Chiropractic Woo?

[vIQleS]

If I give a hyperglycemic diabetic 6 units of insulin and the blood sugar comes down, I take it from your line of reasoning, that there is nothing that that can prove the glucose didn't come down due to a placebo effect.

There is something... what was it now? Oh yes - Randomised double-blind trials.

(And as someone else mentioned - objectively measurable, physiological changes)

 

[Rodney]

Ummm... the placebo effect doesn't work until you introduce the placebo.

It's like if you took an aspirin and still had a headache and a friend told you he had the best cure in the world. Even if it's a sugar pill, there's no chance the placebo effect is going to work before you swallow it.

The point is that the author presumably had some belief in the efficacy of the surgery, or he wouldn't have agreed to it. So, why didn't his pain go away following surgery, rather than later, following chiropractic adjustments?

 

[Drudgewire]

The point is that the author presumably had some belief in the efficacy of the surgery, or he wouldn't have agreed to it. So, why didn't his pain go away following surgery, rather than later, following chiropractic adjustments?

I can't pretend to know what's in the guy's head, but there's a whole host of possibilities... from the sense of hopelessness after the first surgery didn't work making him less susceptible to trust the latter ones coupled with a sense of desperation turning to hope because something else is out there "those damn doctors" don't like very much and some are swearing by,

 

[fls]

He states that the three surgeries did not alleviate his chronic shoulder and arm pain.

Two of the surgeries were on the lower back so they would not have been directed at alleviating shoulder and arm pain. He does not mention ongoing chronic low back pain, or that the first two surgeries were unsuccessful. He only mentions the one surgery on his neck as unsuccessful at alleviating his shoulder and arm pain.

All the chiropractic treatments have done for him is temporarily alter his subjective perception after each manipulation. He still has chronic shoulder and arm pain. We can't tell whether or not he he had a similar alteration in his perception after his surgery, but since it wasn't reinforced by repeated visits, or helped out by massage-like features, we wouldn't really expect it to have made much of an impression (from a placebo point-of-view) compared to regular chiropractic manipulation.

Linda

 

[fls]

The point is that the author presumably had some belief in the efficacy of the surgery, or he wouldn't have agreed to it. So, why didn't his pain go away following surgery, rather than later, following chiropractic adjustments?

You need to read more carefully. His pain hasn't gone away with the chiropractic adjustments.

Linda

 

[Formerly]

It's merely anecdotal, but seeing a chiropractor after a car accident caused more pain, not less. My lower back kept "going out" after adjustments, to the point where I could barely walk. As soon as I stopped seeing the quack, my back felt fine.

I was going to add my own painful and negative anecdote, but it doesn't really prove much.

I just wanted to add that for some of us who have seen chiros, they do damage that never heals and give ya pain that never completely goes away.

 

[JJM]

George Magner wrote a book "Chiropractic: The Victim's Perspective" that provides material on this topic. Edzard Ernst once estimated that 50% of chiro customers experience transient discomfort. In true, perverse Altie style- chiros explain that discomfort means the treatment is "taking effect."

So, of course, your anecdotes prove nothing; but they provide a basis for a study. When those studies are done, they find a pattern consistent with your observations.

 

[Blue Wode]

George Magner wrote a book "Chiropractic: The Victim's Perspective" that provides material on this topic. Edzard Ernst once estimated that 50% of chiro customers experience transient discomfort. In true, perverse Altie style- chiros explain that discomfort means the treatment is "taking effect."

Apparently, that’s known as ‘retracing’…

Chiropractic patients occasionally experience the phenomenon of retracing. Retracing is the re-experiencing or re-awakening of pain or other symptoms, including memories or even emotions that seem suddenly to erupt to the surface. It appears to be a part of the healing process.

-snip-

Patients going though a particularly intense retracing pattern may feel as if they've had a serious relapse or are perhaps even getting worse.
Although retracing experiences usually last a short time and often pass relatively quickly, patients have been known to terminate their care as a result of them. During this period it is especially important that the patient tell the doctor what is going on. Patients who terminate their care as a result of retracing symptoms will be cheating themselves of a healing experience.

http://www.planetc1.com/cgi-bin/n/search.cgi?category=1&keyword=CA+Lynne&page=5

[My bold]

On the other hand, a chiropractor who delays referring a deteriorating patient to an appropriate specialist for a thorough medical evaluation could be cheating the patient out of receiving prompt treatment for a more serious problem.

I have benefitted greatly from chiropractors for years. Once I had numbness and tingling in my arm from my shoulder to my fingers that lasted a month. Neurologists found nothing wrong with me. One good crack to my neck from a chiropractor was all it took. I got up from the table and I was cured.

Although neurologists found nothing wrong with you, some of the symptoms you were experiencing can be experienced by people who have carpal tunnel syndrome. Interestingly, the latest systematic review for non-surgical treatment (other than steroid injection) for carpal tunnel syndrome includes chiropractic care as one of several therapies that “did not demonstrate symptom benefit when compared to placebo or control”.

http://www.cochrane.org/reviews/en/ab003219.html

I would venture to say a lot of it sounds like a "foot in the door" technique. You went in for a nice massage and their knowledge of anatomy may make it sound reasonable that they know what they're doing. After that they try and make it sound like they can cure more ailments.

And if chiropractors were able to “cure more ailments” one would expect their longevity to be on a par with that of medical doctors or, at the very least, the general population. But, according to this recent survey (which was carried out by a chiropractor), chiropractors’ life-spans are shorter than both:

The chiropractic cliché “Chiropractic Adds Life to Years and Years to Life” was examined for validity. It was assumed that chiropractors themselves would be the best informed about the health benefits of chiropractic care. Chiropractors would therefore be most likely to receive some level of chiropractic care, and do so on a long-term basis. If chiropractic care significantly improves general health then chiropractors themselves should demonstrate longer life spans than the general population.

Two separate data sources were used to examine chiropractic mortality rates. One source used obituary notices from past issues of Dynamic Chiropractic from 1990 to mid-2003. The second source used biographies from Who Was Who in Chiropractic – A Necrology covering a ten year period from 1969–1979. The two sources yielded a mean age at death for chiropractors of 73.4 and 74.2 years respectively.

The mean ages at death of chiropractors is below the national average of 76.9 years and is below their medical doctor counterparts of 81.5.

This review of mortality date found no evidence to support the claim that chiropractic care “Adds Years to Life.”


Full text here:

Morgan, L. Does Chiropractic ‘Add Years to Life’? J Can Chiropr Assoc. 2004 September; 48(3): 217–224

http://www.jcca-online.org/client/cca/JCCA.nsf/objects/V48-3-P217-224/$file/V48-3-P217-224.pdf

[My bold]

ETA: The JCCA link should work if you copy and paste it.

 

[Rodney]

You need to read more carefully. His pain hasn't gone away with the chiropractic adjustments.

Linda

Not permanently, but as the author of the article states:

"I've been adjusted, and not just my back and golf swing but my outlook as well. I step into the bright sunshine outside Loebig's Great Falls office a little lighter on my feet, a little less aware of the chronic pain in my right shoulder. My head feels looser on my neck, and I feel taller. The sensation of well-being won't last, I know. It could be a matter of days, or even hours, before the pressure builds again and my joints stiffen with stress and tension. But for now, I'll take it."

 

[JoeEllison]

Not permanently, but as the author of the article states:

"I've been adjusted, and not just my back and golf swing but my outlook as well. I step into the bright sunshine outside Loebig's Great Falls office a little lighter on my feet, a little less aware of the chronic pain in my right shoulder. My head feels looser on my neck, and I feel taller. The sensation of well-being won't last, I know. It could be a matter of days, or even hours, before the pressure builds again and my joints stiffen with stress and tension. But for now, I'll take it."

So, that author has figured out how to rip off his insurance company, by getting them to pay for a massage? That doesn't show any effect of chiropractic whatsoever.

 

[Rodney]

So, that author has figured out how to rip off his insurance company, by getting them to pay for a massage? That doesn't show any effect of chiropractic whatsoever.

Some might wonder why, if you're right, the Georgetown surgeon didn't recommend a masseuse instead of a chiropractor.

 

[JoeEllison]

Some might wonder why, if you're right, the Georgetown surgeon didn't recommend a masseuse instead of a chiropractor.

Because insurance pays for one, and not the other. Pretty simple, I would have thought even you could have figured that one out.

 

[Gord_in_Toronto]

Because insurance pays for one, and not the other. Pretty simple, I would have thought even you could have figured that one out.

There's a sports therapy clinic in the plaza close to where I live -- the hourly rate for a chiropractor is $5 less than for a physiotherapist. To do with their respective levels of training I would guess.

 

[Gord_in_Toronto]

Not permanently, but as the author of the article states:

"I've been adjusted, and not just my back and golf swing but my outlook as well. I step into the bright sunshine outside Loebig's Great Falls office a little lighter on my feet, a little less aware of the chronic pain in my right shoulder. My head feels looser on my neck, and I feel taller. The sensation of well-being won't last, I know. It could be a matter of days, or even hours, before the pressure builds again and my joints stiffen with stress and tension. But for now, I'll take it."

Sort of like those cured by Benny Hinn; rising from their wheelchairs to dance on the stage and, in the following hour, now out of camera shot, they are writhing in pain?

 

[fls]

Not permanently, but as the author of the article states:

"I've been adjusted, and not just my back and golf swing but my outlook as well. I step into the bright sunshine outside Loebig's Great Falls office a little lighter on my feet, a little less aware of the chronic pain in my right shoulder. My head feels looser on my neck, and I feel taller. The sensation of well-being won't last, I know. It could be a matter of days, or even hours, before the pressure builds again and my joints stiffen with stress and tension. But for now, I'll take it."

I also feel "a little less aware of the chronic pain in my right shoulder" while I'm watching a good movie.

Linda

 

[Physiotherapist]

I would be prepared to pay the $5 more to see the Physical Therapist anyday rather than a chiro. Not that I'm biased of course!!

I reckon that a mixture of physical therapy and advanced bodywork techniques could have gotten rid of the numbness and tingling down your arm just as effectively as the chiropractic adjustment that you had. It would also have alleviated your residual stiffness too.

As much as I like my patients and enjoy the work that I do, I don't want to see them all the time. I like to see them and work with them to resolve the problems that they are having and then discharge them from treatment. If their problems are not resolving with the treatments that I am doing with a certain time frame, then I think about referring them elsewhere for further diagnosis, but definitely not a chiropractor.

 

[Rodney]

I also feel "a little less aware of the chronic pain in my right shoulder" while I'm watching a good movie.

Linda

So I guess there's no benefit to feeling better for as much as several days. The author should have had more surgery, which didn't do anything to relieve his pain and undoubtedly costs several times as much.

 

[Physiotherapist]

Rodney,

No. The author could have gone to see a physical therapist instead of a chiropractor and could have got long lasting relief from his problems.

I will admit that I have been to see a chiropractor myself a couple of times and after going twice I didn't go back. None of the adjustments seemed to last for any length of time.

What people seem to forget is that soft tissue work is important and chiropractors seem to do little of that. There is a lot more soft tissue/muscles that are attached to the bones and joints that pull them out of place rather than bones or joints themselves being out of alignment (subluxation as a chiro quack would say) Once you sort out the tissue that is pulling them out of place, then a lot of the problems start to resolve.

Sounds like this guy was having frozen shoulders. This is notoriously difficult to treat and surgery is not always successful in treating it.

A frozen shoulder will resolve with time and perhaps this co-incided with the chiropractic treatment, so it was assumed that the chiropractor was responsible for the cure. This is the natural course of symptoms that will get better and worse and if treatment co-incides with symptoms decreasing, then it could be thought that chiropractic was responsible.

The same thing happens with homeopathy. People take a sugar pill at a time when their symptoms are declining anyway and when this happens they dangerously think that it is the homeopathy that has worked, when it fact it isn't and can't be. Exactly the same with thing can happen with chiropractic.

This guy would probably have got better on his own without any further treatment. Things do spontaneously resolve and there is also the natural progression of disease too.

The body, left to its own devices is a very good self-healing mechanism.

 

[fls]

So I guess there's no benefit to feeling better for as much as several days.

The point is that dressing up distraction, attention and a little accidental physiotherapy with a Just So story makes the process unnecessarily inefficient. There are better ways to acheive those same results, and an application of critical thinking has the potential to improve upon the outcome. Getting caught up in the Just So story of chiropractic constrains the possibility of advancement.

The author should have had more surgery, which didn't do anything to relieve his pain and undoubtedly costs several times as much.

Opportunity costs are important to consider. By focussing on chiropractic, the author may be losing the opportunity to gain greater value from spending his resources - either by spending less for the same value, or by getting greater value through the use of physiotherapy (an evidence-based field instead of non-evidence-based) or other treatments.

Linda

 

[Blue Wode]

Let's consider what the author of the Washington Post article has to say about his treatment by medical doctors: "After three spinal surgeries since 2002, two lumbar and 2004's brutally intrusive cervical fusion, which put a piece of cadaver bone in my neck in a procedure that was supposed to correct chronic shoulder and arm pain -- and didn't -- I'm hoping to minimize my time under the knife."

Maybe the author of the Washington Post article was specially selected to be the star of a slick marketing exercise instigated by the American Chiropractic Association…

Washington Post Article Shines Favorable Light on Chiropractic

-snip-

This latest news article is just one of the many media relations efforts conducted by the ACA on behalf of its members. ACA's public relations team works to increase demand for chiropractic care and ensure that chiropractic receives accurate and favorable exposure in the media. Through proactive news releases, letters to the editor, and other vehicles, the ACA has reached millions of consumers with pro-chiropractic messages.

http://www.amerchiro.org/press_css.cfm?CID=2432

BTW, it appears that the ACA endorses subluxation theory:
http://www.amerchiro.org/level2_css.cfm?T1ID=10&T2ID=117#68