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❝Twenty six fatalities were published in the medical literature and many more might have remained unpublished.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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Fall Asleep In 2 Minutes (Doctor Explains)
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.
Beyond “sleep hygiene”, Dr. Siobhan Deshauer has insights to share:
Rest for your body and mind
First, do still do the basics. That means dimming/filtering lights for an hour before bed, lowering the room temperature a little, ensuring you have nice fresh sheets, not having alcohol or caffeine before bed, and getting out of bed if you’re not asleep within half an hour, to avoid associating being in bed with wakefulness.
Next, the extra tips:
- Progressive relaxation: tense and relax each muscle group from toes to head
- Box breathing: inhale, hold, exhale, and hold for 4 seconds each; helps calm the nervous system (it’s called “box breathing” because of the 4:4:4:4 setup)
- Diaphragmatic breathing: focus on belly breathing, with longer exhalation to activate the parasympathetic nervous system (note that this can, and even ideally should, be done at the same time as the previous)
- Cognitive shuffling: think of words starting with each letter of a chosen word while visualizing them (this is like “counting sheep”, but does the job better—the job in question being preventing your brain from moving to anything more strenuous or stressful)
For more on all of these plus some extra side-along advice, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Non-Sleep Deep Rest: A Neurobiologist’s Take ← a way to get many of the benefits of sleep, while awake
Take care!
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Feel Great, Lose Weight – by Dr. Rangan Chatterjee
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We all know that losing weight sustainably tends to be harder than simply losing weight. We know that weight loss needs to come with lifestyle change. But how to get there?
One of the biggest problems that we might face while trying to lose weight is that our “metabolic thermostat” has got stuck at the wrong place. Trying to move it just makes our bodies think we are starving, and everything gets even worse. We can’t even “mind over matter” our way through it with willpower, because our bodies will do impressive things on a cellular level in an attempt to save us… Things that are as extraordinary as they are extraordinarily unhelpful.
Dr. Rangan Chatterjee is here to help us cut through that.
In this book, he covers how our metabolic thermostat got stuck in the wrong place, and how to gently tease it back into a better position.
Some advices won’t be big surprises—go for a whole foods diet, avoiding processed food, for example. Probably not a shocker.
Others are counterintuitive, but he explains how they work—exercising less while moving more, for instance. Sounds crazy, but we assure you there’s a metabolic explanation for it that’s beyond the scope of this review. And there’s plenty more where that came from, too.
Bottom line: if your weight has been either slowly rising, or else very stable but at a higher point than you’d like, Dr. Chatterjee can help you move the bar back to where you want it—and keep it there.
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Aging Is Inevitable… Or is it?
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Aging is inevitable… Or is it?
We’ve talked before about how and why aging happens. We’ve also talked about the work to tackle aging as basically an engineering problem, with the premise that our bodies are biological machines, and machines can be repaired. We also recommended a great book about this, by the way. But that’s about interfering with the biological process of aging. What about if the damage is already done?
“When the damage is done, it’s done”
We can do a lot to try to protect ourselves from aging, and we might be able to slow down the clock, but we can’t stop it, and we certainly can’t reverse it… right?
Wrong! Or at least, so we currently understand, in some respects. Supplementation with phosphatidylserine, for example, has shown promise for not just preventing, but treating, neurodegeneration (such as that caused by Alzheimer’s disease). It’s not a magic bullet and so far the science is at “probably” and “this shows great promise for…” and “this appears to…”
Phosphatidylserene does help slow neurodegeneration
…because of its role in allowing your cells to know whether they have permission to die.
This may seem a flippant way of putting it, but it’s basically how cell death works. Cells do need to die (if they don’t, that’s called cancer) and be replaced with new copies, and those copies need to be made before too much damage is accumulated (otherwise the damage is compounded with each new iteration). So an early cell death-and-replacement is generally better for your overall health than a later one.
However, neurons are tricky to replace, so phosphatidylserine effectively says “not you, hold on” to keep the rate of neuronal cell death nearer to the (slow) rate at which they can be replaced.
One more myth to bust…
For the longest time we thought that adults, especially older adults, couldn’t make new brain cells at all, that we grew a certain number, then had to hang onto them until we died… suffering diminished cognitive ability with age, on account of losing brain cells along the way.
It’s partly true: it’s definitely easier to kill brain cells than to grow them… Mind you, that’s technically true of people, too, yet the population continues to boom!
Anyway, new research showing that adults do, in fact, grow new braincells was briefly challenged by a 2018 study that declared: Human hippocampal neurogenesis drops sharply in children to undetectable levels in adults after all, never mind, go back to your business.
So was adult neurogenesis just a myth to be busted after all? Nope.
It turned out, the 2018 study had a methodological flaw!
To put it in lay terms: they had accidentally melted the evidence.
A 2019 study overcame this flaw by using a shorter fixation time for the cell samples they wanted to look at, and found that there were tens of thousands of “baby neurons” (again with the lay terms), newly-made brain cells, in samples from adults ranging from 43 to 87.
Now, there was still a difference: the samples from the youngest adult had 30% more newly-made braincells than the 87-year-old, but given that previous science thought brain cell generation stopped in childhood, the fact that an 87-year-old was generating new brain cells 30% less quickly than a 43-year-old is hardly much of a criticism!
As an aside: samples from patients with Alzheimer’s also had a 30% reduction in new braincell generation, compared to samples from patients of the same age without Alzheimer’s. But again… Even patients with Alzheimer’s were still growing some new brain cells.
Read it for yourself: Adult hippocampal neurogenesis is abundant in neurologically healthy subjects and drops sharply in patients with Alzheimer’s disease
In a nutshell…
- We can’t fully hit pause on aging just yet, but we can definitely genuinely slow it
- We can also, in some very specific ways, reverse it
- We can slow the loss of brain cells
- We can grow new brain cells
- We can reduce our risk of Alzheimer’s, and at least somewhat mitigate it if it appears
- We know that phosphatidylserine supplementation may help with most (if not all) of the above
- We don’t sell that (or anything else) but for your convenience, here it is on Amazon if you’re interested
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Vision for Life, Revised Edition – by Dr. Meir Schneider
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.
The “ten steps” would be better called “ten exercises”, as they’re ten things that one can (and should) continue to do on an ongoing basis, rather than steps to progress through and then forget about.
We can’t claim to have tested the ten exercises for improvement (this reviewer has excellent eyesight and merely hopes to maintain such as she gets older) but the rationale is compelling, and the public testimonials abundant.
Dr. Schneider also talks about improving and correcting errors of refraction—in other words, doing the job of any corrective lenses you may currently be using. While he doesn’t claim miracles, it turns out there is a lot that can be done for common issues such as near-sightedness and far-sightedness, amongst others.
There’s a large section on managing more chronic pathological eye conditions than this reviewer previously knew existed; in some cases it’s a matter of making sure things don’t get worse, but in many others, there’s a recurring of theme of “and here’s an exercise for correcting that”.
The writing style is a little more “narrative prose” than we’d have liked, but the quality of the content more than makes up for any style preference issues.
Bottom line: the human body is a highly adaptive organism, and sometimes it just needs a little help to correct itself. This book can help with that.
Click here to check out Vision for Life, and take good care of yours!
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Vital Aspects of Holistic Wellness
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It’s Q&A Day!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
Q: I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress
You’re going to love our Psychology Sunday editions of 10almonds! You might like some of these…
- Relationships: Seriously Useful Communication Skills!
- Purpose: Are You Flourishing? (There’s a Scale)
- Managing stress: Lower Your Cortisol! (Here’s Why & How)
- Also about managing stress: Sunday Stress-Buster
- Also applicable to stress: How To Set Your Anxiety Aside
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What Mattress Is Best, By Science?
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.
The Foundations of Good Sleep
You probably know the importance of good sleep for good health. If not, here’s a quick refresher:
- Why You Probably Need More Sleep
- How Sleep-Deprived Are You, Really?
- The 6 Dimensions Of Sleep (And Why They Matter)
You should also definitely check out this quite famous book on the topic:
Why We Sleep – by Dr Matthew Walker
What helps, to get that good sleep
We’ve covered this a little before too, for example:
- Safe Effective Sleep Aids For Seniors
- Sleep Better With Better Air
- How To Nap Like A Pro (No More “Sleep Hangovers”!)
How to level-up from there
One of the biggest barriers to good sleep for many people is obstructive sleep apea:
Healthier, Natural Sleep Without Obstruction!
We covered (in the above article) a whole lot of ways of mitigating/managing obstructive sleep apnea. One of the things we mentioned as beneficial was avoiding sleeping on one’s back, and this is something Mayo Clinic’s Dr. Somers agreed with:
Back Sleeping, And Sleeping Differently After 50
“But side-sleeping is uncomfortable”
If this is you, then chances are you have the wrong mattress.
If your mattress is too firm, you can get around it by using this “five pillow” method:
Click Here If The Embedded Video Doesn’t Load Automatically
If your mattress is too soft, then sorry, you really just have to throw that thing out and start again.
The Goldilocks mattress
While different people will have different subjective preferences, the science is quite clear on what is actually best for people’s spines. As this review of 39 qualified scholarly articles concluded:
❝Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment❞
~ Dr. Gianfilippo Caggiari et al.
Read in full: What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature
Note: to achieve “medium-firm” that remains “medium firm” has generally been assumed to require a memory-foam mattress.
How memory-foam works: memory-foam is a moderately thermosoftening material, designed to slightly soften at the touch of human body temperature, and be firmer at room temperature. This will result in it molding itself to the form of a human body, providing what amounts to personalized support for your personal shape and size, meaning your spine can stay exactly as it’s supposed to when you’re sleeping on your side, instead of (for example) your hips being wider meaning that your lumbar vertebrae are raised higher than your thoracic vertebrae, giving you the equivalent of a special nocturnal scoliosis.
It will, therefore, stop working if
- the ambient temperature is comparable to human body temperature (as happens in some places sometimes, and increasingly often these days)
- you die, and thus lose your body temperature (but in that case, your spinal alignment will be the least of your concerns)
Here’s a good explanation of the mechanics of memory foam from the Sleep Foundation:
Sleep Foundation | What is Memory Foam?
An alternative to memory foam?
If you don’t like memory foam (one criticism is that it doesn’t allow good ventilation underneath the body), there is an alterative, the grid mattress.
It’s very much “the new kid on the block” and the science is young for this, but for example this recent (April 2024) study that concluded:
❝The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.❞
~ Dr. Heather Hausenblas et al.
Read in full: Effectiveness of a grid mattress on adults’ sleep quality and health: A quasi-experimental intervention study
However, that was a small (n=39) uncontrolled (i.e. there was no control group) study, and the conflict of interest statement is, well, interesting:
❝Heather A. Hausenblas, Stephanie L. Hooper, Martin Barragan, and Tarah Lynch declare no conflict of interest. Michael Breus served as a former consultant for Purple, LLC.❞
~ Ibid.
…which is a fabulous way of distracting from the mention in the “Acknowledgements” section to follow, that…
❝Purple, LLC, provided financial support for the study❞
~ Ibid.
Purple is the company that invented the mattress being tested. So while this doesn’t mean the study is necessarily dishonest and/or corrupt, it does at the very least raise a red flag for a potential instance of publication bias (because Purple may have funded multiple studies and then pulled funding of the ones that weren’t going their way).
If you are interested in Purple’s mattress and how it works, you can check it out here ← this is a link for your interest and information; not an advertisement or an endorsement. We look forward to seeing more science for this though, and echo their own call for randomized controlled trials!
Summary
Sleep is important, and while it’s a popular myth that we need less as we get older, the truth is that we merely get less on average, while still needing the same amount.
A medium-firm memory-foam mattress is a very good, well-evidenced way to support that (both figuratively and literally!).
A grid mattress is an interesting innovation, and/but we’d like to see more science for it.
Take care!
Don’t Forget…
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