Chiropractors: The Good, the Bad, and the Ugly

Before I begin, let me give you a little insight to where my perspective on the healing comes from. By training, I'm a scientist. I am really good at looking at issues critically and deciphering facts and problems based on factual evidence and sound theories. At the same time, I always had an interest in alternative medicine and while I lived in Seattle for 5 years, I had the chance to experience directly and learn various healing modalities such as naturopathic physician care, acupuncture, homeopathy, Nambudripad's Allergy Elimination Techniques (NAET). Some of my knowledge comes from being the inquisitive patient, some comes from discussions with students of Bastyr College of Naturopathic medicine who I befriended while in Seattle. While in Seattle I also took several classes on Reiki, and became a Reiki Master/Teacher and hence I have the insiders perspective on how energy healing works and what it can and can't do.

I am a strong advocate of alternative therapies in conjunction with or sometimes instead of traditional medicine. However, recently, I have been really bothered by practices of chiropractors (some not all) and I feel that there are many out there that take advantage of the general lack of understanding of how the human body works in patients to keep their businesses going. I write this article with the goal to educate moms on the good, the bad, and the ugly associated with chiropractic care, especially as many chiropractors now advocate for 'maintenance care' not only for adults but also for children.

As you will see below, I do believe that chiropractic adjustments can be very useful, especially when they are performed as part of the whole body healing, but unfortunately, when done in isolation, chiropractic adjustments often only set you up on a path of going, and going, and going back to your chiropractor for more treatments, rather than getting well.

The work of a chiropractor is to manipulate the spine to remove misalignments. Misalignments in the spine are often referred to as subluxations. Traditional chiropractic philosophy is based on the belief that misalignments in the spine are the root cause of illness. Hence they remove the misalignments in the spine with the hope that the illness will go away as well. The idea behind this theory is that all body organs are connected to the spine through nerves. If there is misalignment in the spine, it will cause a problem with the nerves and then other organs connected to them. If you consider long term chiropractic care for yourself or your family, be sure that this theory of all illness originating from spine misalignments resonates with you. It doesn't with me. Here is why.

The spine connects to joints, then to muscles and ligaments that support the spine and its structure. If there is a problem within the spine, the muscles in the close proximity to the spine misalignment (and often not only in that region) will also be affected. Typically some muscles will become overly tight and some will become weak, as muscles work in pairs. This is what's commonly referred to a muscle imbalance. In addition to the musculoskeletal system in your body, there is a biochemical system, and an emotional system. The biochemical system includes your blood chemistry, hormones, vitamins, minerals, and hence this system is vital to your well-being. Emotions, including moods and attitudes have also been shown to contribute to and to aid illnesses. The musculoskeletal, the biochemical, and the emotional systems within our body are very intimately connected to create our well-being or sickness. If we become ill, all of these systems will be affected and disease will manifest in all. I think it's naive to believe that all disease starts from the spine. For example, if you never go out in the sun and eventually become Vitamin D deficient, it is likely that you will develop problems in your spine since Vitamin D deficiency leads to muscles weakness. This in turn will likely lead to spine misalignments. Similarly, severe emotional trauma, never addressed properly, over time may lead to sickness which will likely cause some spine misalignment. I believe that it's correct to say that most illness will manifest itself in the spine, but that is not the same as saying that all illness originates in the spine. One thing to keep in mind is that the somewhat simplistic philosophy behind chiropractic and illness was developed at time when people had no choice but to eat minimally processed foods from local sources, before there were any chemicals in the environment, and at a time before drugs, vaccinations, and other environmental factors were impacting our health. In our modern society, there are other factors that contribute to creating illness, which must be addressed.

In my opinion, removing the cause of the illness is the best approach for curing it. Finding the cause of the illness is often the tricky part. This is where a doctor with a broad range of expertise and education is most helpful. Ideally, the physician you pick as your doctor is familiar with how disease manifests itself in the musculoskeletal system, as well as in the biochemical and emotional system. Such a physician can best determine how to get all these systems back into balance.

Chiropractic treatments have the best chance of curing problems most directly related to disturbances in the musculoskeletal system of the body. Many joint, and muscle pains can be aided by chiropractic manipulation. The question is, whether the pain will stay away. If the treatment is for an injury such as back pain due to someone lifting a heavy object in awkward manner, one to several chiropractic adjustments will usually get rid of the pain for good. The reason is that the cause of the pain was the spinal misalignment, and once removed, the patient is usually pain free.

What about chronic pain though? Moms often develop neck and shoulder pain from nursing and carrying their children. Lower back pain and sciatica are also quite common. All chiropractors happily address these conditions, but how they are addressed varies greatly between chiropractors.

It is a very common chiropractic practice to manipulate the spine to try to get it back to its proper alignment, and ask the patient to come back multiple times in a week, often for long periods of time. The reason for the multiple return visits is not addressing the cause of the spine misalignment. If the cause of the problem is not removed, few hours to a few days after the adjustment, the spine slowly returns to its previous state.

Why? Because the muscles that are tight are pulling it in the direction of previous misalignment and the weak muscles can't support the corrected structure. So the patient goes back to the chiropractor, and the process is repeated. 5, 10, 20, 40, sometimes 60 times, usually 1 to 3 times a week over a course of weeks. Then once a week, then once a month. After all those adjustments, it is possible that the muscles over time slowly adapt into the new corrected shape from the repeated adjustments, but typically if treatment is stopped, the spine will go back to the misalignment as the cause of the problem was never addressed by the chiropractic practitioner. Many moms I know have chronic neck or lower back pain, and all feel better after visiting a chiropractor. The problem is that they need to keep seeing the chiropractor in order to feel better.

The underlying reason for chronic pain is often postural patterns (such as forward rounded shoulders from computer use) and muscle imbalances (strong quadriceps and weak hamstrings in runners or after pregnancy). That's only part of the picture though. Spine misalignment can also be caused by and exacerbated by a food allergy, such as dairy intolerance, or vitamin deficiency. The misalignments due to these factors can be as severe as from chronic postural patterns. Chiropractic adjustments will keep making the patient feel better after every adjustment, however if the cause is never addressed, the problem will keep coming back. In these examples, it would make most sense to address the cause of the illness (vitamin D deficiency or dairy intolerance) rather than the symptom (spine misalignment).

A good chiropractor should be able to determine what the cause of the muscle imbalance and/or spine misalignment is, whether it is purely structural or whether there is an underlying problem such as a nutrient deficiency, a food sensitivity, a toxic overload, or a hormonal imbalance. This takes not only a good chiropractor but an inquisitive mind set as well as good doctoring skills. These are not taught in all chiropractic schools, and the good chiropractors have usually had lots of other training, for example in applied kinesiology.

Hence in my view, chiropractic adjustments are useful to address some musculoskeletal issues. For sure, for acute injuries to the system. When it comes to chronic pain though, the key to getting rid of the issue is addressing the cause. A practitioner who understands how the body works will use a combination of spinal manipulation with physical therapy to address tight and weak muscles, and offer a plan on removing the cause of the ailment (postural habits, etc). This would be similar to the work of a physical therapist skilled in spinal manipulation. Often however even that is not enough. A chiropractor with a firm belief that removing spine misalignments is all that is needed to treat a person will likely keep a person with a vitamin deficiency or a food allergy in treatment for months (and be unsuccessful). I think that is plain ignorant. To treat a person, all aspects of the body have to be considered and for that a holistic practitioner acknowledging the whole body approach to healing is needed. A good chiropractor will recognize the limitation of his or her work and will refer a patient to someone else if spinal manipulation is not producing lasting results.

Long term Chiropractic Care

Many chiropractors think that regular spinal manipulations are necessary to stay healthy. After all, in their minds, all disease originates in the spine, and hence small misalignments should be frequently removed for optimal health. It is not clear to me whether these chiropractors actually believe this or whether they simply understand that they will have clients for life, as long as the client believes that he or she should see the chiropractor once a month for optimal health. Of course, services are not limited to adults. Many chiropractors now offer a family package and start adjusting children from infancy; For maintenance: once a month for the rest of their lives.

Maintenance may be a good idea a couple times a year or after accidents to prevent the problem of "as the twig is bent, so grows the tree". However, there is more to good maintenance healthcare than adjusting. The biochemical and emotional systems also need maintenance, and typically people with more balanced chemical and emotional systems will need less adjustments to stay feeling good. A good alternative to using a chiropractor for health maintenance is using a practitioner who can address the full spectrum of healthcare and preventive maintenance, such as a Naturopathic Doctor also trained in physical medicine.

In summary:

The good: chiropractic manipulation can be extremely helpful in reducing or removing pain, often chronic.

The bad: Typical chiropractors address only the structural component of the problem. Some will often guidance on how to stretch and strengthen affected muscle groups to help the spine in alignment. Most do not tackle the chemical/hormonal aspect of the problem which are often the hidden cause of spinal misalignments. There is also an emotional aspect of spinal alignments which is rarely addressed.

The ugly: Chiropractors often set up their practice with the intention of keeping the clients coming and coming and coming. It's not uncommon to see packages of 60 to 80 visits sold upfront: not only for you - but for your entire family, whether they are ill or not!

Optimal Solution: Finding a practitioner who understands the relationship between the musculoskeletal, biochemical, and emotional systems in your body, and can get to the cause of your problem. This can be a holistic chiropractor, naturopathic doctor trained in spinal manipulation, or perhaps a chiropractor who's also an acupuncturist.