Does Chiropractic Deserve The Bad Rep It Has?

Photo by Jesper Aggergaard

In January of 1974, a student named Sara Michaels was out of school for several weeks due to a teacher’s strike. She couldn’t exactly recall the specific chain of events, but for reasons that were then beyond her, she developed the worst migraine she had ever felt in her life. The blinding pain manifested from these episodes would seemingly prostrate her for days on end.

Then one day, Sara learnt that a local church member who was visiting happened to be skilled at chiropractic adjustments. Sara had never heard of such a thing, but she was battling migraines and pain so bad that she would have agreed to anything the man offered.

The man performed his routine examination, working his way up from the feet to the upper back, checking specific trigger points and massaging gently, before stopping at the neck to make his clincher manoeuvre. Sara heard a loud POP as the chiropractor gave her her first cervical adjustment.

But what surprised Sara the most was not ear-splitting, spine-chilling pop that reverberated throughout the room. It was the fact that this single adjustment gifted her the ability to see again. She remembered the lingering pain from the migraine abruptly stop and regaining full vision to both eyes.

Sara Michael’s case isn’t a one-off. Chiropractic success stories like hers densely populate the world wide web: in personal blogs, Reddit threads, and some even featured in more popular publications. And yet the polarising end of the spectrum tells a different tale.

In the morning January 29, 2016, 34 year old model Katie May had her spine adjusted by a chiropractor after pinching a nerve during her latest photoshoot session. She noted that the pain hadn’t disappeared and tweeted about it, asking for suggestions from her followers.

The pain persisted for the next four days, upon which she decided to make another visit to the chiropractor. She made a mental note to tweet about it, unbeknownst that it was going to be one of her final tweets she would have ever posted. Katie May died two days later from a stroke caused by an arterial rupture during her last chiropractic manipulation.

In 2013, a four-month old baby’s spine was fractured from a chiropractic adjustment. Luckily, the fracture was not fatal and the baby survived. Other times the patients are not so lucky. Just last year, 80-year old John Lawler became unresponsive after a drop-table adjustment. He was treated in the hospital for a neck fracture but died the next day.

The American Chiropractic Association claims that vertebral artery dissection — which is thought to be the most common cause of death in chiropractic incidents — happens roughly once in every 5.85 million adjustments.

The practice of chiropractic medicine was invented in the 1890s by David Daniel Palmer, the tenets of which he claimed to have been received from a doctor who had died 50 years earlier. This field of study was based upon the understanding that vertebral joint misalignments, which Palmer termed vertebral subluxations, interfered with the body’s function and its innate ability to heal itself. And hence chiropractic, which means “to be done by hand”, was established as an alternative medicine practice, and has been in practice for more than a century.

The general consensus is that chiropractors are not medical doctors, since they do not hold medical degrees. They do, however, undergo extensive training through a chiropractic graduate program. On average, a person would require 8 years of chiropractic education before they are licensed as a chiropractor. This is of course not the same in all countries.

Contrary to popular belief, chiropractors can actually treat more than just back pain. They are capable of treating conditions like menstrual pain, acid reflux, and constipation, and can also realign the pelvis for ease of vaginal delivery. This is achieved by making necessary adjustments on the musculoskeletal system — such as postural correction and spinal muscle strengthening for conditions like GERD.

There are some things however, that chiropractors simply cannot treat. Because of their non-invasive nature, broken bones and infections are completely out of the question, and nobody in the right mind would go to a chiropractor for medical emergencies. For metabolic and vascular disorders, the discerning line is less clear.

Though the practice has been around for over a hundred years, evidence backing the effectiveness and safety of chiropractic is weak, as little attention is paid to this niched and narrow scope of study. The more established practice of modern medicine is of greater appeal to research grants, which skews the focus away from the less incentivised chiropractic research. And there’s a good reason for this.

Society commends logical evidence more than anything. We crave for proof and rational explanations. You wouldn’t believe me if I told you Michael Jackson faked his death and is currently residing with the indigenous New Guinean tribes. But you probably would be swayed if I showed you credible evidence.

And so while rational proof is an excellent metric for gauging scientific development and evolution, it does not explain why Red Bull was able to compete with industry giants Coca Cola by making their concoctions taste less delicious and more like medicine. It made no sense, but it worked. The same logic works for why you will never be fired for “working too much” or “being too careful”. You could, however, risk your career by going against the rules and focus on something that’s completely uncalled for — like Dr. Michael Burry with his 2008 market shorting antics, which churned his company over $700 million. Fortunately for him, there was nobody above him to fire himself.

Flaws and shortcomings in employment regulations also mean a percentage of individuals will manage to escape the necessary requirements for a certain job, which is why there are always unethical and incompetent people riddled in every profession. Some just happen to hold positions that are riskier to others. Unethical doctors, teachers, artists, and businesspeople all exist, no single field of occupation is immune to the threat of incompetents.

But why is the spotlight shone so bright on chiropractors?

Because they portray the perfectly unlucky combination of a field of study that isn’t backed up with strong objective evidence and the meddling hands of a small percentage of unfit chiropractors contaminating the industry. When you take into account the high-risk profile of the healthcare industry and potent media coverage in the age of social media uprise, the consequences can be fatal, even if unfair.

Should we get rid of chiropractors? Absolutely not. Extinguishing the practice of chiropractic means giving into the inherent flaws of society, and letting it take over our critical-thinking selves. Risk is anyhow relative. There is a 25 in 1 million chance of dying from taking aspirin, a risk which is 147 times that of chiropractic-associated deaths.

What I suggest we should focus on instead is further yet improving and tightening the current regulations for chiropractors, performing routine audits on chiropractic clinics, and devoting more hours and dollars into chiropractic research to testify for its supposed benefits.

If anything, there is a lot we can learn from the events and controversies that have riddled the century-old chiropractic practice. It perfectly highlights the sheer complexity of science, proving that there is still plenty to learn and discover in the ever-expanding field of science.

Over the course of her life, Sara Michaels would undergo two other chiropractic adjustments. One was for a refractory case of slipped herniated discs, which was only resolved after several sessions of tendon adjustment, and another for ovarian bleeding caused by PCOS, which miraculously reversed her infertility. When asked if she thought chiropractic care helped, she said “I wouldn’t be without it”.



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Jonathan Adrian

Jonathan Adrian


Junior doctor, writer, photographer, and part-time social media strategist.