Forbes Article Trashing Chiro/OMT

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There is not a whole lot of evidence that would make chiro better than the standard of care for anything.

OMM for the most part is not evidence based either.

Both have questionable scientific underpinnings with chiro being completely divorced from the way we know the body works at the current time.
 
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Chiro is pseudoscience.

Their neck manipulation is the scariest considering it can lead to spontaneous dissection of an artery that will give you a massive stroke
 
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It’s excellent and true.

Unfortunately there is a growing population in this country that dismiss glaring falsehoods and ignore science in favor of how things stimulate their feels.

In the trailer parks it’s “the flu shot gives me the flu”, in the Bay Area it’s “GMOs give you cancer”, but it’s all the same.
 
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IMO, the article is a little too one-sided.
 
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The chiropractic videos always looked intuitively dangerous lol might be 'cause I was an EMT it's like the opposite of holding c-spine
 
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I won't comment on OMM; But I would never go to a Chiropractic specialist or a naturopath.. In the age of reason we should seek treatment from doctors/providers who believe in evidence based medicine.

I also probably would be uneasy if my doctor said they think evolution isn't true, but that wouldn't necessarily make me question them unless they were academics.
 
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I can't say chiro is 100% BS - I slipped a disk in middle school. Couldn't sit, stand up, or walk by myself. Hell, I had to have help getting on and off the toilet - any movement at all in my back made me have back spasms to the point that I was on the floor again. I saw a chiropractor 2x a week for around two months, and I was able to walk, stand, and sit on my own again a few weeks in. Took probably 4-5 months before my back was normal and I didn't have to stand in the back of class instead of sitting to avoid putting pressure on my back, but that was okay.

Looks like the standard treatment for those types of muscle spasms from the allopathic side once OTC anti-inflammatories fail (according to Dr. Google, feel free to correct me if I'm wrong) is prescription muscle relaxers, narcotics, and possibly back surgery. I'm still pretty happy that I didn't have to have narcotics or back surgery as a teenager.

Granted, n=1 and I never saw a MD for these problems, but I still can't help but feel like chiropractors have their place - for certain conditions in certain people.
 
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I can't say chiro is 100% BS - I slipped a disk in middle school. Couldn't sit, stand up, or walk by myself. Hell, I had to have help getting on and off the toilet - any movement at all in my back made me have back spasms to the point that I was on the floor again. I saw a chiropractor 2x a week for around two months, and I was able to walk, stand, and sit on my own again a few weeks in. Took probably 4-5 months before my back was normal and I didn't have to stand in the back of class instead of sitting to avoid putting pressure on my back, but that was okay.

Looks like the standard treatment for those types of muscle spasms from the allopathic side once OTC anti-inflammatories fail (according to Dr. Google, feel free to correct me if I'm wrong) is prescription muscle relaxers, narcotics, and possibly back surgery. I'm still pretty happy that I didn't have to have narcotics or back surgery as a teenager.

Granted, n=1 and I never saw a MD for these problems, but I still can't help but feel like chiropractors have their place - for certain conditions in certain people.

what exactly did the chiropractor do? was it like physical therapy or did he do the cracking thing?
 
I can't say chiro is 100% BS - I slipped a disk in middle school. Couldn't sit, stand up, or walk by myself. Hell, I had to have help getting on and off the toilet - any movement at all in my back made me have back spasms to the point that I was on the floor again. I saw a chiropractor 2x a week for around two months, and I was able to walk, stand, and sit on my own again a few weeks in. Took probably 4-5 months before my back was normal and I didn't have to stand in the back of class instead of sitting to avoid putting pressure on my back, but that was okay.

Looks like the standard treatment for those types of muscle spasms from the allopathic side once OTC anti-inflammatories fail (according to Dr. Google, feel free to correct me if I'm wrong) is prescription muscle relaxers, narcotics, and possibly back surgery. I'm still pretty happy that I didn't have to have narcotics or back surgery as a teenager.

Granted, n=1 and I never saw a MD for these problems, but I still can't help but feel like chiropractors have their place - for certain conditions in certain people.

No orthopod in their right mind would give narcotics or do back surgery for a disc problem in a young person. PT, nsaids, and time is what solves the issue in a few weeks. That’s what likely happened to you. You would have gotten better with or without the chiropractor, but they may have done “physical therapy” type things that sped up the process. Correlation =/= causation.


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The larger issue here is that there is a ton that medicine does that has been shown to be ineffective. Knee scopes and vaginal/prostate exams are just a few of things routinely done that don’t have evidence behind their efficacy, and more than a little data that shows they are a waste of time and resources. I would love to see how much medicare $$$ is spent on knee scopes.

I am definitely not OMMs biggest fan, far from it, but a pretty good chunk is literally just PT. If PT can bill for it then a DO should be able to. Anyone billing for cranial should be arrested for fraud.

One does not need to give equal time to psuedo science.

There are parts of OMM that should only be taught at Hogwarts, but a decent chunk of it is actually helpful and is basically PT. It’s also generally used as part of a larger treatment plan, and not the sole treatment as is often the case with chiropractics. Basically the “PT, NSAIDs, and rest” that was mentioned above except replace PT with OMM.
 
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what exactly did the chiropractor do? was it like physical therapy or did he do the cracking thing?
Both - he did back cracking, and worked with me on exercises and gave me some to do at home for back strengthening.
 
I will say that after motorcycle accidents, I always went to a chiropractor. MD recommended muscle relaxers, whereas the chiropractor shoved me back into place. However, everything else is bull#h@t. It can't cure cancer or prevent the flu, but I wanted my spine to line up without months of therapy and plenty of narcotics.
 
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I am definitely not OMMs biggest fan, far from it, but a pretty good chunk is literally just PT. If PT can bill for it then a DO should be able to. Anyone billing for cranial should be arrested for fraud.

I've heard PT and DO compared. Which came first if they are even applicable to compare?

+1 for the people who had chiropractic success. He did teach me some exercises/stretches to do along with the adjustments. It helped some lower back/hip pain I had in sports. I honestly don't think we could have afforded to try to go to an ortho or physical therapy at the time. The chiropractor was free for sports players and a chance to get out of class :)
 
When i saw a chiro, he spent more time stretching my spine than cracking it. It felt great and i definitely left feeling better than I went in.

Not that it probably matters, but OMM is lumped into CAM practices, which also include chiro, acupuncture, herbals, etc
 
I've heard PT and DO compared.

PT and DO are not comparable. DO is a fully licensed medical degree and in practice essentially indistinguishable from the MD whereas PT is an allied health profession.

OMM and PT can be comparable for a number of techniques, as to when the techniques were first introduced by both sides I have no idea but they most likely were developed somewhat separately based on the same principles around a similar time.
 
The larger issue here is that there is a ton that medicine does that has been shown to be ineffective. Knee scopes and vaginal/prostate exams are just a few of things routinely done that don’t have evidence behind their efficacy, and more than a little data that shows they are a waste of time and resources. I would love to see how much medicare $$$ is spent on knee scopes.

I am definitely not OMMs biggest fan, far from it, but a pretty good chunk is literally just PT. If PT can bill for it then a DO should be able to. Anyone billing for cranial should be arrested for fraud.



There are parts of OMM that should only be taught at Hogwarts, but a decent chunk of it is actually helpful and is basically PT. It’s also generally used as part of a larger treatment plan, and not the sole treatment as is often the case with chiropractics. Basically the “PT, NSAIDs, and rest” that was mentioned above except replace PT with OMM.
Could you please tell me which parts of OMT are evidence based? I keep on hearing there are good parts, tell me an indication and a technique so I can look at the data myself.

Here is a systematic review where they looked at OMT for muscloskeletal pain and found no evidence of efficacy.
Osteopathy for musculoskeletal pain patients: a systematic review of randomized controlled trials
 
I will say that after motorcycle accidents, I always went to a chiropractor. MD recommended muscle relaxers, whereas the chiropractor shoved me back into place. However, everything else is bull#h@t. It can't cure cancer or prevent the flu, but I wanted my spine to line up without months of therapy and plenty of narcotics.

Given that chiro has been shown to be no more effective than sham treatment, it’s likely that you would have gotten better anyway.
 
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PT and DO are not comparable. DO is a fully licensed medical degree and in practice essentially indistinguishable from the MD whereas PT is an allied health profession.

OMM and PT can be comparable for a number of techniques, as to when the techniques were first introduced by both sides I have no idea but they most likely were developed somewhat separately based on the same principles around a similar time.
What are these modalities and what are they efficacious to treat for ?
 
Lets start here. This took me 5 seconds to find. Maybe you should educate yourself on what we actually learn in OMM.

https://www.jospt.org/doi/abs/10.2519/jospt.2003.33.9.502?code=jospt-site
Did you just link an article with 19 people , which was not blinded to the investigators and had double the attrition rate in intervention arm vs placebo arm and hang your hat on that? Also look at their confidence intervals. Results are interesting, There are trials that support the use of homeopathy with larger N's do you think we should run out and teach that to everyone as well?
 
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Did you just link an article with 19 people , which was not blinded to the investigators and had double the attrition rate in intervention arm vs placebo arm and hang your hat on that? Results are interesting, There are trials that support the use of homeopathy with larger N's do you think we should run out and teach that to everyone as well?

Bro. Chill. I don't believe in OMM, but you need to hop off your "evidence based" high horse because tons of medical specialties lack proper evidence based medicine or practice against the evidence base. As Grey said above, this isnt just an OMM problem. Ortho as an easy example has many procedures that either lack evidence base, or go against the evidence. Literally after the AAOS published their rotator cuff guideline in 2011 numerous orthopaedic journals/societies thrashed the fact that there were literally ZERO recommendations with high quality evidence base, and most of the treatment guidelines were 100% opinion. Mind you, rotator cuff surgeries aren't some sort of zebra procedure, and there wasn't even enough quality evidence to compile a quality guideline. Also, knee scopes are coming under fire for being no better than placebo but they are still done. Plastic surgery as a field literally had to have a dedicated annual meeting a few years ago to "decide" to be an evidence based field. In fact, the reason we have this stupid opioid epidemic right now is because of one LETTER TO THE EDITOR in NEJM that said "hey guys opioids don't cause addiction in my very small group of patients" This happens in tons of fields. OMM is mostly silly, but it still has just as much evidence as a lot of medicine (zero-none). The fact that you would harp on something as low-scale as OMM for lacking evidence when we cut people open and give people pills every day with a lack of proper EBM for the procedures really shows how ignorant you are to the current literature backing a large proportion of medical procedures.

/rant
 
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Did you just link an article with 19 people , which was not blinded to the investigators and had double the attrition rate in intervention arm vs placebo arm and hang your hat on that? Also look at their confidence intervals. Results are interesting, There are trials that support the use of homeopathy with larger N's do you think we should run out and teach that to everyone as well?

Oh see I thought we were just throwing studies out there that proved our point. In that other thread you linked a study that only included 16 randomized controlled trials, where not a single one had a methodological quality rating of 5 (some had ratings of 1...) and they found that 5/16 actually showed significantly stronger reduction in MSK pain compared to controls, and then you tried to paint this picture that their findings somehow proved that OMM doesn’t help with MSK pain. The only conclusion anyone can accurately get out of that is that there isn’t enough data to go one way or the other.

You also are completely ignoring the point I brought up in my original post. What about the mounds of data that show that knee scopes are essentially worthless? How about the compelling data that says that prostate and vaginal exams have no utility in clinical practice?

Medicine is completely full of modalities and treatments that have zero evidence backing their efficacy. Going after OMM as hard as you are is a little ridiculous seeing as it takes 5 minutes to do and is very cheap compared to the thousands of dollars a patient may spend on a knee scope or back fusion that may in actuality only cause them more pain for months in end and lead to even greater healthcare expenditures.

I’m all for getting rid of practices that don’t have efficacy, but get rid of all of them instead of just cherry picking the ones you don’t like.
 
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Bro. Chill. I don't believe in OMM, but you need to hop off your "evidence based" high horse because tons of medical specialties lack proper evidence based medicine or practice against the evidence base. As Grey said above, this isnt just an OMM problem. Ortho as an easy example has many procedures that either lack evidence base, or go against the evidence. Literally after the AAOS published their rotator cuff guideline in 2011 numerous orthopaedic journals/societies thrashed the fact that there were literally ZERO recommendations with high quality evidence base, and most of the treatment guidelines were 100% opinion. Mind you, rotator cuff surgeries aren't some sort of zebra procedure, and there wasn't even enough quality evidence to compile a quality guideline. Also, knee scopes are coming under fire for being no better than placebo but they are still done. This happens in tons of fields. OMM is mostly silly, but it still has just as much evidence as a lot of medicine (zero-none).

Another tu quoque fallacy, just because someone else is doing something wrong doesnt make this right. Also last I checked we were talking about OMM and Chiro if we were talking about Ortho id be arguing the same thing. Another thing, those societies are actually trashing each other.
All I have asked for from the experts is give me an indication , and give me a technique that is evidence based. I keep on hearing there is good evidence for OMM for certain modalities, I am just asking for that.
 
Another fallacy, just because someone else is doing something wrong doesnt make this right. Also last I checked we were talking about OMM and Chiro if we were talking about Ortho id be arguing the same thing. Another thing, those scoeities are actually trashing each other.
All I have asked for from the experts is give me an indication , and give me a technique that is evidence based. I keep on hearing there is good evidence for OMM for certain modalities, I am just asking for that.

There is none, nobody will be able to provide you with any, and I don't see why it matters honestly. Seems pretty benign compared to the pills and procedures we are pumping into people with a lack of evidence. If somebody thinks a chiro/osteopath cured them by cracking or stretching their muscles then good for them. I would prefer people see a ciro/osteopath than hit up their local pain management clinic.
 
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