Chiropractors Are Going Viral, But Here’s Why You Shouldn’t Skip Physical Therapy

Last updated:09 December, 2024, 10:38 IST

Although there are some developing studies that suggest chiropractic may have merit, there is not enough data to establish safety. In fact, it is often associated with mild to moderate adverse effects and, in rare cases, serious complications.

Judging by social media trends, chiropractic seems like a new trend, but it is not a new technology. (Image: Shutterstock)

The reel of a person who appears to be a doctor treating patients with a loud sound from their bones is going viral on social media. Although this may seem unsettling at first, these are professional “chiropractors” who specialize in spinal and joint adjustments.

Chiropractors are those who do “chiropractic”. It is pronounced “ke-roe-practic”. The history of the art reveals that the word ‘Chiropractic’ is derived from the Greek words chir, meaning ‘hand’, and praktos, meaning ‘done’, together meaning ‘done by hand’.

Judging by social media trends, chiropractic seems like a new trend, but it is not a new technology. Chiropractic originated in 1895, and Daniel David Palmer is credited with developing the practice. According to the University of Minnesota on its website, Palmer “adjusted” the spine of a deaf janitor and claimed to restore his hearing.

Although chiropractic is an old practice, it has faced challenges in gaining worldwide acceptance, primarily due to the lack of strong scientific evidence. Nevertheless, chiropractors now work in more than 90 countries around the world.

In fact, chiropractic care is regulated in 50 states of the United States and is the largest alternative medicine profession in the United States with approximately 70,000 members. It is slowly gaining momentum in India. Let’s discuss whether you should believe it or physiotherapy is the best option.

How does this therapy work?

From stretching and using constant pressure to manipulation of certain joints – chiropractors use manual treatment methods, mostly using the hand that involve quick and gentle thrusts.

They claim that the purpose of manipulation is to improve the movement and function of the joints. Manipulation involves applying force to the affected area, moving the joint beyond its normal range of motion. This may produce a crackling sound. Globally, people turn to them for treatment of lower back pain, neck pain, muscle aches and headaches besides other musculoskeletal pain.

Published studies in favor of chiropractic

Spine manipulative therapy (SMT) produces similar effects to recommended treatments for chronic back pain, according to a study published in the British Medical Journal.

The study states that SMT appears to be superior to non-recommended interventions for improving function in the short term, but “clinicians should inform their patients about the potential risks of adverse events associated with SMT.”

Similarly, another study published in the Journal of the American Medical Association (JAMA) concluded that “in patients with acute low back pain, spinal manipulative therapy (SMT) was associated with modest improvements in pain and function for up to 6 weeks.” However, it added that “variability across study results was large” meaning the findings are not reliable.

A retrospective study published in the journal Nature looked at a large dataset of chiropractic clinics in Hong Kong. It found that serious adverse events (AEs) occurring in relation to spine manipulative therapy (SMT) were “rare” – with an incidence of 0.21 per 100,000 SMT sessions.

But it also said, “Further research is needed on this topic, possibly through a practice-based research network that could increase the sample size and allow such analysis.”

Therefore, studies showed the effectiveness of some techniques but failed to establish solid evidence on the effectiveness of the therapy.

The other side of the science-based story

According to a major critical analysis published in Science Direct, the journal of Pain and Management, “Chiropractors’ belief in ‘innate’ subluxation or spinal manipulation is not rational.”

This article asks the question, “Does chiropractic produce more benefits than harms?” It states, “Current chiropractic practice raises several concerns.”

The analysis reviews several studies and concludes that the effectiveness, safety, and cost of spinal manipulation are uncertain. This suggests that more and better quality studies are needed. “Until robust data become available, we can question the value of this popular approach to health care,” the study said.

The article makes clear that this overview “will be rejected by proponents of chiropractic” as being biased or one-sided, but it was intended to offer a critical assessment.

“Currently, such evaluation is not provided by chiropractors, yet progress in any field is difficult without critical evaluation.”

Another study titled “Frequency and Clinical Predictors of Adverse Reactions to Chiropractic Care in the UCLA Neck Pain Study” found that adverse reactions to chiropractic care for neck pain are common.

Of the 280 participants (83 percent) who responded, 85 (30.4 percent) had 212 adverse symptoms as a result of chiropractic care.

The study states, “Given the potentially high risk of adverse reactions and the lack of demonstrated effectiveness of manipulation on mobilization, chiropractors should consider a conservative approach to applying manipulation to their patients, especially those with severe neck pain.” Should do.”

Although some developing studies are suggesting that this practice is worthwhile, there is currently not enough data to establish the safety of chiropractic manipulations. “It is often associated with mild to moderate adverse effects and, in rare cases, serious or fatal complications.”

Dr. AB Cyriac Philip, known for his satirical criticisms of alternative medicine, including Ayurveda and homeopathy, described chiropractic as a “pseudo-scientific practice without any evidence” in a post on the social media platform X.

“There is not enough data to establish the safety of chiropractic manipulations. It is often associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. Many deaths have been linked to this technique,” ​​he wrote in a long post rubbishing the practice, which has gained popularity in India after some reels went viral on social media platforms.

Whom to trust?

In many countries where this therapy is popular, there are bodies responsible for accreditation and oversight. For example, in the US, the National Board of Chiropractic Examiners (NBCE) provides reassurance to the general public.

According to the NBCE website, “NBCE examinations provide assurance to the general public that – whether a chiropractor has attended school or is licensed – he or she has achieved a baseline of knowledge as well as competency in diagnosis, diagnostic imaging, principles of Have demonstrated chiropractic, allied clinical sciences and chiropractic practice.”

However, in India, there is no designated person to oversee whether the person offering these services is adequately educated or trained to provide this otherwise risky treatment. When News18 spoke to many chiropractors, they said that they have a degree from America or they are registered physiotherapists and also do chiropractic. But many others have obtained certifications from some institutions that are not popular or obscure. But, all this goes uncontrolled as there is no prescribed body to monitor or check the authenticity of chiropractors.

Unlike physiotherapists – who are registered under the Indian Rehabilitation Council Act, 1994 and registered under state medical councils – chiropractors are not liable to follow any medical code of conduct.

“If we have 100 patients coming to us in a week, 50 come for chiropractic treatment. However, chiropractic is only a part of the treatment and not the complete treatment. The actual treatment is physiotherapy and we can use chiropractic for some activities,” a physiotherapist and chiropractor, who works at a Gurugram-based wellness clinic, told News18.

In short, it is advisable to choose a healthcare professional based on their skills, qualifications and certifications rather than their popularity on social media, such as viral reels or number of followers.