The Truth About Scoliosis

Most people develop a scoliosis during adolescents and is often referred to adolescent idiopathic (unknown origin) scoliosis. I have a theory it may develop if one side (unilateral) of the spinal muscles are relatively tight compared to the other side especially during a growth spurt, in particular the I use the analogy of tying a rope to a bamboo tree on one side, it will inevitably grow/curve to that direction. In this diagram you can see the “ropes” that are attaching to the spine.

The problem is not the scoliosis or misalignment itself but potentially the original muscle problem that set up the misalignment in the first place, for a number of people the muscles that set up the scoliosis aren’t always going to be causing any pain either, there are many factors involved. However, for those who’s muscles are causing pain once you get rid of the underlying muscle problem, imbalance, tension, the associated back pain will often subside, although the alignment of the spine won’t actually change. Once you get to adulthood the shape of the bones will tend to change shape based off wolfs law which states bones will adapt/remodel due to the mechanical pressure placed on them, this typically cannot be reversed even after months of these scam “corrective care programs” designed to realign the spine. You can take an x-ray before and after months of treatment and the only difference will be in your bank account.

It’s not a coincidence that people who supposedly get their spine “realigned” have to keep going back regularly for “realignment“.

Back pain sufferer’s may feel their pain first thing in the morning, typically they have a hot shower and then move around and the pain and tension usually eases, that’s not because your spine magically realigned itself after having a hot shower, it’s because the heat and movement stimulated blood to the muscles. Similarly, people who sit for extended periods of time may feel tension and discomfort in the postural muscles, get up and change postures and tension typically eases, this has nothing to do with your spine going back in to alignment. Similarly people who have high levels of stress may experience pain and tension due to the ‘fight or flight’ part of the nervous system and the effect on muscle tension, being relaxed or stressed doesn’t determine whether your spine is misaligned or not.

If you have been told your back pain is because of a scoliosis, misalignment or your hips are out more than likely that’s not the case. If you’re looking for an evidenced based and logical approach to back pain book online today and get an initial appointment discount.

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kieranfThe Truth About Scoliosis
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How To Avoid These Treatment Scams

Under normal circumstances most reasonable people would be hesitant to pay $80-$90 for a ten minute treatment that has them going back two to three times a week over several weeks as opposed to only needing one longer, wholistic treatment a week over the same period, you’re potentially paying double in unnecessary treatment costs by needing so many short, symptomatic and frequent 10-minute visits. So how does the chiropractor overcome this? Take unnecessary x-rays, lie and claim your pain is a result of your bones being out of alignment, having a straight neck, or arthritis and sign you up for months of treatment to correct your alignment or fix the curve in your neck. A lot of people will end up getting months of treatment and assumed it “fixed them”, however, most people’s pain may of went away in that time without any treatment and if you want to see how much your posture or alignment has improved after months of treatment, ask a colleague to take a photo of you when you’re not expecting it and you’ll probably notice not much has changed.

Fortunately there are plenty of effective, ethical and honest chiropractors who genuinely want to help you, with most people only needing 2 or 3 weekly treatments, then as needed. By reading the information below you can hopefully discern the good, from the bad by being aware of the most common scams.

Payment Upfront & “Corrective Care Plans”

X-Rays & Scare Tactics

Cookie Cutter Treatments

Subluxations, Misalignments & “Pinched Nerves”

How To Avoid Getting Scammed

X-Rays & Scare Tactics

There are decades of research showing the vast majority of findings on x-rays have nothing to do with pain and are more just age related ‘wear and tear’, you can take x-rays of people who don’t have back pain vs with back pain and they will be almost identical. Often chiropractors will take x-rays, tell their client their spine is misaligned or the curve in their neck is reduced, the x-rays are then used that as justification for needing regular and long term “corrective” care plans.

I think this is the worst out of all the scams, as it exposes the individual to unnecessary radiation, the cost to the taxpayers, through Medicare and then to the individual who then books in for months of treatment to have their spine realigned or neck curve restored. Research clearly shows, people who have routine scans done tend to suffer more pain, longer duration and become more dependent on treatment… the goal of any chiropractor routinely taking x-rays.

I have written an entire article detailing on how and why most x-rays are used as a scare tactic and how they make pain worse, you can read the article here.

Payment Upfront & “Corrective Care Plans”

If you’re needing so much treatment, its cheaper to buy them in bulk, it may be worth seeing a professional that isn’t purely motivated in getting you back for repeat visits for their own financial gain. If by the 3rd or 4th visit your still only getting symptomatic relief that’s usually a good sign to find another healthcare provider, if you’re needing months of treatment, your pain probably would of went away on its own without treatment. Also, if your paying for 10 or more visits upfront, how could they possible know how many treatments you need and why does everyone need the same amount of treatments? It’s a very dishonest, almost predarotry sales tactic.

I like to refer to these chiropractors as “whack, crack & keep em comin back” chiropractors, they usually treat for 10 minutes, doing the exact same treatment every time you go and everyone else pretty much gets the exact same treatment as you. It’s a conveyor belt approach, treat as many people as possible an hour and get them returning as often as possible, its a business model and not healthcare. I highly recommend reading my article on a wholistic approach to pain and wellness.

Subluxations, Misalignments & “Pinched Nerves”

Some chiropractors will claim that these “misalignments” or “subluxations” will put pressure on the nerves then lead to a myriad of different symptoms. There has not been a single study, nor any evidence that these “subluxations” exist. The originator of chiropractic made these claims in the 1800’s as a result of supposedly restoring someone hearing through chiropractic treatment of the mid back. The issue with that is, the nerve for the ear is located in the brain and does not extend into the spine. The idea chiropractic helps with illness or disease is as true now, as it was in the 1800’s!I can understand these claims in the 1800’s but to still have health professionals making these claims despite everything we know about biology, physiology, anatomy etc.. is absurd, ironically these are usually the same chiropractors that usually refer to themselves as “doctors”.

How To Avoid Getting Scammed

If you have any doubt or queries it’s usually best to call in advance and ask if x-rays are usually required, they may say that it depends on a case by case basis which is usually means yes. Find out how long a typical visits lasts. Make sure they adapt their treatment to your individual needs, if you haven’t in responded to two or three visits, they should be making changes to their approach and if still little improvement then seek an alternative professional, if they were ethical they would refer you on to someone else. Avoid chiropractors who use terms like misalignments, subluxations or pinched nerve, their understanding of the spine, nervous system and pain is rudimentary at best.

Tired of living with neck and shoulder pain? Click here to see how I can help.

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kieranfHow To Avoid These Treatment Scams
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Why X-rays Are So Damaging.

There has been over a decades worth of scientific research showing x-ray findings of people with back pain versus people without back pain are almost identical.

From my experience it always seems to be the same chiropractors who routinely x-ray their clients despite research showing they potentially do more harm than good, expose people to unnecessary radiation and additional costs to the individual and/or taxpayers, they tend to be chiropractors who only treat for 10 minutes and get symptomatic relief. Under normal circumstances most people wouldn’t pay $80-$90 for a treatment that gets similar results to taking over-the-counter pain medication, they are often told their spine is “broken”, misaligned, degenerated, their neck curve is too flat, etc… and it’s normal to need multiple visits a week or regular ongoing treatment and lifelong “maintenance care” to prevent more “damage” from occurring. This is despite none of these things being related to most people’s pain, their are just as many without pain that would have these findings and most people only need 2-4 weekly visits with a wholistic approach and as needed after that, which can be reduced by keeping active, self-treatment techniques, managing stress levels, getting enough sleep, etc…

X-ray findings between people with back pain and without back pain are almost identical, they do not improve outcomes and do more harm than good!

Researchers found no evidence that the use of routine x-rays to assess the function or structure of the spine, improves clinical outcomes and benefits patients.

Researchers in another study concluded; in most cases the potential benefits from routine imaging, including spinal X-rays, do not outweigh the potential harms. The use of spinal X-rays should not be routinely performed in chiropractic practice. (Jenkins 2018)

Another study found routine imaging does not seem to improve clinical outcomes and exposes patients to unnecessary harms & the overuse of imaging also contributes to the high and growing costs associated with low back pain (Chou 2011).

A study published in American Journal of Neuroradiology found many imaging-based degenerative features (arthritis/misalignments) are likely part of normal aging and unassociated with pain. (Brinjiki 2018)

A 2019 study: Imaging in LBP may be associated with higher medical costs, increased healthcare utilization and more absence from work”. (Lemmers 2019)

Another study published in the British Medical Journal found “Imaging may do more harm than good when serious conditions are not suspected and is likely to prolong recovery in patients with non-specific low back pain”. (Hall 2021)

There are dozens of research done over two decades that all have similar findings.

Malice or Incompetency?

I know its its not always possible to attribute malice to which incompetency or ignorance can explain, but the same chiropractors who routinely x-ray their clients are usually the same chiropractors who treat for 10 minutes, do no muscle or rehab work and see their clients multiple times a week and regularly for months on end. It’s one thing to x-ray someone to look for “misalignments” but it’s another thing to use those x-rays to create fear and dependency on treatment and to justify charging someone for months of treatment that would would normally be resolved in only a handful of sessions with a wholistic and evidenced based approach.


W. Brinjikji,a P.H. Luetmer,a B. Comstock,b,c B.W. Bresnahan,c L.E. Chen,c R.A. Deyo,f S. Halabi,g J.A. Turner,d A.L. Avins,h,i K. James,c J.T. Wald,a D.F. Kallmes,a and J.G. Jarvikc,e Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

Roger Chou, Amir Qaseem, Douglas K Owens, Paul Shekelle, Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians Ann Intern Med  2011 Feb 1;154(3):181-9.

Amanda M Hall, Kris Aubrey-Bassler, Bradley Thorne, Chris G Maher. Do not routinely offer imaging for uncomplicated low back pain BMJ 2021 Feb 12;372:n291

Hazel J Jenkins , Aron S Downie, Craig S Moore , Simon D French  Current evidence for spinal X-ray use in the chiropractic profession: a narrative review Chiropr Man Therap 2018 Nov.

G P G Lemmers, W van Lankveld, G P Westert, P J Van der Wees, J B Staal. Imaging versus no imaging for low back pain: a systematic review, measuring costs, healthcare utilization and absence from work. Eur Spine J. 2019 May;28(5):937-950.

kieranfWhy X-rays Are So Damaging.
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Work From Home Survival Guide

With our daily and work lives changing so rapidly and more people working from home, I’m sure many of you have experienced an increase in work related pain and discomfort, fortunately by implementing some healthy spinal habits throughout the day and without needing expensive or specialised ergonomic chairs this can be avoided. The main culprit is not moving or static postures, if you were to sit for an extended period of time with perfect posture you are still likely to feel pain, likewise if you were to stand all day and limit movement, it would also lead to pain and discomfort.

The best antidote to pain is movement.

With the nature of working from home, incidental movement such as walking to and from the home/office, public transport, between meetings and appointments, access to gyms/exercises classes have all been limited, it’s becoming more imperative now than ever people create an artificial demand for movement in our lives. A good way to make use of the time saved on commuting to work can be used to go for a brisk 30-45 minute walk or jog prior to settling into the home office.

Everyone has a different stress capacity or tolerance when it comes to sitting, for some it can be as little as 30-60 minutes for others it could longer, a relaxed muscle with good blood and oxygen supply will have a higher capacity, if a muscle is tense, it gets fatigued much quicker, lactic acid develops and tension & discomfort usually follows. Similar to holding a tight fist, it doesn’t take too long before tension and discomfort is felt in the hand and forearm muscles, compared to a relaxed hand.

Make a note how long you sit for before the muscles feel tense and uncomfortable and try to get roughly 5-10 minutes of exercise just prior to the onset of pain; things such as air squats, hip and shoulder rotations, push ups, body weight lunges can all be used to great effect, do these at regular intervals as needed throughout the day.

Try have a couple of alternate setups, it could be as simple as changing from an office chair to an excise ball, or a couch and using that for 15 minutes to shift certain stress points to other locations on the body & spine. For the vast majority of people these will be more effective than just “sitting up straight”.

When I am treating someone with back pain, specifically associated with not moving (sitting) I make sure to release the main affected postural muscles. For low back pain; the hamstrings, glute and spinal muscles, for mid/upper back and neck pain; spinal, shoulder and arm muscles, combined with the advice described above, and self treatment techniques to effectively target and release to problem muscles for fast results.

kieranfWork From Home Survival Guide
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When to Worry About Back Pain.

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The bark of most back pain is worse than the bite, even when the pain levels are quite bad or even debilitating its usually nothing serious. Although for small percent of back pain suffers will have an underlying pathology or medical issue which is less than 3%. Without trying to oversimplify things most back pain felt stem from the soft tissues namely the muscles, although these are very often overlooked as a major contributor.

Things like MRI’s & x-rays a notoriously bad at diagnosing back pain when it comes bulging discs, arthritis, “alignment” etc… which were all previously associated with back pain in the past and often misleading. However, when I am treating someone for the first time or even over an extended period of time I always have in the back of mind and on the look out for anything that may indicate a more serious cause of their pain, such as autoimmune diseases particularly rheumatoid arthritis or other autoimmune arthritis, cancer, infections, fractures and several other culprits which may be a more serious cause of back pain.

This article is just to give you a very brief background in how to discern the difference between common musculoskeletal back pain and a more serious cause of your back pain. If you have any concerns its always best to see you GP or health practitioner such as a chiropractor or physiotherapist for a detailed assessment. It’s worth mentioning even more serious causes of back pain may not be painful and may fly under the radar at least at the beginning but usually becomes more apparent as time goes on. The level or intensity of pain overall is not a good indicator, but the type of pain and when it is or isn’t felt is often noteworthy. On the flip side you can have extreme back pain and it may be nothing more than a muscle spasm, I usually explain it to my patients it’s similar to having a calf cramp which is very painful but the cramp involves the muscles around your spine and can’t just be stretched out like a normal cramp.

Two symptoms or situations that require urgent medical attention is numbness around groin and buttocks with or without loss of bowel/bladder control. Or when you have experienced force from a fall or accident sufficient to cause a fracture, this may be falling of a ladder (even a low one), off a bike etc… even if pain levels are that high.

Three signs that need to be investigated further but not considered medical emergencies like the two example above.

  1. You have felt back pain for more than 6 weeks.
  2. If the pain has stayed the same or actually gotten worse.

(Both if these are even more important if you have been getting treatment.)

  • There is at least one coinciding “red flag from the list below”.

List of “ red flags” which are signs and symptoms of a more serious cause of back pain.

History of corticoid steroid use (especially important for fracture(s)

General signs of illness such as fever, chills

Unexplained weight loss

Family history of autoimmune disease, gradual but progressive increase of pain particularly before the age of 40 and unresponsive to treatment, significant low back stiffness in the morning, rashes etc..

“sciatic” like symptoms pain and needles and numbness in both legs, less of a concern if located in one leg.

Current or previous history of cancer.

So if you are experiencing back pain and you fit the description for potential serious cause of back pain it may be a good idea to book in to see your GP.

kieranfWhen to Worry About Back Pain.
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Do You Suffer From Morning Back Pain?

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Back pain and stiffness in the morning is a common complaint I see in my practice, most people will state they wake up with pain and stiffness, get moving and have a hot shower then it will subside and then by the end of the day the pain and stiffness will return, it may also be the case it specifically is only felt for the first 30-60 minutes then completely fine for the rest of the day until the next morning. There are two main reasons why back pain first thing in the morning occurs, a more serious but less common cause and a less serious but much more common cause.

Serious But Less Common Cause

Inflammatory back pain (IBP) which is usually a result of auto-immune arthritis (not to be confused with osteo-arthritis) such as rheumatoid arthritis can include symptom of morning back pain and stiffness. This type of pain will usually wake the person up rather than feeling pain and stiffness once you are up and moving. The reason why pain is felt in the morning is not very clear but may have something to do with the body’s natural inflammatory circadian rhythm.

Other indications of IBP include more widespread pain in other joints such as hands, wrist feet, a family history of auto-immune arthritis, a recent infection and respond well to anti-inflammatories. Imaging such as x-rays, MRI and blood tests are required to confirm.

Not Serious but Much More Common

Myofascial or muscle pain is by far the most common reason for morning back pain and stiffness. It is usually a result of deep tightness and trigger points that run a good portion of the lower and lower mid back namely the erector spinae muscles. Typically the is no pain until you actually get up and start moving and putting on your shoe’s and socks can be a chore and it usually settles down fairly quickly, especially after having a hot shower as this increases blood circulation which allows the muscles to relax. Typically the trigger points are still there so as the muscles are being used throughout the day they can fatigue and tire quicker and the stiffness and tension will return later in the day.

I have treated hundreds of these over the years and assuming it hasn’t become too chronic or the muscles are not too deconditioned it is a very easy fix and usually only takes a couple of sessions. As the trigger points can be quite deep in the muscles a strong, deep tissue massage to the erector spinae muscles is what is usually required. Also doing self treatment/trigger point release using a tennis or lacrosse ball will greatly speed up the process and make sure it doesn’t come back anytime soon.

kieranfDo You Suffer From Morning Back Pain?
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Your Best Chiropractor in Sydney CBD – Why I Don’t Do Ten Minute Treatments

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Patients who have experienced this sort of 10-minute treatment before they come to me frequently state that they got the impression the practitioner was focused more on treating them quickly and having them come back frequently,often requiring treatment several times a week (which is absolutely not needed) or experienced little in the way of relief even though they’ve had 3 treatments.

Its highly unlikely to be able to provide quick & fast relief of chronic pain in just 10 minutes and not possible to correct posture without addressing the muscles as its the muscles which are responsible for holding the skeleton in an upright position and not the other way around. In fact, in my opinion the idea of fixing posture it is often used as marketing ploy to justify charging up to $70 and leaving people more willing to pay for such a short amount of time. 

Being a chiropractor myself, its sad to say that there seems to be a particular problem with other chiropractors putting profits before patients; it’s deeply frustrating to read research demonstrating that chiropractors on average see patients 4.5 times more often than an osteopath and 2.5 times more than physiotherapists. This research was undertaken in Australia, by chiropractors themselves, employing health fund data.

I believe that chiropractic treatment is the most effective when properly employed. However, 10-minute sessions, inevitably offering the same treatment independent of what the patient actually needs, treating six patients per hour and possibly more than 50 each day and geared towards the greatest profit.

kieranfYour Best Chiropractor in Sydney CBD – Why I Don’t Do Ten Minute Treatments
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Weak Core, Pilates and Back Pain.

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There is usually not a week goes by where I am seeing a back pain client for the first time and they tell me they think their pain is because of a “weak core”. The fact is, the whole concept of a weak core and its relationship to back pain is dubious to say the least. It mainly stems from research done in the 1990’s by Australian physiotherapists which showed a delayed onset to the firing of the core muscles namely the transverse abdominus (Tra) in people with low back pain. This has spawned a massive industry of mainly physiotherapists, Pilates instructors, personal trainers telling their clients to brace their core by, “pulling the belly button towards the spine”, or “sucking the stomach in”, in an attempt to prevent or relieve back pain.

The idea of the core being a corset of muscles that stabalise the spine is anatomically incorrect, as the body is integrated with a 3D movement system that involves a large variety of muscles and connective tissue that span many parts of the body to control movement of the spine. The biggest issue with the idea of bracing or tensing the spine is the vast majority of people I treat already have quite tense/overworked back muscles, stiff spines, poor movement patterns and heightened fear avoidance behaviors I’m not sure what the goal of bracing the spine actually is. Stuart McGill a Canadian world leader in spinal biomechanics research say’s pulling the stomach in/hollowing may actually weaken the spine.

Another thing to note is most people feel back pain and stiffness first thing in the morning or when sitting for extended periods of time. There is no reason why a weak core would cause back pain under these circumstances as there is very little force on the spine, whether a core is strong or weak is not an issue. Also sitting while bracing your core would feel extremely unnatural and potentially aggravate the problem.

More than likely the delayed onset of firing of the core muscles found in the research the original research has more to do with the response of pain as a neurological coping mechanism to avoid low back pain rather than the other way around. Pilates is probably the biggest proponent of bracing the core or sucking in the stomach with instructors and physiotherapist a like charging exorbitant fee’s for classes when in fact you would more likely benefit just as much if not more from general exercise such as resistance training, swimming, yoga etc… With a recent systematic review finding; There is low- to moderate-quality evidence that Pilates is more effective than minimal intervention with most of the effect sizes being considered medium. However, there is no conclusive evidence that Pilates is superior to other forms of exercises. When you consider you can do other forms of exercise for free or comparably at very low costs with similar if not better results for lower back pain, pilates or doing endless plank exercises may not be the best choice.

kieranfWeak Core, Pilates and Back Pain.
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Is Cracking Your Own Neck Bad?

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This is something I get asked quite often, and generally speaking cracking your own neck is likely not causing any damage to the joints or the surrounding muscles. However; the issue is you shouldn’t actually feel pain or tension resulting in the urge to regularly twist, rotate and stretch your neck and get the associated audible popping or cracking sound for relief.

A result of the joint cracking is a signal being sent to the spinal cord where pain is processed and inhibits pain there. However, its usually the muscles which are tight, this restricts blood flow causing lactic acid to develop, which then stimulates the free nerve endings in the muscles (pain fibers outside of spinal cord). The joint cracking produces a sudden but usually short term pain relief at level of spine where it is processed but not originating from, the originating pain from the muscles overrides it and the urge to crack returns as pain is continuously been sent from the muscles, it becomes a painful and frustrating cycle of cracking, short term relief, cracking etc…. The neck pain suffer’s who feel the urge to regularly crack their own neck will greatly relate to this cycle.

The type of tightness is usually a result of long term stress and long term restriction in blood supply. There is what I can only describe by feel as gristle that develops in the tissues and by physically reducing the gristle with techniques I have refined over the years working at specific directions across the ‘grain’ of the muscle fibers (see diagram above) and returning proper blood supply not only does the feeling of needing to crack their own neck but also neck pain in general and associated headaches can be relieved quite quickly despite it being a chronic condition and that many other therapies have been able to provide relief for. I have also developed a technique or “homework” so pain suffer’s can effectively treat their own muscles.

kieranfIs Cracking Your Own Neck Bad?
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Migraine Treatment (Part 2)

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In this article I will go through 2 groups of commonly used medications, however; its important you see a medical practitioner such as a GP for specific information for your individual needs. When used correctly under the proper supervision prescribed medications can be effective in preventing , lessening the severity and/or reducing the frequency of migraines. I will also go in to detail of non medication alternatives. It may be necessary a holistic approach that combines different treatments may be more effective than either one on its own.

Acute Medications

As I mentioned in my previous article, there are several phases of migraines which include the predome phase which includes symptoms prior to the attack such as Fatigue, light sensitivity, neck tension and stiffness, irritability, yawning, food cravings, difficulty sleeping, feeling unsettled etc… It is usually recommended not to take this group of medications during the predome phase but to wait until the attack to occur. The reason for this is because if used too frequently and/or in combination with other pain relief medication can lead to medication overuse migraines. It’s important it is only reserved for when absolutely necessary and other non medication options have failed to prevent the attack.

Preventative Medications

There are several types of preventative medications on the market and are the latest medications to be developed. They work by blocking receptors in the area’s of the brain which chemicals attach to that cause a migraine. They are generally taken once a month and by injection. It is usually only prescribed if you have 15 headache days a month, 8 of which are migraines and the migraine suffer have failed 3 other types of medications to prevent a migraine. They typically do not cause medication overuse migraines and tend to increase effectiveness the longer the sufferer is using them.

Non Medication treatments

It’s important to look at 2 or 3 days prior to the commencement of the symptoms to see if there are any commonalities that may not be so obvious, a migraine diary may be very useful in that regard. Not only recording the intensity/length/frequency/location of the migraine but mood/stress levels, sleep patterns, foods/drinks consumed, for females noting time of menstrual cycle, weather, medications.

In my experience stress is one of the most common triggers that cause a migraine, it could be worth while making a list of things that cause undue stress and tension and work out a plan to reduce those, counselling or psychotherapies may help, yoga, regular exercise, meditation or simply increasing your leisure time and doing things that you enjoy.

I have found treating the muscles generally of upper back, neck, shoulder, scalp and temple usually provide the best results and more specifically the levator scapula which attaches to the shoulder blade and the vertebra of the upper neck as well as the sub-occipitals which are small muscles that connect the neck to the skull are the biggest culprits when it comes to neck and muscle tension as a triggering factor for migraines. It is usually best to get treatment prior to the attack.

kieranfMigraine Treatment (Part 2)
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