How to pick a chiropractor?

sijomial · October 2019

I live in England.

Just back from my Osteopath this afternoon as it happens, in my previous post I alluded to the lack of reassessment before manipulation. What I forgot to mention was the huge difference in appointment times I've commonly found between Chiro and Osteos.

Despite my chap knowing me well over the course of many years and different injuries we just spoke for longer than the entire appointment duration I got from the Chiro I used in the past to get the history and current state of my injury completely understood.

And then he did a load of hands on soft tissue work and assessment and said....
"However many times you ask I'm not going to use force to manipulate/adjust your joints today as it would be totally inappropriate at this stage of your recovery."
(He's know I'm not a patient patient!)

That leads to perhaps my biggest objection based on my own experience - being just given a standard manipulation/adjustment routine rather than personalised treatment that is reassessed constantly.

mgeesman · October 2019

If you have chronic back problems check out the book "The Mindbody Prescription" by Dr John Sarno. A few bucks on Amazon and well worth the read. I had chronic back problems, surgery and chiro and was still being told I needed more aggressive surgery. After reading his book and doing some self reflection, I seldom have any back pain. When I do, I go back to what I learned and it's better in a few days.

AnnPT77 · October 2019

@julanig612 , the post below was USA/Michigan (I think our USA licensing regulations vary by state).

You sound like your heart - and ethics! - are in the right place: Good show!

Best wishes for a successful practice, and a long and happy career that's a blessing to your community. :flowerforyou:

AnnPT77 wrote: »

Like sijomial, I see an Osteopath (affiliated with the health service of a major university, and a faculty member there) for manipulation.

Some of my friends see and swear by chiropractors; the pattern I see with the ones considered good are as others suggest above: Not over-reaching the core effectiveness of the modalities or claiming cure-all properties, willingness (eagerness, even) to refer to an MD or a GP DO for things that are not core to musculoskeletal (or potentially related soft tissue) issues.

Horror contrast to the latter: A chiropractor who effectively put my mother-in-law in the hospital in dire condition for a longish stay, by either misdiagnosing or imagining he could treat a major blood clot in a limb (I'm not sure which of misdiagnosis/mistreatment it was).

I'm not anti-chiropractor. When relevant questions arise on MFP, I have, and would again, suggest seeing a chiropractor as one option for things more within a rational scope of practice, with other options, depending on the situation, being things like seeing an osteopath, physical therapist, well-credentialed & experienced licensed massage therapist, etc.

As with those sources, if I went to a chiropractor, I'd be looking for effective treatment (short course unless the problem were chronic), and recommendations (including printed instructions where relevant) for things like stretches or exercises that could be done at home to complement the treatment. The chiropractor should be doing enough of a medical history on first visit to identify any potential concerns that could affect treatment or explain symptoms (to avoid things like that blood clot fiasco!), and on subsequent visits should ask about changes in health/symptoms/meds since last visit.

I've had personal contact with a chiropractor trying to put people on contracts for "wholistic wellness programs" using pretty skeezy tactics (and ideas poorly founded in science, IMO) that included selling supplements and long-term ongoing treatment program contracts. Don't be that guy.

To be more specific, this is how I reported my encounter with him, on another thread:

I went to a meeting recently where the speaker was speaking as an expert about "digestive health".

It was a hearty broth of pure nonsense, but here's just one highlight: Everyone will benefit from giving up dairy, gluten and (especially) sugar. Sugar is poison, because it spikes your insulin. But honey is a superfood, especially local honey. Fruit is good for you, because fiber. Agave syrup is OK, because it's natural, but not a superfood, partly because no fiber. Stevia is bad like sugar, just like other things that taste sweet (even if they have no nutrients/calories) because your body has been programmed to . . . I dunno, do something bad . . . just because it has a sweet taste like sugar.

I'm sitting there thinking " . . . but . . . but . . . it's all just sucrose, glucose and fructose!" (except the Stevia of course)

I am not lying, exaggerating, or misrepresenting. (My career made me very good at taking accurate notes on things I violently disagree with, because it was an essential skill.)

His incoherent steaming pile of pseudoscientific crapitude was being delivered to a group of cancer survivors . . . and the whole talk was implicitly hawking a multi-visit (or online) multi-step remediation program.

"If you have questions, be sure to fill out the question sheet with your contact info, and leave it on the table, so we can get back to you." (In response to any question requesting actual actionable specifics.)

He was coy about cost, but said his office would give you the paperwork to submit to your insurance company for insurance coverage. (Odds most US insurance would cover, I think: Near zero.)

The thing I thought was truly sleazy and unethical is the bolded. The rest is just . . . silliness.

Just don't be that chiropractor. Please. One is enough. Too many, even.

:flowerforyou:

magnusthenerd · October 2019

Avoid the ones that believe in the subluxation "theory" of illness and think they're going to treat tuberculosis by finding the right spot to move your bones at to cure it.

I was listening to an actual evidence based Chiro recently and he pointed out high tech diagnosis or even physical diagnosis doesn't have a great record of evidence for it. It sounds like it should logically follow that shape of bones and muscle can be the source of pains or problems, but we really don't have the evidence for it. It is possible for someone's bone shape to be one typically claimed to be problematic with none of the problems, and someone else with a perfect shape that has all of the pain and inflexibility in the world. It is possible to x-ray and thermograph areas that should be screaming with pain based on the results, but the person has no issues. It is possible for someone to have the exact opposite situation. Pain is a less understood science than we'd like to admit because it goes so greatly into the subjective experience.

So look for someone that is looking to treat your actual problem based on feedback of what is actually improving things.

kshama2001 · October 2019

julanig612 wrote: »

Thank you all for your honest responses. It has been quite an eye opener to hear the different perspectives. I can't help but feel shame for my profession if the experience of the majority of people is such a negative one where the motives of the care providers are in question. I wish to do better in that regard, at the very least I now have an extensive list of what not to do 😉
I am curious as to which countries the respondents are from as where I am from we are heavily legislated and monitored, for example, treatment package sales and marketing/product pedalling of any kind is illegal and will result in losing your license to practice. I don't stock products either as I have always felt that it taints the patients opinion when I suggest they get something that I sell, even if it is a necessary part of the treatment plan.
Thanks again for the helpful feedback.

I'm from the US and while I have had good or neutral experiences in the states of Massachusetts and New York, I have heard about the sort of experiences mentioned here.

I had a friend in Florida who was a massage therapist at a clinic that specialized in extracting as much money as possible from auto insurance policies after accidents.

Theoldguy1 · October 2019

idioblast wrote: »

I've seen a few chiropractors in the past, usually when my hips are not aligned and causing pain that no amount of stretching, PT, or exercise helps. I just started seeing a new practice that was highly recommended in a local "Moms" facebook group. This practice does offer a lot of "holistic" things I'm not too interested in, but they don't push it hard, mostly just provide the info. The one thing that I have really liked that hasn't been provided before are a series of x-rays throughout the process. X-rays at the beginning, middle and end to show the difference the adjustments and home care have made.

No offense, but are you trained to interpret x-rays in determine what a difference in before and after scans means as far as pain?

If you Google you will find there are instances of people with horrible looking x-rays, MRIs, and no pain, and those with "perfect" scans and intense pain.

julanig612 · October 2019

We were never trained to find subluxation in an X-ray and though I have seen it done it isn't something I would be comfortable doing. It's a lot of radiation exposure. It is also very expensive to send a patient for x-rays here, so when I do send someone for x-rays it's because I am looking for a pathology. You are right though. Some of the worst backs I have seen on X-ray have had less pain than those with normal results. In my limited experience spasmodic muscles are most often the culprits causing serious pain. Fascia has also come to light as a big game player in chronic pain conditions.

youngmomtaz · October 2019

I am in Canada and was a registered massage therapist(3000 credit hour training) for 10 years. I worked with a chiro for many of those years and have been seeing one for most of my life. I found my clients healed better from muscle trauma when both adjusted and given massage treatment. I had less regular clients and more “I feel great, will schedule in again when I need you” type clients, it was awesome to see such fast changes in their pain levels. My experience: I would leave the office feeling wonderful, but my neck would go back to exactly what it was before the treatment within half an hour. My hips/low back were always an issue, my Physio and I pushed for a scan to determine leg length and potential descrepancys and when we were rewarded with finding I had a descrepancy and I was adjusted according to that I now have better results. I actually have not been adjusted in over 5 years, but am not opposed to going back if needed. My youngest started appointments at 9months of age. Recurring blown eardrums(7 times with 50% reduced hearing at one point) and horrible pain and having to wait a year to get tubes installed made me bring him in. One gentle adjustment and his doc the next day was appalled! How did we get the swelling behind his eardrums to release after less than 12hours?? We brought him weekly for about a month, then monthly about 3 months, now he is 11yo and as soon as he feels minor ear pain we go in and get him adjusted. About once a year. He never had surgery and usually reminds me when winter hits to make him an appt as prevention.

We have never had anyone insist on a schedule of appointments, and have never had any weird experiences with sales or other product pushing.

How to pick a chiropractor?

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