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❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.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:
- 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.
- 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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The Imperfect Nutritionist – by Jennifer Medhurst
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The idea of the “imperfect nutritionist” is to note that we’re all different with slightly different needs and sometimes very different preferences (or circumstances!) and having a truly perfect diet is probably a fool’s errand. Should we just give up, then? Not at all:
What we can do, Medhust argues, is find what’s best for us, realistically.
It’s better to have an 80% perfect diet 80% of the time, than to have a totally perfect diet for four and a half meals before running out of steam (and ingredients).
As for the “seven principles” mentioned in the title… we’re not going to keep those a mystery; they are:
- Focusing on wholefood
- Being diverse
- Knowing your fats
- Including fermented, prebiotic and probiotic foods
- Reducing refined carbohydrates
- Being aware of liquids
- Eating mindfully
The first part of the book is a treatise on how to implement those principles in your diet generally; the second part of the book is a recipe collection—70 recipes, with “these ingredients will almost certainly be available at your local supermarket” as a baseline. No instances of “the secret to being a good chef is knowing how to source fresh ingredients; ask your local greengrocer where to find spring-harvested perambulatory truffle-cones” here!
Basically, it focusses on adding healthy foods per your personal preferences and circumstances, and building these up into a repertoire of meals that will keep you and your family happy and healthy.
Pick Up Your Copy Of The Imperfect Nutritionist From Amazon Today!
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The Wim Hof Method – by Wim Hof
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In Wednesday’s main feature, we wrote about the Wim Hof Method, and/but only scratched the surface. Such is the downside of being a super-condensed newsletter! However, it does give us the opportunity to feature the book:
The Wim Hof Method is definitely loudly trumpeted as “up there” with Atomic Habits or How Not To Die in the category of “life-changing” books. Why?
Firstly, it’s a very motivational book. Hof is a big proponent of the notion “if you think you can or you think you can’t, you’re right” idea, practises what he preaches, and makes clear he’s not special.
Secondly, it’s backed up with science. While it’s not a science-heavy book and that’s not the main focus, there are references to studies. Where physiological explanations are given for how certain things work, those explanations are sound. There’s no pseudoscience here, which is especially important for a book of this genre!
What does the book have that our article didn’t? A good few things:
- More about Hof’s own background and where it’s taken him. This is generally not a reason people buy books (unless they are biographies), but it’s interesting nonetheless.
- A lot more advice, data, and information about Cold Therapy and how it can (and, he argues convincingly, should) be built into your life.
- A lot about breathing exercises that we just didn’t cover at all in our article, but is actually an important part of the Wim Hof Method.
- More about stepping through the psychological barriers that can hold us back.
Bottom line: this book offers benefits that stretch into many areas of life, from some simple habits that can be built.
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Ginger Does A Lot More Than You Think
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Ginger’s benefits go deep!
You are doubtlessly already familiar with what ginger is, so let’s skip right into the science.
The most relevant active compound in the ginger root is called gingerol, and people enjoy it not just for its taste, but also a stack of health reasons, such as:
- For weight loss
- Against nausea
- Against inflammation
- For cardiovascular health
- Against neurodegeneration
Quite a collection! So, what does the science say?
For weight loss
This one’s quite straightforward. It not only helps overall weight loss, but also specifically improves waist-hip ratio, which is a much more important indicator of health than BMI.
Against nausea
Ginger has proven its effectiveness in many high quality clinical trials, against general nausea, post-surgery nausea, chemotherapy-induced nausea, and pregnancy-related nausea.
Source: Ginger on Human Health: A Comprehensive Systematic Review of 109 Randomized Controlled Trials
However! While it very clearly has been shown to be beneficial in the majority of cases, there are some small studies that suggest it may not be safe to take close to the time of giving birth, or in people with a history of pregnancy loss, or unusual vaginal bleeding, or clotting disorders.
See specifically: Ginger for nausea and vomiting of pregnancy
As a side note on the topic of “trouble down there”, ginger has also been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:
See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial
Against inflammation
Ginger has well-established anti-inflammatory (and, incidentally, which affects many of the same systems, antioxidant) effects. Let’s take a look at that first:
Read: Effect of Ginger on Inflammatory Diseases
Attentive readers will note that this means that ginger is not merely some nebulous anti-inflammatory agent. Rather, it also specifically helps alleviate delineable inflammatory diseases, ranging from colitis to Crohn’s, arthritis to lupus.
We’ll be honest (we always are!), the benefits in this case are not necessarily life-changing, but they are a statistically significant improvement, and if you are living with one of those conditions, chances are you’ll be glad of even things described in scientific literature as “modestly efficacious”.
What does “modestly efficacious” look like? Here are the numbers from a review of 593 patients’ results in clinical trials (against placebo):
❝Following ginger intake, a statistically significant pain reduction SMD = −0.30 ([95% CI: [(−0.50, −0.09)], P = 0.005]) with a low degree of inconsistency among trials (I2 = 27%), and a statistically significant reduction in disability SMD = −0.22 ([95% CI: ([−0.39, −0.04)]; P = 0.01; I2 = 0%]) were seen, both in favor of ginger.❞
To de-mathify that:
- Ginger reduced pain by 30%
- Ginger reduced disability by 22%
Read the source: Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials
Because (in part) of the same signalling pathways, it also has benefits against cancer (and you’ll remember, it also reduces the symptoms of chemotherapy).
See for example: Ginger’s Role in Prevention and Treatment of Gastrointestinal Cancer
For cardiovascular health
In this case, its benefits are mostly twofold:
- It significantly reduces triglycerides and LDL cholesterol, while increasing HDL cholesterol
- It significantly reduces fasting blood sugar levels and HbA1c levels (both risk factors for CVD)
Against neurodegeneration
This is in large part because it reduces inflammation, which we discussed earlier.
But, not everything passes the blood-brain barrier, so it’s worth noting when something (like gingerol) does also have an effect on brain health as well as the rest of the body.
You do not want inflammation in your brain; that is Bad™ and strongly associated with Alzheimer’s and Parkinson’s.
As well as reducing neuroinflammation, ginger has other relevant mechanisms too:
❝Its bioactive compounds may improve neurological symptoms and pathological conditions by modulating cell death or cell survival signaling molecules.
The cognitive enhancing effects of ginger might be partly explained via alteration of both the monoamine and the cholinergic systems in various brain areas.
Moreover, ginger decreases the production of inflammatory related factors❞
Check it out in full, as this is quite interesting:
Role of Ginger in the Prevention of Neurodegenerative Diseases
How much to take?
In most studies, doses of 1–3 grams/day were used.
Where to get it?
Your local supermarket, as a first port-of-call. Especially given the dose you want, it may be nicer for you to have a touch of sliced ginger root in your cooking, rather than taking 2–6 capsules per day to get the same dose.
Obviously, this depends on your culinary preferences, and ginger certainly doesn’t go with everything!
If you do want it as a supplement, here is an example product on Amazon, for your convenience.
Enjoy!
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What’s the difference between vegan and vegetarian?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Vegan and vegetarian diets are plant-based diets. Both include plant foods, such as fruits, vegetables, legumes and whole grains.
But there are important differences, and knowing what you can and can’t eat when it comes to a vegan and vegetarian diet can be confusing.
So, what’s the main difference?
Creative Cat Studio/Shutterstock What’s a vegan diet?
A vegan diet is an entirely plant-based diet. It doesn’t include any meat and animal products. So, no meat, poultry, fish, seafood, eggs, dairy or honey.
What’s a vegetarian diet?
A vegetarian diet is a plant-based diet that generally excludes meat, poultry, fish and seafood, but can include animal products. So, unlike a vegan diet, a vegetarian diet can include eggs, dairy and honey.
But you may be wondering why you’ve heard of vegetarians who eat fish, vegetarians who don’t eat eggs, vegetarians who don’t eat dairy, and even vegetarians who eat some meat. Well, it’s because there are variations on a vegetarian diet:
- a lacto-ovo vegetarian diet excludes meat, poultry, fish and seafood, but includes eggs, dairy and honey
- an ovo-vegetarian diet excludes meat, poultry, fish, seafood and dairy, but includes eggs and honey
- a lacto-vegetarian diet excludes meat, poultry, fish, seafood and eggs, but includes dairy and honey
- a pescatarian diet excludes meat and poultry, but includes eggs, dairy, honey, fish and seafood
- a flexitarian, or semi-vegetarian diet, includes eggs, dairy and honey and may include small amounts of meat, poultry, fish and seafood.
Are these diets healthy?
A 2023 review looked at the health effects of vegetarian and vegan diets from two types of study.
Observational studies followed people over the years to see how their diets were linked to their health. In these studies, eating a vegetarian diet was associated with a lower risk of developing cardiovascular disease (such as heart disease or a stroke), diabetes, hypertension (high blood pressure), dementia and cancer.
For example, in a study of 44,561 participants, the risk of heart disease was 32% lower in vegetarians than non-vegetarians after an average follow-up of nearly 12 years.
Further evidence came from randomised controlled trials. These instruct study participants to eat a specific diet for a specific period of time and monitor their health throughout. These studies showed eating a vegetarian or vegan diet led to reductions in weight, blood pressure, and levels of unhealthy cholesterol.
For example, one analysis combined data from seven randomised controlled trials. This so-called meta-analysis included data from 311 participants. It showed eating a vegetarian diet was associated with a systolic blood pressure (the first number in your blood pressure reading) an average 5 mmHg lower compared with non-vegetarian diets.
It seems vegetarian diets are more likely to be healthier, across a number of measures.
For example, a 2022 meta-analysis combined the results of several observational studies. It concluded a vegetarian diet, rather than vegan diet, was recommended to prevent heart disease.
There is also evidence vegans are more likely to have bone fractures than vegetarians. This could be partly due to a lower body-mass index and a lower intake of nutrients such as calcium, vitamin D and protein.
But it can be about more than just food
Many vegans, where possible, do not use products that directly or indirectly involve using animals.
So vegans would not wear leather, wool or silk clothing, for example. And they would not use soaps or candles made from beeswax, or use products tested on animals.
The motivation for following a vegan or vegetarian diet can vary from person to person. Common motivations include health, environmental, ethical, religious or economic reasons.
And for many people who follow a vegan or vegetarian diet, this forms a central part of their identity.
More than a diet: veganism can form part of someone’s identity. Shutterstock So, should I adopt a vegan or vegetarian diet?
If you are thinking about a vegan or vegetarian diet, here are some things to consider:
- eating more plant foods does not automatically mean you are eating a healthier diet. Hot chips, biscuits and soft drinks can all be vegan or vegetarian foods. And many plant-based alternatives, such as plant-based sausages, can be high in added salt
- meeting the nutrient intake targets for vitamin B12, iron, calcium, and iodine requires more careful planning while on a vegan or vegetarian diet. This is because meat, seafood and animal products are good sources of these vitamins and minerals
- eating a plant-based diet doesn’t necessarily mean excluding all meat and animal products. A healthy flexitarian diet prioritises eating more whole plant-foods, such as vegetables and beans, and less processed meat, such as bacon and sausages
- the Australian Dietary Guidelines recommend eating a wide variety of foods from the five food groups (fruit, vegetables, cereals, lean meat and/or their alternatives and reduced-fat dairy products and/or their alternatives). So if you are eating animal products, choose lean, reduced-fat meats and dairy products and limit processed meats.
Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healing Arthritis – by Dr. Susan Blum
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We previously reviewed another book by this author, her Immune System Recovery Plan, and today it’s more specific: healing arthritis
Of course, not all arthritis is rooted in immune dysfunction, but a) all of it is made worse by immune dysfunction and b) rheumatoid arthritis, which is an autoimmune disease, affects 1% of the population.
This book tackles all kinds of arthritis, by focusing on addressing the underlying causes and treating those, and (whether it was the cause or not) reducing inflammation without medication, because that will always help.
The “3 steps” mentioned in the subtitle are three stages of a plan to improve the gut microbiome in such a way that it not only stops worsening your arthritis, but starts making it better.
The style here is on the hard end of pop-science, so if you want something more conversational/personable, then this won’t be so much for you, but if you just want the information and explanation, then this does it just fine, and it has frequent references to the science to back it up, with a reassuringly extensive bibliography.
Bottom line: if you have arthritis and want a book that will help you to get either symptom-free or as close to that as is possible from your current condition (bearing in mind that arthritis is generally degenerative), then this is a great book for that.
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The Vagina Bible – by Dr. Jen Gunter
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The vagina is mysterious to most men, and honestly, also to a lot of women. School education on this is minimal, if even extant, and as an adult, everyone’s expected to “just know” stuff. However, here in reality, that isn’t how knowledge works.
To remedy this, gynecologist Dr. Jen Gunter takes 432 pages to give us the low-down and the ins-and-outs of this remarkable organ that affects, and is affected by, a lot of the rest of our health.
(On which note, if you think you already know it, ask yourself: could you write 432 pages about it? If not, you’ll probably still learn some things from this book)
Stylistically, this book is more of a textbook in presentation, but the writing is still very much easy-reading. The focus is mostly on anatomy and physiology, though she does give due attention to relevant healthcare options; what’s good, what’s bad, and what’s just plain unnecessary. In such cases, she always has plenty of science to hand; it’s never just “one woman’s opinion”.
If the book has a downside, it’s that (based on other reviews) it seems to upset some readers with unwelcome truths, but that’s more in the vein of “she’s right, of course, but I didn’t like reading it”.
Bottom line: if you have a vagina, or spend any amount of time in close proximity to one, then this is a great book for you.
Click here to check out The Vagina Bible, and upgrade your knowledge!
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