Chiropractic: Separating Myth from Fact

Introduction

In the realm of medicine, chiropractic care has garnered both praise and skepticism. While many people swear by its efficacy in relieving pain and promoting overall well-being, others remain skeptical, questioning its scientific foundation. In this blog post, we aim to delve into the world of chiropractic care, separating myth from fact to help you make informed decisions about whether this form of healthcare is right for you.

Myth #1: Chiropractors are not real doctors

Fact: While chiropractors are not medical doctors, they are highly trained professionals who undergo rigorous education and training. Chiropractic education involves a four-year doctoral program, including anatomy, physiology, and clinical training. Chiropractors are licensed healthcare professionals who specialize in musculoskeletal and neuromusculoskeletal disorders. Chiropractic schools are accredited through the Council of Chiropractic Education (CCE) which is recognized by the Council for Higher Education Accreditation (CHEA) and is a member of the Association of Specialized and Professional Accreditors (ASPA). To put into perspective how Chiropractic education compares, here’s a breakdown by hours of education per subject across different medical disciplines based on 2016 Academic Calendars:  

Doctor of Chiropractic (DC) - 3591 Academic Hours; 1023 Clinical Hours

Medical Doctor (MD) - 2600 Academic Hours, 2200 Clinical Hours

Doctor of Osteopathy (DO) - 2145 Academic Hours, 2520 Clinical Hours

Doctor of Physical Therapy (DPT) - 1356 Academic Hours, 1311 Clinical Hours 

These hours aren't intended to conclude that one discipline is better than another. It's to show that chiropractic education mirrors the education of other medical disciplines based on higher education accreditation parameters. 

Myth #2: Chiropractic care is only for back pain

Fact: Although chiropractors are often associated with treating back pain, their scope of practice extends beyond spinal issues. Chiropractic care aims to enhance overall health and well-being by improving overall joint mobility (including joints beyond the spine), decreasing muscle tension, and restoring faulty movement patterns. Many patients seek chiropractic care for issues such as headaches, plantar fasciitis, carpal tunnel syndrome, and many other conditions. Chiropractors have an intricate knowledge of anatomy and biomechanics of not just the spine, but of the entire musculoskeletal system.  

Myth #3: Chiropractic adjustments are dangerous and commonly cause strokes

Fact: Chiropractic adjustments, also known as spinal manipulations, are generally safe when performed by a qualified and experienced chiropractor. Research indicates that serious complications from chiropractic adjustments are extremely rare. Stroke risk seems to be the biggest concern for most skeptics of chiropractic, but the research doesn’t necessarily follow. A 2015 study analyzed a potential correlation between chiropractic visits, primary care physician (PCP) visits, and stroke. The study found: “No significant association between VBA stroke and chiropractic visits. We conclude that manipulation is an unlikely cause of VBA stroke.” The study did however find “a significant association between PCP visits and VBA stroke. The positive association between PCP visits and VBA stroke is most likely due to patient decisions to seek care for the symptoms (headache and neck pain) of arterial dissection (stroke).” (1) This study suggests that chiropractic manipulation may not increase the risk of stroke, rather, impending stroke patients may have a higher likelihood to seek care from a variety of providers, including chiropractors. Another study concluded, “We found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care.” (2)

All this being said, a good chiropractor should still screen at-risk patients for possible stroke, even further decreasing the already extremely rare occurrence. At Bergner Chiropractic, we take a thorough history and exam, as well as utilize the Cincinatti Prehospital Stroke Scale and other orthopedic exams to ensure that our patients are not at increased risk. 

We will always tailor our approach to your specific needs, ensuring a safe and effective treatment.

Myth #4: Chiropractic care is not based on scientific evidence

Fact: While the scientific community continues to explore the mechanisms behind chiropractic care, numerous studies support its effectiveness. Research suggests that chiropractic adjustments can be beneficial for conditions such as lower back pain (3,4,5,7), neck pain (6,7), and headaches (8,9). These studies only address adjustments in isolation, as this is the most disputed aspect of chiropractic care. The research for adjustments when combined with soft-tissue work and rehabilitative exercise is even more robust.  

It's important to note that chiropractic care may not be suitable for every health condition, and a collaborative approach with other healthcare providers may be necessary for comprehensive care. At Bergner Chiropractic, we have a comprehensive health network that is well-equipped to connect you with the most suitable healthcare professional for your condition. In the event that we are not the right fit, we will ensure you find the appropriate match.  

Myth #5: Once you start chiropractic care, you have to continue forever

Fact: The frequency and duration of chiropractic care varies depending on individual needs and health goals. Some patients may find relief after a few sessions, while others may choose ongoing care to prevent the recurrence of issues and ensure optimal performance (10). Patient expectations are sometimes at odds with reality, as it takes time and consistency for injuries to heal. In addition, building durability to avoid future worsening of the original injury takes time and consistency as well; but if your chiropractor has given you a clear treatment plan and you have followed it without getting any results, then they should refer you to the next best option. This is the standard of care at Bergner Chiropractic. We always aim to find the minimum therapeutic dose for you to maximize your results and get you to complete resolution.  

Conclusion

Chiropractic care remains a subject of debate, but separating myth from fact is crucial for making informed decisions about its potential benefits for your health. By understanding the education and training of chiropractors, the range of conditions they can address, and the safety of chiropractic treatments, you can approach this healthcare option with greater confidence.  

References:

1. Kosloff TM, Elto D, Tao J, Bannister WM. Chiropractic care and the risk of vertebrobasilar stroke: results of a case-control study in U.S. commercial and Medicare Advantage populations. Chiropractic & Manual Therapies (2015) 23:19

2. J. David Cassidy, DC, PhD, DrMedSc, Eleanor Boyle, PhD, Pierre Co^te’, DC, PhD, Yaohua He, MD, PhD, *Sheilah Hogg-Johnson, PhD, Frank L. Silver, MD, FRCPC, and Susan J. Bondy, PhD. Risk of Vertebrobasilar Stroke and Chiropractic Care Results of a Population-Based-Case-Control and Case-Crossover Study. SPINE Volume 33, Number 4S, pp S176-S183.

3. Haldeman S, Dagenais S. What we have learned about the evidence-informed management of chronic low back pain? The Spine Journal. 2008(8): 266-277.

4. Von Heymann WJ, Schloemer P, Timm J, Muehlbauer B. Spinal high-velocity low-amplitude manipulation in acute nonspecific low back pain: a double-blinded randomized controlled trial in comparison with diclofenac and placebo. Spine (Phila Pa 1976). 2013 Apr 1; 38(7): 540-8.

5. Goertz CM, Long CR, Hondras MA, et al. Adding chiropractic to standard medical therapy for nonspecific low back pain. Spine (Phila Pa 1976). 2013; 38:627-34

6. Korthals-de Bos IB, Cost effectiveness of physiotherapy, manual therapy and general practitioner care for neck pain: economic evaluation alongside a randomized controlled trail. British Medical Journal, 2003. 326(7395): p. 911.

7. Bronfort G, Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine, 2004. May-June 4(3): p.335-56.

8. Tuchin PJ, e.a., A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther, 2000. 23(2): p.91-95.

9. Dunning J, Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinic trial. BMC Musculoskeletal Disorders, 2016. 16(64).

10. Senna MK, Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcomes? Spine (Phila Pa 1976), 2011. Aug 15; 36(18): p.1427-37.