Is Chiropractic All It’s Cracked Up To Be?

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Is Chiropractic All It’s Cracked Up To Be?

Yesterday, we asked you for your opinions on chiropractic medicine, and got the above-depicted, below-described set of results:

  • 38% of respondents said it keeps us healthy, and everyone should do it as maintenance
  • 33% of respondents said it can correct some short-term skeletal issues, but that’s all
  • 16% of respondents said that it’s a dangerous pseudoscience and can cause serious harm
  • 13% of respondents said that it’s mostly just a combination of placebo and endorphins

Respondents also shared personal horror stories of harm done, personal success stories of things cured, and personal “it didn’t seem to do anything for me” stories.

What does the science say?

It’s a dangerous pseudoscience and can cause harm: True or False?

False and True, respectively.

That is to say, chiropractic in its simplest form that makes the fewest claims, is not a pseudoscience. If somebody physically moves your bones around, your bones will be physically moved. If your bones were indeed misaligned, and the chiropractor is knowledgeable and competent, this will be for the better.

However, like any form of medicine, it can also cause harm; in chiropractic’s case, because it more often than not involves manipulation of the spine, this can be very serious:

❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.

The reported pathology usually was a vascular accident involving the dissection of a vertebral artery.

Conclusion: Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit.❞

Source: Deaths after chiropractic: a review of published cases

From this, we might note two things:

  1. The abstract doesn’t note the initial sample size; we would rather have seen this information expressed as a percentage. Unfortunately, the full paper is not accessible, and nor are many of the papers it cites.
  2. Having a vertebral artery fatally dissected is nevertheless not an inviting prospect, and is certainly a very reasonable cause for concern.

It’s mostly just a combination of placebo and endorphins: True or False?

True or False, depending on what you went in for:

  • If you went in for a regular maintenance clunk-and-click, then yes, you will get your clunk-and-click and feel better for it because you had a ritualized* experience and endorphins were released.
  • If you went in for something that was actually wrong with your skeletal alignment, to get it corrected, and this correction was within your chiropractor’s competence, then yes, you will feel better because a genuine fault was corrected.

*this is not implying any mysticism, by the way. Rather it means simply that placebo effect is strongest when there is a ritual associated with it. In this case it means going to the place, sitting in a pleasant waiting room, being called in, removing your shoes and perhaps some other clothes, getting the full attention of a confident and assured person for a while, this sort of thing.

With regard to its use to combat specifically spinal pain (i.e., perhaps the most obvious thing to treat by chiropractic spinal manipulation), evidence is slightly in favor, but remains unclear:

❝Due to the low quality of evidence, the efficacy of chiropractic spinal manipulation compared with a placebo or no treatment remains uncertain. ❞

Source: Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain

It can correct some short-term skeletal issues, but that’s all: True or False?

Probably True.

Why “probably”? The effectiveness of chiropractic treatment for things other than short-term skeletal issues has barely been studied. From this, we may wish to keep an open mind, while also noting that it can hardly claim to be evidence-based—and it’s had hundreds of years to accumulate evidence. In all likelihood, publication bias has meant that studies that were conducted and found inconclusive or negative results were simply not published—but that’s just a hypothesis on our part.

In the case of using chiropractic to treat migraines, a very-related-but-not-skeletal issue, researchers found:

❝Pre-specified feasibility criteria were not met, but deficits were remediable. Preliminary data support a definitive trial of MCC+ for migraine.❞

Translating this: “it didn’t score as well as we hoped, but we can do better. We got some positive results, and would like to do another, bigger, better trial; please fund it”

Source: Multimodal chiropractic care for migraine: A pilot randomized controlled trial

Meanwhile, chiropractors’ claims for very unrelated things have been harshly criticized by the scientific community, for example:

Misinformation, chiropractic, and the COVID-19 pandemic

About that “short-term” aspect, one of our subscribers put it quite succinctly:

❝Often a skeletal correction is required for initial alignment but the surrounding fascia and muscles also need to be treated to mobilize the joint and release deep tissue damage surrounding the area. In combination with other therapies chiropractic support is beneficial.❞

This is, by the way, very consistent with what was said in the very clinically-dense book we reviewed yesterday, which has a chapter on the short-term benefits and limitations of chiropractic.

A truism that holds for many musculoskeletal healthcare matters, holds true here too:

❝In a battle between muscle and bone, muscle will always win❞

In other words…

Chiropractic can definitely help put misaligned bones back where they should be. However, once they’re there, if the cause of their misalignment is not treated, they will just re-misalign themselves shortly after you walking out of your session.

This is great for chiropractors, if it keeps you coming back for endless appointments, but it does little for your body beyond give you a brief respite.

So, by all means go to a chiropractor if you feel so inclined (and you do not fear accidental arterial dissection etc), but please also consider going to a physiotherapist, and potentially other medical professions depending on what seems to be wrong, to see about addressing the underlying cause.

Take care!

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    We’ve written before about depression and “flourishing” but what about when one isn’t exactly flourishing, but is not necessarily in the depths of depression either? That’s what this book is about.

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  • Sweet Dreams Are Made of THC (Or Are They?)

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  • Top Foods Against Neuroinflammation

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  • Revealed: The Soviet Secret Recipe For Success That The CIA Admits Put The US To Shame

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    Today’s edition of 10almonds brings you a blast from the past with a modern twist: an ancient Russian peasant food that became a Soviet staple, and today, is almost unknown in the West.

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    Щи да каша — пища наша (Shchi da kasha — pishcha nasha)

    Shchi and buckwheat are what we eat

    Top tip: buckwheat makes an excellent (and naturally sweet) alternative to porridge oats if prepared the same way!

    Где щи, там и нас ищи (Gdye shchi, tam i nas ishchi)

    Where there’s shchi, us you’ll see

    Голь голью, а луковка во щах есть (Gol’ gol’yu, a lukovka vo shchakh yest’)

    I’m stark naked, but there’s shchi with onions

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    Our culinary cultural ambassador Nastja is here to offer her tried-and-tested recipe for…

    …Russian cabbage soup (yes, really—bear with us now, and you can thank us later)

    There are a lot of recipes for shchi (see for yourself what the Russian version of Lifehacker recommends), and we’ll be offering our favorite…

    Nastja’s Nutritious and Delicious Homemade Shchi

    Hi, Nastja here! I’m going to share with you my shchi recipe that is:

    • Cheap
    • So tasty
    • Super nutritious*
    • Vegan
    • Gluten Free

    You will also need:

    • A cabbage (I use sweetheart, but any white cabbage will do)
    • 1 cup (250g) red lentils (other kinds of lentils will work too)
    • ½ lb or so (250–300g) tomatoes (I use baby plum tomatoes, but any kind will do)
    • ½ lb or so (250–300g) mushrooms (the edible kind)
    • An onion (I use a brown onion; any kind will do)
    • Salt, pepper, rosemary, thyme, parsley, cumin
    • Marmite or similar yeast extract (do you hate it? Me too. Trust me, it’ll be fine, you’ll love it. Omit if you’re a coward.)
    • A little oil for sautéing (I use sunflower, but canola is fine, as is soy oil. Do not use olive oil or coconut oil, because the taste is too strong and the flashpoint too low)

    First, what the French call mise-en-place, the prep work:

    1. Chop the cabbage into small strips, ⅛–¼ inch x 1 inch is a good guideline, but you can’t really go wrong unless you go to extremes
    2. Chop the tomatoes. If you’re using baby plum tomatoes (or cherry tomatoes), cut them in half. If using larger tomatoes, cut them into eighths (halve them, halve the halves, then halve the quarters)
    3. Chop the mushrooms. If using button mushrooms, half them. If using larger mushrooms, quarter them.
    4. Chop the onion finely.
    5. Gather the following kitchenware: A big pan (stock pot or similar), a sauté pan (a big wok or frying pan will do), a small frying pan (here a wok will not do), and a saucepan (a rice cook will also do)

    Now, for actual cooking:

    1. Cook the red lentils until soft (I use a rice cooker, but a saucepan is fine) and set aside
    2. Sauté the cabbage, put it in the big pot (not yet on the heat!)
    3. Fry the mushrooms, put them in the big pot (still not yet on the heat!)

    When you’ve done this a few times and/or if you’re feeling confident, you can do the above simultaneously to save time

    1. Blend the lentils into the water you cooked them in, and then add to the big pot.
    2. Turn the heat on low, and if necessary, add more water to make it into a rich soup
    3. Add the seasonings to taste, except the parsley. Go easy on the cumin, be generous with the rosemary and thyme, let your heart guide you with the salt and pepper.
    4. When it comes to the yeast extract: add about one teaspoon and stir it into the pot. Even if you don’t like Marmite, it barely changes the flavour (makes it slightly richer) and adds a healthy dose of vitamin B12.

    We did not forget the tomatoes and the onion:

    1. Caramelize the onion (keep an eye on the big pot) and set it aside
    2. Fry the tomatoes and add them to the big pot

    Last but definitely not least:

    1. Serve!
    2. The caramelized onion is a garnish, so put a little on top of each bowl of shchi
    3. The parsley is also a garnish, just add a little

    Any shchi you don’t eat today will keep in the fridge for several days, or in the freezer for much longer.

    *That nutritious goodness I talked about? Check it out:

    • Lentils are high in protein and iron
    • Cabbage is high in vitamin C and calcium
    • Mushrooms are high in magnesium
    • Tomatoes are good against inflammation
    • Black pepper has a host of health benefits
    • Yeast extract contains vitamin B12

    Let us know how it went! We love to receive emails from our subscribers!

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  • How Beneficial Is MCT Oil, Really?

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    • Mixed, because the results varied widely (probably because of the aforementioned problems).

    Rather than pick at individual studies, let’s look at this review and meta-analysis of 13 studies, with a combined sample size of 749 people (so you can imagine how small the individual RCTs were):

    ❝Compared with LCTs, MCTs decreased body weight (-0.51 kg [95% CI-0.80 to -0.23 kg]; P<0.001; I(2)=35%); waist circumference (-1.46 cm [95% CI -2.04 to -0.87 cm]; P<0.001; I(2)=0%), hip circumference (-0.79 cm [95% CI -1.27 to -0.30 cm]; P=0.002; I(2)=0%), total body fat (standard mean difference -0.39 [95% CI -0.57 to -0.22]; P<0.001; I(2)=0%), total subcutaneous fat (standard mean difference -0.46 [95% CI -0.64 to -0.27]; P<0.001; I(2)=20%), and visceral fat (standard mean difference -0.55 [95% CI -0.75 to -0.34]; P<0.001; I(2)=0%).

    No differences were seen in blood lipid levels.

    Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected.❞

    So, if we’re going to take those numbers at face value, that means a net weight loss, over the course of the trial period, was…

    *drumroll*

    0.51kg (that’s about 1 lb).

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    Effects of medium-chain triglycerides on weight loss and body composition: a meta-analysis of randomized controlled trials

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    It may again be a case of individual studies cancelling each other out. For example…

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    This study found that it worsened lipids in 17 young men, worse even than taking an equivalent amount of sunflower oil:

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    In short, it’s a gamble.

    It may be good for insulin sensitivity, though

    This one seems to be specific to people with type 2 diabetes. The paper heading says it all, but we include the link in case you want to know the details (the short version is, it improved insulin sensitivity in diabetic subjects only (not others), and didn’t affect anything else that was measured:

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    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

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    Learn to Age Gracefully

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