Don Exnihilote wrote:What do you have against chiropractors? I don't know or care about the science, but sometimes there is no other avenue of relief.
You may not know/care about the science, but that is the theme of this thread, which is why I've mentioned it. But there's a larger social/economic component. Read on.
Chiropractic: A Skeptical View
Chiropractic is the most significant nonscientific health-care delivery system in the United States. As a result of their high level of organization and aggressiveness, chiropractors are licensed to practice in all 50 states and several foreign countries. Although a minority of chiropractors offer rational treatment, chiropractic's cultism is so well entrenched that the profession should be viewed as a societal problem, not simply as a competitor of regular health-care.
Spinal manipulation can be useful, but chiropractic's theoretical basis rests largely on a strange and never-demonstrated notion of "subluxations."
Chiropractic Vertebral Subluxations: Science vs. Pseudoscience
An orthopedic subluxation, a true vertebral misalignment, or a mechanical joint dysfunction that affects mobility in the spine is not the same as a “chiropractic subluxation” that is alleged to cause disease by interfering with nerve supply to organs. Such a subluxation has never been proven to exist. There is no plausible theory and no credible evidence to support the contention that “nerve interference” originating in a single spinal segment can cause an organic disease.
Unable to provide evidence that commonly occurring vertebral misalignment can cause organic disease, advocates of the subluxation theory have reasoned that there must be some other type of joint dysfunction that can affect general health. They have chosen, by consensus, to call this undetectable lesion a “vertebral subluxation complex,” which “embraces the holistic nature of the human body, including health, well-being, and the doctor/patient relationship as well as the changes in nerve, muscle, connective, and vascular tissues which are understood to accompany the kinesiologic aberrations of spinal articulations.”1
Some chiropractors claim to be able to locate these elusive subluxations by using surface electromyography, thermography, vibratory instruments, leg length checks, or by palpating the spine.
A largely ignored landmark review of the literature by a Ph.D. and a chiropractor (Nansel and Szlazak), published in 1995, concluded that there is not a single appropriately controlled study to indicate that any dysfunction in structures of the spinal column is a cause of organic disease.2 The review noted that pain and other symptoms referred from a spinal segment can “create overt signs and symptoms that can mimic, or simulate (rather than cause), internal organ disease,” lending no support to the vertebral subluxation theory. Spinal nerves are commonly irritated or compressed, causing pain and other symptoms in the musculoskeletal structures supplied by the affected nerve. But even the most severe compression of a spinal nerve does not cause organic disease.
A review of the current evidence on the epidemiology of the subluxation construct (Mirtz, et al, 2009) also failed to find any credible evidence supporting the chiropractic vertebral subluxation theory. This paper, authored by three chiropractors and a Ph.D., concluded that “No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.”3
While there is justification for use of the word “subluxation” when referring to a mechanical-type spinal problem, there appears to be no justification whatsoever for suggesting that a “chiropractic subluxation” can affect general health.
As some of you know, my wife writes the coverage guidelines for one of the largest health insurance companies in the country. These guidelines are based on science and efficacy, as determined by the medical community's standard practice of care and professional peer-reviewed journals which conduct actual science (e.g. double-blind, randomized controlled trials). According to her expert opinion having researched medical technology for over a decade, there is no credible science that supports chiropractic as legitimate, efficacious health care. The only reason your health insurance pays for it is due to lobbying efforts by the industry, thus carving out a huge hole in our rational, scientific, evidence-based health care system for pseudo-science, by-passing our professional standards for medicine. And driving up costs for everyone in order to fund a vast medical fraud.