Two weeks have passed since I wrenched my lower back, and just two days since my final visit to the chiropractor. I must admit that my back pain is considerably better! I still have some slight discomfort and tightness, but it is almost back to baseline. The last time I strained my back, I was an invalid for over 6 weeks. I am not sure to what I should attribute my rapid improvement. Was it due to Dr. D? Was my back strain less severe this time? I am not sure. I do know that it is great to be feeling better. This seems to be a good time to examine the evidence behind some of the techniques and claims asserted at my chiropractor’s office.
First, let’s analyze the advertisement for Estronex which is posted throughout the chiropractor’s office. Now I know this is not, strictly speaking, related to “chiropractic” care, but I do think the things a practioner chooses to promote reflect on the type of medicine he or she practices. This test claims to help determine a women’s risk for breast cancer by measuring the levels of various “good” and “bad” estrogen metabolites in her urine. The web site for this test suggests that certain imbalances in these levels are associated with an increased cancer risk. It goes further by saying that through dietary changes, these imbalances can be corrected. It references two studies to support these claims. I found both of these articles. The first thing that struck me was that both articles are authored by employees of the company which makes Estronex. This is a major conflict of interest, and in my mind means that any conclusion by the authors needs to be taken with a big grain of salt. The articles themselves are merely reviews rather than research articles. The larger review article espouses the urine estrogen metabolite test to “determine one’s 2/16a ratio [for] . . . determination of cancer risk…” The same article, however, admits that “no conclusive data has yet to be published showing cancer incidence falls when individuals are treated with interventions that raise the ratio…” The Estronex test appears to be a waste of money, and it makes me question the professionalism of the chiropractors who willingly advertise and provides such a baseless test to their female patients.
The second claim I felt compelled to investigate was the “before” and “after” MRI pictures for spinal decompression therapy. I found these claims difficult to stomach. If such a miraculously effective non-invasive procedure existed, why was this previously unknown to me? If this simple procedure could really resolve a herniated disc, I would be shouting it from the mountaintops and leading the millions of people who suffer from sciatica to the Promised Land. I suppose you detect my cynicism. One theory regarding the possible mechanism by which decompression works is that traction on the spine lowers intradiscal pressure thereby allowing a herniated disc to return to its normal position. On the internet, I quickly found a scathing repudiation of spinal decompression. One doctor documented (with references) 10 pages of anti-decompression evidence. He points to a study in the 1980’s that showed intradiscal pressure actually increased with traction as the back muscles contracted to resist the traction. It appears that traction might decrease back pain, although there is no evidence that it is superior to any other intervention. A recent review published in the journal Chiropractic and Osteopathy by Dr. Daniel in 2007 concluded, “Only limited evidence is available to warrant the routine use of non-surgical spinal decompression, particularly when many other well investigated, less expensive alternatives are available.” I could find no well-done studies that substantiated its use. This all jibes with my conclusion that although spinal decompression feels good and intuitively makes some sense, in the end, it has no clear benefit.
Despite not agreeing with some of the claims and techniques which my chiropractor used, I must admit that I still found some merit in my visits. In general, he and his staff provided a lot of “hands-on” attention. Second, I liked the fact that adjustments, spinal decompression, and the prescribed physical therapy are all pro-active attempts at getting me better, unlike an internist’s technique of prescribing medicines to alleviate the symptoms. I must admit I am not sure if the chiropractor made a difference, but I am feeling better and I do feel that chiropractors remain a reasonable option for the treatment of back pain. I suspect that much like traditional physicians, there are good and bad chiropractors. Mine was just okay.
[Next week, Acupunture]
That was interesting, Scott. I have learned some lessons from this. I have always avoided listening to what some chiropractors have to offer to people I have known. At least, I have known how helpful some can be. Will wait to read the next adventure on Acupuncture.
ReplyDeleteWhen it comes to treating disorders of the musculoskeletal system and the nervous system, chiropractic care is one of the solutions to look into. They use a drug-free and hands-on approach in restoring one’s health that was once damaged. But sadly, just like in any other profession, there are pros and cons with proceeding with such treatment. That’s why it’s always advisable to many, especially for first timers, to research first, to make sure that they are getting treatments from a certified and trusted chiropractor. Anyway, thank you for your well-explained opinion. This will surely help people that are considering getting chiropractic treatments for themselves.
ReplyDeleteDerek Sparks @ Forgey Chiropractic