Help With Rebutting Chiropracty

[tkingdoll]

But see, my point is, there are plenty of people out there who have hung out shingles as chiropractors who don't preach "subluxations" at you, but who only concentrate, yes, on physical therapy. So those are the chiropractors that I want the OP to not dismiss automatically, out of hand, just because they've hung out a shingle as a chiropractor. I'm saying don't dismiss an entire discipline just because of a few wack practitioners.

There are wack dentists and veterinarians, too, but you don't dismiss dentistry or veterinary medicine as entire disciplines because of that.

Is my point.

I'm not sure you know the history of Chiropractic then. It's not like the history of dentistry or vetinary medicine

If a Chiropractor does not practice Chiropractic (the theory of innate energy forces causes blockages through subluxations), then he/she is not a Chiropractor, but a Physical Therapist.

 

[tkingdoll]

Just bumping this to say the Chiropractic factsheet download is now available at

http://www.skeptics.org.uk/factsheets/Chiropractic.pdf

It covers all the basics and is aimed not at skeptics or true believers but the general public. Feel free to download and distribute it, hopefully some of you will find it a useful resource for situations like the OP.

 

[Ginarley]

This forum is full of revelations for me I'd always assumed that dentist = teeth doctor, optometrist = eye doctor, and chiropractor = back doctor. Clearly the last one isn't the case if chiropractors are quack - so my question is: what is a real back doctor called? Or more precisely, where should I go to sort out my back and neck problems?

[off topic]This is one of the major criticisms of us skeptics - we say "no" to a lot of things but rarely point out the proper alternative (or at least give it very little time relative to shooting down the woo).[/off topic]

All suggestions welcome!

 

[Blue Wode]

This is one of the major criticisms of us skeptics - we say "no" to a lot of things but rarely point out the proper alternative (or at least give it very little time relative to shooting down the woo).

That’s a very good point.

so my question is: what is a real back doctor called? Or more precisely, where should I go to sort out my back and neck problems?

As long as you have seen your GP to rule out any serious problems, then your best bet would probably be to see a physiotherapist/physical therapist since they are far less likely to indulge in quackery-related practices. And if low back pain is your problem, it's possible that you may not need spinal manipulative therapy since the best and most up-to-date systematic review on spinal manipulation for acute or chronic low back pain concludes that there is no evidence that it is superior to standard treatments such as medication for pain, exercises, or care given by a general practitioner. See here:
http://www.update-software.com/abstracts/AB000447.htm

As for your neck problems, since there have been numerous case reports of complications associated with neck manipulation, including stroke and death, it would be best to see a physiotherapist/physical therapist who avoids using it:

Spinal manipulation for neck pain is a treatment with unknown benefits and unknown harm. Because of this and the fact that serious risks are on record, a responsible risk–benefit assessment cannot ignore the risks and cannot come out in favour of spinal manipulation. Remember the supreme law in medicine: first do no harm. Other therapies for neck pain exist, e.g. exercise, which are supported by at least as good evidence for benefit and which are at the same time free of significant risks. The inescapable recommendation based on the best evidence available today is to use exercise rather than spinal manipulation as a treatment for neck pain.

Quoted from the second section of this debate:

Spinal manipulation for neck pain – more good than harm?
Ernst E, Focus Altern Complement Ther 2004; 9: 107–10
http://journals.medicinescomplete.com/journals/fact/current/fact0902a06d01.htm

Hope the above is of some help to you.


Tkingdoll, thank you for posting the link to the excellent factsheet. It's perfectly clear that if chiropractors were forced by regulation to adhere to evidence-based treatment approaches, then a large number of them would be out of business in next to no time.

 

[Ginarley]

Thanks Blue Wode, that was a very useful reply - appreciated

 

[MrMonty]

... so my question is: what is a real back doctor called? Or more precisely, where should I go to sort out my back and neck problems?

I've been going through this for the past month, so here's my experience.

Have had back pain before, even threw it out a few months ago. This time, pain is intense and focused in the left leg. Wife convinces me to go to a Chiropractor. Chiroprator takes Xrays, pushes on my back some, puts an ice pack on along with some wierd electro-vibrating thing. He wants me to come back 2-3 times a week at first. His bill included things like a "Comprehensive Exam" for $100, $25 for the ice pack... that's all I can remember. Anyway, results were that I felt no better and it was getting worse. I appeased my wife by going and will never, ever, ever go to a Chiro again. The Chiro's main purpose seems to be to get people into his shop and get lots and lots of business. He wants you in his place for "treatment" or "adjustments" from birth to death. I'm not kidding, in every room he had a poster showing a child being born and stating that the doctors are screwing up everybody just by pulling them out of the birth canal, so bring your kids in as soon as possible. First Exam Is Free! Those posters alone turned me off to Chiro big time.

So, the real treatment started when I went to my GP. He sent me to a Spine Specialist. Spinal guy sent me to a Physical Therapist. The PT makes sense and his main objective isn't to see you as often and as long as possible. I've got quite a regiment of exercises to do but some of them definitely give me relief after doing things like sitting for a while. I've also regained a lot of mobility and lost a lot of the pain.

Monty

 

[Beleth]

If a Chiropractor does not practice Chiropractic (the theory of innate energy forces causes blockages through subluxations), then he/she is not a Chiropractor, but a Physical Therapist.

Hmmm.

Who are we non-chiropractors to define what makes someone a Chiropractor and what doesn't?

My uncle went to (real) medical school. In his entire medical career he never treated a single patient; instead, he worked at an insurance company as their expert witness in lawsuits. He kept up to date on medical techniques and breakthroughs; he knew what he was talking about. He just didn't put any of that knowledge into practice. Was he a Doctor?

 

[Ginarley]

Thanks for sharing your story Monty, its a lesson I'm glad I don't have to learn the hard way! I'm glad to hear things are better for you!

 

[Ducky]

Hmmm.

Who are we non-chiropractors to define what makes someone a Chiropractor and what doesn't?

My uncle went to (real) medical school. In his entire medical career he never treated a single patient; instead, he worked at an insurance company as their expert witness in lawsuits. He kept up to date on medical techniques and breakthroughs; he knew what he was talking about. He just didn't put any of that knowledge into practice. Was he a Doctor?

Who are we non-police officers to define what makes someone a police officer? That is the most ridiculous question ever. Of course we know what makes a professional a professional. If someone is not a police officer they are simply a security guard. We know what it takes to be a doctor, or a PhD or an attorney. We know what it takes to be a Chiropractor. You can google the requirements for Chiropractor schools in the US. You can see the certificate that is given out and it is clear that they go by subluxations and the like in practice, or they are simply doing physical therapy.

Your uncle is like Terry. Terry in training is an aerospace engineer. In profession, he is a programmer.

Professionally your uncle was not a doctor. He was trained as one, however. I don't see where you said he was board certified or did an internship/residency. If this was the case then again, he is a doctor in training and an insurance professional in practice.

 

[Soapy Sam]

I'm not sure you know the history of Chiropractic then. It's not like the history of dentistry or vetinary medicine

If a Chiropractor does not practice Chiropractic (the theory of innate energy forces causes blockages through subluxations), then he/she is not a Chiropractor, but a Physical Therapist.

We have to be careful with that term, teek. In Britain, "Physical therapist" is a catch-all term that might refer to a masseur, an osteopath, or anyone who did..uh..physical therapy.
In America, a "Physical Therapist" is what we in the UK call a "Physiotherapist" - ie a state registered medical professional with recognised qualifications. (And many of whom do use techniques we might consider "woo", such as TENS machines, accupuncture of a sort and ultrasound with the power turned off. Yes, really. There's a lot of Weatherwaxian headology in physiotherapy).

If what is required to treat a particular problem actually is manipulation, then we need a "physical therapist" (in the general sense) who is experienced in manipulation.

The only person I could find with that experience had a sign on his door saying "Chiropractor".

So I went to a chiropractor. The history of chiropractic was wholly irrelevant to the situation. If the man with the necessary experience was a barber, then I would have gone to a barber.
If that is the situation described in the OP, then I would be hypocritical if I was to say "on no account go to someone who calls himself a chiropractor". What matters is - does he have the skills you are looking for?

The hard part is identifying the technique required (which we cannot be 100% certain of) and then finding the person able to apply it. That diagnostic stage is critical- particularly in the case of neck manipulation, which we all agree carries risks. It should be as broad as necessary or possible and absolutely must include qualified doctors. Nobody should have neck manipulation on a whim and any practitioner prepared to do it without xrays and consultation with the doctor and radiologist is a dangerous quack, whatever it says on his door.

 

[Blue Wode]

If what is required to treat a particular problem actually is manipulation, then we need a "physical therapist" (in the general sense) who is experienced in manipulation.

The only person I could find with that experience had a sign on his door saying "Chiropractor".

So I went to a chiropractor. The history of chiropractic was wholly irrelevant to the situation.

As you have indicated before, it seems that you were very fortunate that the history of chiropractic was wholly irrelevant to your situation. Others are not so lucky.

The hard part is identifying the technique required (which we cannot be 100% certain of) and then finding the person able to apply it.

A very hard part indeed.

That diagnostic stage is critical- particularly in the case of neck manipulation, which we all agree carries risks. It should be as broad as necessary or possible and absolutely must include qualified doctors.

Do you mean medical doctors? According the General Chiropractic Council’s website, doctors of chiropractic - who are not medical doctors and do not receive an equivalent medical training - are “primary care practitioners” which means that many people will consult a chiropractor without a GP referral. And for all patients consulting chiropractors in the UK, only about 10% of chiropractors will routinely communicate with their patients’ GPs (they are not required by law to do so).

In addition to that, the General Chiropractic Council’s Patient Information Leaflet says that “chiropractors can provide a package of care that is evidence based”. But the big question is will they? How many patients can tell the difference between scientific manual therapy and chiropractic philosophy? Here’s the problem:

The chiropractic profession, which began with a founding father in 1895, is identified primarily by its use of manipulation. But chiropractic is based upon a vertebral subluxation theory that is generally categorized as supporting a belief system. The words "manipulation" and "subluxation" in a chiropractic context have meanings that are different from the meanings in evidence-based literature. An orthopedic subluxation, a partial dislocation or displacement of a joint, can sometimes benefit from manipulation or mobilization when there are joint-related symptoms. A chiropractic subluxation, however, is often an undetectable or asymptomatic "spinal lesion" that is alleged to be a cause of disease. Such a subluxation, which has never been proven to exist, is "adjusted" by chiropractors, who manipulate the spine to restore and maintain health. The reasons for use of manipulation/ mobilization by an evidence-based manual therapist are not the same as the reason for use of adjustment/manipulation by most chiropractors.

http://jmmtonline.com/documents/HomolaV14N2E.pdf

Soapy Sam:

Nobody should have neck manipulation on a whim and any practitioner prepared to do it without xrays and consultation with the doctor and radiologist is a dangerous quack, whatever it says on his door.

Agreed. However, some chiropractors – especially those who buy into the subluxation theory - believe that most human ailments are the result of misalignment of the atlas and axis (the top two bones of the spinal column) and that every patient they see needs neck manipulation.

At the end of the day, what’s very important to understand is that although the function of chiropractic regulation (in the UK) is to protect patients and set standards, it doesn’t regulate treatment approaches and this allows dangerous quackery-related practices to flourish unchecked.

MrMonty:

The Chiro's main purpose seems to be to get people into his shop and get lots and lots of business. He wants you in his place for "treatment" or "adjustments" from birth to death. I'm not kidding, in every room he had a poster showing a child being born and stating that the doctors are screwing up everybody just by pulling them out of the birth canal, so bring your kids in as soon as possible. First Exam Is Free! Those posters alone turned me off to Chiro big time.

There seems to be a lot of truth in your observations. This from the British Chiropractic Association’s website:

A healthy future
As your children grow, you will be getting their eyes and teeth checked regularly. Consider giving them regular chiropractic checkups too, which could give them the best start in life with a healthy spine and nervous system.

Can a chiropractor treat a newborn baby?
Yes, in fact the sooner your baby is checked, the sooner any injury of stresses from the birth can be dealt with safely and gently.

Don’t children just grow out of it?
Not necessarily. Problems with their spines and nervous systems might not show obvious symptoms for years. Colic, ear infections, learning difficulties or frequent illness may be signs that your children’s nervous system is not working efficiently.

http://www.chiropractic-uk.co.uk/gfx/uploads/textbox/Happy families.pdf

How the mess that is chiropractic can be cleaned up is anyone’s guess.

 

[Josh Redstone]

This is an interedting tiopic which I always have trouble sorting out for myself, simply because I'm biased. From time to time, I'd go to a chiropractor. During high-school for instance, I was usually involved in some kind of straining activity, and I got hurt. The chiropractic treatments made me feel better. It's very possible it was just a placebo effect, or maybe the effects were the 'physical therapy' type effects some of you mentioned, but at least they worked on that level. So, as far as that goes, I'm kind of neutral. If you're a concenting adult and you'd like to visit a chiropractor, then go ahead.

What I do have a problem with is chiropractic treatment being applied when there is nothing wrong, like on a child who's spinal chord isn't even fully developed. Again, if you're a concenting adult who wants to go to a chiropractor, fine. However if I had kids, I would never take them to a chiropractor.

Another thing I'm curious about are the required certifications for chiropractic in other countries. Here in Canada, you've got to have at least a Bachelor's Degree in Biology, plus the Doctor of Chiropractic (which is a four year degree if I remember right).

 

[Blue Wode]

If you're a concenting adult and you'd like to visit a chiropractor, then go ahead.

I would add that those consenting adults have a right to be provided with reliable information on their treatment, including the evidence for it and the risks it might carry. Unfortunately, here in the UK, chiropractic consent procedures seem to leave a lot to be desired:

Consent or submission? The practice of consent within UK chiropractic

“Results suggest that valid consent procedures are either poorly understood or selectively implemented by UK chiropractors.”

http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=15726031&dopt=Abstract

Josh Redstone:

Another thing I'm curious about are the required certifications for chiropractic in other countries. Here in Canada, you've got to have at least a Bachelor's Degree in Biology, plus the Doctor of Chiropractic (which is a four year degree if I remember right).

In the UK, the Bachelor of Science degree at the University of Glamorgan only requires reasonably good grades on leaving school:
http://www.glam.ac.uk/coursedetails/685/130

Similar grades are required for the Master of Chiropractic degree from the Anglo European College of Chiropractic:
http://www.aecc.ac.uk/college/admissions/entry_requirements.asp

Interestingly, this is what one UK chiropractic association, the United Chiropractic Association, has to say about chiropractic training:

It is the responsibility of the Doctor of Chiropractic to locate subluxations, and reduce or correct them. This is done through a series of gentle and safe chiropractic adjustments specifically designed to correct the vertebral subluxations in your spine. Chiropractors are the only professionals who undergo years of training to be the experts at correcting subluxations.

http://www.united-chiropractic.org/modules/tinycontent/index.php?id=1

And here’s what the UK Skeptics factsheet on chiropractic has to say about that:

There is no evidence that chiropractic subluxations actually exist…

Read on:
http://www.ukskeptics.com/factsheets/Chiropractic.pdf

 

[Josh Redstone]

I would add that those consenting adults have a right to be provided with reliable information on their treatment, including the evidence for it and the risks it might carry. Unfortunately, here in the UK, chiropractic consent procedures seem to leave a lot to be desired:

I agree that reliable information is not always provided, which is a shame, since not to many people will actually go out and research something like this before trying it. Like someone else already mentioned, many people are under the impression that a chiropractor is a back doctor, which isn't true.
I myself have been doing some research ever since I saw Penn & Teller look at chiropractic on B*llsh*t!, and I was also subject to a lot of mis-information.

However I'm also trying to bear in mind that practices of medicine do change over time. The guy who 'dicovered' chiropractic was a weirdo by many of today's skeptical standards, but then again, look at some of the thing Hipprocrates believed.
Don't get me wrong, I don't believe in subluxations, or that back problems are the cause of all disease, I'm just saying there are probably a number of chiropractors out there who don't practise the 'old school' chiropractic, and that those methods should be looked at in a proper scientific.

EDIT - So I suppose what I'm getting at, is separating all the junk science and looking at what's left, which probably isn't that much, and whether or not this should even be called chiropractic in the traditional sense is another matter, but it might be worth thinking about.

Either way, however, I probably won't be headed back to a chiropractor any time soon

 

[Belz...]

I'll be keeping an eye on this, as I'm very confused. I didn't realize there was any woo going on about it at all. I know people who swear by it, but they are people with chronic back problems, not anyone with any sort of disease or something that they claim is being treated by it.

I have lots of back problems, but I got tired of chiropractors really quickly. The only good thing about them is the temporary relief of pain, something you can do yourself once you get the hang of it.

 

[Beleth]

Who are we non-police officers to define what makes someone a police officer? That is the most ridiculous question ever.

If you say so. I wish you had put a little thought into it, though.

Of course we know what makes a professional a professional.

Then it should be trivial to spell it out. Please, be my guest. I ask because you contradict yourself in these next sentences:

If someone is not a police officer they are simply a security guard. We know what it takes to be a doctor, or a PhD or an attorney. We know what it takes to be a Chiropractor. You can google the requirements for Chiropractor schools in the US. You can see the certificate that is given out and it is clear that they go by subluxations and the like in practice, or they are simply doing physical therapy.

In the first sentence, you make it clear that there are two parts to being a police officer: there's certification, and there's earning a wage doing what you are certified to do. In the third and fourth sentences, you make it clear that the only thing necessary to be a Chiropractor is certification.

Personally, I think that it's a combination of certification and practice. But I also know that in practice, one does not do every subset of every task one is qualified to do. While getting my CS degree, I got an A in a class called "Transmission Lines". At one point in my life I could tell you all about transmission lines, why it's important to put resistors at the end of them, what the wave properties of electrical impulses are while going through transmission lines with different properties, etc. But I have never in my engineering practice done anything with transmission lines. Does that invalidate me as a computer scientist?

If one gets certified in Chiropracty, and one makes a living manipulating backbones in the chiropractic tradition, then one is a Chiropractor, whether one delves into the subluxation aspect of it or not.

 

[Ducky]

If you say so. I wish you had put a little thought into it, though.

I could say the same of you.

ETA: Surely you see the sophistry of saying "But we're not one of those how can we know?"

Then it should be trivial to spell it out. Please, be my guest. I ask because you contradict yourself in these next sentences:


In the first sentence, you make it clear that there are two parts to being a police officer: there's certification, and there's earning a wage doing what you are certified to do. In the third and fourth sentences, you make it clear that the only thing necessary to be a Chiropractor is certification.

No, I did not contradict myself. If the chiropractor has a physical therapist certifacation then they are a physical therapist. If the chiropractor gets a certifacation in chiropractic and subluxations then they are a chiropractor.

Regardless, a chiropractor that only works on lower backs and does not try to use spinal manipulation on babies, or try to cure hayfever with spinal manipulation is NOT practicing Chiropractic techniques. They are practicing techniques taught to physical therapists.

Here is one site that lists a set of requirements to be a chiropractor. From that same site the definition of subluxation is given. It is a wonderful apologetic attempting to make Chiropractors sound medical and more like physical therapists. Yet we know this history of this practice.

So yes, to be a chiropractor and not a physical therapist requires a specific certifacation.

If one gets certified in Chiropracty, and one makes a living manipulating backbones in the chiropractic tradition, then one is a Chiropractor, whether one delves into the subluxation aspect of it or not.

In order to get certified as a Chiropractor one HAS to delve into the subluxations. However in practice if all they do is alleviate lower back pain then they are acting as a physical therapist, and should have gone with that degree. If they disagree with their own training about spinal manipulations shoudl be started at birth, and curing cancer/hay fever etc then they aren't a Chiropractor. They are using physical therapy to treat physical ailments and should have been certified as a physical therapist. Until they are a physical therapist I will continue to call them a quack. To have the Chiro degree means they delved into the subluxations in school.

Your analogy about one class is irrelevant. Subluxations are a fundamental part of the degree. If you had said you don't agree with something fundamentally part of a CS degree then you may have an apt analogy.

 

[Beleth]

Fowlsound -

I have a confession to make. I had a brain fart and was using "subluxation" to mean fixing organ problems by relocating joints, instead of the act of relocating joints themselves. I hope this makes my position clearer.

I think we agree that a Chiropractor that relocates joints is still a Chiropractor. Where we might disagree are the other cases.

- Is a Chiropractor who doesn't relocate joints still a Chiropractor?
You say no; I actually tend to agree with you.

- Is a Chiropractor who only relocates joints to fix joint problems (and not to fix organ problems) still a Chiropractor?
I say yes; I'm not sure what you would say.

I could say the same of you.

*shrug* At least I didn't resort to insults straight out of the gate.

No, I did not contradict myself. If the chiropractor has a physical therapist certifacation then they are a physical therapist. If the chiropractor gets a certifacation in chiropractic and subluxations then they are a chiropractor.

There you go again. Does it require practicing subluxation to be a chiropractor, or does it not?

Regardless, a chiropractor that only works on lower backs and does not try to use spinal manipulation on babies, or try to cure hayfever with spinal manipulation is NOT practicing Chiropractic techniques. They are practicing techniques taught to physical therapists.

But they're certified as a Chiropractor, and they're practicing subluxation on adults! How does that make them not Chiropractors?

In order to get certified as a Chiropractor one HAS to delve into the subluxations. However in practice if all they do is alleviate lower back pain then they are acting as a physical therapist, and should have gone with that degree.

Even if they use subluxations to alleviate the lower back pain?

If they disagree with their own training about spinal manipulations shoudl be started at birth, and curing cancer/hay fever etc then they aren't a Chiropractor.

Ahh, so it's certification, and practice, and mindset now, is it? I now disagree with your earlier statement that "of course we know what makes a professional a professional". At least you don't seem to.

They are using physical therapy to treat physical ailments and should have been certified as a physical therapist. Until they are a physical therapist I will continue to call them a quack. To have the Chiro degree means they delved into the subluxations in school.

Sigh...

Your analogy about one class is irrelevant. Subluxations are a fundamental part of the degree. If you had said you don't agree with something fundamentally part of a CS degree then you may have an apt analogy.

It wasn't just transmission lines. I took a boatload of hardware courses. I haven't done anything with that knowledge at all. I question whether it was necessary for me to take it. So am I not a computer scientist yet?

 

[scottder]

Found this in a local "Parents Magazine" h++p://ik3a.com/chiro.png (chage ++ for tt).

I did of poking around, and I believe the same man has done talks at local libraries agains vaccinating children.

 

[Ducky]

Fowlsound -

I have a confession to make. I had a brain fart and was using "subluxation" to mean fixing organ problems by relocating joints, instead of the act of relocating joints themselves. I hope this makes my position clearer.

I think we agree that a Chiropractor that relocates joints is still a Chiropractor. Where we might disagree are the other cases.

- Is a Chiropractor who doesn't relocate joints still a Chiropractor?
You say no; I actually tend to agree with you.

- Is a Chiropractor who only relocates joints to fix joint problems (and not to fix organ problems) still a Chiropractor?
I say yes; I'm not sure what you would say.

Then you haven't been reading.

*shrug* At least I didn't resort to insults straight out of the gate.

You still haven't acknowledged the sophistry of your original post in this thread. Insults or not, you basically asked how can we know what a chiropractor is without being one. Surely you see the fallacy in this?

There you go again. Does it require practicing subluxation to be a chiropractor, or does it not?

Yes it does.

But they're certified as a Chiropractor, and they're practicing subluxation on adults! How does that make them not Chiropractors?

Even if they use subluxations to alleviate the lower back pain?

Ahh, so it's certification, and practice, and mindset now, is it? I now disagree with your earlier statement that "of course we know what makes a professional a professional". At least you don't seem to.


Sigh...

Thank you for showing a lovely strawman. Let me re-clarify for you.

Firstly, subluxation manipulation isn't curing the back pain, the manipulation is. This is a technique also used in a legitimate field of medical professionals called physical therapists. If a chiropractor is simply manipulating the spine to alleviate back pain then they are acting as a physical therapist. If they claim the subluxation nonsense is the reason for the back pain alleviation then they are practicing physical therapist techniques while claiming chiropractic causes for alleviation of pain.

Quite simply: If a chiropractor makes no mention of subluxations and simply manipulates spines to alleviate lower back pain then they are acting as a physical therapist regardless of training. (Which means if they wanted to simply be a physical therapist they should have goten that degree instead.)

Clear enough, or do you have more pedantry?

It wasn't just transmission lines. I took a boatload of hardware courses. I haven't done anything with that knowledge at all. I question whether it was necessary for me to take it. So am I not a computer scientist yet?

in training and practice you are a computer scientist. If you started manipulating spines to alleviate back pain you would be acting as a physical therapist regardless of your training. If you were to start wiring houses you would be acting as an electrician regardless of training. The problem is you don't have proper training to act as those, and the same is true of a chiropractor. For physical therapy, go to a physical therapist, not someone who acts as one without the proper training.