How do you know who's a good one? Years ago, neighbors gave glowing references for a local chiropractor. He did some manipulation and then tried out a new gizmo he'd gotten - something like a barrel you drape your body over, facing forward. This caused horrible pain. Later an MRI showed I had two bulging disks in my low back that neither he nor I knew about. His new toy was just about the worst thing for that.
22
All chiropractors, PT's, MD's, etc. were beginners at one time and the skill of handling/understanding musculo-skeletal pathology is one that takes time to develop. Moreover all bodies are different and respond differently. It seems like many of the commentators view pain management in the same manner as buying a new appliance. You don't just plug into a new practitioner and the pain goes away. (Sometimes, though, which is great.) Unfortunately the whole discussion I think reflects our current society in which everyone is painted black or white. The chiropractor who didn't help is a thief, a scoundrel, a crook. The one who did help deserves sainthood. The method that worked for me is the only way that works. If you think your way works, you're being dishonest with yourself.
19
My Chiropracter is amazing, providing pain relief that no drug can match and effecting lasting change that aids mobility. Hurts so good!
13
I think the risk good doctor is your pocketbook. I've had spinal fusion and I have had "many" manipulations. I certainly appreciate both but I don't appreciate the monetary manipulative control of our health care by the all knowing AMA. You don't know what you don't know.
6
What about going with your ending sentence and the current scientific recommendations: Nothing but simple home treatment for 6 weeks for the usual low back ache? Works, cheap and doesn't medicalize or whatever to a common human malady!
The data on chiro care is still sketchy and minimal. Why haven't they done any real studies to see if what they do actually does any good?
The data on chiro care is still sketchy and minimal. Why haven't they done any real studies to see if what they do actually does any good?
35
Keep moving, strengthen supporting muscles.
Squats with huge kettle bells helped chase away my sciatica pain, and constant crunches, not pills, keep it at bay.
Manipulation has its risks; do research, get recommendations.
Squats with huge kettle bells helped chase away my sciatica pain, and constant crunches, not pills, keep it at bay.
Manipulation has its risks; do research, get recommendations.
16
People with spinal stenosis, degenerative or bulging disks or other degenerative spinal conditions are fools to undergo aggressive manipulations by a chiropractor. Your pain is not due to something being 'out of alignment'...and you may very well end up injured or, at the very least, worse than when you walked in.
Low impact exercises, core strengthening and stretching are key to controlling pain and maintaining range of motion but a PT regime should be set up with a certified orthopedic physical therapist. Once you learn how to do the exercises properly, you can do them yourself at home or at the gym.
Low impact exercises, core strengthening and stretching are key to controlling pain and maintaining range of motion but a PT regime should be set up with a certified orthopedic physical therapist. Once you learn how to do the exercises properly, you can do them yourself at home or at the gym.
60
My chiropractor says that his profession is an easy one to corrupt. I have had good success with minor problems, but for the biggies he suggested seeing an orthopedist, perhaps a neurologist.
He has seen some disreputable chiropractors take patients on a long profitable ride, knowing their treatment is of little affect.
So be careful.
He has seen some disreputable chiropractors take patients on a long profitable ride, knowing their treatment is of little affect.
So be careful.
18
And you never mentioned osteopathic manipulation...
21
From the chiropractor who diagnosed me with nerve damage to the one who told me I needed to drink gallons of water a day to the one who said I had fibromyalgia, What scientific evidence do they have for any of this nonsense?
22
I'd like to see a comparison between chiropractic treatment of back pain and just waiting for it to get better with time.
19
My mother's polio rehab in the 1930s was done by a chiropractor. She had been paralyzed on her left side. As an adult, her left side was somewhat weaker than her right, but it didn't show in her appearance or gait. She was grateful to have avoided Sister Kenney 's treatment. In 1999, my physician referred me to both a microneurosurgeon and a chiropractor for a spondylolythesis, a back condition that had me walking with a cane. The surgeon told me to avoid surgery at all costs. The chiropractor got me back to normal. I go faithfully for realignment and have remained able. Whatever studies indicate, I'm thankful my doctor made those referrals.
21
I like many in this comment section was skeptical about going to a chiropractor.
I have had two failed back surgeries by prominent surgeons. Both left me with debilitating nerve pain. In the past 10 years I have done numerous physical therapy sessions, pain injections, medications, and even a trial for a nerve stimulator. Non worked,left me with more pain issues, and medications made me depressed.
Last year after doing a massage, my massage therapist gave me the name of a
Chiropractor who had helped some of her clients. Of course, I was very reluctant but I made an appointment.
The Chiropractor very helpful and when I returned to Florida I did more research and found a local Chiropractor who has helped me with my pain.
My nerve pain will never go away, but for at least a week or two I have some relief. I often wonder if I started chiropractic care for what was considered a simple L4 5S one problem if I would be experiencing the nerve pain I have today and for the rest of my life.
I suggest to anyone who may want to see a chiropractor to do your research. Go by word-of-mouth and/or make appointments with chiropractors and find out who you like.
Be wary of those who peddle supplements. My does not.
I also suggest you do yoga or simple exercises 3 or 4 days a week and do meditation.
Good luck.
I have had two failed back surgeries by prominent surgeons. Both left me with debilitating nerve pain. In the past 10 years I have done numerous physical therapy sessions, pain injections, medications, and even a trial for a nerve stimulator. Non worked,left me with more pain issues, and medications made me depressed.
Last year after doing a massage, my massage therapist gave me the name of a
Chiropractor who had helped some of her clients. Of course, I was very reluctant but I made an appointment.
The Chiropractor very helpful and when I returned to Florida I did more research and found a local Chiropractor who has helped me with my pain.
My nerve pain will never go away, but for at least a week or two I have some relief. I often wonder if I started chiropractic care for what was considered a simple L4 5S one problem if I would be experiencing the nerve pain I have today and for the rest of my life.
I suggest to anyone who may want to see a chiropractor to do your research. Go by word-of-mouth and/or make appointments with chiropractors and find out who you like.
Be wary of those who peddle supplements. My does not.
I also suggest you do yoga or simple exercises 3 or 4 days a week and do meditation.
Good luck.
20
I gave up on my chiropractor after 18 years. Why? Because he treated me for "first rib" issues which turned out to be a dental problem needing a root canal, and "psoas" issues which turned out to be hip dysplasia and culminated in 2 hip replacements. I regret that I spent so much money over the years, but he was a nice guy and I liked the hands-on therapy. Unfortunately his diagnostic skills were impaired by his biases.
As a doctor, I routinely encounter impoverished patients, desperate for relief from back pain, who go to chiropractors, receive sketchy diagnoses, and are given $2000 proposed treatment plans. I tell them, if the chiropractor is willing to give you a money-back guarantee, then sign up. If you have thousands of extra dollars to spend, go ahead. If not, I have a whole program of lifestyle and other non-opioid options for you.
As a doctor, I routinely encounter impoverished patients, desperate for relief from back pain, who go to chiropractors, receive sketchy diagnoses, and are given $2000 proposed treatment plans. I tell them, if the chiropractor is willing to give you a money-back guarantee, then sign up. If you have thousands of extra dollars to spend, go ahead. If not, I have a whole program of lifestyle and other non-opioid options for you.
21
I have scoliosis and also have had several sports related injuries. My non-force chiropractor has saved me from pain meds and expensive orthopedists. I've also been to a traditional chiropractor, but I highly recommend a good non-force practitioner. It doesn't involve any scary neck cracking or heavy pressure. And it works.
15
For years, the American Medical Association conspired to discredit the chiropractic profession. (See link on court decision against the AMA.)
http://www.nytimes.com/1987/08/29/us/us-judge-finds-medical-group-conspi...
Doctors - and journalists - unaware of this history continue to doubt the efficacy of chiropractic care. Fortunately, science through good clinical trials are starting to change the tide of public opinion. I suffered from recurring back and neck problems after a series of car crashes, and nothing worked to alleviate my pain until I tries chiropractic care. It has helped me through other health challenges as well. Thank you for reporting on this - I'm sure it will help other people find relief.
http://www.nytimes.com/1987/08/29/us/us-judge-finds-medical-group-conspi...
Doctors - and journalists - unaware of this history continue to doubt the efficacy of chiropractic care. Fortunately, science through good clinical trials are starting to change the tide of public opinion. I suffered from recurring back and neck problems after a series of car crashes, and nothing worked to alleviate my pain until I tries chiropractic care. It has helped me through other health challenges as well. Thank you for reporting on this - I'm sure it will help other people find relief.
11
I have had great success with planks. Start with five seconds and reach a maximum two minutes of front and side planks. Five minutes per day. Safe. No sudden push or pull. No cost. Should cure most if not all types of back pain.
11
The reason for commonplace musculoskeletal low back pain is still unknown and can differ markedly between people. Chiropractic, invented by one man, Daniel David Palmer, over 100 years ago is pseudoscientific and still unproven. If it were effective, why has it taken hundreds of trials to tell? In the words of Cervantes, "If the cause of the symptoms are unsure, t'would be a miracle to find a cure". Chiropractic is misleading and chiropractors are hucksters.
19
A serious problem with chiropractors is that there is no way to tell if they are believers in magical 'subluxation' or not; if their training is otherwise as good as some say, why not just become MDs? Are they drawn to becoming chiropractors because of a yearning for irrational, magical answers to disease and treatment? If magic is what you want, there are many cheaper 'practitioners' to try whose hand waving does less harm.
OTOH, insurance companies will cover chiropractic, as it is often cheaper than real medical treatment.
OTOH, insurance companies will cover chiropractic, as it is often cheaper than real medical treatment.
12
Having an MD does not, either, magically make you a healer. There are many pathways to knowledge, and knowing and sticking to the tried and tested is, often times, limiting. History has a way of showing us that what we thought was "real" was in fact quite the opposite. Finally, a good scientist would be open to exploration and ideas, to avoid the pitfalls of pedantry.
8
I stopped going to a chiropractor when I found yoga. I didn't have to wait for an appointment to realign my spine.
16
my dad (now retired) started his chiropractic practice in the late 60s at a time when most mds considered them quacks. for years after he retired i had patient after patient (and in some cases, the offspring of those patients) tell me how much they loved and appreciated that my dad took such good care of them. it still makes me proud.
13
How about the fact that if you suffer a debilitating or disabling back injury in an auto accident and you are involved in a claim against someone else, your attorney will advise you NOT to seek chiropractic treatment as an opposing attorney will have a field day in court, should the case ever reach that point.
A chiropractor who is not a doctor is not considered to be an expert witness, no matter what real benefit the patient may experience. Insurance companies won't approve it in many cases, and you are left with the scenario that law and insurance combine rapt the outset to dictate your health care if one is unfortunate enough to find themselves in such a claim against a third party.
And that is just scratching the surface of what I went through, even with very good health insurance.
A chiropractor who is not a doctor is not considered to be an expert witness, no matter what real benefit the patient may experience. Insurance companies won't approve it in many cases, and you are left with the scenario that law and insurance combine rapt the outset to dictate your health care if one is unfortunate enough to find themselves in such a claim against a third party.
And that is just scratching the surface of what I went through, even with very good health insurance.
12
It is my assertion that the belief that low back pain, just goes away is a dangerous one. I understand that this might what many physicians experience, but this perception is based on frustrated patients who do not return because they are not satisfied with the traditional approaches to treating back pain, eg. naproxen, flexoril etc.. We know that many people develop fear avoidance behaviors after multiples bouts of back pain and start to limit their avidity due to fear of re-injury. This lack of activity leads to a whole new collection of health conditions. The body is phenomenal at creating strategies to prevent pain, which work well in the short term but have an eventual breaking point. The most obvious example is the person that has neck pain but uses their entire back to rotate around and check their blind spot. They don't have "neck pain," but that is because they are not using the neck and instead putting that stress elsewhere which will eventually lead to pain in those areas. This belief that back pain will go away is a one-way road to expensive, invasive procedures that start with NSAIDs and end with surgery. It is obvious that our current model for treating back pain is flawed based on the societal impacts alone. We need to re-think how we view back pain and address it early, before potential dangerous procedures are the only option.
17
Thanks. As a physician trained in the 70s, DCs had no place. Abd now, the attitude of several of us had changed, especially when there is a team approach and coordination with an orthopedic surgeon, physical therapist, maybe a yoga class and etc. My own "proof" came when on a trip to learn TCM in China, two"massage doctors" palpated and then pummeled my badly injured hip in a fall and I was able to both climb the Great Wall and dance at my son's wedding. The effect does not last and damage to bones as we age only gets worse with time. What was very impressive was their knowledge of anatomy, and ability to diagnose with their fingers.
16
I have scoliosis and see a chiropractor every 6 weeks. In the run up to that time I get pain in my neck, the back of my knees, and in my hip. A gentle realignment is what is needed as often my pelvis is out of alignment. Like all things, it depends on the practitioner.
My Chiropractor has given me excersises which has helped to strengthen my back.
As with dr.s there are good chiropractors and bad, get recommendations first.
My Chiropractor has given me excersises which has helped to strengthen my back.
As with dr.s there are good chiropractors and bad, get recommendations first.
31
I have fairly severe neck issues from being in rear ended in vehicles at high speeds over the years. I only see chiropractors for the condition for over twenty years and only need an over the counter pain killer once in awhile. I have moved away from my chiropractor and am very hesitant to just see any "doctor" to manipulate my neck/back for relief. You must research any doctor you see. After being an insurance claim adjustor twenty years ago I have essentially avoid medical doctors and am a healthy active 60 something. You need to have some responsibility in your own health and well being.
3
It really depends on the condition/ailment/injury you look at, and the time period. For some things it's very effective, at least for making you feel much better now instead of months or years from now. If the study is for the wrong conditions, or for how much better you feel 5 years later, it can show no effect, but what's the effect of pain relieving drugs 5 years later, or even 1 day later?
A good example: Me doing squats with too much weight for my age. I felt something go and had a lot of pain in my upper back. A rib got pulled out of place. The chiropractor put it back and immediately 80-90% of the pain and disability gone, about back to normal just a few days after. Would have probably healed on its own, but maybe months of pain and disability. A study looking at effect after 6 months might never catch this. People like chiropractic in large part because they do immediately walk out feeling better.
Also, big range of quality/ethics of chiropractors, but a good one can be very good for certain things.
A good example: Me doing squats with too much weight for my age. I felt something go and had a lot of pain in my upper back. A rib got pulled out of place. The chiropractor put it back and immediately 80-90% of the pain and disability gone, about back to normal just a few days after. Would have probably healed on its own, but maybe months of pain and disability. A study looking at effect after 6 months might never catch this. People like chiropractic in large part because they do immediately walk out feeling better.
Also, big range of quality/ethics of chiropractors, but a good one can be very good for certain things.
6
Like anything else, you have to find a good one: be it a restaurant with a good chef or car repair center with a good mechanic. I've found a great chiropractor who is a wonderful healer. Dr David Pico on 58th St in NYC, if I can note his name.
I remember, many years ago, my PCP dismissed the idea of chiropractic medicine and prescribed some Naproxen.
Now I know that keeping the spine in line and flexible is crucial for a healthy body. I'm in my mid-60s, feel great, and I'm quite limber. Don't believe the chiropractic skeptics. Try a spinal adjustment for yourself; better than drugs when your back is stiff and sore.
I remember, many years ago, my PCP dismissed the idea of chiropractic medicine and prescribed some Naproxen.
Now I know that keeping the spine in line and flexible is crucial for a healthy body. I'm in my mid-60s, feel great, and I'm quite limber. Don't believe the chiropractic skeptics. Try a spinal adjustment for yourself; better than drugs when your back is stiff and sore.
1
Chiropractic intervention has effectively and rapidly treated my infrequent incidences of lower back or neck pain. Medical intervention in the form of NSAID's, narcotics, bed rest or simply waiting it out was not effective except for temporary pain relief (due to the drugs). It is patently absurd to give credence to any claims of chiropractic having a positive effect on disease processes e.g. infections, liver failure, cancer etc, etc. Chiropractic manipulations should also NEVER be performed on infants in my opinion.
3
I guess I'm finding it hard to understand why a medical doctor doesn't have more working knowledge of chiropractic care (outside of the literature reviews cited). What was the purpose of writing this piece if only to keep questioning people with back pain still on the fence? I've found more than anything that being "in shape" (yoga, massage, sleeping well) helps the most with chronic back pain, but for those not able to get to that point because of the pain, what are the solutions there outside of opiod, etc. ? I appreciate bringing alternative treatment to light, and would appreciate more to have competent medical professionals in both traditional and non-traditional medicine who have a holistic understanding of the body and ability to provide referrals to vetted professionals!
8
My physical therapist wife realized, after working with me (a chiropractor) for over 10 years, that we both have our strengths and weaknesses. She also realized there are ethical, evidenced based chiropractors and ones who still cling to the "subluxation" theory and whose primary focus is $$ vs the patient's welfare. The author of the other article whose wife is a PT is not well versed about many facts in his comments and paints an unfair broad brush on the chiropractic profession. There are many places in this country where chiropractors work in multidisciplinary environments, to include hospitals and military and VA facilities. Chiropractic universities, much like many PT, Optometry, Dental and Podiatric programs are accredited by organizations with no relationship with those organizations who accredit medical schools. And all chiropractic programs are regionally accredited--by the same organizations who accredit other health care programs. I will admit the chiropractic profession still has an unacceptably high percentage of "subluxation based" practitioners but that number has been decreasing significantly over the past 2 decades. But again, please don't stereotype the profession by the actions of the 18% (a number that was verified by a study a few years ago).
8
Frankly, with the over-use of opioid-based medications, where up to 10% of people prescribed it end up with dependency conditions, the use of any safe, non-pharmaceutical therapy to relieve pain should be given a high priority.
12
My physical therapist wife would be apoplectic were she to read this column in which the author (who as an MD should know better) essentially equates the two fields, mentioning them in the same sentence twice. They are quite different in several important ways. Physical therapy is a mainstream medical field with training carried out in medical schools while chiropractors have their own schools which are independent of medical schools and function pretty much like any trade school. PTs practice under an MD's referral and prescription, which must be documented for them to get paid by insurance. Chiropractic patients are largely self-referred and pay out of pocket (though some insurances now pay for it). PTs do not, indeed can not, order tests or imaging, which are almost always done anyway before an MD referral. Chiropractors take and read their own X-rays in their offices and virtually always find one or more "subluxations" which require multiple "adjustments" to correct initially and then maintenance treatments to keep everything in proper alignment. Not so strangely, medical radiologists can almost never see the "subluxations" on chiropractic X-rays. PT get no teaching about the business aspect of private practice while the business of chiropractic is a major part of the curricula . PTs have clearly and legally defined scopes of practice. Chiropractors increasingly are venturing into areas, e.g. nutrition, neuropathy treatment, which are clearly outside their expertise.
93
Your comment is factually inaccurate. There is a good reason chiropractors are called Doctors of Chiropractic. Chiropractic school is not a "trade school" akin to plumbers or electricians. It is a graduate school program of 5 academic years. The prerequisites for chiropractic school are identical to those for medical, dental, and podiatry school. In fact the curriculum in chiropractic schools is identical to medical school except that chiropractors study more anatomy, physiology and diagnosis, as well as adjusting, but study less pharmacology. There is at most one class on business. Chiropractors are considered primary care physicians who can make referrals to specialists, order imaging studies and lab tests in most states.
In contrast, the education of physical therapists varies by program but can be up to 3 years. Physical therapists are not doctors and can practice only via referrals.
Mentioning physical therapists and chiropractors in the same phrase is not an insulting comparison to physical therapists, it is a flattering one.
In contrast, the education of physical therapists varies by program but can be up to 3 years. Physical therapists are not doctors and can practice only via referrals.
Mentioning physical therapists and chiropractors in the same phrase is not an insulting comparison to physical therapists, it is a flattering one.
8
Chiropractors have more training in Anatomy and the science of movement and the physiology of our muscular- skeletal and nervous than do most Physicians and almost all Physical Therapists. And the author of the previous comment is entirely wrong to say all Chiropractors generally find a "subluxation" on and x-ray. Perhaps that was true of some sub par Chiropractors 40 years ago. And as for learning about the business aspects of a private practice - that is also taught in Medical School. And what is wrong with making a profit while at the same time , helping an individual have more function and less pain?
I'm not saying is you're wrong, but I can tell you that hundreds of PT dollars later, I found a new chiropractor and after having paid less than half of what I spent on PT (this was even after insurance) I'm finally feeling better. My chiropractor worked with me and gave me exercises that really helped my pain - a combination of low back pain and left heel pain, so that now I can actually move again - something PT did not provide. I'm not saying PT doesn't work, I just think to discredit the work of qualified chiropractors isn't fair. Both have their place.
5
Chiropractors mislabel everything that they do. Most pack pain is due to muscle spasm which responds to massage. Chiropractors provide massage and I do believe that helps.
However, spinal manipulation to shift bones and align them can not be done that easily in office setting. It usually takes a car accident or major fall to shift bones out of alignment and it takes anesthesia and major force to put the bone back in alignment. Scoliosis correction through surgery takes release of all ligaments and major force application under anesthesia to correct the curve. So when a chiropractor claims to realign something in office settng - my reaction in disbelief is "really?" This mis-representation is what makes their care suspect in my opinion.
However, spinal manipulation to shift bones and align them can not be done that easily in office setting. It usually takes a car accident or major fall to shift bones out of alignment and it takes anesthesia and major force to put the bone back in alignment. Scoliosis correction through surgery takes release of all ligaments and major force application under anesthesia to correct the curve. So when a chiropractor claims to realign something in office settng - my reaction in disbelief is "really?" This mis-representation is what makes their care suspect in my opinion.
20
Chiropractors do not re-align anything. They release vertebrae that are subluxated (stuck out of their range of motion) and allow the vertebrae to resume their normal range of motion. Surgery re-aligns vertebrae and reflects the surgeons opinion of where the bone should be.
2
Are there deaths and injuries that result from chiropractic treatment? Of course there are. I think the number was 84 in a recent year in the United States.
Shouldnt we ask how this rather small number compares to the number of deaths caused by MDs, surgeons and medicines? Those number in the tens of thousands every year.
I go to a chiropractor who started his career as a physical therapist and became a chiropractor after realizing the limitations of what he could accomplish through physical therapy alone. He's kept me upright and reasonably functional for years after a surgery with the "best surgeon in the state" that went terribly wrong, nearly killed me and caused permanent disability. During subsequent surgeries to correct some of the damage I came out of the OR with a dislocated shoulder.
Without the chiropractor I'd probably be in a wheelchair by now.
Without that original overly aggressive surgeon I'd be whole and healthy.
Shouldnt we ask how this rather small number compares to the number of deaths caused by MDs, surgeons and medicines? Those number in the tens of thousands every year.
I go to a chiropractor who started his career as a physical therapist and became a chiropractor after realizing the limitations of what he could accomplish through physical therapy alone. He's kept me upright and reasonably functional for years after a surgery with the "best surgeon in the state" that went terribly wrong, nearly killed me and caused permanent disability. During subsequent surgeries to correct some of the damage I came out of the OR with a dislocated shoulder.
Without the chiropractor I'd probably be in a wheelchair by now.
Without that original overly aggressive surgeon I'd be whole and healthy.
14
I also suffered a lot from lower and upper back pain over the years. The Feldenkrais method worked wonders for me. It is a very safe and powerful technique that relies on gentle movements that aim to make the mind and body work in sync. I also tried chiropractic and was a little scared of the upper back manipulation. In general I have heard from many who swear by chiropractic, but I think the dangers outweigh the benefits.
11
It is very important to understand, that the overwhelming majority of physical therapists do not utilize spinal manipulation and therefore "pooling" PT treatment and chiropractic care may not be appropriate. I have been a PT for 18 years and have never done a spinal manipulation. When it come to cost, the author may have mislead the readers, as more typical medical care, such as injections and surgical procedures, while possibly being provided in fewer instances that the non or semi invasive procedures, are clearly much more costly, and not necessarily more effective. Physicians have little to no education about the specifics on physical therapy interventions and more so chiropractic care, and therefore may have a less than desirable lnowlege base to comment on efficacy. Certainly in the area of standard physical therapy care for back pain, the pros are many, the cons, non existent.
10
I am a chiropractor and I became one because it was profoundly helpful for me when I got injured. I also have a degree in Biochemistry. There is a lot of controversy around chiropractic mainly for one reason, not all chiropractors are the same. There are chiropractors who insist on using "old school" philosophies about nerve interference, but modern chiropractic care focuses on biomechanics and restoration of function. Spinal "manipulation" is a term that is inaccurate, because it is not just being "manipulated". We are restoring motion into an area, that by experience, we know what normal moment is and by doing an adjustment, causing it to be closer to normal. It involves considering force use, direction (vector), amplitude and other factors one should use, not simply just "cracking" someone. By doing an adjustment, it is a relief of physical stress on a given system. Ask anyone who has had an adjustment about the instant relief it can have. That's not placebo. Truthfully, it is the claims that chiropractors have made over the years that make people question chiropractors. For neuromusculoskeletal issues, most chiropractors know what is in their scope, what they should do & when it is beyond what they should treat. I have patients who were told they need surgery & with treatment, no longer did. I have also seen many who have had physical therapy with no relief, but chiropractic did help. I also turn those away when I think can't help. http://www.DrTChiro.com
15
I'm 61 years old, have scoliosis with 30º bend @ L3 and L4, spinal stenosis, and arthritis in my low back. Major pain in my gluts and hamstrings and of course my low back. The gluts and hamstring pain came on in Feb 2017. I've tried chiropractic care, and acupuncture and have felt little relief from either. Pilates and massage seem to be more effective. I've been told by 2 spine specialists that the rod and screws surgery will be needed to relieve my pain. Question to any spine doctors out there- can chiropractic spinal manipulation help scoliosis at all? Certainly can't straighten spine much, if any at all, right?
7
Look into 'Clear Institute'. I have seen pre and post X-rays when I lived with an intern that was interning with them at Parker University.
For scoliosis, try the Shroth Method. Some physical therapists have been trained to do it.
Repeatedly, my chiropractor has succeeded after allopathic doctors failed to help me. The real question should be: When is a medical doctor the best healer for the problem?
6
My consistent yoga practice has stood me in good stead for the past fifty years. Nothing fancy, no ankles behind my ears, just a personal routine that has
evolved over time with classes, books, youtube and even two weeks of study in Mysore, India. I have never experienced back pain. As they say, check it out.
evolved over time with classes, books, youtube and even two weeks of study in Mysore, India. I have never experienced back pain. As they say, check it out.
2
From personal experience, I know that some chiropractics are unscrupulous and will give a scary list of future debilitations if numerous, regular visits are not made to their office.
For my money, chiropractic is about as medical as scientology is religious.
For my money, chiropractic is about as medical as scientology is religious.
21
One of the greatest medical and urban myths of the modern era is the myth of the anatomical and neurological role played in back pain by the so-called 'herniated disc' or 'prolapsed disc' which are just fancy, pseudo-medical terms for the more down to earth expressions of 'ruptured disc' or 'slipped disc.'
For years, those who manually laboured for their living, such as farmers, ditch and grave diggers, would merely refer to their 'pulled back', 'strained back' or 'bad back'. Then, in the early fifties in Anglophone cultures, almost overnight, anyone who had a desk job in an office was starting to complain about their 'slipped discs'. Medical doctors compounded the problem, referring patients for back surgery. Orthopaedic surgeons, in the USA and elsewhere, specialising in surgery of the back made fortunes.
The problem, as in fact we have known for many years, is that MRIs of the healthy population reveal that the so-called slipped disc, ruptured disc, herniated disc, or prolapsed disc, are very common and typically are completely symptom free. Further, much acute and chronic back pain is not associated with the presence on an MRI of a locally herniated disc bulging and pressing against a nerve.
For a useful introduction to the medical and urban myth of role of the so-called herniated disc in backpain, see http://www.simplebackpain.com/discectomy.html
For years, those who manually laboured for their living, such as farmers, ditch and grave diggers, would merely refer to their 'pulled back', 'strained back' or 'bad back'. Then, in the early fifties in Anglophone cultures, almost overnight, anyone who had a desk job in an office was starting to complain about their 'slipped discs'. Medical doctors compounded the problem, referring patients for back surgery. Orthopaedic surgeons, in the USA and elsewhere, specialising in surgery of the back made fortunes.
The problem, as in fact we have known for many years, is that MRIs of the healthy population reveal that the so-called slipped disc, ruptured disc, herniated disc, or prolapsed disc, are very common and typically are completely symptom free. Further, much acute and chronic back pain is not associated with the presence on an MRI of a locally herniated disc bulging and pressing against a nerve.
For a useful introduction to the medical and urban myth of role of the so-called herniated disc in backpain, see http://www.simplebackpain.com/discectomy.html
3
The Subluxation theory that underpins the Chiropractic should be tested. It would be easy to do and take only a couple years at most. But the Chiropractors don't want to- they know they have a good thing going.
Does it "work" for some people? Well, who doesn't like a good backrub and the placebo effect can be as high as 70%.
Does it "work" for some people? Well, who doesn't like a good backrub and the placebo effect can be as high as 70%.
5
I have scoliosis in my lower back, and I do yoga and other stretches and back strengthening exercises and activities (gardening? walking?) as my "physical therapy;" it's certainly cheaper than a chiropractor -- which isn't recommended for the lower back, but which I wouldn't use anyway -- and much better for me overall. And it's incredibly effective. But I am reminded of my nephew, who started suffering severe back pain; after a lot of tests, he discovered that his back muscles were weak, so he began to walk more and do other strengthening exercises -- and voila! His pain disappeared!
3
I am a family physician, and some one who has had low back pain, sciatica and even a ruptured disc. I have known for at least 20 yrs that stretching and exercise is essential.
The writer, a pediatrician, does not seem to understand that chiropractic spinal manipulation and physical therapy are very different. As a pediatrician, maybe this is outside his realm of expertise. Also, many chiropractors use Active Release which does not involve trying to actually manipulate any bones.
Back pain does tend to get better with time...but the pain can become the focus of your life. There IS good treatment that is not just about "treating the symptoms" as if that is a pacifier to give to a patient so you can go on to REAL problems.
Dr Carroll is really off on this column. He should have discussed it some doctors that treat this significant condition on a regular basis.
The writer, a pediatrician, does not seem to understand that chiropractic spinal manipulation and physical therapy are very different. As a pediatrician, maybe this is outside his realm of expertise. Also, many chiropractors use Active Release which does not involve trying to actually manipulate any bones.
Back pain does tend to get better with time...but the pain can become the focus of your life. There IS good treatment that is not just about "treating the symptoms" as if that is a pacifier to give to a patient so you can go on to REAL problems.
Dr Carroll is really off on this column. He should have discussed it some doctors that treat this significant condition on a regular basis.
18
I have received great benefit from chiropractic treatment. In at least one instance, I walked in with significant discomfort from sciatica symptoms (couldn't stand or sit comfortably). I walked out pain free. I frankly have received better care (and more caring) from my very good chiropractor than from my run of the mill family doctor. And yet -- my health insurance will pay any charge from my familly doctor, but limits my yearly visits to my chiropractor.
15
I am a chiropractor in practice for 35 years.
1. Yes, acute episodes of low back pain resolve with time. However, latent myofascial pain patterns and joint dysfunction often remain, and people have repeated incidents of acute antalgia and disability because the underlying issues of instability have not been resolved. It minimizes the impact of low back pain on the public to say it resolves with time. It happens for a reason, and if the patient can understand this she can help get in charge of her back problem.
2. Manipulation, massage, and acupuncture work well to interrupt joint dysfunction and myofascial pain. There is no NSAID or opiod that can compete with these methods. The medical profession needs to champion these methods and STOP prescribing medications that contribute to addiction.
3. Imaging for acute low back pain is a waste of time and money and hurts the patient with unnecessary radiation. MD’s and chiropractors need to realize this and stop ordering these tests unless there is a disease process to rule out.
5. The medical profession is responsible for one of the worst drug epidemics in our history. Acupuncture, massage therapy, chiropractic care: these are the solutions we need to help stop this epidemic and give patients healthy safe choices for their pain and dysfunction.
1. Yes, acute episodes of low back pain resolve with time. However, latent myofascial pain patterns and joint dysfunction often remain, and people have repeated incidents of acute antalgia and disability because the underlying issues of instability have not been resolved. It minimizes the impact of low back pain on the public to say it resolves with time. It happens for a reason, and if the patient can understand this she can help get in charge of her back problem.
2. Manipulation, massage, and acupuncture work well to interrupt joint dysfunction and myofascial pain. There is no NSAID or opiod that can compete with these methods. The medical profession needs to champion these methods and STOP prescribing medications that contribute to addiction.
3. Imaging for acute low back pain is a waste of time and money and hurts the patient with unnecessary radiation. MD’s and chiropractors need to realize this and stop ordering these tests unless there is a disease process to rule out.
5. The medical profession is responsible for one of the worst drug epidemics in our history. Acupuncture, massage therapy, chiropractic care: these are the solutions we need to help stop this epidemic and give patients healthy safe choices for their pain and dysfunction.
34
I am a double boarded Pain Physician who utilizes Osteopathic Manipulation judiciously, in well selected patients, as part of my multi-quilled armamentarium. It doesn't cure diabetes, but it can assist in certain acute and chronic pain conditions. Certain types of spinal manipulation are more risky than others, for example: high velocity low impact maneuvers (think creepy neck cracking). Aggressive spinal manipulation can cause boney fractures, epidural hematoma (bleeding near the spinal cord), as well as fatal or disabling vascular injuries (vertebral artery dissections). However, other types of spinal manipulation can include indirect mobilizing techniques that are both safe and affective. It was good to see an article promoting non opioid, non surgical options for low back pain. Please include more non invasive, non-pharmacological pain modulating articles, as the opioid crisis certainly needs less fuel accelerant.
19
I think the medical establishment's problem with chiropractic treatment is largely an (arrogant) assumption that nothing can surpass allopathic, Western medicine. I don't intend to minimize the pain and physical damage some commenters have described, but I suspect those injuries were caused by chiropractic treatment done BADLY, not because chiropractic treatments are always harmful. Regular doctors can make huge mistakes too - I know that from personal experience.
15
Those readers who are presenting anecdotal evidence of bad experience with individual chiropractors should ask themselves whether one couldn't offer similar experience with traditional doctors. Sure, there are good and bad chiropractors, just like there are good and bad doctors. This isn't evidence that chiropracty is inherently dangerous or fraudulent.
I personally have had great success with chiropracty--and, during my time in Europe, with osteopathy, which is similar (if not better)--for a variety of musculoskeletal complaints. I'm not sure why people doubt the effectiveness of the practice: human beings have articulated skeletons, and we do genuinely get mis-aligned over time, which causes pain and other problems. Chiropractors and osteopaths directly address those issues.
In addition, chiropractors (and European osteopaths) are often trained in other beneficial, non-traditional practices. They listen to their patients and often are much more dogged at getting to the bottom of a complaint than traditional doctors. It really is a shame they're treated as quacks and not covered by insurance.
I personally have had great success with chiropracty--and, during my time in Europe, with osteopathy, which is similar (if not better)--for a variety of musculoskeletal complaints. I'm not sure why people doubt the effectiveness of the practice: human beings have articulated skeletons, and we do genuinely get mis-aligned over time, which causes pain and other problems. Chiropractors and osteopaths directly address those issues.
In addition, chiropractors (and European osteopaths) are often trained in other beneficial, non-traditional practices. They listen to their patients and often are much more dogged at getting to the bottom of a complaint than traditional doctors. It really is a shame they're treated as quacks and not covered by insurance.
10
"The art of medicine consists of amusing the patient while nature cures the disease." - Voltaire
Perhaps chiropractors are better at stand-up than MDs or DOs. Or no worse at the very least.
Perhaps chiropractors are better at stand-up than MDs or DOs. Or no worse at the very least.
5
I went to a chiropractor a number of years ago, but I'll never go to another one. I had all over pain (back then misdiagnosed as fibromyalgia). He did the neck manipulation on me. I was lucky I didn't suffer permanent problems. At that time, I didn't know I had a genetic disorder involving connective tissue. The funny thing is, he mentioned my joints were subluxated, yet never put two and two together. Duh! It took a rheumatologist to make the diagnosis several years later.
I also didn't like the idea that he prescribed some mysterious medication, which I don't even remember what it was for or even the name of it (and I found out later he wasn't authorized to even prescribe anything) He wanted me to take this expensive stuff (handed to me at the front desk). I never took it, and I'm glad because I later mentioned it to an M.D. who was horrified by my experience. She said I could have had serious health consequences had I taken the stuff. Not only that, even she couldn't tell me why this guy thought it would be a good idea for me to take it..
To add insult to injury, he kept comparing me to his other patients, downplaying my condition. After this, I said no more to these charlatans.
I also didn't like the idea that he prescribed some mysterious medication, which I don't even remember what it was for or even the name of it (and I found out later he wasn't authorized to even prescribe anything) He wanted me to take this expensive stuff (handed to me at the front desk). I never took it, and I'm glad because I later mentioned it to an M.D. who was horrified by my experience. She said I could have had serious health consequences had I taken the stuff. Not only that, even she couldn't tell me why this guy thought it would be a good idea for me to take it..
To add insult to injury, he kept comparing me to his other patients, downplaying my condition. After this, I said no more to these charlatans.
13
I have been a ceramic tile contractor for almost 40 years and chiropractic adjustments have kept me going without a doubt. No drugs. I'm 64 years old and today I put down about 100 sq ft of slate and grouted a bathroom floor. It works! And in the long run it saves money that is lost due to injuries.
8
Read H. L. Mencken on chiropractic.
After you wipe away the tears of laughter, you'll understand that nothing has changed.
After you wipe away the tears of laughter, you'll understand that nothing has changed.
2
I would like to second the comments of Bob from East Lansing. I went to chiropractors for many years for a bad back and knee. But it wasn't until I started seeing an osteopath than I had more prolonger relief. Unlike chiropractors, osteopaths actually go to the equivalent of medical school and are much less likely to hurt you through ignorance. If they do manual manipulation, they can be of immense help with urgent or chronic conditions.
6
Chiropractic is based on the theory that disease is caused by a blockage of health-energy through your nerves, and that by clearing those blockages, you can heal diseases. This is obviously nonsense, but that's the basis of chiropractic.
But then there are people who advertise themselves as chiropractors who don't do that, and instead treat their patients with basic physical therapy techniques. So anyone who's ever gone to a chiropractor and gotten relief was probably just getting some unlicensed physical therapy.
This being the case, what's with these "chiropractors" who don't practice the nonsense that actual chiropractic is based on? Why do they call themselves "chiropractors" and not "physical therapists?" Is it just harder to get a PT license than a chiropractor's license?
But then there are people who advertise themselves as chiropractors who don't do that, and instead treat their patients with basic physical therapy techniques. So anyone who's ever gone to a chiropractor and gotten relief was probably just getting some unlicensed physical therapy.
This being the case, what's with these "chiropractors" who don't practice the nonsense that actual chiropractic is based on? Why do they call themselves "chiropractors" and not "physical therapists?" Is it just harder to get a PT license than a chiropractor's license?
5
DC's are necessary, unless you have a "Trick back", where the trick is to try to sue the beJesus out of somebody; just as there many doctors of chiropractory, there are even more backs with unexplained hard to find nerve endings that are just barely touched by some unknown object – bone vertebrae or such, like the L4 L5 condition that I have, which gets real sore if I pick up a spare tire wrong but not if I dead-lift way way over the 60 or 100 pound limit that I was restricted to it one time; Some pre-exercise and warming of the back – plus hot showers helps too.
This article is a poor representation of the truth of what Chiropractic is, and I can say this because I have nearly 20 years of clinical experience as a Chiropractor. First off, what is the fundamental truth that separates Chiropractic and makes it distinct from all other health care professions? Do you know? The author of this article is obviously ignorant of this fact because our primary scope is not mentioned and explained. And yes, it is fact not opinion. These words "treat" and "manipulate" are words that belong to medicine not Chiropractic. I'll tell you what, if The New York Times is really interested in understanding the truth of what Chiropractic is, feel free to reach out to me and I'll write you an article that is backed by my clinical experience, historical truth, and valid research, which boils down to what we call expertise, a most important ingredient completely void in this "For Bad Backs..." article.
5
A better therapy would be NSAIDs/Tylenol for pain and skip the quackery.
3
If anyone cares to look at the peer reviewed statistics on morbidity and mortality, you would quickly see that manipulation is one of the safest therapies on record.
DEATHS due to spinal manipulation are vanishingly rare. For every anectdotal story of such I can personally show you many, many, more caused by other traditional therapies. Care to guess how many THOUSAND Americans died of opiate related causes last year? Most started as out as regular folks with simple pain needs.
I have worked "Both Sides of The Street' in this regard, including 5-6 years in a chronic pain clinic at the 4th busiest VA hospital in the country.
We now have a Chiropractic residency program, as we have seen the clear benefits and patient satisfaction afforded by this therapy.
DEATHS due to spinal manipulation are vanishingly rare. For every anectdotal story of such I can personally show you many, many, more caused by other traditional therapies. Care to guess how many THOUSAND Americans died of opiate related causes last year? Most started as out as regular folks with simple pain needs.
I have worked "Both Sides of The Street' in this regard, including 5-6 years in a chronic pain clinic at the 4th busiest VA hospital in the country.
We now have a Chiropractic residency program, as we have seen the clear benefits and patient satisfaction afforded by this therapy.
15
I've had success from chiropractic treatments. Lower back pain caused by improper or just plain too heavy lifting, and long-term (years) chronic shoulder pain that I'm sure what caused it.
Yes, back strains will usually heal on their own given the chance. But the shoulder pain was nagging me for a long time but never bad enough to seek care. When I mentioned it to my PA, she recommended a chiropractor as the first thing to try. It worked. Much improvement after one visit, gone in three and never returned. That isn't a placebo effect.
Chiropractic is not the answer to everything and a good practitioner will tell you what they can and cannot treat. Don't knock it.
Yes, back strains will usually heal on their own given the chance. But the shoulder pain was nagging me for a long time but never bad enough to seek care. When I mentioned it to my PA, she recommended a chiropractor as the first thing to try. It worked. Much improvement after one visit, gone in three and never returned. That isn't a placebo effect.
Chiropractic is not the answer to everything and a good practitioner will tell you what they can and cannot treat. Don't knock it.
15
Some people try yoga to ease various kinds and degrees of back pain, and many are pleased with the results. However, as with every kind of therapy, there are possible downsides. Some years ago, a New York Times reporter, William J. Broad, wrote a book titled The Science of Yoga: The Risks and Rewards in which he recounts the injury he suffered in a yoga class, and suggests ways to reduce the risks. So we run into risks at every turn.
4
Very true. Everything has its downside. Yoga put my back in a bad way. But I figured out what poses were hurting me, stopped doing them, kept the rest and added other exercises. My exercise routine is now an integral part of my life. It's trial and error, like much of the rest of life!
4
I have a mild scoliosis that didn't qualify for a brace due to my growth and the type of curve. I suddenly developed symptoms of a UTI that wouldn't go away- lasting 3 years between high school and college. As a result, I became anxious about sitting in traffic, movies, tests, dates anything without my concentration shifting back to my body and an irrational sense of needing to go the bathroom. It had gotten in the way of day to day quality of life. It was uncomfortable and embarrassing with no signs of stopping. My doctor prescribed pyridium and inserted metal rods into my uretha to 'help' but it didn't work. Feeling frustrated and wanting help I found a chiropractor, Brian Anthony in the town of Soquel,CA. I was at times skeptical ( I didn't like feeling I had to see him regularly). I went in for about 4 months and literally one day the entire problem was gone. I don't know if it was a nerve issue or what but I have the belief that with my body responded to this noninvasive therapy under his care. I'm not here to convince someone who doesn't believe in non-traditional therapies to believe. I'm a strong believer in finding the right balance of what works for you - being open to different ways of approaching health and well being. I've been very fortunate to overcome several health issues with good support from traditional and nontraditional practitioners over the years. Good luck to anyone who is trying to find alternatives to living in chronic pain.
8
Mark Crislip at our blog Science-Based Medicine was nowhere near as impressed with the JAMA meta-analysis as Mr. Carroll is:
https://sciencebasedmedicine.org/spinal-manipulation-and-the-jama-meta-a...
https://sciencebasedmedicine.org/spinal-manipulation-and-the-jama-meta-a...
8
I am under VA care. Recently I began to experience lower back pain, probably associated with a lower leg injury sustained many years back but which causes me to walk in a slighly awkward way.
My treating physician started me with orthotics for my increasingly arthrtic feet, which has helped a lot to redistribute the forces affecting my gate. Since some lower back pain persisted, my doctor prescribed next a meeting with the clinic's physical therapist. The VA policy is to prefer routine physical exercises as a first step. I have had one group meeting, and have an appointment for a meeting by myself. At this meeting, we talked about posture a lot. We were given a foam wedge to use in our chairs while sitting, and we were shown how to roll a town to insert between the chair and the lower back; just the posture changes I have made and the exercise progarm has already brought me good results. It is a benefit of VA treatment that it is assumed you will be an active partner in your healthcare. Being asked to be self-motivating puts "caring" in care.
My treating physician started me with orthotics for my increasingly arthrtic feet, which has helped a lot to redistribute the forces affecting my gate. Since some lower back pain persisted, my doctor prescribed next a meeting with the clinic's physical therapist. The VA policy is to prefer routine physical exercises as a first step. I have had one group meeting, and have an appointment for a meeting by myself. At this meeting, we talked about posture a lot. We were given a foam wedge to use in our chairs while sitting, and we were shown how to roll a town to insert between the chair and the lower back; just the posture changes I have made and the exercise progarm has already brought me good results. It is a benefit of VA treatment that it is assumed you will be an active partner in your healthcare. Being asked to be self-motivating puts "caring" in care.
6
I have many friends who seem to be helped by chiropractors. The one caveat I would share was told to me by a neurosurgeon to whom I went because of back pain. After looking at the pictures of my back and those of my neck which were accidentally in the same file, he said, " By all means go to a chiropractor and see if it helps your back, but under no conditions let anyone manipulate your neck. Real and devastating damage can occur." I've never forgotten that and in reacting to the comments below it can't be stated to strongly.
6
That was very good advice. When I went to see a chiropractor a few years ago, I didn't know this. I was lucky I didn't come away with any permanent damage because he manipulated my neck, but I really felt pain and discomfort for days.
Just last year, a young model named Katie May died as a result of chiropractic treatment. The autopsy revealed that she had a stroke as a result of a ruptured artery in her neck just a few hours after a chiropractic visit.
Just last year, a young model named Katie May died as a result of chiropractic treatment. The autopsy revealed that she had a stroke as a result of a ruptured artery in her neck just a few hours after a chiropractic visit.
3
My chiropractor went through medical school and could have taken the test for becoming an MD, but instead he did the additional chiropractic training. Had it not been for him, I would have never worked again.
I realize there are varying opinions, just as I am sure there are both good and incompetent medical doctors and/or chiropractors. Questioning the training and disparaging the profession can apply to both professions. Results matter and for those issues that chiropractors can improve or cure, why not refer the patients for this type of treatment? Professional jealousy is not an appropriate reason to not do so.
I realize there are varying opinions, just as I am sure there are both good and incompetent medical doctors and/or chiropractors. Questioning the training and disparaging the profession can apply to both professions. Results matter and for those issues that chiropractors can improve or cure, why not refer the patients for this type of treatment? Professional jealousy is not an appropriate reason to not do so.
24
The asthma reference is an NIH review of 45 reviews stating that there is no disorder, including bck pain, that spinal manipulation is effective.
As a retired EM physician, I think that the most effective treatments are time, stretching, heat (after the first 2 days), ice massage (1 direction for 8 minutes), and good posture (avoid sitting). Avoid surgery without a true nerve deficit, narcotics more than a few days, maintenance therapy, and disability compensation. Since doctors including orthopedists get llitle results, a chiropracors may help, but their theory is wrong.
As a retired EM physician, I think that the most effective treatments are time, stretching, heat (after the first 2 days), ice massage (1 direction for 8 minutes), and good posture (avoid sitting). Avoid surgery without a true nerve deficit, narcotics more than a few days, maintenance therapy, and disability compensation. Since doctors including orthopedists get llitle results, a chiropracors may help, but their theory is wrong.
2
I am a physical therapist of over 36 yrs experience treating back and neck pain. Much of what we PTs do is teaching. Every person with mechanical spinal pain (most common type) needs to learn strategies to self manage symptoms, basic spinal anatomy and biomechanics, posture (and how bad posture relates to symptoms) and body mechanics (knowing how to lift, etc is important). All of these together allow the person to be independent, to head off symptoms, to respond to symptoms appropriately. Taking a pain pill without correcting one's posture or performing exercises specific to the type of pain one has is useless - the pain will come back eventually. And being correctly taught and practicing correctly what one is taught prevents anther visit to a health care practitioner. And, THAT saves health care dollars which seem to be in tight supply right now.
21
I have two observations. First, most insurance companies do cover chiropractic care. I asked to get it removed from my policy to try to lower my premium and the carrier refused to remove it. A second observation is one that I learned from a neurosurgeon colleague. He told me that chiropractors were like going to your mother. They ask you where it hurts, they touch the area and they tell you if it hurst again to come back. This is much like a mother who provides support and comfort, a kiss to the "boo boo" and tells you that she's always there for you. I'm not sure if chiropractic is beneficial for its physical effects or emotional ones. I suspect it is the latter.
3
Try it before you make judgements. I'll tell you what, if you ever experience back pain you come by my office and I'll treat you for free if you don't improve. If you do improve, you can still have the free care but you need to respond back to every thread on how Chiropractic care has helped change your view on alternative therapies and how it's positively changed your life.
23
I had spinal stenosis (with foot drop) and had surgery 20 years ago by the surgeon who told me that quote. I was pain free from the minute I awoke from anesthesia.
1
My several significant and painful upper, mid, and lower spinal issues are visible on X-ray film and were diagnosed by medical doctors. I tend to avoid surgery, and over many years visited many chiropractors and a D.O. . . the good, the bad, the ugly. An ultra competent chiropractor who has several certifications from the National Upper Chiropractic Association gave my life back to me. I am grateful. Also, a D.O. who is also a Palmer Chiropractic College graduate has been of great help. No spinal fusion for me, no more sacroiliac going out, no more headaches. No upper and mid back pain.
1
As a mental health professional, I cannot understate the importance of understanding that depression follows the same neural pathway that lower back pain does. Exercise improves both. It's tough for people with either diagnosis to attempt any type of workout, but moving around does help. It's a start.
8
Not all backs are served by exercise. That should not be recommended in all situations for example where scar tissue from an earlier operation is resting against a nerve and exercising rubs the nerve against the rough scar tissue as is my case. I was in Boston Back Clinic in the 1990's and the head doctor put me on a rigorous stretching and exercise program. I did. Then I got the flu. I was in bed for over a week and my back stopped hurting. He said - STOP EXERCISING!
1
Why does no one pay attention to back pain that does not go away? I've had lower back pain every morning for many years. I'm extremely fit for my age, yet it it is there every morning. Some days it fades away by noon, others it does not. I've tried pretty much everything, but it's always there in the morning. Its just extremly frustrating to repeatedly read "it goes away in time". Mine certainly does not.
3
Hey Bob,
I'm a competitive jiu jitsu practitioner, so my spinal health is integral to my physical and mental wellbeing. I had a discectomy in 2015 and I've never looked back. Massage, physical therapy, pain medication, and chiropractics did nothing for me. Don't rule out surgery because people claim it goes away in time. I was miserable but felt fully recovered in two weeks after surgery.
Finding a good neurologist was a lifesaver for me. It can get better!
I'm a competitive jiu jitsu practitioner, so my spinal health is integral to my physical and mental wellbeing. I had a discectomy in 2015 and I've never looked back. Massage, physical therapy, pain medication, and chiropractics did nothing for me. Don't rule out surgery because people claim it goes away in time. I was miserable but felt fully recovered in two weeks after surgery.
Finding a good neurologist was a lifesaver for me. It can get better!
5
Bob, it is called inflammation. Ever sprain your ankle and you wake up the morning with a balloon at the end of your leg due to swelling, edema, fluid retention associated with an injury? You are constantly injuring your back mechanically with some sort of micro injury that results in inflammation and swelling around the spinal joint causing stretch stimulation of pain fibers. You move causing the fluid to diffuse and you feel better, plus motion fibers in the joint out number pain fibers 3 to 1 and overwhelm the pain fibers. Find someone, like a chiropractor or physical therapist, that can assess the ergonomics of your activities that is causing you constant irritation. It is something in your lifestyle my friend.
2
Bob, they are referring to the "most common" subset of back pain people. The truth is , most serious experts on back pain (whether they are chiropractors, PTs, or MD/DOs) DO clearly differentiate between chronic low back pain and acute low back pain. Your type can be frustrating. You have said you tried everything, perhaps you have. Consider: chiropractic, pt, high-quality inversion table (look up back-a-traction type table) , change mattress, McKenzie-type protocols. Some of the theories behind chronic morning pain/stiffness is two things 1- the disc recharges (thickens) overnight while sleeping and this new bio-mechanical setting causes tissue stress and subsequent pain. Another idea is that the local Mechanoreceptor nerves in lumbar-sacral junction are somehow more "sensitized" in certain people. I wont tell you what to do but i will tell you that many people with chronic low back pain are able to finally "dial the right combination" and get rid of it. Good luck.
2
My chiropractor is excellent. About 15 years ago I had a terrible bout of sciatica and she was able to resolve it. She is very low on woo and works with direct joint and muscle manipulation. I see her once a month for maintenance and she is the first person I go to for pain. She has yet to steer me wrong.
25
Indeed "the placebo effect" can be very pronounced in many patients - and today's chiropractors [and other such for many centuries] have taken advantage of this well known medical occurrence.
3
Any intervention including surgery can facilitate a placebo effect. Not a bad thing.
Chiropractic is based on the theory that sickness is caused by a blockage of health-energy flowing through your nerves, but sure, let's endorse it. That's some sound medical science right there.
2
For many people wait and see works just and well as any therapy. How can anyone say that chiropractic works better than nothing? Chiropractors have been giving what is essentially a sham treatment using a little device which flicks a little plunger against a body part. Their patients fall for it. In fairness, medical doctors can get a similar effect by giving a fairly mild prescription while saying the patient will feel better in a few days.
Back pain is subjective so there is no way to really test any treatment. People with no visible problems on an X-ray or MRI can complain of severe pain, while those with severe changes don't. Logic dictates, go with the shortest and least expensive course of treatment before sending someone for a sham treatment. Especially one which has to be repeated many times to get any improvement because the chiropractor says that's what is required. Sounds like hocus-pocus. A faith healer could do just as well.
Back pain is subjective so there is no way to really test any treatment. People with no visible problems on an X-ray or MRI can complain of severe pain, while those with severe changes don't. Logic dictates, go with the shortest and least expensive course of treatment before sending someone for a sham treatment. Especially one which has to be repeated many times to get any improvement because the chiropractor says that's what is required. Sounds like hocus-pocus. A faith healer could do just as well.
3
After an active and healthy life, I developed tremendous lower back pain. The MRI showed a laundry list of ills, which I was told by 3 back surgeons could - maybe - be alleviated by double level fusion surgery. On the verge of acquiescing to having the surgery, after having tried a number of other treatments, I discovered the Egoscue method for back pain relief. It saved my life and taught me a few lessons.
First, there are many paths to a potential recovery. You often have to go down a number of them to find the one that works for you. The comments in this section underscore that.
Second, we Americans expect someone else to "cure" us. This avoid the responsibility for our own pain and cure and delegates it to others. When we develop the mindset and motivation that we have the power to cure ourselves, we are one big step closer to the cure.
Third, many back problems are of our own making due to being inactive, overweight or engaged in the same repetitive physical activities (i.e., the runners, cyclists or swimmers who do little or nothing else). This creates muscular weaknesses that misaligns the spine. A total body exercise program that facilitates strength, alignment, balance and flexibility is the key to back health.
My daily workout regime consisting of Egoscue positions, yoga poses and traditional exercises, have me, at age 61, fitter and stronger than at any other time in my life - and no back pain.
First, there are many paths to a potential recovery. You often have to go down a number of them to find the one that works for you. The comments in this section underscore that.
Second, we Americans expect someone else to "cure" us. This avoid the responsibility for our own pain and cure and delegates it to others. When we develop the mindset and motivation that we have the power to cure ourselves, we are one big step closer to the cure.
Third, many back problems are of our own making due to being inactive, overweight or engaged in the same repetitive physical activities (i.e., the runners, cyclists or swimmers who do little or nothing else). This creates muscular weaknesses that misaligns the spine. A total body exercise program that facilitates strength, alignment, balance and flexibility is the key to back health.
My daily workout regime consisting of Egoscue positions, yoga poses and traditional exercises, have me, at age 61, fitter and stronger than at any other time in my life - and no back pain.
8
There are two kinds of patients. Type 1 says to her health practitioner, "Doc, fix me," thereby treating herself no differently from how she would have her mechanic repair her automobile. Type 2 says to her health practitioner, "Doc, let's work together to fix me," and enters into a cooperative relationship of therapy, learning, and personal responsibility. Type 1 is in a dependent relationship; Type 2 is in a relationship of mutual respect and responsibility. Whether you choose to see a chiropractor or a physician, choose carefully. Your outcome depends how you view yourself as a patient and therefore upon your choice of practitioner.
8
Walking works for me. We were about to fly to Europe, and I twisted while getting dressed, and had lower back pain, Stretching didn't help. Sitting was painful, so I walked for about a half hour. The pain was gone. Walking has worked for me for many years, and I'm now eighty. I filled out many accident reports at work when I strained my back, but never missed a day, because it was so effective. My wife goes to a particular chiropractor who helps her, but based on need only, not routinely. I would go to him if pain persisted.
How many chiropractors does it take to change a lightbulb? One, but it takes 30 visits. Chiropractic treatment may be useful for some people, and as a family doctor, I do refer to a limited number of chiropractors whom I feel are careful and judicious in their treatments. But I also like to say that "while some patients swear by them, others swear at them. " I have seen patients spend thousands of dollars and the only benefit was that their wallet lost weight. Try anything for a while, but it should be clear after 4 or 5 sessions whether it is helping or not.
35
And those thousands of dollars are still far less than one surgical intervention which may or may not work. Many doctors these days do their intake with their back turned to you, typing into the computer what you tell them, then send in the nurse to take vitals. 10 minutes, barely a glance at the body in front of them. And I would bet every single one of them thinks they've done a thorough evaluation. And, Doctor: let me ask you what percent of your training involved evaluating pain as it relates to the musculo-skeletal system? Not internal medicine, not pharmacology, not differential diagnosis of disease, but the musculo-skeletal system as a kinesiological, biomechanical unit. After all, the majority of visits to doctors' offices are for this sort of ailment. Do you know how to tell if a pelvis is misaligned? Do you assess that in your 10 minute treatments? Do you know what to suspect if a person's pain is present while standing vs. sitting? If you don't know these answers right off the bat, I'd hesitate taking your advice on a bad back. I am not a fan of all chiropractors, just as I do not place all of my trust in doctors. But sometimes it helps to be open minded about things in which you don't have all the expertise.
6
I go to a sports medicine chiropractor in a clinic and it has been very helpful in keeping me active and running as I age. I am reading comments here that seem to be full of inaccurate information about chiropractic treatment including "it takes 30 visits". That is not my experience at all. And, many health plans do cover visits - my out of pocket costs have been reasonable and limited. In this clinic I have also benefitted from massage and acupuncture, also covered by insurance.
2
I am an MD but I would like to put in a plug for my Osteopathic, DO, colleagues. The article made it sound like the only option for manipulation treatment is chiropractic. DO's do the same medical training as MD's but include manipulation. Also they use many gentler techniques. I have found them to be more skilled in osteopathic manipulation and more aware of the medical issues as well.
18
Unfortunately, all the D.O.'s I know would agree they're versed in manipulation, but there skills in it aren't as fine tuned as a D.C.'s.
As a matter of fact, pretty much none of the D.O.'s in the hospital that I work in manipulate. Either they don't have the actual time involved to manipulate, so they simply write a prescription or they don't feel comfortable with their skills.
As a matter of fact, pretty much none of the D.O.'s in the hospital that I work in manipulate. Either they don't have the actual time involved to manipulate, so they simply write a prescription or they don't feel comfortable with their skills.
5
Based on experience of treatment for "regular" back problems from injuries from lifting, sports, etc., I have tried chiropractors, osteopaths (DO/MD) and physical therapy. In brief, I will not go to chiropractors again-too painful, slow improvement , if any, and just too unscientific for me. DOs: I have considered my DO to be the best discovery made regarding medical care. In addition to been an evidence-based, knowledgeable doctor, my DO had provided osteopathic manipulations that have given instant relief for back and neck pain with no aggravation of symptoms. I have also gone to PT and while I have not liked most (aggravated symptoms, etc.) I have found the PT practitioners who use Active Release techniques to be very helpful. But if it is a back issue, go to the DO first. Here is THE reason why: I recommended to a friend that she see my DO because of complaints of constant back pain. When she went, the DO diagnosed a urinary infection. That experience says it all. DOs are doctors/MDs!
6
I wish the article had fleshed this out as well. Physical therapists are also trained in manipulation techniques. I hate perpetuating the myth that only one profession uses a certain technique.
In response to Tim's comment: PTs are evidence-based, doctorate-level providers. Our training includes screening for other medical conditions, such as UTI. I find as a profession we do a horrendous job educating the public as to what we do, so I try to do so as often as I can!
In response to Tim's comment: PTs are evidence-based, doctorate-level providers. Our training includes screening for other medical conditions, such as UTI. I find as a profession we do a horrendous job educating the public as to what we do, so I try to do so as often as I can!
1
Years ago I attended a Harvard course on alternative medicine - I am a retired internist. I found the lectures of a chiropractor very informative. He warned against chronic adjustments to maintain alignment claiming that those adjustments can overstretch the spinal support system causing long-term problems. He also warned us about malingering patients: the window of his treatment room faced on the parking lot and he would observe some patients arriving with a normal walk but when ushered into his office exhibited signs of severe back pain. Usually there was some type of compensation involved.
6
For more than two years I could not move my head from a sprained neck. I went to many doctors who prescribed heat and aspirin, and chiropractors who simply cracked my neck. Finally, when I was very close to the permanent self-harm solution, a stranger on the bus recommended a different chiropractor. I was skeptical but had nothing left to lose. He was from the old school, probably 75 years old and spent three hours with me. Finally, he diagnosed the problem as being in my hips. I was born a breach baby with a dislocated hip, something I had forgotten about oh, about forty years prior and probably had some sort of weakness there. One month of adjustments on my hips a week apart, and I was permanently healed. He never even touched my neck! One caveat: I must always wear shoes with solid arch support.
16
I have had one great chiropractor - long ago - and two poor ones. The problem is health view and level of treatment. The good one was holistic and saw chiropractic as a part of a regime that included diet, stretching, meditation and exercise. She took time and applied manipulation specific to my needs and pain levels. The other two ran patient mills with a half dozen people seen at a time. A quick crack, then onto a series of machines. In "The Simpsons", Homer goes to see "Dr. Steve", a chiropractor and after a quick manipulation says he feels "a little better." The DC says "I'll need to see you three times a week for many years." That last part rings true about the worst patient mills. But any MD who focuses on chiropractic claims of chiropractors 50 or 100 years ago should remember leeches, blood-letting and more recent prescriptions of morphine drops for baby teething and an arsenic/mercury mix for syphilis.
4
The difference between claims of doctors and chiropractors 50 to 100 years ago is that doctors don't make those claims anymore. Treatments that have been proven not to work are not used anymore. Chiropractic is still based on the same false ideas it was founded on, even if many of it's practitioners have abandoned them.
2
Chiropractic, as a profession, is barely a 100 years old. And as a regulated healthcare field, not even 50 years old. Given more time and research, it will find its way out of the dark ages, just like allopathic medicine did. Or has everyone forgotten that the cure for psychological disorders 60-70 years ago was either a) high voltage to the head or b) frontal lobotomy?
1
Finally. I have been (ignoring the ignorant bias) going to a chiropractor for over 30 years for pain relief for various things like sciatica and other muscular aches and pains.
I have found many physical therapists to be poorly trained and useless- the turnover is high in many facilities.
I know anecdotal evidence is not the best, but I am encouraged that more studies are being done on a practice that I have found to be effective for me.
As to Yoga, it too can be dangerous too if practiced poorly. I like to do it but it does not take the place of a competent chiropractor.
I have found many physical therapists to be poorly trained and useless- the turnover is high in many facilities.
I know anecdotal evidence is not the best, but I am encouraged that more studies are being done on a practice that I have found to be effective for me.
As to Yoga, it too can be dangerous too if practiced poorly. I like to do it but it does not take the place of a competent chiropractor.
5
So your Chiropractor made you feel better? So do astrologists, fortunate tellers and shammanists, not to mention organized religion. Your experience may be valid, but it may also be just a placebo effect.
15
Dear Anne Harper,
What you said could be true or as much as you don't want to hear it.......It may be actually helping!!
What you said could be true or as much as you don't want to hear it.......It may be actually helping!!
Must have been a placebo effect that fixed many of my adolescent patients' scoliosis without braces or surgery, or those bulging discs that "magically" went away in dozens of my adult patients.
All the chiropractors did for me was make the pain go away for a few hours, at most. It took a knowledgeable orthopedist to figure out that all of the mountain biking I was doing was making my hamstrings extremely tight. These were putting too much strain on my lower back and overwhelming my core muscles. I wasted months having my back cracked, massaged, and zapped with a peizo "stimulator" when what I really needed was to learn how to stretch my leg muscles and strengthen my cores.
2
I agree with Bob from Atlantic City. I have seen 2 patients with paralysis because of neck manipulation that was either improperly done or done on older people who had severe spinal stenosis or blood supply problems to their spinal cords, neither of which can be appreciated with simple X Rays before hand. I think this article should have been more explicit about the benefits to LOWER spine and muscle manipulation, which can be helpful and is much less dangerous. JH
5
Jane, I've seen several patients that have had paralysis due to neck surgeries. Do we stop performing neck surgeries? Or maybe you take the good with the bad and hope the good vastly outnumber the bad?
3
I will leave it to people much smarter than me to refute the meta-analysis that was done.
Too bad the Times lacks the critical thinking of Science Based Medicine editors.
https://sciencebasedmedicine.org/spinal-manipulation-and-the-jama-meta-a...
Too bad the Times lacks the critical thinking of Science Based Medicine editors.
https://sciencebasedmedicine.org/spinal-manipulation-and-the-jama-meta-a...
5
The meta-analyses discussed are fine. It's Dr. Carroll's failure to discuss the limitations in the research they reviewed that's the problem
1
Peer-reviewed publications are fundamental to the nature of most health professions, where they serve to chronicle the evolution of a profession’s intellectual foundations and drive advances in education and patient care. Chiropractic speaks for itself: for decades it has had no peer review journals, so no record exists that we can use to examine its intellectual underpinnings or evaluate if and how far the patient care has progressed over its history. In the absence of such a record, we can only conclude that chiropractic is driven by dogma, not science, and we have little choice but to regard it as a form of faith healing.
Of course, to those people who, by their own personal criteria, feel better after chiropractic manipulation, this is all irrelevant. For them, chiropractic works. We know that manipulation, stretching, and core strengthening may indeed work to relieve lower back pain, and may even be used by many MDs in preference to surgery, for example. Such courses of treatment are supported by peer-reviewed studies.
But what of those patients who aren’t helped? And what of those with other conditions, for whom, instead of chiropractic, a timely scientific diagnosis and course of medical treatment might mean the difference between good health and debility – or worse? Perhaps we should ask, do chiropractors have their own professional version of, “first, do no harm?”
Of course, to those people who, by their own personal criteria, feel better after chiropractic manipulation, this is all irrelevant. For them, chiropractic works. We know that manipulation, stretching, and core strengthening may indeed work to relieve lower back pain, and may even be used by many MDs in preference to surgery, for example. Such courses of treatment are supported by peer-reviewed studies.
But what of those patients who aren’t helped? And what of those with other conditions, for whom, instead of chiropractic, a timely scientific diagnosis and course of medical treatment might mean the difference between good health and debility – or worse? Perhaps we should ask, do chiropractors have their own professional version of, “first, do no harm?”
5
My husband had chronic, debilitating lower back pain. His doctor sent him for cortisone shots, three rounds of shots did not touch the pain. He went for physical therapy for months. It wasn't working. The doctor was starting to talk back surgery. But first, we found a well respected chiropractor who also has a medical degree. In a few sessions, he was pain free. And has been, ever since.
You need to pick your chiropractor carefully, but for many things they can help tremendously. We now use this chiropractor as an adjunct to our regular doctors for my family's medical needs. And we are all the better for it.
You need to pick your chiropractor carefully, but for many things they can help tremendously. We now use this chiropractor as an adjunct to our regular doctors for my family's medical needs. And we are all the better for it.
43
Physical therapy, si!
Chiropractic, no!
Chiropractic, no!
6
Just so chiropractors don't treat unrelated problems with spinal manipulation, it seem like good advice.
2
My Chiropractor has kept me "in line" for 7 years now since a very painful time with a bulging disc. I see him monthly and will continue to do so since I am able to enjoy most of my normal activities.
9
Having used chiropractors for the occasional back problem over the last 30 years, I can attest that chiropractic manipulation has worked for me. I find that it works best when combined with exercise that keeps me strong. I can also say that like any other profession, there are some chiropractors that are better than other.
12
I've suffered excruciating lower back pain on and off for almost half a century. The best practitioners for my back pain, and for that off my wife, were trained osteopaths. Gradually, over many decades I learned how to take care of my own back pain and that of others.
Partner assisted stretching is the key. Lie down on your back on a hard, flat surface. Your partner gently lifts your straight leg, right or left, by the ankle, starting on the worst affected side of your back, as you resist the lift by pushing down.
Push down against your partner's lift for a slow count of six. Relax. Your partner lifts your straight leg a little higher. Push down again for a count of six. Your partner winches your leg a little higher. Push down for six. Relax. Repeat until the pain in your lower back and/or leg is so excruciating that you are screaming out loud. Your partner then relents and gently lowers your leg to the floor.
Switch to the other leg. Repeat the process. Switch back to the first leg. Your partner should be able to winch your leg a little higher this time before the pain becomes too much.
Eventually your straight leg should be at ninety degrees to your torso, and your partner is pushing your straight leg towards your head by pressing the hollow between his/her neck and shoulder against the back of your heel, and leaning in using all his/her weight to winch your leg a further few millimetres against your will.
TBC
Partner assisted stretching is the key. Lie down on your back on a hard, flat surface. Your partner gently lifts your straight leg, right or left, by the ankle, starting on the worst affected side of your back, as you resist the lift by pushing down.
Push down against your partner's lift for a slow count of six. Relax. Your partner lifts your straight leg a little higher. Push down again for a count of six. Your partner winches your leg a little higher. Push down for six. Relax. Repeat until the pain in your lower back and/or leg is so excruciating that you are screaming out loud. Your partner then relents and gently lowers your leg to the floor.
Switch to the other leg. Repeat the process. Switch back to the first leg. Your partner should be able to winch your leg a little higher this time before the pain becomes too much.
Eventually your straight leg should be at ninety degrees to your torso, and your partner is pushing your straight leg towards your head by pressing the hollow between his/her neck and shoulder against the back of your heel, and leaning in using all his/her weight to winch your leg a further few millimetres against your will.
TBC
7
No,no, no no no no no No!!! Screaming out loud is not good treatment. Pain when raising a straight leg is a diagnostic test for disc herniation. Please go to a medical doctor for diagnostics before trying to fix anything with these medieval torture antics. You may make things much worse!
10
So-called 'disc herniation' is largely a medical myth, an old wives' tale perpetuated in the Western medical community by medical schools.
This has been known since at least the early 90s according to the 1992 paper by Alf Nachemson, MD, PhD, (1931–2006), which has 805 citations according to Google Scholar:
'Scientific scrutiny of the low back problem demonstrates its socioeconomic importance in most industrialized societies. Natural history studies reveal that the prognosis for the low back pain patient is excellent; for those with sciatica and painful spondylolisthesis it is good. It is even relatively good for those older patients with symptoms of spinal stenosis. Although today there is a better understanding of pain, the pathomechanism of low back pain is unknown. However, for patients with sciatica, spondylolisthesis, and spinal stenosis, physicians are beginning to get a better perception of what causes the pain. Psychosocial factors, including insurance benefits, have been demonstrated to be more important than biomechanical workload not only for acute but also for chronic low back pain patients who are unable to work. Orthopedic surgeons must recognize this fact when contemplating operations for patients with ill-defined back syndromes. Rarely are diagnoses scientifically valid, nor is the effectiveness of surgery proven by acceptable clinical trials.'
http://journals.lww.com/corr/abstract/1992/06000/newest_knowledge_of_low...
This has been known since at least the early 90s according to the 1992 paper by Alf Nachemson, MD, PhD, (1931–2006), which has 805 citations according to Google Scholar:
'Scientific scrutiny of the low back problem demonstrates its socioeconomic importance in most industrialized societies. Natural history studies reveal that the prognosis for the low back pain patient is excellent; for those with sciatica and painful spondylolisthesis it is good. It is even relatively good for those older patients with symptoms of spinal stenosis. Although today there is a better understanding of pain, the pathomechanism of low back pain is unknown. However, for patients with sciatica, spondylolisthesis, and spinal stenosis, physicians are beginning to get a better perception of what causes the pain. Psychosocial factors, including insurance benefits, have been demonstrated to be more important than biomechanical workload not only for acute but also for chronic low back pain patients who are unable to work. Orthopedic surgeons must recognize this fact when contemplating operations for patients with ill-defined back syndromes. Rarely are diagnoses scientifically valid, nor is the effectiveness of surgery proven by acceptable clinical trials.'
http://journals.lww.com/corr/abstract/1992/06000/newest_knowledge_of_low...
7
Even if you are fated to have your spine opened from front and back eventually for serious rebuilding, these chiros will make the pain leave you alone for a while.
If there's a good chance spinal manipulation can relieve the problems at hand you are far ahead going this route, if only because of the bacteria you pick up in hospitals.
If there's a good chance spinal manipulation can relieve the problems at hand you are far ahead going this route, if only because of the bacteria you pick up in hospitals.
5
My chiropractor gave me my life back. He uses both spinal manipulation and acupuncture. My MRI in 2009 showed me to have an AP dimension of 5-6 mm in the lower lumbar spine (L4 and L5) - severe spinal canal stenosis - as well as a host of other back problems. I went to three of the most highly touted orthopedic surgeons in town and they all told me that I had to have spinal fusion. The regular orthopedists wanted to inject steroids into my spine. Because I know the downsides of both treatments, I chose to go to a wonderful chiropractor, Dr. Luby Chambul, instead. I also went to a number of physical therapists and put together an exercise routine that I do every day. Anyone who is considering back surgery should be warned that spinal fusion is the only operation with a syndrome named after it, Failed Back Surgery Syndrome. It is a nightmare of chronic pain and it is all too common. Yes, there are chiropractors who should not be practicing, but there are also MD's who should not be practicing. There are bad apples in every profession, from the priesthood to the academic dean to the plumber.
Sherry Loller
2313 Pennington Bend Road (current location)
Nashville TN 37214
615-889-2968 (day or night)
615-877-1647 (cell)
Sherry Loller
2313 Pennington Bend Road (current location)
Nashville TN 37214
615-889-2968 (day or night)
615-877-1647 (cell)
30
Decades after Chiropractors were victorious in a lawsuit vs. the AMA for making false claims against the efficacy of chiropractic treatments, a doctor in 2017 dares to suggest that chiropractic therapy might be as good as any other non-medical intervention (I.e., addicting pills and/or surgery).
Wow! What paternalistic courage on the part of this MD! And you give this your attention as though it's news?! What, was Monday a day to recycle old and irrelevant non-news?
Meanwhile, in the many intervening years, countless (because that's your undone job, not mine) people experienced successful relief from the pain that medical science could not provide.
Nevertheless, the AMA and the insurance industry made damned sure that benefits for chiropractic treatment were restricted. Despite this, how many chiropractic practices have thrived because people know what works and don't mind spending their hard earned money on licensed Chiropractic doctors who know and take the time to explain what they are doing and why it works.
Not a perfect analogy, but how many car owners learn to avoid their car dealers high costs and scapegoating explanations as soon as they can find a trustworthy private mechanic?
Wow! What paternalistic courage on the part of this MD! And you give this your attention as though it's news?! What, was Monday a day to recycle old and irrelevant non-news?
Meanwhile, in the many intervening years, countless (because that's your undone job, not mine) people experienced successful relief from the pain that medical science could not provide.
Nevertheless, the AMA and the insurance industry made damned sure that benefits for chiropractic treatment were restricted. Despite this, how many chiropractic practices have thrived because people know what works and don't mind spending their hard earned money on licensed Chiropractic doctors who know and take the time to explain what they are doing and why it works.
Not a perfect analogy, but how many car owners learn to avoid their car dealers high costs and scapegoating explanations as soon as they can find a trustworthy private mechanic?
17
And in other news: Doctors meet and agree to allow that the sky is blue! Thanks fellas, we weren't sure, but I do have to tell you that between all the ignorant fools you refer to as patients, there was an inkling that that darn overhead mystery did resemble "blue" especially on clear sunny days. Now we can all stop wondering!
Wow, just wow. This is one of the clearest examples of the ego and myopia that is the profession of medicine in this country. Imagine all the lost money, pain, and suffering put on people with back pain by doctors who see everything as a nail needing their drug and surgery hammer. It's obscene.
Bring this article to mind next time doctors refuse to admit they overprescribe opiates and cost this society billions in misery, for the sake of profits.
Wow, just wow. This is one of the clearest examples of the ego and myopia that is the profession of medicine in this country. Imagine all the lost money, pain, and suffering put on people with back pain by doctors who see everything as a nail needing their drug and surgery hammer. It's obscene.
Bring this article to mind next time doctors refuse to admit they overprescribe opiates and cost this society billions in misery, for the sake of profits.
24
I am a midwife, and it is the same in my profession. The occasional MD will look at the data and declare that out of hospital birth for healthy moms attended by a trained, licensed midwife is OK---Gee, Thanks for that! Like I needed you to tell me what I have known for decades....and now I and my practice are somehow "legit" because the MD said says so!
7
It called applying the scientific method, the same method that gave you smart phone and freedom from infectious diseases.
5
So... not helping much (allopathic physician) = not helping much (chiropractor), and that's reason to "rethink biases"?
Management of back pain has been sloppy by everyone in all specialities because it is a complex disease. But to imply that chiropractic practice has an equal diagnostic, therapeutic, or conceptual footing to standardl practice is dangerous.
Management of back pain has been sloppy by everyone in all specialities because it is a complex disease. But to imply that chiropractic practice has an equal diagnostic, therapeutic, or conceptual footing to standardl practice is dangerous.
2
"Some physicians are concerned about the cost of spinal manipulation."
Ha! I'd prefer they be more concerned about the cost of their own services! Physician, heal thyself.
Ha! I'd prefer they be more concerned about the cost of their own services! Physician, heal thyself.
22
Mom knew this when she rubbed on the Vick's.
4
While Mr. Carroll recognizes that "chiropractors" can be helpful, he doesn't really get into the nuances of practice (or malpractice), skill levels and approaches to relieving back pain, as any doctor should be doing with their patients. There are different approaches to addressing pain with spinal alignment, musculature, balance, movement, stretching and exercise. I have found that an integration of all of these is essential.
When I was in my 20s, I was rear-ended in an auto accident. The doctor at the time gave me a pain reliever and sent me on my way. Several months later, my lower back went into painful spasms. A shot of Demerol got me off the floor and into bed for days. That reoccurred months later. Fortunately, a friend referred me to a practitioner who was successful.
That practice involved a combination of deep massage to relax key muscles in my lower back, stretching, and spinal manipulation only through a range of motion - i.e., no sudden snaps or machines.
Over the years, I learned that I had at least one herniated disc. I was advised against surgery as too risky. I established a long relationship with 2 'chiropractic' practitioners, both of whom worked in an integrated fashion. This has worked very well. I'm now 71, and occasionally need to get my back "adjusted." But it's always in a larger context of what is happening in my aging body. Traditional medical doctors have consistently failed to do just that.
When I was in my 20s, I was rear-ended in an auto accident. The doctor at the time gave me a pain reliever and sent me on my way. Several months later, my lower back went into painful spasms. A shot of Demerol got me off the floor and into bed for days. That reoccurred months later. Fortunately, a friend referred me to a practitioner who was successful.
That practice involved a combination of deep massage to relax key muscles in my lower back, stretching, and spinal manipulation only through a range of motion - i.e., no sudden snaps or machines.
Over the years, I learned that I had at least one herniated disc. I was advised against surgery as too risky. I established a long relationship with 2 'chiropractic' practitioners, both of whom worked in an integrated fashion. This has worked very well. I'm now 71, and occasionally need to get my back "adjusted." But it's always in a larger context of what is happening in my aging body. Traditional medical doctors have consistently failed to do just that.
6
Jeez, watch the testimonies roll out. Please, please do NOT encourage people to go to sham practitioners for anything, even back pain. Many chiropractors, if not most, claim to be able to cure almost anything with absolutely nothing that has been proven to help, and can possibly be dangerous. If you think patients are equipped with the knowledge to recognize medical overreach by these practitioners, you have not been watching the insidious creep of chiropractors and naturopaths into all areas of treatment, nearly all with no scientific basis or training. Regular physicians can and do prescribe massage, physical therapy with some exercises that can benefit people with back pain. It is vital that we keep standards of medicine which prevent people wasting money, time, and potential dangerous practices from proliferating.
4
I guess you can say the same thing about medical doctors as well....I have seen many people in my social work practice addicted to pain killers before and after surgeries that went awry. I have a wonderful chiropractor who knows what to do and not do. They are not "sham" but trained and licensed medical professionals. Like any healthcare provider, you seek recommendations and referrals to professionals who are respected in their field. Be your own advocate!
6
Amy, many people do not have the knowledge or resources to be their own good advocate. We must rely on standard rigorous scientific studies to determine the efficacy of treatments. Yes, chiropractors have training, but much of it is filtered through the lens of subluxations as the basis of most pathology, which is bogus. Plus chiropractors experience very little supervised clinical time in their education. And yet they claim to be able to treat patients as their primary care doctors. Much of their business come from the sale of supplements out of the offices. This is considered to be poor clinical practice by any standard. To justify chiropractic, you present the opioid epidemic and failed surgeries in standard medicine. Yes that does happen, but in the vast numbers of patients treated, they are minimal. Standards of care must be maintained by using principles of scientific methodology, not by personal anecdote.
2
No. My experience with chiropractors has not been a positive one. I had one guy try to convince me I needed a months and months of work to correct my spine when all I ended up needing were some muscle relaxers.
5
My experience, and it is only one data point, is that a chiropractor session relieves the back/neck/leg/shoulder pain for a short while, on the order of hours, but does little to make the pain go away permanently. After spending a year and a whole lot of money trying to eliminate a lower back/leg problem, I gave up on my chiropractor and followed advice from my sports physician. He suggested massage and explained to me why he thought it world work. The short description is that your skeletal related pain is most likely due to your bones in miss-alignment and muscles are what cause your bones to be misaligned. Your muscles are in a long term spasm and a chiropractor cannot fix. A massage therapist understands how muscles and bones interact and can locate the spasms keeping your bones out of aliment. They work that muscle (which can be painful) so that it has a chance to release. My experience has be has been 100% positive for neck/shoulder/lower back aches . I usually completely forget that I had any pain at all after 3 sessions. Massage, for those who do not like back pain!
5
As a dutch citizen i am used to restrictive medication or surgery (god forbid) as we have a long standing practice of finding alternative ways and using the self healing of the human body. I have also suffered from severe lower backpains for most of the early 2000-s. For which I have been referred regularly to chiropractors who manipulated the discs. This worked very well for non hernia issues based on my experience. But in 2010 I was struck by bad fortune and my back was killing me. It took a neurologyst 15min to diagnose a lowerback hernia. No MRI needed, though a later MRI for other purposes confirmed the correctness of the diagnosis. Contrary to the standard practice of taking out the disk for my ordeal, he referred me to mensendieck therapy to correct posture and painrelief. After 12 months of treatment I was completely cured from my pain without surgery. I can function (work, family etc) almost normally, with very limited adjustments to life. One side effect that i have to live with till today: i am continuing part of my therapy work outs (endurance, strength and coordination) 3 days a week for 30min. And while getting older, physically (and mentally) i feel better than during any time of above period.
5
After forty four years of standard medical practice, I cannot recommend a chiropractor. There are certain groups and ages that are in great danger, when given chiropractic manipulation. I have seen, in my office, many older patients who had permanent nerve damage, when their old arthritic discs were manipulated. A ragged disc is a rough saw, in the hands of a manipulator. Then there are those groups that have an unknown irregularity, that causes such manipulation to do more damage that it would on the average person. Most scary, is when the Chiropractor treats things that they were unable to diagnose = they put off life saving therapy for something that could have been diagnosed in another office. There appear to be no groups that benefit from the instant trauma that is used. Rather, slow manipulation, known as massage, can really help. I have prescribed professional physical therapy, since I started practice. It is more effective, with more modalities to use, than ever. And it has a safe record. In between a trained Physical Therapist and Chiropractor ? I would rather that the person have sessions with a massage therapist. I do not EVER remember having to treat anyone who had a massage or regular physical therapy.
2
Nobody ever mentions the fact that neck manipulation puts you at an increased risk of stroke. When most back pain goes away on its own no matter what you do, ie, there is no measurable effect you wouldn't get without placebo, and there is a risk of a serious (albeit rare) side effect, a risk benefit analysis suggests that chiropractic is not something you should do.
5
You should read some of the research on this topic. Below I have provided a link to pub med for you. You will find why no one is talking about it anymore. Penn State's Department of Neurology conducted a Systematic Review and Meta-analysis on "Risk of Stroke" and their conclusion... "There is NO convincing evidence to support a causal link between chiropractic manipulation and CAD. Belief in a causal link may have significant negative consequences such as numerous episodes of litigation." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/
My dad was a General Practitioner in a small town here in Ohio, starting his practice right after WWII. He had his office in the lower level of my grandmother's Victorian home. My grandmother, who was born in the late 1800's, saw the local chiropractor on a regular basis! Back in the day, I think every doctor in Greenville referred to the chiropractor as The Bone Cracker! Funny, but my grandmother lived to be 101, was driving into her 90's and never seemed to slow down until the last few years of her life! Free medical care was right downstairs, but she chose otherWise!
3
Aaron, as a physician myself, I really do wish that you would refrain from venturing outside of your field (pediatrics). Your commentary completely misses the point: regional backache is a common, nearly always benign, typically remitting predicament of the human condition. Regardless of cause, most people (70 percent) with regional backache not identifiable to some underlying pathology (spondyloarthropathy, cancer, rheumatic disease, etc.) experience uneventful resolution within two weeks and 90 percent are well by six weeks with or without specific treatment. Your commentary highlights one of the most significant errors in medicine: promoting treatment for a condition whose natural history (much like the common cold) is generally favorable and generally improves within days to weeks with or without treatment. Whether it be acupuncture, chiropractic care, spinal manipulation, sham injections, physical therapy (and all its attendant modalities), etc.), there are no long term, randomized, prospective cohort studies proving that specif treatment favorably alters the natural history of common regional backache. You are, in effect, promulgating medicalization of common regional backache as a disease meritorious of specific treatment.
8
The best way to manage back pain (or any other pain) is to do engage in the exercises and other scientifically validated practices (meditation, yoga, etc.) that you can be taught to do at home safely and effectively.
Of course, whatever the practice, you can never underestimate the power of the placebo effect which is its own form of "mind over matter." And that applies most of all to pain.
Of course, whatever the practice, you can never underestimate the power of the placebo effect which is its own form of "mind over matter." And that applies most of all to pain.
4
Myofascial release has produced amazing results for me-- relieving low back, shoulder, and wrist pain. I'm lucky to have a very experienced practitioner in my neighborhood.
1
Every medical procedure, every chiropractic manipulation has the possibility of some harm. I do go to a chiropractor and find relief, I also go to my physicians and get procedures and medicines that allow me to live more comfortably.
With and procedure, regardless of whom it is that is doing it, always has some risk. So much depends on the individuals make-up as to whether or not something will go awry.
With and procedure, regardless of whom it is that is doing it, always has some risk. So much depends on the individuals make-up as to whether or not something will go awry.
3
This article is dangerous and lumps chiropractors in with physical therapists.
I'm an MD and use referrals to physical therapy for treatment of back pain regularly, and there is a lot of scientific support for what physical therapists do. Most importantly - it's SAFE.
Unfortunately, patients often want a quick passive fix. Chiropractors will often manipulate a spine and "crack" it, which releases endorphins and feels good short term but ends up resulting in long term damage to spinal segments if done too often.
Here's my MD advice: Avoid the chiro for your back pain and visit a physical therapist instead. Then put the time in to strengthen and stabilize your core with a pilates program.
I'm an MD and use referrals to physical therapy for treatment of back pain regularly, and there is a lot of scientific support for what physical therapists do. Most importantly - it's SAFE.
Unfortunately, patients often want a quick passive fix. Chiropractors will often manipulate a spine and "crack" it, which releases endorphins and feels good short term but ends up resulting in long term damage to spinal segments if done too often.
Here's my MD advice: Avoid the chiro for your back pain and visit a physical therapist instead. Then put the time in to strengthen and stabilize your core with a pilates program.
3
Why not lump chiropractors in with physical therapists? The problem I have with your comment is the antiquated perception that you have of chiropractors. That's not to say there are not sham chiropractors but there are also sham doctors and sham physical therapists.
You see, the problem with healthcare starts with this type of attitude and lumping a profession into one category.
Should I just say that you're a drug pusher? would that be fair?
By the way can you provide your references for this release of endorphins and long term damage to spinal segments? I would truly like to read that.
A good physical medicine specialist will not just 'crack' you but demonstrate appropriate exercises and core strengthening. Did you notice I said physical medicine therapist? D.O.s are trained to manipulate and so are some physical therapists. The goal of any therapist/doctor is to empower the patient to learn to self manage their pain symptoms.
So here's my advice. Stop fear mongering.
Many people have had great results with chiropractic. Does that mean it is for everyone? No. If you walk into a chiropractic office and are immediately given a 20+ visit treatment plan with a bunch of BS then find yourself another one. Same as if you are spending 3+ hours a week in physical therapy.
With the rising cost of healthcare, providers should work together as a team to treat the patient not their symptoms. This will be far better for the patient as a whole and certainly much more economical.
You see, the problem with healthcare starts with this type of attitude and lumping a profession into one category.
Should I just say that you're a drug pusher? would that be fair?
By the way can you provide your references for this release of endorphins and long term damage to spinal segments? I would truly like to read that.
A good physical medicine specialist will not just 'crack' you but demonstrate appropriate exercises and core strengthening. Did you notice I said physical medicine therapist? D.O.s are trained to manipulate and so are some physical therapists. The goal of any therapist/doctor is to empower the patient to learn to self manage their pain symptoms.
So here's my advice. Stop fear mongering.
Many people have had great results with chiropractic. Does that mean it is for everyone? No. If you walk into a chiropractic office and are immediately given a 20+ visit treatment plan with a bunch of BS then find yourself another one. Same as if you are spending 3+ hours a week in physical therapy.
With the rising cost of healthcare, providers should work together as a team to treat the patient not their symptoms. This will be far better for the patient as a whole and certainly much more economical.
8
I've had several back and neck injuries during an active life. At age 61 I developed a lower back herniated disk with pretty bad sciatica. Sleeping was difficult as my entire leg from hip to toes hurt a great deal and turning over in bed was agonizing. Driving more than 15 minutes was also painful. Thank goodness walking was fine. But stairs were not.
I went to an orthopedist who recommended cortizone shots directly into the spine which terrified me. Also the literature said they would provide very short term benefits. I went to physical therapy-moist heat, electro stimulation, core strengthening-it helped a lot. When my insurance ran out for that I went to a nuccal chiroprator who very gently manipulated my neck as he said alignment issues can aggravate a herniated disk. Afterwards he uses some kind of extraordinarily comfortable chair in a dark room to allow the relaxation to set-simply heavenly. It was quite helpful and not dangerous.
it has taken 3 years but I have returned to being quite active-gardening, swimming, lifting, bending, stretching, driving, sleeping-it's all good. I do know of a woman who has cauda equina as a result of a bad chiropractic treatment. She is in her 30's but paralyzed and incontinent now. You must research your chiropractor, their training and methods. But the same is true for some M.D.'s.
I went to an orthopedist who recommended cortizone shots directly into the spine which terrified me. Also the literature said they would provide very short term benefits. I went to physical therapy-moist heat, electro stimulation, core strengthening-it helped a lot. When my insurance ran out for that I went to a nuccal chiroprator who very gently manipulated my neck as he said alignment issues can aggravate a herniated disk. Afterwards he uses some kind of extraordinarily comfortable chair in a dark room to allow the relaxation to set-simply heavenly. It was quite helpful and not dangerous.
it has taken 3 years but I have returned to being quite active-gardening, swimming, lifting, bending, stretching, driving, sleeping-it's all good. I do know of a woman who has cauda equina as a result of a bad chiropractic treatment. She is in her 30's but paralyzed and incontinent now. You must research your chiropractor, their training and methods. But the same is true for some M.D.'s.
3
I would like to know if chiropractic manipulation can relieve pain specifically due to spinal degeneration/stenosis that is due to age or injury. I have both, and I am here to tell you that the pain does not go away--I have 10 years of cortisone shots, diet, exercise, recommended stretching, traction, physical therapy, and chiropractic visits to attest to it. If it gets better, one wrong move starts the cycle all over again.
Me, too. Nothing has helped and the pain/discomfort is now just a part of my life.
2
At 75, I've had lower back problems since I was a teen. Many times in high school I had to wear a corset just to be able to walk. Early on I found that strengthening my core along with stretching, exercise and a healthy diet, I could mostly live pain free. No pills or surgery which was recommended even when I was a teen.
At times, a wrong move or twist can lay me up for up to a week but again, with ice packs, stretching and common sense, I overcome without taking a pill or getting a shot! Sometimes I've had physical therapy to move things along.
At times, a wrong move or twist can lay me up for up to a week but again, with ice packs, stretching and common sense, I overcome without taking a pill or getting a shot! Sometimes I've had physical therapy to move things along.
1
My back issues started in my mid thirties(i am now 60 years young). After many trips to PT's and Orthopedics doctors, the back calmed down. In my 50's, the back flared up and numbness, pain was on the increase. One weekend the back "exploded". In agony and no where to turn on a Sunday, a neighborhood Chiro was available to help. He was and is highly regarded. He did the standard, heat and Tens units treatment. Then did some "decompression". Well, at first I feel better, then within 5 minutes after leaving, the pain traveled and hit my knee like a lighting bolt. I was in agony and remained that way until a kind pain specialist, sent me for an MRI, and some pain injections. It took me over 3 weeks for the back to calm down. Aka, i had quite a bit of damage, and ended up with spinal fusion. Best to turn to an experienced PT
1
While chiropractors may help with bad backs, many overreach and offer advice about many other health issues which are beyond their training and licenses. They are not qualified to offer advice about ailments and illnesses other than that, particularly those that are contrary to the advice of physicians. Patients should beware.
5
As many of the comments make explicit, there is no good evidence for the use of chiropractic in the treatment of low back pain, beyond a single session in the acute phase. It's important to realize --and difficult for many --that comparing ineffective treatments to other ineffective treatments and finding them equivalent proves nothing. My new book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery explains this in considerable detail and explores options for which there is scientific evidence.
1
After having many bouts of my lower back going out I saw a physical therapist. (I'm now 66 and have had issues for 35 years or so.)
I was given specific exercises and stretching to do. Before when my back would 'go out', I might be in severe pain for several weeks. Now when I have back issues the pain is considerably less and lasts only a few days at most.
I once saw a Chiropractor when I was much younger and there was literature in his office regarding spinal manipulation and the treatment of diabetes.
Someone will have to explain that one to me.
I was given specific exercises and stretching to do. Before when my back would 'go out', I might be in severe pain for several weeks. Now when I have back issues the pain is considerably less and lasts only a few days at most.
I once saw a Chiropractor when I was much younger and there was literature in his office regarding spinal manipulation and the treatment of diabetes.
Someone will have to explain that one to me.
1
years ago I read a long term research book on low back pain solutions involving more than a thousand patients over 10 years who tried acupuncture, Chirorpractic manipulation, yoga, physical therapy, surgery, etc. The two with the highest satisfaction for long term results were yoga and physical therapy.The least effective were Chiropractors and surgery.
The book was published 20+ years ago and maybe out of print.
The book was published 20+ years ago and maybe out of print.
1
Something that was not addressed in the article is osteopathic physical manipulation in contrast to chiropractic treatment. Osteopaths are physicians who use the scientific method to evaluate the effectiveness of their treatments. Also, because they are physicians themselves, they have excellent judgment about when to use manipulation versus other treatment modalities. I have learned a lot from my osteopathic colleagues over the years.
2
OSTEOPATHY should also be included. It is remarkably effective.
3
Dr. Carroll cites the review in the Annals of Internal Medicine. It is worth noting that while what he says is true he leaves out some important things.
First of all, the quality of the evidence for supporting spinal manipulation was of a low quality. Second, while almost all the studies looked at the level of pain reduction, virtually none looked at the impact of treatment on the level of functioning. It is improvement in level of functioning that is considered to be the measure of success in treating patients with chronic pain. I don't know if Dr. Carroll, like many physicians, is unaware of this or simply chose to ignore it.
With regard to the treatment of low back pain, we know what doesn't work (steroids, most opioids, injections) but still have very limited information on what does.
First of all, the quality of the evidence for supporting spinal manipulation was of a low quality. Second, while almost all the studies looked at the level of pain reduction, virtually none looked at the impact of treatment on the level of functioning. It is improvement in level of functioning that is considered to be the measure of success in treating patients with chronic pain. I don't know if Dr. Carroll, like many physicians, is unaware of this or simply chose to ignore it.
With regard to the treatment of low back pain, we know what doesn't work (steroids, most opioids, injections) but still have very limited information on what does.
3
No one should underestimate the harm Chiropractors can do. I had a herniated disk and went to a recommended Chiropractor for pain relief. After two sessions his "spinal manipulation" made the pain far worse. I was in unbelievable agony for nine months. My pain was eventually relieved by cortisone shots. After four shots a month apart the pain disappeared. While I have had a few occasional bouts of pain when I got sick I can live a normal life again. While I can believe that despite the recommendation I may have gone to an incompetent Chiropractor, how can anyone know who is competent if there is not even a theory of how spinal manipulation works. When someone tells me that they are going to a Chiropractor I tell them my story and do my best to discourage them.
79
JS doesn't say whether chiropractor treatment was for a slipped disc in the neck or lower back. Aaron Carroll writes specifically about seeking chiropractic treatment for lower back pain. Years ago I had a herniated disc in the cervical area - and I mistakenly went to a chiropractic several times. The pain intensified and finally I ended up in an OR having spinal fusion. When I consulted an orthopedic surgeon for a second opinion before the surgery, he said that he would never recommend chiropractic treatments for the upper back/neck area. Too much nerve activity and too many things to go wrong. Of course I'll never know if the treatments landed me in the OR. But to be on the safe side one should probably not seek chiropractic for cervical region.
1
Yet, there are people with the same disks who have avoided surgery and pain for years. The ones I know of are slimmer than most of us so maybe that is a factor.
I have had chronic back pain since I was 8 years old. I am now nearly 70. At times, it has been so severe as to have been debilitating. It has certainly been a factor in everything I choose to do. I have been receiving chiropractic treatment for 15 years and found it beneficial. The quality of practitioners varies greatly. Some are crackpots. In the last few years I have been treated by a chiropractor who is intelligent, capable, knowledgeable, and modest. With his treatment, the exercises he suggests, and some massage, my back is better than it has ever been. At 70 I am in less pain than when I was 30.
56
If the treatments were actually correcting the problem you would not have to have them for fifteen years. It seems that you are addicted to the treatments and the reassurance the chiropractor is giving you that he is helping. How much has this cost you over the long haul?
3
My wife is a physiotherapist who has worked for chiropractors. Her experience is that while chiropractors can be helpful, chiropractors often over treat, leaving the patient too loose. In her own practice, she does use manual therapy, as any good therapist does. Often, a single treatment is all that is needed to clear 90% of the pain. It's often just a matter of pulling the joint a bit apart then moving it so the pieces go back in their proper places, whether the joint be in the back or anywhere else. (Degenerative pain is another matter). Personally, I have found traction to be effective when I have neck or upper back pain. The vertebrae are pulled apart, sucking bulging discs back in.
2
Two of my best friends are chiropractors, and I'm sure they'll appreciate this article. For me as a potential patient, though, it's frustratingly vague. As the author notes (although not until toward the end) there seems to be a wide range in what constitutes chiropractic treatment -- and the summarized studies aren't granular enough to help patients evaluate specific options. What would the author have made of a study saying that "medical treatment" can be effective -- without specifying what KIND of medical treatment?
14
Hi AJ,
The article is very vague about the type of therapy used to treat these patients, and I understand your frusteration. As someone currently mid-way through chiropractic school I am well aware of the variety of techniques that are used. You may find it comforting to know that the vast majority of these studies evaluate high-velocity, low-amplitude adjustments. These types of adjustments are the most common adjustments utilized by chiropractors (diversified technique, mainly). As for the traditional interventions that adjustments are compared to, these studies usually implement opioids, muscle relaxants, or a combination of both. I hope this clears things up a bit.
The article is very vague about the type of therapy used to treat these patients, and I understand your frusteration. As someone currently mid-way through chiropractic school I am well aware of the variety of techniques that are used. You may find it comforting to know that the vast majority of these studies evaluate high-velocity, low-amplitude adjustments. These types of adjustments are the most common adjustments utilized by chiropractors (diversified technique, mainly). As for the traditional interventions that adjustments are compared to, these studies usually implement opioids, muscle relaxants, or a combination of both. I hope this clears things up a bit.
1
This article does a disservice to readers by not naming the chiropractic theory that underpins the "claims" that some (many, potentially most) actually proclaim in their practices. Knowing which chiropractors are followers of the Subluxation Theory will tell you if you are working with someone with an evidence-based viewpoint or not (hint: you really want one who doesn't follow this). Simply Google "chiropractic subluxation theory" to read about this idea for yourself.
14
As a physician (md, not do, so no manipulative experience), I can tell you that I believe spinal manipulation has 2 modes of working. First and most importantly, it keeps the bones and joints moving. restricted movement is the biggest factor in chronic back pain, so any movement should help. Secondly, every chiropractor I have met is upbeat and very positive about their chances of having the patient feel better. This creates a strong placebo effect as well as gives a positive sensation to patients for whom stress and depression coexist with their back pain.
45
I had a bike accident where I went over the handle bars and landed on concrete. I'm in my 50's. I didn't break anything luckily but I was very bruised sore and had pinched nerves. I was given percocet which was a godsend then, I could hardly move without it. It was what I reached for in the morning before I could begin to even think about getting out of bed. As the bruises receded I still had a lot of neck pain, back pain and pinched nerve. I got tired of increased pain pills that were masking something. They offered me injections in my back. Instead I went to a chiropractor. He could tell immediately what was wrong with my body. He used heat, ice, and then manipulation on my neck, ribs in the back, my hips and within minutes I could feel the blood flowing, no more tingling of pinched nerves. He recommended swimming for low impact exercise. These sessions took awhile but I steadily decreased the pain pills. Manipulation makes sense and it sure works for me. All my medical doctor would recommend was increased dosages and possible surgery. I needed neither.
110
If spinal manipulation is shown to be effective, then why shouldn't it be part of the arsenal of all doctors/physical therapists treating back pain? I would feel much more comfortable going to people who didn't ascribe their treatments to some dubious scientific theories or philosophies.
And I would give greater weight to studies that included people who were not biased towards holistic treatments.
And I would give greater weight to studies that included people who were not biased towards holistic treatments.
6
"If spinal manipulation is shown to be effective, then why shouldn't it be part of the arsenal"....And the key word here is "if". "If" controlled clinical trials showed that spinal manipulation is superior to a typical back message; "if" exactly what is meant by spinal manipulation was clearly defined; and "if" the charlatan element of the chiropractor was eliminated and the cost of a spinal manipulation was set appropriately to the value received; then it might be worthy of consideration....but not before.
11
If "the cost of a spinal manipulation was set appropriately to the value received"! That sets a pretty low bar for regular doctor visits. Why not apply it to them too?
Doctors of Chiropractic attend 4-5 years of schooling after earning a B.S. There are different types of Chiropractic specialization, and some of those work for things other than back pain. I had a constant headache from the time I was about 12 years old which had been looked into by many different specialists in medicine, including head x-rays, and nothing was found. I lived on aspirin. When I was 28 I visited a Chiropractor who specialized in Applied Kinesiology. During his exam he pressed on a spot on my lower abdomen, and my constant headache stopped for the first time in 14 years. His diagnosis was that it wasn't related to my head at all but to a problem with the large intestine, which was easily corrected by manipulation that he showed me to do on my own. Say what you like, but I no longer have to buy aspirin by the 1.000 pill bottle.
2
re: BarbaraAnn's comment re: her surgery for back pain-
exactly what did the surgeons DO during the surgery- what was the cause of your back pain - was it a herniated disc(s) problem or something else? and how long was the surgery & recovery time...just curious
exactly what did the surgeons DO during the surgery- what was the cause of your back pain - was it a herniated disc(s) problem or something else? and how long was the surgery & recovery time...just curious
1
Jack LaLanne was a chiropractor who believed in body strength for prevention, nutrition, and common sense.
9
Yeah, but he only lived to be 97.
5
My few visits to one chiropractor did not help at all, and when he started telling me things like "eggs have more calcium than milk," I decided that he--and chiropractic in general--was not something I wished to explore. Over the years, I've found physical therapists to be the true heroes in helping people get through an episode of back pain and--as important--help them avoid new episodes of back pain.
103
Add to this discussion the tremendous benefit you will get from figuring out how you are moving yourself in ways that lead to the pain, and how you can move yourself differently to heal and avoid or minimize the pain in the future! Many interventions, from PT or chiropractic through surgeries, will not improve things permanently unless you re-educate your whole system. This takes the kind of attention, self-care, and curiosity built into the Feldenkrais Method, Alexander Technique, yoga and other such modes of inquiry, attention and practice. Sometimes it takes only a small change, such as noticing how to align yourself well over your legs in walking, or re-mobilizing inactive ribs, to relieve the lower back of the inordinate work it's doing. A teacher in these modalities can provide immediate, affordable guidance for starting and maintaining this process of reorganization that ultimately each person takes over for themselves, at which point it is free and freeing.
23
Your list of self-help methodologies should also include the Egoscue approach, which helped me greatly.
1
Well, after having to retrieve my best friend after a chiropractic session that left her immobilized, my sense of the practice is that, while it may work in many cases, the tail risk of a session gone bad is just too high.
12
I'm sorry this happened to your friend and I find it alarming. All studies have shown such an event to be an extreme rarity. As a chiropractic student who has been treated by many different chiropractors, and who grew up with a chiropractor as a father, I can almost certainly attribute an event like that to incompetency on the doctor's part. It is important to research and find a competent chiropractor with good reviews and results, just as you would not put your health in the hands of an incompetent MD with bad reviews.
3
While in college, I went to a chiropractor for upper back and neck stiffness and pain that had been nagging me for a few years. The first few treatments did help tremendously. But when the chiropractor encouraged me to continue with statements like "these next few treatments should help your acne" I said good bye. I really felt that was verging on quackery.
47
I weight train three times a week with a chiropractor as a partner. My father was an old-school surgeon who considered chiropractors as frauds. About a month ago, I was in the middle of a set, and felt that dreaded sensation in a small muscle in my back that meant I had strained something, it was going into spasm, and I was in for four days of walking funny and not working out.
I hobbled back to the bench where my partner, Eric, and my trainer were doing something else. I explained that I'd just injured something, and was going to have to end the workout. Eric literally laid me on a weight bench, adjusted me, and I actually felt the sound in my back as it took effect. Instant relief. Pain gone. I got up and finished the set, and the workout.
I'm now a convert. It can work. It really can.
I hobbled back to the bench where my partner, Eric, and my trainer were doing something else. I explained that I'd just injured something, and was going to have to end the workout. Eric literally laid me on a weight bench, adjusted me, and I actually felt the sound in my back as it took effect. Instant relief. Pain gone. I got up and finished the set, and the workout.
I'm now a convert. It can work. It really can.
83
"...along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective..."
The results of 29 studies on the efficacy of acupuncture were reported in a recent issue of Scientific American. The overwhelming conclusion was that, at best, the procedure provided slight diminution of pain because of the body's natural secretion of adenosine. Simply administering enzymes that induce the body to form adenosine achieved the same result. There's a good reason insurance companies don't pay for acupuncture treatments.
The results of 29 studies on the efficacy of acupuncture were reported in a recent issue of Scientific American. The overwhelming conclusion was that, at best, the procedure provided slight diminution of pain because of the body's natural secretion of adenosine. Simply administering enzymes that induce the body to form adenosine achieved the same result. There's a good reason insurance companies don't pay for acupuncture treatments.
33
I had the opposite experience. after a snowboarding accident left me in severe pain and a cervical collar for a month, with physical and medical therapy providing little relief for the pain and immobility, I tried accupuncture. 25 needles for 20 minutes, and I walked out pain free with complete mobility. some pain and stiffness returned after a week, but very little. Subsequent treatments by other practioners didn't help, but then they used very few needles and shorter times. I suspect the quality of the practioner has a great deal to donwith it.
1
Scientific America is a pop culture magazine. It is not a medical journal. I also could find no evidence of the retrospective study you mention. Finally, many insurers do cover acupuncture and by your logic it therefore must work!
This article really should point out that there are types of back pain that don't go away with time (e.g., autoinflammatory back pain caused by ankylosing spondylitis) and that people suffering from such conditions could be permanently damaged by a chiropractor's spinal manipulations.
69
Rupert, do you have proof of permanent damage by chiropractors? Have you read the research on this? If so, please provide some or any evidence to back up your claims. Thank you.
I would agree that manipulation can be very beneficial for many types of lower back pain but be aware that lower back pain has many different sources. Most are amenable to Chiropractic manipulation but some can be aggravated by manipulation. A good Chiropractor will be able to diagnose the different types and treat accordingly.
7
I agree Dr. Corenman. Like any professions competence varies from person to person.
I am married to a Chiropractor, and have received only Chiropractic care for the past 20 years. She treats much more than spinal dysfunction. In a world where 250,000 patients are dying annually from the correct prescription of medications in this country (not to mention the opiod epidemic) Chiropractics' track record is light years ahead in health care by comparison to allopathic physicians. In our practice we frequently see harm done by allopathic doctors. These patients do not go back to their practicioner so the doctor rarely hears about it.
Part of the benefits of Chiropractic care in addition to adjustments is learning how to live a healthy lifestyle. Diabetes, heart disease, and cancer are all largely lifestyle illnesses. No amount of care can overcome the amount of harm unhealthy lifestyles cause.
I am married to a Chiropractor, and have received only Chiropractic care for the past 20 years. She treats much more than spinal dysfunction. In a world where 250,000 patients are dying annually from the correct prescription of medications in this country (not to mention the opiod epidemic) Chiropractics' track record is light years ahead in health care by comparison to allopathic physicians. In our practice we frequently see harm done by allopathic doctors. These patients do not go back to their practicioner so the doctor rarely hears about it.
Part of the benefits of Chiropractic care in addition to adjustments is learning how to live a healthy lifestyle. Diabetes, heart disease, and cancer are all largely lifestyle illnesses. No amount of care can overcome the amount of harm unhealthy lifestyles cause.
When I was 27, a chiropractor broke my neck, specifically C-2, way up high by my brain. I nearly died on her table. She quit chiropractic as a result of this. With no advice at the time, I didn't sue. Now at 64, one ear is always numb and tingling, and my neck pain is constant.
Chiropractic has real risks. A doctor should first and foremost, do no harm.
Chiropractic has real risks. A doctor should first and foremost, do no harm.
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Sorry for your injury.
But, would you agree that ALL medical procedures carry risk? Iatrogenic deaths in America, or "death by medical intervention" is the #3 cause of death behind heart disease, and cancer.
I agree, a doctor should first and foremost, do no harm. This is not the case for "real doctors" in our current medical system.
Again, I'm very sorry for your injury. That is extremely saddening to hear and an extremely rare event. As the article states, not all chiropractors are created equally. Chiropractic does carry risk, but over 99% of the time the benefits far outweigh the risk. Government statistics confirm that conventional medical care is above and beyond more risky.
But, would you agree that ALL medical procedures carry risk? Iatrogenic deaths in America, or "death by medical intervention" is the #3 cause of death behind heart disease, and cancer.
I agree, a doctor should first and foremost, do no harm. This is not the case for "real doctors" in our current medical system.
Again, I'm very sorry for your injury. That is extremely saddening to hear and an extremely rare event. As the article states, not all chiropractors are created equally. Chiropractic does carry risk, but over 99% of the time the benefits far outweigh the risk. Government statistics confirm that conventional medical care is above and beyond more risky.
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Please provide evidence of this claim. What chiropractor "broke your neck" and you "nearly died"? Do you have the MRI report or pre/post X-rays available to defend your claim? I would love to see your proof. Because to break a cervical vertebra "specifically C2" it takes 1000-1250lbs of torque. If you have no proof to back of your claims then this comment is complete slander, just like the rest of your facebook page/comments. Also provide the "real risks" you talk about. I'll provide you with research that will completely hault all of these statements. If you have ANY proof at all please provide it to me [email protected]
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That's why this article specifically suggested his approval of chiropractic was limited to lower back pain. The C-spine is a much more dangerous area to "manipulate."
Last year I had a long episode (three months to recover, a relapse two months later) of debilitating back pain, acute sciatica. My MD at first attributed it to "out of shape guy tries to get in shape too fast." I didnt think it was that, but followed his prescription of total bed rest - like I could do anything else. With no improvement after a week, still in excruciating pain, I returned and was given a short course of steroids. Evidently that shrunk some of the inflammation, so I could stand more than 90 seconds without agony. But the MD had nothing else to offer as treatment. I found an acupuncturist who is also an MD, and experienced some relief from each session. My doctor and an orthopedic surgeon scoffed at acupuncture as "voodoo" but feeling better after being treated and holding the improvement seemed important to me. No doubt time helped me heal, but so did the acupuncture, while the drugs were the only arrow in the MD's quiver, and even that he was reluctant to prescribe without a waiting period, perhaps for insurance sake. Re-evaluating unconventional therapies is worthwhile.
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That first physician you had was a doozy. Total bed rest is far more likely to exacerbate the pain than to alleviate it. And steroids have been found to have no benefit.
As to acupuncture, I am a physician who practices acupuncture and despite what your doctors told you there is actually very good science on the way acupuncture relieves pain.
As to acupuncture, I am a physician who practices acupuncture and despite what your doctors told you there is actually very good science on the way acupuncture relieves pain.
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I was born with a very mild spinal defect called spondylolisthesis, of which I was unaware until I began experiencing intermittent but very significant lower back pain while still in my early 20's. I went to an orthopedist who properly diagnosed the condition and prescribed a wide plastic girdle and an opioid. I discontinued treatment pretty quickly.
After a particularly bad instance of my back "going out again" at the age of 27, I selected a local chiropractor out of the White Pages and I gently crab-walked to his office.
His adjustments relieved me immediately, and I did wind up buying into what a former commenter refers to as the "subscription-style" approach. The chiropractor referred to it as "prophylactic care."
I have been returning to that office ~ twice a week for these last 21 years. The friendships I have made there over 21 years are meaningful to me; however, the underlying reason for my visits is that I have had no significant recurrences of lower back pain.
I still get a sore lower back from time to time, but frankly, I'm a 48-year old who bicycles 200+ miles per week and otherwise sits to work so I'd be surprised if I didn't feel some strain occasionally. I honestly feel that my relationship to my chiropractor has not only saved me from pain but has fostered an environment conducive to continuing to be very active and recursively feel even healthier and more athletically ambitious.
I look forward to my visits and will see him later this morning!
After a particularly bad instance of my back "going out again" at the age of 27, I selected a local chiropractor out of the White Pages and I gently crab-walked to his office.
His adjustments relieved me immediately, and I did wind up buying into what a former commenter refers to as the "subscription-style" approach. The chiropractor referred to it as "prophylactic care."
I have been returning to that office ~ twice a week for these last 21 years. The friendships I have made there over 21 years are meaningful to me; however, the underlying reason for my visits is that I have had no significant recurrences of lower back pain.
I still get a sore lower back from time to time, but frankly, I'm a 48-year old who bicycles 200+ miles per week and otherwise sits to work so I'd be surprised if I didn't feel some strain occasionally. I honestly feel that my relationship to my chiropractor has not only saved me from pain but has fostered an environment conducive to continuing to be very active and recursively feel even healthier and more athletically ambitious.
I look forward to my visits and will see him later this morning!
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Twice a week for 21 years! That doesnt sound like its working if you have to keep going.
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Having suffered with recurrent low back pain for thirty years, when I was forty I was referred to an osteopath who practiced osteopathic manipulative therapy which is similar in many ways to what a chiropractor does. It changed my life. While I never got permanent relief, when I had renewed pain, a trip to the osteopath set me straight. They never promised a permanent cure, but when you're sore enough, even a few weeks or months of relief is worth the investment.
Now, living in Costa Rica, I have no access to an osteopath, but I do have two excellent chiropractors whom I see monthly for a massage and spinal adjustment. They always find something to set right. In the ten years that I've seen them, I've had almost no recurrence of pain and when I have, they have helped immensely. Sometimes, when I had very acute pain, their care has been assisted by a physical therapist.
And all this has been accomplished without the need for medication, surgery, a back brace, or any other "typical" therapy.
When in doubt, get a recommendation from a friend and give an osteopath or a chiropractor a try.
Now, living in Costa Rica, I have no access to an osteopath, but I do have two excellent chiropractors whom I see monthly for a massage and spinal adjustment. They always find something to set right. In the ten years that I've seen them, I've had almost no recurrence of pain and when I have, they have helped immensely. Sometimes, when I had very acute pain, their care has been assisted by a physical therapist.
And all this has been accomplished without the need for medication, surgery, a back brace, or any other "typical" therapy.
When in doubt, get a recommendation from a friend and give an osteopath or a chiropractor a try.
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For years I periodically consulted a chiropractor for relief of lower back pain. I did not accept the chiropractor's claims about the prophylactic benefits of spinal manipulation, and I really disliked the subscription-style sales approach. However, the treatment provided immediate short-term pain relief, and seemed to shorten the duration of my typical period of slowly waxing and waning back pain ... all without drugs.
Oddly enough, several years ago, I developed a life-altering sciatica problem. Simultaneously, the lower back pain ended. Because the reigning medical theory was that bulging vertebral discs were the cause of sciatica, I decided it might not be safe to experiment with chiropractic for treatment of that condition.
Oddly enough, several years ago, I developed a life-altering sciatica problem. Simultaneously, the lower back pain ended. Because the reigning medical theory was that bulging vertebral discs were the cause of sciatica, I decided it might not be safe to experiment with chiropractic for treatment of that condition.
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It is possible that sciatica is caused by bulging vertebral discs, you just don't feel it in your back.
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A disc bulge can be benefited with chiropractic care.
The real question is: WHY is the disc bulging?
Find the answer to this, correct the CAUSE, and allow the body to heal.
A great Chiropractor would be able to find this answer.
(ie: faulty gait, leg length inequality (funcitonal/structural), pelvic rotation...all of which will lead to postural and ambulatory compensations...causing a disc to "bulge".) good luck!
The real question is: WHY is the disc bulging?
Find the answer to this, correct the CAUSE, and allow the body to heal.
A great Chiropractor would be able to find this answer.
(ie: faulty gait, leg length inequality (funcitonal/structural), pelvic rotation...all of which will lead to postural and ambulatory compensations...causing a disc to "bulge".) good luck!
Curious why the article while mentioning different modalities fails to mention the Feldenkrais Method which has proven so effective for so many with back pain. Its gentle movements allows students to become aware of their particular near-muscular organization, thus helping them to help themselves to relieve pain.
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sp. correction- should be neuro-muscular, not near, oh the joys of auto spell check!
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I have benefited from chiropractic treatment of lower back pain. I would rather go to a physical therapist than a chiropractor. However, most of my insurance plans have been stingy about authorizing and covering physical therapy, while generously paying for chiropractic. As a result, I often use chiropractic as a "side door" to get physical therapy-style treatment from a chiropractor.
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Shop around and find a Chiro you prefer! Some are very similar to P.T.s...Chiropractors are very different from one another, and like any profession, there are good ones and bad ones.
If you visit a Chiro you do not like, don't assume that all chiropractors are of the same skill, philosophy, experience, and dedicaiton!
Leave that one, and move on to the next.
If you went to a bad dentist, you wouldn't write-off dentistry as a whole and claim it to be pseudo-science, would you? I hope not.
Good Luck!
If you visit a Chiro you do not like, don't assume that all chiropractors are of the same skill, philosophy, experience, and dedicaiton!
Leave that one, and move on to the next.
If you went to a bad dentist, you wouldn't write-off dentistry as a whole and claim it to be pseudo-science, would you? I hope not.
Good Luck!
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Insurance companies in MA are probably looking for "The Pooch" right now.
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Congrats - you are the beneficiary of aggressive antitrust litigation pursued by chiropractors years ago that literally forced their way into being treated as "real doctors" and getting insurance coverage. It's a shame our system works that way.
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When I had incapacitating back pain my sessions with a chiropractor made it worse, to the extent that he told me to stop coming. A spinal epidural also did not help. By the time I went to a surgeon for a second opinion, I could not sit, stand, or walk without excruciating pain. Surgery cured it from one day to the next. Now, years later, whenever I feel a twinge of back pain I redouble my back exercises, but I would not try a chiropractor. I realize that this is one anecdote, not a study.
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I thought I was the only one! Turned to a local chiropractor after 4 months of back pain accompanied by sciatica... and after physical therapy, epidural treatment, etc. Nice guy who in just a few weeks managed to make what was bad completely unendurable to the point where I went to an out of network spine surgeon. A couple microdiscectomies later, I still manage to mess myself up once or twice a year but a combination of basic maintenance exercises, OTC painkillers, liniments and a couple weeks of patience gets me back where I should be. No more risktaking for me.
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Over the years I tried several chiropractors for my lower back pain as well as pain related to the cervical spin. Each and every time, the first question was "what kind of insurance do you have?" from which they calculated how many times they could see me -- I had great insurance and before even examining me they were talking to me about 13 and 26 weeks of appointments. And each time the pain got worse and I stopped going after 1 or 2 sessions.
I enjoyed some very long lasting relief from epidural steroid injections but when the disk bulging just got too much I finally had surgery on both the lumbar and cervical spines, by a neuro-surgeon (I would never let an orthopedist near my spine) and so far have had permanent relief.
I wouldn't bring my dog to a chiropractor.
I enjoyed some very long lasting relief from epidural steroid injections but when the disk bulging just got too much I finally had surgery on both the lumbar and cervical spines, by a neuro-surgeon (I would never let an orthopedist near my spine) and so far have had permanent relief.
I wouldn't bring my dog to a chiropractor.
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