In this post we discuss the problems with chiropractic treatment, in particular regular or ongoing use of this method.
I remember my first chiropractic adjustment. After a huge crack, I left the practitioner’s office feeling 2 inches taller. Wow I thought, instant change, impressive.
Subsequent treatments neither produced the same noise, or the same sense of relief. I was seeing the gentleman concerned for a recurring hamstring issue, so the adjustments to my spine didn’t really seem that relevant. To me at least.
Chiropractic theory of the body
Chiropractors claim to treat a wide variety of maladies, but the majority of people see them for either lower back or neck pain.
Central to the chiropractic theory of the body is that physical issues can be traced to something they call subluxations in the joints of the spine.
Subluxation is a medical term which means a joint has partially dislocated. This is identified in hospitals by X-ray and causes considerable pain.
In chiropractic it means something more subtle. They often describe subluxations as ‘mini dislocations’ which are too small to be seen on scans.
Chiropractors claim these small misalignments in the joints of the spine interfere with the function of the nervous system by impeding its signalling.
They suggest their adjustments can correct for these misalignments and both reduce pain and improve health.
Are chiropractic subluxations real?
Subluxations in the chiropractic sense are controversial. Because they can’t be seen on scans, there is no scientific proof they actually exist. Something which some chiropractors recognise as an issue.
Even if subluxations in this context do exist, the suggestion that they have an effect on general health is certainly not proven.
It has been pointed out that even in cases where there is clear pressure on the nerves of the spine, such as with disc bulges, there are no long term consequences to health.
What do chiropractic adjustments achieve?
Whilst the evidence does suggest adjustments can have an impact on back and neck pain, they are no more effective than more conventional approaches to these issues.
The characteristic pop, which is the hallmark of these adjustments, appears to have no therapeutic benefit in itself. The accepted explanation for this sound suggests it’s caused by dissolved gas escaping from the synovial fluid within the joint. This occurs when the force of the adjustment separates the joint surfaces.
You’ll notice that cracks and pops can occur outside of the therapeutic setting with little effect.
One explanation for the impact of any treatment may be attributed to its effect on the muscular system. It has been shown that adjustments may reduce tension in the muscular system, although this doesn’t always occur.
The context in which the treatment takes place likely has a considerable effect. As well as the relationship between the patient and the practitioner.
What are the dangers of chiropractic adjustments?
Chiropractic adjustments are not without risk. Any time you introduce a relatively large force to a very specific area of the body, there’s a danger things can go wrong. These forces have been measured at up to 400N, which is the equivalent of a 90lbs person standing on you.
Whilst thankfully rare, there have been fatalities and life changing injuries as a result of chiropractic adjustments.
More common are side effects like muscle soreness, fatigue and headaches, which occur in around 50% of people.
With repeated adjustments over a period of time, the largest cost may be one of opportunity. Whilst some chiropractors give exercise to support their treatments, many do not.
If subluxations are real, the only thing that we can alter to keep the spine stable is the muscular system. You may be better off investing your time in a process that has a greater chance of a long term pay off such as resistance training.
Anecdotally, I find people who have received long term chiropractic care lack self efficacy and are under the impression they require regular adjustments, even if they’re no longer in pain. Something which the evidence doesn’t support.
Summary
Whist chiropractic treatment can have an influence on back and neck pain, this must be weighed against the potential risks.
Repeated treatments over longer periods of time are not supported by the evidence. Neither is the effect on specific diseases, which some chiropractors claim to treat.
Chiropractic’s greatest achievement may be to associate the feeling of stiffness that accompanies back and neck pain with a joint issue that may or may not exist, and a sound with a treatment effect which certainly doesn’t.