As a future practicing MD, what's your take on chiropractics?

May 4, 2010
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I have my own opinions, Im curious as to what you guys/gals think about the current practice of chiro's?
 

iniquus

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I don't necessarily know enough to make an educated decision. However, a doctor at a top hospital told me that no one should ever go to the chiropractor. If you are having a back problem, then you will either go to orthopedics or physical therapy.

A chiropractor will most likely give a treatment that only helps for the short-term. By ensuring that you come back, they have a steady patient base. A physical therapist will work on strengthening your back muscles, so you have a long-term solution to back pain. If the problem is more medically related, then someone in orthopedics should be seen.
 

TarHeelEMT

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One of my all time favorite H+Ps from pediatrics went something like this:

Mother took patient to chiropractor after three day history of fever, neck swelling, and sore throat. Patient was evaluated by chiropractor spine was adjusted. One day later, patient presented with mother to emergency department complaining of worsening fever, neck swelling, sore throat, and new onset of posterior neck pain and decreased range of motion.

(Note: The kid had a retropharyngeal abscess with mass effect in his airway)
 

gettheleadout

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I've heard that manipulation works better than placebo, which makes sense, but still I'd rather patients see more medically related professions (physical therapists, ortho specialists, etc..) that don't try to cure ear infections by fixing some magical subluxation in your SPINE.

Medicine should be a

 

WorldChanger36

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Chiros are not needed.There practice is questionable at best, although they have gotten lucky with a few studies although as the last poster stated these are covered in medicine and they actually work to fix the problem.

Although this thread will most likely bring back the Chiros are not real docs flame war, most people on here don't have a very high opinion of Chiropractic. If you hurt your back go to a doctor that can rehab it back into shape not to a doctor that can just block the pain with meds or a Chiro that will crack your bones and tell you that he could have prevented that flu you had last week if you came in earlier.
 

Perrotfish

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1) The adjustment of the spine does not work for any condition, including lower back pain, relative to placebo or sham manipulation

2) The manipulation of the neck is dangerous and can result in vertebral artery tears and an increased incidence of stroke

3) Chiropractic practicioners are more likely than any other profession to default on their student loans because the huge number of schools has flooded the market with professionals. As such there is a lot of pressure on chiropractors to keep their customers forever, regardles of whether or not they recover. Taking money from someone without providing a useful service in exchange is bad, expecially when you're taking a LOT of money.

4) A bad chiropractor can be a gateway drug, with just enough scientific knowledge to make even more pseudoscientific professions (accupuncture, healing crystals) seem reasonable to your otherwise credulous patients.

5) Chiropractors seem to be more likely than any other CAM profession to overmanage their patients, rather than refering to a real healthcare profession for real medical conditions. It's dangerous when you have patients thinking of someone without meaningful healthcare training as their primary practicioner.

6) Of all the CAM practicioners I've met, chiropractors have always been the most intelligent, had the best personalities, have the strongest education in physiology, and as far as I can judge have been the most completely sincere in their belief that they are helping people. They're not scam artists, or at least they're not trying to be. That being said our primary duty is to our patients and, much like shamens, Hmong exorcists, and that doctor who did all of those lobotomies in the 70s the fact that chiropractors are very sincere does not preclude them from being wrong. Even if they're good enough with physiology to be competent physicial therapists you can't risk sending your patients to them just because you need a PT appointment and the patient prefers a chiro.
 

WorldChanger36

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6) Of all the CAM practicioners I've met, chiropractors have always been the most intelligent, had the best personalities, have the strongest education in physiology, and as far as I can judge have been the most completely sincere in their belief that they are helping people. They're not scam artists, or at least they're not trying to be. That being said our primary duty is to our patients and, much like shamens, Hmong exorcists, and that doctor who did all of those lobotomies in the 70s the fact that chiropractors are very sincere does not preclude them from being wrong. Even if they're good enough with physiology to be competent physicial therapists you can't risk sending your patients to them just because you need a PT appointment and the patient prefers a chiro.
This point here is what makes Chiros the scariest. Just like faith healers eventually they can get people to walk away from the good medicine that just could save their lives.

Sincerely wrong is always the worst kind of wrong to be.
 

mmmcdowe

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If non-cervical manipulation makes you happy, makes you feel more in control, or makes you more likely to follow my medical advice then I'm not going to actively speak out against it. If you ask for my opinion, I will tell you that the efficacy of chiropractic medicine in pain management is still debated enough that I would try more conventional therapies first and the evidence for efficacy in other medical conditions is such that I would not recommend it as a primary or even adjuvant therapy. If any CAM practitioner is trying to get you off my treatment regimen in favor of theirs, especially for something with other dangers besides pain, then we have a problem.

For me, it's just like taking glucosaminoglycans and whatnot for rheumatoid arthritis. The evidence does not weigh in favor of it, but if it helps you subjectively then as long as it isn't hurting you or bankrupting you I'm not going to fight that battle most of the time. Honestly, my biggest problem is with herbalism more than any other CAM. Screw efficacy testing, I just think it's terrifying that people are subjecting their bodies to substances that may be detrimental to their health on top of unproven efficacy. At least I can say excess alcohol and chronic NSAID use is bad for you and what the most common complications are.