Authored by Miguel Borbon
Snap, Crackle, Pop! You may be thinking of the famed cereal treats, Rice Krispies, but these onomatopoeiae are used to describe the sounds from a different sort: chiropractic adjustments.
Social media has seen a wave of viral videos where the sounds of back cracking and neck popping, intrigue some and worry others. Many in medicine are quick to disapprove and be wary of the efficacy of the practice, and while some believe in its legitimacy, globally the scientific consensus is that the practice is alternative medicine and should not be recommended to patients. In the US, it's more of a mixed bag of criticism, both valid/ based on evidence, and others based on pseudoscience. The practice itself is rooted in ancient techniques and perfected using pseudoscience. Modern science has been able to improve on its ideas, but some core values of the original chiropractic practice remain today. There is evidence to suggest that the practice is helpful to patients, but many only look at short-term outcomes rather than long-term evidence. The podcast did an episode on chiropractic and explains a range of adverse effects on patients and medicine in general. Regarding chiropractic as a whole, this piece will take a relatively deep dive down the rabbit hole as information for and against chiropractic will be mentioned. To jump to different parts, provided below is a table of contexts.
Table of Contents:
History
What it is
Evidence for and against
Global vs the US
Conclusion
History: From Bonesetting to Modern Chiropractic
Historically, there has been mention of “manual medicine” dating back to almost 500 BCE, but it wasn’t until the 19th century that “bonesetters” emerged in England, reviving the once old popular form of alternative medicine. Daniel David Palmer (DD Palmer) is said to be its co-founder, along with his son, B.J. Palmer in 1895. Combining osteopathic techniques from Andrew Taylor Still (founder of osteopathy) and so-called “magnetic healing” he used this basis to continue his work and established the first school of chiropractic in 1896. DD Palmer believed that “innate intelligence” is what allows the body to automatically heal itself, especially when combined with the vertical subluxation of the spinal column. Basically, if the spine ain’t straight, you are not innate. From this concept, DD Palmer believed his work on spinal manipulation was similar to that of a god-like intelligence and even believed that it could be a cure-all for diseases. Such history and concepts drove many in established medicine to refute such claims on chiropractic. However, disciples of chiropractic won in a 1990 US Supreme Court Case, ultimately calling out established medicine and continuing its role as a form of “real medicine”. Such an alternative form of medicine has been shared widely today, but many are wary and unacquainted with the practice. So what exactly is chiropractic?
What Exactly is Chiropractic
Chiropractic (Latin for “of the hand”) involves spinal manipulations on subluxations, or a dislocation in the body, to treat various musculoskeletal pains. DD Palmer’s definition was based more on the “static misalignment of a single vertebra”, thereby blocking the flow of energy hindering the body from healing itself (innate intelligence). His son however looked at how the atlas and the axis were the cause of many illnesses and that by “adjusting” these areas, sick people can get better (this was all unproven). Following these concepts has led to a mixture of chiropractors that either adhere to the original dogma of DD Palmer or blend traditional medicine with chiropractic adjustments. When it comes to the work and knowledge needed to understand chiropractic, chiropractors themselves are not medical doctors by trade. They attend up to 8 years of undergraduate and graduate programs and ultimately receive their license and certification, depending on the state they reside in. In terms of schooling, they do take courses based on anatomy, biology, and physiology, and continue to take courses in research, clinical studies, and even pediatrics. Chiropractors today tend to focus on healing the lower back, whiplash-related incidents, neck pain, and even headaches. Regarding safety, once a chiropractor starts practicing their work, most people have found that it is a safe and alternative form of musculoskeletal therapy. Many do combine chiropractic with traditional forms of medicine and physical therapy, but others use chiropractic as their main source of medicine.
Evidence on Efficacy and Effects
Some studies have supported the practice of treating back pain and any musculoskeletal problems, but there has been no real scientific consensus on chiropractic treatment of chronic, nonmusculoskeletal problems. Chiropractors and experts claim that the practice is safe, and instances where people have experienced worsened conditions are rare. Because chiropractic has helped to reduce pain in the back, neck, etc. it comes as no surprise that many see it as an alternative form of therapy, over conventional medicine. Now it's not safe to say that this is the best alternative, since the World Health Organization released a list where it is unsafe for certain people with health conditions like:
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