Chiropractic: A Little Physical Therapy, a Lot of Nonsense
Hall, Harriet, Skeptic (Altadena, CA)
CHIROPRACTIC MEANS DIFFERENT things to different people. For some, it is a practical way to get quick relief from mechanical back pain. For others, it is a cult-like belief system based on demonstrably false ideas and a magnet for every kind of quackery that endangers our public health and sometimes even kills patients.
A science like chemistry develops gradually over many decades with input from many different scientists. A pseudoscience like chiropractic can be invented instantaneously by one person. D.D. Palmer, a grocer and magnetic healer, invented chiropractic on September 18, 1895. He did something to a deaf man's back. The man said he could hear again. This is particularly ironic, because the nerves to the ear don't go anywhere near the spine, and no chiropractor today claims to be able to cure deafness. Palmer immediately deduced that all disease was caused by out of place bones (95% in the spine and 5% in other bones), but he never tried to test his hypothesis in any way; he just forged ahead and treated thousands of patients.
Ironically, 1895 was also the year that Louis Pasteur died. Most rational people accept the germ theory of disease, but chiropractic theory rejects it, and many chiropractors today continue to believe that germs can't hurt you if your spine is in alignment. And 1895 was the year Wilhelm Roentgen discovered x-rays. D. D. Palmer thought he could feel bones out of place in the spine; he called them subluxations (partial dislocations). There are such things as true medical subluxations that show up clearly on x-rays. When they got around to documenting chiropractic "subluxations" with x-rays, nothing showed up. But that didn't matter to the chiropractors. Their belief system had already been established, and nothing was going to change their minds. They just changed their definition: instead of an actual subluxation, they were treating a "vertebral subluxation complex": "A complex of functional and/or structural and or pathological articular changes that compromise neural integrity and may influence organ system and general health." Translated: "We are going to call anything we want to manipulate a subluxation."
Chiropractic theory is based on three principles:
(1) bony displacement causes all disease;
(2) displacement interferes with nerve function;
(3) removing the interference allows Innate (a vitalistic force) to heal the body.
All three of these principles are false.
(1) Chiropractic subluxations have never been demonstrated;
(2) No impairment of nerve function has been documented;
(3) No such vitalistic force has been detected.
Palmer was under the misconception that all bodily functions are controlled by the nerves. He didn't know about hormones. He didn't know we would learn to transplant organs that would function in the new body with no nerve connections at all. He reasoned in a prescientific manner, and his attitude was more that of a religious believer than a rationalist; he spoke of a God-given calling and seriously considered making chiropractic a religion. D.D. Palmer's son B.J. was unscrupulous and a marketing genius. The success of chiropractic is largely due to his early efforts.
Spinal manipulation was nothing new. Others offered it, particularly osteopaths (they thought it restored blood flow rather than nerve function). During the course of the 20th century, osteopaths accepted scientific medicine. Today, American osteopaths take the same specialty training residencies and pass the same licensing exams as MDs. Chiropractic chose to remain in its own limbo. No school of chiropractic has ever been associated with a university, unless you count the University of Bridgeport, an institution closely associated with the Unification Church of Sun Myung Moon.
What does the evidence show? Spinal manipulation therapy (SMT) is as effective as other treatments for certain types of low back pain, and may offer superior early relief, but the long-term outcome is no better. …