipulating the spine in order to relieve pain (nothing else and certainly nothing about "chi lines") who genuinely seems to fix people without hurting them. I'm still too frightened to see him knowing the damage he could cause me and that chiropractic treatment is not gentle and involves a lot of "violent" movements and popping and cracking and snapping.

My "chiropractor" is fantastic. He's a physiotherapist who abandoned chiropractics for physiotherapy. The first time I took my partner to see him due to a misaligned ribcage he came out saying "Gordon really doesn't like chiropractors, does he?" He starts most of his sessions with new patients by saying "I will not be doing anything chiropractic." I do think some small amount of the knowledge he accumulated as a student of chiropractics and a chiropractor has made him a better physiotherapist. Occassionally he does do something to my spine that results in a pop followed by relief. The majority of chiropractics is garbage though.

Sorry everyone if this topic has already been done. Thanks for the link, Mr Samsa.

Actually, now that I think of it, my colleague might have said "meridian line" about her bellybutton piercing thing. She also mentioned "chi", but she could have been talking about her acupuncturist...or her homeopathic "doctor"....

Next question (different, but related, topic): What do acupuncturists do? And is it medically beneficial?

Some studies have demonstrated acupuncture is more effective than placebo. Most have not.

Meridians are lines across the anatomy which supposedly affect a specific organ or other part of the body. Acupuncture points are points (duh) along the meridians (or not. There are extra acupuncture points too. Acupuncture is a fly by the seat of your pants kind of "medicine". You just kind of make it up as you go.) Whether these points or meridians even exist is not known.

By stuffing needles in these points, pain can supposedly be relieved. Some acupuncturists believe it's in fact a cure all and think they can fix anything by poking people.

And that's what an acupuncturist does.

I know a couple massage therapists who provide acupuncture so if your mate's chiropractor does as well, I wouldn't be the least bit surprised. The training required isn't exactly rigorous or challenging.

Some people get immense relief from acupuncture and that's great. It's not evidence based medicine though.

Bolero wrote:Next question (different, but related, topic): What do acupuncturists do? And is it medically beneficial?

There's a good overview of the issue by Steven Novella here: Why I am skeptical of acupuncture.

Basically, traditional acupuncturists will insert needles into your body along meridians, which are like the spiritual veins that transport chi throughout the body. Theoretically, this is supposed to make you feel better. More recently though, you'll get Western practitioners who talk of how silly the idea of chi is, and instead they insist that acupuncture produces a minor pain response from the body which releases endorphins to make you feel better.

So, does it work? No.

There are multiple ways to test acupuncture depending on which claim you're hoping to debunk. The first is the claim that the needles must be placed along a meridian in order to have an effect, so you set up two groups where one group has needles inserted in the "correct" place whilst the other group has needles inserted at random on their body. When we do this, we find that there is no difference between the two.

Next, we test whether there is some kind of pain response that has an actual effect in our body. For this we set up two groups, one where they receive proper acupuncture, and a second group where they are poked in the side with toothpicks without any penetration. Again, we find no difference between the two.

There was a paper recently that was discussed here (Acupuncture might not be complete hokum after all) where they actually measured the chemical response produced by inserting an acupuncture needle into a mouse paw and, surprise, they found that the mouse body responded to this stimulus.

The first, and most hilarious, problem with this study is that they were using mice. Animal subjects are obviously very important for helping us make advances in medicine, but there is a clear difference between the size of a mouse paw and a human hand. The equivalent experiment in humans would be to thrust a javelin through a human hand and see if the body releases pain-relieving chemicals. The second problem was that the relief produced by these chemicals would be far less than the effect of taking an aspirin.

In short, acupuncturists are con-men and/or idiots that significantly increase your chance of infection, and there is no medical benefit at all to acupuncture. (And just in case someone wants to disagree with me, anecdotes are not evidence ).

Yeah, but this girl I know was trying to get pregnant for a year, and then she went to see an acupuncturist, and she fell pregnant right awa.....

Mr.Samsa wrote:In short, acupuncturists are con-men and/or idiots that significantly increase your chance of infection, and there is no medical benefit at all to acupuncture. (And just in case someone wants to disagree with me, anecdotes are not evidence ).

Oh, right.