Chiropractic and Osteopathy
I paid $2 to attend a talk by a chiropractor on headaches. I get a three-day headache about once a month, which usually responds to some extent to pain killer. I'm interested in trying something new.
The guy seemed quite sensible. He works only on the top of the spine; he doesn't promise miracles. Quite a few people may get headaches because of a trauma--even some time ago, such as a car crash; and it could have been quite a low-speed crash. Most of the crowd were women. One asked about headaches that coincide with the menstrual cycle, or menopause; he said glandular problems are a separate subject. Another person asked about seizures; he said they should be seen by a neurologist. So far, so good.
Problems arose as the talk went on. Some people there had been to chiropractors. One lady said she got great results. One woman said all that chiropractors had ever done was a global adjustment of her entire head and neck; she was surprised that this guy was talking about individual vertebrae. He started up a fancy testing machine, and asked for volunteers to be tested. One woman was very gung ho. Her headaches are severe, and we could all see she had bad posture. This chiropractor started promising to work on her posture, saying it would take a long time.
He sounded vaguely threatening; if we don't get chiropractic treatment, we'll probably have a miserable old age. As for trauma as a source of trouble: the original trauma for all of us is childbirth (what about C-sections?), and children should definitely get chiropractic treatment. Chiropractic (or some other method that is part of his practice, including hypnosis, massage and acupuncture) can probably help with asthma and HD/ADD in children.
So I go to the web.
This Ph.D. calmly explains that there is definitely such a thing as Spinal Manipulation Therapy (SMT), and it definitely helps some people with specific aches and pains. It will either work in a few weeks, or not at all. It won't solve big problems like overall posture, much less severe illnesses. Lots of people, including some fully licensed medical practitioners, are trained in SMT, but the easiest practitioners to gain access to are probably chiropractors. Unfortunately, chiropractors collectively are neither scientific nor ethical in their approach. There is no study to show that any two chiropractors will make the same diagnosis based on the same x-ray or other tests; nor that they will apply the same treatment, even if they agree on the diagnosis. Some work on this or that specific vertebrae; some, as our fellow audience member reported, take the "shot gun" approach and work on the entire head and neck. Almost all venture out into other forms of "alternative" or "drug-free" medicine, claiming that this allows them to treat the whole person through an entire life--not just react to problems as medical doctors do. Few of these therapies produce consistent results.
Final warnings:
1. Have the problem evaluated by a medical doctor first. Have underlying serious illnesses ruled out before deciding that the problem is neuromusculoskeletal. Heart disease, cancer, kidney dis' ease, and other serious problems that need prompt medical care may manifest themselves as back pain and dysfunction. Don't allow an overzealous, inadequately trained chiropractor to keep you from prompt diagnosis and care. If the chiropractor recommends X-rays, have them done by a radiologist.
2. If you decide to try SMT, inform your doctor. Ask if there is any reason you should not have SMT (osteoporosis is one common contraindication). if not, ask for his or her help in locating the most skillful practitioner in the area (physiatrist, physical therapist, chiropractor, etc.). Some doctors feel that SMT hasn't been scientifically proven effective, but most are willing to go along with a patient who wishes to give it a try.
3. Remember that the main value of SMT lies in the rapidity of the relief it provides. If you have not experienced significant relief within three weeks, discontinue SMT. Do not submit to long-term care. Do not sign a contract. And do not accept the idea of preventive chiropractic care. Education about how to prevent back problems by safe lifting techniques, proper exercise, and ergogenics (analyzing and redesigning the workplace to avoid injuries) is valuable.
4. Avoid practitioners who:
* Appear overconfident or cultist in their zeal for chiropractic care
* Disparage regular medicine as jealously antichiropractic
* Criticize prescription drugs or surgery in an ideological manner
* Attack immunization, fluoridation, pasteurization, or other public health practices
* X-ray all of their patients, or routinely use full-spine x-rays.
* Use scare tactics such as claiming that the failure to undergo chiropractic care could lead to serious problems in the future
* Sell herbs or dietary supplements
* Perform colonic irrigations. These have no medical value and can be dangerous [23].
* Claim that subluxations exist and that their correction is important.
5. Children should not be treated by chiropractors. There are no childhood conditions that chiropractors are better qualified than physicians to treat.
The guy I heard committed a lot of these faux pas.
So maybe I need to consider seeing an osteopath. They sounded a hundred years ago like chiropractors today; but they now work very closely with medical doctors. And they are skilled in SMT and other manipulation.
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