Chiropractors

[Dave Gray]

By and large, I believe the profession of chiropractics to be complete and utter bullshit.  I won't go as far to say that it's completely useless; There's probably a placebo affect in there somewhere, and I imagine that it helps alleviate some specific things in a way similar to getting a massage, but the overall concept of "realignment" carries no real medical value.  I think it's an accepted form of snake-oil.

There is a person I know who is very, very nice.  We aren't "friends", in that we hang out outside of our common interests, but we are acquaintances that are in a club together, so I see her each weekend.  We're friendly -- we talk about things, she's creative and we share ideas on some of our other projects.  Anyway, this is what she does for a living and she's really passionate about it.  She's recently started her own business, and I get a lot of links to her things -- like asking to become a fan or vote for her in some local business contest -- stuff like that.  She isn't pushy or anything like that.

Anyway, my interest in her well-being (being as that I like her as a person and think that she's genuinely pleasant) conflicts with my desire to rid the world of pseudoscience.  If she were a plumber or something, I'd give her advice on SEO to make her have a better website.  How would you handle this?

[Buddhagirl]

My chiropractor is the only person that can help with my piriformis issues. (I actually get a pain in my ass. Seriously. That's what it is.) I have a tilted pelvis. The more I run the more tilt there is. I go in. He readjusts and my hips go back to a normal position.  If I do my exercises everything stays in line. When I don't, my piriformis starts to hurt again and I can't run.

Not sure why you consider it pseudoscience, but you should man up and tell her that's what you think of her profession. Otherwise, you're being dishonest with her and she'll understand that you don't wish her success with her business.

[Sunstroke]

I see chiropracty a lot like I see the eyedrops, Visine. The more you use it, the more you need to use it, when you probably should have just used some natural saline tears or something to start with.

I do think you should help her if you can though... You aren't going to rid the world of this form of pseudoscience in your lifetime, so you may as well help her just to be nice and set a shining example for others.

I am anti-religion at my very core, but when my neighbor (a local church pastor) asks me if I can help him move or lift something, I don't think "no, he's religious...I better not help him, as I'd be indirectly helping organized religion." I say "no sweat, pastor John" and help him out.

[Buddhagirl]

I see chiropracty a lot like I see the eyedrops, Visine. The more you use it, the more you need to use it, when you probably should have just used some natural saline tears or something to start with.

I agree with this. Honestly, if I were better with my stretching and strengthening I wouldn't need to see the chiro.

Further, I don't understand the people that go to the chiro for a cold or stuff like that.

[Dave Gray]

I don't want to spout off about chiropractics, since I admittedly don't know a ton about it.  Here's a link from a skeptical publication explaining its lack of a medical basis.  ...if you're interested.

http://www.skepdic.com/chiro.html

(I actually read this after I made my post, but a lot of the major issues are the same.)

In short, testimonials of people saying that it works for them (like in your case) aren't good enough for science.  Medicinal practices need to pass a double-blind study with a control group to eliminate the various biases that come with this kind of thing.

[Buddhagirl]

I don't want to spout off about chiropractics, since I admittedly don't know a ton about it.  Here's a link from a skeptical publication explaining its lack of a medical basis.  ...if you're interested.

http://www.skepdic.com/chiro.html

(I actually read this after I made my post, but a lot of the major issues are the same.)

In short, testimonials of people saying that it works for them (like in your case) aren't good enough for science.  Medicinal practices need to pass a double-blind study with a control group to eliminate the various biases that come with this kind of thing.

The only issue I have here is that when dealing with pain issues it varies widely from person to person why they are in pain. I'm not quite sure how you would control that.

I've tried physical therapy, medical drs, etc. A quick adjustment of the hips and I'm up and running. That's all the proof I need. Of course, this is an experiment of one as are most things like this.

However, that's beside the point. If you don't believe in it you need to tell her. Period. Otherwise, you're being disingenuous.

[bsfins]

Hijack,but perhaps the same realm....What about acupuncture? Do you consider it bunk too?

[Dave Gray]

The only issue I have here is that when dealing with pain issues it varies widely from person to person why they are in pain. I'm not quite sure how you would control that.

I've tried physical therapy, medical drs, etc. A quick adjustment of the hips and I'm up and running. That's all the proof I need. Of course, this is an experiment of one as are most things like this.

However, that's beside the point. If you don't believe in it you need to tell her. Period. Otherwise, you're being disingenuous.

A control group just means that you're not doing anything.

Ideally, you have large groups of people to test, to reduce statistical anomalies.

Then you have a test where you're doing "correct" chiropractics.
Then a test where you have "incorrect" chiropractics.
Then a test where you use a previously proven treatment (perhaps a medicine or heat wrap or something...who knows).
Then a test where you do nothing. (a control group)

A double-blind study means that the patient doesn't know which of the treatments they're getting AND the doctor doesn't know which treatment they're giving.  It's hard in applications like chiropractics and acupuncture. 


Why do I need to tell he?r -- I don't tell you what I think of your job, out of nowhere.  If she asked me, I'd absolutely say something, but to this point, I've had no reason to bring it up.

[Buddhagirl]

Then you have a test where you're doing "correct" chiropractics.
Then a test where you have "incorrect" chiropractics.
Then a test where you use a previously proven treatment (perhaps a medicine or heat wrap or something...who knows).
Then a test where you do nothing. (a control group)

This is kind of my point. How do you control something that works differently for different people. One person physical therapy works. The next active release therapy works. Maybe the next person just needs to strengthen that part of the body. That's part of the issue with any sort of "pain" issues.

I think you need to tell her so that you don't have to conflict with your desire to rid the world of pseudoscience. I would hate to think someone respects me etc when he/she actually thinks I'm a quack. That's what this is really about. You think she's a quack.

[Phishfan]

^^^ It is a bit impossible to do any type of blind study. In order to not know the chiropracter is not treating you, you basically have to have no idea what a chiropracter is. Like you said it doesn't lend itself to that type of study.

I don't think you can call it pseudoscience because some people actually need these treatments and they do indeed cause a change in the body.

Generally speaking, my problem is that chiropracters tend to not turn people away if they do not need the service. A medical doctor would not give you medicine just because you feel you have a problem. A Chiropracter will typically ask you to come back three times a week for uneccesary reasons.

[Dave Gray]

That's what this is really about. You think she's a quack.

Hmm....sort of.  I actually don't "hate" chiropractics, like I do something like homeopathy, which I think is an outright scam.  I think that it does have benefits, but not in the realm (or for the reasons) that it claims.  I don't think that chiropractics is unethical or completely without merit like some other forms of psuedoscience.  It's kind of a "tweener". 

But if it comes up, maybe I'll mention it.  It's kind of like religion.  I don't hide my religious views, but at the same time, I don't go telling random people that I think their religion doesn't make any sense.

[StL FinFan]

I think chiropractics (and acupuncture) have a place in pain management.  However, as far as these  being able to treat or cure disease, I call bullshit.

Just a note:  I took my dog to a colleague who was certified in veterinary acupuncture and she taught me how to do it on my dog for her hip arthritis.  It helped and improved her quality of life without potentially harmful drugs.  She had liver disease so I did not want to give her anything other than what was absolutely necessary.  I started treating her with glucosamine/chrondroitin and acupuncture when she was 12.  She lived to be 17, when I euthanize her when her arthritis got so bad she could not get up anymore.

[bsmooth]

What would you say to those of us who have gone the traditional route and see your beloved medical professionals, only to be told they cannot find anything wrong, or they put you on drugs that mess your head up so bad you feel like you are falling down drunk?
I have been that route for over a year with my back and neck problems. When I told them that I had partial loss of feeling in my feet, they stuck needles into my legs and ran an electric current through my nerves, and that did not work.
I actually had one doctor say that I should just lose some weight ( she has since been fired for her treatment of patients).
I have found some relief finally through a chiropractor, and we are working on the other issues that the other doctors and their "real" science could not figure out.
Far from being a pseudoscience, I would call it a niche medical field that can help with certain  health aspects that get overlooked in the standard way of medical thinking.

[Dave Gray]

health aspects that get overlooked in the standard way of medical thinking.

I reject this assessment that there is anything other than a standard way of medical thinking (or any kind of thinking).  In order for anything (medical or otherwise) to be deemed effective, it has to pass certain standards.

I'm not a blind supporter of big medicine or anything like that.  But just because a doctor couldn't find anything wrong with you doesn't mean that chiropractics is effective.  Even if it "works for you", it's not necessarily effective.  I know that sounds like a stupid statement, but given how confirmation bias and placebos work, it makes sense.

There is no such thing as an alternative treatment.  If any treatment passes basic scientific tests, it's adopted.  Perhaps your doctor doesn't adopt it, but it is a proven treatment.

[fyo]

There is only one valid method: The scientific method. It's simple, it requires openness -- both of method and of mind. The latter tends to fail for some .

Anyway, Dave is essentially right. There is no such thing as alternative treatment -- only treatment that has been scientifically proven, treatment for which no studies have been done, and treatments which have been proven to work no better than placebo.

While blinding (and double-blinding) is indeed important in validating a treatment, it's by no means the only element. "Randomization" is also extremely important (essentially determining which patients are subjected to which treatment). Poor randomization can easily skew the results making a bogus treatment appear to work quite well -- even with double blinding!!!

Let me cut to the chase: Chiropractic doesn't appear to be bogus (not entirely, anyway).

I didn't know, had mixed "feelings" about it, so I looked it up. There's an awesome non-profit, independent research institution called The Cochrane Collaboration (cochrane.org). Their main focus is systematic reviews of health care treatments. To say that their research has saved lives is an understatement. (They've also repeatedly concluded that a bunch of big pharma drugs had undiscovered harmful side effects, worked no better than cheaper alternatives, no better than placebo etc).

Anyway, this is the logical choice to go for solid scientific FACT about a treatment.

With regards to chiropractic, there are a numbers of ongoing studies, but if we focus on one aspect - spinal manipulative therapy, there are some conclusions. This treatment is performed by chiropractors, as well as other health professionals, including doctors. It's not "all of chiropractic", just a single "intervention" performed by chiropractors, amongst others. Anyway:

A Cochrane review of spinal manipulative therapy (SMT) for low-back pain concluded that SMT was not superior to other effective treatments, but was more effective than placebo (Assendelft 2004).

http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005427/frame.html
(you have to click "next" to get the full text, which includes the cited part).

So, SMT isn't bogus. It may not be a magic pill, but it apparently does work. On average, it's not better than other effective treatments (which include "pain medication", "exercises", "physical therapy", and others), but it's better than placebo.

Homeopathy, on the other hand, is complete and utter bullshit.

Crystal therapy, likewise, is complete and utter bullshit.