chiropractor help? (my dad is seeing one)

[dingler44]

Hey all... I've been worried about my father(54 yrs old) for the past several weeks as he hurt himself lifting.

At first he had a terrible pain in his lower abdomen... close to the groin. It was so bad he could barely walk and hobbled around the house all day. After getting up from sleep... or sitting for several hours he would stiffen up and it'd be even worse.

So after about a week the pain moved into his thigh. He's stubborn about seeking help so avoided it as long as possible but I found out recently that he's decided to go back to a chiropractor that he visited about a decade ago about neck problems.

My dad was pleased enough w/ his previous experience(about the neck) to go back.

I asked about the chiropractor's diagnosis and my pops says the chiro took x-rays and said it was a slipped disc... and now he's doing whatever kind of massages they do. Both of my parents also claim this guy has an excellent reputation around town.

NOW - to the purpose of this post...

I don't know much about chiropractic but the dictionary definition:

A system of therapy in which disease is considered the result of abnormal function of the nervous system. The method of treatment usually involves manipulation of the spinal column and other body structures.

- the definition doesn't really seem to match my dad's reason for going... and the doc doesn't seem to be saying that there's a disease present... rather the slipped disc and pinched nerve diagnosis.

I would like to visit this chiropractor's office myself and investigate the "doc's" background. What kind of things should I look for and ask about at the chiropractor's office to find out if the guy has a legit side or if he's all out quack?

Is it possible he's actually good with back and neck injuries but advertises chiropractic for the alternative medicine market?

Any advice would be deeply appreciated. Thank you!

[epepke]

Quote:

Originally posted by dingler44
I asked about the chiropractor's diagnosis and my pops says the chiro took x-rays and said it was a slipped disc... and now he's doing whatever kind of massages they do. Both of my parents also claim this guy has an excellent reputation around town.

I don't have an automatic dismissal and hatred of chiropractors, as I have seen them do good things in the past. I know of one chiropractor who diagnosed lung cancer from an X-ray and notified a radiologist.

However, I would suggest that you persuade your father to get his chiropractor to give the films to a radiologist. A damaged disc could easily be something that requires surgery or some other medical treatment. The only way to tell is to get a good radiologist to look at the films.

[Zep]

From the sound of where he was hurting I would make an amateur guestimate that there is nothing wrong with your father's back particularly, but that it is more likely a hernia or similar groin strain from lifting. This is quite common in older folk who "overdo" themselves.

Back strain is always noticeable in the back itself. Slipped disks hurt in the back, as well as the affected nerves. But this isn't what you described.

I agree with epepke - get your father X-rayed and examined by a doctor, not a chiro. Unattended hernial strains or outright hernias CAN get extremely dangerous quickly, and can even be lethal.

[Beckett]

Dingler44, are you familiar with Stephen Barrett, M.D. and www.quackwatch.org? Along with www.quackwatch.org Barrett also operates http://www.chirobase.org/, which is devoted to the subject of chiropractic.

My own experience with a chiropractor occurred and ended over a decade ago when I was suffering from recurring headaches. (Actually, I still suffer from recurring headaches but the pain from these is different and doesn't respond to over-the-counter drugs like the headaches I had during my teens or still get on occasion.) Anyway, at the time, while viewing my x-ray(s?), I was informed by my chiropractor that two of my vertebrae were fused together or something like that. I was to visit about a half dozen times for massages and each visit ended with my head being quickly turned to one side (spinal manipulation?).

In retrospect, the massages didn't seem to be anything more than what I could have received from a masseuse and, from what I've read, the spinal manipulation was of no actual benefit. I believe I may have missed one or two treatments but don't honestly remember as I often delayed visits. If it's true that I did end my treatment prematurely, I still don't think it would have mattered much in my case. The treatment I was getting could have been performed the same at a massage parlor or by a girlfriend if I actually had one, making visiting a chiropractor unnecessary.

From, what you've described of your father's ailment I'm inclined to agree with the others that your father should get a second opinion from a radiologist who would focus not only on the spinal column but organs as well.

I hope he gets the medical attention he requires and recovers soon.

[mroek]

I don't have any personal experience with chiropractors, but I am skeptical about their business.

This article does not make the chiros look good:

http://www.skepticreport.com/health/strokespinal.htm

-Øyvind

[epepke]

Quote:

Originally posted by mroek
I don't have any personal experience with chiropractors, but I am skeptical about their business.

This article does not make the chiros look good:

In general, I think that chiropractors are a waste of skin and are even more disgusting than psychiatrists, if that is possible.

However, this is a specific question about a specific problem with a specific person that has been treated by a specific chiropractor. Generalities do not necessarily apply to specifics.

[Soapy Sam]

I had treatment from a chiropractor once. My experience was positive. He also required x-rays (done elsewhere, not by him), as it was a neck problem. His manipulative work greatly improved long term pain in my neck and arms which seems related to two compressed neck vertebrae. He gave me no nonsense about subluxations, said nothing I considered in any way unscientific and he was professional and informative. I had and still have no complaint. But that was a back problem. Would I see him about a hernia? No.
Maybe I was lucky. There are good and bad GPs too.

If the guy is straight up, he will have nothing to hide and should be willing to talk to you about his methods. That said, his time is money, so expect to pay for it. Also, there is the matter of patient confidentiality. Sounds to me like your father is able to make up his own mind, so be careful you don't get cross threaded with him.

[dingler44]

I'll be talking to my father again soon... and will try to get more details. I will also ask he and my mom if they had or might consider bringing the x-rays to a radiologist.

Thanks for your responses. I can always count on finding both experience and compassion here.

[dingler44]

Quote:

Originally posted by Beckett
Dingler44, are you familiar with Stephen Barrett, M.D. and www.quackwatch.org? Along with www.quackwatch.org Barrett also operates http://www.chirobase.org/, which is devoted to the subject of chiropractic.


I hope he gets the medical attention he requires and recovers soon.

Chirobase is great... just what I was looking for. Thanks for the tip!

[HopkinsMedStudent]

I did a literature search for chiropractic research awhile back. Here are a few studies and their conclusions:


http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low-back pain.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

DISCUSSION AND CONCLUSION: The majority of subjects improved with manipulation. Baseline variables could be identified that were predictive of which subjects would not improve.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: Spinal manipulative therapy produces slightly better outcomes than placebo therapy, no treatment, massage, and short wave therapy for nonspecific low back pain of less than 3 months duration. Spinal manipulative therapy, exercise, usual physiotherapy, and medical care appear to produce similar outcomes in the first 4 weeks of treatment.

http://www.jfponline.com/content/200...1203_00925.asp

CONCLUSIONS: Thirty-nine trials met the inclusion criteria for this study; 29 trials assessed spinal manipulative therapy in patients with acute pain, 29 studies evaluated patients with chronic pain, and 14 studies included patients with mixed or indeterminate durations of pain.

For patients with acute low back pain, the only reported clinically significant improvement in short-term pain occurred among patients receiving spinal manipulation as compared with sham therapy (10-mm difference in pain by visual analog scale [95% confidence interval, 2–17 mm]).

In comparisons with all other conventionally advocated therapies, spinal manipulation showed no statistical or clinical difference among patients with acute low back pain. Similarly, among patients with chronic low back pain, the only clinically significant findings exist in comparison with the sham therapy or “ineffective therapies” groups. No differences were found for the outcomes of short-term or long-term function.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=14622659

CONCLUSIONS: None of the 4 trials convincingly demonstrated the superiority of CSM over control interventions. In conclusion, the notion that CSM is more effective than conventional exercise treatment in the treatment of neck pain was not supported by rigorous trial data.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12743225

CONCLUSIONS: This case-controlled study of the influence of SMT and cervical arterial dissection shows that SMT is independently associated with vertebral arterial dissection, even after controlling for neck pain. Patients undergoing SMT should be consented for risk of stroke or vascular injury from the procedure. A significant increase in neck pain following spinal manipulative therapy warrants immediate medical evaluation.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: Only very few randomised clinical trials of chiropractic manipulation as a treatment of non-spinal conditions exist. The claim that this approach is effective for such conditions is not based on data from rigorous clinical trials.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12383058

CONCLUSIONS: Despite claims that spinal manipulation is an effective treatment for headache, the data available to date do not support such definitive conclusions.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12779297

CONCLUSIONS: There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: There is no evidence that spinal manipulative therapy is superior to other standard treatments for patients with acute or chronic low back pain.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=12443522

CONCLUSIONS: It is concluded that spinal manipulation does not produce clinically worthwhile decreases in pain compared with sham treatment, and does not produce clinically worthwhile reductions in disability compared with NSAIDs for patients with chronic low back pain. It is not clear whether spinal manipulation is more effective than NSAIDs in reducing pain of patients with chronic low back pain.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: There is insufficient evidence to support the use of manual therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically relevant outcomes. Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

CONCLUSIONS: After 6 months of follow-up, chiropractic care and medical care for low back pain were comparable in their effectiveness. Physical therapy may be marginally more effective than medical care alone for reducing disability in some patients, but the possible benefit is small.

[HopkinsMedStudent]

Here's an enlightening 10 min video about chiropractic, produced by PBS "Scientific American" documentary show.

You need a realone media player or a windows media player plug in to view the video. You can download the plug ins/players from the scientific american website, just click on "video preferences" in top right corner.

http://pbs-saf.virage.com/cgi-bin/vi...oID=pbssaf1210

[HopkinsMedStudent]

Overall, the research on chiro is mixed. Some studies show benefit over placebo for some kinds of low back pain and neck pain. If you find a chiro who is claiming to treat asthma, infertility, etc then run away quickly.

The problem with chiropractic is that their educational system is not nearly standardized enough. Some schools of chiropractic teach outright quackery, whereas others are much more based on a scientific approach.

I would compare chiro schools today to medical schools of the early 1900s. Back then there were many medical schools teaching quackery. Through the Flexner report and other reforms, the quack schools were gradually shut down and only the science-based schools remained.

Here's an example of the mindset of the quackier group of chiropractors. They are not necessarily representative of all chiros, but a good chunk of them believe the nonsense printed here:

www.jvsr.com

[Rolfe]

Isn't it about time this thread had a visit from Olaf to say that you're all closed-minded cynics trying to suppress all the treatments that really work, etc., etc., fill in the rest for yourselves....?

Rolfe.

[Lisa Simpson]

Quote:

Originally posted by HopkinsMedStudent
Overall, the research on chiro is mixed. Some studies show benefit over placebo for some kinds of low back pain and neck pain. If you find a chiro who is claiming to treat asthma, infertility, etc then run away quickly.

My sis-in-law went to one of those quacks that said they could treat her infertility. It took me a lot of time to convince her that he was just a quack. It was almost like she was addicted to having her back cracked.

[Zep]

The thing with chiropractors is that the method used involves massage, not just the proven dangerous "spinal manipulation". Now it is quite clear that there is a lot of good evidence that a nice back massage, not even at the level of a professional remedial massage, is often helpful in relieving aches and pains in the back, and can make you feel better than you did. Not to mention that, given the right circumstances, it can lead to even more desirable personal results! Further, professional remedial massage (such as sports massage) has a good history of efficacy, and seems to be based on fairly sound medical principles.

Which all suggests that any positive effects that chiropractors do achieve can easily be attributed to the massage and NOT "spinal manipulation". And this should also be a testable claim - get chiros to do their treatment WITHOUT the manipulation stuff, and see if the patient still responds well.

But then that would make them "ordinary masseuses" as a result - out of pocket!

[Suezoled]

Quote:

Originally posted by Lisa Simpson


My sis-in-law went to one of those quacks that said they could treat her infertility. It took me a lot of time to convince her that he was just a quack. It was almost like she was addicted to having her back cracked.

Hope Lisa, they give a person hope. Usually false, blatently false, terribly false hope, but hope nonetheless. To give up on the chiro when you're desperate is to give up hope and accept the idea the answer is not so easy.

[BobM]

Quote:

The thing with chiropractors is that the method used involves massage, not just the proven dangerous "spinal manipulation".

Where do you get that info? Neck manipulation can be dangerous. I've seen nothing about spinal manipulation being hazardous.

I'm just trying clarify.

[Silicon]

Don't go to these guys when you have an injury.

Very bad.

If you have a chronic problem, and you've seen medical doctors for it, you might try chiropractic as a pain relief system.

But not as a result of an injury, I beg you.


My grandmother died of cancer after visiting a chiropractor for months trying to rid herself of a pain that turned out to be a tumor pushing against a nerve.

Not saying she wouldn't have died anyway. But now we don't know, do we?


PLEASE, PLEASE see an MD.

My grandmother's chiro was a quack, to be sure. The way I knew it was when he had brochures in his lobby touting spinal manipulation as a way to cure allergies. That rang serious alarm bells in me, even though I'd only had high-school physiology.

[Virgil]

The chiros must believe in this stuff. there must be thousands of them in the USA alone and they can't all be con artists? I knew a guy who went to chiro school and at least during undgrad he was as and honest and ethical as everyone else. what gives?


He saw it as a medical school he could get into with low grades and less work than an MD program. but he wanted to be a "doctor" and help people etc. I think he was genuine.

can one be an ethical chiro and is there a place for them in mainstream scientific medicine?

Virgil

[HopkinsMedStudent]

Virgil,

Yes, it is possible to be an ethical, professional chiropractor.

As I said, some chiropractic schools are science based and use chiropractic only for conditions proven to be effective with RCTs and other research.

The problem is, these science-based chiro schools are few and far between. Most of them teach and advocate quackery.

[Silicon]

Unfortunately self-delusion is the easiest trap of all to fall into.

I don't think most of the quacks know they're quacks.

[Rolfe]

Quote:

Originally posted by HopkinsMedStudent
.... use chiropractic only for conditions proven to be effective with RCTs and other research.

What conditions would these be, then? I thought it was only a "maybe helps a bit with some types of lower back pain" situation. Seems like a pretty limited sort of practice after several years at college.

Rolfe.

[HopkinsMedStudent]

Quote:

Originally posted by Rolfe
What conditions would these be, then? I thought it was only a "maybe helps a bit with some types of lower back pain" situation. Seems like a pretty limited sort of practice after several years at college.

Rolfe.

You are right, its only for lower back pain. I think there may be 1 study showing it more effective than placebo for neck pain, but thats it (neck manipulation has been shown to increase risk of vertebral artery dissection, though, so its a mixed bag).

The "positive" studies for chiropractic involving low back pain generally show that its more effective than placebo, but no better than regular medical care.

Another reason why chiropractic is infiltrated by quackery is because its VERY HARD to make a living as a legitimate chiropractor. As you suggested, its really only proven for one "condition" so its hard to make money treating only one condition.

The student loan default rate for chiropractors is the highest of any group. Many chiros have a very hard time finding a job. Chiropractic school is 4 years after college, so there is substantial debt incurred by chiropractic students.

Due to these economic pressures, many chiros "shift to the dark side" and practice quackery in order to increase their patient base. Most of the really "successful" chiro practices are based on shady principles.

[Lisa Simpson]

That chiro on Bullsh!t was the worst quack I have ever seen. What kind of jerk manipulates the spine of a 2 minute old baby? At least the doc my sis-in-law went to was that far out there.

[Eos of the Eons]

Base for chiroquackery: The spine is the only thing that needs to be touched in order to make EVERYTHING all better. EVERYTHING that is wrong with you will be attributed to something in your spine-whether that be the case or not.


The first chiroquack claims that the 'energy' force is affected by the spine being 'out of line'. That causes every problem known to man. Thus, the first chiroquack claims to have cured deafness by 'realigning' the patient's spine.


Whether or not the chiroquack went to a more scientific based school, the whole thing is based on fantasy, and not fact.

Never ever ever let a chiro touch your neck.

Your dad needs to see a doctor who can determine what your dad did to other parts of his body. It doesn't sound like his problem has anything to do with his back.

Quote:

At first he had a terrible pain in his lower abdomen... close to the groin. It was so bad he could barely walk and hobbled around the house all day. After getting up from sleep... or sitting for several hours he would stiffen up and it'd be even worse.

So after about a week the pain moved into his thigh.

A chiroquack cracking his back will not help this one bit, but a chiroquack is taught to attribute everything to the spine (thus the slipped disc). The poor deluded chiro will never look for the real problem.

If your dad is lucky he just pulled a muscle, and it will get better on its own if he doesn't do anything more to make it worse.

He should really get that looked into though.

[Corallinus]

It is possible to get referred pain, so it still could be a back problem.

I would suggest seeing an MD though.

There are some chiropractors who are ok as long as they stick to back problems. I went to see one once and he was actually very good. He never did any neck manipulation and used gentler manipulation that was very effective. No cracking all the time. He trained at Palmer West and this seemed to be a very science based course. They study sports chiropractic there. I have heard very poor things about the Life Chiropractic College though.

[Dragon]

Quote:

Originally posted by Zep
From the sound of where he was hurting I would make an amateur guestimate that there is nothing wrong with your father's back particularly, but that it is more likely a hernia or similar groin strain from lifting. This is quite common in older folk who "overdo" themselves.

Back strain is always noticeable in the back itself. Slipped disks hurt in the back, as well as the affected nerves. But this isn't what you described.

I agree with epepke - get your father X-rayed and examined by a doctor, not a chiro. Unattended hernial strains or outright hernias CAN get extremely dangerous quickly, and can even be lethal.

Zep, I have to disagree about "slipped discs" - I have suffered in the past and my pain, for the first month at least, was down my left leg not in the back at all. In fact I never had much pain in my back compared to the sciatica. This is because the herniated disc irritates the sciatic nerve and causes one to feel the pain wherever the nerve is coming from.

Dingler
I agree about seeing a proper doctor and x-rays, though. I would also recommend a CT scan.
Also, rather than a chiropractor or osteopath I suggest a physiotherapist (after proper diagnosis) to help reahabilitation - my experience was good, worked me hard, lots of different exercises (many to do myself), got me fit again.