I just came across this website entitled 11 HARD QUESTIONS ABOUT CHIROPRACTIC PHYSICIANS. The title fascinated me; I am always in favour of addressing hard questions. I therefore read the 11 questions with interest; and I quite liked them. However, the answers provided by the author, a chiropractor of course, struck me as being more than a little uncritical towards chiropractic (feel free to click on the above link and see for yourself). Therefore, I decided to try my own answers (except for No 5). And then – being in the swing of it – I added a few more supplementary questions as well.
In other words, the first 11 questions are the ones posed by the chiro but the 4 additional ones are mine, and so are all the answers. Here we go:
Question No 1: What can a chiropractic physician do for me that another doctor can’t?
Nothing.
Question No 2: Does chiropractic therapy really work?
No. The best evidence available today fails to show that chiropractic spinal manipulations work for any condition. If one is generous, one might make an exception for back pain, but even for this symptom, the evidence is flimsy.
Question No 3: What other types of health problems can chiropractic treatment help?
None.
Question No 4: What does a chiropractic physician do to find my problem?
He/she often uses non-validated diagnostic techniques that are prone to give fantasy-results. You might also get extensive X-rays – mostly because the chiropractor wants to pay for the expensive equipment.
Question No 5: What therapies do chiropractic physicians use?
Chiropractic physicians may use manual and physical therapies including manipulation of the spine and joints of the arms and legs. Supportive therapies may also include massage, myofascial release, and therapeutic modalities such as ultrasound, electric stimulation and diathermy. Rehabilitative measures are often used such as specific corrective exercises to stabilize your problem. (This is the only answer I roughly agreed with, and I therefore left it unchanged.)
Question No 6: What is the standard length of treatment?
This depends mainly on the patient’s ability to pay. As a rule of thumb, as many treatments as possible will be given. Many chiros even advocate ‘maintenance treatment’ which means you receive regular spinal manipulations even when there is nothing wrong with you. The little porky they give you as an explanation is that this prevents future illnesses.
Question No 7: Is chiropractic care covered by insurance?
Because of very active lobbying by chiro interest groups, it may well be.
Question No 8: If I need a referral, how do I ask my doctor to refer me to a chiropractic physician?
Chiros are presently trying very hard to be accepted as ‘primary care physicians’; this means you can consult them directly without the need of a referral.
Question No 9: If I go see a chiropractor do I need to keep on going?
Only if you believe the nonsense about maintenance treatment they often tell you (see above) for which there is not a jot of convincing evidence.
Question No 10: What training do chiropractors have?
Not enough to realise that their spinal adjustments fail to generate more good than harm.
Question No 11: How should I select a good chiropractic physician?
If you are ill, it’s best to see are real doctor and avoid chiros.
AND NOW MY SUPPLEMENTARY QUESTIONS
No 1 Are chiros really physicians?
The definition of a physician is : ‘A person trained and licensed to practice medicine; a medical doctor’. Therefore, the answer is no.
No 2 What are the risks of spinal manipulations or adjustments, the main treatments used by chiros?
~50% of all patients have mild to moderate adverse effects that last 2-3 days.
In addition, several hundred cases of severe complications have been noted, including strokes and deaths.
No 3 How are such adverse outcomes monitored?
There is no effective monitoring system at all.
No 4 Is such an omission responsible or ethical?
No.
55 Responses to 11 Hard (and 4 very hard) Questions About Chiropractic Physicians
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Edzard’s first supplementary question gets to the crux of the problem:
“Are chiros really physicians?
The definition of a physician is : ‘A person trained and licensed to practice medicine; a medical doctor’.
Therefore, the answer is no.”
That’s it.
Anyone who uses the style or title ‘chiropractic physician’ has to explain why.
Are they intending to mislead, and dupe vulnerable and gullible patients?
Are they intending to secure funds from insurance companies or patients?
Are they not misselling their services as a physician whilst not being a physician?
Are they intending to defraud?
Are they practicing medicine without a licence?
Are regulatory authorities who fail to act on this issue complicit in a fraud?
Is that not unethical, immoral and a crime?
Just asking.
I practice in Tennessee and the Tennessee law lists us as chiropractic physicians.
0260-02-.02 SCOPE OF PRACTICE.
(1) Any person who possesses a valid unsuspended and unrevoked license issued by the Board has the right to use the title licensed chiropractic physician. No other person shall assume this title on any work, letter, sign, figure, advertisement, or device to indicate that the person using the same is a licensed chiropractic physician. The work performed includes offering case management procedures and recommendations for health care and services to the
public.
If you don’t like it, your fight is with the TN state legislature.
@ Richard Cole on Thursday 12 May 2016 at 01:33,
As explanation of the above, I refuse to address a chiro as “Doctor” simply because you are not.
“If you don’t like it, your fight is with the TN state legislature.”
Ah yes, the USA where freedom includes the right to sell anything, including high-power weapons to loons who then shoot many people. It also ensures some groups can title themselves with something they have not earned. I don’t include the USA in my list of civilised countries.
Richo, I’ve had a look at your website and you sell plenty of wu, including acupuncture. Let’s see;
http://colepaintherapygroup.com/our-team/dr-richard-cole/
This says you are qualified in Applied Kinesiology(1), Pediatrics(2), Radiology(3), and Neurology(4). This means you are qualified in;
(1) complete farcical nonsense,
(2) more complete farcical nonsense,
(3) something which takes real doctors about 10 years of education to attain, and
(4) ditto.
As a graduate of Palmer College, none of this surprises me. I can’t find any reference to subluxations, despite Palmer being one of the bastions of such crap.
When I see news reports about the US, I am always reminded; I never want to go there; it is a strange place; many people are very nice; and there are more wackjobs than you can poke a stick at (including you).
Seems like I’m the only one amazed at (I clicked on a link in the original article) JMPT:
The Journal of Manipulative and Physiological Therapeutics (JMPT) is the most respected and widely read chiropractic science journal in the world, and it is the only chiropractic journal indexed in Medline. JMPT is dedicated to the advancement of chiropractic health care. It taps into the latest information in chiropractic therapeutics and features high-quality, peer-reviewed journal articles and practical information for clinical settings.
JMPT is owned and produced by National University of Health Sciences in Lombard, Ill., and is published nine times per year by Elsevier, one of the world’s leading publishers of science and health information.
Price: $185
Honestly, if I had no idea about chiropractic, or hadn’t read any of your posts on this blog, I could have been convinced for its’efficacy just by the above sentences. Science! also: scary!
“…it is the only chiropractic journal indexed in Medline.”
I didn’t know that. Medline isn’t exactly the most selective database (it treads a fine line between being comprehensive and including only worthwhile science and it usually errs on the side of being comprehensive). So this datum is, for me, the most damning single fact to demonstrate that chiropractic is beyond the pale of reason.
@ Edzard
Can you explain the difference between chiropractic therapy and therapies used by chiropractic physicians?
@ AN Other on Sunday 08 May 2016 at 20:31
“@ Edzard
Can you explain the difference between chiropractic therapy and therapies used by chiropractic physicians?”
“AND NOW MY SUPPLEMENTARY QUESTIONS
No 1 Are chiros really physicians?
The definition of a physician is : ‘A person trained and licensed to practice medicine; a medical doctor’. Therefore, the answer is no.”
Fancy having to point out something so basic to you? Please read a post thoroughly before asking (more stupid) questions?
@ Frank
I was asking a question using the terms written in the article. I know that chiropractors are not physicians and I did read that in the article.
So, to help you answer the question i wrote i will re-phrase it:
Can you explain the difference between chiropractic therapy and therapies used by chiropractors?
p.s. can you answer it too Edzard
I think your question might be answered if you read Edzard’s book Trick ot Treatment. They talk about “straights” and “mixers”.
@ AN Other on Monday 09 May 2016 at 08:22,
If you don’t know what your question is, how do you expect anyone else to know? (It isn’t the first time either.)
Personally, I can’t see why the prof would bother.
The question hints at something and it doesn’t take Sherlock Holmes to see it. Chiros have been steadily stealing therapies and modalities from other professions in an attempt to legitimise the nonsense started by Palmer. That MIGHT happen when they stop being chiropractors and give up the unearned moniker of “doctor”. Until then, they are charlatans masquerading as health practitioners.
@ Frank
I knew what my question was, it was just you that took exception to the terms used.
Can you explain how a therapy or modality is stolen?
My point is that chiropractic is not a therapy or a modality. Spinal manipulation is a technique that is commonly used by chiropractors. I would say it is over utilised and misused by chiropractors more than other professions who use spinal manipulation. But chiropractic does not equal spinal manipulation.
Chiropractic is a profession that was founded on discredited theory misaligned vertebrae (subluxations) cause nerve interference and it is this that causes disease. Any chiropractor who practices on this basis is being dishonest and as you put it a charlatan.
A chiropractor should use any evidence based therapy as long as they use it in light of the biopsychosocial model of care and current basic science (e.g. pain physiology). This would mean using a wide variety of modalities not just one excessively. This approach should be applied by all the profession who deal with musculoskeletal complaints
@ AN Other on Monday 09 May 2016 at 11:19
“I knew what my question was, it was just you that took exception to the terms used.”
Oh christ, here we go again. I didn’t take “exception” to anything; your question was worded in a way that misrepresented what the prof had written. If the question has to be re-written to exact its original intention, it wasn’t well worded initially.
“Can you explain how a therapy or modality is stolen?”
Yep, it is self-evident and I ask; do I really need to spell it out? (However, knowing you, it will be necessary. Chiro started as innate intelligence and subluxations; where does the rest of their bag of tricks come from?)
“My point is that chiropractic is not a therapy or a modality. Spinal manipulation is a technique that is commonly used by chiropractors. I would say it is over utilised and misused by chiropractors more than other professions who use spinal manipulation. But chiropractic does not equal spinal manipulation.”
When did that deviation occur? Are you suggesting chiro is not defined by SM and they do not claim special powers in that area? Do other professions use the trade-mark thumpy-thumpy table, the handheld little clicky things, “applied kinesiology” (that always make me laugh, the stupidity of it), or artery tearing neck twists?
“Chiropractic is a profession that was founded on discredited theory misaligned vertebrae (subluxations) cause nerve interference and it is this that causes disease. Any chiropractor who practices on this basis is being dishonest and as you put it a charlatan.”
Bingo!
“A chiropractor should use any evidence based therapy as long as they use it in light of the biopsychosocial model of care and current basic science (e.g. pain physiology). This would mean using a wide variety of modalities not just one excessively. This approach should be applied by all the profession who deal with musculoskeletal complaints”
“biopsychosocial”? The one described by psychiatrist Niall McLaren;
“Since the collapse of the 19th century models (psychoanalysis, biologism and behaviourism), psychiatrists have been in search of a model that integrates the psyche and the soma. So keen has been their search that they embraced the so-called ‘biopsychosocial model’ without ever bothering to check its details. If, at any time over the last three decades, they had done so, they would have found it had none. This would have forced them into the embarrassing position of having to acknowledge that modern psychiatry is operating in a theoretical vacuum.”
Come on AN Other, are you a nurse, a social worker or some other allied health care person who thinks they are a doctor?
@ Frank
Where did I misrepresent what Prof Ernst had written?
“Yep, it is self-evident and I ask; do I really need to spell it out? (However, knowing you, it will be necessary. Chiro started as innate intelligence and subluxations; where does the rest of their bag of tricks come from?)”
Chiropractic theory started as innate intelligence and subluxations. That is not the same as the techniques (therapies or modailities) used by chiropractors.
“Do other professions use the trade-mark thumpy-thumpy table, the handheld little clicky things, “applied kinesiology” (that always make me laugh, the stupidity of it), or artery tearing neck twists?”
The simple answer to this question is yes, except for the thumpy table.
““biopsychosocial”? The one described by psychiatrist Niall McLaren;”
No – the one developed by Gordon Waddell – see below
In 1987, a physician by the name of Gordon Waddell published a paper entitled, “A New Clinical Model for the Treatment of Low-Back Pain”. This paper was well-received and won the 1987 Volvo Award in Clinical Sciences. The paper was revolutionary and provided a new theoretical framework for medical management of low back pain (due to Waddell’s increasing concern about medical mismanagement and patient disability). In this paper, Waddell proposed the notion that the biopsychosocial concept can be used as an operational model that explains many of our patient’s clinical presentations.
@ AN Other on Monday 09 May 2016 at 12:44
“Where did I misrepresent what Prof Ernst had written?”
You asked this when the prof clearly stated chiros are not physicians; “Can you explain the difference between chiropractic therapy and therapies used by chiropractic physicians?”. You’ve asked a similar questions before, maybe a couple of times.
“Chiropractic theory started as innate intelligence and subluxations. That is not the same as the techniques (therapies or modailities) used by chiropractors.”
I repeat;
When did that deviation occur? Are you suggesting chiro is not defined by SM and they do not claim special powers in that area?
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
“The simple answer to this question is yes, except for the thumpy table.”
You claim to know a great deal about chiros and other therapists, including that other manual therapists use the handheld clicky thing (Activator?) Where is this braod knowledge of yours derived? If you won’t answer, to use a crass idiom, I call bullsh!t.
““biopsychosocial”? The one described by psychiatrist Niall McLaren;”
No – the one developed by Gordon Waddell – see below
In 1987, a physician by the name of Gordon Waddell published a paper entitled, “A New Clinical Model for the Treatment of Low-Back Pain”. This paper was well-received and won the 1987 Volvo Award in Clinical Sciences. The paper was revolutionary and provided a new theoretical framework for medical management of low back pain (due to Waddell’s increasing concern about medical mismanagement and patient disability). In this paper, Waddell proposed the notion that the biopsychosocial concept can be used as an operational model that explains many of our patient’s clinical presentations.”
Yes, I read that, however, you have conveniently ignored the substantial criticism of the idea, including that it propagated psychosomatic illnesses and hypochondria.
I also repeat;
Come on AN Other, are you a nurse, a social worker or some other allied health care person who thinks they are a doctor?
@ Frank
How can misrepresent what Prof Ernst has written when he already explained that chiropractic physicians are not physicians. I am not stating in my question that Prof Ernst said chiropractors are physicians. All I was doing was just using terms that were part of the article to construct a question (which Prof Ernst still hasn’t answered).
Chiropractors do use spinal manipulation more than other manual therapists. However, using spinal manipulation does not make a chiropractor or chiropractic. It is the discredited chiropractic theory that makes a chiropractor and chiropractic not the therapy or modality being used.
So, for example, if a chiropractor just used exercises and said it was a way to cure all illnesses by the removal of subluxations and releasing their innate intelligence. That chiropractor would still be practicing nonsense, even though the therapy being used has an evidence base.
I answered this question before – I have worked with a variety of manual therapist including physios, osteos, massage therapists, chiros, acupuncturists etc.
I didn’t ignore the substantial criticism. There was no more to add except that it is a valid criticism of the biopsychosocial theory. However, it is still a widely used concept across a broad range of disciplines and it is used to address the variety of factors that can have an influence on someones illness.
Why does it matter that you need to know my occupation? Are you saying that I could only comment on things that I have direct experience or training in? Does it mean that no one should comment on something unless they are an expert in that field? Who decides whos an expert in a given field?
@ AN Other on Tuesday 10 May 2016 at 15:28
“How can misrepresent what Prof Ernst has written when he already explained that chiropractic physicians are not physicians. I am not stating in my question that Prof Ernst said chiropractors are physicians. All I was doing was just using terms that were part of the article to construct a question (which Prof Ernst still hasn’t answered).”
Is English your first language?
“Chiropractors do use spinal manipulation more than other manual therapists. However, using spinal manipulation does not make a chiropractor or chiropractic. It is the discredited chiropractic theory that makes a chiropractor and chiropractic not the therapy or modality being used.
So, for example, if a chiropractor just used exercises and said it was a way to cure all illnesses by the removal of subluxations and releasing their innate intelligence. That chiropractor would still be practicing nonsense, even though the therapy being used has an evidence base.”
Is there any chance you will answer the question?
“I answered this question before – I have worked with a variety of manual therapist including physios, osteos, massage therapists, chiros, acupuncturists etc.”
I still call bullshit. In order to have the knowledge you claim, you must have worked close enough to have witnessed the interaction between the patient (in the case of medically-based practitioners) and gullible (in the case of non-med) and the person dispensing the treatment, which leads to the question I asked about your occupation. Why and how were you so close and why for both med and non-med?
“I didn’t ignore the substantial criticism. There was no more to add except that it is a valid criticism of the biopsychosocial theory. However, it is still a widely used concept across a broad range of disciplines and it is used to address the variety of factors that can have an influence on someones illness.”
You put forward a statement as if it was totally accepted among all medical professionals, and it clearly and substantively is not. You quoted without regard for the criticisms. Is that balanced, truthful, or unbiased?
“Why does it matter that you need to know my occupation? Are you saying that I could only comment on things that I have direct experience or training in? Does it mean that no one should comment on something unless they are an expert in that field? Who decides whos an expert in a given field?”
Training in what? You have skin in this and I would like to know what it is. Your occupation would give an indication, or an explanation of your very close contact with that range of people would do.
I do wonder at your logic and command of language.
@ Frank
Which question have I not answered?
You can choose not to believe me but I have worked with a wide variety of professions – it is called multi-disciplinary practice.
Your initial reply to the mentioning of biopsychosocial (see post on Monday 9th May @ 11:19) was to produce a paragraph by Niall McLaren that was a criticism. Is that balanced, truthful, or unbiased?
I would also point out that I don’t think I implied that the biopsychosocial model was totally accepted amongst all medical professionals. As all theoretical models, there are supporters and crtitics, but I would suggest that the vast majority of medical professionals do apply the biopychosocial model in their clinical practice.
p.s. will you answer my long standing question to you – Is there evidence for spinal manipulation of the thoracic spine for thoracic spine pain?
@AN Other on Wednesday 11 May 2016 at 09:02
Which question have I not answered?
I repeat;
When did that deviation occur? Are you suggesting chiro is not defined by SM and they do not claim special powers in that area?
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
“You can choose not to believe me but I have worked with a wide variety of professions – it is called multi-disciplinary practice.”
I know what a “multi-disciplinary practice” is and I don’t need to tell me. The question is; why are you involved in a “multi-disciplinary practice”?
To repeat;
I still call bullshit. In order to have the knowledge you claim, you must have worked close enough to have witnessed the interaction between the patient (in the case of medically-based practitioners) and gullible (in the case of non-med) and the person dispensing the treatment, which leads to the question I asked about your occupation. Why and how were you so close and why for both med and non-med?
Training in what? You have skin in this and I would like to know what it is. Your occupation would give an indication, or an explanation of your very close contact with that range of people would do.
“Your initial reply to the mentioning of biopsychosocial (see post on Monday 9th May @ 11:19) was to produce a paragraph by Niall McLaren that was a criticism. Is that balanced, truthful, or unbiased?”
It was to produce some balance, introduce other relevant information, and try to counter your bias. It was to answer your assertion, without compromise, that it was the current model for patient interaction.
“I would also point out that I don’t think I implied that the biopsychosocial model was totally accepted amongst all medical professionals. As all theoretical models, there are supporters and crtitics, but I would suggest that the vast majority of medical professionals do apply the biopychosocial model in their clinical practice.”
No, of course not (guffaw). That is why you offered no view to the contrary.
“p.s. will you answer my long standing question to you – Is there evidence for spinal manipulation of the thoracic spine for thoracic spine pain?”
No, for the reasons I told you.
I still wonder at your logic and command of language.
@ Frank
I repeat;
When did that deviation occur? Are you suggesting chiro is not defined by SM and they do not claim special powers in that area?
There is no deviation – chiropractic is defined by its discredited theory not by its use of SM. Some chiropractors may say that their SM is unique to them but SM is just SM regardless of which profession performs it.
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
“You can choose not to believe me but I have worked with a wide variety of professions – it is called multi-disciplinary practice.”
I know what a “multi-disciplinary practice” is and I don’t need to tell me. The question is; why are you involved in a “multi-disciplinary practice”?
Why can’t I be involved in a multi-disciplinary practice?
To repeat;
I still call bullshit. In order to have the knowledge you claim, you must have worked close enough to have witnessed the interaction between the patient (in the case of medically-based practitioners) and gullible (in the case of non-med) and the person dispensing the treatment, which leads to the question I asked about your occupation. Why and how were you so close and why for both med and non-med?
Because I have worked with both med and non-med – see answer above
Training in what? You have skin in this and I would like to know what it is. Your occupation would give an indication, or an explanation of your very close contact with that range of people would do.
I still don’t see how my occupation is relevant. You seem to be very interested in these matters too. What is you occupation?
“Your initial reply to the mentioning of biopsychosocial (see post on Monday 9th May @ 11:19) was to produce a paragraph by Niall McLaren that was a criticism. Is that balanced, truthful, or unbiased?”
It was to produce some balance, introduce other relevant information, and try to counter your bias. It was to answer your assertion, without compromise, that it was the current model for patient interaction.
“I would also point out that I don’t think I implied that the biopsychosocial model was totally accepted amongst all medical professionals. As all theoretical models, there are supporters and crtitics, but I would suggest that the vast majority of medical professionals do apply the biopychosocial model in their clinical practice.”
No, of course not (guffaw). That is why you offered no view to the contrary.
I think I need to re-cap this part of the conversation. I initially mentioned biopsychosocial in the following context:
“A chiropractor should use any evidence based therapy as long as they use it in light of the biopsychosocial model of care and current basic science (e.g. pain physiology). This would mean using a wide variety of modalities not just one excessively. This approach should be applied by all the profession who deal with musculoskeletal complaints”
Your reply was as follows:
“biopsychosocial”? The one described by psychiatrist Niall McLaren;
“Since the collapse of the 19th century models (psychoanalysis, biologism and behaviourism), psychiatrists have been in search of a model that integrates the psyche and the soma. So keen has been their search that they embraced the so-called ‘biopsychosocial model’ without ever bothering to check its details. If, at any time over the last three decades, they had done so, they would have found it had none. This would have forced them into the embarrassing position of having to acknowledge that modern psychiatry is operating in a theoretical vacuum.”
How is this reply balanced, truthful, or unbiased? Also were was my bias in my first use of biopsychosocial?
“p.s. will you answer my long standing question to you – Is there evidence for spinal manipulation of the thoracic spine for thoracic spine pain?”
No, for the reasons I told you.
What were those reasons? Was it because you couldn’t find any evidence for spinal manipulation of the thoracic spine for thoracic spine pain? Is the fact that you had treatment which has no evidence base particularly embarrassing for someone who is all about logic and evidence?
AN Other on Wednesday 11 May 2016 at 11:00
“There is no deviation – chiropractic is defined by its discredited theory not by its use of SM. Some chiropractors may say that their SM is unique to them but SM is just SM regardless of which profession performs it.”
I repeat;
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
“Why can’t I be involved in a multi-disciplinary practice?”
I didn’t suggest you couldn’t; my question was why? I do suspect you were the receptionist or practice manager.
“I still don’t see how my occupation is relevant. You seem to be very interested in these matters too. What is you occupation?”
I am interested for the reasons I said but you seem to ignore as if the question did not exist.
“How is this reply balanced, truthful, or unbiased? Also were was my bias in my first use of biopsychosocial?”
Seriously, do you have a problem with comprehension? I have asked this question before, perhaps more than once. I repeat; you presented a concept as if it was universally accepted but it is not. I pointed this out with a quote but you still don’t seem to understand. What does it take? You read what you want to see, not process the text in front of your eyes.
If I was to take a punt, I would guess you are a woman and you were the receptionist. To be blunt, I don’t think you are smart enough to have completed any tertiary education, even though the alt-med is not real education.
Quote:___________________________________________________________________________________
“p.s. will you answer my long standing question to you – Is there evidence for spinal manipulation of the thoracic spine for thoracic spine pain?”
No, for the reasons I told you.
What were those reasons? Was it because you couldn’t find any evidence for spinal manipulation of the thoracic spine for thoracic spine pain? Is the fact that you had treatment which has no evidence base particularly embarrassing for someone who is all about logic and evidence?
_______________________________________________________________________________________
Let me recap; it was more than 20 years ago before I became aware of the importance of evidence, but I told you that already. Is it embarrassing? No, because the fellow was a physiotherapist and had extensive experience, including with an Australian Rules Football team where he was the team physio. Watch Aussie Rules once and then tell me physios lack skills. It is the best and hardest football code in the world.
I did go to a chiro about 32 years ago for sciatica down the right leg, on a suggestion from someone I thought I could trust. The chiro X-rayed, said I had a disc problem (I knew that already given the intense pain), and treated me on the thumpy-thumpy table, to no avail unless you could count exacerbating the problem enough to make me not able to walk. I was referred to a neurosurgeon by my doctor who had an MRI done, since a disc lesion would NOT show on an X-ray. All those years later, a laminectomy at L5-S1 and no pain since.
Medicine – 1, chiro – 0.
Unless you have something sensible to say, don’t expect anything further from me.
@ Frank
“There is no deviation – chiropractic is defined by its discredited theory not by its use of SM. Some chiropractors may say that their SM is unique to them but SM is just SM regardless of which profession performs it.”
I repeat;
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
OK – lets take spinal manipulation and mobilisation. This was used as far back as ancient Greek times, so that where it comes from.
“Why can’t I be involved in a multi-disciplinary practice?”
I didn’t suggest you couldn’t; my question was why? I do suspect you were the receptionist or practice manager.
The reason I work at a multi-disciplinary practice is because I want to.
“I still don’t see how my occupation is relevant. You seem to be very interested in these matters too. What is you occupation?”
I am interested for the reasons I said but you seem to ignore as if the question did not exist.
You reasons are not relevant and I can’t see how my above reply is ignoring the question.
“How is this reply balanced, truthful, or unbiased? Also where was my bias in my first use of biopsychosocial?”
Seriously, do you have a problem with comprehension? I have asked this question before, perhaps more than once. I repeat; you presented a concept as if it was universally accepted but it is not. I pointed this out with a quote but you still don’t seem to understand. What does it take? You read what you want to see, not process the text in front of your eyes.
You seem to have the same issue – you read what you want and not process the text in front of your eyes! Please quote exactly where I presented a concept as if it was universally accepted.
“p.s. will you answer my long standing question to you – Is there evidence for spinal manipulation of the thoracic spine for thoracic spine pain?”
No, for the reasons I told you.
What were those reasons? Was it because you couldn’t find any evidence for spinal manipulation of the thoracic spine for thoracic spine pain? Is the fact that you had treatment which has no evidence base particularly embarrassing for someone who is all about logic and evidence?
_____________________________________________________________________
“Let me recap; it was more than 20 years ago before I became aware of the importance of evidence, but I told you that already. Is it embarrassing? No, because the fellow was a physiotherapist and had extensive experience, including with an Australian Rules Football team where he was the team physio. Watch Aussie Rules once and then tell me physios lack skills. It is the best and hardest football code in the world.”
You have never told me it was 20 years ago and I would like to see the evidence that you did. What is the most dangerous thing a clinician can say – “in my experience”. Also, your adulation of Aussie Rules and the fact that you got better, doesn’t mean that the physio you saw was right to use the treatment he did. That’s why you have evidence.
“I did go to a chiro about 32 years ago for sciatica down the right leg, on a suggestion from someone I thought I could trust. The chiro X-rayed, said I had a disc problem (I knew that already given the intense pain), and treated me on the thumpy-thumpy table, to no avail unless you could count exacerbating the problem enough to make me not able to walk. I was referred to a neurosurgeon by my doctor who had an MRI done, since a disc lesion would NOT show on an X-ray. All those years later, a laminectomy at L5-S1 and no pain since.”
Your anecdote regarding you low back pain with right leg pain seems to have inconsistencies. You have mentioned that this happened 30 plus years ago, that’s about 1985. Australia did not get its first MRI until 1986 – how did you have a MRI, when it wasn’t in Australia? Also, when you have talked about this episode in past discussions, you said “the chiropractor took x-rays and didn’t find the two ruptures”. This statement implies that at this time you didn’t know that x-rays would not show the intervertebral disc. Now you seem to know this.
In addition, the intensity of pain doesn’t correlate with structure (disc) or severity of the injury i.e. hurt doesn’t equal harm.
@ AN Other on Friday 13 May 2016 at 17:13,
Well, the only thing you got right is about the MRI. It was a CAT scan, my mistake. It was nearly 32 years ago.
“You have never told me it was 20 years ago and I would like to see the evidence that you did.”
No interest. You have a selective memory anyway.
“Also, when you have talked about this episode in past discussions, you said “the chiropractor took x-rays and didn’t find the two ruptures”. This statement implies that at this time you didn’t know that x-rays would not show the intervertebral disc. Now you seem to know this.”
No, it means that the chiro didn’t find the two ruptures that the neurosurgeon found and hooked out with “a bit of wire” (his words). I knew there was a disc problem because I had severe sciatica. The chiro took X-rays because she could, not because she thought she could find anything. In retrospect, the idea that chiro thumping could do anything to alleviate sciatic pain is silly.
“Also, your adulation of Aussie Rules and the fact that you got better, doesn’t mean that the physio you saw was right to use the treatment he did. That’s why you have evidence.”
Oh, for christ’s sake, stop the emotive crap (you are, indeed, a woman); I enjoy Aussie Rules, adulation is a word used as a pejorative and you know it.
“The reason I work at a multi-disciplinary practice is because I want to.”
For someone who works at a “multi-disciplinary practice” which has witchcraft in it, you are big on evidence but prepared to sell your supposed principles for cash.
“In addition, the intensity of pain doesn’t correlate with structure (disc) or severity of the injury i.e. hurt doesn’t equal harm.”
Thanks doc, for your dose of folksy wisdom. Did the chiro at the “multi-disciplinary practice” tell you that?
“You seem to have the same issue – you read what you want and not process the text in front of your eyes! Please quote exactly where I presented a concept as if it was universally accepted.”
I already have.
“I repeat;
The “therapies and modalities” used by chiros didn’t just appear by magic; where did they come from? It certainly isn’t research because they don’t do any research, apart from pointless concoctions to justify chiro, and certainly not anything meaningful.
OK – lets take spinal manipulation and mobilisation. This was used as far back as ancient Greek times, so that where it comes from.”
Oh gawd, you are obtuse; the question was posed in the context of chiro, not within written history. When, and from where, did these treatments appear in chiro?
At least we have established a couple of things; you are a woman, you are a receptionist, you have a selective memory, you are Australian but probably live in NSW or Queensland, and you are a hypocrite.
“Unless you have something sensible to say, don’t expect anything further from me.”
I’m done. Stalk someone else.
@ Frank
“Well, the only thing you got right is about the MRI. It was a CAT scan, my mistake. It was nearly 32 years ago.”
You have never told me it was 20 years ago and I would like to see the evidence that you did.
“No interest. You have a selective memory anyway.”
It seems to me that you have a selective memory. You are able to remember exact words from your neurosurgeon (see below) but you can’t remember the imaging technique used to guide the operation.
“No, it means that the chiro didn’t find the two ruptures that the neurosurgeon found and hooked out with “a bit of wire” (his words). I knew there was a disc problem because I had severe sciatica. The chiro took X-rays because she could, not because she thought she could find anything. In retrospect, the idea that chiro thumping could do anything to alleviate sciatic pain is silly.”
The chiro may have used a treatment that may not have been helpful for disc problems. But the chiro did diagnose that you had a disc problem. Also, you can only guess that you had a disc problem, you wouldn’t have known this just by your severe leg pain.
“Also, your adulation of Aussie Rules and the fact that you got better, doesn’t mean that the physio you saw was right to use the treatment he did. That’s why you have evidence.”
“Oh, for christ’s sake, stop the emotive crap (you are, indeed, a woman); I enjoy Aussie Rules, adulation is a word used as a pejorative and you know it.”
You seem to have a low and stereotypical view of women. Also someone who says this about Aussie Rules “It is the best and hardest football code in the world.” doesn’t just enjoy that sport, they love it. Therefore, I would say the use of adulation was appropriate.
“In addition, the intensity of pain doesn’t correlate with structure (disc) or severity of the injury i.e. hurt doesn’t equal harm.”
Thanks doc, for your dose of folksy wisdom. Did the chiro at the “multi-disciplinary practice” tell you that?
No. I learnt that from Professor Peter O’Sullivan, Professor Lorimer Moseley and Louis Gifford.
“At least we have established a couple of things; you are a woman, you are a receptionist, you have a selective memory, you are Australian but probably live in NSW or Queensland, and you are a hypocrite.”
“Unless you have something sensible to say, don’t expect anything further from me.”
“I’m done. Stalk someone else.”
Again you have guessed things and have established nothing. The only thing you got right is that you are done – your credibility that is.
I have another hard question for this so-called “chiropractic physician”; why are you treating babies?
http://colepaintherapygroup.com/4-myths-of-pediatric-chiropractic-chiropractic-for-babies-and-children/
@Richard Rawlins
Agree with all your points! also add the abuse of the title “Doctor (of chiropractic)”. Pisses me off bigtime!
Now to answer the questions above!
Q1. Chronic back pain and musculoskeletal pain. Chronic pain is poory managed by general practicioners who also do not like seeing it in practice! Happy to cite papers which are organized on my desktop into 140+ folders. 1 minute copy and paste! Papers are pro, con, range from low – high quality and primarily from the last few years! The list will be rather long though but if you ask for it?
Q2. Again happy to cite evidence. As for low back pain I mirrored your view Edzard until I read the 2008 special supplement of The Spine Journal titled “Evidence-Informed management of chronic low back pain with….”
http://www.ncbi.nlm.nih.gov/pubmed/?term=Evidence-informed+management+of+chronic+low+back+pain+Spine+J
It has articles written by experts on each approach that were then compiled by Scott Haldeman (Chiro, MD, PhD, Neurologist).
Now I am equally skeptical on all approaches. The evidence base for chiropractic is equal or better that other approaches so the next question is the cost/benefit and the risk benefit and again chiropractic stacks up well!
Some recent papers on cost may be of interets:
http://www.jmptonline.org/article/S0161-4754%2816%2900055-5/abstract
http://www.jmptonline.org/article/S0161-4754%2816%2900054-3/abstract
http://www.jmptonline.org/article/S0161-4754%2816%2900053-1/abstract
Q3. If its for mythical subluxations then yes the answer is none! For common conditions listed on the website then yes we can help!
Q4. If it is looking for mythical subluxations with techniques like AK, SOT, NET, Not etc then I agree with you. If it is utilizing standard orthopedic and neurological tests combined with feedback from the patient to put them into context that leads to a diagnosis, prognosis, care plan and rehab with agreed upon time frames then I disagree with you! As for X-rays, the guidelines here are very clear. There must be a valid clinical reason like trauma, rule out contraindications/red flags etc! Blanket screening for subluxations is not one of them!
Q5. I would have to disagree with you on this one Edzard. Ultrasound, electric stimulation and diathermy have scant evidence to support their use! Some physio’s cling to them but the majority are abandoning them! Some chiro’s utilize them but their numbers is small!
Q6. The answer here is on average 8 visits. One of the private health insurer here HCF sends me a quarterly summary of my services with comparisons to the average utilization cost etc. Interesting tabilation. This number matches research studies! I do not support maintenence for removal of subluxations. That is a toxic dependent relationship! Chronic pain management that aims at making the patient independent is what I aim for ASAP!
Q7. In the poltics of medicine I am happy that my association is lobbying! Otherwise the doctors would eat us alive!
Q8. We are already primary contact practitioners. Getting onto a doctors referral network is a different. Doctors do not refer lightly as it reflects straight back on them so developing this trust took me years. They also hold me accountable which is important!
Q9. Treatment is about making the patient independent not dependent. The practice management guru’s are one of my major pet hates!
Q10. Due diligence! I have had this conversation with Blue many times. Check thier website and make inquiries. Its no different for selecting a GP of physio! Good and bad in every profession. The doctors who refer to me are aware of the different factions within chiropractic and my new patients are also better informed than most on this blog realize!
Q11. If its chronic pain see a chiro or physio first as GP’s do not handle back pain very well and do not like seeing it in their practices!
Bonus Q’s
Q1. See reply to Richard !
Q2 & 3. %0% temporary soreness matches similar studies done by the physio’s and is also part of my mandatory Informed Consent! Not an issue!
As for Adverse Events this recent systematic review and meta-analysis by neurosurgeons is interesting!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/
I don’t agree with the title but it should stimulate an interesting debate! The neurosurgeons also talk about the poor quality and high risk of bias of the case reports. Thats medical bias not chiropractic! This paper shows the need for an accurate and systematic adverse event reporting system which I support 100%!
An adverse event reporting system was discussed here 2 years ago:
https://www.mja.com.au/insight/2014/7/support-chiropractor-reporting
Recently talked to a medical specialist on what had become of the AE reporting system and he replied that there was “snivelling” from the hospitals about who would pay for it and it went no further! As you can see from the articles discussion there is no AE reporting for Chiro, ostoe, physio, GP’s in private practice etc. It is needed by all. Chiropractic has just highlighted the issue.
Q4. I agree! Needed by all!
Critical Chiro wrote: “Q7. In the poltics of medicine I am happy that my association is lobbying! Otherwise the doctors would eat us alive!” Why might that be?
Critical_Chiro wrote: “The evidence base for chiropractic is equal or better that other approaches so the next question is the cost/benefit and the risk benefit and again chiropractic stacks up well!”
No it doesn’t.
Quote
“Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them (11). And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment.”
Ref: Spinal manipulation for the early management of persistent non-specific low back pain — a critique of the recent NICE guidelines, Edzard Ernst, Int J Clin Pract (18th August 2009).
Reference (11) is Ernst E. Chiropractic: a critical evaluation. J Pain Sympt Man 2008; 35: 544–62. Page 6 of the paper mentions a report that indicates that only 11% of all cervical manipulations are “appropriate” and gives the reference Coulter I, Hurwitz E, Adams A, et al. The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND, 1996:18e43.
In other words, there are no standards in chiropractic. As has been said before, if chiropractic spinal manipulation were drug, it would almost certainly have been taken off the market.
@BW
If you look at The Spine Journal link in my post there is an article by Scott Haldeman where he tabulates the evidence behind all approaches for treating chronic low back pain, not all the approaches for mythical subluxations!
There are standards in chiropractic especially in regards to education with accreditation of education institutions by CCEA, ECCE and CCE. The failure of Barcelone and McTimony to gain accreditation is a good sign. The subluxationists peddle their BS outside the universities at tripe fests like Rubicon, Edinburgh Lectures etc. I think their biggest fear is reform and legislation that enforces modern standards being shoved down their throats. I’m all for this approach as reasoning with them has not worked and this is where the critics like you, Edzard, Frank + Frank etc are important! Critics are needed to point out the BS and they can help add weight to reform. As I have said before there are 20 odd high priests of the BS church that present at all the Tripe Fests. Targeting these individuals and not their camp followers will diminish their influence and aid reform!
@FO
Medicine is politics Frank! I have grown up in a medical family where I have witnessed the guerilla warfare constantly going on between doctors. Unit versus unit, registrars protecting their own beds while trying to slip a patient into another departments bed, hospital versus hospital, battles for theatre time, battles with polititians etc. Doctors are political animals and they play the game and especially the press like a Stradivarius! Health is their game and we have to play by their rules which means lobbying and pushing your professions case and playing politics!
Critical_Chiro wrote: “There are standards in chiropractic especially in regards to education with accreditation of education institutions by CCEA, ECCE and CCE. The failure of Barcelone and McTimony to gain accreditation is a good sign.”
I don’t know about the CCEA or the CCE, but the ECCE’s standards are questionable. Firstly, it has no statutory powers. Secondly, on appeal, it recently reviewed its refusal to accredit the McTimoney College of Chiropractic. A report of the appeal’s findings has been sent to the ECCE’s Commission on Accreditation and a decision is awaited. If it ultimately approves accreditation for the McTimoney College of Chiropractic, it will serve only to further condone chiropractic quackery that is already rife in Europe.
Embedded references regarding the above can be accessed here:
http://www.zenosblog.com/2016/02/the-scotland-college-of-chiropractic-out-of-kilter-with-science/
@C_C
Sure, I know about medical politics. But you wrote: “In the poltics of medicine I am happy that my association is lobbying! Otherwise the doctors would eat us alive!” That seems a stark contrast from your often repeated assertion that doctors refer lots of their patients to you, to the point of relying on your services. Could it be that deep down you recognize chiropractic is evidence-free, crackpot quackery? And most real doctors know that?
@BW
Lets wait and see!
@FO
Not really Frank, the internal politics in medicine is vicious! The doctors I refer to and who refer to me are very aware of the politics. The recent RACGP article is an example! I discussed this article with my doctors immediately after it came out and every one of them responded with “medical politics, we’re happy with you!” I communicate with my doctors so they understand what I do is coming from me and not sweeping statements from the RACGP! The RACGP has just started a $2.5 million advertising campaign that is annoying the majority of GP’s that are not members. It implies that if you are not a member then you are not up to date and doing ongoing education!
“Could it be that deep down you recognize chiropractic is evidence-free, crackpot quackery? And most real doctors know that?”
Carpet bombing Again!
You are ignoring chiropractics evidence base! It matches and exceeds other approaches for the treatment of chronic back pain, see the reference above to the 2008 Spine Journal! If it is for mythical subluxations then I agree with your evidence free, crackpot quackery! As I have said before, doctors do not refer lightly. They know how I practice, I give them detailed reports and we stay in constant communication. You do not appreciate the level of accountability that doctors wield and how difficult it is for a chiro, physio or specialist to get onto their referral network!
“And most real doctors know that?”
So if a doctor refers to a chiro then they are not real doctors or are you are referring to dickhead chiro’s who abuse the title ” doctor”? (One of my major pet hates!)
“There is no effective monitoring system at all.”
How did you ethically and responsibly come up with “~50% of all patients have mild to moderate adverse effects that last 2-3 days.”, if there is no effective monitoring system?
because there are large prospective studies [by chiros] that show this to be so.
I see. It’s not ~50% of all patients, it’s ~50% of folks involved in some large prospective studies [by chiros]. Thanks.
if the studies are multiple, come up with the same figures and are large enough [which they were] the two can be assumed to be the same.
@ jm on Monday 09 May 2016 at 07:41
You never miss an opportunity to display your ignorance.
How do YOU think research works? Does everyone who has a treatment need to be asked? Do you think all of the statistics courses in universities are a waste of time and should be shut down?
Ok, so I should read it as “~50% of all patients are assumed to have mild to moderate adverse effects that last 2-3 days, based on some large prospective studies [by chiros].” Again, thanks.
You don’t know how science works so not knowing anything about a key oart of it is no surprise.
Despite this, you are still prepared to make such asinine remarks. You reap the benefits of science every day but are devoid of any understanding of it.
Can you please check this video and tell me if this is all fake : https://www.youtube.com/watch?v=tbgjIba1A7c
Please watch this video too : https://www.youtube.com/watch?v=2IU9emzBDRA
Please watch it and tell me if the subjects in this video are actors or not ? also what do you suggest for these people ( given they’re not acting) . would medication help in this situation ?
Thanks,
-Bill
@ Bill on Monday 09 May 2016 at 20:53,
The idiot (err, chiro) who made these stupid videos is in hot water for treating babies. It looks like actors but who knows? The Indian fellow is supposed to be in pain but there is no sign of it. When I had sciatica, every movement (even smiling) was painful, not so him.
As for finding a subluxation, he will get a Nobel Prize because no one has ever found one before. Interestingly, although it is supposed to be a subluxation, he then describes a pocket of water under the skin which is not a displacement of the spine which a subluxation is supposed to be. This peanut makes things up as he goes along, even if it is complete nonsense.
Either of both should have seen a doctor and/or a physiotherapist, instead of a witchdoctor.
@FC
The adolescent who injured his back and saw that chiro was in pain for 4 months and had exhausted all other approaches (doctors and physio!) I see this type of patient regularly in my practice and when communicating with their doctors I discuss the diagnosis and it most definitely NOT subluxation!
When that chiro first started posting those video’s I rang his practice and told him that if he obtained the patients consent then it is a testimonial which is banned by the regulators. If there is no signed consent then it violates patient confidentiality. Either way its not on and he should take them down. Even after all that has happened they are still up on YouTube but since they are probably the main marketing tool for his practice, not unexpected! Idiot!
“The adolescent who injured his back and saw that chiro was in pain for 4 months and had exhausted all other approaches (doctors and physio!)”
You know this for a fact? Corroborating evidence?
@ Frank Collins,
Frankly I have to say that you seem a little bit biased against Chiropractors , I’m not a chiro nor a doctor ..but I see a chiro for back problems and it helps a lot .
I tried the other approach , the medication approach and I prefer the chiro care vs the medication.
I think the main problem is a communication and trust problem between MDs and Chiros and vice-versa. I think there are benefits for Spinal manipulations like it or not.
Now I agree some chiros thinks that they know all , but this applies to some MDs I encountered… I think the MDs and Chiros need to work together and not against each other… any criticism needs to be constructive and not just try to call the other idiots ..and other names…
I lived in Europe where I used to see osteopaths and here in the US I see chiros both provide me with needed care…
Maybe you are a seasoned doctor and you may have had bad experience with chiros …mine was positive though i’m very skeptic and I like to dig into things…and again out there there are bad MD/Chiro/Dentist…etc…
and what about the evidence? don’t you think that it is rather more important than what you are referring to?
If you need published evidence to figure out how physical medicine is affecting you…perhaps some training & practice is in order. Most folks can tell if their back feels better after being worked on. Bill seems to have a good handle on that.
@ Bill on Wednesday 11 May 2016 at 18:11
“Frankly I have to say that you seem a little bit biased against Chiropractors”
Yep, because it is a crock of shite, without virtually any evidence to support any of it. Plus, chiros claim to be able to cure diseases, some of which medicine does not know the cause.
“I’m not a chiro nor a doctor ..but I see a chiro for back problems and it helps a lot .
I tried the other approach , the medication approach and I prefer the chiro care vs the medication.”
An anecdote and worthless. https://en.wikipedia.org/wiki/Anecdotal_evidence
“I think the main problem is a communication and trust problem between MDs and Chiros and vice-versa. I think there are benefits for Spinal manipulations like it or not.”
Why would a doctor (a real one) “trust” a chiro? Again; https://en.wikipedia.org/wiki/Anecdotal_evidence
“Now I agree some chiros thinks that they know all , but this applies to some MDs I encountered… I think the MDs and Chiros need to work together and not against each other… any criticism needs to be constructive and not just try to call the other idiots ..and other names…”
https://www.logicallyfallacious.com/tools/lp/Bo/LogicalFallacies/97/Faulty_Comparison
https://en.wikipedia.org/wiki/False_dilemma
And probably others but I am running out of time.
“I lived in Europe where I used to see osteopaths and here in the US I see chiros both provide me with needed care…”
An anecdote. https://en.wikipedia.org/wiki/Anecdotal_evidence You have a prior, unsurprisingly.
“Maybe you are a seasoned doctor and you may have had bad experience with chiros …mine was positive though i’m very skeptic and I like to dig into things…and again out there there are bad MD/Chiro/Dentist…etc…”
Wrong assumption to start with.
https://en.wikipedia.org/wiki/False_dilemma
Bill, you are not a sceptic or you wouldn’t have written what you did. You may like to believe you are a critical thinker but the evidence is clearly to the contrary
@ jm on Wednesday 11 May 2016 at 20:35,
“If you need published evidence to figure out how physical medicine is affecting you…perhaps some training & practice is in order.”
As usual, you misunderstood simple prose. No surprise.
“Most folks can tell if their back feels better after being worked on. Bill seems to have a good handle on that.”
https://en.wikipedia.org/wiki/Anecdotal_evidence
The link is for other people who might read this post. It is wasted on alt-meds like jm, who believe they can “feel” the universe.
Of course it’s anecdote, Frank. Bill was relaying his personal experience. And yes, crazy as it seems – Bill (and most people) are fully capable of “feeling” their backs. It’s not mysticism – you don’t have to throw the bones to tell if your back hurts, or whether or not physical manipulations makes you feel better.
@ jm on Friday 13 May 2016 at 05:17
“Of course it’s anecdote, Frank. Bill was relaying his personal experience. And yes, crazy as it seems – Bill (and most people) are fully capable of “feeling” their backs. It’s not mysticism – you don’t have to throw the bones to tell if your back hurts, or whether or not physical manipulations makes you feel better.”
Again jm, you don’t lose an opportunity to display your ignorance, despite being informed about a subject time and time again.
https://simple.wikipedia.org/wiki/Placebo
https://en.wikipedia.org/wiki/Placebo
https://en.wikipedia.org/wiki/Halo_effect
Surely, you can’t be as dopey as you seem.
@Edzard
let the medical community work on it …
I’m a patient so the evidence I need is when my back pain goes away and i’m breathing better… but I don’t discount the benefits of SM because I “yet” don’t have the full evidence..
Another question : Do you also consider osteopathy as quackery ? if no/yes what’s the difference between DOs/Chiros beside DOs power to prescribe meds ? I have experience with both and I get very similar results..
Again i’m only trying to learn and hope in a constructive discussion ( also planning to buy your book) since i’m interested in alternative medicine.
osteopathy is very different in the US than it is in the UK or the rest of Europe. therefore, your question is unanswerable in just a few sentences.
Hopefully will see an article in future answering that on your blog.
This is a good point Edzard, Bill was referring to back problems, and as you are aware most National Guidelines recommend spinal manipulation and other treatments such as exercise and lifestyle advice, treatments commonly delivered by chiropractors. Indeed, in the UK two independent NICE guideline groups have come to this conclusion regarding effective treatments and recognise that chiropractors can play a role delivering this type of care.
Chiropractors and osteopaths have to work together. Let me recommend you a book written by F. Ricard and it could be very helpful. It is called “OSTEOPATHIC TREATMENT OF THE LOW BACK PAIN AND SCIATICA CAUSED BY DISC PROLAPSE”. You will find more information here: http://medoslibrosalud.com/en/osteopathy/114-osteopathic-treatment-of-the-low-back-pain-and-sciatica-caused-by-disc-prolapse.html
All the best!
The problem for chiropractors is that the 99% who are rapacious charlatans give the 1% a bad name.
The best advice to any chiropractor who wants to be viewed as a member of civilised society is: Retrain as a physiotherapist.