Did you know that a chiropractor can help you with menstrual pain and discomfort during pregnancy? I didn鈥檛 either, but some chiropractors in the city I live in seem to think they can do just about anything.
I went on the website of the Quebec order of chiropractors and accessed a听. I clicked on their websites and soon was troubled to see chiropractors boldly professing they could help with digestive issues, vertigo, and 鈥渃reating an environment for easier, safer [baby] delivery.鈥� Some recommended long lists of dietary supplements, and one chiropractor was giving advice on her blog about how white sugar and corn syrup are toxic to the nervous system and how they increase acid levels in the body. None of this is true, by the way.
Whenever the director of our Office spots something a bit fishy online鈥攁 new health gadget, a bonkers supplement鈥攈e often says 鈥淚 bet there鈥檚 a chiropractor behind it.鈥� And he鈥檚 usually right.
Why are chiropractors attracted to so much junk science?
A desire for a limitless scope of practice
Growing up, I was under the impression that chiropractors were medical doctors who specialized in back pain. In reality, chiropractic is a so-called complementary and alternative medicine that was dreamed up by a Canadian expat in the nineteenth century.
Daniel David Palmer was born in Ontario and moved to the United States as a young man in听, first to Illinois, then to Iowa where he would become famous. He was not a physician; instead, he was a jack of all trades, working successively as a schoolteacher, grocery store owner, and magnetic healer. He combined his beliefs in magnetic healing with manipulative techniques he most likely learned from the founder of osteopathy into a听听He called it 鈥渃hiropractic,鈥� meaning 鈥渄one by hand,鈥� a practice that was born on September 18, 1895, when Palmer performed his first adjustment on an elevator operator and janitor named Harvey Lillard and allegedly cured him of the deafness he had been experiencing for many years.
As with so many origin stories, the proclaimed miracle of the day changed in the telling, with Palmer听. He had adjusted Lillard鈥檚 spine in an elevator鈥� or maybe it was in Palmer鈥檚 office鈥� or maybe Palmer had accidentally hit the janitor鈥檚 back with a book and thus fully appreciated the power of rectifying spinal issues. Regardless of what actually happened, Palmer came to believe that a divine life force he called 鈥渋nnate intelligence鈥� needed to flow through the spine uninterrupted. When so-called 鈥渃hiropractic subluxations鈥� got in the way, all manners of health problems arose. A good back-cracking would restore the flow of this celestial juice.
None of this, however, makes sense in light of modern science. We now understand life as a complex dance of biomolecules: no life force has ever been detected. Moreover, the idea that there is one true cause to all diseases鈥攁 chiropractic subluxation, which听听and is often now referred to as a 鈥渇unctional entity,鈥� meaning that it can鈥檛 be seen on X-rays but can only be inferred鈥攊s a hallmark of pseudosciences. Diseases are complex and varied. No single bugaboo explains all ills, and no single intervention cures everything. Despite these intellectual hurdles, chiropractic is alive and well, and many jurisdictions have professional orders dedicated to legitimizing and regulating the practice.
Some chiropractors do limit themselves to treating musculoskeletal problems and do not believe in subluxations, blurring the lines between chiropractic and physical therapy. The exact scope of practice of chiropractors depends on their province or state, but it鈥檚 not rare to see them make claims online that paint them as your one-stop shop for any health concern. Flushing out alleged toxins, treating sports concussions, using escharotics which destroy tissue and scar the skin, even boosting your immune system against COVID-19鈥攖here is seemingly nothing a chiropractor can鈥檛 do. A听听looking at the websites of chiropractic clinics in ten of the largest metropolitan areas in Canada found that roughly a third of them advertised services to diagnose or treat allergies and asthma. While it is true that everything in the body is connected, the idea that asthma can be remedied by forcing the spine into a proper alignment beggars belief.
In Denmark, researchers found that听听mentioned conditions that have nothing to do with muscles and bones鈥攑roblems like insomnia, constipation, and breastfeeding issues鈥攁nd that this was likelier when the clinic advertised treating infants and children. (Even more astonishing findings were reported in France, where听听of chiropractic websites mentioned these types of problems with no explanation as to why chiropractic might be the answer.)
The Danish researchers then听听some of these chiropractors, the ones willing to say yes, to ask them why their websites offered treatments for non-musculoskeletal disorders. Some blamed their website and how it hadn鈥檛 been updated in a while; but then, why were things like ear infection and incontinence listed there in the first place? But interestingly, another argument was that cracking the spine could have unexpected benefits. You just never knew. 鈥淚 always treat musculoskeletal,鈥� said one chiropractor, 鈥渁lways the spine, but it might in turn help the bed wetting.鈥� One dared say that they could just tell, from clinical experience, who would benefit from a chiropractic adjustment for a non-musculoskeletal issue and who wouldn鈥檛. I strongly suspect that听别惫别谤测听client that shows up with a wallet will be told they can benefit from a chiropractic adjustment. After all, a fat wallet can really throw you off balance, and who knows what health problem might develop as a consequence?
One reason for this is that most chiropractors think that they are 鈥減rimary care providers.鈥� One interpretation of this phrase is that you don鈥檛 need a referral to go see a chiropractor compared to a medical specialist, which is fair. But a more insidious one is that chiropractors see themselves as competent enough to treat a wide range of health issues. A听听of nearly 500 U.S.-based chiropractors in the 1990s revealed that 445 (that鈥檚 nine in 10) saw themselves as primary care practitioners, while only 20 of them said that chiropractors should really only be musculoskeletal spine specialists. Far from simply talking to their patients about back problems, the surveyed chiropractors reported discussing with their patients problems like AIDS, cancer detection and the pros and cons of vaccines within the last three months, the way a family doctor would. What this indicates is a strong desire for a limitless scope of practice.
The more services a chiropractor can offer, the more money they can make鈥攁nd this income comes in handy when paying off a massive student debt. The Palmer College of Chiropractic, founded by the father figure of the profession, currently charges nearly听听per term听to learn this pseudoscience. North of the American border, our own Canadian Memorial Chiropractic College in Toronto will charge you almost听听a year听in tuition alone听if you鈥檙e Canadian. In total, a four-year program at CMCC comes up just shy of CAD 115,000. No wonder chiropractors look for anything they can sell, including supplements and weird gadgets.
And this business orientation is actually taught to them and reinforced throughout their career. Dr. Stephen Barrett of the website Quackwatch relays this preoccupation with 鈥減ractice building鈥� in an听听entitled 鈥淗ow Chiropractors Oversell Themselves.鈥� They are constantly courted by ads for seminars on how to get rich through chiropractic. The trick? Telling prospective clients chiropractic is your very first step when experiencing any sort of health problem. It鈥檚 a way of life. Chiropractic can鈥檛 simply be about fixing today鈥檚 problem; it must also be about preventing tomorrow鈥檚 trouble via regular maintenance.
When cracking the spine isn鈥檛 enough, chiropractors expand their offerings. A听听of South African chiropractors revealed that some of them were also dabbling in lifestyle and nutritional counseling (which can be legitimate if backed by a solid education), as well as听听and听听(which are pseudoscientific in nature).
Two further surveys shine a light on which chiropractic student is likely to exemplify the phenomenon of听听whereby cranks don鈥檛 just believe one wrong thing: they believe many of them.
The deciding factor? Magic.
Paying lip service to evidence-based medicine
In 2016, 444 students from two chiropractic programs in Australia answered a听听that was focused on 鈥渘on-evidence-based health care beliefs.鈥� They were asked if they thought chiropractic could help the immune system, improve the health of infants, or make it easier to give birth, all things that chiropractic cannot do. Almost half of the students in the last two years of the program answered yes to these questions. These beliefs grew over time while studying chiropractic, from year one to year five, getting more common when a student was close to graduating.
The researchers behind the survey speculated that this widespread overconfidence could be due to the perception that chiropractic, in its unique and distinct nature, was superior to science. Whereas medicine is guided by science, putting anecdotes and eminence at the听bottom听of its pyramid of evidence, chiropractic might elevate them to the top instead. Hence the Danish chiropractors who said they could just tell whose insomnia or incontinence might benefit from a good back-cracking just because of their clinical experience.
And it鈥檚 not just confidence in testimonials and experience that leads to this drifting away from evidence: it鈥檚 magical thinking as well. In a听, the same Australian team learned that magical beliefs were linked to a chiropractor desiring a limitless scope of practice. Students were asked if they agreed or disagreed with statements that we know are scientifically false. 鈥淎n imbalance between energy current lies behind many illnesses,鈥� for example, or 鈥渋f we don鈥檛 somehow clean our bodies, unhealthy toxins remain in them.鈥� These statements borrowed beliefs from homeopathy, reflexology and sympathetic magic, and those chiropractic students who had adopted them were more likely to want to treat patients for just about anything, even health problems for which they had not been trained.听
Some chiropractors have a problem with this, but chiropractic organizations typically don鈥檛. They adopt a 鈥渂ig tent鈥� approach, which provides shelter to the more outrageous quacks. They will say that they want the profession to 鈥渇ollow the evidence,鈥� but as the Australian researchers conclude in their paper, 鈥渢his evidence-friendly approach could be seen as paying lip service to evidence-based medicine.鈥� Basically, they talk the talk without walking the walk, and they mingle with practitioners whose outlandish interventions can only be justified with a shrug and a 鈥測ou never know.鈥�
This magical thinking, coiled around a contrarian posturing in the face of actual medicine, has pushed the profession in the welcoming arms of Robert F. Kennedy Jr鈥檚 Make America Healthy Again movement. Kennedy听听theirs as 鈥渁n embattled profession鈥� fighting 鈥渢he medical cartel:鈥� it鈥檚 no wonder chiropractors have donated so generously to him and that they now have a liaison keeping chiropractic organizations connected to the larger MAHA movement.
The chiropractic profession has also had, since its inception, an anti-vaccine bias. D.D. Palmer called vaccines听听To be clear, not every chiropractor is anti-vaccine; but why endorse a medical product you鈥檙e not allowed to administer when you think cracking the spine boosts the immune system? No wonder Kennedy, a leader of the modern anti-vaxx movement, called chiropractors 鈥渕y kind of people.鈥�
The principle at play here is the same one underlying conspiracy thinking: reject the mainstream and embrace the alternative, no matter how bizarre or contradictory it may be.
Faced with college debts, a blitz of practice-building ads, and the belief that the world runs on magic, it鈥檚 no wonder so many chiropractors go beyond the already questionable spinal adjustments and adopt a growing panoply of piffle and claptrap.
Take-home message:
- Chiropractic is not a medical specialty but an alternative practice concocted by a magnetic healer in 1895 who thought he cured a man of his deafness by cracking his spine
- Many chiropractors advertise services, supplements, and gadgets that have nothing to do with treating back problems
- Factors that explain this include needing to pay back large student debts; being courted by businesses promising to teach them how to get rich from chiropractic; and believing in magical notions
