The Truth About Chiropractic

[T_Nation]

by Dr. Grove Higgins

Busting the Myths and Uncovering the Science

Do chiropractors have a bad reputation? Do they deserve it? And what can they really do for athletes besides crack necks? Answers here.

When you hear the word “chiropractor,” what comes to mind? For many, it’s a cracking sound, a bit of fear, or even skepticism.

But what if I told you that chiropractors could help you unleash your peak athletic performance? As a chiropractor, I’m here to bust the myths and explain the science behind how chiropractic care can improve your biomechanics, enhance your neurological drive, activate your muscles, and help you recover from hard training.

Debunking the Myths About Chiropractors

Let’s start by addressing the elephant in the room: the unfair reputation of chiropractors.

Myth 1: Chiropractors only treat back pain

While it’s true that chiropractors can provide effective treatment for back pain, their scope of practice is much broader. Chiropractors can also treat headaches, neck pain, joint pain, and other musculoskeletal conditions. Also, many chiropractors offer wellness care, which focuses on maintaining good health and preventing future health problems.

Myth 2: Chiropractic adjustments are dangerous

Another common myth is that spinal manipulations are dangerous and can cause harm. But the reality is that chiropractic adjustments are generally safe and effective in treating various conditions. A study published in the Journal of Manipulative and Physiological Therapeutics found that the risk of serious adverse events from spinal manipulation is extremely low.

Myth 3: Chiropractors aren’t real doctors

Contrary to popular belief, chiropractors are real doctors who’ve undergone extensive education and training. Chiropractors must complete a rigorous four-year doctoral program and pass state licensing exams to practice. Additionally, chiropractors often collaborate with other healthcare professionals, such as medical doctors and physical therapists, to provide comprehensive patient care.

Chiropractic care is based on evidence-based medicine and focuses on the relationship between the spine and the nervous system. Adjusting the spine and other joints can improve the nervous system’s function, leading to various health benefits, including peak athletic performance.

How Does Chiropractic Care Boost Athletic Performance?

Enhancement 1: Biomechanics

Biomechanics is the science of movement and plays a crucial role in athletic performance. Chiropractic care can help improve your biomechanics by ensuring that your spine and joints are aligned correctly. This alignment allows for a better range of motion, increased flexibility, and decreased risk of injury. As a result, you can perform at your best by keeping your body in top form.

Enhancement 2: Neurological Drive and Activating Muscle

Neurological drive refers to the signals sent from your brain to your muscles. You can increase your strength and power output by improving your neurological movement. Your ability to create deep and meaningful muscle contractions drives neuromuscular adaptations and, ultimately, hypertrophic changes resulting in bigger, stronger muscle.

Chiropractic care can help enhance your neurological drive by ensuring that your nervous system is functioning optimally. This is done by ensuring optimal biomechanics resulting in better proprioception and, thus, enhanced neurological function. The result? Your body can send and receive signals more effectively, thus enhancing performance.

“Muscle activation” refers to the process of engaging your muscles to perform a specific movement. Chiropractic care helps activate your muscles by making sure your spine and nervous system function optimally. When your body is in alignment, your muscles work together effectively, increasing power and strength.

Enhancement 3: Exercise Recovery

Exercise, in essence, is controlled damage to get results. Chiropractic care can help you recover faster by improving your body’s ability to heal itself by helping to reduce inflammation, decrease pain, and increase joint range of motion.

Chiropractors can help address the underlying biomechanics misalignments through joint manipulation. Soft tissue cumulative trauma from repetitive motions can be addressed using techniques such as Active Release Techniques, trigger point therapies, dry needling, therapeutic stretching, and others. These techniques reduce inflammation, increase blood flow, enhance oxygen utilization, improve muscle metabolism, decrease pain, and increase range of motion, leading to faster recovery and improved overall health.

Summary and Your Questions Answered

Chiropractic care helps you unleash your peak athletic performance by improving your biomechanics, enhancing your neurological drive, activating your muscles, and helping you recover. Consider adding a chiropractor to your team. You might just be surprised by the results.

Have questions for a chiropractor? Post them below!

References

References

1. Balthazard, P., de Goumoëns, P., Rivier, G., Demeulenaere, P., Ballabeni, P., & Dériaz, O. (2012). Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic nonspecific low back pain: a randomized controlled trial. BMC musculoskeletal disorders, 13(1), 1-8.
2. Niazi, I. K., Türker, K. S., Flavel, S., Kinget, M., Duehr, J., Haavik, H., & Taylor, D. (2015). Changes in H-reflex and V-waves following spinal manipulation. Experimental brain research, 233(4), 1165-1173.
3. Bialosky, J. E., Bishop, M. D., & Robinson, M. E. (2011). The influence of expectation on spinal manipulation induced hypoalgesia: an experimental study in normal subjects. BMC complementary and alternative medicine, 11(1), 1-8.
4. Keil, D., Meisinger, V., Wirtz, N., & Pfeifer, K. (2020). Effects of Chiropractic Treatment on the Stabilizing Muscles of the Spine: A Systematic Review of Controlled Clinical Trials. Journal of manipulative and physiological therapeutics, 43(5), 427-436.
5. Coulter, I. D., Hurwitz, E. L., Adams, A. H., Meeker, W. C., Hansen, D. T., Mootz, R. D., & Aker, P. D. (1999). The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA: RAND Corporation.

Debunking the Myths

6. Rubinstein, S. M., et al. (2019). Spinal manipulative therapy for acute low back pain: an update of the Cochrane review. The Spine Journal, 19(11), 1865-1873.
7. Ailliet, L., & Rubinstein, S. M. (2018). Manual therapy for chronic obstructive pulmonary disease (Protocol). Cochrane Database of Systematic Reviews, 5, CD012717.
8. Adams, J. et al. (2019). 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, 27(1), 1-13.
9. Licensing Requirements for Chiropractors. Federation of Chiropractic Licensing Boards.

Neurological Drive and Activating Muscle

10. Maffiuletti, N. A., Aagaard, P., Blazevich, A. J., Folland, J., Tillin, N., & Duchateau, J. (2016). Rate of force development: physiological and methodological considerations. European journal of applied physiology, 116(6), 1091-1116.
11. Haavik-Taylor, H., & Murphy, B. (2007). Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential study. Clinical Neurophysiology, 118(2), 391-402.
12. Niazi, I. K., Türker, K. S., Flavel, S., Kinget, M., Duehr, J., Haavik, H., & Taylor, D. (2015). Changes in H-reflex and V-waves following spinal manipulation. Experimental brain research, 233(4), 1165-1173.
13. Keil, D., Meisinger, V., Wirtz, N., & Pfeifer, K. (2020). Effects of Chiropractic Treatment on the Stabilizing Muscles of the Spine: A Systematic Review of Controlled Clinical Trials. Journal of manipulative and physiological therapeutics, 43(5), 427-436.
14. Bronfort, G., Haas, M., Evans, R. L., & Bouter, L. M. (2001). Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine Journal, 1(2), 167-181.

Recovering from Exercise

15. Teodorczyk-Injeyan, J. A., et al. (2010). Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. Journal of manipulative and physiological therapeutics, 33(2), 117-121.
16. Cambron, J. A., et al. (2010). Side-effects of massage therapy: a cross-sectional study of 100 clients. Journal of manipulative and physiological therapeutics, 33(9), 647-653.
17. Close, P. J. (2011). Does chiropractic care have a role in facilitating post-exercise recovery? Journal of the Canadian Chiropractic Association, 55(4), 269.
18. Jochumsen, M., et al. (2017). Effects of chiropractic care on strength, balance, and coordination of athletes: a review of the literature. Journal of chiropractic medicine, 16(2), 105-116.
19. Kofotolis, N. D., et al. (2013). The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients. Journal of manipulative and physiological therapeutics, 36(8), 527-538.
20. McKechnie, A., et al. (2015). Chiropractic treatment of upper extremity conditions: a systematic review. Journal of manipulative and physiological therapeutics, 38(9), 613-619.

[OM.Bodi]

Chiropractic work is BS. Daniel David Palmer was a scammer. No need to risk a stroke or damage to the spine for an “adjustment”.

There are many studies done on the increase risks with their manipulations.

[jcpjcp]

I wouldnt be able to lift without a chiropractor
I have been to at least 100 sessions since 10-15 years

[fitafter40]

Chiro has allowed me to walk straight, run, strength train and play golf

[cdep89]

@Dr_Grove_Higgins

Have questions for a chiropractor? Post them below!

I was just trawling through youtube videos looking for help about something, and this popped up right after. I wonder if you could help me.

I injured the ulnar side of my wrist after an impact 15 days ago. There was no swelling after the injury but a lot of pain especially when trying to supinate or deep flexion. The pain decreased massively within 48 hours but obviously not fully recovered. The lack of any swelling, redness or bruising makes me think it’s nothing to worry about too much.

After those first 48 hours I started doing reps of things like wrist rotations and very light stretches. On the 5th day I went into the gym to see what I could do - I started off just doing some work with a very thin resistant band and it wasn’t feeling too bad. Straight away I figured out I couldn’t barbell bench but I was able to do some machine chest press reps up to around 40kg-50kg for high rep, it was a bitt uncomfortable (and I probably shouldn’t have done it) but I was desperate to train. I also managed to do shoulder machine press which didn’t hurt at all (I still kept the weight light though). After that I tried to see what I could grip and worked up to 225lb+ doing RDLs for high reps which was a relief and made me think again it can’t be anything too serious.

Yesterday I managed to stabilize a 10kg kettlebell above my head, OHP with a trap bar, and smith machine bench around 40kg for 20+ reps far from failure, the main difficulty was spinning the bar to rerack it as that flexion hurts for the same reasons I can’t use a free weight.

With what I’ve told you, do you think this is a case of just waiting it out and continuing to do what I can do? Or do I need to see someone? Have any advice for me?

Massive thanks for your time.

[doogie]

I’ve seen so many chiropractors adjusting babies for gout and other things for the medicaid money. I’ve had them tell me they can cure sleep apnea, IBS, leaky gut–all kinds of things. I find it really hard to trust any of it.

[Dr_Grove_Higgins]

@OM.Bodi history aside, a lot developed at the same time. Dr. Still developed Osteopathy out of a conviction that medicine created more harm than good. Near the same time, DD Palmer made his first “adjustment,” Roentgen invented the X-Ray. Remember, medicine was still using bloodletting, had only started doing surgery and washing hands, and the Merck Manual read like a textbook for oriental herbal medicine practice. Shucksters, hucksters, and wide-eyed inventors were virtually indistinguishable from legitimate scientists and practitioners.

To tell you the truth, if I had med DD Palmer, I’d have run too!

However, I want to be honest in my discussion here and still respect your opinion. I have left out all the sources I cite here (spare the brain damage), but if you want to check my sources, here is the link to all of them: https://www.neuroathletechiro.com/discussionofrisksandbenefits

Let’s address the risks first. While chiropractic care is generally considered safe for treating certain musculoskeletal conditions, there are some risks and potential side effects associated with it. It is essential to note that the following information is not exhaustive.

Risks of seeing a chiropractor may include:

1. Mild discomfort: Some patients may experience temporary soreness, stiffness, or discomfort after an adjustment. 50% average. (Carnes et al., 2010)
2. Nerve compression: In rare cases, spinal manipulation may lead to nerve compression, causing pain, numbness, or tingling in the extremities (Di Fabio, 1999).
3. Vertebral artery dissection and stroke: While extremely rare, there have been reported cases of vertebral artery dissection and stroke following cervical manipulation (Cassidy et al., 2008; Church et al., 2016).
4. Infection: Although rare, an infection can occur following chiropractic treatment, particularly if the chiropractor uses unsterilized equipment (Burke et al., 2007).
5. Temporary worsening of symptoms: Some patients might experience a temporary worsening of their symptoms after chiropractic treatment, particularly if the underlying condition is not appropriately addressed. 50% experienced, same as in #1 above (Carnes et al., 2010).

Of course, comparing the risks of chiropractic care to other medical treatments depends on the specific condition being treated and the treatment methods used. Comparing the risks of chiropractic care to other medical treatments for specific conditions:

1. Neck pain: Chiropractic care has been shown to be effective in treating neck pain, with risks comparable to other conservative treatments such as medication and physical therapy.

• ​​​Low back pain: Chiropractic care, particularly spinal manipulation, has been found to be as effective as other conservative treatments for low back pain, such as physical therapy, exercise, and medication, with fewer side effects (Bronfort et al., 2010).

2. Headaches: Spinal manipulation may be effective in treating tension headaches and cervicogenic headaches, with risks comparable to or lower than other treatments such as medication (Bryans et al., 2011).

Here is a brief comparison of the risks of many of the options available to people for pain/injury/dysfunction:

1. Chiropractic care: Mild side effects, such as soreness or discomfort, occur in approximately 50% of patients (Rubinstein et al., 2007). However, serious complications are rare, occurring at a rate of less than 1 in 100,000 (Dabbs & Lauretti, 1995; Haldeman & Rubinstein, 2004).
2. Physical therapy: The risk of minor side effects, such as soreness or discomfort, is relatively low, although specific numbers are not readily available. Serious complications are rare (Carnes et al., 2010).
3. Medical/medicine treatment: The risk of side effects varies significantly depending on the medication used. For example, gastrointestinal issues with nonsteroidal anti-inflammatory drugs (NSAIDs) occur in about 10-20% of patients (Moore et al., 2015). For opioids, risks are much higher, with addiction rates ranging from 8-12% (Vowles et al., 2015).
4. Surgical treatment: Complication rates for common low back surgeries, such as lumbar discectomy or spinal fusion, range from 10-20% (Yoshihara, 2012; Pannell et al., 2015). Infections, nerve damage, or other serious complications occur in about 1-4% of patients (Rihn et al., 2009; Singh et al., 2012).

Likewise, the benefits of each are also comparative.

• Chiropractic care: Success rates for chiropractic care in treating low back pain can vary, with approximately 60-80% of patients experiencing significant pain relief and functional improvement after receiving spinal manipulative therapy (Cherkin et al., 2003; Haas et al., 2005). Time to symptom resolution varies but can range from a few weeks to a few months, depending on the patient’s condition and adherence to the treatment plan.
• Physical therapy: Physical therapy has a similar success rate to chiropractic care in treating low back pain, with around 60-80% of patients experiencing substantial improvements in pain and function (Delitto et al., 2012; Ferreira et al., 2013). Recovery time depends on the individual’s condition and response to treatment, but it can take anywhere from a few weeks to several months.
• Medical/medicine treatment: The success rates for medical treatment of low back pain depend on the specific medication used. For example, success rates for NSAIDs in providing pain relief are around 60-80% (Roelofs et al., 2008). Opioids can be more effective in relieving severe pain but carry a higher risk of addiction and side effects (Vowles et al., 2015). The time to symptom resolution with medications varies greatly, depending on the patient’s response, adherence to the medication regimen, and underlying cause of the pain.
• Surgical treatment: This is really not comparable, but here it goes, just to be fair… Surgical success rates for treating specific causes of low back pain, such as spinal stenosis or herniated discs, range from 70-90% (Weinstein et al., 2006; Jacobs et al., 2011). Time to symptom resolution can range from a few weeks to several months, depending on the type of surgery and the individual’s recovery process. However, it’s important to note that surgery is usually reserved for severe cases or when conservative treatments have been unsuccessful.

NOTE: Did you see the 60-80% success rate above? It is something I saw in my days in acute care physical therapy working with strokes and amputees and continue to see to this day in alternative medicine… Everything works! For somebody, at some level, and better for others.

It is important to emphasize that these risk and benefit estimates are approximate and may vary depending on individual patient factors, the practitioner, and specific treatment approaches. Moreover, it is essential to consider that the risks and benefits of each treatment modality can be influenced by factors such as the skill and experience of the healthcare provider, adherence to clinical guidelines and best practices, and the proper use of medications or surgical techniques.

Many studies mention that the success of any treatment largely depends on the individual’s commitment to following the prescribed treatment plan, participating in recommended exercises or physical therapy sessions, and making any necessary lifestyle changes. In some cases, a multimodal approach combining different treatment modalities might be the most effective way to manage pain.

The safety and efficacy of most mainline medicine as well as alternative practices is the ability of the practitioner. A good practitioner takes time, listens and takes an amazing history/interview, exercise systematic diagnostic skills, and is not afraid to change their strategy in helping an individual when they assess and see it is not working.

[Dr_Grove_Higgins]

@cdep89 If you are a healthy guy, I’d like to see more healing by now - going on what you wrote. However, it sounds like you are progressing. If you can do movement pain-free, not necessarily 100% comfortable necessarily, and without altering your movement patterns too much, continue on the path you are on. But it is always prudent to get even a cursory check if you can.

FYI, Here is what tissue healing looks like from a time and phase perspective. The article it is linked to is great:

Keep me in the loop. - Doc

[Njord]

I see a Chiro once per week, followed by an acupressure masseuse. I highly recommend the combo to anyone. Just find an acupressure pro who doesn’t care if you cuss really loud. Even if you’re good at steeling yourself, they can surprise you.

[cdep89]

Thanks for the reply even though I don’t like that first lines forecast! Heh. To be fair I did expect to be better than this over the first two weeks considering how quickly the pain settled. From the resources online I see a wrist/hand injuries have a healing time anywhere between 1-8 weeks depending on severity, for really bad ones people are talking months on end - which I really doubt I could have considering there being no deformity, no bruising, no swelling and after the first 48 hours no real pain pressure point.

I actually went to a doctor for other issues yesterday and mentioned it at the end. She didn’t even have a look, feel around, or check range of motion, just said that if i’m concerned then get an X-Ray. An X-Ray would mean a potential 5 hours sitting around around in an accident and emergency department waiting to be seen so I’m a bit apprehensive of doing that. Will see how my next upper session goes on Friday then maybe go on the weekend. Just wanna liffffft. From that image you posted I’m still in the proliferation timeframe so maybe I just need to wait a bit more.

[flabbrgastd]

In 1994 I was suffering with excruciating back pain for about 9 months. One of my real estate customers told me that her sister worked for a chiropractor and I should go see him. It so happened that he was an atlas orthogonal chiropractor whose primary focus is the atlas. When the doc explained how my skull not sitting squarely on my first vertebrae was why my low back hurt so bad, I thought he was a quack. But when he showed me why, I gave it a try.

He had me stand on a two peddle scale that measured the difference in weight carried on each foot. I was carrying 38 pounds more on my left foot than my right. Normal is 2 or 3 pounds. After the first adjustment, about 75% of the pain was gone and the difference in the weight on each foot fell to 3 pounds.

A couple of years later and I had to find another doc, because the 1st doc moved. I have been a bodybuilding since I was 19 and was progressing pretty good at the time. I did not like anything to get in the way of my workouts, so I knew the importance of keeping my back in alignment. The new doc had a test he would do that proved beyond a shadow of a doubt that what he did worked. He would have me lay on my back on the table and raise my arm. He would push down on my arm while I resisted. He would do the same with my leg. When he pushed down on my leg and my atlas (neck) was out, I could not resist him pushing my leg back to the table. After the adjustment, he could pick himself off the floor pushing down on my legs, and I could hold his weight. He could not push my leg down.

So anyone who is interested in pushing more weight and getting better results in a gym definitely needs a good chiropractor. But there are different methods of chiropractic adjustments. I have used several over the years, and still to this day, I prefer atlas orthogonal chiropractors. I have problems because when I was young, I used to twist my neck to pop it. So, going to a chiropractor that cracks my neck is not my preference. However, even that will give you relief.

[rico1]

I have had more damage done to me by quote en quote “medical doctors.” I only go to them for a referral to go to a chiropractor or message therapist for pain management. I can tell myself to use some ibuprofen for 2 weeks and ice without wasting time waiting to get in to see a doctor. Or better yet get a worthless cortisone shot.
Your very misinformed about chiropractic.

[TomInTulsa]

I know it sounds like the “set up” for a joke but my son hurt his neck and back falling off a trampoline when he was about 12. His neck would not quit hurting and would “POP” when he looked to the right. Our General Practitioner exhausted his options and gave us the name of a Chiropractor. 3 visits and he was healed. It was pretty amazing. I had a similar issue with a recurring pain the middle of my back several years later. Like with most things medical I think it depends on your issue and the quality of the Doctor. But there is no doubt in my mind that Chiropractic care does work for certain ailments.

[demonthrall]

You want the biggest proof chiropractors work?

Most insurance pays for them as an alternative treatment method.

This means it reduces surgeries and other expensive treatments after car accidents and other trauma. It makes financial sense for them.

If anything is constant, its Insurance companies making a profit!

[Rp2311]

Heres the thing. A chiropractor self interest is in conflict with the patients. I have seen multiple chiropractors try to give patients a year long pass for 3 to 4k a year for their service. Maybe when they stop doing stupid unethical things like that maybe I would respect what you do. But it seems what chiropractors do best is string people along for the money grab.

[dylan5150]

My guy has helped with my back, neck, shoulders, wrist and knees. I walk in and tell him my head feels head like it weighs 100 pounds and he gets right to work and I feel better by the end. There are charlatans, but not all of them.

[mjaaron]

Wow. Nothing screams science like astronomically biased accounts of self worth. Im so convinced now.

[fitafter40]

Then don’t go to one…simple as that

[RT_Nomad]

From my experiences, not all chiropractors are created equal.

When I hurt my back in my late 20’s (1976) I went to a chiropractor who adjusted me, took my money and sent me home and rescheduled for next week. Eventually I told him that my hip pocket hurt worse than my back. My compound leg training was limited to leg pressing, I could not squat.

I much later (around 1988) met a chiropractor at the gym. He adjusted me, and had me go outside and take a walk with long strides. My problem had been SI joint misalignment. My back got better quickly.

When my traps were getting terribly sore, I found a chiropractor who did heat, followed with deep muscle massage to release trigger points and followed with neck and upper back adjustment, and then ice. She told me to ease up on the weights. I told her that I came to her so I wouldn’t have to ease up on the weights.

My first chiropractic experience was terrible. I felt that he literally stole my money, and I got no relief. Maybe it was the doctor or maybe it was the technological advancement. I don’t know.

I will say that the notion that chiropractic medicine can cure all ills has always been a ridiculous claim to me. And that was claimed in the 1970’s.

[Mandors]

“Chiropractors must complete a rigorous four-year doctoral program and pass state licensing exams to practice.” That’s rather disingenuous. Are chiropractors “medical” doctors, or just more pretentious PHD’s slinging “Dr.” in front of their names?