YSK that chiropractors are not medical doctors and "Systematic reviews... have found no evidence that chiropractic manipulation is effective"

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.

I would also point out that any pro quackocracker post you see here is the one time they might have helped someone just out of random chance, those people are loud and tell everyone how great their quackocracker is. Its simple confirmation bias, they have a sample size of one, themselves, this is not how data works.

I go to a sports physiotherapy group. Much better results when the goal is to help me recover so I don't need to come to them.

You can also search out a GP that is a DO Instead of an MD in the US.

They still learn osteopathic manipulation, which is a broader form of manipulation not limited to the spine that helps with stretching-type exercises. But they are certified (often with the same board exams even) and licensed on par with MDs. Many clinics have DOs among their providers.

In my corner of the world, most CPs are also PTs. Or rather the other way around: they use chiropractic as one of many therapeutic means in their portfolio. I have to say, I very much appreciate this approach, as it relives the initial pain/discomfort but also addresses the underlying problem.

This is a great point. My MiL is a chiropractor (a non-quacky one), and she incorporated a lot of PT into her practice. Additionally, I read a couple years ago that PTs are beginning to incorporate the good things from chiro (whatever they are. I'm not a doctor) into their own practice.

A roundabout way of saying that we learned some things from chiro, but PT was always the future.

I see my chiropractor once ever couple of years, I do most my own chiropractic stuff myself so I only visit her when I can't deal with it. She knows I'm not gonna come back for a mother year or 3 so she doesn't even tell me to book.

A chiropractor will just tell you to come to them more often,

If you are going to one that does, you are going to the wrong one. There are a lot of quacks in professions and some of them are AMA licensed doctors too.
I was very skeptical of them until a friend recommended one he personally knew for my painful shoulder - he even offered to pay for the visit if it didn't help. I was amazed when I walked out of the office completely pain free.
Many professional sports athletes seek out massage and chiro with good results because they cannot afford miss events and can't test positive for the drugs that many conventional doctors would push.
There is a place for all avenues of remedies depending on the problem. Incompetents can be found in all professions. That said, is far too easy for a poser to set themselves up as a chiropractor.

A lot of it can be done at home without a pt. Foam rollers and yoga mats are your friend. Even better if you can get a second pair of hands that know how to pop a back properly.

That's not exactly the truth.

Yes, there are plenty of medical practitioners that poorly represent their profession. I'm sure you could easily apply the same logic here to PT, NP, DO, MD, etc.

What should be emphasized is that Chiropractic has heavily evolved, like any other healthcare field and there is a high degree of overlap between PT and DC methodologies. So much so, PT has lobbied for adoption of joint manipulation.

A good DC won't limit themselves to 5 minutes visits for a quick adjustment. A good DC is evidence-based, incorporates rehab and education, and provides care to the body and systems.

A chiropractor is way cheaper than PT. Money is such a limiting factor for so many people that, while your advice is true, it has a similar vibe to telling a broke person with car trouble to just pay a mechanic to fix it. It's the best option but I don't blame them for trying something less expensive.

PTs are also broadly not very helpful with very limited knowledge. I don’t think I've ever met somebody who was genuinely helped by PT, though I’m sure some of them out there take their jobs seriously.

Strokes, but also broken necks.

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

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.

Yeah, I was coming in here to say similar.

Chiropractors aren't just not effective, they are fucking dangerous.

loose an afternoon

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

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.

These people, whoever-the-fuck they are, need to be regulated.

alternative mental therapists

can see this in the future for the next fascist conservative president - MY CHIROPRACTOR SAYS I'M FINE!

So, DO's in many of not most states in the US have the same licensure and practice limitations as MDs and charge/are reimbursed similarly. I'm many cases they actually attend the same residency programs as allopathic/MDs. Most I've worked with drop 99% of the Osteopathic manipulation stuff soon as they graduate. Naturopaths on the other hand....

You've got it in reverse. See that "possible exception for back pain"? Chronic pain related to joint issues is ALL chiros do, insurance used to cover that when you had a back injury or whiplash, things it works for. Then insurance stopped covering that, pretty sure it's because they favor you getting a prescrip for pain killers but that's conspiracy on my part, and a lot of chiros started to turn to less savory things, as they did that more and more snake oil types who claim chiropractic work is some fuckin miracle come out of the woodwork.

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.

I’m a radiologist and I too have seen multiple cases of vertebral artery dissections and stroke immediately following chiropractic manipulation. Absolutely no chance I would ever suggest someone see a chiropractor.

It's because what they're doing can sometimes provide temporary relief and when it works, it works fast. An underlying cause has made some inflammation, they stretch things out, relieve some pressure in places that shouldn't have pressure. But they're not fixing anything, just letting your body get back up to barely functioning until the underlying cause rears it's head again. Messed up discs are their bread and butter, but they're just resetting the house of cards you call a back.

Actually fixing the problem is a big, expensive, scary, painful deal and (US) chiros let insurance companies off the hook for a long time.

Someone who knows what they're doing, and knows the limits of what they can do, can benefit certain physical conditions you may have. But they're not doctors. They have no prescribing power. A lot of people go there thinking that they can also prescribe them a medication, which is not the case. But there's no standards for being a chiropractor, so each one is different and some may do little to help you or even hurt you or name you and in some rare cases, kill you

I'm 100% on board with science and evidence based therapies but I've had a similar experience with back pain. I won't let them manipulate my neck at all though.

I could share anecdotal evidence, and we know what that's worth. But the idea that they're all witch doctors rings false. Just as the notion that a certified physical therapist is just dandy.

All told, I'd shy away from chiropractors, especially these days.

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.

I think you’re exaggerating. Quite a few of them are from the field of functional medicine, which is certainly totally legitimate.

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

I mean, if you want to re-shape your nose you can either go to a cosmetic surgeon, or run full speed ahead into a brick wall. Either method would accomplish the mission. One is cheaper, one is more predictable, both are potentially lethal.

typically you see your PCP first.

PCP is the one who makes referral to other physician specialists, like a pain and rehabilitation medicine physician. the PM&R's attempt to identify the pain generators through a series of different types of injections sometimes accompanied w/ PT, OT, MT, and possibly chiro.

when those fail (conservative treatment), the Pt is referred to either a neurosurgeon or orthopedic surgeon.

Wow, an entire weekend!

Depends on the country. In some, it's a 3 year (standard) university degree.

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.

I don't believe in it, and I'll never go, but my girlfriend does.

Yes, she has to keep going back, but when they "pop" the correct thing, she's pain free for weeks. When she holds off going, she's in pain and can't sleep until she goes.

I personally don't trust them, and it's a lot of money for temporary relief, but I guess it kinda works? As long as you're fine with the trade-off being fucking paralyzed when they crank your neck at the speed of sound.

I will add, as someone with a connective tissue disorder, that a quick "pop" can help a subluxated/dislocated joint, but that's something that can and should be done by an actual physician. And if someone has joints that are especially unstable (for example, bc of a connective tissue disorder), subluxations/dislocations can happen pretty regularly.

This is NOT a defense of chiropractors. And chiropractors are even more dangerous for people like me because it's easier for them to seriously damage our joints. Go to a PCP, a rheumatologist, a physical therapist, it doesn't matter, just go to a real doctor.

My wife went to a chiropractor weekly for the last few months of her pregnancy (the chiro office specialized in pregnancy chiropractic). It helped with managing some of the back pain she already had plus the new ones. The best way she described it was like a massage for your bones, feels good and alleviates pain in the short term but doesn't fix anything long term

First hit isn’t even free

I messed up my hip once.. couldn't get it right .. super painful. Chiropractor did it up and was ok from then on. Who knows!

They get paid a lot less per hour, have less support staff, and less equipment. Hence any given unit of time they spend with you costs less. Additionally you have more options of which to choose.

Been to a doc recently? Think of how fast they try to get you out of the room. Feels like you are begging them to please listen to you. Well a chiropractor can spend the time talking to a patient. Of course you feel better, someone heard you complain for over 30 seconds and really listened to you. And if you weren't listened to you, you just go find another one.

One of my best friend’s fathers

How many fathers did they have?

They never complained afterwards.

All the time? No, but it's happened before. Particularly with high neck manipulations that sever the spinal cord above the point where the nerves that control autonomic functions branch off from the neck (I think that's C2?) Randomly? Also no. It's a very predictable result of spinal manipulation. Just like lung cancer doesn't happen 'randomly'; if you smoke enough and long enough, it's pretty likely, but if you don't smoke at all it's very, very rare.

It's definitely happened. I think the technical term is "vertebral artery dissection." I don't think it's like a daily occurrence or anything, but there is a very real risk of it happening whenever you get a chiropractic adjustment on your neck. Basically you have some delicate arteries running through your neck bones and the sharp sudden movement of certain chiropractic adjustments have the potential to rupture them. It can cause a stroke and some various other bad things that can happen when blood flow through the spine is interrupted.

Everything looks like a nail when you're a hammer.

Jackhammer grip reporting, everything looks like porn if you squint hard enough!

They knew what they were doing.

Nope still bullshit here and not USA, you have problems with your bones and muscles? Go to a physiotherapist.

Laws and accreditation don't change how the human body works (and, importantly in the case of chiropractic performances, doesn't work). No energy lines to unblock, your humors or bile aren't unbalanced, a wheatstone bridge can't detect alien ghosts and some distant planet's apparent motion from the Earth's perspective isn't causing your misfortune. We're just meat machines no matter which map lines you're inside and a medical professional who can't keep their mysticism and fantasy out of the workplace can not be trusted to maintain their patients' physical or mental health.

Seriously. I had a friend extolling how good his experience with his chiropractor was, in response to my tale about physical therapy after a skiing accident. I ended the argument pretty quickly by asking "how often do you have to go back"

That’s a weird standard. People see physicians for years because of chronic issues.

Are you saying my brothers oncologist isn’t legit because he has to see him for life ?

Not all their techniques are garbage. DO are trained in manipulation as well. The basic premise of chiropractics is what’s at fault. I’ve seen newer chiropractics switch to more PT style of treatment. No idea if that’s in their scope but I know one who rarely adjust people. It’s mainly massage, weight lifting and body mechanics.

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

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

That's just a physiologist right?

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

How does a chiropractor prescribe an MRI? Seems like that shouldn’t be possible 🤔

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

Right? I feel like that is 90% of the reason to get it.

Unless you have so much pain that you're unable to do even the most basic PT exercises, like me. PT did absolutely nothing, and it was $200 out of pocket for each stupid appt.