Quacks

[link2swim06]

This remind me of a conversation I had with my uncle a year ago (hes a chiropractor)

Me: So I am planning on going to med school

Him: Are you smart enough to get into med school?

Me: Well, hopefully I have a 3.6

Him: You know 90% of meds prescribed are no help to patients, they are just being pushed to make the drug companies rich, right?

Me: Such as what drugs?

Him: Aspirin

Me: I thought it was good for people w/ pain and heart attacks

Him: No in chiropractic school, my professor burned it and it turned into black tar. It just eats at your stomach lining.

Me: Well I made acetylsalicylic acid in O-chem lab and it was a white solid.

Him: What is that?

Me: The primary active ingredient in aspirin

Him: Ya i know I was just testing you. You know in chiropractic school we take all the same pharmacology class that med students do

Me: Why would you take those classes if you can't prescribe meds?

Him: To figure out how the MDs have polluted peoples bodies with toxic chemicals, so we can figure out how to treat them correctly

Me: Oh I see

Him: You know drug companies are so greedy they figured out the cure for cancer a few years ago but will not release it because they would lose alot of money on their current cancer drugs

Me: Well, I do both clinical and lab research and find this hard to believe. Don't you think someone would leak this information.

Him: No, because they pay off all the universities that do the research.

Me: (changing subject) Did you practice on others or manikins in chiropractic school.

Him: We practiced on each other after we learned to read x-rays of our own body

Me: Wait, you took X-rays of yourself in school?

Him: Ya, How can you expect to treat someone if you don't know what your own body is like?

Me: Isn't it harmful to have radiation that you don't need?

Him: That is just something the AMA brain washes people into thinking.

Me: Ok then

---

Members don't see this ad.

 

[meister]

Well aspirin is pretty damn hard on the stomach, but it definitely is no black tar, don't know WTF that is about. A co-worker's brother that I know is in chiro school and always gives me a hard time. Pretty annoying.

I just smile and nod.

 

[gujuDoc]

This remind me of a conversation I had with my uncle a year ago (hes a chiropractor)

Me: So I am planning on going to med school

Him: Are you smart enough to get into med school?

Me: Well, hopefully I have a 3.6

Him: You know 90% of meds prescribed are no help to patients, they are just being pushed to make the drug companies rich, right?

Me: Such as what drugs?

Him: Aspirin

Me: I thought it was good for people w/ pain and heart attacks

Him: No in chiropractic school, my professor burned it and it turned into black tar. It just eats at your stomach lining.

Me: Well I made acetylsalicylic acid in O-chem lab and it was a white solid.

Him: What is that?

Me: The primary active ingredient in aspirin

Him: Ya i know I was just testing you. You know in chiropractic school we take all the same pharmacology class that med students do

Me: Why would you take those classes if you can't prescribe meds?

Him: To figure out how the MDs have polluted peoples bodies with toxic chemicals, so we can figure out how to treat them correctly

Me: Oh I see

Him: You know drug companies are so greedy they figured out the cure for cancer a few years ago but will not release it because they would lose alot of money on their current cancer drugs

Me: Well, I do both clinical and lab research and find this hard to believe. Don't you think someone would leak this information.

Him: No, because they pay off all the universities that do the research.

Me: (changing subject) Did you practice on others or manikins in chiropractic school.

Him: We practiced on each other after we learned to read x-rays of our own body

Me: Wait, you took X-rays of yourself in school?

Him: Ya, How can you expect to treat someone if you don't know what your own body is like?

Me: Isn't it harmful to have radiation that you don't need?

Him: That is just something the AMA brain washes people into thinking.

Me: Ok then

precisely why i dont trust those in nonconventional medical fields.

 

[facetguy]

This remind me of a conversation I had with my uncle a year ago (hes a chiropractor)

Me: So I am planning on going to med school

Him: Are you smart enough to get into med school?

Me: Well, hopefully I have a 3.6

Him: You know 90% of meds prescribed are no help to patients, they are just being pushed to make the drug companies rich, right?

Me: Such as what drugs?

Him: Aspirin

Me: I thought it was good for people w/ pain and heart attacks

Him: No in chiropractic school, my professor burned it and it turned into black tar. It just eats at your stomach lining.

Me: Well I made acetylsalicylic acid in O-chem lab and it was a white solid.

Him: What is that?

Me: The primary active ingredient in aspirin

Him: Ya i know I was just testing you. You know in chiropractic school we take all the same pharmacology class that med students do

Me: Why would you take those classes if you can't prescribe meds?

Him: To figure out how the MDs have polluted peoples bodies with toxic chemicals, so we can figure out how to treat them correctly

Me: Oh I see

Him: You know drug companies are so greedy they figured out the cure for cancer a few years ago but will not release it because they would lose alot of money on their current cancer drugs

Me: Well, I do both clinical and lab research and find this hard to believe. Don't you think someone would leak this information.

Him: No, because they pay off all the universities that do the research.

Me: (changing subject) Did you practice on others or manikins in chiropractic school.

Him: We practiced on each other after we learned to read x-rays of our own body

Me: Wait, you took X-rays of yourself in school?

Him: Ya, How can you expect to treat someone if you don't know what your own body is like?

Me: Isn't it harmful to have radiation that you don't need?

Him: That is just something the AMA brain washes people into thinking.

Me: Ok then

Your uncle does not speak for all chiropractors. Make that ANY chiropractors! Wow...that guy is out there. Although I'm sure you made up at least the xray/radiation part (at least I really hope you did!). And the cancer cure thing...c'mon. For your sake, I hope he's your uncle by marriage and not by genetics.

 

[thechad]

...There are a lot of cures for cancer...

 

[link2swim06]

Your uncle does not speak for all chiropractors. Make that ANY chiropractors! Wow...that guy is out there. Although I'm sure you made up at least the xray/radiation part (at least I really hope you did!). And the cancer cure thing...c'mon. For your sake, I hope he's your uncle by marriage and not by genetics.

Ya I know 1 chest xray ~ 1 day at the beach radiation-wise, but by the end of the conversation I was just egging him on. He is my genetic relative but the rest of my family is normal and I guess he must have been dropped as a bady or ate paint chips.

 

[grandslam521]

I wonder if he would have chosen he words more carefully if he knew his kin was gonna parade a paraphrased casual conversation to embarrass him in front of smart-*ss teens and twenty somethings on this crazy, and now officially useless, thread. Shut 'er DOWN, Mod. Puh-llleeaaassseee?

I thought this was a pretty good thread overall. It was nice to see some thought-provoking debate about an important topic. You can't say that about a lot of the threads on SDN.

Also, if his uncle really said that, then he SHOULD be embarrassed!

 

[meister]

I wonder if he would have chosen he words more carefully if he knew his kin was gonna parade a paraphrased casual conversation to embarrass him in front of smart-*ss teens and twenty somethings on this crazy, and now officially useless, thread. Shut 'er DOWN, Mod. Puh-llleeaaassseee?

Chosen his words more carefully? Yeah I guess he slightly misspoke when he indicted the entire medical profession for being in on a giant conspiracy with the pharmaceutical companies, or said ASA was black-tar, or that there already exists a "cure for cancer" and that it's being voluntarily withheld from the public for profit.

If all you're going to do is ****-and-run in MD threads, why not just head back over to your DO forum and do it there to your heart's content?

 

[Random Anesthesiologist]

This is the cutest thread EVAR!!!!!!!!!!!!!!!!!

I love how the pre-meds think they know so much more than the med students and physicians posting here LULZ!

I don't know why you med students and physicians even bother to carry on with the preemies - IF they make it into med school, they'll figure it out.

If not, let them go to their chiropractors and holistic practitioners. Perhaps they would be in the running for the yearly Darwin awards

 

[meister]

lol!! You make the prospect so appealing. Can I still drink from your water fountain though??
Should I move to the back of the bus, little man?

You can drink from my water fountain if you stop ****ting in it.

 

[gujuDoc]

This is the cutest thread EVAR!!!!!!!!!!!!!!!!!

I love how the pre-meds think they know so much more than the med students and physicians posting here LULZ!

I don't know why you med students and physicians even bother to carry on with the preemies - IF they make it into med school, they'll figure it out.

If not, let them go to their chiropractors and holistic practitioners. Perhaps they would be in the running for the yearly Darwin awards

Whose posts were you referring to? I only said "this is why I don't trust chiropracters" or something to that extent. But then again I didn't read the rest of the thread on the other pages in full detail so not sure what you are referring to.

 

[Mr hawkings]

Whose posts were you referring to? I only said "this is why I don't trust chiropracters" or something to that extent. But then again I didn't read the rest of the thread on the other pages in full detail so not sure what you are referring to.

relax, i dont think he/she was referring to your post

 

[gujuDoc]

relax, i dont think he/she was referring to your post

Oh ok.

 

[facetguy]

.
...or is it non-existant vertebral mechanoreceptors now? don't affect your nevous system...

...there is no way to fix the musculoskeletal problems of your back by pushing on it, wherever you might choose to push on it. It can't affect your spinal neves, it can't affect your muscles, so what is it affecting?...

Perrotfish, you never answered my question. And you really should explain what you mean by these comments. Either that, or go back and hit the books.

 

[stewiegriffin81]

What I find bizarre about this thread is that most people on here don't do any reading. For god's sake, the highest level of evidence indicates that spinal manipulation is not effective for any condition. For those who keep parroting the 'evidence' that spinal manipulation is effective for lower back pain, there are more negative systematic reviews than there are positive ones. The same goes for acupuncture.

Sheesh!

For those who like references:

Derry, et al (2006). "Systematic review of systematic reviews of acupuncture published 1996-2005". Journal of the Royal Society of Medicine. 6, 4. Pp. 381-386.

Ernst and Canter (2007). "A Systematic Review of Systematic Reviews of Spinal Manipulation". Journal of the Royal Society of Medicine. 99, 4. Pp. 192-196.

 

[facetguy]

What I find bizarre about this thread is that most people on here don't do any reading. For god's sake, the highest level of evidence indicates that spinal manipulation is not effective for any condition. For those who keep parroting the 'evidence' that spinal manipulation is effective for lower back pain, there are more negative systematic reviews than there are positive ones. The same goes for acupuncture.

Sheesh!

For those who like references:

Derry, et al (2006). "Systematic review of systematic reviews of acupuncture published 1996-2005". Journal of the Royal Society of Medicine. 6, 4. Pp. 381-386.

Ernst and Canter (2007). "A Systematic Review of Systematic Reviews of Spinal Manipulation". Journal of the Royal Society of Medicine. 99, 4. Pp. 192-196.

Reading one review of spinal manipulation amounts to expertise? If you go back and read through the thread, we've been through all this. At the very least, spinal manipulation is at least as effective as any other treatment to which it has been compared (particularly for low back pain but also neck pain). No single discipline or treatment modality can claim it is superior to others, be it various meds, physical therapy, exercise, "general practitioner care", chiropractic, or whatever. I sound like a broken record, but from where you sit right now you believe you will cure all of your back pain patients. But once you are out in the field for awhile you will come to realize that your treatments fail quite frequently, and your patients will still want help. They will probably end up at a chiropractor's office anyway, so it might as well be a chiropractor who you know is reasonable and with whom you can collaborate. Why is that so difficult?

 

[stewiegriffin81]

Reading one review of spinal manipulation amounts to expertise?

Ah yes, your famous ad hominem attacks. I should have known! You'd make a good lawyer, no doubt.

If you go back and read through the thread, we've been through all this. At the very least, spinal manipulation is at least as effective as any other treatment to which it has been compared (particularly for low back pain but also neck pain). No single discipline or treatment modality can claim it is superior to others, be it various meds, physical therapy, exercise, "general practitioner care", chiropractic, or whatever.

*to the tune of Dr. Cox and some bells....* Wrong wrong wrong wrong, wrong wrong wrong wrong!!!! At the very least, there is some evidence that it is as effective as other treatments, and there is also evidence that it is not as effective as other treatments. I suggest you go back to the literature.

I sound like a broken record, but from where you sit right now you believe you will cure all of your back pain patients. But once you are out in the field for awhile you will come to realize that your treatments fail quite frequently, and your patients will still want help. They will probably end up at a chiropractor's office anyway, so it might as well be a chiropractor who you know is reasonable and with whom you can collaborate. Why is that so difficult?

Please do not make unfair assumptions about me. I do not believe I will cure all of my back pain patients. Given that the evidence indicates that the majority of back pain arises from psychosocial issues, I certainly do not expect that I will cure them of anything.

Secondly, even if it turns out to be true that chiro is as effective as other treatments, I still wouldn't recommend it, as it sure as hell has more side effects than exercise or massage....

 

[facetguy]

Ah yes, your famous ad hominem attacks. I should have known! You'd make a good lawyer, no doubt.

Stewie, I'm not attacking you, so please calm down. And I have no interest in a law practice.

*to the tune of Dr. Cox and some bells....* Wrong wrong wrong wrong, wrong wrong wrong wrong!!!! At the very least, there is some evidence that it is as effective as other treatments, and there is also evidence that it is not as effective as other treatments. I suggest you go back to the literature.

I think we can say that this would apply to just about any intervention. Picking through the literature, we could find a study to suggest any form of treatment was not shown to be effective. As an off-the-top-of-the-head example, I know I've read studies that found muscle relaxors to be of no benefit to back pain patients, and yet muscle relaxors are prescribed thousands of times per day, every day, for back pain. Why? Because, although a particular study found them ineffective, some people DO benefit from them. Imagine that. Same for spinal manipulation.

Please do not make unfair assumptions about me. I do not believe I will cure all of my back pain patients. Given that the evidence indicates that the majority of back pain arises from psychosocial issues, I certainly do not expect that I will cure them of anything.

Again, I'd ask that you take a deep breath here. Psychosocial issues do play a role in back pain. Very good.

Secondly, even if it turns out to be true that chiro is as effective as other treatments, I still wouldn't recommend it, as it sure as hell has more side effects than exercise or massage....

As I've stated previously, please don't make the error of simply equating chiropractic with just spinal manipulation. Chiropractors utilize a whole variety of treatments, including exercise and soft tissue techniques. And I believe you when you say you would not recommend chiropractic care, which is fine, as long as you've done what you believe to be your due diligence in forming that opinion. Others here have espoused a much more sophomoric, knee-jerk position. One went so far as to proclaim he 'knows' that spinal manipulation doesn't work, then went on to utilize such a simplistic, outdated theory as the basis of his all-knowing opinion that it is embarrassing. That person is of the belief that chiropractors have imagined "non-existent mechanoreceptors", I believe the quote was...talk about uninformed. Not knowing the science is one thing, but claiming to be some kind of expert while not even knowing the basics is just unreal.

As to the 'more side-effects' issue, the safety record of chiropractic is difficult to argue against.

 

[stewiegriffin81]

I think we can say that this would apply to just about any intervention. Picking through the literature, we could find a study to suggest any form of treatment was not shown to be effective. As an off-the-top-of-the-head example, I know I've read studies that found muscle relaxors to be of no benefit to back pain patients, and yet muscle relaxors are prescribed thousands of times per day, every day, for back pain. Why? Because, although a particular study found them ineffective, some people DO benefit from them. Imagine that. Same for spinal manipulation.

This is not the same at all. For most (admittedly not all) standard treatments, the balance of evidence is skewed towards positive evidence of efficacy. This does not currently hold for spinal manipulation.

As I've stated previously, please don't make the error of simply equating chiropractic with just spinal manipulation. Chiropractors utilize a whole variety of treatments, including exercise and soft tissue techniques.

This is true, and given the lack of decent published studies on the other treatments, I certainly cannot say anything for or against this.

As to the 'more side-effects' issue, the safety record of chiropractic is difficult to argue against.

This is not true. There is good evidence that side effects from spinal manipulation are greatly under-reported, and so the real effect is not currently known (although it is certainly higher than the current estimates. This is hardly surprising since there is no formal (as far as I know) reporting mechanism at this stage.

Moreover, the discussion on side effects here seem to focus on the (presumably) rare and (obviously) serious adverse outcome of stroke/dissection/paralysis. However, the proportion of mild to medium adverse outcomes are actually quite high indeed. An excellent example is:

Hurwitz, et al (2004). "Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA Neck Pain Study." Journal of Manipulative and Physiological Therapeutics. 27, 1 . Pp. 16 - 25

High rates of adverse effects such as this make the safety record a little more equivocal...

 

[facetguy]

This is not true. There is good evidence that side effects from spinal manipulation are greatly under-reported, and so the real effect is not currently known (although it is certainly higher than the current estimates. This is hardly surprising since there is no formal (as far as I know) reporting mechanism at this stage.

Moreover, the discussion on side effects here seem to focus on the (presumably) rare and (obviously) serious adverse outcome of stroke/dissection/paralysis. However, the proportion of mild to medium adverse outcomes are actually quite high indeed. An excellent example is:

Hurwitz, et al (2004). "Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA Neck Pain Study." Journal of Manipulative and Physiological Therapeutics. 27, 1 . Pp. 16 - 25

High rates of adverse effects such as this make the safety record a little more equivocal...

Stewie, if we are talking about 12-24 hours of mild soreness after treatment in a relatively small number of people, I don't think that's anything to panic about. And there have been other studies similar to the Hurwitz (a chiropractor, by the way) study you noted, with similar findings of mild side-effects. And believe me, I've heard all kinds of side-effects stories from patients over the years regarding other forms of treatment, from the massage therapist who "killed me", to the physical therapy session that "set me back weeks", to the medication that "tore a hole in my stomach". Does that negate the usefulness of these other modalities? Of course not. Side-effects are everywhere you look, and the studies cut all ways. And, again, I appreciate the fact that you even bother to look at the available literature.

 

[turkeyjerky]

Stewie, if we are talking about 12-24 hours of mild soreness after treatment in a relatively small number of people, I don't think that's anything to panic about. And there have been other studies similar to the Hurwitz (a chiropractor, by the way) study you noted, with similar findings of mild side-effects. And believe me, I've heard all kinds of side-effects stories from patients over the years regarding other forms of treatment, from the massage therapist who "killed me", to the physical therapy session that "set me back weeks", to the medication that "tore a hole in my stomach". Does that negate the usefulness of these other modalities? Of course not. Side-effects are everywhere you look, and the studies cut all ways. And, again, I appreciate the fact that you even bother to look at the available literature.

I've always found it interesting how chiropractors and other defenders of cam seem to have unlimited amounts of time to spend defending their practices on an internet forum for medical students.

Don't you have anything better to do with your time, like hawk overpriced vitamin supplements to your customers, err...I mean "patients"?

 

[facetguy]

I've always found it interesting how chiropractors and other defenders of cam seem to have unlimited amounts of time to spend defending their practices on an internet forum for medical students.

Don't you have anything better to do with your time, like hawk overpriced vitamin supplements to your customers, err...I mean "patients"?

I'm headed where you already are. That's how I ended up here. Besides, it looks like I'm the only one here.

You got somethin' against vitamins?

 

[silas2642]

I'm headed where you already are. That's how I ended up here. Besides, it looks like I'm the only one here.

You got somethin' against vitamins?

One of my lecturers said that studies have pretty much shown that all they really do is make people produce really expensive pee. He said the only thing necesarry to make sure you're getting everything your body needs is a well-balanced diet-- the only people who needs those expensive vitamin supplements are the people with pathological vitamin deficiencies. So if put down the cheetoes and pick up a frickin' carrot.

 

[facetguy]

One of my lecturers said that studies have pretty much shown that all they really do is make people produce really expensive pee. He said the only thing necesarry to make sure you're getting everything your body needs is a well-balanced diet-- the only people who needs those expensive vitamin supplements are the people with pathological vitamin deficiencies. So if put down the cheetoes and pick up a frickin' carrot.

I disagree. Sounds like old thinking to me. Ask your lecturer if he eats a boatload of oily fish everyday, because that would be about the only way to get adequate amounts of vitamin D, just as one example.

 

[Excelsius]

I've always found it interesting how chiropractors and other defenders of cam seem to have unlimited amounts of time to spend defending their practices on an internet forum for medical students.

Don't you have anything better to do with your time, like hawk overpriced vitamin supplements to your customers, err...I mean "patients"?

You know, the sheer ignorance of medical students in this forum is so disappointing. I hope that at least some of you are trolls because if not, I don't think I will enjoy my med school as much. Undergrad is full of immature, parochial, anthropomorphic silhouettes. Now I' afraid med school is just a continuum from the same spectrum.

Listen, buddy, don't YOU have anything better to do? All of you med students and residents here who started this pointless, insulting, stupid thread, don't you have anything better to do? You always come to pre-allo forum and bitch and moan about long hours of school and rotations, yet you apparently have plenty of time to start threads like this. I wouldn't mind if you made a thread challenging chiropractors, but that's not the case here. Some immature med student started a thread calling an entire discipline a "quack" and the rest of the disciples came to the ship. Why don't you let this thread die already? If you had half the brains, you'd see that this issue is really a NON-ISSUE. You have a resident who refers is patients to "quacks." You have med students admitting that chiropractors allow for moderate improvement of LBP, and the fact that these guys have been around since 1890 (plenty of time for smart asses like you to prove that it is harmful, but you haven't). So then why do you keep coming here and fueling this thread? And take a look at your total lack of reason: a med student has started this thread, med students are attacking CAMs left and right, and yet YOU have the wits to tell the only defender of CAMs that he should shut up and has nothing better to do? What did you expect, oh omnicient one, that you just start a thread attacking a profession and not have even a single member of that profession try to defend different view points. Yeah, that's pretty scientific. This thread was dying, but no, some med students had to drop in and open their stupid mouths.


And here is another bright spark:

One of my lecturers said that studies have pretty much shown that all they really do is make people produce really expensive pee. He said the only thing necesarry to make sure you're getting everything your body needs is a well-balanced diet-- the only people who needs those expensive vitamin supplements are the people with pathological vitamin deficiencies. So if put down the cheetoes and pick up a frickin' carrot.

If your lecturer said jump off the bridge, would you? I hope you would. Even I know that the reason some supplements are helpful is because the soil that grows your food is becoming more and more depleted and many foods today DO NOT have the same nutritional values as they had in the past. Some of you munching on fast food should read the news once in a while. Fast food contains too much omega-6 and barely any omega-3 because all the cows eat is corn. This is just ONE example. Other people take vitamin D simply because they don't get enough sun exposure. And here is a newsflash: did you know that A LOT of MDs take supplements? Maybe none of them have the gray matter that some med students here or their professors have.


Anyway, I just got very pissed and probably wasn't as polite as I should have been. I am more disappointed than anything. Instead of wasting your time trying to disprove something that is of no consequence, I would love to see you discuss some of the problems healthcare is facing today. I don't give a damn if your attending yelled at you today and you wanted to vent on CAM. Maybe you can use your anger to attack the insurance companies that make all of us do so much paperwork. Now there's a real enemy, why don't you take on it? I think it's because you may not have the smarts to do it. After all, attacking CAM is so easy. And think about this - many of you guys are worthless as students. Seeing how residents are slapped around, you do nothing. You guys don't even have the guts to come out into an anonymous forum and name your schools or residency programs and write down all the negatives so that the current pre-meds don't end up in the same **** that you are in. Instead of that happening, we see sites like scutwork.com BACKING DOWN from reporting those bad residency spots because all of you are scared ****less. That's fine, but don't come here and attack cam when you have your tail pretty far up your ass. Even of you were to PROVE that chiropractors are useless, I don't see it affecting either patients or doctors. But it could placate some of your uber-egos. So if you want to do it, just shut up, go into a room, and waste all your time on chiropractor research trying to prove that they harm patients.

Many of you here are a disgrace for the medical community. I got no respect for you. Luckily there have been med students here that didn't get down to the low level of garbage and were reasonable and respectful in their arguments. I seriously doubt some of you are really in med school. And if you are, the system sucks.

 

[cpants]

I disagree. Sounds like old thinking to me. Ask your lecturer if he eats a boatload of oily fish everyday, because that would be about the only way to get adequate amounts of vitamin D, just as one example.

Probably the worst vitamin you could have chosen as an example of the need for supplements. Not only do you not need supplements, you don't even need to eat a balanced diet to get enough vitamin D. All you need is a little sunshine and your body will make plenty of its own.

 

[silas2642]

You know, the sheer ignorance of medical students in this forum is so disappointing. I hope that at least some of you are trolls because if not, I don't think I will enjoy my med school as much. Undergrad is full of immature, parochial, anthropomorphic silhouettes. Now I' afraid med school is just a continuum from the same spectrum.

Listen, buddy, don't YOU have anything better to do? All of you med students and residents here who started this pointless, insulting, stupid thread, don't you have anything better to do? You always come to pre-allo forum and bitch and moan about long hours of school and rotations, yet you apparently have plenty of time to start threads like this. I wouldn't mind if you made a thread challenging chiropractors, but that's not the case here. Some immature med student started a thread calling an entire discipline a "quack" and the rest of the disciples came to the ship. Why don't you let this thread die already? If you had half the brains, you'd see that this issue is really a NON-ISSUE. You have a resident who refers is patients to "quacks." You have med students admitting that chiropractors allow for moderate improvement of LBP, and the fact that these guys have been around since 1890 (plenty of time for smart asses like you to prove that it is harmful, but you haven't). So then why do you keep coming here and fueling this thread? And take a look at your total lack of reason: a med student has started this thread, med students are attacking CAMs left and right, and yet YOU have the wits to tell the only defender of CAMs that he should shut up and has nothing better to do? What did you expect, oh omnicient one, that you just start a thread attacking a profession and not have even a single member of that profession try to defend different view points. Yeah, that's pretty scientific. This thread was dying, but no, some med students had to drop in and open their stupid mouths.


And here is another bright spark:



If your lecturer said jump off the bridge, would you? I hope you would. Even I know that the reason some supplements are helpful is because the soil that grows your food is becoming more and more depleted and many foods today DO NOT have the same nutritional values as they had in the past. Some of you munching on fast food should read the news once in a while. Fast food contains too much omega-6 and barely any omega-3 because all the cows eat is corn. This is just ONE example. Other people take vitamin D simply because they don't get enough sun exposure. And here is a newsflash: did you know that A LOT of MDs take supplements? Maybe none of them have the gray matter that some med students here or their professors have.


Anyway, I just got very pissed and probably wasn't as polite as I should have been. I am more disappointed than anything. Instead of wasting your time trying to disprove something that is of no consequence, I would love to see you discuss some of the problems healthcare is facing today. I don't give a damn if your attending yelled at you today and you wanted to vent on CAM. Maybe you can use your anger to attack the insurance companies that make all of us do so much paperwork. Now there's a real enemy, why don't you take on it? I think it's because you may not have the smarts to do it. After all, attacking CAM is so easy. And think about this - many of you guys are worthless as students. Seeing how residents are slapped around, you do nothing. You guys don't even have the guts to come out into an anonymous forum and name your schools or residency programs and write down all the negatives so that the current pre-meds don't end up in the same **** that you are in. Instead of that happening, we see sites like scutwork.com BACKING DOWN from reporting those bad residency spots because all of you are scared ****less. That's fine, but don't come here and attack cam when you have your tail pretty far up your ass. Even of you were to PROVE that chiropractors are useless, I don't see it affecting either patients or doctors. But it could placate some of your uber-egos. So if you want to do it, just shut up, go into a room, and waste all your time on chiropractor research trying to prove that they harm patients.

Many of you here are a disgrace for the medical community. I got no respect for you. Luckily there have been med students here that didn't get down to the low level of garbage and were reasonable and respectful in their arguments. I seriously doubt some of you are really in med school. And if you are, the system sucks.

Maybe you should take some kava kava and a lavendar oil bath or something; you seem a little wound.

 

[njbmd]

Please remember that people have a right to post their opinions whether you agree with them or not. If you don't like what they say, then disagree but try to be respectful even if the poster is not.

 

[stewiegriffin81]

Stewie, if we are talking about 12-24 hours of mild soreness after treatment in a relatively small number of people, I don't think that's anything to panic about. And there have been other studies similar to the Hurwitz (a chiropractor, by the way) study you noted, with similar findings of mild side-effects.

True, and I think I didn't quote the best study anyway. Others have shown that over a 1/3 of patients with adverse effects will have those effects lasting for more than 24 hours (Cagnie, 2004). Anyway, here is a better study.

Ernst (2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100, 1. Pp. 330-338.

And believe me, I've heard all kinds of side-effects stories from patients over the years regarding other forms of treatment, from the massage therapist who "killed me", to the physical therapy session that "set me back weeks", to the medication that "tore a hole in my stomach". Does that negate the usefulness of these other modalities? Of course not. Side-effects are everywhere you look, and the studies cut all ways. And, again, I appreciate the fact that you even bother to look at the available literature.

The problem here is the risk/benefit ratio. The risk exists, and is certainly severely underestimated. The benefit may or may not exist. This leads to a rather unfavourable risk/benefit ratio, to the extent that it shouldn't be regularly recommended as a treatment at this time.

the fact that these guys have been around since 1890 (plenty of time for smart asses like you to prove that it is harmful, but you haven't).

We have. We know it is harmful. We just don't know exactly how harmful it actually is given the approximate 100% under-reporting of adverse effects. Thus, as I've said a couple of lines above, the risk/benefit ratio is not one conducive to its use. More importantly, the onus is on 'YOU' to show that it is safe, not that 'we' have to show it is harmful.

Even of you were to PROVE that chiropractors are useless, I don't see it affecting either patients or doctors.

Nonsense. If we had unequivocal evidence that chiro is useless, it would mean that doctors would never refer patients to chiros. This obviously would have some effect.

 

[vadd0]

And as you can see by this thread, the differences between CAM practitioners and fanatics, pre-meds, DOs, and MDs make for enjoyable reading.

Oh, I almost forgot. A tautology is something that is true simply because of how it is written. Some of you can have your pseudoscience, and you can even legally push it to patients, but you cannot change the rules of logic.

gg.

 

[TMP-SMX]

It's one thing purchasing vitamins from someone who will charge you a dollar a pill with no guarantee that it has what is says it has and a whole different ball game when you take a CVS/Centrum multivitamin that is 6 cents a pill.

Vitamin D? The only people that are vitamin D deficient are those that are lactose intolerant/and or do not drink milk for some reason, dark skinned in a northern latitude, and take no multivitamin. You will notice that those that meet those three criteria are often the same individuals, and they are often hypertensive because their diets include very little calcium and potassium while having a boatload of sodium from prepared meals. Welcome to Detroit.

 

[facetguy]

Probably the worst vitamin you could have chosen as an example of the need for supplements. Not only do you not need supplements, you don't even need to eat a balanced diet to get enough vitamin D. All you need is a little sunshine and your body will make plenty of its own.

You are so far off base here. I won't even bother to respond, other than to ask what people in, say, the northeastern US or all of Canada do about sun exposure over the winter months? Asking questions about something you know so little about is fine and indeed encouraged. Pretending you are some kind of expert when you clearly are not is ridiculous and some could argue dangerous. Keep studying, sport.

 

[facetguy]

The problem here is the risk/benefit ratio. The risk exists, and is certainly severely underestimated. The benefit may or may not exist. This leads to a rather unfavourable risk/benefit ratio, to the extent that it shouldn't be regularly recommended as a treatment at this time.

I'm still not sure how you arrive at this.

We know it is harmful.

I think you are overstating this by quite a bit.

 

[facetguy]

Vitamin D? The only people that are vitamin D deficient are those that are lactose intolerant/and or do not drink milk for some reason, dark skinned in a northern latitude, and take no multivitamin. You will notice that those that meet those three criteria are often the same individuals, and they are often hypertensive because their diets include very little calcium and potassium while having a boatload of sodium from prepared meals. Welcome to Detroit.

Thank you for confirming why medical education needs an overhaul when it comes to nutrition. I will at least give you partial credit based on your recognition of the difficulties dark skinned individuals have getting enough vitamin D. As for the milk/lactose intolerance issue, do you realize that a glass of milk contains 100 IU of D (and one study--Holick, I think it was--took random samples of milk off of store shelves around the country and found that some contained no vitamin D or less than claimed). To get enough vitamin D you would have to drink 10 or 20 glasses of milk every day...are you thirsty? And the typical multivitamin contains 400 IU of D, not nearly enough.

Get up to speed on the massive volume of recent vitamin D research. Your future patients will appreciate it.

 

[cpants]

I disagree. Sounds like old thinking to me. Ask your lecturer if he eats a boatload of oily fish everyday, because that would be about the only way to get adequate amounts of vitamin D, just as one example.

You are so far off base here. I won't even bother to respond, other than to ask what people in, say, the northeastern US or all of Canada do about sun exposure over the winter months? Asking questions about something you know so little about is fine and indeed encouraged. Pretending you are some kind of expert when you clearly are not is ridiculous and some could argue dangerous. Keep studying, sport.

The sun still shines in the winter in all of the continental US and the vast majority of Canada (especially the populated parts). A Caucasian person needs about 10 minutes of sunlight per day to manufacture enough vitamin D; a person of color slightly more. These are exposure levels you can get walking to and from your car.

Regardless, my point was that your example was poor, since the professor would not, in fact, have to eat pounds of bluefish to get enough vitamin D, nor would he have to take pills. All he would need to do is eat a normal diet and get a little UV light.

There is plenty of controversy on whether or not patients should take daily vitamin supplements, since there is little evidence that it helps anyone without deficiency, and in some cases it can actually cause harm (overdose, increased risk of disease, drug interactions). Hmmm, little evidence of benefit and possible harm to patients....sound familiar?

 

[facetguy]

The sun still shines in the winter in all of the continental US and the vast majority of Canada (especially the populated parts). A Caucasian person needs about 10 minutes of sunlight per day to manufacture enough vitamin D; a person of color slightly more. These are exposure levels you can get walking to and from your car.

During the winter months, the sun comes in at a lower angle, and as such the UVB rays (which stimulate the production of D) travel through the ozone layer longer and are filtered out. So, in the middle of winter, vitamin D production is essentially zero even on the sunniest of days. Very basic stuff. And, just so you are aware, studies have been done that have looked at vitamin D levels in people living in the sunniest regions of the country (southwest, Florida, California, etc) and the world (Middle East, etc) and still find vitamin D deficiency in high numbers.

Regardless, my point was that your example was poor, since the professor would not, in fact, have to eat pounds of bluefish to get enough vitamin D, nor would he have to take pills. All he would need to do is eat a normal diet and get a little UV light.

Vitamin D is probably among the best of examples for justification of supplements, as the diet is a very poor source of vitamin D, we avoid the sun like the plague these days, using sunblock of SPF 8 reduces vitamin D production 95%, SPF 15+ reduces it 99%+.

Have you looked at the numbers in terms of vitamin D insufficiency/deficiency in this country and around the world? They are abysmal and most vitamin D researchers/experts use the term 'epidemic' or 'pandemic' when describing the situation.

Tell your lecturer to have his blood tested for 25-hydroxy-D...he's probably low and you'll be benefitting his health (that's gotta be good for some extra credit, no?).

Where in your own diet do you get your vitamin D? Just curious.

There is plenty of controversy on whether or not patients should take daily vitamin supplements, since there is little evidence that it helps anyone without deficiency, and in some cases it can actually cause harm (overdose, increased risk of disease, drug interactions). Hmmm, little evidence of benefit and possible harm to patients....sound familiar?

A few points here:
1) It is always best to get our nutrients from foods. No argument there.
2) Unfortunately, our diets do not provide adequate nutrients in many cases. See, for example, the NHANES data.
3) I am not recommending megadoses or unsafe amounts of supplements.
4) Inadequate amounts of nutrients can be very harmful. See, for example, the work of Bruce Ames and collegues who describe DNA damage from inadequate levels of various nutrients.
5) Look into epigenomics and its related offspring, nutrigenomics. Fascinating stuff. Start with Randy Jirtle's work at Duke.
6) Our discussion hasn't even delved into the lack of omega-3s and overabundance of omega-6s in our diets and the impact on inflammation and all the associated diseases (including cardiovascular disease. By the way, the recently released big Crestor study basically suggests that statins work more because of their effect on inflammation than on cholesterol/HMG-CoA reductase. Why are we all so inflamed?).
7) Broaden your horizons vis-a-vis nutrition. It will be helpful to you in your career.

 

[koopa_troopa]

You are so far off base here. I won't even bother to respond, other than to ask what people in, say, the northeastern US or all of Canada do about sun exposure over the winter months?

Being from Canada, I always find it funny that some people have no clue what it is like in Canada . We get sun throughout the year. The exception might be part of the northern territories where very relatively less people live.

 

[grandslam521]

Useful and relatively brief summary of Vitamin D in diet and as a supplement.

http://ods.od.nih.gov/factsheets/vitamind.asp

 

[RisingSun]

This remind me of a conversation I had with my uncle a year ago (hes a chiropractor)

Me: So I am planning on going to med school

Him: Are you smart enough to get into med school?

Me: Well, hopefully I have a 3.6

Him: You know 90% of meds prescribed are no help to patients, they are just being pushed to make the drug companies rich, right?

Me: Such as what drugs?

Him: Aspirin

Me: I thought it was good for people w/ pain and heart attacks

Him: No in chiropractic school, my professor burned it and it turned into black tar. It just eats at your stomach lining.

Me: Well I made acetylsalicylic acid in O-chem lab and it was a white solid.

Him: What is that?

Me: The primary active ingredient in aspirin

Him: Ya i know I was just testing you. You know in chiropractic school we take all the same pharmacology class that med students do

Me: Why would you take those classes if you can't prescribe meds?

Him: To figure out how the MDs have polluted peoples bodies with toxic chemicals, so we can figure out how to treat them correctly

Me: Oh I see

Him: You know drug companies are so greedy they figured out the cure for cancer a few years ago but will not release it because they would lose alot of money on their current cancer drugs

Me: Well, I do both clinical and lab research and find this hard to believe. Don't you think someone would leak this information.

Him: No, because they pay off all the universities that do the research.

Me: (changing subject) Did you practice on others or manikins in chiropractic school.

Him: We practiced on each other after we learned to read x-rays of our own body

Me: Wait, you took X-rays of yourself in school?

Him: Ya, How can you expect to treat someone if you don't know what your own body is like?

Me: Isn't it harmful to have radiation that you don't need?

Him: That is just something the AMA brain washes people into thinking.

Me: Ok then

I herniated L5/S1 in the spring and got into a conversation with a chiropractor at Starbucks while studying. He claimed that because of his immense anatomy knowledge, which far exceeded that of a medical doctor, that he could read plain films and musculoskeletal MRIs better than radiologists. I just nodded and smiled.

He said that he could relieve my sciatica by hooking me up to some device in his office that pulled my feet and torso in different directions, stretching out my lumbar vertebrae so that the herniated disc could pop back in. I was too afraid of collateral damage to give it a try.

 

[meister]

Being from Canada, I always find it funny that some people have no clue what it is like in Canada . We get sun throughout the year. The exception might be part of the northern territories where very relatively less people live.

Yeah man but you don't get sun exposure while actually inside your igloo

 

[stewiegriffin81]

I'm still not sure how you arrive at this.

The serious adverse side effects of spinal manipulation are hugely under-reported, and so the actual risk is much, much higher than what has been claimed on this thread (and elsewhere, mind you). Couple this with equivocal evidence of benefit, and you're looking at an unfavourable risk/benefit ratio. The last Ernst article I quoted earlier has the best summary on this. Look, if proper surveillance were done such that we could actually trust the adverse side effect rates, and they showed that the rates were relatively low, and also more studies came out indicating the efficacy of spinal manipulation such that they outweighed the negative ones then (and only then) would I recommend its use.

I think you are overstating this by quite a bit.

Well, this might come down to semantics unfortunately. I admit I was responding to Excelsius' emotionally driven vitriol. We know it is harmful in the literal sense that it can cause serious side effects (as can all therapies, of course). I should have made that more clear. I admit also that we do not know for certain that spinal manipulation is on the whole harmful, but at this point it is certainly leaning towards it.

 

[facetguy]

Being from Canada, I always find it funny that some people have no clue what it is like in Canada . We get sun throughout the year. The exception might be part of the northern territories where very relatively less people live.

I never said it wasn't sunny up there. I just said you have a problem with UVB penetration during the winter months and therefore a concern with vitamin D levels over the winter. I've heard Canada is a beautiful place (I've only been to Toronto, myself)...no disrespect intended.

 

[facetguy]

Useful and relatively brief summary of Vitamin D in diet and as a supplement.

http://ods.od.nih.gov/factsheets/vitamind.asp

Skimming through this, I'd agree that it is useful and reflects much of the recent data. And please note the comments about diet being a poor source of vitamin D.

 

[facetguy]

I herniated L5/S1 in the spring and got into a conversation with a chiropractor at Starbucks while studying. He claimed that because of his immense anatomy knowledge, which far exceeded that of a medical doctor, that he could read plain films and musculoskeletal MRIs better than radiologists. I just nodded and smiled.

Yes, an overstatement on his part. Although, you'd have to admit that the average chiro does have a better handle on musculoskeletal anatomy than the average MD, particularly those involved in primary care.

He said that he could relieve my sciatica by hooking me up to some device in his office that pulled my feet and torso in different directions, stretching out my lumbar vertebrae so that the herniated disc could pop back in. I was too afraid of collateral damage to give it a try.

He is referring to 'decompression therapy', which is as yet unproven except, of course, for its cost!

 

[facetguy]

Yeah man but you don't get sun exposure while actually inside your igloo

My next lit search will be on UVB penetration into igloos!

 

[facetguy]

The serious adverse side effects of spinal manipulation are hugely under-reported, and so the actual risk is much, much higher than what has been claimed on this thread (and elsewhere, mind you). Couple this with equivocal evidence of benefit, and you're looking at an unfavourable risk/benefit ratio. The last Ernst article I quoted earlier has the best summary on this. Look, if proper surveillance were done such that we could actually trust the adverse side effect rates, and they showed that the rates were relatively low, and also more studies came out indicating the efficacy of spinal manipulation such that they outweighed the negative ones then (and only then) would I recommend its use.


Well, this might come down to semantics unfortunately. I admit I was responding to Excelsius' emotionally driven vitriol. We know it is harmful in the literal sense that it can cause serious side effects (as can all therapies, of course). I should have made that more clear. I admit also that we do not know for certain that spinal manipulation is on the whole harmful, but at this point it is certainly leaning towards it.

We'll have to agree to disagree.

 

[grandslam521]

Skimming through this, I'd agree that it is useful and reflects much of the recent data. And please note the comments about diet being a poor source of vitamin D.

I agree with this; however, it appears that NHANES showed only about 10 percent of the sample having a deficient amount of Vit D.

 

[cpants]

I agree with this; however, it appears that NHANES showed only about 10 percent of the sample having a deficient amount of Vit D.

Exactly. This is the problem with vitamin supplementation. Do you want to give the whole population bioactive chemicals, when only 10% actually need the supplement. IMO, better to encourage a healthy diet, regular exercise and then treat deficiencies should they arise.

On a side note, nutritional requirements are notoriously based on very shady science. We frankly do not know what the optimal levels of most vitamins are. Furthermore, vitamins can have negative effects even in sub-overdose concentrations. A famous recent example: a recent study of the protective effects of Vit. E and selenium had to be stopped, because the supplements were actually shown to increase cancer and diabetes risk.

 

[Excelsius]

...
On a side note, nutritional requirements are notoriously based on very shady science. We frankly do not know what the optimal levels of most vitamins are. Furthermore, vitamins can have negative effects even in sub-overdose concentrations. A famous recent example: a recent study of the protective effects of Vit. E and selenium had to be stopped, because the supplements were actually shown to increase cancer and diabetes risk.

I agree, but that's because there isn't a lot of research done on vitamins. Why would someone waste his/her time on vitamin research when he can spend that time working for Viagra and making a lot of money? Any research into these things takes some level of altruism, which many lack. The least we can do is not attack it until it is properly studied.

There was another study that showed the elderly taking vitamin E have an increased chance of death (JHU, I think). But here is the catch - vitamin E, like most vitamins, is not made of just one molecule. It consists of several types of tocopherols and tocotrienols. The artificial vitamin E that you buy consists of not only just ONE of the useful forms (tocopherol, which is far less potent anti-oxidant than tocotrienol), but it contains 50% junk that your body has no use for. That is because synthetic vitamin E is made of d,l-alpha-tocopherol. The body has no use for the levorotatory enantiomer, therefore it is junk. Yet the study at JHU used this synthetic form. How can we conclude vitamin E is inefficient or even harmful when we give the patients only 10% of vitamin E (missing alpha, beta, gamma, delta tocopherols and tocotrienols) of which 50% could be harmful (no studies on the effects of the levorotatory enantiomer)? It could be the L enantiomer to blame and without a proper control, you can't ascertain that.

My point is that things are not as simple. I have had a strong interest in supplements because I want to know, rather than let some vitamin sellers tell me what is good or bad for me. In my research I found that it is much more difficult to get the vitamins you need than just going to Rite Aid and buying one. You really have to get down to the molecular level, which the average person cannot do. That's why instead of banning all vitamins, I think doctors should take the more active approach and recommend that manufacturers call something vitamin E ONLY if it contains all eight forms and no useless enantiomers (otherwise the label must say "synthetic, 10% vitamin E", just like "10% juice"). We have a lot of work to do here.

As a side note, I did a small vitamin experiment myself. I fed huge amounts of vitamin A to identical rabbits (my sister's, but she didn't know). One of them got the synthetic vitamin A, the other the natural from fish oil (I made sure they both got the same IUs). After a week, the rabbit that was taking the synthetic one began to look sick and lost about 30% of its fur. The other rabbit? Healthy as a bull. Now sure, this is a small study with an insignificant P, but it still demonstrates something. I think there have also been studies in the poising by synthetic vitamin A for people who spend long time in the Arctic, but no such effects have been observed with natural A...

 

[facetguy]

I agree with this; however, it appears that NHANES showed only about 10 percent of the sample having a deficient amount of Vit D.

There are many studies that would strongly disagree with this. Again, I haven't read through your whole link, but I'm thinking the RDA values used there are the older, much lower values. We know now that the minimum serum 25-OH-D is 30 ng/mL (the older value was around 20). Below 30 or 32 ng/mL, we see an elevated PTH and calcium starts getting ripped out of bone. Many now consider the optimal (not just the minimal) levels of 25-OH-D to be around 50-60 ng/mL.