Science and Chiropractic

Have you ever read or heard something that on the surface made sense for a second but when you thought about it, it was completely banal? I had that experience this morning. One of my patients shared an article with me from Fox News about chiropractic. The article (that you can find here) was overall very positive with some interesting things to say. Unfortunately, the last paragraph is so stupid it is laughable. Mind you, I am not criticizing the author but rather the quote. Here it is:

“We’ve all seen the results,” says Dr. Nicholas DiNubile, an orthopedic surgeon and the author of the FrameWork book series. “But we need scientific research that shows what chiropractors can do.” For serious pain, DiNubile recommends that an orthopedic or sports-medicine specialist be your first stop.

Let’s talk about Science, since he referenced it. If you look up the word “science” in the dictionary, there are several definitions each with the general concept of a system used to come to knowledge from ignorance. In the scientific method  one asks a question, hypothesizes the answer, experiments, observes, and finally theorizes. If you look at Dr. DiNubile’s quote, you wonder if he really knows anything about science. The first thing he says is that we have seen the results. So, if the modern concept of chiropractic has been an ongoing experiment since the 1800’s, and we have over 100 years of observation, and “We’ve all seen the  results,” what type of scientific research exactly is needed, Dr. DiNubile?

To me, this smacks of a turf war jab. For years many medical associations have tried to maintain their hold on the world of healthcare by demanding scientific proof on their terms from every other industry. For them, they have established that “scientific research” has to be double blind, random, controlled experiments published in a peer reviewed journal. That works great for medication because a placebo can look just like the real thing and neither the doctor or the patient needs to know, which constitutes the double blind, and as long as you do your best to control or account for all of the factors, you can can get published in a scientific journal. Try performing a placebo adjustment! For that matter, orthopedists cannot really follow their own ridiculously stringent definition of scientific research unless a surgeon is unaware of whether he did or did not do a surgery. Does this mean we need more scientific research to see if knee surgery works? Along the same line, does that mean that we should not be doing knee surgery until we have more research?

In this chiropractor’s opinion, we do not need more research we need more people. We need people with enough sense to look at the results and to give chiropractic a chance. Case studies and anecdotal evidence over a long period of time is some of the best research we can do. We need people who are willing to conduct their own scientific experiment to see if their condition can be helped with chiropractic care. Finally, we need to be open to considering what works instead of doing nothing because a so called expert thinks we need more research.

2 Comments

  1. Hi Jared-

    That quote does sound like a turf war jab. That’s unfortunate.

    Funny you should use knee surgery as an example. In 2010, the New England Journal of Medicine published a study showing similar outcomes for people undergoing early ACL reconstruction with people undergoing rehabilitation with optional ACL surgery later. More than 60% of the people in the second group ended up not having surgery.

    It would be interesting to see a similar study of early versus optional later chiropractic treatment. Are you familiar with any studies like that?

    1. I remember that study about the ACL. You shared it with me when I was considering my surgical options. I have read some general control studies of those who have been treated with chiropractic, those treated with PT, and those not treated and chiropractic is always favorable.

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