As chiropractic has become an integral part of the health care system, many myths have developed. The fact of the matter is that the majority of the general public does not know what we do. Let’s address some of the more common myths and misconceptions that you may have heard:
Myth #1 – “They are not “real doctors”.
Chiropractors are licensed as health care providers in every state and dozens of countries around the world. While the competition for acceptance in chiropractic school is not as competitive as medical school, the chiropractic and medical school curriculum are extremely rigorous and virtually identical. In fact, chiropractors have more hours of classroom education in anatomy and physiology than their medical colleagues!! As part of their education, chiropractic students also complete a residency program where they must treat patients in a clinical setting, supervised by licensed doctors of chiropractic. Once chiropractic students graduate, they have to pass four sets of national board exams as well as state board exams in the states where they want to practice.
Just like medical doctors, chiropractors are professionals that are subject to the same type of testing procedures, licensing and monitoring by state and national peer-reviewed boards. Federal and state programs, such as Medicare, Medicaid, and Workers’ Compensations programs cover chiropractic care, and all federal agencies accept sick-leave certificates signed by doctors of chiropractic. Chiropractors are also commissioned as officers in the military.
Myth #2 –“They can’t be real doctors because they cannot prescribe drugs”
The biggest difference between chiropractors and medical doctors lies not in their level of education, but in their preferred method of caring for people. Medical doctors are trained in the use of medicines, drugs and surgery. As a direct result, if you have a chemical problem, such as diabetes, ulcers, or a bacterial infection, medical doctors can be very helpful. However, if your problem is that your spine is mal-aligned or you have soft tissue injury that is causing pain, aside from an anti-inflammatory drug to reduce the inflammation, there is no drug in existence that can fix the problem. You need a physical solution to correct a physical problem. This is where chiropractic can really make a difference. Chiropractors provide physical solutions such as adjustments, exercises, stretches and muscle therapy to help the body heal from conditions that are physical in origin, such as back pain, muscle spasms, headaches, and poor posture.
Another distinction is the fact that it is completely appropriate and highly recommended to receive chiropractic care even if you do not have symptoms. Unlike standard medical doctors, whom you visit when you have a symptom to be treated, chiropractors offer adjustments to improve spinal alignment and overall well-being before symptoms develop.
Myth #3 – “Medical Doctors do not like them”
The American Medical Association initially opposed chiropractic from the early 1940’s up to the late 1970s and early 1980s, and purposely conspired to try to destroy the profession. A landmark lawsuit in the Supreme Court of Illinois on August 27,1987, found that the American Medical Association was guilty of conspiracy and was ordered to pay restitution to the chiropractic profession.
From this time to the present, the opinion of most medical doctors has dramatically changed. Many people have conveyed to their medical doctors about the great results they experienced at their chiropractors office. Hospitals across the country are starting to allow chiropractors on staff, and many chiropractic offices work very closely with their local MD’s. Chiropractors and medical doctors are now much more comfortable working together in cases where medical care is necessary as an adjunct to chiropractic care.
Myth #4 –“Once you start going, you will never stop, you have to keep going for the rest of your life”.
The decision of whether or not to continue with care should be made on a case by case basis. The factors that would influence maintenance care would include things such as the amount of arthritis, patient’s occupation, general health, and overall commitment to continuing with the stretches and/or exercises prescribed. It is the responsibility of the treating doctor to educate and train their patients with the goal in mind of self preservation. However, in cases of advanced arthritis or when the ADL (activities of daily living), are such that the patient is at continued risk of exacerbation of their condition, maintenance care might be a necessary option. This is something that should be discussed with your chiropractor and it should be a mutual decision.
Myth #5 - "If you crack your knuckles too much, you’ll get arthritis (and so chiropractic adjustments can’t be good for you either)!"
This is absolutely false. Extensive research has been done on the topic of early onset osteoarthritis and its link to chronic knuckle cracking and has actually found that knuckle cracking can cause a delay in the development of osteoarthritis!. That’s not to say that you should crack your knuckles every chance you get. This article found that there were indeed injuries sustained through knuckle cracking by way of the person applying too much force to their finger causing sprains.
1Chan PS, Steinberg DR, and Bosanko DJ. Consequences of knuckle cracking: A report of two acute injuries. American Journal of Orthopedics. 1999 May. Vol 41(5), 949-50
Myth #6 - "I do not need to see a Chiropractor, I can just crack my own body!"
Maybe you can, but it’s generally not a good idea! The chiropractic adjustment or manipulation is delivered by a highly trained, well experienced doctor to the joints that are dysfunctional and in need of manipulation (usually due to a restriction of some sort). Contact points, line of thrust and degree of force are extremely important factors in the effectiveness and safety of an adjustment. When you “self crack” what happens most of the time is that you are “cracking” a joint or joints that are hypermobile (too much motion), and you are simply accentuating the instability of these joints, thus actually making the hypomobile joint even tighter and perpetuating the very problem that you are coming in for.
Myth #7 - "It hurts to receive a spinal adjustment."
An adjustment, as mentioned above, is delivered by a highly skilled doctor with years of training and a lot of clinical experience. Rarely do patients experience discomfort as a direct result of the manipulation. However, as with any manually applied therapy, “post adjustment soreness”, in the initial stages of your treatment, in rare occasions may occur. This can be compared to “post exercise muscle soreness” and will generally subside after the first or second visit.
2Meeker WC, Haldeman S. Chiropractic: A profession at the crossroads of mainstream and alternative medicine. Annals of Internal Medicine. February 5, 2002. Vol. 136, No 3.
Myth #8 - "Spinal Adjustments are dangerous and can cause serious side effects including stroke and death!"
To simply say that a manually applied manipulation of a joint is without risk would be false. Chiropractic is widely recognized as one of the safest and effective forms of health care available today. But the reality is that no form of health care is completely without risk. The number of deaths even loosely linked to a spinal adjustment in the history of chiropractic health care (well over 100 years) is extremely low. What is overlooked by many people claiming that typical medical care is much safer, is the number of deaths per day directly resulting from negligence or improper care of a patient from a medical doctor or in a hospital.
Some major complications that have come up in the literature resulting from a spinal manipulation include vertebrobasilar artery dissection ( strokes) and disc herniations.
The odds of having a disc herniation due to an adjustment are said to be about one in one hundred million adjustments, and of those that do cause a herniation, 49% of them were done while the patient was anesthetized. Anesthetizing patients is a practice of which a chiropractor cannot perform, thus the chances of a chiropractor creating a herniation becomes even lower (we’re not the only health professionals who are allowed to manipulate). Furthermore, the spinal discs are most susceptible to injury when the body is flexed and rotated. A proper spinal adjustment will have the patient positioned in slight extension and very little, if any rotation, especially in the neck, thus alleviating virtually all the stress and tension on the discs.
Vertebrobasilar artery dissections are a hot topic in chiropractic right now. Dissection occurs when an artery in the back of the neck becomes damaged and sometimes may cause a stroke. In particular, many people have become scared of receiving a manipulation of the neck out of fear of this occurrence. This, again, is due to misinterpretation of facts. It is estimated that the chance of this occurring ranges from 3 or 4 in one million adjustments, to 1 in four million adjustments. In an article written by Haldeman, Kohlbeck, and McGregor their results indicated that a stroke, or vertebrobasilar artery dissection in particular, should be considered a random, unpredictable occurrence of any neck movement. These neck movements could include having your hair done at a salon, turning to check your blind spot while driving, spinal manipulation, or even simply cradling a phone on your shoulder. Another article by Rothwell, Bondy, and Williams concluded that the incidence of stroke is so low that it’s too hard to study accurately.
Dr. Walter Herzog, Associate Dean of Research at the University of Calgary published a study that concluded there is no force applied to the arteries of the neck during an adjustment and that the arteries are not stretched during an adjustment.
There are many risk factors for stroke that astute chiropractors take into consideration before manipulating their patients including blood clotting problems, hypertension, smoking, high cholesterol, birth control pills, heart problems, or trauma from blows to the head. So if you’re still concerned about neck manipulation, be sure to speak to your chiropractor about any risk factors you may have. He or she will be more than happy to find other methods of treatment that suit your needs.
As a point to ponder in regards to risks of therapy, the incidence of severe complications arising from the intake of acetylsalicylic acid (aspirin) is very high ranging from stomach upset, to gastric bleeds, to death.
The efficacy and safety of chiropractic treatments is well researched, and new research is being done every day. In fact, it was noted by David Edy, M.D., PhD from Duke University that only 15% of medical interventions are supported by research, yet are performed on a regular basis by medical doctors and surgeons alike. This just goes to show that there will always be treatments in every profession that scientists will be unable to prove; we just know it works through years and years of clinical experience.
Assenddelft W, Bouter L, Knipschild P. Complications of spinal manipulation: A comprehensive review of the literature. Journal of Family Practice. May 1996. Vol. 45(5), 475.
Haldeman S, Kohlbeck FJ, and McGregor M. Stroke, cerebral artery dissection, and cervical spine manipulation therapy. Journal of Neurology. Aug 2002. 249(8):1098-104.
Rothwell DM, Bondy SJ, and Williams JI. Chiropractic manipulation and stroke: A population-based case-control study. Stroke. May 2001.
Herzog W. Internal forces sustained by the vertebral arteries during spinal manipulative therapy. Journal of Manipulative and Physiological Therapeutics. Oct. 25, 2002. Vol. 8, 504-10.