Opinions on chiropractors.

I've been having issues with my back for a few months now. It really only affects me when I sleep as the pain mostly ends up in my ankle by the time I wake up. It's gotten better and sometimes worse, at one point it was painful to lay down even for a few minutes. Understandably, I am getting desperate for a full night of sleep and also not waking up in pain.

So, I went to the general doctor and have done the medication and had a cortizone shot. Neither of these helped at all and the next step according to him is to get an MRI. As that is quite expensive, I'm hesitant to do this as it seems like it would also lead to surgery. I've been to the chiro a few times and it seemed like it was helping, but I can't be sure. My wife is on the side of the general practitioner. I just wanted to see some opinions from you all as I try to figure out what I should do. Have you had good experiences with a chiropractor?

Also, please don't turn this into a free health care debate. I can afford it and have insurance, I'm just cheap.

I have lower back pain that I treat with stretching and exercise. I personally think that chiropractors are a waste of money, but know people who would call them a life-saver.

I had a really great chiropractor. He did adjustments to deal with pain, and get things in the right place, but he also made me do strengthening exercises, and traction sessions to ensure that my PROBLEMS were fixed, not just the SYMPTOMS.

My headaches finally went away. I think it was worth it, but not all chiropractors work that way, some are just snake-oil salesmen.

I'm a big believer in outcome-driven choices when looking at healthcare options. If chiropractic is giving you positive results, it's probably worth continuing.

I've had great results with acupuncture for various issues, and it can be especially effective for treating pain issues. No idea whether there are good practitioners in your area, though.

(Boilerplate disclaimer that I would never recommend alternative medicine as a substitute for seeing a good M.D., but as a complementary care choice I've seen plenty of folks get great results).

Two of my friends have seen a chiropractor that they swear by and doesn't do the whole "come back 3 times a week for the rest of your life" bit.

Why not try physical therapy?

I have had a bad back off and on for years now.

When I had a really painful episode last year I went to a chiropractor. It did not help at all. She should not even saw me. She should have known that whatever she does would not help.

A couple things that help a bit while you are in pain. Stretching your back, hamstrings and calves. A good PT will tell you what stretches would work the best.

But really the only thing that works is time. And be careful when you start feeling better. Use your legs to pick things up, better posture while on the computer, keep your muscles stretched, etc.

One of my best friends is a chiropractor, and he has helped me with a few things. I think that as long as the person your going to see if actively trying to fix the issue with more than just adjustments then it for sure is a great thing. The way my buddy explains it, is that sometimes you just need to get things put back into the correct place, so that you can really work on fixing what the underlying issues are. If the person you see just does the adjustment and gives no advice how to fix the overall problem, find a different chiropractor.

There are two kinds of chiropractors. The kind that offers you help with your back, and the kind that offers to cure everything you've ever had wrong with you ever. Never trust the second kind, not even to treat your back.

If you've got insurance, why not see a back specialist?

First off, sorry you're going through all that. I have chronic pain problems myself and being unable to sleep makes it even worse.

Is there any other reason besides the cost that makes you reticent to get the MRI? At least then y'all might see and KNOW what's causing the problem - bone, nerve, overly tight muscles and tendons, whatever - and then you can research your options. Remember that getting the test itself doesn't equal "THOU MUST NOW HAVE SURGERY." Doctors can't make you do anything you don't want to.

As for my own experience? The only chiropractor who ever helped thought most of the claims chiropractors make are bull****. Also, you will rarely have the problem permanently addressed - and those continuing appointments add up. I eventually found a medicine combination, stretching routine, and exercises that helped.

Hope that made sense and helped a bit; I'm still spaced out from not sleeping because my lower back and hips kept me awake. (Yeah, I know that sounds weird after the last paragraph, but I'm 8 months pregnant and no longer on meds. Or can do all the stretches. Or see my toes.)

I have no basis for my opinion, other than my mother has ongoing back pain that she sees a chiropractor for. It has never been cured.

I don't think that they're effective.

Often, like you said above, there's no diagnosis, no scientific method, just trial and error "treatments" which alleviate pain in the short term; if you happen to stumble upon the right "treatment". Most often their approach is to throw the pot of pasta at the wall and see what sticks. If your chiropractor is someone who encourages second opinions, xrays, other diagnostics before treatment, you may have a winner.

I see there are some conditions for which there may be no "cure" and the best thing that you can do is manage chronic pain. Make sure this is you before you seek this kind of treatment. Also ask yourself. What is the cost of a valid diagnostic like an MRI compared to the ongoing cost of pain management treatments like chiropractics.

Yes, the MRI is expensive, but so is chiropractic treatment. And with the MRI you have a lot higher chance of actually figuring out what is wrong and doing something constructive about it. I have a friend who monkeyed about with stuff for over two years before giving in and getting an MRI. She had two herniated disks and none of that nonsense she'd been doing would have ever done a damned thing to help. Now that they've begun treating the problem, the chiropractor works with her doctor to help and she is getting better as long as she doesn't do stupid stuff like try to lift her 80 pound dog.

Personally, I haven't had any luck with chiropractors over the years. I've tried it four or five times, but all of them have been Yoreel's "Type 2". I've never met one that wasn't. The best one tried everything he could think of for two months and when none of it helped, he gave me my money back. He genuinely cared and really tried. I think we both felt bad about it by the end.

The only reason I have done it again is because sometimes you get to a point where you have to try SOMETHING. But that's an awfully expensive placebo if you've got something real going on.

tl;dr: Get the MRI.

I've seen one chiropractor for a trapped nerve kind of thing in my upper back. The initial treatment (an Atlas adjustment) helped a bunch, but after going back 3 times to have him spend 5 minutes poking me with a plastic gun-tool seemingly at random, I played the 'quack' card and didn't go back.

Of course, it's quite possible that my body would have healed just as well without his initial treatment. Or that a decent massage would have done just as much good.

Based on that one experience, I don't plan on seeking chiropractic treatment again. It did set off a whole host of bullsh*t detectors in my head.

An MRI from a medical doctor might not be that much better than a chiropractic doctor poking you with a plastic gun-tool:

An infamous 1994 study published in The New England Journal of Medicine imaged the spinal regions of ninety-eight people with no back pain or any back related problems. The pictures were then sent to doctors who didn't know that the patients weren't in pain. The end result was shocking: two-thirds of normal patients exhibited "serious problems" like bulging, protruding or herniated discs. In 38 percent of these patients, the MRI revealed multiple damaged discs. Nearly 90 percent of these patients exhibited some form of "disc degeneration". These structural abnormalities are often used to justify surgery and yet nobody would advocate surgery for people without pain. The study concluded that, in most cases, "The discovery by MRI of bulges or protrusions in people with low back pain may be coincidental."

Or consider this: A large study published in the Journal of the American Medical Association (JAMA) randomly assigned 380 patients with back pain to undergo two different types of diagnostic analysis. One group received X-rays. The other group got diagnosed using MRI's, which give the doctor a much more detailed picture of the underlying anatomy.

Which group fared better? Did better pictures lead to better treatments? There was no difference in patient outcome: the vast majority of people in both groups got better. More information didn't lead to less pain. But stark differences emerged when the study looked at how the different groups were treated. Nearly 50 percent of MRI patients were diagnosed with some sort of disc abnormality, and this diagnosis led to intensive medical interventions. The MRI group had more doctor visits, more injections, more physical therapy and were more than twice as likely to undergo surgery. Although these additional treatments were very expensive, they had no measurable benefit.

http://scienceblogs.com/cortex/2008/...

Hmm, has MRI analysis improved at all in the last 17 years, though?

Jonman wrote:

I've seen one chiropractor for a trapped nerve kind of thing in my upper back. The initial treatment (an Atlas adjustment) helped a bunch, but after going back 3 times to have him spend 5 minutes poking me with a plastic gun-tool seemingly at random, I played the 'quack' card and didn't go back.

Even the non-quacks can be expensive. My co-pay on PT is $25. The first couple of sessions involved an evaluation and teaching me exercises to help the back. The third one involve the therapist watching me do the exercises. I was like, I just paid $25 to have a guy watch me stretch. As sexy as that sounds, I never went back.

My mother is a nurse and she believes that they are quacks, one and all. So, therefore, I believe they are quacks, one and all.

I've been going to a chiropractor for a few months now. I was having headaches and I hit the last straw when I threw my neck out drying my hair with a towel. They took an x-ray of my neck and back, went over the details of healthy curvature and based on my fairly basic issue recommended a couple weeks of three times a week, then a few weeks of twice a week and now once a week few for a few months. Then I'm done.

We took updated X-rays a couple weeks in and I could see for myself the difference in the spine.

I've been given exercises to do and some head weights to wear for a few minutes a day to strengthen the neck which also helps.

Regardless of how much of it is crap and how much of it has merit, the results speak for themselves. I do the work suggested, honor the process and I make sure I don't miss appointments. I haven't had any real headaches since about two weeks into the process and my neck feels mobile and clear in a way it hasn't for a long time. I won't be doing it for the rest of my life, but it's been great for getting me back to a healthy place I can maintain.

Physiotherapy is what i would suggest with the caveat that you should trust your own feeling on how the treatment is going. My uncle is an excellent physio but i've also seen mediocre ones. Personally i think that if you're not able to feel and see what's wrong in a lot of these cases then you're not the right person to be treating the problem.

As someone who has to review and evaluate medical records, generally for neck & back pain, from primarily chiropractors and orthopedists, it certainly seems like 99% of all chiro offices are just overpaid massage parlors. Standard regiment is usually hot and cold packs (cryotherapy), massage, manipulation, infrared, some electro-stim and maybe some "lasers". I've also had to attend numerous seminars by some of the "good" chiros who completely rag on what a lot of these strip mall "come back 3 times a week for 2 years" chiros do. Apparently there is no licensing agency and no real exam for chiros. In short there's no oversight in place like regular MD's or even attorneys have. About the only time these places get shut down for quackery is if the local police bust them for insurance fraud.

And, as mentioned above, it's more unusual for MRIs to come back with no bulges or herniations than it is for them to find them. It's just a part of aging and regular ol' wear and tear with maybe some trauma thrown in now and again. It seems like it's only when you have nerve impingement that most orthos start talking about possible surgery though even then they're generally more likely to try injections first. In the end most of the chiro and orthos I've had to listen to tend to say that exercise, strengthening the core muscles and increasing flexibility is the best treatment for your run of the mill back pain.

And, of course, in full disclosure I am not a doctor so don't listen to anything I say regarding health matters.

Certis wrote:

I've been going to a chiropractor for a few months now. I was having headaches and I hit the last straw when I threw my neck out drying my hair with a towel. They took an x-ray of my neck and back, went over the details of healthy curvature and based on my fairly basic issue recommended a couple weeks of three times a week, then a few weeks of twice a week and now once a week few for a few months. Then I'm done.

We took updated X-rays a couple weeks in and I could see for myself the difference in the spine.

I've been given exercises to do and some head weights to wear for a few minutes a day to strengthen the neck which also helps.

Regardless of how much of it is crap and how much of it has merit, the results speak for themselves. I do the work suggested, honor the process and I make sure I don't miss appointments. I haven't had any real headaches since about two weeks into the process and my neck feels mobile and clear in a way it hasn't for a long time. I won't be doing it for the rest of my life, but it's been great for getting me back to a healthy place I can maintain.

It's quite possible that chiropractors are more regulated in Canada. Here, they literally claim they can cure your allergies.

Here is my 2 cents. What you want is someone to fix your back pain. Depending on the base cause this will include calming muscle spasms and body mechanic education. Might include realignment of bones if said bones are misaligned. Wheither it is a Chiropractor or a Physical Therapist is the question. Where I live, there is a turf war. Frankly, as a Physical Therapist Assistant, I could care less which you pick. What you want is someone who will do the following. Look for someone who will use heat modalities for pain management. This often includes moist heat and can include electric stimulation to calm muscles or ultrasound. Joint mobilization IF APPROPRIATE. Not all back problems need to be mobilized. Exercises to keep the joints in their proper alignment and biomechanic education to prevent them from misaligning again. Chiropractors often fall short on the exercise and back school education. Physical Therapists will do all of the above. Shop around and find someone good you can afford. It will take a series of visits for the education and pain management. What it should not be is a once a week visit for the rest of your life.

Good Luck!

ChrisGwinn wrote:

It's quite possible that chiropractors are more regulated in Canada. Here, they literally claim they can cure your allergies.

Nope, some of them make ridiculous claims like that up here too.

Funkenpants wrote:
Jonman wrote:

I've seen one chiropractor for a trapped nerve kind of thing in my upper back. The initial treatment (an Atlas adjustment) helped a bunch, but after going back 3 times to have him spend 5 minutes poking me with a plastic gun-tool seemingly at random, I played the 'quack' card and didn't go back.

Even the non-quacks can be expensive. My co-pay on PT is $25. The first couple of sessions involved an evaluation and teaching me exercises to help the back. The third one involve the therapist watching me do the exercises. I was like, I just paid $25 to have a guy watch me stretch. As sexy as that sounds, I never went back.

If he was any good he would have been telling you if you are doing them correct or incorrect. He just sat there and watched without any input? If that is the case you are correct and the service sucked for the price.

My brother-in-law is a PTA. He makes sure his patients are doing the exercises correct.

Kehama wrote:

As someone who has to review and evaluate medical records, generally for neck & back pain, from primarily chiropractors and orthopedists, it certainly seems like 99% of all chiro offices are just overpaid massage parlors. Standard regiment is usually hot and cold packs (cryotherapy), massage, manipulation, infrared, some electro-stim and maybe some "lasers". I've also had to attend numerous seminars by some of the "good" chiros who completely rag on what a lot of these strip mall "come back 3 times a week for 2 years" chiros do. Apparently there is no licensing agency and no real exam for chiros. In short there's no oversight in place like regular MD's or even attorneys have. About the only time these places get shut down for quackery is if the local police bust them for insurance fraud.

I don't typically do this, but I have to pipe up here. Your assertion that there is not any licensing agency, and no oversight or regulation is simply wrong. There may not be a NATIONAL licensing of chiropractic, but I know for a fact Iowa, SD, California and NY all have state licensing of chiropractors, all of which require continuing education credits every year or every 2 years (just like doctors, lawyers, CPAs) and have discipinary boards and complaint processes. Like any time you visit a doctor, go to a lawyer, or any such professional, the unfortunate reality today is that a consumer MUST investigate the person they are seeing to insure the professional competency is there. (and feel free to take my statements as total bunk also - go do a quick google search or two). I also am not so green to think that the oversight systems are able to handle every complaint quickly or completely, hence the "chiropractic can cure allergies" stuff still happens, but it happens with MDs and such also.

Full disclosure - I see a chiropractor from time to time; he even told me once he thought I might have a herniated disc and that I should go see an MD, which he expected would recommend an MRI. I read up on the situation and decided I was not being patient enough, continued to do the exercises and treatment. After 4 weeks, the pain was gone and I'm now back to the "every 6 weeks" appointment schedule. I do, however, think my chiropractor is one of the "good" ones.

I'd echo what most others say - if it is helping you, it doesn't matter what other people, even professionals, say.

Cymbrogi wrote:

I don't typically do this, but I have to pipe up here. Your assertion that there is not any licensing agency, and no oversight or regulation is simply wrong. There may not be a NATIONAL licensing of chiropractic, but I know for a fact Iowa, SD, California and NY all have state licensing of chiropractors, all of which require continuing education credits every year or every 2 years (just like doctors, lawyers, CPAs) and have discipinary boards and complaint processes. .

Ah, sorry about that then. Most of my education is centered around handling chiros out of Florida so I only know there's no controlling agency for that state.

CheezePavilion wrote:
Or consider this: A large study published in the Journal of the American Medical Association (JAMA) randomly assigned 380 patients with back pain to undergo two different types of diagnostic analysis. One group received X-rays. The other group got diagnosed using MRI's, which give the doctor a much more detailed picture of the underlying anatomy.

Which group fared better? Did better pictures lead to better treatments? There was no difference in patient outcome: the vast majority of people in both groups got better. More information didn't lead to less pain. But stark differences emerged when the study looked at how the different groups were treated. Nearly 50 percent of MRI patients were diagnosed with some sort of disc abnormality, and this diagnosis led to intensive medical interventions. The MRI group had more doctor visits, more injections, more physical therapy and were more than twice as likely to undergo surgery. Although these additional treatments were very expensive, they had no measurable benefit.

http://scienceblogs.com/cortex/2008/...

Ok took me a while to find that JAMA article http://jama.ama-assn.org/content/289...

Having quickly skimmed it a) it is a fabulous example of appallingly conducted medical research b) as such you can't really use it as an argument against the usefulness (or not) of MRI for diagnosis. All it tells you a given group of people if only allowed access to 1 diagnostic test will perform about as well as another, and there is actually no other information there.

e2a: My point being; don't be so credulous about the latter part of that scienceblogs article.

What Chiropractor means to me:
IMAGE(http://i.imgur.com/fKW9yl.jpg)

Kehama wrote:
Cymbrogi wrote:

I don't typically do this, but I have to pipe up here. Your assertion that there is not any licensing agency, and no oversight or regulation is simply wrong. There may not be a NATIONAL licensing of chiropractic, but I know for a fact Iowa, SD, California and NY all have state licensing of chiropractors, all of which require continuing education credits every year or every 2 years (just like doctors, lawyers, CPAs) and have discipinary boards and complaint processes. .

Ah, sorry about that then. Most of my education is centered around handling chiros out of Florida so I only know there's no controlling agency for that state.

I was curious and did some more digging before you mentioned Florida and I have to say that I am not quite so right myself either, as it appears Florida didn't require testing until July 1, 2009. That was pretty surprising to me and means there are a lot of grandfathered chiropractors in Florida that have a license and never passed an exam other than the chiropractic coursework. It may very well be there are other states that don't have any licensure/exam requirements at all or just recently required such items.

Just reinforces the thoughts here - do your homework before just blindly going into something.

goman wrote:

If he was any good he would have been telling you if you are doing them correct or incorrect. He just sat there and watched without any input?

He said stuff like, "Good," and "okay- that's 30 seconds. Now the other leg..." These weren't really complex movements and stretches. There was also 15 minutes of me laying on a table in a room with a heating pad on my back, which felt nice. But not $25 worth of nice.

I have recently come to realize the value of an MRI, and encourage everyone to get as many of them as they can justify.