I got more help from my chiropractor than my MD!!!!

[JaneAustenFan]

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After over a year of recovery from a major car accident, I have come to the conclusion that my doctor (and the specialist he sent me to) are far less capable of treating certain injuries than my chiropractor. All my doctors did was give me pain medication (which of course I was thankful for, but I didn't get much else except some PT which did not help at all). I didn't start to heal and walk correctly again until I went to a chiropractor (which I did on my own because I was desperate to get better).

What pissed me off was that my primary care physician had kind of given up and said basically wait an see how far you can recover, but there is nothing else I can do for you except give you pain meds. He then went on a 10 minute rant (he took up the rest of the time I had for my appointment) when I told him at my next visit that I was seeing a chiropractor. It was a bit ironic that the person who wasn't helping me much was criticizing a profession that was helping me more.

The specialist my doctor sent me to was fine with my visits to the chiropractor since they seemed to be helping, but chiropractic care wasn't even brought up as a treatment option by the specialist either.

Why is there such a difference in opinion among MDs about the effectiveness of chiropractic care?

 

[MegaProjectile]

Traditionally the relationship between MDs and chiros hasn't been in the best of terms. A lot of MDs, particularly older generation, still hold some suspicion towards them(rightfully so in some situation) due to the lack of science or research in some of their claims. Chiropractic treatment is useful and effective for certain injuries. But just how much? What kind of injuries? Is the effectiveness long term or is it just placebo? These questions still linger and more research still needs to be done before the allopathic establishment can unabashedly recommend its patients there. There are some doctors who will recommend chiropractors wholeheartedly but I think most will first send you to a PT or PM&R before chiropractors.

Glad it worked out for you though.👍

 

[SparkleMotion]

Perhaps because DCs and MDs don't provide the same services. This is like saying your mechanic didn't clean your car half as well as your car cleaner did.

To the second part though, I don't know. Maybe something to do with chiro being a holistic practice - it comes off sounding something like homeopathic.

 

[Law2Doc]

...
Why is there such a difference in opinion among MDs about the effectiveness of chiropractic care?

The problem most physicians have with chiropractors is that while they may be good at certain manipulation techniques which may or may not be medically useful/necessary for certain limited conditions, they don't know medicine, yet often treat anyway. Back pain is one of those vague symptoms that could be caused by something very benign, to something life threatening. At one end of the spectrum, chiropractors do fine because there isn't really a good medical cure for most chronic back pain, so anyone that can make you feel better is probably adding value, even if there's no medical science supporting it. At the other end of the spectrum a non-medical course of treatment can actually be life threatening.

Most doctors know of at least one patient who died because they went to a chiropractor first, which ended up delaying treatment significantly for a cancer that should not have been treated chiropractically, and which would have been caught by most MDs/DOs. The most important skill you can have as a medical specialist is knowing when a problem is something outside of your own specialty, and folks who attend med school and then do a more generalized internship year before their specialty residency tend to have a much better handle on what's not in their scope of expertise thanks to this broad training. Chiropractors by contrast may see a patient with back pain and start on a course of manipulation, whereas a physician might be quicker to get concerned and send this person into a CT scanner and actually see a tumor at a time when it's still operative. So that's why physicians would not recommend chiropractors -- this is a field which runs afoul of good medicine in many cases, and all too often keeps sick people from actually getting the medical care they need. In your case where you already saw a physician and they had nothing more to offer you, then sure, a chiropractor might be your next stop. But in most other cases, it's probably not a medically sound path to take.

Not to mention that the physicians and chiropractors have had a very long legal battle history. Doctors tried to sue chiropractors out of existence a generation ago, calling them "quacks" who should not be allowed to call themselves doctor or touch patients. The physicians did not do a good job of convincing the courts that their monopoly on health issues was warranted, and after a very lengthy series of suits in multiple courts, the chiropractic industry won, much to the dislike and hostility of physicians.

So yeah, there's both good reason and long history of bad blood between physicians and chiropractors. If you are pre-allo and planning to go down the road of physician, you will ultimately come across folks who were done wrong by their chiropractors and you will start to appreciate why non-medical intervention that the lay public thinks is medical is a really dangerous idea, and all too often results in delays in treatment for folks who can't afford to wait.

 

[Nasrudin]

The problem most physicians have with chiropractors is that while they may be good at certain manipulation techniques which may or may not be medically useful/necessary for certain limited conditions, they don't know medicine, yet often treat anyway. Back pain is one of those vague symptoms that could be caused by something very benign, to something life threatening. At one end of the spectrum, chiropractors do fine because there isn't really a good medical cure for most chronic back pain, so anyone that can make you feel better is probably adding value, even if there's no medical science supporting it. At the other end of the spectrum a non-medical course of treatment can actually be life threatening.

Most doctors know of at least one patient who died because they went to a chiropractor first, which ended up delaying treatment significantly for a cancer that should not have been treated chiropractically, and which would have been caught by most MDs/DOs. The most important skill you can have as a medical specialist is knowing when a problem is something outside of your own specialty, and folks who attend med school and then do a more generalized internship year before their specialty residency tend to have a much better handle on what's not in their scope of expertise thanks to this broad training. Chiropractors by contrast may see a patient with back pain and start on a course of manipulation, whereas a physician might be quicker to get concerned and send this person into a CT scanner and actually see a tumor at a time when it's still operative. So that's why physicians would not recommend chiropractors -- this is a field which runs afoul of good medicine in many cases, and all too often keeps sick people from actually getting the medical care they need. In your case where you already saw a physician and they had nothing more to offer you, then sure, a chiropractor might be your next stop. But in most other cases, it's probably not a medically sound path to take.

Not to mention that the physicians and chiropractors have had a very long legal battle history. Doctors tried to sue chiropractors out of existence a generation ago, calling them "quacks" who should not be allowed to call themselves doctor or touch patients. The physicians did not do a good job of convincing the courts that their monopoly on health issues was warranted, and after a very lengthy series of suits in multiple courts, the chiropractic industry won, much to the dislike and hostility of physicians.

So yeah, there's both good reason and long history of bad blood between physicians and chiropractors. If you are pre-allo and planning to go down the road of physician, you will ultimately come across folks who were done wrong by their chiropractors and you will start to appreciate why non-medical intervention that the lay public thinks is medical is a really dangerous idea, and all too often results in delays in treatment for folks who can't afford to wait.

OP,

I agree with this person. However as a sufferer of protracted pain syndrome from a physical injury it is not we that are the lay person. As is the common theme when dealing with your numerous physicians in this area. Pain management is only now making some grudging developments. And very little is understood about etiology of pain and the spine and it's surrounding tissue. And just like the chiro's the MD/DO's will forge ahead treating you despite vastly inept results.

They may be right in assessing their competitors ineptness. But they are woefully poor at judging their own.

After years of struggle I have found only two things that work on the underlying cause rather than just smothering the symptoms superficially. Exercise and a healthy lifestyle that improves stress management--good sleep, diet, etc. More specifically hot yoga for exercise. And no physician even knew what they were talking about when I discusses my exercise routine with them. So they have become the periodic fillers out of paperwork for me while I treat myself with Yoga.

You'll have to find your own way is all I'm saying. Using your physical intuition and guarding yourself from harm.

Best of luck.

 

[MegaProjectile]

OP,

I agree with this person. However as a sufferer of protracted pain syndrome from a physical injury it is not we that are the lay person. As is the common theme when dealing with your numerous physicians in this area. Pain management is only now making some grudging developments. And very little is understood about etiology of pain and the spine and it's surrounding tissue. And just like the chiro's the MD/DO's will forge ahead treating you despite vastly inept results.

They may be right in assessing their competitors ineptness. But they are woefully poor at judging their own.

After years of struggle I have found only two things that work on the underlying cause rather than just smothering the symptoms superficially. Exercise and a healthy lifestyle that improves stress management--good sleep, diet, etc. More specifically hot yoga for exercise. And no physician even knew what they were talking about when I discusses my exercise routine with them. So they have become the periodic fillers out of paperwork for me while I treat myself with Yoga.

You'll have to find your own way is all I'm saying. Using your physical intuition and guarding yourself from harm.

Best of luck.

You are right. New industries tend to open when there is a deficiency in the existing structure or even absence of care. Pain management using the allopathic model has had quite a few criticisms since it mainly treats the symptoms while the source of pain remain. We are having to deal with a whole new generation of Americans addicted to painkillers(vicodin, demerol etc). Some patients want something different and when this happens patients actively seek out other forms of therapy such as acupuncture, yoga and , yes, chiropractory. Newer doctors, in my experience, are more liberal in allowing their patients to explore other forms of treatments. Some even recommend alternative health practitioners while they monitor the patient's condition for improvements or complication. Which is the way it should be done.

Chiropractors were wrong in overreaching their boundaries. MDs were also wrong their heavy-handed approach of trying to banish their competitors. Both can co-exist. Patients just need to know that not everyone who calls themselves "doctor" are medical doctors. Patients still need to go their PCPs for regular check-ups. That last part has been the reason for most of the tension as some patients tend to abandon their doctors when they go seek out alternative treatments.

 

[fahimaz7]

After over a year of recovery from a major car accident, I have come to the conclusion that my doctor (and the specialist he sent me to) are far less capable of treating certain injuries than my chiropractor. All my doctors did was give me pain medication (which of course I was thankful for, but I didn't get much else except some PT which did not help at all). I didn't start to heal and walk correctly again until I went to a chiropractor (which I did on my own because I was desperate to get better).

What pissed me off was that my primary care physician had kind of given up and said basically wait an see how far you can recover, but there is nothing else I can do for you except give you pain meds. He then went on a 10 minute rant (he took up the rest of the time I had for my appointment) when I told him at my next visit that I was seeing a chiropractor. It was a bit ironic that the person who wasn't helping me much was criticizing a profession that was helping me more.

The specialist my doctor sent me to was fine with my visits to the chiropractor since they seemed to be helping, but chiropractic care wasn't even brought up as a treatment option by the specialist either.

Why is there such a difference in opinion among MDs about the effectiveness of chiropractic care?

B/c chiropractors fail to practice evidence-based medicine. That, and the fact that some of them are treating hypertension, diabetes, and cancer through "spinal adjustments".

Some day they may get respect, but until they recognize the limitations of their practice, and provide evidence for their approaches, then no one is going to give them much respect. They are also the #1 professional to default on their loans.

 

[Law2Doc]

... Both can co-exist. Patients just need to know that not everyone who calls themselves "doctor" are medical doctors. ...

This puts an unrealistic burden on poorly informed patients. As you will see in med school rotations, most can't even tell the difference between a med student and a doctor, let alone two people wearing white coats who both call themselves doctor. Too many industries intentionally try to mislead patients in this way, ranging from calling themselves doctor, to wearing long white lab coats, to calling their practices "Alternative Medicine" (which suggests both that it's evidence based "medicine" and that it's a legit alternative, which in some cases it isn't). In many areas of commerce, ads and tags that mislead are called false advertising and fraud. Somehow in the arena of healthcare you are allowed to mislead and expect the customer to know better. Troubling IMHO.

 

[Tired Pigeon]

Having seen two patients end up in the neuro ICU with vertebral artery dissections after a chiropractic "manipulation", I would not be eager to refer a patient to a chiropractic practitioner. Just my anecdotal experience, YMMV.

 

[jturkel]

The problem most physicians have with chiropractors is that while they may be good at certain manipulation techniques which may or may not be medically useful/necessary for certain limited conditions, they don't know medicine, yet often treat anyway. Back pain is one of those vague symptoms that could be caused by something very benign, to something life threatening. At one end of the spectrum, chiropractors do fine because there isn't really a good medical cure for most chronic back pain, so anyone that can make you feel better is probably adding value, even if there's no medical science supporting it. At the other end of the spectrum a non-medical course of treatment can actually be life threatening.

Most doctors know of at least one patient who died because they went to a chiropractor first, which ended up delaying treatment significantly for a cancer that should not have been treated chiropractically, and which would have been caught by most MDs/DOs. The most important skill you can have as a medical specialist is knowing when a problem is something outside of your own specialty, and folks who attend med school and then do a more generalized internship year before their specialty residency tend to have a much better handle on what's not in their scope of expertise thanks to this broad training. Chiropractors by contrast may see a patient with back pain and start on a course of manipulation, whereas a physician might be quicker to get concerned and send this person into a CT scanner and actually see a tumor at a time when it's still operative. So that's why physicians would not recommend chiropractors -- this is a field which runs afoul of good medicine in many cases, and all too often keeps sick people from actually getting the medical care they need. In your case where you already saw a physician and they had nothing more to offer you, then sure, a chiropractor might be your next stop. But in most other cases, it's probably not a medically sound path to take.

Not to mention that the physicians and chiropractors have had a very long legal battle history. Doctors tried to sue chiropractors out of existence a generation ago, calling them "quacks" who should not be allowed to call themselves doctor or touch patients. The physicians did not do a good job of convincing the courts that their monopoly on health issues was warranted, and after a very lengthy series of suits in multiple courts, the chiropractic industry won, much to the dislike and hostility of physicians.

So yeah, there's both good reason and long history of bad blood between physicians and chiropractors. If you are pre-allo and planning to go down the road of physician, you will ultimately come across folks who were done wrong by their chiropractors and you will start to appreciate why non-medical intervention that the lay public thinks is medical is a really dangerous idea, and all too often results in delays in treatment for folks who can't afford to wait.

This puts an unrealistic burden on poorly informed patients. As you will see in med school rotations, most can't even tell the difference between a med student and a doctor, let alone two people wearing white coats who both call themselves doctor. Too many industries intentionally try to mislead patients in this way, ranging from calling themselves doctor, to wearing long white lab coats, to calling their practices "Alternative Medicine" (which suggests both that it's evidence based "medicine" and that it's a legit alternative, which in some cases it isn't). In many areas of commerce, ads and tags that mislead are called false advertising and fraud. Somehow in the arena of healthcare you are allowed to mislead and expect the customer to know better. Troubling IMHO.

very informative and helpful posts. thanks for the good info/read! 👍

 

[Alwaysbehopeful]

Also most people don't shop around for PCPs. I'm not sure if this is the case but with me I used to hate my PCP. She never listened to me and only took 5 mins to see me. I got really frustrated and so I switched to another PCP who was AWESOME! She never overbooked her patients and gave everyone 15-30 mins. She was great and would really want to get to know me.

So I know it can be frustrating if the doctors you are seeing aren't your cup of tea but shop around a little bit. Also I think chiro and alternative medicine practices like acupuncture is great for certain things. But like someone previous said for example acupuncture claims to help people lose weight which is pretty debatable.

Go to your specialist and ask them why they don't recommend chiro! I would want to know! Glad you are feeling better though!

 

[Charles_Carmichael]

I don't trust "alternative" medicine because I haven't come across any evidence (ie. studies) that suggests they're useful or that they're equal/better than available allopathic therapies. It seems to me that people turn to alternative practitioners, in large part, due to a distrust of conventional medicine.

 

[JaneAustenFan]

The problem most physicians have with chiropractors is that while they may be good at certain manipulation techniques which may or may not be medically useful/necessary for certain limited conditions, they don't know medicine, yet often treat anyway. Back pain is one of those vague symptoms that could be caused by something very benign, to something life threatening. At one end of the spectrum, chiropractors do fine because there isn't really a good medical cure for most chronic back pain, so anyone that can make you feel better is probably adding value, even if there's no medical science supporting it. At the other end of the spectrum a non-medical course of treatment can actually be life threatening.

Most doctors know of at least one patient who died because they went to a chiropractor first, which ended up delaying treatment significantly for a cancer that should not have been treated chiropractically, and which would have been caught by most MDs/DOs. The most important skill you can have as a medical specialist is knowing when a problem is something outside of your own specialty, and folks who attend med school and then do a more generalized internship year before their specialty residency tend to have a much better handle on what's not in their scope of expertise thanks to this broad training. Chiropractors by contrast may see a patient with back pain and start on a course of manipulation, whereas a physician might be quicker to get concerned and send this person into a CT scanner and actually see a tumor at a time when it's still operative. So that's why physicians would not recommend chiropractors -- this is a field which runs afoul of good medicine in many cases, and all too often keeps sick people from actually getting the medical care they need. In your case where you already saw a physician and they had nothing more to offer you, then sure, a chiropractor might be your next stop. But in most other cases, it's probably not a medically sound path to take.

Not to mention that the physicians and chiropractors have had a very long legal battle history. Doctors tried to sue chiropractors out of existence a generation ago, calling them "quacks" who should not be allowed to call themselves doctor or touch patients. The physicians did not do a good job of convincing the courts that their monopoly on health issues was warranted, and after a very lengthy series of suits in multiple courts, the chiropractic industry won, much to the dislike and hostility of physicians.

So yeah, there's both good reason and long history of bad blood between physicians and chiropractors. If you are pre-allo and planning to go down the road of physician, you will ultimately come across folks who were done wrong by their chiropractors and you will start to appreciate why non-medical intervention that the lay public thinks is medical is a really dangerous idea, and all too often results in delays in treatment for folks who can't afford to wait.

Hmm, okay. I just won't mention my visits there to him anymore.
Thanks,
-JAF

 

[JaneAustenFan]

Having seen two patients end up in the neuro ICU with vertebral artery dissections after a chiropractic "manipulation", I would not be eager to refer a patient to a chiropractic practitioner. Just my anecdotal experience, YMMV.

Yikes

 

[JaneAustenFan]

Also most people don't shop around for PCPs. I'm not sure if this is the case but with me I used to hate my PCP. She never listened to me and only took 5 mins to see me. I got really frustrated and so I switched to another PCP who was AWESOME! She never overbooked her patients and gave everyone 15-30 mins. She was great and would really want to get to know me.

So I know it can be frustrating if the doctors you are seeing aren't your cup of tea but shop around a little bit. Also I think chiro and alternative medicine practices like acupuncture is great for certain things. But like someone previous said for example acupuncture claims to help people lose weight which is pretty debatable.

Go to your specialist and ask them why they don't recommend chiro! I would want to know! Glad you are feeling better though!

I probably will switch primary care physicians, because I have had some other issues with this doctor (he is constantly yelling at his staff and he has yelled at me another time, even before I told him about visiting the chiropractor. And for no reason really; I think he is under a lot of stress).

 

[ronaldo23]

After over a year of recovery from a major car accident, I have come to the conclusion that my doctor (and the specialist he sent me to) are far less capable of treating certain injuries than my chiropractor. All my doctors did was give me pain medication (which of course I was thankful for, but I didn't get much else except some PT which did not help at all). I didn't start to heal and walk correctly again until I went to a chiropractor (which I did on my own because I was desperate to get better).

What pissed me off was that my primary care physician had kind of given up and said basically wait an see how far you can recover, but there is nothing else I can do for you except give you pain meds. He then went on a 10 minute rant (he took up the rest of the time I had for my appointment) when I told him at my next visit that I was seeing a chiropractor. It was a bit ironic that the person who wasn't helping me much was criticizing a profession that was helping me more.

The specialist my doctor sent me to was fine with my visits to the chiropractor since they seemed to be helping, but chiropractic care wasn't even brought up as a treatment option by the specialist either.

Why is there such a difference in opinion among MDs about the effectiveness of chiropractic care?

To sum up a physician's view on chiropractors, which I don't necessarily agree or disagree with...

"You went to a chiropractor (A), and you got better (B). That is not science; A & B may be true, but B is not a result of A. Lots of people didn't go and still got better. The key to quackopractic is to be in the right place at the right time. In other words, be there while the healing process occurs, put a little hands-on (massage, etc.) and take credit for any good outcome. The rest you massage until their insurance runs out and then send them on their way (usually to a real physician).
In the meanwhile, make sure you take lots of high-dose xrays of every human who walks in the door so that in 20 years everyone glows in the dark and reflective clothing is a thing of the past. (a hint to the consumer: all back films show something...nobody has a spine without some so-called abnormality). BTW, it takes 4 years after med school to become a radiologist and to know really how to read an xray; these guys have a couple of weeks of formal radiology instruction. They make the rest of it up as they go. Lastly, with all due respect to low achievers, I can tell you that the top 10% of no high school I know of ever decide to go into such a "field". These folks are generally hand-picked from the bottom of the academic barrel and simply dream of being called "doctor" by the kids who have smoked them all their lives.
Okay, don't get me started! "

 

[futureboy]

I believe there were studies 10-15 years ago that said that for certain basic injuries (cervical strain, etc.), chiropractic care was just as effective as the standard physician treatment (muscle relaxers, pain killers, physical therapy). As long as the patient sees a physician to rule out something more serious, it is probably ok to go to the chiropractor.

 

[JaneAustenFan]

To sum up a physician's view on chiropractors, which I don't necessarily agree or disagree with...

"You went to a chiropractor (A), and you got better (B). That is not science; A & B may be true, but B is not a result of A. Lots of people didn't go and still got better. The key to quackopractic is to be in the right place at the right time. In other words, be there while the healing process occurs, put a little hands-on (massage, etc.) and take credit for any good outcome. The rest you massage until their insurance runs out and then send them on their way (usually to a real physician).
In the meanwhile, make sure you take lots of high-dose xrays of every human who walks in the door so that in 20 years everyone glows in the dark and reflective clothing is a thing of the past. (a hint to the consumer: all back films show something...nobody has a spine without some so-called abnormality). BTW, it takes 4 years after med school to become a radiologist and to know really how to read an xray; these guys have a couple of weeks of formal radiology instruction. They make the rest of it up as they go. Lastly, with all due respect to low achievers, I can tell you that the top 10% of no high school I know of ever decide to go into such a "field". These folks are generally hand-picked from the bottom of the academic barrel and simply dream of being called "doctor" by the kids who have smoked them all their lives.
Okay, don't get me started! "

Umm, interesting perspective. Okay, I am really not going to say anything to my doctor tomorrow when I see him.
Thank you,
-JAF

 

[JaneAustenFan]

I believe there were studies 10-15 years ago that said that for certain basic injuries (cervical strain, etc.), chiropractic care was just as effective as the standard physician treatment (muscle relaxers, pain killers, physical therapy). As long as the patient sees a physician to rule out something more serious, it is probably ok to go to the chiropractor.

Yeah, I am not going to stop seeing my chiropractor, but I am not going to mention anything more to my doctor either.

 

[futureboy]

From the New England Journal of Medicine:

CURRENT ORIGINAL ARTICLE Vol 339 No 15 Pg 1021 October 8, 1998
A Comparison of Physical Therapy, Chiropractic Manipulation, and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain, Daniel C. Cherkin, Ph.D., Richard A. Deyo, M.D., M.P.H., Michele Battié, Ph.D., R.P.T., Janet Street, M.N., C.P.N.P., and William Barlow, Ph.D.
ABSTRACT Background and Methods There are few data on the relative effectiveness and costs of treatments for low back pain. We randomly assigned 321 adults with low back pain that persisted for seven days after a primary care visit to the McKenzie method of physical therapy, chiropractic manipulation, or a minimal intervention (provision of an educational booklet). Patients with sciatica were excluded. Physical therapy or chiropractic manipulation was provided for one month (the number of visits was determined by the practitioner but was limited to a maximum of nine); patients were followed for a total of two years. The bothersomeness of symptoms was measured on an 11-point scale, and the level of dysfunction was measured on the 24-point Roland Disability Scale. Results After adjustment for base-line differences, the chiropractic group had less severe symptoms than the booklet group at four weeks (P=0.02), and there was a trend toward less severe symptoms in the physical-therapy group (P=0.06). However, these differences were small and not significant after transformations of the data to adjust for their non-normal distribution. Differences in the extent of dysfunction among the groups were small and approached significance only at one year, with greater dysfunction in the booklet group than in the other two groups (P=0.05). For all outcomes, there were no significant differences between the physical-therapy and chiropractic groups and no significant differences among the groups in the numbers of days of reduced activity or missed work or in recurrences of back pain. About 75 percent of the subjects in the therapy groups rated their care as very good or excellent, as compared with about 30 percent of the subjects in the booklet group (P<0.001). Over a two-year period, the mean costs of care were $437 for the physical-therapy group, $429 for the chiropractic group, and $153 for the booklet group. Conclusions For patients with low back pain, the McKenzie method of physical therapy and chiropractic manipulation had similar effects and costs, and patients receiving these treatments had only marginally better outcomes than those receiving the minimal intervention of an educational booklet. Whether the limited benefits of these treatments are worth the additional costs is open to question.
Source Information From the Group Health Center for Health Studies (D.C.C., J.S., W.B.), the Departments of Health Services (D.C.C., R.A.D.), Family Medicine (D.C.C.), Medicine (R.A.D.), and Biostatistics (W.B.) and the Center for Cost and Outcomes Research (R.A.D.), University of Washington, Seattle; and the Department of Physical Therapy, University of Alberta, Edmonton, Canada (M.B.). Address reprint requests to Dr. Cherkin at the Group Health Center for Health Studies, 1730 Minor Ave., Suite 1600, Seattle, WA 98101. Ful

 

[JaggerPlate]

Not to try and flame here, or present this treatment as CAM or something (too) much like chiro, but I'd seriously go see a DO that specializes in manipulative medicine if you're looking for this type of relief. It's manual therapy in a variety of different modalities, but it's from a physician who can better diagnose, and refer/understand the 'allopathic' side of the situation probably a little better than a chiropractor. The biggest complaint I hear from DOs concerning Chiro (I'm going to a DO school next year) is that the DC's use 'shot gun' approaches in certain instances, meaning that there is less diagnosis and probability of return to proper structure/function, and more chances of some of the injuries people were discussing earlier. I'm not bashing Chiro, and I'm not touting osteopathic manipulation as some great thing that should be substituted for evidence based treatments (ie pain meds), but it's something I think you should check out based on your DC comments.

 

[holyhekshler]

Just to add my two cents: I think that 98% of MDs have absolutely no interest in and no knowledge of how to treat chronic pain conditions. They push pills, often criticize the patient, and do not offer alternatives. I had horrible experiences before finding help through an alternative therapy much Less accepted than chiropractics. This therapy saved my life. I have limited experience with chiropractic so I can't really speak to its efficacy. However, like the OP, I have also learned to manage my issues with exercise and yoga and have managed to keep my pain at reasonable levels. My research goal while in medical school is to provide more concrete evidence of how alternative therapies do, in fact, help pain patients. I am so eternally frustrated by the naysayers. Skepticism IS healthy, don't get me wrong, but, doctors MUST be more open to accepting that they are not doing a good job treating pain patients, and thus, must be more open to "alternative" methods. I am so hopeful that one day in the not too distant future, some of these therapies will make their way into the mainstream. I wish I could say your experience with your doctor was atypical but it is quite the opposite. Sometimes I wish every physician and medical student would have to live with chronic pain, maybe just for a month, and see how it would change them as people. Anyway, I could rant about this for days but I'll stop. for more open minded physicians making it into the medical profession.

 

[holyhekshler]

Also, about the article posted above, it certainly does not read as evidence to prove that these therapies do not work (not that I think that was the poster's reason for posting), but in fact I think it's encouraging. The key thing is that treatment was limited to one month, and still patients did have positive results with therapy. I would gamble to say that if treatment was continued, even for just one extra month they results would have been better. The article certainly shows that this therapy is expensive, but even the modest results could have significantly change the participants quality of life.

 

[TheDuder]

I think that 98% of MDs have absolutely no interest in and no knowledge of how to treat chronic pain conditions. They push pills, often criticize the patient, and do not offer alternatives. I had horrible experiences before finding help through an alternative therapy much Less accepted than chiropractics. This therapy saved my life. I have limited experience with chiropractic so I can't really speak to its efficacy. However, like the OP, I have also learned to manage my issues with exercise and yoga and have managed to keep my pain at reasonable levels. My research goal while in medical school is to provide more concrete evidence of how alternative therapies do, in fact, help pain patients.

This is a pretty typical attitude in the world of CAM proponents. You're already sure that your pet therapy works, so you want to generate research that supports the conclusion you've started with. I suggest you keep an open mind when conducting research. Design a well controlled and rigorous study and follow the results to logical conclusions even if those conclusion are not personally desirable. Particularly with pain and other subjective complaints, ANY novel intervention will likely appear to provide some benefit even if that intervention cannot be having a positive physiological effect (ie sugar pills).

I would gamble to say that if treatment was continued, even for just one extra month they results would have been better.

Better for whom? Self-limiting conditions improve over time. If I strain my back and sit on the couch eating Lay's potato chips for the next three days does that mean Lay's chips improve back pain? Think about it.

You should go to sciencebasedmedicine.org and read every article written, starting from the oldest posts, on so-called complementary therapies. It's good to be open-minded, but as a physician you can't just give a free pass to a therapy because it helped you. You have to apply the same standards for proof of efficacy and safety to all interventions. 👍

 

[csmittyB]

Having seen two patients end up in the neuro ICU with vertebral artery dissections after a chiropractic "manipulation", I would not be eager to refer a patient to a chiropractic practitioner. Just my anecdotal experience, YMMV.

I don't get this mind set. If you encounter 2 patients that have unexpected complications during surgery, will you then "not be eager" to refer a patient to a surgeon? There is a risk with any medical procedure.

 

[45408]

I don't get this mind set. If you encounter 2 patients that have unexpected complications during surgery, will you then "not be eager" to refer a patient to a surgeon? There is a risk with any medical procedure.

BUT THERE IS ALSO A BENEFIT, or at least there should be. If there is not a proven benefit for an "alternative medicine" modality - and for most of them, there isn't - then you should not take any risk at all. Acupuncture has had multiple hits against it lately about its lack of efficacy, but even that has risks - people have gotten MRSA from dirty needles, a pneumothorax from a needle to the chest, and other complications. "Western" medicine constantly reviews its methods to see if they actually work, and if they don't, we typically stop doing them.

I'm applying for a surgery residency right now, and guess what? I'm not eager to refer a patient for surgery unless they truly need it. I saw a guy die of a complication after getting his gall bladder removed. Surgery is dangerous. I tell my friends to avoid it if possible.

 

[run174]

This website does a great job of discussing issues such as this one.

http://www.sciencebasedmedicine.org/?p=3022

The End of Chiropractic


In cases like the OP's Physical Therapist >>>>>>>>Chiropractors

 

[holyhekshler]

This is a pretty typical attitude in the world of CAM proponents. You're already sure that your pet therapy works, so you want to generate research that supports the conclusion you've started with. I suggest you keep an open mind when conducting research. Design a well controlled and rigorous study and follow the results to logical conclusions even if those conclusion are not personally desirable. Particularly with pain and other subjective complaints, ANY novel intervention will likely appear to provide some benefit even if that intervention cannot be having a positive physiological effect (ie sugar pills).


Better for whom? Self-limiting conditions improve over time. If I strain my back and sit on the couch eating Lay's potato chips for the next three days does that mean Lay's chips improve back pain? Think about it.

You should go to sciencebasedmedicine.org and read every article written, starting from the oldest posts, on so-called complementary therapies. It's good to be open-minded, but as a physician you can't just give a free pass to a therapy because it helped you. You have to apply the same standards for proof of efficacy and safety to all interventions. 👍

By a 'better' result I mean more significant compared to the 'control
group' who had a pamphlet. Overall healing time was irrelevant because
both the therapy groups and the control group were measured at the
same time intervals. I just mean if you kept the exact same
experimental model and just gave the therapy groups 2 months of
therapy versus one that the results at time intervals of greater than
one month would be more significant. So your potato chip analogy does
not make sense because again, overall time was irrelevant. Either way,
PT and chiropractics does pretty much the opposite of sitting on the
coach by trying to mobilize joints, muscles, etc. I will certainly
keep in mind that in my research I will have to be extremely
convincing to change peoples minds, and I will certainly try to create
a good experiment, thank you : )

It's good to be open-minded, but as a physician you can't just give a free pass to a therapy because it helped you. You have to apply the same standards for proof of efficacy and safety to all interventions. 👍[/QUOTE]

p.s. I agree with you here 🙂

 

[Law2Doc]

I don't get this mind set. If you encounter 2 patients that have unexpected complications during surgery, will you then "not be eager" to refer a patient to a surgeon? There is a risk with any medical procedure.

I think the point is the same one I made above -- that pretty much all physicians know a few patients who became needlessly dead because they sought non-medical care for a medical problem. It's not the same as a complication -- it's chiropractors doing what they do, perfectly and to someone's detriment because they lack the training to handle certain problems but not the knowledge base to know when they lack the training. Because this is so rampant -- not just a case or two, the physicians went into a long drawn out legal battle, throwing around words like "quack", a generation ago. They lost, but not necessarily because they were wrong. They lost because they didn't do a good job of explaining the necessity of a medical background to a group of lay people in the courtroom, many who think of medicine as "magic" and can't discern why one group of people wearing white coats is saying they take care of people better than another group of people in white coats. It's very hard to explain the need for evidence based knowledge to someone who never attended college and couldn't get out of jury duty. So chiropractors survived the onslaught. Not because their complication rates weren't bad, but because the people deciding the case didn't understand the importance of a medical background in handling medical issues any better than the chiropractors.

Again, if there is nothing medically addressable in terms of your chronic pain, then sure, go to a chiropractor. If they make you feel better, great. You could also go to massage, or aroma therapy, or get a pedicure or take a hot bath or whatever makes you feel better. But don't kid yourself that any of this is an "alternative" to medicine. And don't read articles and kid yourself that nothing you read "does not read as evidence to prove that these therapies do not work". You need proof -- that something DOES work, before you use it and be medically sound. Not lack of proof that it doesn't. That's not evidence based. That's "lack of evidence based" practice -- saying as long as I don't know something is bad, I will presume it isn't. It's a good way to kill a lot of patients.

You go see your doctor first, because many times pain is a symptom of something medically serious. Otherwise it's sort of like self medicating -- trying to cure cancer with Tylenol.

 

[csmittyB]

BUT THERE IS ALSO A BENEFIT, or at least there should be. If there is not a proven benefit for an "alternative medicine" modality - and for most of them, there isn't - then you should not take any risk at all. Acupuncture has had multiple hits against it lately about its lack of efficacy, but even that has risks - people have gotten MRSA from dirty needles, a pneumothorax from a needle to the chest, and other complications. "Western" medicine constantly reviews its methods to see if they actually work, and if they don't, we typically stop doing them.

I'm applying for a surgery residency right now, and guess what? I'm not eager to refer a patient for surgery unless they truly need it. I saw a guy die of a complication after getting his gall bladder removed. Surgery is dangerous. I tell my friends to avoid it if possible.

You do have a solid point. I suppose it is just that I tend to put "alternative Medicine" in the same category as elective procedures like lipo, face lifts, cosmetic botox etc. As far as I'm aware, there is not much medical benefit to those, yet people are still willing to overlook the risks and pay to have it done. I do agree that one should first go to a physician for a problem, but if they find nothing wrong, I don't think seeing a chiropractor is asking for a oneway trip to the ER as a quad.

 

[SouthernSurgeon]

I don't get this mind set. If you encounter 2 patients that have unexpected complications during surgery, will you then "not be eager" to refer a patient to a surgeon? There is a risk with any medical procedure.

Well, in anything we do in medicine, we look at how the risks stack up in comparison to the potential benefits. There is a risk to any medical procedure but for some circumstances the risk is unacceptably high.

And when you are talking about a treatment (cervical manipulation) with NO proven benefits, you have to weigh the risks a lot more...

 

[boaz]

http://www.webmd.com/stroke/news/20030512/neck-cracking-raises-stroke-risk

 

[Perrotfish]

You do have a solid point. I suppose it is just that I tend to put "alternative Medicine" in the same category as elective procedures like lipo, face lifts, cosmetic botox etc. As far as I'm aware, there is not much medical benefit to those, yet people are still willing to overlook the risks and pay to have it done. I do agree that one should first go to a physician for a problem, but if they find nothing wrong, I don't think seeing a chiropractor is asking for a oneway trip to the ER as a quad.

There is absolutely a benifit to cosmetic surgery. That benifit might not be increased lifespan or decreased pain, but there is a demonstratable change vs. a sham procedure and that change is what the patient wanted. That is a benifit, as defined by the patient.

The problem with Chiros (or any other CAM procedure) is that they can't demonstrate the benifits they're claiming, the patient goes out the same way the came in (except for a few vertebral artery tears). They just flat out don't work when compared to a sham procedure. That's what makes them a scam, they're not doing what the patient is paying to have done, and the patient doesn't notice because the body generally heals itself over time and the CAM practicioner takes the credit. The OP is a pretty typical example. Pharm companies used to do the same sort of thing, selling sugar pills and 'active' water, which is why we now make them undergo double blind trials vs. active placebos to determine if they're actually acomplishing anything.

CAM makes it's money off the patients urgent need to 'do something!'. Nothing is as frustrating as being in pain and not being able to do anything to fix it. Now medicine is desperately trying to figure out how to do something for these people, and has often succeeded (ask any grandmother with a new knee or hip) but what we won't do is tell the patient that we're doing something when we don't have any ideas left other than rest and pain killers. So our patients turn to CAM practicioners to fill the long space of time until their bodies get around to healing.

Maybe we should go back to the days when physicians proscribed placebos, then at least we could make sure that our patients weren't being scammed out of their savings every time they were in pain. That or we need to move forward into a world that subjects CAM practicioners to the same standards as medical practice, but where we're at now is unacceptable.

 

[csmittyB]

There is absolutely a benifit to cosmetic surgery. That benifit might not be increased lifespan or decreased pain, but there is a demonstratable change vs. a sham procedure and that change is what the patient wanted. That is a benifit, as defined by the patient.

So the patient can define the benefit when it comes to a medically unnecessary cosmetic procedure performed by a physician, yet the patient cannot define the benefit of CAM "procedure"😕

 

[JaneAustenFan]

Saw my doctor today. The fact that I was seeing the chiropractor still somehow slipped out. "Well I suppose they help some people", is all he said.
At least he didn't yell this time. 🙂
Now I am not afraid to see him anymore. Not that I was really "afraid" afraid before.

 

[FIREitUP]

So the patient can define the benefit when it comes to a medically unnecessary cosmetic procedure performed by a physician, yet the patient cannot define the benefit of CAM "procedure"😕

well the results are definitely more tangible in a cosmetic surgery. the body doesn't make wrinkles disappear or tuck your tummy or fix your crooked nose. with CAM procedures not only are there no tangible effects, but the claims are widely unsubstantiated with empirical evidence by way of a clinical research study.

 

[BBender716]

http://www.drgrisanti.com/mddc.htm

Saw this on SDN awhile back.

I think this settles it: DC's are much more qualified in every way than MDs 🙄

 

[Evergrey]

http://www.drgrisanti.com/mddc.htm

Saw this on SDN awhile back.

I think this settles it: DC's are much more qualified in every way than MDs 🙄

I hope no one on the Internet reads that and actually believes it

 

[JaneAustenFan]

To sum up a physician's view on chiropractors, which I don't necessarily agree or disagree with...

"You went to a chiropractor (A), and you got better (B). That is not science; A & B may be true, but B is not a result of A. Lots of people didn't go and still got better. The key to quackopractic is to be in the right place at the right time. In other words, be there while the healing process occurs, put a little hands-on (massage, etc.) and take credit for any good outcome. The rest you massage until their insurance runs out and then send them on their way (usually to a real physician).
In the meanwhile, make sure you take lots of high-dose xrays of every human who walks in the door so that in 20 years everyone glows in the dark and reflective clothing is a thing of the past. (a hint to the consumer: all back films show something...nobody has a spine without some so-called abnormality). BTW, it takes 4 years after med school to become a radiologist and to know really how to read an xray; these guys have a couple of weeks of formal radiology instruction. They make the rest of it up as they go. Lastly, with all due respect to low achievers, I can tell you that the top 10% of no high school I know of ever decide to go into such a "field". These folks are generally hand-picked from the bottom of the academic barrel and simply dream of being called "doctor" by the kids who have smoked them all their lives.
Okay, don't get me started! "

That is not a very nice thing to say. My chiropractor seemed competent and sensible. She was very clear that there were some things that she could help me with and other things that were beyond her expertise. My doctor's solution was always more pain medication. I spent a year and a half of my life in a fog.

 

[BBender716]

I hope no one on the Internet reads that and actually believes it

But it includes data readily available to the public! Apparently they got all of this from the 1997 MSAR.

I'd like to ask Dr. Grisanti who he'd have operate on him. I bet he picks the medical professional with more "classroom anatomy hours". 😛

 

[JaggerPlate]

http://www.drgrisanti.com/mddc.htm

Saw this on SDN awhile back.

I think this settles it: DC's are much more qualified in every way than MDs 🙄

"My objective is to simply present the truth and the "raw" facts, and let you, the consumer make an "informed" decision."

🙄

 

[JaggerPlate]

Saw my doctor today. The fact that I was seeing the chiropractor still somehow slipped out. "Well I suppose they help some people", is all he said.
At least he didn't yell this time. 🙂
Now I am not afraid to see him anymore. Not that I was really "afraid" afraid before.

Your doctor sounds excessively mean. You could find another physician who isn't so intimidating. The last thing in the world you should want is a doctor that you are afraid to share things with ... it defeats the whole purpose.

 

[Evergrey]

That is not a very nice thing to say. My chiropractor seemed competent and sensible. She was very clear that there were some things that she could help me with and other things that were beyond her expertise. My doctor's solution was always more pain medication. I spent a year and a half of my life in a fog.

Yeah I feel like the big problem is when chiropractors move beyond their scope of practice (manual therapy) and start doing stuff that is just way out there. Your chiropractor seems pretty good.

Shifting topics, I honestly think the whole "Doctor" part of the DC degree should be dropped. The term "Doctor" connotes someone practicing at a highly trained and informed level, since doctor is latin for "teacher." In my personal opinion, I don't really view DCs within this category.

 

[Perrotfish]

So the patient can define the benefit when it comes to a medically unnecessary cosmetic procedure performed by a physician, yet the patient cannot define the benefit of CAM "procedure

The patient defines the benifit: i.e. what they want out of the therapy. Research can then determine whether or not the therapy is actually causing that benifit, as the patient defines it.

Example:

Patient goes to a massage therapist because they like the feeling of massage. The patient has defined a benifit, and the therapy has delivered that benifit.

Patient goes to massage therapy to help them get over the flu. The time to get over a flu infection is the same whether they go to massage therapy or not. The benift, as defined by the patients, is not delivered by the therapy. If the therapist is aware of what the patient wants out of the therapy and agrees to 'treat' him anyway then that therapist has crossed the line and become a scam artist.

The reason Chiropractors take so much abuse is that they focus their practice so exclusively on 'treating' diseases for which their therapy does not improve the outcome.

 

[JaneAustenFan]

Your doctor sounds excessively mean. You could find another physician who isn't so intimidating. The last thing in the world you should want is a doctor that you are afraid to share things with ... it defeats the whole purpose.

Yeah. I tried just seeing the specialist only, but I need to make time to find a good one and switch.

 

[csmittyB]

The patient defines the benifit: i.e. what they want out of the therapy. Research can then determine whether or not the therapy is actually causing that benifit, as the patient defines it.

Example:

Patient goes to a massage therapist because they like the feeling of massage. The patient has defined a benifit, and the therapy has delivered that benifit.

Patient goes to massage therapy to help them get over the flu. The time to get over a flu infection is the same whether they go to massage therapy or not. The benift, as defined by the patients, is not delivered by the therapy. If the therapist is aware of what the patient wants out of the therapy and agrees to 'treat' him anyway then that therapist has crossed the line and become a scam artist.

The reason Chiropractors take so much abuse is that they focus their practice so exclusively on 'treating' diseases for which their therapy does not improve the outcome.

I agree with you here. Claiming to treat the flu etc, via Chiropracty, massage, etc, is wrong. I guess I'm just assuming that the only reason people see a chiropractor is for back pain, hell, thats why I saw one (only after seeing a physician who X-rayed me, gave me Oxy and told me to take it easy).

 

[JaggerPlate]

Yeah. I tried just seeing the specialist only, but I need to make time to find a good one and switch.

It can be difficult to find a new doc, but the one you go to now just seems too angry or something. It's just not cool to feel so uncomfortable with your doctor that you would be afraid to share something with him, like seeing a DC.

 

[VTBuc]

Ask your chiropractor about vaccinations and you'll see why the scientific community frowns upon them.