Are chiropractors and osteopaths different? Are they quacks?
February 5, 2007 4:29 AM   Subscribe

Chiropracty and osteopathy: what's the difference, and are they respectable fields of medicine or means of separating sick people from their money (or somewhere in between)?
posted by handee to Health & Fitness (22 answers total) 2 users marked this as a favorite
Osteopathy is a respectable field of medicine that is comparable to the MD degree. Osteopaths obtain a DO degree, but can work alongside MDs in most any setting that MDs do. I'm am MD, not a DO, so do not have the insight as to the specific differences betw the degrees. There are some things that DOs differ on as far as philosophy of medicine vs MDs, but practically speaking these differences are not large.

Chiropracters are, IMHO, a different story. Although there can be reputable chiropracter, I'd definitely see an orthopedic surgeon for complaints that some see chiropracters for.
posted by cahlers at 4:34 AM on February 5, 2007

There is very little practical difference - in 21st century America - between MDs and DOs, although DOs are more likely to incorporate some form of manipulation (back, spine) into their practice. Both types of doctors have the same types of privileges, skills, and federal (Medicare, etc) recognition.

Chiropractic, in my experience, is good for treating some types of back pain and back injury, but is NOT a cure-all for other types of ailments, which is why it continues to have a relatively negative connotation -- some practitioners adhere to the belief that chiropractic can treat/cure just about anything.
posted by davidmsc at 4:43 AM on February 5, 2007

As handee is from the UK it should be noted that osteopaths in the UK are not the same as in the US. UK osteopaths are not medical doctors but rather practitioners of manipulation based therapies, as is a chiropractor. Osteopaths concentrate more on muscle manipulation whereas chiropractors focus more on joints and nervous systems.

I had some back problems that I believe were alleviated by a chiropractor although I suspect that it also could have been from the constant ice and Advil that she prescribed. I also once attended an open day at an osteopathic medicine college in London and ultimately didn't buy it.
posted by gfrobe at 4:58 AM on February 5, 2007

I tried a chiropractor for back pain (on the recommendation of a friend) and found it worse than useless.
posted by languagehat at 6:00 AM on February 5, 2007

I've always seen chiropractors as more of an adjunct to a really good deep-tissue massage. (in fact, I know of one local chiropractor who actually has a masseuse in the office with him)
If there is truly something structurally wrong with your spine (bulging or herniated disc, for instance) there isn't a damn thing a chiropractor can do to, except for a temporary relief of the tension.
posted by Thorzdad at 6:12 AM on February 5, 2007

I only have anecdotal evidence to add - I have back pain and used to see an osteopath before I lived in London. She was amazing and used cranial osteopathy to stop my migraines in their tracks.

Then I moved to London and went through a series of expensive and useless chiropractors AND osteopaths before I stumbled painfully onto the doorstep of my local physiotherapist (recommended by my GP) and I haven't looked back since.

Of course, IANAD, but my advice is to go to your doctor and get a recommendation to a decent physio. They have chiropractors and osteopaths at my physio's practice, too, BTW.
posted by unmusic at 6:18 AM on February 5, 2007

Not that you asked for my advice...
posted by unmusic at 6:19 AM on February 5, 2007

Quackwatch and its related site Chirobase makes informative (albeit somewhat partisan) background reading on this subject. I would say that somebody's professional title in this area cannot in itself be used as a sure guide that they are - or are not - quacks. This includes a number of doctors and others with full medical training.
posted by rongorongo at 6:43 AM on February 5, 2007

As far as chiropractic is concerned - it's helped me, but it hasn't helped others that I know, but the most important thing is to find a chiropractor whose methods you are most comfortable. Don't let them pressure you into whatever they are selling. I think word of mouth is the best way to find a chiropractor.
Don't know anything about osteopaths & I'm located in the US.
(Note: I worked for a chiropractor in the past - I do not subscribe to the whole chiropractic can solve all of your ailments theory, but it has helped my back problems)
posted by ellebee at 7:28 AM on February 5, 2007

My family doctor is a DO, and my experience is that 1) DO's don't do much back manipulation these days; and 2) DO's can think outside the box better than MD's, and tend to carry fewer patients.

Chiro's tend to be quacks. While occasional back manipulation might be a good thing... exercise is way better.
posted by ewkpates at 7:49 AM on February 5, 2007

Professor Edzard Ernst, the UK's foremost expert, whose chair is funded to promote research into complementary therapies, considers at present that the evidence base suggests "no evidence of benefit, and clear evidence of harm" for osteopathy/chiropractic.
link to full text of fairly recent review
posted by roofus at 7:52 AM on February 5, 2007

I've had great experience with my chiropractor, and see her once a month (I also see a massage therapist monthly). This regimen keeps my back pains to a minimum.

She is rather small and I am rather pain-intolerant, so if she can't get something to move then she gives it a good rub-down with Biofreeze and we try again in a week. She doesn't force anything. I have never come out of her office in more pain than I went in. Though my hips tend to get out of alignment and after she's straightened them out (so my legs are again the same length) I trip over things.

The only osteopath I've seen was an enormous man who muscled me around until I was groaning in pain, then prescribed me some physical therapy at the local NovaCare, which did little to help.
posted by booth at 8:07 AM on February 5, 2007

I am not an MD, I am an EE. I have used conventional MDs (allopaths) in the past (obviously!) and an occasional chiropractor.

Both disciplines have their share of dingbats. I have gotten homeopathic remedies from both, so to uniformly label chiros as quacks seems to overlook the possibility that there are fruitcakes in both bins. How many chiropractors have amputated the wrong limb or left a surgical instrument in a body cavity?

Most people don't have a clue of what goes into a medical education, nor a chiropractic one. Any MD in his right mind would agree that his/her comprehension of the body and all that that entails is well short of perfect. It is not safe to assume that an MD is an expert, just because of the "MD" suffix. Nor does it seem appropriate to globally state that something straddling massage and DO work is quackery.

For certain, reasoning skills are normally distributed in both, and that means that half of all allopaths are 'below average'. Presented with a specific problem, one of them might be more likely to resolve it optimally. By optimally, I mean with minimal risk, minimal intervention, and rapid results.

That said, I have been occasionally unimpressed with allopaths, and common malpractice awards show them to be batting considerably less than 1000. I have also been unimpressed with chiropractors from time to time.

I don't know what kind of chiropractors respondents here have been visiting, but my own experience with strained back and neck muscles and misadjusted vertebrae have been usually reconciled in a single visit. No surgery, no muscle relaxers, no prescriptions.

As I said, I'm an engineer, and I recognize that the mechanical system that is a body can indeed be abused in such as way as to leave pieces 'misadjusted' and that someone with training in manipulating the surrounding structures can use physics to reposition the relevant elements. Once every year or two I turn while lifting something and am nearly incapacitated by pain that does not resolve with time. A good chiro can take such a transient injury and resolve it, PDQ. (I wouldn't visit one for cancer, obviously!)

What exactly does everyone think an MD does with a disarticulated joint? How about a general dislocation? These MDs resolve with good old mechanical MOVEMENT, supported by clear anatomical knowledge. This approach, I suggest, is shared by chiropractors from reputable institutions... such as Palmer.

I am not a proponent of quackery, nor an adherent of magic. I don't buy into homeopathy, crystals, aromatherapy, and I am skeptical of accupuncture. I do trust the lever, however.

And I wisely fear both the scalpel and the prescription pad.

Sadly, this same discpline competition is repeated in the OB-Gyn/midwife conflict. MD's have a vested interest in have MD-only solutions to medical problems, as do the institutions who teach them.
posted by FauxScot at 8:38 AM on February 5, 2007

A few members of my family go to osteopaths and cannot speak highly of them. Here is an anecdotal story.

My brother is a tuba player and spent a summer in a marching band. Towards the end of the summer he noticed a strange knot developing in his pectoral muscle that sort of restricted his movement. It persisted for a few months after he let the band. Somewhat alarmed he went to see a doctor, who was unable to diagnose it and suggested he might need surgery. On my mother's advice he went to see an osteopath.

In one session, the osteopath figured out the cause of the soreness: in the marching bend, whenever they came to a stop they always raised their right knee high and then stomped the ground in unison on the final step. The force of his foot stomping on the ground, combined with the weight of his tuba, was straining his muscle. She gave him a few simple stretching exercises to do every day and within two weeks he was as good as new.
posted by PercussivePaul at 9:06 AM on February 5, 2007

er, cannot speak highly *ENOUGH* of them.
posted by PercussivePaul at 9:32 AM on February 5, 2007

Osteopathy is simply more holistic than allopathic medicine. They think more about systems in your body rather than isolated symptoms. They will generally look to your lifestyle including diet and nutrition, stress level, activity and health before deciding what's wrong with you. DO's tend to argue that their medical education is as rigorous as that of an allopathic school. I don't know about that. They are liscensed and accredited, so it's not like they don't know what they're doing, but they definitely did not get a "regular" medical school experience. Not sure about the residency. I think they can do allopathic residencies. So, take that into consideration. Chriopracty, I kinda think, is quackdom.
posted by sneakin at 9:32 AM on February 5, 2007

The term allopath, as used by those who support some "alternative" medical theory, is a misnomer and really propaganda to define medicine as being homeopathic or nonhomeopathic (that is, "allopathic").

I don't think that medical physicians have any trouble referring patients to allied health professionals. I've been sent to physiotherapists by several physicians. The difference is that physiotherapy is not founded on pseudoscience the same way that chiropractic is.
posted by grouse at 9:42 AM on February 5, 2007

AH, I love these questions!!!! DO student here!!

You've gotten some of the differences b/w DO and MD and chiropractor thus far, so I won't delve into that.

However, the foundations of osteopathy: the body is a unit (mind, body, spirit); the body is self-healing; structure and function are interrelated; and rational osteopathic care is based upon the previous three principles! (last one seems redundant but nevertheless, an important principle).

We can do anything and everything MD's do. Chiropractors are an outgrowth from early osteopathy, before we began to include drugs/pharmacology into our practice (after antibiotics, there was no way getting around using drugs). That said, yes a lot of DOs are getting away from the roots; however, there are a great handful that practice only OMM (osteopathic manipulative medicine/treatment). From just 6 months into my first year--I have been able to treat back pain, muscle spasms, restriction in motion (arms, legs, neck, any joints) and we just finished with cranial motion (great in relieving headaches--tension, migraines, etc) and our last class involved sinus drainage--which I can testify that works (little anecdote--I was congested on that day and after the treatment within the next 10 minutes I was clear as a whistle).

All that I have learned to do with nothing but my hands. So in response, you will find DO's in every type of medicine and this special field of OMM with no one else. We can Diagnose and treat, do surgery, whatever you need. I've heard people that love DO more because since we use our hands so much to learn, that doesn't leave us in our practice and thus we are more "caring, responsive, sensitive" to our patient's needs.

At any rate, I hope this helps! You can always email me if you have any more questions (I think it's in my profile . . . ).
posted by uncballzer at 10:38 AM on February 5, 2007 [2 favorites]

In the USA, MDs and DOs are licensed the same way and are eligible to enter the same post-school training residencies. One DO I knew told me that DOs are basically "like MDs, but we do manipulations too." Their training in anatomy, physiology and pathology is the standard mainstream medical curriculum.

Chiropractors, on the other hand, base their diagnoses and treatments on bizarre theories about subluxations and malalignments of the spine and other bones. Mainstream medicine rejects these theories.

Bear in mind that "allopathy" is not an appropriate way to refer to mainstream medicine as practiced by MDs and DOs. It is a term invented by alternative-medicine practitioners in the 19th century; its use implies an ax to grind.
posted by ikkyu2 at 1:04 PM on February 5, 2007

Purely anecdotal, but in my experience Chiros tends to do minor tweaks and prods and tell you to come back next week so they can do the same, at which they tell you to come back next week and...

Osteos, on the other hand, ask you what is wrong, attack it with vigour, and tell you that you may need two or three follow up sessions.

The difference seems to be between a gentle maintainance and actually fixing a problem. Chiros made me generally feel good, while Osteos actually seemed to change things.

I have to disagree entirely with what gfrobe says too - my Osteo takes great delight in making my back or ribs crack as they release. He also specialises in Cranial Osteopathy, which is damned nearly witchcraft...

To explain, because I'm drunk and I'll forget to come back: Cranial Osteopathy isn't just to do with the head, confusingly... He once spent ten seconds playing with my left leg and managed to convince me taht one leg was about 4 inches longer than the other. 10 seconds later, and I could stand again. Witchcraft, I tells you...
posted by twine42 at 1:43 PM on February 5, 2007

Purely anecdotal, but in my experience Chiros tends to do minor tweaks and prods and tell you to come back next week so they can do the same, at which they tell you to come back next week and...

This was also my experience. Weekly sessions of chriopracty did very little for my chronic back pain, and the little they did do was probably the result of the nice massage before each session. Meanwhile, it was always "well, come back next week". I've never tried osteopathy, but thanks to this thread I'm considering it!
posted by vorfeed at 3:01 PM on February 5, 2007

Why is the noun "chiropractic" not "chiropraxy" or something? That always bugs me.
posted by AmbroseChapel at 3:19 PM on February 5, 2007

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