Chiropractic is an alternative medical treatment founded in the 19th century by Canadian-born Daniel David Palmer. Palmer believed that misalignment of the bones in the body, mostly in the spinal column, was the underlying cause of all disease. In 1897 he opened the Palmer School of Chiropractic in Davenport, Iowa, and started teaching his techniques.
Palmer believed in spiritualism and claimed that he received the principles of chiropractic from a dead physician named Jim Atkinson with whom he was contact. Here is how Palmer described it:
“The knowledge and philosophy given me by Dr. Jim Atkinson, an intelligent spiritual being, together with explanations of phenomena, principles resolved from causes, effects, powers, laws and utility, appealed to my reason. The method by which I obtained an explanation of certain physical phenomena, from an intelligence in the spiritual world, is known in biblical language as inspiration. In a great measure The Chiropractor’s Adjuster was written under such spiritual promptings.”
Contemporary chiropractors believe that when the spine is in correct alignment as a result of spinal adjustment, the “innate Intelligence” of the body can then act (by way of the nervous system), to heal disease.
Chiropractic is complete bunk, of course. No properly controlled study has ever shown conclusively that chiropractic is effective in treating any condition.
So why is chiropractic so widespread? Chiropractic care is included in most health insurance plans in North America. Such tolerance for a dubious treatment can be explained partly by the gradual acceptance of alternative medicine that Timothy Caulfield has called “the creep of pseudoscience” (http://healthydebate.ca/opinions/naturopaths-and-the-creep-of-pseudoscience)
But it isn’t the uneducated and scientifically illiterate who are seeking chiropractic treatment. I know university professors who swear by their chiropractors. Despite the complete lack of scientific evidence for its effectiveness, chiropractic seems to work, at least in the minds of its devotees.
A friend of mine who is a retired GP has a theory. Nobody (one hopes) goes to a chiropractor to treat a serious, life-threatening condition. People go to chiropractors for minor pain, mostly back pain. It so happens, my GP friend assures me, that most back pain resolves over time. When the resolution of the pain coincides with a series of chiropractic treatments, the sufferer naturally attributes the resolution to the treatments. She tells her friends, most of whom will suffer from back pain at some point, and the chiropractor’s practice grows. The placebo effect doubtless plays a role too.
There is evidence that chiropractic manipulation of the neck can cause a stroke (https://www.sciencebasedmedicine.org/stroke-death-from-chiropractic-neck-manipulation/). But many legitimate medical treatments also carry some risk.
Magical thinking is an abiding part of the human condition. Makers of amulets like rabbit’s foot keychains exploit magical thinking for profit. Militant New Atheists would say that makers of rosaries do the same. Deepak Chopra has made a fortune exploiting gullibility. Chiropractic is a mostly harmless form of magical thinking, and I am sure most chiropractors are not charlatans but really believe in the efficacy of what they do. Are psychologists, management consultants, and presidential candidates really much better?
6 thoughts on “Chiropractic: A Pain in the Neck”
Gosh, Alan, you have a bugbear about chiropracty (as it more properly should be called!). Toward the end of your diatribe you say: “The placebo effect doubtless plays a role too.”
Undoubtedly (as it more properly should be said !) a placebo effect is there, as it is in all medicine, confirmed by a controlled study or otherwise. But, you know, the placebo effect is an incredibly valuable circumstance in the world of health and disease. If one feels better after some treatment, or after some mumbo-jumbo, what does it matter if it is due to the placebo effect? At least, what does it matter to the beneficiary of the effect?
Of course I believe that all drugs and treatments marketed by the medical profession should be supported by properly controlled clinical trials …. Of course I do! But we shouldn’t malign the placebo effect just because it falls outside that ideal, because it is a useful one.
“Doubtless” is a perfectly good adverb, Reuben, and “chiroprachty” is not a word at all, at least not one that appears in dictionaries. I completely agree that the placebo effect is very valuable, especially for chiropractors.
Because of my light-hearted teasing about “chiropracty” and “doubtless”, you may have missed my more serious point about placebo effect:
When one says “it’s only a placebo effect” (whatever “it” might refer to) I say that it doesn’t matter to the person experiencing it. You feel a pain in the back, you go to the chiropractor, (s)he does whatever mumbo-jumbo, and you feel better…. this is not restricted to chiropractic …. a normal physician can give you an ineffective treatment, based on a less-than-perfect diagnosis, but you feel better because of placebo …. I think that most physicians might agree that this is a useful effect.
Some time ago I went to a physiotherapist for a strained muscle, and he asked whether he could apply acupuncture ….. (that was to be in addition to the main treatment which he offered). Having determined that he wouldn’t charge me “extra” for it, I said “sure, if you want to!” …. It was ineffective (of course), but I wondered afterwards: the placebo effect can work, but only if you aren’t aware that it is a placebo effect. Maybe the acupuncture didn’t work because I believe it is only based on a placebo effect…. Might I have been better off with naivete but also with a muscle that felt better! 🙂 ?
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But doesn’t the placebo effect ultimately depend on ignorance? And it doesn’t work for really serious stuff like leprosy, eh?
Yes, indeed ….. Of course you’re right, and I am not advocating voodoo medicine. All I’m saying is that one shouldn’t make statements like: “It’s no good because it’s only a placebo effect.” The fact that it results in a desirable outcome on some occasions for some people means that it “worked” in spite of the ignorance …. or, maybe because of the ignorance as I alluded to before. No, one shouldn’t advocate quack medicines just because it works sometimes …. one should just recognize that if someone feels better in spite of it, then it’s not all that bad …… for that person …. on that occasion!
But all I said was that the placebo effect also plays a role in addition to the happy coincidence that the resolution of minor pain often happens to coincide with chiropractic treatment.