MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Central retinal artery occlusion, nystagmus, Wallenberg syndrome, ophthalmoplegia, Horner syndrome, loss of vision,  diplopia, and ptosis are all amongst the eye-related problems that have been associated with chiropractic upper spinal manipulations. Often the damage leaves a permanent deficit – happily, not in this instance.

US ophthalmologists published the case of a 59-year-old Caucasian female who presented with the acute, painless constant appearance of three spots in her vision immediately after a chiropractor performed cervical spinal manipulation using the high-velocity, low-amplitude technique. The patient described the spots as “tadpoles” that were constantly present in her vision. She noted the first spot while driving home immediately following a chiropractor neck adjustment, and became more aware that there were two additional spots the following day.

Slit lamp examination of the right eye demonstrated multiple unilateral pre-retinal haemorrhages with three present inferiorly along with a haemorrhage over the optic nerve and a shallow, incomplete posterior vitreous detachment. Optical Coherence Tomography (OCT) demonstrated the pre-retinal location of the haemorrhage.

These haemorrhages resolved within two months.

The specialists concluded that chiropractor neck manipulation has previously been reported leading to complications related to the carotid artery and arterial plaques. This presents the first case of multiple unilateral pre-retinal haemorrhages immediately following chiropractic neck manipulation. This suggests that chiropractor spinal adjustment can not only affect the carotid artery, but also could lead to pre-retinal haemorrhages.

In the discussion section of their paper, the authors stated: Upper spinal manipulation with the HVLA technique involves high velocity, low-amplitude thrusts on the cervical spine administered posteriorly. No other aetiology of the pre-retinal haemorrhages was found on work-up (no leukemic retinopathy, hypertension, diabetes, or retinal tear). The temporal association immediately while driving home from the chiropractic procedure makes other causes less likely, although we cannot exclude Valsalva retinopathy or progressive posterior vitreous detachment. Given the lack of any retinal vessel abnormalities or plaques along with the temporal association, we postulate that the chiropractor neck manipulation itself induced vitreo-retinal traction that likely led to pre-retinal haemorrhages which were self-limited. It is also possible that the HVLA technique could have mechanically assisted with induction of a posterior vitreous detachment.

If the authors are correct, one has to wonder: how often do such problems occur in patients who simply do not bother to report them, or doctors who do not correctly diagnose them?

82 Responses to Chiropractic neck manipulations can damage your eyes

  • http://redcliffewellness.com/eye-problems-helped-chiropractic/

    More investigation to protocols of care are necessary.

    From my own empirical experience, improvement of visual fields improve under chiropractic spinal manipulation and not just under cervical manipulation under medical manipulation. http://redcliffewellness.com/eye-problems-helped-chiropractic/

  • Here is a link to the case report:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097227/

    The corresponding citation is:
    Paulus YM, Belill N. Preretinal hemorrhages following chiropractor neck manipulation. American Journal of Ophthalmology Case Reports. 2018;11:181-183. doi:10.1016/j.ajoc.2018.04.017.

  • “…but this case demonstrates that it can also lead to multiple preretinal hemorrhages.”

    Should have wrote “may”, not “can”.

    • Should have WRITTEN, DC … should have “written.”

      More to the point, no doubt you tell patients who present with neck pain, “I’m going to adjust your neck and it may NOT help” and add that “It CAN cause a stroke.”

      Right?

      Of course, cracking a neck CAN help and it may NOT cause a stroke. That’s because cracking a neck in some people, some of the time, CAN sometimes help with some presentations just as in some people, some of the time it CAN sometimes cause a stroke.

      Right?

      Well, now you should consider that cracking a neck CAN sometimes cause “multiple preretinal hemorrhages.”

      Right?

      ~TEO.

  • So neck manipulation can do all sorts of things…..it just happens that improving health or relieving pain aren’t two of them.
    “Manipulation for neck pain does not work”. Bogduk
    And having been to numerous quacks over my lifetime I will agree with the professor.

    • Actually, what Bogduk wrote is that spinal manipulation might reduce neck pain but it doesn’t eradicate neck pain.

      • DC wrote: “Actually, what Bogduk wrote is that spinal manipulation might reduce neck pain but it doesn’t eradicate neck pain.”

        @ DC

        Yes, he did say that, before continuing with: “it is not more effective than other interventions, which do not require the same degree of allegedly necessary training and skill, which do not carry the same risks of morbidity, and which the patients can do for themselves, if and once properly instructed.”

        Ref. https://www.jpain.org/article/S1526-5900(03)00733-8/fulltext

        • is it not strange how these little bit tend to get missed!

        • Yes. But my reposnse was in regards to what Kinney wrote…which misrepresented what Bogduk wrote.

        • @BW: thank u for that more complete discussion. I’m sure “DC” will have some piffle to try to further defend his vainglorious income stream.
          Of course he/she is still left with the untenable proposition of answering the “what, where, when and how” to deliver this remarkable “big idea” to his marks? WHO taught him/her how, where and when to do “it”? AND to do it “correctly”…vs just goin’ a whackin’ wherever it hurts?
          Where is that arcane knowledge stored? At a $200,000 4 year, pretend-doctor, non-transferable diploma mill?? Who taught THEM? AND why does it take 4 years??
          Perhaps most likely it’s all a “big guess” and based on whatever entrepreneurial story-line they need to get cash from the gullible.
          Ahh science-based Chiro-quackery.

  • http://animalchiropractic.org/contact_animal_chiropractic.htm

    apparently you do not even have to be a DVM to get certified in animal chiropractic therapy. This is a great example of pseudo-medicine trying to infiltrate the veterinary profession.

  • And so many examples of so-called believers seeking verisimilitude.

  • I wonder if prosecutors ever refer to this blog for evidence the defendant participated in, and was exposed to, information that should’ve deterred use of procedures that injured the defendant’s patient?

    I do hope so.

  • the story was today (!) reported in the Daily Mail. (https://www.dailymail.co.uk/health/article-6229057/Chiropractors-neck-cracking-harm-sight-cause-bleeding-inside-eye.html)
    they quoted me thus:
    “Edzard Ernst, an expert in alternative medicine, said chiropractic treatments were too dangerous and not sufficiently effective to be recommended for any condition.”
    the quote was on their request me stating by email to their ‘science correspondent’:
    “Chiropractors frequently manipulate patients’ neck in such a way that the joints are taken beyond their physiological range of motion. This can lead to all sorts of problems, sometimes even death. This new report suggests that chiropractic neck manipulations can also damage the eyes. The ensuing problems tend to be temporary, it is likely that such eye-damage occurs often after chiropractic treatments. Chiropractic neck manipulations are not convincingly effective for any condition; as they can cause a lot of harm, their risk/benefit balance is clearly negative. In other words, we should not use or recommend them.”
    this quote was deemed too long and they asked me to agree to the following, shortened one:

    “Edzard Ernst, an expert in the study of alternative medicine and former professor at the University of Exeter, said: ‘Chiropractors frequently manipulate patients’ neck in such a way that the joints are taken beyond their physiological range of motion.
    ‘The ensuing problems tend to be temporary but it is likely that this kind of eye damage occurs often after chiropractic treatments.
    ‘Chiropractic neck manipulations are not convincingly effective for any condition as they can cause a lot of harm. Therefore we should not use or recommend them.’ ”
    WHAT HAS UK SCIENCE JOURNALISM COME TO???

  • No one is more critical of “chiropractic,” chiropractors, and chiropractism than I am. Even so, my response is that your truncated statements end up sounding a little too severe. That’s a problem with any summary statement, of course. To wit, without any nuance or explanation, comments and important criticisms may be dismissed and miss all the fundamental silliness of The Chiropractic Premise that precedes any risks attendant to cracking a neck. Damage occurring as a result of treating with an empty medical intervention only adds insult to this primary injury, which is the application of an arbitrary and fictitious medicine to manage bona fide medical diagnoses.

    That said, I will only weigh in on a part of what I see after a quick read. For example, taking joints beyond their physiologic range of motion may sound more ominous and dangerous than it really is. When you crack your knuckles, for example, you’ve taken these same synovial-type finger joints beyond their physiologic range of motion. And, cracking your knuckles or your neck does not a medicine make … except if you’re a chiropractor in the latter case of the neck.

    Of course, damage to ligaments and joint surfaces can and does occur when that narrow paraphysiologic joint range — apparently a relatively “safe zone” — is exceeded by anything more than in a controlled fashion … let’s say if your neck is injured in an auto accident in the extreme or with more force than needed to get the desired “POP” at the hands of a chiropractor in Chiroville, a barber in New Delhi, a filipino collecting a buck in a bar to crack your neck, or a Turkish masseur finishing his massage in an Istanbul bathhouse with bilateral cervical fireworks. A poke in the eye with a burning stick, after all, is likely to be unpleasant and do tissue damage, no matter. Defended chiropractors who argue complete safety without telling about all the potential damage they can do are simply FOS. Totally.

    Part of being a chiropractic student is that you get to be a chiropractic patient while you’re learning the trade. So, not to go-on too much at this point, I’ll leave you with a quick anecdote. While learning one particular chirodigm (The Thompson Technic) in chiropractic school, I volunteered to be the “adjusting dummy” for the teacher to demonstrate how a “drop table” works. The drop table has segmented sections that are first “cocked” so that when the chiropractor applies their manual “adjustment” to the prone patient, the table segment releases and drops a short distance amidst a noisy mechanical clatter. This teacher was a brute and maintained his hand position and pressure to the back of my neck until the neck segment bottomed-out.

    I saw stars. Lots of them.

    The surrounding students and class were asking me if I was OK because, apparently, I just lay there for I don’t know for how long, non-responsive. At some point, I indicated that I thought I was OK, rose from the table, finished the class and left school to go home. After dropping a classmate off in front of his house in Oakland, I proceeded less than half a short block and drove directly into the back of car that was double parked … without braking. I can’t say with confidence that one thing had to do with another … but hey. Could have happened to anyone at anytime, too.

    Right? 🙂

    ~TEO.

    • “Funny” anecdote. I too was ‘adjusted’ in a similar fashion by the Cadillac-of-Chiroquacks, one Vern Pierce DC PhC! (C-is for Chiropractic….they made up a fake-doctor-degree and a fake professor-degree).
      The C5-slam as it was affectionately known left me in pain, and ‘distress’ for more than a month. It also seemed to be correlated to a bout of vertigo (I never had previously) and that has plagued me intermittently ever since.
      This reprobate was a really BIG deal in the profession for decades….until he died at 61 from septicemia from refusing antibiotics for a non-healing wound. Preferring instead that “innate cures everything as long as there are no subluxations”. This “technique” (and variations) still perpetuates today. There is no underpinnings of truth or reason to chiropractic….irrespective of whether PTs or DOs also buy into its erroneous-nonsense.
      “IT” can’t be reformed, no more than Islam can be. It’s history IS it’s future.

  • There are four five “professions” that practice “Spinal Manual Therapy”. Chiropractors, Osteopaths, Physiotherapists, Medical Practitioners and untrained manipulators.
    To attribute this type of incident only to chiropractors negates that this could have happened to a patient receiving care from any of the above five professions. This is a fundamental flaw with these types of articles.

    • it’s a case report!
      and the case happened with a chiro
      NOT ROCKET SCIENCE, IS IT?

      • Causality cannot be inferred from an uncontrolled observation. An association does not imply a cause-effect relationship. The observation or event in question could be a mere coincidence. This is a limitation shared by all the descriptive studies [47]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001358/

        • absolutely right!
          but with adverse effects, it is wise to consider the possibility of causality. it is in the interest of patient safety and it is what we do with adverse effects of drugs.

          • We should consider possiblity as well as probability..

          • exactly!
            and the authors of the case report – the people who might best be able to judge the probability in this case – thought causality is very probable.

          • Well, they postulated.

          • @DC
            You said:

            Well, they postulated

            It would be very interesting to hear your thoughts as to what explains the findings described in this case. What do you think caused them, if not what the chiropractor did?
            Do you have a more plausible explanation than the authors?

          • “…although we cannot exclude Valsalva retinopathy or progressive posterior vitreous detachment.”

          • @DC
            Not good enough. Valsalva retinopathy is a phenomenon which does not occur without a triggering forceful Valsalva action. Maybe you should look up what that is. Wikipedia has a good article on it. There is no history of any forceful Valsalva-causing activity such as heavy lifting, forceful coughing, straining on the toilet, or vomiting. The authors are trying to be thorough but they can actually exclude Valsalva retinopathy as there was no such history , which is the only way to set such a diagnosis.
            The only forceful activity or action in the history is the neck wringing, which immediately preceded the symptoms.
            As to the second phenomenon the authors present, that is partly incorrect as the symptoms resolved so the pathology was obviously not progressive and the vitreous detachment may have been caused byt forceful jerking of the head as well, so this is not a differential diagnosis.

            Are you still certain the trauma of HVLA neck manipulation had nothing to do with the hemorrhage and retinal detachment found as cause of the symptoms that immediately followed? If so, how do you explain (away?) this obvious relationship and the quite credible hypothesis of causality?

          • “…which is the only way to set such a diagnosis.”

            If that’s true, we all better make sure that our heavy lifting & coughing diaries are up to date. Alas, even when I was younger I couldn’t have given you an accurate coughing and heavy lifting history. I would have kept better notes if I’d known it was so important.

            “What do you think caused them, if not what the chiropractor did?”

            If a patient presents, without having seen a chiro and reports no heavy lifting, forceful coughing, etc on their history…how do explain that away?

          • “Are you still certain the trauma of HVLA neck manipulation had nothing to do with the hemorrhage and retinal detachment…”

            You seemed confused, I never said that.

          • Did I say you ‘said’ that? 😀

            (But our little lurker “jm” is certainly confused 😉 )

    • There are four five “professions” that practice “Spinal Manual Therapy”. Chiropractors, Osteopaths, Physiotherapists, Medical Practitioners and untrained manipulators. To attribute this type of incident only to chiropractors negates that this could have happened to a patient receiving care from any of the above five professions. This is a fundamental flaw with these types of articles.

      Oh, PUH-LEAZE, GibleyGibley.

      Cracking the joints of the Chiropractic Spine has been the bread and butter of The Chiropractic Enterprise since its inception in 1985. It remains so today. Chiropractors crack joints. What does that mean here? It means that when you go to a chiropractor, the likelihood that you’re going to get cracked is almost certain. In case you hadn’t noticed, that’s what chiropractors do. Take a look.

      Yes, in some chiropractic offices you might also get some ultrasound, let’s say, if this sort of “adjunct” therapy is allowed under their license; but, odds are you aren’t going to escape the office without getting cracked. Typically, even if a patient complains of low back pain, they’re going to get a low-back crack as well as a thoracic spine and neck cracking. You can’t be too careful, after all. Similarly, if you complain of a headache, you’re not getting out of the office without a side-posture maneuver and mid-back crunching. That’s simply what most every chiropractor does, unless they are purely an Activator Methods, SOT, or NUCCA practitioner, for example. And, even then. Chiropractors are quite enthusiastic about these bone-cracking “Adjustments,” in case you hadn’t noticed.

      Now, consider the other practitioners who, for some reason, you pretend routinely crack necks. They don’t. Physical therapists typically _mobilize_ with a range of gentle passive motion all the way up to a grade five mobilization (rarely, never mind routinely done) in which they “pop” joints. Osteopaths in the United States practice biomedicine, prescribing labelled drugs and doing surgery. Manual therapy is an elective for the D.O. and you’d have to actually look for one who corrects “Spinal Lesions” or who does Cranial “work,” or Bloodless Surgery. As for getting your neck cracked by an MD … well, you’ve got to be kidding.

      You seem bothered by the very idea that chiropractors who crack necks might cause any unintended and undesirable effects. It doesn’t appear that post-neck cracking retinal hemorrhages or other eye problems are all that common, although the numbers aren’t known. Moreover, if chiropractors have anything to do with it, the statistics never will be known. Chiropractors don’t take criticism very well. So, when things go south at the hands of a chiropractor, the denials that “chiropractic” had anything to do with it are reflexive, defended, and predictable. It seems that most every chiropractor was at home watching TV when the accident happened and didn’t see or hear anything. Pretty stupid for so many reasons. But who’s counting.

      You’re not a chiropractor, are you?

      ~TEO.

  • About 5 weeks ago, I visited a Chiropractor – one who had been practising for 30 years and came recommended to me – because I had a headache and a really stiff neck. A neck manipulation was performed with considerable force which immediately (within a few seconds) caused a bright flash in my right eye, a brief loss of vision and a gritty feeling in the eye. I also felt dizzy. In fact, the Chiropractor told me to sit still for a minute or two as he peered into my face because he said I looked really pale and then told me “how well I had done and that the neck had adjusted beautifully” and to come back in a week for a follow-up session. My eye felt a little odd but the Chiropractor didn’t seem concerned. I went to my car & happened to glance at my face in the rear-vision mirror & was horrified to see that my right eye was looking quite bloody. There is no way that the Chiropractor could have missed my bloody eye because he peered into my face after the manipulation. I went straight home and noticed a short time later that there were two small black spots visible when I looked at my cream walls and was alarmed. They definitely were not there before! I sought medical advice and learned that I had a retinal tear and was advised that the force of the manipulation would have caused it and that, in fact, this is certainly a situation that my Eye Doctor had seen before following a Chiropractic neck manipulation.

    There is NO CHANCE in the world that I would EVER visit a Chiropractor again – and I am extremely lucky that I sought medical advice so the tear was picked up on. I am also very, very angry that this happened at all. I have no history of previous retinal tears & are in excellent health having just passed a physical examination with flying colours just prior to the Chiropractor visit. And I want to warn people that this can happen!

  • Interesting reaction. I have two current patients who had an adverse reaction to a dental procedure. I guess they should never go to a dentist again, eh?

  • @Toodles: I am intimately and experientially aware of what “they” do in practice having “lived it” for a decade. Since no one can “treat away” another persons pain, (and IF exercise may be a helpful modality a DC is still the far less competent purveyor of it) a DC practice is perniciously loaded with entrepreneurial-theatrics (drop-tables, Activators, Arthostims, Gonstead, diversified, upper-cervical, AK etc etc etc..) ..ALL pointless and ALL based entirely on getting a treatment-retention-hook in the ill informed and gullible. “Treatments” that seem profound but are a stop-gap while the DC collects his fee and waits out natural pain-attrition.
    Professor Ernst is far more aware and objective regarding all these things than YOU are. Perhaps you might read his books and learn some real facts. Though that could have a negative impact on your cash-flow, and that is what a DC is all about now isn’t it…? If not that, what else?

  • A care is not depend upon one accident. If someone dies during heart stunting, what would be your reaction then?

    • “A care is not depend upon one accident.”
      indeed!
      each intervention has to be judged on the question weather it generates more good than harm. and this is where chiropractic fails.

  • I have been seeing a chiropractor for several months. He does gentle neck manipulations. A few days ago I noticed spots and “cobwebs” in my left eye. Being a diabetic and thus very sensitive to issues involving my eye and retina, I immediately went to see my retina specialist. He did all his tests and concluded it was not a bleed due to any abnormal vessels in my eye. But there was some blood in my vitreous gel. He asked me to follow up in 3 weeks. I do not know there is a connection with chiropractic manipulations, but it makes me wonder if I should stop going to the chiropractor??

    • Having experienced a retinal tear (see my comment a few comments up from yours) from a neck manipulation, I personally wouldn’t. I also had two black spots in my vision after this manipulation which have NOT resolved. My eye specialist said that the trauma that I had he sees in people that have had, for example, whiplash or some over extension of the neck or head injury. Being a diabetic, you are already aware that it puts your eyes more at risk. The best advice I can give from being a layperson is: go with your gut – and if it quacks like a duck, it’s a duck. You don’t get second chances with your sight.

  • After a chiropractic appointment today, I experienced small stars in my vision. I’m a 36yr old female who had issues with her right shoulder/shoulder blade/rib out of place. There were adjustments done to my neck as well. After adjustments, during the electromagnectic pulse therapy at the office, I began seeing the stars (tiny, bright spots in my vision). Should this be cause for concern or normal?

  • Being an eye surgeon, I would say that it is actually true as I have some patients which face some problems after their chiropractic sessions. Thus, one should be careful while selecting a chiropractor.

  • Alan Henness: The only careful way to select a chiropractor is not to select one at all

    Choosing a chiropractor to diagnose and manage any given complaint is NOT a good idea. This understatement aside, it appears “chiropractic” and chiropractors aren’t going away anytime soon. That said, for those who can’t help themselves and who don’t know any better, I created “SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR.” If they are followed scrupulously, the chances of finding yourself in the office of chiropractic meatball will be minimized. In a chiropractic jungle, this is no small thing. Consider these GUIDELINES as making the best of a bad deal.

    ——————————————-

    SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR

    1) Avoid a chiropractor who attributes any of your problems to Vertebral Subluxation and sells the Adjustment as the solution to your complaint.

    2) Avoid a chiropractor who practices any brand name Technique (e.g. Activator, NUCCA, Biomechanics, Gonstead, Applied Kinesiology, Thompson, Pierce-Stillwagon, Biophysics, Toggle-recoil, B.E.S.T., Network, etc. etc., or any combination of these Chirodigms).

    3) Avoid a chiropractor who uses x-rays to locate your Subluxation and probably any chiropractor who has an x-ray machine in their office.

    4) Avoid a chiropractor who wants to see you a given number of times per week in an effort to get you to the point of being on a “maintenance schedule” and probably any who use the word “maintenance” as a goal of treatment.

    5) Avoid a chiropractor who suggests that MDs are simply against “chiropractic” and those who in ANY way imply that chiropractice is somehow better than medicine.

    On the other side of each “avoid” coin above:

    1) Seek a chiropractor who acknowledges differences in tissue and who does not neatly conceptualize pathophysiologic complexity into a Spinal Demon.

    2) Seek a chiropractor who when asked, “What techniques do you practice” says that their treatment will depend on what’s wrong with you, and NOT some chiropractic abstraction of your spine and complaint.

    3) Seek a chiropractor who uses a medical facility for x-rays and orders them to rule out fracture and/or pathology as indicated by the case history and medical (not chiropractic) exam.

    4) Seek a chiropractor who may or may not choose to treat, and who emphasizes patient empowerment by teaching you how to take better care of yourself.

    5) Seek a chiropractor who is not competing with MDs at your expense in their effort to promote “chiropractic” and their practice. If you feel like you’re being “sold”… don’t “buy.”

    I suspect it will be much more difficult than you think to find a chiropractor if you adhere to these guidelines… but, that is exactly what I suggest you do.

    ~TEO.

    • If you really believe “Choosing a chiropractor to diagnose and manage any given complaint is NOT a good idea”, why in the world would have guidelines for choosing one?

      Maybe you should contemplate Alan’s guideline.

      • jm: If you really believe “Choosing a chiropractor to diagnose and manage any given complaint is NOT a good idea”, why in the world would have guidelines for choosing one?

        hehehe … I REPEAT:

        [I]t appears “chiropractic” and chiropractors aren’t going away anytime soon. That said, for those who can’t help themselves and who don’t know any better, I created “SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR.” If they are followed scrupulously, the chances of finding yourself in the office of chiropractic meatball will be minimized. In a chiropractic jungle, this is no small thing. Consider these GUIDELINES as making the best of a bad deal.

        I would add that while my SOME GUIDELINES are by no means foolproof, they do LIMIT the likelihood that you’ll find yourself in the OFFICE of a fool. Again, this is no small thing viewing the chiropractic landscape from where I’m sitting.

        Remember the credulity of the chiropractic patient, too. Mix this with The Chiropractic Rumor and an understandable ignorance of “chiropractic” and chiropractic culture and the risk of a perfect chiropractic storm is nearly assured. There will be no bottom to what the chiropractor and their patient might attribute clinically to their acting-out of chiropractic ritual and dance, all of it now fully embedded and DEEPLY buried in billable diagnostic and treatment codes.

        I have little doubt the chiropractic joke has gone too far. You may disagree, but damage control might be the best anyone who knows better can do at this point. With this in mind, my SOME GUIDELINES is available not only to patients considering “giving chiropractic a chance,” but to third party payers, too, as well as to chiropractors themselves. They are deceptively simple but go to the heart of the chiropractic matter by eliminating what is uniquely empty about the Chiropractic Enterprise.

        ~TEO.

      • “You may disagree, but damage control might be the best anyone who knows better can do at this point.”

        I completely disagree with that. If you think something is a “bad idea”, Alan’s guideline would be the best you could do.

        The only way your guidelines make sense is if, by “bad idea”, what you really mean is “specific types of chiropractic treatments have benefits that outweigh the risks”.

        • jm: The only way your guidelines make sense is if, by “bad idea”, what you really mean is “specific types of chiropractic treatments have benefits that outweigh the risks”.

          I don’t think I can more clear about what I mean by “bad idea” and making the “best of a bad deal” when it comes to The Chiropractic Choice, The Chiropractic Spectacle, and The Chiropractic Enterprise. Importantly, I’m not sure what part of “[I]t appears ‘chiropractic’ and chiropractors aren’t going away anytime soon” you don’t appreciate or don’t believe. In fact, it would be useful for you to specify what part of anything I’ve written about “chiropractic” and chiropractors with which you disagree.

          Perhaps what stands between you and my SOME GUIDELINES is a resistance to acknowledging, never mind accepting, that The Chiropractic Joke has gone too far. To wit, chiropractors are called “Doctor,” healthcare insurance reimburses chiropractors for their so-called “Adjustments” of “Chiropractic Subluxations,” and chiropractors are fully licensed healthcare practitioners. Moreover, because of “Any Willing Provider” legislation (what I call “Any Willing Moron” legislation), health insurance carriers are required to allow chiropractors to become members of the carriers’ networks of providers. At least, this is the situation in the U.S. The profession’s relentless march of chiropractic imbecility has successfully oozed its Chiropractic oobleck and medical simulacrum through any and all legislative cracks.

          Frankly, considering all this, I don’t know what your objection could be to my SOME GUIDELINES. Again, it would be useful to specify your critique beyond, “I disagree.” Like me, there’s a lot to dislike about The Chiropractic Problem. But, if you acknowledge there IS a problem, then I would consider better and _realistic_ ways of dealing with it. Frankly, I’m not even sure you’re representing Alan’s position properly … a single sentence, which when read alone and without context is “the short” of what I would likely say at a party when someone asks me if they should see a chiropractor.

          ~TEO.

        • I’m not agreeing or disagreeing with anything you’ve written about chiropractic. That’s not the issue. I’m not sure why you don’t understand this.

          A Bad Idea

          Alan’s guideline: don’t do it.
          You: here’s how you could do it.

          Which approach really thinks the idea is bad?

          • jm: I’m not agreeing or disagreeing with anything you’ve written about chiropractic. That’s not the issue. I’m not sure why you don’t understand this.

            I don’t understand “this” because what I wrote and continue to write certainly IS “the issue.” It’s you who disagrees with what I’ve written.

            Remember? 🙂

            That’s OK, of course. But, you’ve said nothing as I’ve requested about what (exactly) your objections are. To wit, you wrote:

            jm: A Bad Idea

            Alan’s guideline: don’t do it.
            You: here’s how you could do it.

            Which approach really thinks the idea is bad?

            Well, this is hopeless. Without commenting substantively about anything specific I’ve written, including my SOME GUIDELINES or my responses to you about them, you’re just touching your own nose. Clearly you’re bothered by my SOME GUIDELINES, but refuse to say more about what your objections are. From the way you’ve framed your, ahem, “argument” above (“Here’s how you COULD do it”), your objection seems to be that my SOME GUIDELINES allows for the possibility of a chiropractic profession … which apparently bothers you and to which your only, entire, and final response is, “NO FKN WAY.”

            Well, in case you hadn’t noticed, you’re WAY too late. Take a look. Hence my argument of “damage control” and “making the best of a bad deal.” My SOME GUIDELINES don’t represent a strategy for how chiropractors and all their legislative shenanigans and empty medicine COULD infiltrate a healthcare system as you represent. In the U.S., at least, THAT horse left the barn long ago. Yet, this seems to be where you’ve chosen to dig-in your heels even though “You: here’s how you could do it” has nothing to do with my SOME GUIDELINES or anything I’ve ever said about what chiropractors think, say, and do.

            Is it really possible that all you have to say here is “Alan says this” and “TEO says that?”

            You do what you want.

            ~TEO.

          • John,

            You said “Choosing a chiropractor to diagnose and manage any given complaint is NOT a good idea.” If that’s the case, no guidelines for choosing a chiro (other than “not to select one at all”) are necessary.

            Poking yourself in the eye with a sharp stick…is NOT a good idea. All harm, no benefit. You could write up a list of guidelines, with things:

            1. Wood choice for the stick. Some people are allergic to some woods, some woods splinter more than others. Avoid the splintery ones.

            2. Angle of attack. You’ll want to miss major arteries, etc.

            3. Size of stick. (see #2)

            4. Velocity. Faster is probably better.

            5. Cell phone handy. Dial 9-1…and keep your finger on the 1.

            Or, your guideline could be “Don’t do it”.

            You’d only offer guidelines #1-5 if you thought there was some benefit to poking yourself in the eye with a sharp stick. Since you’re offering up guidelines for selecting a chiropractor…what benefits could one reap, assuming all of your guidelines are followed?

            If there are some, Edzard should write a post. If there aren’t any…recommending a chiro would be unethical, wouldn’t it?

          • hehehe … the trouble with the straw man argument is that they’re made of straw.

            I wouldn’t recommend that people poke themselves in their own eye with a sharp stick. Moreover, I never have and haven’t here.

            ~TEO.

          • Oh good. Glad you’re on board with the whole stick thing.

            But since you’re offering up guidelines for selecting a chiropractor, there must be some benefit(s) that outweigh the risk. So, what benefits could one reap, assuming all of your guidelines are followed?

    • My list…

      10 ways to spot a scam chiropractor

      1. They talk about “subluxations” and how they cause disease and getting them removed is equal to health.
      2. They require you to have x rays in order to receive treatment.
      3. They use your x rays and compare them to a “normal” x ray.
      4. They don’t give you a diagnosis
      5. They require you to bring a “co-decision maker” to your report of findings.
      6. They never treat you the first day at their clinic.
      7. They use the same scripts for everyone.
      8. They make you pre-pay for long term plans of care.
      9. They have no separate treatment rooms.
      10. They advise you against vaccinations or advise you to stop taking your medications.

      • 11. they do not obtain fully informed consent, including the risks of SMT
        12. they advise maintenance care
        13. they advise treating children
        14. they treat conditions other than back pain
        15. they give advice about medicines
        16. they fail to provide a detailed treatment plan

      • David Letterman Top Ten List on Chiropractors

        10. When you walk, you make a wacky accordion sound.
        9. Keeps saying, “A spine is like a box of chocolates.”
        8. Repeatedly asks, “You a cop? You sure you aint’ no cop?”
        7. Over and over, you hear crunching sounds followed by, “Uh-oh.”
        6. There’s a two-drink minimum.
        5. At end of session, lies down on the table and says, “My turn!”
        4. He was nowhere near Woodstock and yet he’s covered with mud.
        3. Rushes in late to your appointment still wearing his Burger King uniform.
        2. Hints that for an extra $50, he’ll “straighten” something else.
        1. You’re fully clothed and he’s naked.

      • You forgot: they call themselves a DC: doctor of….
        How about those that watch the new Chiroquackery movie called “the Calling”. Or attend virtually ANY chiroquackery convention and contribute to the talk: “it’s all about the nervous system and immune function…THAT’S what “real DCs do….affect the nervous system which controls health”.
        Newbie and oldie DCs who intend to make a living commensurate with their (faux) doctor status can’t just sell bone cracking for 18 mins of “relief”….or a stroke…they gotta sell a concept: wellness through spinal alignment and improved spinal function. Regrettably that is Something 125 years of “dedicated research” lol….has failed to prove was or is even a thing.

    • JB…”…probably any chiropractor who has an x-ray machine in their office.”

      Since you wrote “probably” it indicates that you acknowledge there are allowable deviations to this “guideline”.

      • DC: Since you wrote “probably” it indicates that you acknowledge there are allowable deviations to this “guideline”.

        No, I didn’t “acknowledge” this. Quite the contrary.

        All five AVOID/SEEK pairs in my SOME GUIDELINES are a lot more critical of The Chiropractic Enterprise than you, a typical defended chiropractor, would “probably” like to hear, never mind fully endorse, as in give to each of your patients … what I call patient education. From your posts to this list including your initial response to my SOME GUIDELINES offering “10 ways to spot a scam chiropractor” and now, looking for wiggle room here on the issue of x-ray use by chiropractors, I’m not surprised you didn’t notice how little “oxygen” my GUIDELINES provide for a “dyspneic” chiropractor. After all, you are a fish swimming in chiropractic water.

        Honestly, you could (and should) have answered your own question with regards “probably” had you noticed or appreciated the organization of my SOME GUIDELINES into five AVOID/SEEK pairs — one for each major issue concerning chiropractic practice. I wrote these a long time ago when I participated in many chiropractic forums, at the time as I recall, mainly for chiropractors themselves, but in a format that might be useful to a consumer using the Yellow Pages or the third party payer who really doesn’t know what they’re looking at.

        No matter. Do me a favor and reread the AVOID/SEEK pair related to x-ray use by chiropractors and then tell me why I included “probably” as an AVOID.

        In case you forgot:

        AVOID a chiropractor who uses x-rays to locate your Subluxation and probably any chiropractor who has an x-ray machine in their office.

        SEEK a chiropractor who uses a medical facility for x-rays and orders them to rule out fracture and/or pathology as indicated by the case history and medical (not chiropractic) exam.

        When answering, remember that while my SOME GUIDELINES are by no means foolproof, they do LIMIT the likelihood that you’ll find yourself in the OFFICE of a fool. Keep in mind, too, the GUIDELINES are deceptively simple but go to the heart of the chiropractic matter by eliminating what is uniquely empty about the Chiropractic Enterprise.

        ~TEO.

    • Reading through some VERY old email the other night, I stumbled on some stuff I had forwarded to the producers of A Different Way To Heal?, some of it in response to viewer mail I received after this PBS “Scientific American Frontiers” episode first aired in 2002. While all of it didn’t get published at the PBS site, given that there’s some discussion of my SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR here, this unpublished expansion of each AVOID/SEEK pair might be useful to post.

      ===========================================================

      I read your article about chiropractic education which I located though the pbs.org web site. There was another link in which you discussed how to choose a chiropractor. It wasn’t much more than an outline so I wonder if you wouldn’t mind saying more about your recommendations.

      It’s hard to be brief, but I’ll try to expand a little on each AVOID/SEEK complement to show how, one-by-one, they address a major motif in “chiropractic” and serve to penetrate what uniquely defines and characterizes The Chiropractic. Hopefully, you’ll appreciate a little bit more about what informs each “AVOID/SEEK” recommendation after reading this.

      The first AVOID/SEEK pair refers to the profession’s proprietary diagnosis –the Chiropractic Subluxation ™. Vertebral Subluxation (VS) is like Original Spinal Sin. When it’s invoked as a diagnosis, it makes many doctors of “chiropractic” (DCs) appear to be spinal priests trained to recognize and exorcise Spinal Demons. In fact, insurance companies pay for this service, even though I’m sure they’d be dismayed to hear this. The Chiropractic Subluxation is a self-referential pseudo-diagnostic chiropractic abstraction of anatomy and physiology. It’s unrelated to dissectable tissue (although structures like joints, muscles, and discs are sometimes referenced as THOUGH it is) and is treated as arbitrarily as it was defined in the first place –depending only on the brand of “chiropractic” used in a given office.

      The second AVOID/SEEK complement references the Chiropractic Technique Spectacle. I’ve coined the term “chirodigm” because it neatly expresses the proliferation of chiropractic “Subluxation/Adjustment” pairs euphemistically called “Techniques.” All medicines, whether phony (made-up and delusional) or legitimate (having a BASIS in bioscience), offer a treatment for whatever it is that’s diagnosed. Alt-Med is no different –it’s just that their diagnoses are dubious and arbitrary compared to those of biomedicine. So then, it follows, are their treatments.

      There are over 100 name-brand chirodigms — each defining its own version of a “Subluxation” and each providing a method to locate it, treat it, and bill for it. “Thuh” ADJUSTMENT is the treatment for the Chiropractic Subluxation. Notably, the particular patient isn’t part of the diagnostic equation, since the biomedically arbitrary diagnostic/treatment algorithm used in a particular subluxation-based practice can be repeated on every patient independent of their entering complaint –whether it be vomiting, eye pain, headache, or itchy feet. Very convenient.

      The third AVOID/SEEK combo is intended to address the use of ionizing radiation (x-ray) by those chiropractors who make proprietary [“chiropractic”] diagnostic and clinical inferences from them. I originally wrote my “SOME GUIDELINES” for the consumer, so this is an area of “chiropractic” in which I think “the joke has gone too far.” It’s one thing if you’re to look at subluxation-based “chiropractic” as a form of adult entertainment, but quite another when a diagnostic procedure with the harmful potential of x-ray is used to sell The Chiropractic Dream.

      Some chirodigms, for example, only diagnose and treat “malposition” of the Atlas –the uppermost vertebra in the spine. Toggle-recoil (one of three “Techniques” featured on the segment and demonstrated by Dr. Browning) and NUCCA are two name-brand “upper cervical techniques” that “shoot [their x-rays] first” and ask questions later. Some other chirodigms, like “Gonstead,” take full-spine films to diagnose VS (Vertebral Subluxation) and chiropractically “analyze” the spine. We saw both Drs Browning and Rowe pointing to chirodigm specific x-rays. A misaligned Atlas (Toggle-Recoil Technic) and a Base-Posterior Sacrum (Gonstead Technic) were the predicted Chiropractic Subluxations they diagnosed.

      The point is, these are medically non-diagnostic films used for chiropractic reasons only. There ARE, of course, good medical reasons to take pictures. They might include diagnosing fractures and pathology, for example. But there are only make-believe proprietary chiropractic diagnoses that can be obtained from this imaging WHEN these are films are “technique specific.” Briefly, if your case history and exam indicate the need for x-ray, whatever you’re trying to rule-in or out “ain’t” ever going to be treated by a chiropractor.

      The fourth AVOID/SEEK pair is intended to address the notion of so-called “maintenance care.” (You’ve heard it: “How many chiropractors does it take to screw-in a lightbulb? ONE —but you’ve got to come five times a week.”) REMEMBER that a defining feature of “chiropractic” is the belief that the spine holds the secrets of health and disease. This near spinal fetishism is defined generally in terms of Chiropractic Subluxation and “Thuh” Adjustment and expressed on a day-to-day basis by any number of chirodigms used routinely by DCs.

      So, it turns out that at the core of the chiropractic “onion” I’m describing, there’s this Fundamentalist Belief that Spinal Care is Good –just like GOD is Good. Getting your chiropractic spine REGULARLY checked is something like going to church. And, you really can’t BE too careful! Some chiropractors use the dentist’s argument of “regular check-ups.” No one notices that there really IS such a thing as plaque and dental caries. Again, you should be thinking of the difference between real disease (in this case, “cavities”) and the imagined one that chiropractors assert –VS (Vertebral Subluxation) –the Silent Killer.

      Finally, the last AVOID/SEEK pair raises the issue of the compensatory and competitive chiropractor struggling in the health care marketplace. This is a complicated business and not so easily teased from the chiropractic woodwork. Some DCs are simply “out to make a buck,” to be sure, but MOST, I believe, have a genuine concern for their patients and an unswerving belief that “chiropractic” is a GOOD thing, drugs and surgery are generally BAD things, and that “chiropractic” CAN help –if only science and medicine would “Give Chiropractic a Chance.” Thus, it’s the chiropractic enthusiast and subluxationist who is the LEAST likely to recognize their limits and the fallacy of what they think and do as DCs.

      Hopefully, my little expanded summary of “SOME GUIDELINES” will help identify some of the issues that were briefly explored on the SAF segment about “chiropractic.” I’ve usually been reticent to explain my recommendations since consumers usually have no way to know what informs them, without being chiropractors themselves, that is. So, I appreciate the opportunity.

      Again, what UNIQUELY defines and characterizes “chiropractic” is the Subluxation and “Thuh” Adjustment. Notably, since the inception of the profession in 1895, not a single aspect of anything that is UNIQUE to “chiropractic” has ever been validated –even a little bit. Nonetheless, more than any other Alt-Med, chiropractors have successfully insinuated themselves into the health care marketplace.

      PART of the explanation for this success is due to a confusion between manual medicine (for which there’s SOME evidence that it might help SOME people SOME of the time for SOME limited number of musculoskeletal complaints) and “Thuh” Adjustment, which is a chiropractic therapy directed at treating an arbitrary pseudodiagnostic abstraction variably defined from office to office. My SOME GUIDELINES tries to elucidate this distinction between subluxation-based chiropractic medicines and the application of a generic and relatively unglorified manipulative modality in a limited patient population. They do this by making “tissue the issue” and bioscience the BASIS for legitimate intervention and comparison.

      ~TEO.

  • JB… and then tell me why I included “probably” as an AVOID.

    Why don’t you just tell me…

    • DC: Why don’t you just tell me…

      Try not to be any more of a dime-a-dozen chiropractic fig newton than I suspect. You should be giving these GUIDELINES to your patients instead of nit-picking about the inclusion of “probably” in one of the sections.

      The short of it is chiropractors don’t need to have an x-ray machine in their office. Per my GUIDELINES, if, after your case history and exam you think an x-ray is warranted … you know, for something medical, then send your patient for x-rays at a medical facility. There is certainly no good CHIROpractic reason to obtain films. To get “listings” and “CYA” are two of the worst I hear.

      So, I added “probably” as a supplemental “shorthand” reference for the misuse of ionizing radiation, especially from the chiropractic antler dancer who uses a chirodigm requiring proprietary chiropractic films. Any contraindication to chiropractic treatment you’d see on a film isn’t going to be treated by a chiropractor … certainly not on any given office visit where history and exam suggest a film is needed. All this is made clear in the SEEK section … at least it should be to someone like you who’s familiar with all the jargon and references I make. Notably, each AVOID/SEEK pair makes a single and same statement.

      Do YOU have an x-ray machine in your office? Instead of asking me about the inclusion of “probably,” you should be able to explain why you have one in your office or why you don’t. Believe me, I’ve heard all the rationalizations.

      Tell me something about your practice. Do you “adjust” patients? Anyone who you don’t “adjust?” On what basis do you choose to “adjust” one area or another? IOW, how do you know what needs “adjusting?” Do you “check the legs,” palpate the spine, do you visualize “high shoulders” and “head tilt?” Do you take x-rays routinely? Do you use any particular chirodigm or do you just crack away? Activator? 🙂

      Share a little 🙂

      ~TEO.

      • JB…So, I added “probably” as a supplemental “shorthand” reference for the misuse of ionizing radiation…

        Thanks for trying to clarify.

        Regarding your questions on this topic…

        JB…Do YOU have an x-ray machine in your office?

        Yes and no. A x ray machine came with the practice I bought but I have never used it.

        JB…Do you take x-rays routinely?

        I haven’t personally taken an x ray since I graduated from chiropractic college. I send approximately 10% of new cases or complaints to a medical facility for x rays.

      • @JB👍: you pose the dilemma succinctly as I have also tried to do innumerable times. The truly whacked chiroquackers can’t argue cogently….the “reformers” understand how dominos work and seem to refuse to EVER define “chiroquackery” so as any reasonable or erudite observer could actually discuss it with them.
        These “reformers” refuse to accept that the majority of DCs buy “adjusting tables”, use “adjusting guns”, study “adjusting techniques” and advertise “spinal adjustments”. So WTF are they adjusting IF NOT mal-alignments, misalignments….subluxations? And HTF do they know where they are if not via the arcane chiroquackery gypsy-tricks you mention. It is a hopeless pursuit to seek a true answer from a quack.

      • Last night, I got curious about when and why I wrote my SOME GUIDELINES initially, in part because I remember some chiropractors having an issue with the x-ray AVOID/SEEK, in particular, the “probably [AVOIDING] any chiropractor who has an x-ray machine in their office.” I still haven’t located the “first edition” of SOME GUIDELINES which may have been published to USENET, but I do recall the ruckus it caused in some of the chiropractic forums of that day.

        So, at the risk of going too far afield of the topic here of unintended effects caused by chiropractors, while at the same time “keeping-it chiropractic,” I wanted to flesh-out my previous reply to you about why I included “probably” in my SOME GUIDELINES by posting one from the old days, all about “probably.”

        _______________________________

        Published to USENET December 20, 2000. That’s almost 20 years ago if you’re counting 🙂

        Chiro75 argues: The original statement read that any DC with an x-ray machine in their office should be avoided, implying that a DC that takes x-rays for anything, pathology, diagnosis, or listing determination should be avoided. You forgot to read the ENTIRE statement, Rich.

        No, Chiro75. You are the one with the reading problem. And, since I authored SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR, I get to tell you this 🙂

        Perhaps, you didn’t have a chance to read and absorb what I wrote to another chiropractor who was not as reflexively defensive as you appear to be, but who sought to clarify her question about this particular AVOID/SEEK complement that’s included in my SOME GUIDELINES to address the irresponsible use of ionizing radiation by Subluxationist chiropractors. I’ve copied it below so that you can read it now. I suggest that you read it in ITS entirety 🙂

        ===========================================================

        I agree with most of your recommendations on your list, but … could you elaborate on the second part of the section 3 which is capitalized below?

        Avoid a chiropractor who uses x-rays to locate your Subluxation and PROBABLY ANY CHIROPRACTOR WHO HAS AN X-RAY MACHINE IN THEIR OFFICE.

        Number three AVOID is included to eliminate from consideration any of the Chiropractic Techniques that use x-rays to locate and chiropractically analyze a patient’s “problem.” These include (but are not limited to) chirodigms such as NUCCA, Toggle Recoil, Grostic, Gonstead, Biomechanics, Pierce-Stillwagon, etc, or ANY Chiropractic Technique where the DC takes films to scribble either physically or mentally on them to derive their listing and/or line of drive/correction… not to mention those DCs who might use these pictures to “demonstrate” the need for Chiropractic Care ™ in their so-called report of findings.

        The typical person seeking a chiropractor for a low back complaint, let’s say, has literally no idea about any of this chiropractic technique jungle, or that they may be exposed unnecessarily to ionizing radiation and cancer because the doctor of chiropractic depends on one of these empty clinical abstractions euphemistically called “technique.” The “and probably any chiropractor…” is added, not only to insure consumer protection from these named Subluxationists I’ve listed, but also to protect them from those chiropractors who would take films to cover the chiropractor’s butt (you hear this quite a bit) or any of those chiropractors who simply “want to see what’s going-on” … because they’re chiropractically curious and as if they COULD “see.” Like the technique films themselves, these latter, er, “rationales” for using x-ray are for the doctor, not the patient. They are legally and/or personally motivated and are not medically pertinent. In fact, I would argue they constitute malpractice.

        There are good reasons for taking x-rays, to be sure, and ALL of them are medical. IF a chiropractor thinks, as a result of their history and exam, for example, that it is important enough to warrant the USE of ionizing radiation, whatever it is that concerned them medically is not going to be treated BY a chiropractor or “chiropractic,” and definitely not on the day of the film.

        X-rays are NOT indicated because a chiropractor palpates a “spinous right,” discovers a dreaded leg-length differential, or because they might observe a “high shoulder”… and they are certainly not required because of their pseudo-diagnostic role in some clinically arbitrary Chiropractic Technique algorithm. Since these kinds of “bugs” are so prevalent in the “chiropractic program,” the “probably any chiropractor with an x-ray machine in their office” remains as a “bactericidal” measure against those DCs with insufficient clinical savvy such that, even with their best intentions, they’d talk themselves, their patients, and/or the insurance companies into taking these unnecessary and potentially harmful films.

        Would you amend that recommendation in cases where the DC had appropriated diagnostic ability and applied rational protocols for the utilization of x-ray? If not, why?

        Although _I_ might personally refer to a DACBR whom I know, or possibly one (but not all) who limits their practice to reading films, or EVEN a chiropractor whom I knew personally who had a particular interest and competence in radiography and who had a machine in her office, this is all too specific for public consumption… and so adding their names or degrees under number three’s SEEK counterpart would only serve to confuse the issue. Unfortunately, for these DCs, and those who might be as clinically sharp as they are, they WILL be over-looked by a consumer who diligently adheres to every recommendation I’ve outlined without knowing anything about what informs them.

        But, the numbers of patients who won’t come to these very rare practitioners because of this x-ray recommendation pales in comparison to the number of people who don’t go to a chiropractor AT ALL because of the total bullshit practiced and promoted by the bulk of their colleagues who have given “chiropractic” its well-deserved black-eye and made it necessary to have a SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR necessary in the first place. To those who know exactly what I’m talking about (only), I apologize for the loss of some patients who will skip their office when seeking a chiropractor because they took my advice.

        OTOH, I also say, until these same DCs who CAN find their way out of a chiropractic paper bag take full responsibility for the crap that continues to pass for viable medicine and which surrounds them everywhere in the Chiropractic Byzantium, then they will continue to be embarrassed by their Subluxationist colleagues and suffer the consequences of being identified as “one of them.”

        SOME GUIDELINES FOR CHOOSING A CHIROPRACTOR is a tool designed to effectively isolate what is so professionally cancerous, scientifically stifling, and clinically stupid in the chiropractic profession today. It is a scalpel that neatly separates the “pomp and circumstance” of “Thuh” Adjustment from the biomedical banality of a manipulation. They advocate for the reasoned and non-partisan biomedical application of one form of physical medicine in a relatively limited patient population and in no uncertain terms, they are a statement that the Chiropractic Subluxation was invented by chiropractors so that they could then sell themselves as a solution to this pseudopathology.

        While my SOME GUIDELINES really is intended for the consumer, I have always encouraged chiropractors to use them to evaluate their own relationship to what they think and do on a daily basis. Similarly, they exist for the profession should it ever choose to find a way out of its own chiropractic paper bag.

        TEO.

        • One thing John failed to mention is that even though a pathological process may be present that does not necessarly mean that person can no longer be under chiropractic care. Of course modification of the clinical approach is often warranted. Also communication with the other providers needs to be established.

          • DC: One thing John failed to mention is that even though a pathological process may be present that does not necessarly mean that person can no longer be under chiropractic care.

            Always desperate to find a little chiropractic oxygen.

            Grow-up, DC.

            “Chiropractic Care,” indeed. What are you even talking about?

            As I suspected, a chiropractic meatball 🙂

            ~TEO.

          • JB…Grow-up, DC
            JB…As I suspected, a chiropractic meatball

            John, I am not the one tossing out childish insults.

          • DC: John, I am not the one tossing out childish insults.

            No childish insults, DC. I just describe chiropractic things and chiropractors as I see them. My criticisms are accurate, informed, and insightful. That said, your posts here serve to demonstrate, if not validate, my typical criticisms of “chiropractic” and chiropractors, especially those I’ve made about the compensatory and defended chiropractor. I point these things out as if I were pointing to an open fly in someone’s pants:

            “Excuse me, doctor … aren’t you forgetting something?” 🙂

            It’s ALWAYS been up to you and the chiropractic profession to CLOSE their professional “fly” if they don’t want to be embarrassed when they go out in public. But, because the survival of a “chiropractic” and the relentless march of chiropractic imbecility takes priority in Chiroville, the profession’s BEST efforts to get its act together has never risen above “SURE we’ve got problems … doesn’t every profession.” Well, given all the open “flies” that critics like me a can easily point to and coherently describe, this itself is telling evidence of a profession spinning its chiropractic wheels.

            As for your latest non-sequitur and chiropractic defense: “One thing John failed to mention is that even though a pathological process may be present that does not necessarly [SIC] mean that person can no longer be under chiropractic care” … well, this is simply your lame assurance of a healthcare role for chiropractors (even for sick people) and the desperate peep of any chiropractic meatball struggling to find “oxygen” for themselves and their Chiropractic Choice ™ in my SOME GUIDELINES. My response, which was to simply point this out, isn’t a “childish insult.” In fact, your comment is an expression of the sort of compensatory and competitive behavior we observe frequently enough in Chiroville that I alert the potential chiropractic customer to this motif in the fifth AVOID/SEEK pair of my SOME GUIDELINES. But, who’s counting.

            You see? I didn’t “forget.” 🙂

            I’ve noticed that you typically don’t write more than a sentence or two about anything you post here. You won’t get very far with that. What do you suppose that’s about? For example, I’ve asked: “Tell me something about your practice. Do you “adjust” patients? Anyone who you don’t “adjust?” On what basis do you choose to “adjust” one area or another? IOW, how do you know what needs “adjusting?” Do you “check the legs,” palpate the spine, do you visualize “high shoulders” and “head tilt?” Do you use any particular chirodigm or do you just crack away? Activator?” Of course, you’re not restricted to answering these questions, although I think these would be a good starting place to see what’s on your Chiropractic Mind.

            Of course, you don’t ever have to say anything about anything, never mind about “chiropractic.” But, I do think it would be useful for those reading your posts here to know more about where you’re coming from … “chiropractically,” that is. It may help them to understand your painfully predictable attempts to counter criticisms leveled at what a chiropractor mmight think, say, and/or do in defense of YOUR Chiropractic Choice
            ™. While you’re only one chiropractor to be sure, I believe it will serve to give participants here a CONTEXT for any point you are trying to float and make their replies to you more pertinent.

            Go for it. Certainly, you believe what you think, say, and do professionally is medically worthy so my simple and straightforward questions to you about what you actually do for a patient as a chiropractor are relevant to any critique of “chiropractic” and chiropractors to which you might object. Simply saying you offer Chiropractic Care ™ as you just did is pathetic. In effect, Chiropractic Care ™ is for marketing and WEB advertising, the phrase “under chiropractic care,” a bottomless-pit meaning anything a chiropractor does and worse, wants it to be. Hence my rhetorical question to you, “What does that even mean,” adding a suggestion that you “Grow up.”

            Are you passing out my SOME GUIDELINES to your patients yet? 🙂

            ~TEO.

          • Calling me a “chiropractic meatball” is an insult.

            I actually enjoy having conversations with true skeptics, folks like Bjorn and Blue Wode. But people like John who feel the need to insult and belittle, they are a dime a dozen.

            Yes, some people need to grow up.

  • Chiroquackers become oblivious to the milieu of malarkey to which they exist. Thus they blurt out statements like “chiropractic care” but NEVER supply a definition as to the what, why and how of said activity.
    It’s much like suggesting one “meditate”, “stretch” or “pray” to effect an outcome. Platitudes, vagueness, self-aggrandizement and pointing out the bad-behavior of other professions seem to be their preferred method of engagement.

    • Chiropractic care is simply what most chiropractors do in clinical practice. Things like spinal manipulation, exercise, rehab, ergonomics, lifestyle advice. This has been covered in prior discussions.

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