Chiropractic for Skeptics

Being a dedicated skeptic can be frustrating, especially in Arizona. The media is awash in stories people doing harm to themselves and others by having faith in pseudoscientific or magical cures instead of science-based medicine. Story after story, it’s the same: they waste time, money, emotional capital, and opportunity on ideas that do not work. They never learn and certainly never admit they were wrong.

This is not one of those stories.

Dr. Preston Long is a licensed Arizona chiropractor. He’s also one of the skeptical good guys. Dr. Long quit practicing after he realized that he was doing no good and possibly even doing harm. Now he is a consultant and author who testifies at malpractice trials involving chiropractic and educates consumers on the dangers of this questionable, yet ubiquitous, form of treatment. He is the author of several books, the most recent of which is titled Chiropractic Abuse: An Insider’s Lament. Chiropractors hate him, so you know he’s doing something right.

The following are my notes from Dr. Long’s August 10^th, 2014 presentation titled “Chiropractic for Dummies,” sponsored by the Freedom From Religion Foundation Valley of the Sun Chapter. I added endnotes with my own sources when I could find them. Please keep in mind that the following are my interpretations of his statements. I do not quote Dr. Preston and I am not an expert, so please don’t hold him (or me!) liable for anything incorrect. That being said, enjoy!

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Chiropractic theory depends on the concept of subluxation. The claim is that chiropractic subluxations (not to be confused with orthopedic subluxations) are misaligned vertebrae that are responsible for most ailments.[1] Therefore, they are the primary focus of the chiropractor regardless of other medical issues. How can this be called medicine? Chiropractic is supposedly “separate and distinct” from other forms of medicine.[2] This means that even if a patient is experiencing symptoms from a real disease like cancer, for example, the chiropractor does not even attempt to treat the cancer—only the theoretical subluxations.

Arizona is a hotbed for chiropractic fraud. Regulation is ineffective because it is done solely by other chiropractors. They set their own standards and decide what meets them.[3]

Chiropractors billed insurance companies $496 million in 2012.[4] Virtually all were for the treatment of subluxations.

In Dr. Preston’s opinion, if a patient’s vertebrae were truly misaligned as chiropractors describe,[5] that person would most likely be in a wheelchair.

The placebo effect is responsible for much of the reported improvement after any therapy—including ones that have no actual therapeutic effect.[6] Surgery is the ultimate placebo.

A significant number of strokes are caused by chiropractic neck adjustments, especially for people under the age of forty-five.[7] Celebrity victims of chiropractic-induced strokes include Sharon Stone[8] and Kevin Sorbo.[9]

There is no legitimate medical diagnosis that calls for chiropractic neck adjustment as a treatment.[10]

Dr. Long distinguishes real physical therapy from pseudoscientific ones by the fact that true therapy is difficult and requires patient participation. Pseudoscience offers quick and easy solutions.

Chiropractic spinal adjustments can be especially dangerous for children[11] and animals.[12] Many chiropractors are struggling to find new adult human customers; children and animals represent a source of additional revenue. They are referral customers without the ability to consent.

The process of giving patients informed consent is mandatory for all health care providers. This means the patient must receive a thorough and accurate description of the procedure proposed, an objective assessment of the risks, benefits, and costs, and information on other options before undergoing any kind of medical procedure. In addition the healthcare provider must ensure the patient understands and explicitly consents to the procedure before proceeding.[13] It is common for chiropractors to omit these critical steps and perform adjustments on uninformed people.

The chiropractic business model: First, attract new customers with discounted treatments for common complaints like lower back pain or headache. Next, spend time chatting to make them feel comfortable and listened-to. Then, upsell them on other quackery like homeopathy, cupping, and acupuncture.[14] Finally, sign them up for a full-price, multiple-visit adjustment plan.[15]

Families comprising multiple generations of chiropractors run many chiropractic schools. School enrollment is down about 36% since the mid-1990s and has remained flat since 2002.[16]

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