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❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.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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Hello Sleep – by Dr. Jade Wu
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
We’ve reviewed other sleep books before, so what makes this one stand out?
Mostly, it’s because this one takes quite a different approach.
While still giving a nod to the sensible advice you’ve already read in many places (including here at 10almonds), Dr. Wu looks to help the reader avoid falling into the trap (or: help the reader get out of the trap, if already there) of focussing so much on getting better sleep that it becomes an all-consuming stressor that takes up much of the day thinking about it, and guess what, much of the night too, because you’re busy working out how sleep-deprived you’re going to be tomorrow.
Instead, Dr. Wu recommends to work with your body rather than against it, worry less, and ultimately sleep better. Of course, the “how” of this is what makes most of the book.
She does also give chapters on things that may be different for you, based on such things as hormones, age, or medical conditions.
The writing style is pop-science but with frequent references to scientific papers as appropriate, making good science very accessible.
Bottom line: if you’ve tried everything else and/but good sleep still eludes you, this book will help you to end the battle and make friends with your sleep (a metaphor the author uses throughout the book, by the way).
Click here to check out Hello Sleep, and indeed get better sleep!
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The Well Plated Cookbook – by Erin Clarke
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Clarke’s focus here is on what she calls “stealthy healthy”, with the idea of dishes that feel indulgent while being great for the health.
The recipes, of which there are well over 100, are indeed delicious and easy to make without being oversimplified, and since she encourages the use of in-season ingredients, many recipes come with a “market swaps” substitution guide, to make each recipe seasonal.
The book is largely not vegetarian, let alone vegan, but the required substitutions will be second-nature to any seasoned vegetarian or vegan. Indeed, “skip the meat sometimes” is one of the advices she offers near the beginning of the book, in the category of tips to make things even healthier.
Bottom line: if you want to add dishes to your repertoire that are great for entertaining and still super-healthy, this book will be a fine addition to your collection.
Click here to check out The Well Plated Cookbook, and get cooking!
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Antidepressants: Personalization Is Key!
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Antidepressants: Personalization Is Key!
Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:
- Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
- Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
- Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
- Four respondents said “They are no better than placebo, and are more likely to harm”
- Two respondents said “They merely mask the problem, and thus don’t really help”
So what does the science say?
❝They are no better than placebo, and are more likely to harm? True or False?❞
True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:
- Placebo Effect in the Treatment of Depression and Anxiety ← randomly assigned antidepressants are, shockingly, luck of the draw in usefulness
- Antidepressants versus placebo in major depression: an overview ← “wow this science is messy”
- Comparative efficacy and acceptability of 21 antidepressant drugs: a systematic review and network meta-analysis ← “oh look, it makes a difference which antidepressant we give to people”
Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.
Otherwise it is like getting a flu shot and being surprised when you still catch a cold!
❝They merely mask the problem, and thus don’t really help: True or False?❞
False, categorically.
The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).
❝They may help some people, but the side-effects are alarming: True or False?❞
True or False depending on more factors than we can cover here.
Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.
One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.
❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞
True! Contingently.
That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.
*common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.
For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.
Want to know more about the different kinds?
Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:
Mind | Comparing Antidepressants
Want a drug-free approach?
You might like our previous main feature:
The Mental Health First-Aid That You’ll Hopefully Never Need
Take care!
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Cherries vs Cranberries – Which is Healthier?
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Our Verdict
When comparing cherries to cranberries, we picked the cherries.
Why?
In terms of macros, cherries have a little more protein (but it’s not much) while cranberries have a little more fiber. Despite this, cherries have the lower glycemic index—about half that of cranberries.
In the category of vitamins, cherries have a lot more of vitamins A, B1, B2, B3, B9, and a little more choline, while cranberries have more of vitamins B5, B6, C, E, and K. A modest win for cherries here.
When it comes to minerals, things are more divided: cherries have more calcium, copper, iron, magnesium, phosphorus, potassium, and zinc, while cranberries have more manganese. An easy win for cherries here.
This all adds up to a total win for cherries, but both of these fruits are great and both have their own beneficial properties (see our main features below!)
Want to learn more?
You might like to read:
- Cherries’ Very Healthy Wealth Of Benefits!
- Health Benefits Of Cranberries (But: You’d Better Watch Out)
Take care!
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How to Prevent Dementia – by Dr. Richard Restak
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We’ve written about this topic here, we know. But there’s a lot more we can do to be on guard against, and pre-emptively strengthen ourselves against, dementia.
The author, a neurologist, takes us on a detailed exploration of dementia in general, with a strong focus on Alzheimer’s in particular, as that accounts for more than half of all dementia cases.
But what if you can’t avoid it? It could be that with the wrong genes and some other factor(s) outside of your control, it will get you if something else doesn’t get you first.
Rather than scaremongering, Dr. Restak tackles this head-on too, and discusses how symptoms can be managed, to make the illness less anxiety-inducing, and look to maintain quality of life as much as possible.
The style of the book is… it reads a lot like an essay compilation. Good essays, then organized and arranged in a sensible order for reading, but distinct self-contained pieces. There are ten or eleven chapters (depending on how we count them), each divided into few or many sections. All this makes for:
- A very “read a bit now and a bit later and a bit the next day” book, if you like
- A feeling of a very quick pace, if you prefer to sit down and read it in one go
Either way, it’s a very informative read.
Bottom line: if you’d like to better understand the many-headed beast that is dementia, this book gives a far more comprehensive overview than we could here, and also explains the prophylactic interventions available.
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Twenty-One, No Wait, Twenty Tweaks For Better Health
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Dr. Greger’s 21 Tweaks… We say 20, though!
We’ve talked before about Dr. Greger’s Daily Dozen (12 things he advises that we make sure to eat each day, to enjoy healthy longevity), but much less-talked-about are his “21 Tweaks”…
They are, in short, a collection of little adjustments one can make for better health. Some of them are also nutritional, but many are more like lifestyle tweaks. Let’s do a rundown:
At each meal:
- Preload with water
- Preload with “negative calorie” foods (especially: greens)
- Incorporate vinegar (1-2 tbsp in a glass of water will slow your blood sugar increase)
- Enjoy undistracted meals
- Follow the 20-minute rule (enjoy your meal over the course of at least 20 minutes)
Get your daily doses:
- Black cumin ¼ tsp
- Garlic powder ¼ tsp
- Ground ginger (1 tsp) or cayenne pepper (½ tsp)
- Nutritional yeast (2 tsp)
- Cumin (½ tsp)
- Green tea (3 cups)
Every day:
- Stay hydrated
- Deflour your diet
- Front-load your calories (this means implementing the “king, prince, pauper” rule—try to make your breakfast the largest meal of your day, followed my a medium lunch, and a small evening meal)
- Time-restrict your eating (eat your meals within, for example, an 8-hour window, and fast the rest of the time)
- Optimize exercise timing (before breakfast is best for most people, unless you are diabetic)
- Weigh yourself twice a day (doing this when you get up and when you go to bed results in much better long-term weight management than weighing only once per day)
- Complete your implementation intentions (this sounds a little wishy-washy, but it’s about building a set of “if this, then that” principles, and then living by them. An example could be directly physical health-related such as “if there is a choice of stairs or elevator, I will take the stairs”, or could be more about holistic good-living, such as “if someone asks me for help, I will try to oblige them so far as I reasonably can”)
Every night:
- Fast after 7pm
- Get sufficient sleep (7–9 hours is best. As we get older, we tend more towards the lower end of that, but try get at least those 7 hours!)
Experiment with Mild Trendelenburg(better yet, skip this one)*
*This involves a 6º elevation of the bed, at the foot end. Dr. Greger advises that this should only be undertaken after consulting your doctor, though, as a lot of health conditions can contraindicate it. We at 10almonds couldn’t find any evidence to support this practice, and numerous warnings against it, so we’re going to go ahead and say we think this one’s skippable.
Again, we do try to bring you the best evidence-based stuff here at 10almonds, and we’re not going to recommend something just because of who suggested it
As for the rest, you don’t have to do them all! And you may have noticed there was a little overlap in some of them. But, we consider them a fine menu of healthy life hacks from which to pick and choose!
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