Talk:Chiropractic

The section "History" could use an update

The section "History" could use an update if sources are available.

Looks like the most recent info in that section is from 10+ years ago.

- 189.122.84.88 (talk) 18:49, 31 December 2023 (UTC)

As perennial comments routinely remind us, this article really does need a lot of work, and with enough time I'll get to it, but I do hope someone else gets to it first. I'm pretty sure "Straights" and "Mixers" is a distinction from the 1920s, for example, so far as I'm aware, you won't find modern practitioners labeled as either. There's quite a lot of techniques that aren't mentioned in the article and we have no info on the relative strength of evidence for each: the 1920-style neurocalometer appears to be pure bunk, for example, while other techniques appear to be the exact same as those used by science-based providers. Ideally, we'd have a more detailed history of the various techniques and their relative merits. Feoffer (talk) 03:21, 19 June 2024 (UTC)

In the 2010s the two groups were very much alive, with the Straights being very self-conscious activists (some schools are Straight schools) and Mixers not giving it much thought. The Straights are the "real" traditional chiropractors. You can look at Chiropractic treatment techniques and Spinal adjustment for examinations of treatment methods and techniques. Activator technique is "pure bunk". It was even banned by the province chiro association in one of the Canadian provinces. Applied kinesiology is another quack method used by many chiros. Most Straights still practice Palmer upper cervical [HIO], a belief that "adjusting" C1 will fix everything. HIO stands for Hole-In-One. -- Valjean (talk) (PING me) 03:35, 19 June 2024 (UTC)

GREAT feedback! What do you mean by "very self-conscious activists"? Do mixers not also advocate for their own profession? If I were to walk into any of the many chiro offices you see everywhere and ask if they're "straights or mixers", would they know which one they are?

I only could find one RS about the Activator ban in Saskatchewan which I added to the respective article , do you know how that all turned out?

Reading over the respective pages, it sounds like the "leg test" is total bunk but the activator itself "may be as effective as manual adjustment in treatment of back pain", just through the same mechanism as massage I presume?

It would be really good to add in modern descriptions of Straights vs Mixers, like the HIO thing you reference. I've never heard of that of course, but it sounds pretty important. Feoffer (talk) 04:46, 19 June 2024 (UTC)

I used to be very into this stuff, even leading a reform chiropractor discussion group, even though I'm not a chiro. I used to remember exact names, dates, everything, and was often in contact with Joseph C. Keating Jr., the historian for the profession. We had lots of good conversations, and he shared good stuff from the archives for my book....that I had to drop. IIRC, the ban was lifted after about a year. Activator taps the skin and bony prominences on the spine and other locations. It's so light a tapping that it can't really do anything other than psychological. It's bogus. Combined with the leg length test, it's a complete quack therapy scam system. The HIO technique idea is from B. J. Palmer. He was always figuring out new electrical instruments and quack methods to make more money, and he'd patent them. I don't know if it's discussed much anymore, as I haven't been in contact with that world for a long time. Activate your email. It would probably be well-known among the older generation. Since the ideas behind spinal adjustments are magical thinking (the "intention" determines the result), the same applies to only adjusting the top vertebra (C1) and believing the body will then heal all problems with just that one adjustment. It's a chiropractic hole in one! It works like magic! -- Valjean (talk) (PING me)

Remove opening claims that chiropractic is based in esotericism and is a pseudoscience

The links regarding its "esoteric" roots have nothing to do with esotericism. Also, the references that claim it is a pseudoscience are all just opinion articles. None of them have scientific evidence included. One of them even notes that while chiropractic started with unusual claims, it is now focused on physical therapy and has a scientific basis. If you want to claim it is a pseudoscience because of erroneous thinking in it's origins, then you need to make the same comments about psychology, psychiatry, and many other medical disciplines as well (which obviously are all legitimate by today's standards, as is chiropractic). 2603:8000:DC01:401:6161:C2A0:44A8:D60A (talk) 17:28, 1 August 2024 (UTC)

They're not 'just opinion articles', and all Wikipedia requires is that sources meet WP:RS. They do not have to include 'scientific evidence' to your personal standard. MrOllie (talk) 17:40, 1 August 2024 (UTC)

I'm as anti-chiropractic as they come, but saying "we did the bare minimum" is a bad faith argument. There are plenty of high-quality articles discussing chiropractic as a pseudoscience and no real excuse to not accept criticism of the article just because it happens to be right. 2603:7081:1603:A300:D56:8C74:C3D7:9391 (talk) 16:50, 26 September 2024 (UTC)

No one said "we did the bare minimum". What I did say is that Wikipedia has standards it follows. We're not going to switch standards and rule out references because someone sets the goalposts in some arbitrary place to get rid of results they dislike. MrOllie (talk) 17:09, 26 September 2024 (UTC)

Doctor of Osteopathic Medicine is essentially equivalent to an MD, but we still characterize them as practitioners of pseudoscientific techniques. Much of the profession Chiropractic profession has changed to be essentially PT, but much of it has not. Globally, the field is still beset with snake oil, sorry to say. Feoffer (talk) 05:12, 2 August 2024 (UTC)

I think there is some confusion there. Osteopathy is a red herring here, as this is about chiropractic. DCs are not comparable to DMs. DMs are real medical doctors, most of whom have long since rejected the pseudoscientific underpinnings of original Osteopathy. The chiropractic profession (except in England) still allows claims for non-existent vertebral subluxations and "adjusting" patients for every disease imaginable, using claims that regular spinal adjustments will put the body in a better condition to self-heal. There is no evidence that adjustments make people more healthy. -- Valjean (talk) (PING me) 05:25, 2 August 2024 (UTC)

Yes, I worded that very confusingly. Feoffer (talk) 05:41, 2 August 2024 (UTC)

I want to point out that the articles cited after calling chiropractic "pseudoscientific" are from SBM which is a blog. While they do good work, they have an implicit bias against chiropractic.

The WHO recognizes the World Chiropractic Federation. It also recognizes spinal manipulation as a viable and first step for chronic lower back pain (WHO releases guidelines on chronic low back pain).

I know people get on a high horse, but the body of evidence is massive compared to articles dated in 2008. Nearly 20 years have passed since the articles from Dr. Hall and you're touting it as if it's the end-all.

Medicine changes and updates. I can't and won't speak for every practitioner, but evidence points towards chiropractic being beneficial for patients. It doesn't work the same way Dr. Palmer indicated it would in 1897, but Dr. A.T. Still wasn't correct either.

If you're willing to keep your implicit bias against chiropractic, I'm only one person and cannot stop you, but being willing to accept data contrary to your beliefs is what makes Wikipedia a great resource. Yet, you're doing readers a disservice by using old data with outdated claims.

I'm happy to keep providing updated data. I will concede that some chiropractors still subscribe to outdated beliefs, but I am also willing to provide evidence that MDs, DOs, and other medical providers do as well.

You have a duty to maintain the up-to-date nature of the sources used. Otherwise, what's the point of science if you're going to cling to outdated ideas? Bonewizard1 (talk) 18:19, 18 September 2024 (UTC)

See WP:SBM. Chiropractic is woo and that's been long settled & accepted knowledge. WP:ECREE applies and an exceptional set of sources would be needed to source any change of position. Bon courage (talk) 18:34, 18 September 2024 (UTC)

Lol. I tried. I'm curious who you'll cite as it being "woo." 2600:1008:B10C:CC3A:814A:4C81:47D7:99D9 (talk) 18:49, 18 September 2024 (UTC)

The article is well cited at the end of the first paragraph. Bon courage (talk) 18:53, 18 September 2024 (UTC)

I've read the sources. Pseudoscience is a pejorative term. You may not like chiropractic, but slamming something as pseudoscience leaves no room for discussion because you will dismiss evidence out of hand.

If I gave you a dozen meta-analyses for chiropractic adjustments, would that change your mind? A hundred?

If I gave you studies on patient outcomes? On patient satisfaction?

What is the limit at which something becomes "science?"

Psychiatry is still questionable on what causes depression. Yet it is a medical profession. Podiatry began as chiropody but is now a medical profession.

This Wiki article cites DD Palmer as a problematic character. Look back at the origins of Osteopathic medicine. At the origins of modern medicine. None of it is good.

Yet, you still fault them for the sins of those who came before.

AT Still never went to medical school. Yet DOs are medical doctors.

So, please, define for me what you consider pseudoscience.

I have no problem playing this game and changing the edits however much I can. I think it's a disservice to those who seek chiropractic care into scaring them away when modern evidence points to the benefits and validity. Bonewizard1 (talk) 00:49, 20 September 2024 (UTC)

Wikipedia follows reliable source. If they say something's pseudoscience that is reflected here. End of story. Bon courage (talk) 06:10, 20 September 2024 (UTC)

All pseudosciences of a certain minimum age have studies confirming them, but that is not enough for evidence-based medicine, for science-based medicine or for Wikipedia to say they are not pseudoscience, since primary studies are only the first step of the science process.

On patient satisfaction LOL, that's a good one. If patients were never satisfied, a medical pseudoscience would not even get started.

What is the limit at which something becomes "science?" See WP:MEDRS. --Hob Gadling (talk) 06:16, 20 September 2024 (UTC)

I hear your concern, Bonewizard, and I _do_ wish we could strike a slightly better middle-ground. Anyone who ever leaned back in a chair and felt the pleasant sensation of 'crack your bones' knows that there's something to Chiropractic, however minimal. But unfortunately, Chiropractors as a field are absolutely known for peddling pseudoscience bordering on snakeoil. For the time being, we do have to warn readers that their field is pseudoscientific.

I would, however, love to see, say, comparison between things like chiropractic and, say, opioids, which consensus now accepts were often overprescribed to the point of malfeasanced -- IF we could find GOOD mainstream RSes, not cherry picked research. Feoffer (talk) 08:26, 20 September 2024 (UTC)

The physical manipulation part of chiropractic (sort of maybe) 'works' for pain, but then that's just physical manipulation. Chiropractic, to be distinctively chiropractic, is the whole medical system built on the idea that the spine is the root of all health and that dextrous manipulation can cure all ills. Bon courage (talk) 08:37, 20 September 2024 (UTC)

Absolutely. But what fraction of practicing Chiropractors still preach that whole 'joint popping can cure all ills' nonsense? Enough that we still need to warn the reader, no doubt. But I do feel for the 'modern' practitioners who are, in essence, folk bone-setters, helping people reset a rib or crack their back or what not, and nothing more. But we DO need to err on the side of caution, Chiropractors will still totally take money to test your blood for fictitious 'toxins'. But I do wish there were better labelling between 'I'll help pop your back' vs 'I'll help cure all your ills' types. Feoffer (talk) 08:59, 20 September 2024 (UTC)

Do you have any evidence to support that? From any leadership in chiropractic? They don't teach that.

The spine is central to the profession but no one of any consequence believes that.

Primary evidence is showing immunological changes but the accepted body of work knows and understands there are limits - as there is in any profession. Bonewizard1 (talk) 13:21, 20 September 2024 (UTC)

It's how it's sold. A quick search quickly finds this[1] where chiropractic is being sold to treat allergies on the basis it addresses the 'root cause' of diseases. Reliable sources apparently see things for how they are, not some idealised form confected as a front. Bon courage (talk) 13:51, 20 September 2024 (UTC)

Does this work?

https://www.medscape.com/viewarticle/910617?form=fpf Bonewizard1 (talk) 13:18, 20 September 2024 (UTC)

You were pointed to WP:MEDRS above, you should read it thoroughly. MrOllie (talk) 14:03, 20 September 2024 (UTC)

Pseudoscience is descriptive. You can make a chart of fields claiming to be science and easily determine which belong in which category because we all know what the word means even if we don't like it. Just because it's used dismissively doesn't mean it's inherently a pejorative. 2603:7081:1603:A300:D56:8C74:C3D7:9391 (talk) 16:59, 26 September 2024 (UTC)

As far as I can tell Jjazz76 was correct when they removed "esoteric" from the lead on account of the Simon source not explicitly supporting "esoteric". I get that Simon seems to be hinting at it with "unconventional", but there's too much air between those wording choices. We're in an awkward position where "esoteric" is still present in the body with the same citation.

Regardless of the language choice, I'd support restoring something brief in the opening paragraph, paired with "pseudoscientific", that nods toward the origins of the practice. I can Google [chiropractic esoteric] like the best of them, but I'm hoping someone more familiar with the body of sources can point us toward what the good ones say (or don't say) about this. Firefangledfeathers (talk / contribs) 02:34, 27 September 2024 (UTC)

I'm sorry I didn't also see the mention of "esoteric" in the body, because it is also unsupported by a RS, and I'm going to delete it.

I'm not going to weight in (yet) on the pseudo-science part of the debate (it is late here), but esotericism has a pretty specific enough meaning, and I'm not seeing a strong enough connection here. If there are some good reliable sources, then that's fine, let's include it, but but the connection as it stands seems tangential at best.

One might claim that chiropractic is pseudo-scientific and esoteric, and unconventional but I think each claim needs a reliable source to support it, and they terms are different enough in that one can't use a claim of one as proof of a claim of one of the other. Jjazz76 (talk) 04:24, 27 September 2024 (UTC)

I think it's important to mention the more comprehensive outlook on patient care that modern chiropractors have. In the UK, every chiropractor I have met and worked with, except for members of older generations, use techniques founded in physiotherapy, osteopathy and other fields of healthcare science; with many chiropractors working with osteopaths and sports therapists. Chiropractic has moved away from the idea of spine manipulation being the 'go-to' and instead tend to a patient's needs in much more versatile ways. I hate the way many people see chiropractic as only 'cracking backs' and I wish more would recognise what a chiropractor actually does. If someone would sit in for a chiropractor's average day at the clinic they would see nutritional advice, soft-tissue work, ultra-scans etc. and many other treatments you wouldn't expect. Healthcare professionals are vital for many people whom couldn't function without their help, many patients being turned away from general practitioners, their stories not being heard; drugs can't solve everything. Klondike4 (talk) 00:21, 29 November 2024 (UTC)