- 10almonds
- Posts
- Is Chiropractic All It's Cracked Up To Be?
Is Chiropractic All It's Cracked Up To Be?
Plus: how to get 1% better, weekly
The 10almonds Team
November 11, 2023
⏰ IN A RUSH?
Today’s 30-Second Summary
If you don’t have time to read the whole email today, here are some key takeaways:
Chiropractic therapy is the practice of putting misaligned bones, mostly of the spine, back into correct alignment.
It is not without its risks, and people have died that way, though the numbers appear to be small.
It can help with short-term skeletal problems, but any benefits derived will soon be lost again if you do not treat the actual cause of the misalignment—something which a physiotherapist is better-placed to do.
If you enjoy the condensed daily dose of digestible health information from 10almonds, you might well like today’s sponsor 1and1, too.
This (free!) newsletter's goal is to help you get 1% better every week and build positive wellness habits that stick. They also cover finances, relationships, and more.
Read on to learn about these things and more…
👀 WATCH AND LEARN
What To Eat For Healthy Skin, By Science (8:02)
Skin health menu:
Prefer text? Here’s a text version, with text-based recipes too! 😋
Want to watch it, but not right now? Bookmark it for later 🔖
🩻 MAIN FEATURE
Is Chiropractic All It's Cracked Up To Be?
Yesterday, we asked you for your opinions on chiropractic medicine, and got the above-depicted, below-described set of results:
38% of respondents said it keeps us healthy, and everyone should do it as maintenance
33% of respondents said it can correct some short-term skeletal issues, but that’s all
16% of respondents said that it’s a dangerous pseudoscience and can cause serious harm
13% of respondents said that it’s mostly just a combination of placebo and endorphins
Respondents also shared personal horror stories of harm done, personal success stories of things cured, and personal “it didn’t seem to do anything for me” stories.
What does the science say?
It’s a dangerous pseudoscience and can cause harm: True or False?
False and True, respectively.
That is to say, chiropractic in its simplest form that makes the fewest claims, is not a pseudoscience. If somebody physically moves your bones around, your bones will be physically moved. If your bones were indeed misaligned, and the chiropractor is knowledgeable and competent, this will be for the better.
However, like any form of medicine, it can also cause harm; in chiropractic’s case, because it more often than not involves manipulation of the spine, this can be very serious:
❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.
The reported pathology usually was a vascular accident involving the dissection of a vertebral artery.
Conclusion: Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit.❞
From this, we might note two things:
The abstract doesn’t note the initial sample size; we would rather have seen this information expressed as a percentage. Unfortunately, the full paper is not accessible, and nor are many of the papers it cites.
Having a vertebral artery fatally dissected is nevertheless not an inviting prospect, and is certainly a very reasonable cause for concern.
It’s mostly just a combination of placebo and endorphins: True or False?
True or False, depending on what you went in for:
If you went in for a regular maintenance clunk-and-click, then yes, you will get your clunk-and-click and feel better for it because you had a ritualized* experience and endorphins were released.
If you went in for something that was actually wrong with your skeletal alignment, to get it corrected, and this correction was within your chiropractor’s competence, then yes, you will feel better because a genuine fault was corrected.
*this is not implying any mysticism, by the way. Rather it means simply that placebo effect is strongest when there is a ritual associated with it. In this case it means going to the place, sitting in a pleasant waiting room, being called in, removing your shoes and perhaps some other clothes, getting the full attention of a confident and assured person for a while, this sort of thing.
With regard to its use to combat specifically spinal pain (i.e., perhaps the most obvious thing to treat by chiropractic spinal manipulation), evidence is slightly in favor, but remains unclear:
❝Due to the low quality of evidence, the efficacy of chiropractic spinal manipulation compared with a placebo or no treatment remains uncertain. ❞
It can correct some short-term skeletal issues, but that’s all: True or False?
Probably True.
Why “probably”? The effectiveness of chiropractic treatment for things other than short-term skeletal issues has barely been studied. From this, we may wish to keep an open mind, while also noting that it can hardly claim to be evidence-based—and it’s had hundreds of years to accumulate evidence. In all likelihood, publication bias has meant that studies that were conducted and found inconclusive or negative results were simply not published—but that’s just a hypothesis on our part.
In the case of using chiropractic to treat migraines, a very-related-but-not-skeletal issue, researchers found:
❝Pre-specified feasibility criteria were not met, but deficits were remediable. Preliminary data support a definitive trial of MCC+ for migraine.❞
Translating this: “it didn’t score as well as we hoped, but we can do better. We got some positive results, and would like to do another, bigger, better trial; please fund it”
Meanwhile, chiropractors’ claims for very unrelated things have been harshly criticized by the scientific community, for example:
About that “short-term” aspect, one of our subscribers put it quite succinctly:
❝Often a skeletal correction is required for initial alignment but the surrounding fascia and muscles also need to be treated to mobilize the joint and release deep tissue damage surrounding the area. In combination with other therapies chiropractic support is beneficial.❞
This is, by the way, very consistent with what was said in the very clinically-dense book we reviewed yesterday, which has a chapter on the short-term benefits and limitations of chiropractic.
A truism that holds for many musculoskeletal healthcare matters, holds true here too:
❝In a battle between muscle and bone, muscle will always win❞
In other words…
Chiropractic can definitely help put misaligned bones back where they should be. However, once they’re there, if the cause of their misalignment is not treated, they will just re-misalign themselves shortly after you walking out of your session.
This is great for chiropractors, if it keeps you coming back for endless appointments, but it does little for your body beyond give you a brief respite.
So, by all means go to a chiropractor if you feel so inclined (and you do not fear accidental arterial dissection etc), but please also consider going to a physiotherapist, and potentially other medical professions depending on what seems to be wrong, to see about addressing the underlying cause.
Take care!
❤️ OUR SPONSORS MAKE THIS PUBLICATION POSSIBLE
Get 1% better, every week
If you enjoy the condensed daily dose of digestible health information from 10almonds, you might well like 1and1, too.
This (free!) newsletter's goal is to help you get 1% better weekly and build positive wellness habits that stick. They also cover finances, relationships, and more.
Unlike 10almonds, they put out new editions a couple of times per week, but there’s plenty of practical content in those, to make it very much worthwhile.
After all, gradual habitual improvement gives compound interest over time!
You can opt in here:
|
Please do visit our sponsors—they help keep 10almonds free
🌏 AROUND THE WEB
What’s happening in the health world…
Avocado a day may keep diabetes at bay, suggests nutritional biomarker study
How caffeine impacts cerebral blood flow
How much protein do I need as I get older? And do I need supplements to get enough?
Life's hardships rewire the brain: Study pinpoints neural changes from adversity
Finger-prick test could help spot brain cancer recurrence sooner
Some beneficial effects of exercise may be driven by the immune system, study suggests
New pathway to combat cardiovascular disease identified
More to come tomorrow!
📖 ONE-MINUTE BOOK REVIEW
The Conquest of Happiness – by Bertrand Russell
When we have all our physical needs taken care of, why are we often still not happy, and what can we do about that?
Mathematician, philosopher, and Nobel prizewinner Bertrand Russell has answers. And, unlike many of "the great philosophers", his writing style is very clear and accessible.
His ideas are simple and practical, yet practised by few. Rather than taking a "be happy with whatever you have" approach, he does argue that we should strive to find more happiness in some areas and ways—and lays out guidelines for doing so.
Areas to expand, areas to pull back on, areas to walk a "virtuous mean". Things to be optimistic about; things to not get our hopes up about.
Applying Russell's model, there's no more "should I...?" moments of wondering which way to jump.
Bottom line: if you've heard enough about "how to be happy" from wishy-washier sources, you might find the work of this famous logician refreshing.
What did you think of today's newsletter?We always love to hear from you, whether you leave us a comment or even just a click in the poll if you're speeding by! |
May you always get the best knowledge to make the best health decisions for you,
The 10almonds Team