Since the topic of chiropractic has reared its head in JP's injury post, I thought it best to divert it to its own post as it is certainly a topic in itself.
Now, let me say I have nothing against chiropractic. Many people get better after treatment. I spend a great deal of time with DC's as part of my ART training and many of them are brilliant thinkers, scientists, and rehabilitators.
On the other hand, many of them are quacks (this is just as in any other profession). This unfortunately reflects on the entire profession. It seems wackos in any profession get more attention (mainly cause you can't shoot them without consequences
).
So you can understand some of the burdens of proof faced by the chiropractic profession, I've stolen this from piece on quackwatch.com. You'll see why many chiros fight the uphill battle in the medical field:
"The word chiropractic literally means "done by hand." The term was adopted by chiropractic's founder, Daniel David Palmer. Palmer was a layman with an intense interest in metaphysical health philosophies such as magnetic healing (Mesmer's "animal magnetism"), phrenology, and spiritualism. In 1895, he claimed to have restored the hearing of a nearly deaf janitor by manipulating the man's spine.
Obsessed with uncovering "the primary cause of disease," Palmer theorized that "95 percent of all disease" was caused by spinal "subluxations" (partial dislocations) and the rest by "luxated bones elsewhere in the body." Palmer speculated that subluxations impinged upon spinal nerves, impeding their function, and that this led to disease. He taught that medical diagnosis was unnecessary, that one need only correct the subluxations to liberate the body's own natural healing forces. He disdained physicians for treating only symptoms, alleging that, in contrast, his system corrected the cause of disease.
Palmer did not employ the term subluxation in its medical sense, but with a metaphysical, pantheistic meaning. He believed that the subluxations interfered with the body's expression, of the "Universal Intelligence" (God), which Palmer dubbed the "Innate Intelligence." (soul, spirit, or spark of life). [9] Palmer's notion of having discovered a way to manipulate metaphysical life force is sometimes referred to as his "biotheology."
Scientific Shortcomings
Chiropractors commonly claim that their isolation from the health science mainstream results from organized medicine's opposition. Chiropractic propagandists have made much of a 1987 court decision that found the American Medical Association and others guilty of illegally boycotting chiropractors. But the Wilk case did not uncover any secret conspiracy by doctors to destroy chiropractic. It merely examined whether or not the AMA's ethical prohibition against voluntary professional association with nonscientific healthcare providers violated the Sherman Antitrust Act. On August 27, 1987, District judge Susan Getzendanner decided that it did. She stated in her decision, however, that the AMA's ethical prohibition was not economically motivated, but was based upon the AMA's belief that chiropractic care was did not serve the best interest of patients [10]
Palmer can be forgiven for his nineteenth-century misconceptions, but his followers cannot be excused for failing to avail themselves of the scientific advances of the twentieth century to test chiropractic theory and practice. In fact, chiropractors have never defined a subluxation in measurable terms, nor shown that it even exists. Despite the ability of neurophysiologists to measure nerve impulses, chiropractors have not shown that impinging a spinal nerve alters an impulse beyond the zone of impingement, nor have they shown that disrupting a nerve impulse produces disease. Yale University anatomist Edmund Crelin, Ph.D., demonstrated that only a disabling spinal injury could produce the impingement that Palmer posited as the basis for chiropractic [11].
But laboratory failings do not daunt chiropractors. They argue that no one fully understands the mechanisms of many effective medical procedures. As clinicians they feel capable of detecting subluxations subjectively, even if objective methods for doing so are lacking. However, chiropractors have yet to pass a test of interexaminer reliability. Studies of the ability of two or more chiropractors to find the same subluxation(s) on either the same x-ray film or in the same patients have demonstrated that chiropractors cannot even agree among themselves about what specific conditions need treatment [12-16].
In the mid-1960s, an official delegation of chiropractic representatives, including a radiologist of their own choosing, failed to identify a single subluxation on a series of 20 x-ray films that had been submitted for insurance reimbursement to the National Association of Letter Carriers [14]. In 1972, the Medicare law was amended to include chiropractic care for "subluxations demonstrated by x-rays to exist." A 1986 report by the Inspector General of the Department of Health and Human Services revealed that many payments for chiropractors do not meet this legal requirement [17]. The fact that the federal government does not enforce the rules it has established for chiropractors raises the question of a double standard. Is there one standard for science-based medicine and another for nonscientific practitioners with political savvy?
Chiropractors not only find subluxations as elusive as the mythical unicorn, but they also disagree wildly about how to go about treating them. Some believe that each vertebral level corresponds to a specific disorder. Others believe that it is necessary to manipulate only the seven cervical vertebrae to effect a cure. "Hole-in-one" (their term) practitioners believe that it is necessary to adjust only the atlas (topmost) vertebra. Basic sacral chiropractors agree that only one vertebra needs to be adjusted, but rather than the topmost, it is the sacrum, located at the bottom of the spine. Still another group adjusts both the atlas and sacral vertebrae. Others adjust the entire spine in a shotgun approach, while another group measures leg lengths in order to level up the spine. No scientific criteria have been applied to resolve these conditions.
Anyone visiting a number of chiropractors will be confronted with a bewildering variety of pseudoscientific diagnostic procedures. In 1981 Mark Brown, a reporter for the Quad City Times, spent five months visiting chiropractors in the Davenport, Iowa, area (the birthplace of chiropractic). Diagnostic methods included placing a potato on his chest and pressing down on his arm (applied kinesiology), projecting lines on his back to read body contours (Moire contour analysis), reading the iris and comparing markings with a chart (iridology), measuring leg lengths for unevenness (one chiropractor said Brown's right leg was shorter, another said his left leg was shorter) , measuring skin surface temperature differences, and palpation [16]. Other dubious diagnostic methods used by some chiropractors include pendulum divining, electroacupuncture, reflexology, hair analysis, herbal crystallization analysis, computerized "nutritional deficiency" questionnaires, a cytotoxic food allergy test, and the Reams urine and saliva test.
Chiropractors also employ a wide variety of pseudomedical therapies. Magnetic therapy (placing magnets on the body), homeopathy, herbology, colonics, colored-light therapy, megavitamin therapy, radionics (black box devices), bilateral nasal specifics (inserting a balloon in the nose and inflating it), and cranial manipulation are but a few of the unfounded therapies employed by various chiropractors.
A 1988 trade survey found that 74% of chiropractors in the United States use nutrition supplements in their practices [18]. Many prescribe and sell these directly to patients -- a practice that is generally regarded as unethical in the medical profession.
Chiropractors promote themselves as "drugless practitioners," capitalizing on the restrictions against the use of drugs or surgery that lawmakers have placed upon them. The word drug has several definitions. Included are: articles listed in several recognized official United States pharmacopoeias; articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or animals; articles (other than food) intended to affect the structure or any function of the body [19]. In 1987 the supreme court of Georgia ruled that because chiropractors were licensed as drugless practitioners, they could not prescribe dietary supplements for the prevention or treatment of any condition. Not long afterward, the legislature reacted to chiropractic lobbying by passing a law permitting chiropractors to recommend dietary supplements to their patients, but not to prescribe them as drugs.
The use of x-rays by chiropractors is a related issue. Chiropractors often expose the whole body trunk to x-ray radiation. Since radiation effects are cumulative, exposing patients to radiation always involves a serious benefit-risk evaluation. Chiropractors often justify their use of X-rays as a means of screening patients for serious disease, but a recent probability study by a chiropractic radiologist reveals that full-spine x-rays are twice as likely to induce cancer as to discover it in a patient [20]."
Bill Hartman, HARTMAN certified
Sorry, I digress)and depending on how they market themselves to the general, uneducated public ("Doctor" of Physical Therapy????), things may change. In my mind, the relationship with the MD or DO will always be there for PT's.
Linear Mode
