Let’s say your back hurts. You go to a chiropractor, over a few visits they crack a few joints, and that’s all she wrote, right? That’s certainly what I used to think about chiropractic. The thing is, though, there’s some modern back cracking practice built on some rather out there origins.
Chiropractic was founded in the mid-1890s by D.D. Palmer, and according to Wikipedia, he claimed that the idea came to him from “the other world.” Which other world, you might ask? Apparently, it was a doctor who had died 50 years prior. So yeah, we’re not starting off well.
Old-school chiropractic types, also known “straight” chiropractors, believed in vitalism, meaning that there’s some sort of life energy that distinguishes living from non-living things. Ah, non-measurable life force energy, a popular favourite in quackery. These folks also reject scientific principles. More modern “mixers” accept some of the original beliefs, but also incorporate science.
In traditional chiropractic, all health problems are seen as stemming from vertebral subluxation, as this interferes with the “innate intelligence” expressed through the nervous system, which in turn impairs the body’s natural healing abilities. These so-called subluxations aren’t actually visible on X-ray. “Mixers” accept the idea of other causes of disease in addition to vertebral subluxation.
According to an editorial by Johnson et al, the American Medical Association put up a fight against chiropractic, even creating a “Committee on Quackery” to “contain and eliminate chiropractic.” In 1966, the AMA adopted a policy that described chiropractic as an “unscientific cult” with a “rigid adherence to an irrational, unscientific approach to disease causation.”
Modern “mixer” chiropractic
Websites of modern chiropractic organizations mostly focus on the back pain and other sorts of joint pain that you might expect. That’s what they do, the know how to do it, no problem. However, there’s a bit of quackery mixed in here and there.
The website of the Association of Chiropractic Colleges says this about vertebral subluxation:
Chiropractic is Concerned [sic] with the preservation and restoration of health, and focuses particular attention on the subluxation.
A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.
Sounds a bit different from the “straight” perspective, but a subtle flavour is still there.
The National Center for Complementary and Integrative Health has this to say about chiropractic:
… [It] emphasizes the body’s ability to heal itself. Treatment typically involves manual therapy, often including spinal manipulation. Other forms of treatment, such as exercise and nutritional counseling, may be used as well.
It adds that the purpose of joint manipulations is to improve joint motion and function. That sounds quite reasonable. Nutritional counselling seems like a bit of a random add-on, but I didn’t see an explanation of the reasoning behind that.
Side effects of spinal manipulations are common, and it’s estimated that up to 61% of people experience a short-term worsening of pain and stiffness. In some cases, manipulation of the upper spine can lead to permanent disability or even death. Strokes occur as an adverse event in an estimated 5 out of 100,000 manipulations; note that this is number of manipulations, not number of patients.
In my neck of the woods, there have been chiropractors in the news in recent years for taking an anti-vaccination stance. The original chiropractor, D.D. Palmer, described vaccines as “filthy animal poisons,” and the basis for this was his rejection of the medical field as a whole. Modern anti-vax chiropractors focus heavily on what they see as downsides to the vaccine without acknowledging any public health benefits. “Straight” chiropractors are also against water fluoridation.
More recently in my province (British Columbia, Canada), the regulatory body for chiropractors has issued a directive that chiropractors are not to make claims that they can reposition fetuses in utero, including turning them from breech position. They’re also not allowed to claim that they can make labour shorter, easier, and less traumatic, or that they can treat postpartum depression. The regulator cites lack of evidence as the reason for its directive. The fact that this is even an issue at all clearly implies that some chiropractors were making these unsupported claims in the first place.
If you’d like to see some straight chiropractic quacky fun, you can check out the video here (there’s no hyperlink because I’d rather not give them a backlink): https://www.straightchiro.com/resources/videos/spinal-hygiene-video/
Overall, it sounds like chiropractic started with a foundation of quackery, and then most chiropractors (although not all, like the guy in the video) built some much more reasonable layers over top. The problem with shaky foundations, though, is how do you trust what you’re walking on?
Were you aware of chiropractic’s quacky past (and present)?
- Association of Chiropractic Colleges: Chiropractic paradigm: Scope & practice
- Busse, J.W., et al. (2005). Chiropractic antivaccination arguments. Journal of Manipulative and Physiological Therapeutics, 28(5), 367-373.
- College of Chiropractors of British Columbia: Amendments to the Professional Conduct Handbook and Efficacy Claims Policy: Webster Technique and Pregnancy Related Conditions
- Johnson, C., et al. (2008). Chiropractic and public health: Current state and future vision. Journal of Manipulative and Physiological Therapeutics, 31(6), 397-410.
- National Center for Complementary and Integrative Health: Chiropractic
- Wikipedia: Chiropractic
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