Last update:December 09, 2024, 10:38 AM IST

Although some studies suggest that chiropractic may have benefits, there is insufficient data to establish its safety. In fact, it is frequently associated with mild to moderate side effects and, in rare cases, serious complications.

Judging by the social media frenzy, chiropractic looks like a new fad, but it’s not a new technique. (Image: Shutterstock)

Social media reels featuring someone who appears to be a doctor treating patients with loud crackles coming from their bones have gone viral. Although it may seem unsettling at first, these professionals are “chiropractors” who specialize in spinal and joint adjustments.

Chiropractors are those who practice “chiropractic”. It’s pronounced “kay-ro-practic.” The history of this art suggests that the term “chiropractic” derives from the Greek words cheir, meaning “hand”, and praktos, meaning “made”, which together translate to “made by hand”.

Judging by the social media frenzy, chiropractic looks like a new fad, but it’s not a new technique. Chiropractic has its origins 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 have restored his hearing.

Although chiropractic is an ancient practice, it has struggled to gain global acceptance, mainly due to the lack of solid scientific evidence. Nonetheless, chiropractors now operate in over 90 countries around the world.

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

How does this therapy work?

From stretching to the use of sustained pressure to certain joint manipulations, chiropractors used manual treatment methods using primarily one hand involving rapid, gentle pushing.

They state that the goal of manipulations is to improve joint movement and function. Manipulations involve applying force to the affected area, moving the joint beyond its usual range of motion. This may produce a cracking noise. People all over the world visit them to treat lower back pain, neck pain, muscle pain, and headaches, apart from other musculoskeletal pains.

Studies published in favor of chiropractic

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

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

Similarly, another study published in the Journal of American Medical Association (JAMA) concluded that “among patients with acute low back pain, spinal manipulative therapy (SMT) was associated with modest improvements in pain and function for up to 6 weeks, with transient improvements.” minor musculoskeletal damage”. However, he said that “the heterogeneity of the study results was large”, meaning that the results are not reliable.

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

But he also adds: “Further research on this topic is needed, possibly through a practice-based research network, which could increase the sample size and enable such analysis.” »

Therefore, although studies have shown the effectiveness of certain techniques, they have failed to establish concrete evidence of the therapy’s effectiveness.

Another facet of scientific history

According to an extensive critical analysis published in Science Direct, Journal of Pain and Management, “chiropractors’ belief in ‘innate’ subluxation or spinal manipulation is not rational.” »

This article asks the question: “Does chiropractic generate more good than harm? » He says: “Current chiropractic practice raises many concerns. »

The analysis reviews several studies and concludes that the effectiveness, safety, and cost of spinal manipulation are uncertain. It indicates that more and better studies are needed. “Until compelling data become available, we may question the value of this popular approach to health care,” the study says.

The article states that this overview will be “rejected by chiropractic advocates” for being biased or one-sided, but its goal was to offer a critical assessment.

“At present, such assessment has not been provided by chiropractors, but progress in any area is difficult without critical assessment.”

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 resulting from chiropractic care.

“Given the possibly higher risk of adverse effects and the lack of demonstrated effectiveness of manipulation compared to mobilization, chiropractors should consider a conservative approach to applying manipulation to their patients, particularly those with neck pain severe,” the study indicates.

Although some studies suggest that this practice is beneficial, there is currently insufficient data to establish the safety of chiropractic manipulations. “It is frequently associated with mild to moderate adverse reactions and, in rare cases, serious or fatal complications.”

Dr. Abby Cyriac Philip, known for her sarcastic critiques of alternative medicine, including Ayurveda and homeopathy, described chiropractic as a “pseudo-scientific practice with no evidence” in a post on the social media platform x.

“There is insufficient data to establish the safety of chiropractic manipulations. It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. Several deaths have been associated with this technique,” ​​he wrote in a lengthy post bashing the practice which gained popularity in India after some reels went viral on social media platforms.

Who to trust?

In many countries where this therapy is popular, there are bodies responsible for accreditation and monitoring. For example, in the United States, the National Board of Chiropractic Examiners (NBCE) offers insurance to the general public.

According to the NBCE website, “NBCE exams provide the general public with confidence that – regardless of where a chiropractor was educated or licensed – he or she has demonstrated a foundation of knowledge as well as capability in diagnostics, diagnostic imaging, principles of chiropractic, associated clinical sciences and chiropractic practice.

However, in India, there is no designated person to check whether the person offering these services is sufficiently educated or trained to provide this otherwise risky treatment. Many chiropractors News18 spoke with said they were US-certified or licensed physical therapists and also offered chiropractic. But many others have received certifications from some institutes that are neither popular nor obscure. But all this goes unchecked as there is no designated body to supervise or verify the authenticity of chiropractors.

Unlike physiotherapists – who are registered under the Rehabilitation Council of India Act, 1994 and registered with state medical boards – chiropractors are not required to adhere to any medical code of conduct.

“If 100 patients come to us in a week, 50 come for chiropractic treatment. However, chiropractic is only part of the treatment and not a complete treatment. The actual treatment is physiotherapy and we can use chiropractic for certain movements,” 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 like viral reels or number of followers.