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Can you convince me that chiropractors are real science?
January 30, 2013 11:51 AM   Subscribe

Lots of lumbar pain, limited options. Advise please!

Long story short, my back is in a bad way and has been for about 3 weeks. Some yoga-type stretching makes it ok for a couple hours, as does 3-4 naproxen sodium, but then it's right back again.

I think it's primarily due to being a smidge overweight, having a rambunctious 2 year old, and probably damage I did a long time ago. Pain is exclusively lumbar, centered on spine but radiating out. Heat and ice do nothing.

Everyone's all "go to a chiropractor", but I have so many friends with stories of "we'll need to see you 3x a week for the next 6 months" or whatever, and I just don't trust that.

I have OK insurance but we're also still paying off ~$6k in existing bills. I do not have a GP, as traditionally nothing is wrong with me. SO, do I go to a real doctor---probably group practice, and see what they say, or do I bite the bullet and go to a Chiropractor? I am really not interested in just getting some muscle relaxers and pain meds, those aren't solutions in my book.

Extra scared as my dad's back has has two failed surgeries in exactly the same pot.
posted by TomMelee to Health & Fitness (40 answers total) 3 users marked this as a favorite
 
http://www.skepdic.com/chiro.html
posted by newfers at 11:52 AM on January 30, 2013 [5 favorites]


Well... the science of chiropractic care, as they themselves state it, is NOT science, and has NOT been proven by commonly-accepted scientific methods. HOWEVER. That doesn't mean it won't necessarily help you - it certainly can and does help for SOME ailments. But here's whatcha need to keep in mind:

- If a chiropractor claims that you'll need six months of treatment, leave.
- If a chiropractor claims that they can fix anything OTHER than SOME specific musculoskeletal issues, leave.

To me, chiros are kinda like nutritionists or massage therapists - they are useful as an adjunct to "traditional" medical care in certain situations - it's when they get too big for their britches and start claiming that they can cure cancer that you've gotta flee.
posted by julthumbscrew at 11:56 AM on January 30, 2013 [4 favorites]


If you want real science, go to a real doctor.

Exercise helps too, unsurprisingly. Look into core exercises that don't put pressure on your back, and build up your cardio a bit. It helped me.
posted by Stagger Lee at 11:57 AM on January 30, 2013 [3 favorites]


Yeah, it's debateable.

I went for 3X a week for two years, did TENS therepy and got NO relief. I got some cortisone injections in my spine, that actually worked. There is some evidence that chiropractic works for upper back/neck stuff.

I went to an orthopedist for the cortisone and it's been a real and lasting solution

I had two ruptured disks at L5 and S1.
posted by Ruthless Bunny at 11:57 AM on January 30, 2013


go to a physical therapist instead of a chiropractor. Much more likely to be helpful, and a good one will teach you exercises to improve it and that you can continue doing after you stop seeing the physical therapist
posted by brainmouse at 11:58 AM on January 30, 2013 [20 favorites]


Chiropractic is really hit or miss, mostly miss.

My grandpa kind of darted between careers in his day, and was a chiropractor for several years. (The fact that he was able to dart in and out of the profession should tell you a bit about it.) Some of them are ok--do your research very, very carefully. Anyone who tells you you need regular maintenance back adjustments is probably full of it. Anyone who tells you they're realigning your energy channels or something is definitely full of it. THAT SAID: sometimes chiropractic is OK. If you've really and truly got something out of whack, either due to an injury or a strain, a few sessions (1-2, less than 5) could potentially do you some good.

If I were you, though, I'd find yourself a GP or internist in your network and go to them to get a referral to a specialist (what kind, I don't know) that may be able to help.


In the meantime, for some relief, you might find that a sock bagel helps you out. I described it in a previous comment here.
posted by phunniemee at 11:59 AM on January 30, 2013


A GP will probably refer you to a physical therapist-- which is what I did when I had some back issues. They will give you some exercises to do. This has helped. With insurance, that could/should be cheaper than chiro.
posted by sandmanwv at 11:59 AM on January 30, 2013 [3 favorites]


SO, do I go to a real doctor---probably group practice, and see what they say, or do I bite the bullet and go to a Chiropractor?

Real doctor. Period.

A good doctor can refer you to a good physical therapist or chiropractor, who won't be all "And THIS will cure your gout!", but will be able to take your input and that of the physician who referred you, and help your musculoskeletal issues in concert with other medical treatment.
posted by Etrigan at 12:00 PM on January 30, 2013 [1 favorite]


Go see an osteopath that does manual manipulation. http://en.wikipedia.org/wiki/Osteopathy

(they are real doctors and most that I've been to are quite knowledgeable about the skeletal system and the relation to everything else in your body. If they can't fix you up they have been good, with me at least, about referrals to specialists.)

Depending on where you are I may be able to provide some recommendations.
posted by Feantari at 12:01 PM on January 30, 2013 [8 favorites]


I may be the anomaly here - a chiropractor did indeed help me.

I have thrown out my back three times. The first time, I saw a chiropractor - and he did help loads. Yes, true, it was a situation where I did end up seeing him for about 5 months - but not 3 times a week the whole time (it was 3 times a week for 2 weeks, then 2ce a week for the next couple weeks, then once a week after that, then once every other week). He also did a bit more than just help me treat the symptoms - he took an x-ray and showed it to me to prove "okay, THERE'S the root of your problem", and that was informative and eye-opening (apparently I had scoliosis in that spot and had never known it, and once he had pointed it out I could feel my spine with my fingers and noticed "oh, huh, it is crooked, whaddya know," and after a few weeks I felt it again and realized "hey, wait, it IS straighter". I also was about 2 inches taller after a few weeks of treatment!)

However, I was on workers' comp for that first injury - the next couple times my back went out was on my own dime, and I used a massage therapist those two times and that worked equally as well. So while I did have a good experience with chiropractors, I also couldn't afford to keep it up as a regular thing, and I understand why most people can't do so either. If you can afford to try it a couple times and find a good non-woo guy, check it out for the information it could bring ("I've got an extra bone there? Huh!"); but massage or exercise also work pretty well too.

Good luck.
posted by EmpressCallipygos at 12:02 PM on January 30, 2013 [1 favorite]


Go to a sports medicine doctor or physical therapist. Massage will also be helpful to a certain extent. And yes, definitely work on core strength.
posted by elizardbits at 12:03 PM on January 30, 2013 [2 favorites]


Absolutely, 100%: Go to a real doctor.

Even more true because, if the back pain is a symptom of some other issue, a real doctor is going to be able to pick up on that and pursue diagnosis better than a chiropractor ever will.
posted by yellowcandy at 12:03 PM on January 30, 2013 [1 favorite]


Chiropractic is not scientific in the same way that conventional western medicine is, but it has been known to help some people, so it may be worth a shot. If you are willing to consider alternative medicine, I would also try acupuncture -- it's helped me with back pain a couple times, and I'm as skeptical as they come. Unlike chiropractic, the chances of adverse side effects are virtually zero when treated by a trained practitioner.

In any case, be wary of practitioners who make excessive promises or string you along by not establishing some sort of time frame where you should either feel improvement or stop treatment.

Keep in mind, also, that neither these alternative treatments nor conventional medicine may be sufficient if you have lifestyle issue that need addressing (e.g. sedentary lifestyle, excessive weight).
posted by Behemoth at 12:04 PM on January 30, 2013


I have a terrible back and I went to a back specialist doctor (located via google) whose website specifically said he does not view prescribing medication as a solution for back pain. I would recommend starting with something like that, and seeing what they say.
posted by something something at 12:07 PM on January 30, 2013


Lots of people get relief from back pain from chiropractors, but lots of people get relief from back pain from ALL KINDS of things. I'd go to a regular doctor. Chiropractic is NOT without risks; people have been seriously injured by chiropractic treatment (though this is uncommon) and some chiros seriously overuse x-rays.
posted by mskyle at 12:08 PM on January 30, 2013 [1 favorite]


Awesome. Thanks everyone for confirming what I pretty well suspected. It's been long enough now that I'm a little concerned that there may actually be physical damage.
posted by TomMelee at 12:09 PM on January 30, 2013


Can you convince me that chiropractors are real science?

No one can do that because chiropractic is not science-based medicine. As newfers' link explained, chiropractic is based on the idea that things in your spine called "subluxations" cause most diseases and other medical ailments. No one has ever seen a subluxation or proved that they exist.

At best, when you go to a chiropractor, you are getting unlicensed physical therapy. At worst, you are undergoing dangerous hokum. See a real physical therapist or physician.
posted by Tanizaki at 12:11 PM on January 30, 2013 [4 favorites]


Start with a primary care doc, who will refer you either to a physiatrist or a physical therapist or perhaps to an osteopathic doc.

Good chiropractors are using the same techniques that physical therapists and osteopathic docs do. Bad chiropractors think that they can cure cancer by manipulating "subluxations". Why take a chance? Every physical therapist is going to use the evidence-based techniques, whereas only some chiropractors are.
posted by Sidhedevil at 12:11 PM on January 30, 2013 [1 favorite]


If you want "real science" behind the positive effects that chiropractors can have then I have 2 candidates:
1. The Placebo Effect: If people think that a treatment is doing them good then it does - and often not just trivially either.
2. Spontaneous recovery: We get better

If your dad, and perhaps you, had a really strong belief in the effectiveness of a particular chiropractor - and if you had enough money to pay for one over several months - then I would think it might be worth considering; preferably alongside medical treatment. It does not sound like you have the money to burn. Spend it on a doctor.
posted by rongorongo at 12:11 PM on January 30, 2013 [1 favorite]


This is always the comment I think of when I think of chiropractors.
posted by Coatlicue at 12:12 PM on January 30, 2013 [16 favorites]


It has been my experience that a good chiropractor really can make a big difference when it comes to my particular flavor of back pain.

It has also been my experience that a good chiropractor is almost as hard to find as a unicorn.
posted by spilon at 12:25 PM on January 30, 2013


I tore a muscle in my lower back last summer. Excruciating. My family doctor gave me a cortisone shot and a few days of muscle relaxants + heavy duty pain meds - this combo let the muscles relax out of spasm and start healing. Once the immediate misery was over I upped the amount of core strengthening exercises I do - big improvement.

So my recommendation - get yourself to your primary doctor as a starting point. She/he can send you to a physical therapist, sports med type or orthopod depending on the cause of your pain. You need to know what's causing the pain and having a primary doc is a good thing in general so start there.
posted by leslies at 12:36 PM on January 30, 2013


Adding my voice to the chorus of "go see a medical doctor." Many of the things my friends say their chiros do to bring them relief are an awful lot like the manipulations and exercises I do in the physical therapy my doctor referred me to, but it's without the additional woo and pseudoscience, it's a hell of a lot cheaper, and I have the comfort of knowing a medical doctor has ruled out any serious damage.
posted by rhiannonstone at 12:40 PM on January 30, 2013 [2 favorites]


I had serious pain radiating out from the L5. After verifying that it wasn't a problem with a disk, my GP referred me to a physical therapist, who observed my posture and then gave me a set of core-strengthening exercises. After a couple weeks, no more pain. And my abs are fab, at least they would be if I could see them under the belly fat. I only needed 2 30-minute consultations with my physical therapist; it didn't cost a lot or take a lot of time (other than the daily 10-15 minutes it takes me to work through all my exercises).

In short, see an MD.
posted by brianogilvie at 12:44 PM on January 30, 2013 [1 favorite]


>No one has ever seen a subluxation

Nonsense. Physicians use the term all the time.

I heard a good description once: Chiropractic achieves some of the same things that physical therapy does, and can be helpful as an adjunct to medical care.

But the OP is right about the treatment schedule. Chiropractic is not a one-time fix. A common plan is for the patient to be seen 3 times a week for 4 weeks (much like PT), and then to reassess.

Many people swear by chiropractic. It may be worth a try.
posted by megatherium at 12:47 PM on January 30, 2013 [2 favorites]


Physical therapist here. I get very regular massages and stretches, but still occasionally visit a chiropractor. I do not join the chorus of 'go see a doctor' mostly because lower back pain can take some time to resolve, time a regular doctor does not have.
Here's the thing: spinal stenosis, disc herniation, piriformis syndrome etc can all cause or contribute to back pain. So can twisted hips, inlay soles and a zillion others. The sequence of addressing these issues should be: exercise, posture improvement, stretches, pain medication, operation. Doctors will start at the end of the scale. Chiropractors on the other hand fall in the middle, but often neglect the muscular / ligament part of the deal. In other words a vertebra might be pulled out of line, the chiro will fix the vertebra, but the muscle pulling on it will still be too short and the ailment returns.
My advice find a combi treatment. Yogamassage is one of them. If you go to a doctor, go to exclude the serious bits which will show up on a MRI.
posted by Eltulipan at 12:54 PM on January 30, 2013 [2 favorites]


I go to a chiropractor regularly, around twice a month. I used to go with my mom sometimes, she swears by it and it has really helped her myriad back and neck problems, but hadn't for years until I was in a bad car accident. After the accident my fiance and I were really in pain and went to a chiro his friend recommended. It has really improved our quality of life.

I don't go to the chiro instead of regular check-ups but as a supplement. I don't believe chiropractic can cure all ills but getting a manual adjustment and a massage sure helps my neck.
posted by amapolaroja at 1:02 PM on January 30, 2013


>No one has ever seen a subluxation

Nonsense. Physicians use the term all the time.


But when physicians use the term, they are referring to a dislocation. (see here for link to WHO article defining the difference)
posted by gaspode at 1:03 PM on January 30, 2013 [3 favorites]


I have had problems with lower back pain as well, and I found a physical therapist to be cheaper, less insistent on continual visits, and WAY more effective than a chiropractor.

I was able to go to a physical therapist without a doctor referral, and the exercises she gave me at the initial appointment were so effective that I haven't needed to go back a second time--I just do the exercises.
posted by snorkmaiden at 1:06 PM on January 30, 2013 [1 favorite]


When I did a very bad thing to my knee tendons last summer, my doctor referred me to a chiropractor. I was initially aghast (where I'm from originally, chiro is Grade-A, 200-proof woo, and it killed one of my favourite musicians), but the dude turned out to be a real physiotherapist, entirely un-batshit, and put together a set of stretches and therapy that fixed the knee in a couple of months.
posted by scruss at 1:27 PM on January 30, 2013


I had serious problems with back pain and trapezius muscle pain. Then, because I am uninsured and couldn't afford to see a doctor or therapist regularly, I started doing Bikram yoga. My trap pain was gone after two weeks of going every day, and my back pain disappeared completely within a month.
posted by sevensnowflakes at 1:28 PM on January 30, 2013


Nonsense. Physicians use the term all the time.

I assumed it was understood that I wasn't talking about, say, a lens subluxation in the eyeball. If I must, I will more precisely say "no one has ever seen a chiropractic vertebral subluxation complex".
posted by Tanizaki at 2:35 PM on January 30, 2013


I'm someone who has had quality experiences relieving back pain with both medical doctors and with chiropractors. Based on my own experience, I'd tell you that whether a chiropractor or medical doctor is best suited to help you depends on the nature of the pain.

Five years ago I had surgery to ease what was debilitating sciatica. It was wonderful and I wish I had done it sooner. I spent nearly a year going to physical therapists, chiropractors, and medical doctors until I saw a surgeon who fixed the problem. I have never had sciatica since.

I have, though, had sporadic lower back pain that chiropractors have been able to fix immediately.

In the case of the sciatica, it was very plain why chiropractic care or physical therapy didn't work--a bulging disk was pressing onto my sciatic nerve. When I saw the X-ray and MRIs that showed this, I instantly and intuitively knew that only a medical doctor--a surgeon, in particular--would be the appropriate choice.

But because the nature of other back pain has been quite different, I've had enormous success seeing chiropractors. I would see three to four times a year I wake up feeling "not right" and in discomfort--sometimes it is quite painful. When I feel this way, I also feel as if my body is twisted and not properly aligned--if you've ever experienced this, it's something you can actually feel. In fact, if you look at yourself in the mirror--or have someone take a picture of you with your shirt off from behind--you can see how your body is somewhat crooked. Seeing the chiropractor relieves this instantly, and I walk out of the office pain free.

So, I don't care whether chiropractic medicine is real science or real medicine or not. All I can tell you that when I experience a certain type of back discomfort, what they do works--and it works immediately and it works cheaply. My recommendation to anyone would be to go ahead and see a chiropractor for back pain. If it works, it works. You will know right away. If it doesn't relieve the pain (like in the case of my sciatica, where I experienced very minor relief only to have the pain reoccur quickly), then it is time to move on to medical options.

I have also found that the chiropractors I have had have been concerned with things like doing proper stretching and foam rolling, eating properly, drinking lots of water, and regular exercise. They were reasonable people telling people to do healthy things. They also shared a disdain for what they perceived as western medicine's propensity to attempt to treat every problem with drugs or surgery. This attitude didn't help me a bit when it came to treating my sciatica, but it hasn't gotten in the way of me using chiropractors to relieve the type of back pain that they can help with.

Similarly, I no longer even tell medical doctors that I have visited chiropractors, since they tell me that chiropractors are dangerous and unhelpful.

If you're like me, there may be times when a medical doctor is the most use and there may be times when a chiropractor is of the most use. If I were to have dismissed either one out of hand and refused to see them, I'd either still have debilitating sciatica or I would have constant reoccurrences of lower back pain that would be treated with useless steroid injections, muscle relaxers, or other pain medications.
posted by MoonOrb at 2:37 PM on January 30, 2013 [1 favorite]


Oh, I should add based on Eltulipan's comment, that my advice to see an MD was to (a) rule out a serious problem and (b) get a referral to a physical therapist (especially if your insurance requires seeing your primary care physician before other treatments).
posted by brianogilvie at 2:54 PM on January 30, 2013


I know a lot about chiropractors. Why? Because my dad, my brother, five of my uncles, and nine or ten of my cousins (I can't keep track!) are all chiropractors.

My dad is a good, honest man and I've asked him about the bad reputation of chiropractors. After all, he went to college for four years, then medical school for another four, and he worked on cadavers doing anatomy and physiology and everything else a "real" doctor does. I was surprised to find out there are different fields of chiropractic and some of them are nutty frauds, while others are genuinely helpful.

My relatives all do manual manipulation of the spine/neck/back after doing an x-ray to diagnose the problem. They are basically helping to push your bones and vertebrae back into place where they are supposed to be. But the other fields of chiro are based on alternative healing methods like auras and energy and muscle group connections that are a bit more wacky. I visited a different chiropractor while in college and he had me hold a can of green beans while he pressed on my chest. Then he said "You have a sinus infection!" and told me to take pills made from beef kidneys and brains.

On the other hand, my dad and brother (and uncles) have adjusted me in the past and it has helped me a ton. I have scoliosis (a curved spine) and was in unbearable pain in high school, but my dad fixed it. Now I just wear a shim in my shoe to keep my right heel raised and it's all good.

So my advice is if you want to try a chiropractor, find one that does actual spinal manipulation and doesn't get into the mystic stuff.
posted by tacodave at 3:12 PM on January 30, 2013 [6 favorites]


Once while out of town, I had a serious neck issue (excruciating pain and it felt like my neck was twisted around like one of those primordial birds) come out of nowhere. I later figured out it was from an old injury. My hosts sent me to my first chiropractor and I got instant relief. It was amazing. Agreeing with the people who said, not all chiropractors are created equal and they don't cure cancer or diabetes, but some of them are very good. I got a personal recommendation from someone I trusted completely. I see my current chiropractor four times a year. I think every two months would be a bit better, but I'm paying for it myself. Physical therapy also rocks my world. I find most MD doctors are brusque and impatient and want me to just buck up.
posted by Prairie at 4:47 PM on January 30, 2013 [1 favorite]


There are good reliable chiropractors out there that don't want you to have to keep coming back. Warning signs to look out for.

Are willing to do an adjustment without doing x-rays first. No chiro should be willing to adjust you without knowing what the problem is first.

Continually trying to add sales of supplements or similar to your treatments (ultrasound or muscle stim not included as these can be helpful).

They should after a few adjustments, injury willing give you some exercises to help you.

Cannot give you an idea of how long the course of treatments might need to go on for, you will need more than one, but they should be able to give you a course of adjustments with a definite end date. A lot of relief can be gained from the first adjustment depending on what is wrong though so don't panic.

Try to tell you treatments can cure anything from gout to asthma or whatever.

Be very wary of how they adjust your neck. There is one method that can in very very rare cases cause problems with blood clots. Do not let your chiropractor do that, there are other techniques they can do, if your chiro won't listen to you don't go back.

My FIL is a chiropractor, I was very skeptical and only had my first adjustment to make peace with my new family as they got fed up of me bitching about a neck ache. In that one adjustment he did a lot of good for me with vision problems I was having due to an increase in the pressure of fluid in my brain of all things. Three years of specialists had produced no cause and no cure, within 2 hours of my first adjustment auras and tunnel vision had faded to almost nothing. My brother had great help with migraines using much the same method tacodave did.
posted by wwax at 4:59 PM on January 30, 2013


I have a bulging disc at L5. It was discovered about 5 years back with an MRI after a major episode (I had been having once-every-several-years episodes for 20+ years, but never bothered to get it looked at) that left me basically unable to stand upright for several days.

Since then, I've been pretty good about keeping my muscles strong, and though I do have recurrences of pretty severe pain every year or two (and am having one now), I find that the more attention I pay to making sure the muscular support is there, the fewer problems I have. I do not take pain medication when I do have problems -- I feel like working through the pain incentivizes me to be more diligent in maintaining my body.

Chiropracty is not something I personally would ever consider.
posted by stavrosthewonderchicken at 5:34 PM on January 30, 2013


Any claims that a chiropractor makes regarding moving parts of your spine in and out of alignment are hilariously wrong, and the actions they propose attempting can cause massive, irreversible structural damage to your spine or spinal cord if they are carried out by someone who does not know what he is doing (i.e. someone who thinks that signals carried by your nervous system can be partially occluded by the same mechanism as a kink in a hose). You should be running away from pseudoscience and toward actual medicine as fast as your legs can carry you.

My go-to comment on the subject: If you ever actually handle a cadaverous spine - vertebrae, ligamentous support, muscle and synovial junctions - the notion of realigning vertabrae as you described would be akin to pushing on the origin end of a suspension bridge and expecting it to relocate it's connection on the other side.
posted by Mayor West at 6:29 AM on January 31, 2013


Thanks again everyone. I've got a friend who is a PT, not sure why it didn't occur to me to ask him for help. From there I'll go to a doctor, etc. etc. etc.
posted by TomMelee at 7:18 AM on January 31, 2013


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