I’m sure many of you reading this suffer from neck pain, tension and associated headaches and like many of my clients assume it must be because of your slouched posture. There are many uninformed health providers such as chiropractors & physiotherapists who routinely tell their clients their neck/back pain is from poor posture. There are probably millions of dollars wasted every year on pain sufferers getting treatment to “fix” their posture. Unfortunately, its not that simple, people’s spines come in all different shapes and sizes, so there is no single “good” posture and there is no evidence of an ideal posture preventing pain. If there was, it would be a matter of sitting up straight. In fact, for certain people, sitting with a more upright and tense posture can exacerbate neck/back pain.

As a general recommendation, your next posture is your best posture, rather than focusing on sitting with good posture, instead focus on getting more movement and a variety of postures throughout the day. There was a study that looked at approx. 44,000 female office workers and measured the amount of sitting time and impact on health & back/neck pain. The authors concluded, compared to sitting all the time at work, sitting ≤75% of the time showed significantly lower risks for poor general health, and sitting between 25 and 75% of the time showed significantly lower risks for often reported back/neck pain.

I liken it to making a closed fist, over time your hand & forearm muscles will get tense, tired and achy, you would naturally want to relax and shake your hand and forearm muscles. Just like you wouldn’t tense your hand & forearm muscles, you shouldn’t force yourself into a more upright & tense posture.

Another study found females in their late adolescence who sat in slumped thorax/forward head or intermediate posture rather than upright sitting posture had a lower risk of persistent neck pain as a young adult. This study group which looked at females at 17 and 21 is quite specific, but it’s still an interesting finding nonetheless. The authors also concluded. the practice of generic public health messages to sit up straight to prevent neck pain needs rethinking.

I hope this gave you a new perspective on sitting, neck pain and movement, and how you can implement some evidence based strategies to help manage your own neck pain. There are potentially many more important factors when dealing with pain it’s important to take a more wholistic view when it comes to pain in general, you can find out more by reading this article.

References.

https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732

Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees. https://pubmed.ncbi.nlm.nih.gov/33957889/

Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. https://pubmed.ncbi.nlm.nih.gov/33444448/

I like to use a bucket and water analogy when describing pain in the body. As water is being poured into the bucket and the capacity of the bucket is reached, water will overflow and spill over the sides. Similar to the body, there may be several different physical, lifestyle & emotional stressors (see diagram) and once the body reaches past its tolerance to handle stress, pain may result. If you’re getting treatment, for example, a 10 minute chiropractor, who is isolating the treatment to the joints of the spine through adjustments, and not addressing all the other potential causes of pain (physical, lifestyle, emotional), how much water can they empty out of the bucket? Many find themselves in a position of having to return regularly, sometimes up to, two or three times a week for months! this is similar, if not worse than taking over the counter pain medication.

Body

I highly recommend watching this amazing video that shows you just how interconnected and intricate the spine, muscles, fascia, tendons and ligaments are.

As well as being a chiropractor, I am also a massage therapist with over 20 years experience, even with tens of thousands hours experience, I still need a good 30-45 minute treatment to create change to the muscles & fascia, this is mainly due to just how tense, tight, and “grisly” they get. Seeing a chiropractor for 10 minutes who mainly focuses on adjusting the spinal joints tends to have minimal effect on the muscles and fascia. All it takes is one or two stressful days sitting at the computer, as the chronic, underlying tension returns and you’re back at the chiropractor paying for the exact same treatment that barely got relief 3 days before.

Getting regular exercise and consistently getting quality sleep can’t be underestimated when dealing with the overall picture of pain and tension. Aerobic exercise — the kind that gets your heart and lungs working, like brisk walking — is an important way to fight chronic inflammation. It helps reduce body fat, which contains inflammation-promoting substances. Exercise may also increase the production of hormones that help keep inflammation in check, and hormones that directly reduce pain. Individuals with sleep disturbance and poor quality sleep often report greater severity of pain and for longer durations. The exact mechanism is not fully understood but it is believed to be similar to exercise through promoting anti-inflammatory and surprising pro-inflammatory hormonal responses.

Emotions & Perception.

From my experience emotional stress is one of the biggest factors when it comes to pain, in particular, neck, shoulders & upper back pain as well as headaches. With chronic and long term stress certain hormones are released that may have a major impact on pain levels & inflammation in the body. On a more day-to-day basis, the fight or flight part of your nervous system is activated which has a direct impact on muscle tension or area’s that were already tense become much more sensitive to pain.

People who perceive their pain as a result of damage or a structural issue such as misalignments, reduced curve in neck, degeneration/arthritis tend experience more pain and for a longer duration. Despite most research showing these are not particularly related to pain and more related to the normal aging process, no different to grey hair and wrinkles. This perception can have a dramatic effect on how we experience pain, it may increase the duration of pain, dependency on treatment and decrease in self- reliance, unfortunately there are some chiropractors will use x-rays to take advantage of this. I also think for some, it provides the treatment with more legitimacy and feel they are getting more value out of the treatment, such as having their spine being re-aligned, posture corrected or neck curve restored despite more than likely not being related to pain and no amount of treatment can reverse the normal aging process of the spine.

Unfortunately, there is a great misunderstanding by most health professionals when it comes to chronic back pain with most still operating under the very outdated belief that pain is due to hips being out, disc degeneration, tight hip flexors, a weak core, etc… In my opinion, this is why when large, high-quality studies are done looking at these treatments compared to placebo or no treatment the effects on chronic low back pain are moderate & short-term. Recently I did a seminar on a physiotherapy-led approach called cognitive functional therapy, which looks at the interplay between pain, how it affects function and the role of how we perceive and think about pain has on outcomes, pain can be complex especially if it has become chronic/persistent (over 3 months) and is affecting daily activities, exercise, sleep, mood levels, etc…

You can listen to a 10-minute interview on ABC radio with Professor Peter O’Sullivan about cognitive functional therapy and the results they got when they did a large study comparing to standard care i.e., chiro, physio, massage, etc… with this new approach. Although this study looked at chronic back pain with an average of 4 years duration, it can also be helpful with back pain of different duration and can potentially help people avoid chronic back pain in the first place! https://www.abc.net.au/radionational/programs/breakfast/new-treatment-offers-hope-for-people-with-chronic-back-pain/102294734

Pain equals damage.

Most people with back pain develop it over time, and there is no one particular incident or event that leads to experiencing back pain. Due to day-to-activates the spine particularly the muscles and joints may get painful and sensitive. Pain may be exacerbated by stress, tension, poor sleep, obesity, lack of exercise, fear-avoidant behaviors which may prolong recovery. If pain was simply due to tissue damage, just like spraining an ankle or a cut on the skin the body will heal itself.

Alignment does not equal back pain.

There is not a day that goes by I treat someone with neck pain and have no history of back pain despite having a pelvic misalignment, short leg, scoliosis, pelvic tilt, etc… There are just as many people with “misalignments” without backpain than those with misalignments and backpain. There’s a reason why people who get treatment for “alignment” often get short-term results and constantly need to go back for “realignment”. In fact many high volume business models in chiropractic will use alignment as a marketing tool, its much more financially beneficial to treat someone for 10 minutes, potentially seeing up to 6 people an hour and see them multiple times a week and regularly for months to “realign” them, I call these chiropractors “whack, crack & keep em comin back chiropractors”. It’s a business model and not healthcare.

It’s also worth noting the cracking sound is gas being released from the fluid within your joints, it has nothing to do with bones going back into place. I’m not sure how many pain sufferers would be willing to pay $80-$90 for a 10 minute treatment if it wasn’t to supposedly have their spine realigned, neck curve restored, hips put back in.

Low back pain is rarely serious

Less than 5% of people who have back pain are due to a serious or medical condition such as cancer, trauma, infection, autoimmune/inflammatory arthritis, etc… Having said that it’s still important to screen for such things as part of a routine back pain assessment done by your chiropractor or physiotherapist.

Your back pain is due to “old age”.

Research shows back pain peaks in the age group 45-50 years and then declines thereafter as shown in this graph. Interestingly you can also see the prevalence of back pain has only increased from 1990-2015, clearly how we view back pain and treat it as health providers leaves a lot to be desired.

Pain on movement means you’re damaging your spine.

It’s normal to feel pain on movement when you first experience back pain, this typically comes from the muscles in and around your spine either guarding and trying to protect the area. It’s a normal process and doesn’t represent damage, your muscles and nervous system are generally more sensitive to movement, and the quicker you can get out of pain with good treatment on the spasmed and guarding muscles and reintegrating movement with exercise and graded exposure to painful movement the faster the recovery will likely be.

Scans & X-rays rarely show the cause of back pain.

I have written an article on this particular topic, you can read it here. Not only are scans notoriously bad at diagnosing most back pain, but they actually cause people to become dependent on passive and ineffective therapy and can actually make pain worse!

Posture is not related to low back pain.

Although we may feel pain when sitting, standing, and bending these are rarely the cause of back pain. Rather than focusing on posture, focus on getting a variety of movements and changes in postures throughout the day, if you were to sit with “good posture” all day this is unlikely to change the levels of pain you experience, in fact, it may make it worse as you are tensing the spinal muscles to maintain an upright and rigid posture. Also, avoid treatments that over empathise posture, just like alignment these therapies tend to get very short term results with chronic pain.

A weak core does not cause back pain

Research shows the exercise you do is not that important, getting regular exercise is important as opposed to just strengthening the core, some people will brace and hold their core muscles when it’s usually best to relax the muscles and spine. It’s worth mentioning most people get their back pain when sitting, first thing in the morning, when stressed, tying shoe laces, mundane activities etc… despite these activities having minimal to no core requirements.

You need long term/extensive treatment for back pain.

As you can see, most back pain is not dangerous or a result of your spine being “broken”, you do not need extensive or long-term therapy, and the only people who benefit are the ones who are financially invested in getting you back repeat visits and lifelong treatment. Unfortunately there are greedy and unethical providers who will create more fear and anxiety around your pain to get you dependent on their extensive treatments.

Pain flare up do not equal more damage.

Although pain flare-ups or acute pain can be very painful and distressing it is not a good indication of damage, the bark is almost always more than the bite when it comes to acute back pain. The majority of the time it is an intense spasm of the spinal muscles. Just like having a calf cramp/spasm can be extremely painful it is usually innocuous and self-limiting.

The first thing to remember about posture, for most people it’s only one piece of the puzzle. There are plenty of people with relatively “good” posture and in significant pain, while others with “bad” posture experience very little pain. Pain, especially chronic pain is very complex, costing billions of dollars every year to the Australian economy, if it was a matter of sitting up straight the problem would be easily fixed.

If most people were to base the success of a treatment on pain relief, most wouldn’t keep going back multiple times a week or regularly for months, most end up returning on under the guise of having their posture corrected or spine realigned, they assume it’s normal to only get symptomatic relief because they’re so “broken” not because the inefficiency of the chiropractor. Also, the idea of fixing posture or realigning the spine drives passive treatment, so you have to keep going back to maintain your “posture”, “alignment” so it doesn’t get any worse, you essentially become dependent on expensive therapy, which is great from a financial point of view for the chiropractor but you the pain sufferer end up paying for treatment that offers nothing more than the placebo effect.

The Power Of Placebo.

There are many spending hundreds if not thousands of dollars on treatment that offer nothing more than the placebo effect! Any chiropractor claiming to fix posture in a 10-15 minute treatment and without addressing the underlying muscle imbalances offer nothing more than placebo, they would much rather have you believe they’re fixing posture, than actually spend the 30-60 minute’s required treating the underlying muscle imbalances. Similar to misalignments/scoliosis, you can get months of “corrective treatment”, take an x-ray and bingo! nothing has changed… besides your bank account. It’s worth noting alignment is usually determined by bone shape due to age related wear and tear, so a chiropractor claiming to fix alignment/scoliosis is essentially claiming to regenerate and remodel your bone so your vertebra go from wedged shape (normal age related wear & tear) to perfectly square. Hallelujah, it’s a miracle!!!

A Muscle Problem.

The video below demonstrates a typical muscle imbalance that causes rounded shoulders and forward neck posture. Me personably, I treat the muscles within a wholistic context and rarely focus just on posture.

Chiropractic is great at treating the spinal joints and pain, however, the “cracking” sound is gas bubbles being released from the joints, it has nothing to do with bones being re-aligned or put back into place or fixing posture. Any chiropractor telling you otherwise is misleading you, as there is no scientific evidence suggesting that releasing the facet joints of the spine corrects long term muscle imbalances and posture, assuming it’s a problem in the first place!

Treat The Person, Not The Posture.

If you are in chronic & long term pain, waive a wand and give you “perfect posture”, but keep the chronic muscle tension in around the shoulders & neck, sit all day, stressed, poor sleep patterns, poor nutrition and lack exercise, how much is your pain going to change and for how long? So even if you are getting treatment that supposedly fixes your posture, make sure they’re treating you wholistically and your pain levels should be well under control within 2-5 weekly sessions, if your needing multiple visits a week and regular treatment for months those results are similar to over the counter medication.

Don’t Let a Few Bad Apples Ruin The Cart.

Not all chiropractors are deceitful, most aren’t, but unfortunately, there are enough out there making claims that go against basic principles on what we know about the human body, posture, pain and movement. It’s always best to seek treatment from a provider who is evidenced based, who treats you as a person, not as posture/alignment, does not use x-rays which decades of research show are useless for the vast majority of people and who treats you with the intent of resolving your pain rather than getting you back for multiple visits a week or long term “correction plans” for their own financial gain.

Ok, I know this title may seem like I’m calling to an end to these two fine professions, but the point I am trying to make is there actually shouldn’t be two separate professions or at least pain sufferers shouldn’t have to choose on or the other. Chiropractors typically adjust the spine, specifically the joints while physiotherapists tend to do mostly massage. I have lost count of how many people I have treated over the years who had months of treatment and spent a small fortune on either a typical chiro or physio and I was able to resolve their pain by combining the treatments in only a few sessions.

There is little point of getting your spine adjusted without getting the muscles that attach to it treated or releasing the muscles without releasing and restoring proper pain free movement of the spinal joints which may have been locked up for months There is a good reason why most people only got short term and symptomatic relief from standard chiro and/or physio! Most people cant afford to pay $85+ for a chiropractic adjustment and then $100+ for a physiotherapist, as there are two sperate professionals often times the treatments you get aren’t congruent with each other i.e treating different muscles to where the spine is being adjusted.

The spine and muscle paradox.

Although the spine and muscles are intimately related, however, what they respond to are polar opposites. The spinal joints (where two vertebra meet) respond to a short, sharp and quick adjustment usually effecting 1-2 segments. Where as the muscles respond to a very slow, sustained pressure, there could be 8-10 different muscles that need to be addressed that span over many segments and different body parts. As well as being a chiropractor I have over 10’000 hours experience treating the muscles and I can assure you treating one rarely resolve’s the other. If you have had chiropractic before and found it to be symptomatic and you always left wishing they would spend time really releasing and lengthening your muscles or you have been to a physio and always felt the treatment was too general that’s because neither of them are treating you holistically.

If all you have is a hammer, everything is a nail.

The treatment you end up getting is not the treatment that is best suited for your individual needs, rather whatever the person is trained in. Chiropractors adjust so everything needs to be adjusted, physiotherapist treat muscles so everything needs to be released, stretched, activated. They rarely step outside of their respective lanes, unfortunately its you the pain sufferer that ends up paying for generic treatment that is ineffective.

Fortunately at Sydney Chiropractic & Massage you get the best of both worlds, a comprehensive and unique massage and muscle manipulation refined over 15 years designed to make the adjustments as effective, comfortable and long lasting as possible so you don’t have to choose one or the other or pay the unnecessary expense of seeing two professionals for the same issue. book in to see Kieran today.

Kieran has treated thousands of achy, stiff, tense neck and shoulders and associated headaches over the years and often gets quick results. It’s not uncommon for Kieran to see someone who has seen several other health professionals with minimal results and only after a few treatments with Kieran finally got the relief they needed. The number one reason why most people don’t respond to most treatments is because the postural muscles haven’t been released. A 10 minute chiropractic treatment may provide relief in the short term but the postural muscles that attach to spine inevitably tighten again and you have to go back for months on end.

I cannot over emphasise the role of the muscles when it comes to chronic neck and shoulder pain and headaches. Have a look at the ‘shopping list’ of muscles below and notice how the muscles are attaching directly onto the spine. These muscles get tight and restrict movement and compress the sensitive spinal joints. This is why Kieran always does a comprehensive muscle and massage treatment prior to chiropractic, adjustments are only as effective as the muscle work done prior.

A good way to test this yourself is to run you fingers across the muscles on either side of your neck, do they feel “gristly” and “crunchy” as your fingers flick over the tense muscles like a guitar string. What about the the muscles on top of your shoulders, do they feel soft and relaxed or like concrete? Is there a big knot or lump on top of your shoulder blade? Roll your shoulder back and down and forward in a circular motion, can you hear the tight muscles as they flick over your shoulder blades?

Also be wary of so called “posture experts” who don’t treat the postural muscles. In my experience professionals who treat posture use it more as a marketing tool similar to getting “realigned”, people are more likely to pay $80-$100 for a 10 minute treatment under the guise of having their posture corrected. Most “posture experts” couldn’t tell you what muscles cause poor posture yet alone how to treat them, it takes a lot more than 10 minutes.

Click on the image to get more detail on specific muscles, take note on where they attach onto the spine, how they are aggravated, common associated pain patterns and headaches and effect on forward head posture (FHP). The body compensates by distributing tension across many postural/spinal muscles, It would rather be generally tight everywhere rather than extremely tight in isolation. You’ll have a greater understanding on your own muscle anatomy and how it relates to your pain than most chiropractors, physiotherapist, GP’s etc…

Pec minor and front deltoid. (Muscle that causes forward shoulder posture)

If you’re looking for an effective treatment for neck and shoulder pain book online and claim your initial appointment offer today.

Where low back pain is typically felt

Causes Of Low Back Pain

“Shopping List” of Important Back Pain Muscles.

Success Stories

Low back pain is typically described as tension, stiffness, an ache etc… Most people can’t attribute their back pain to one specific incident but rather a general and accumulating sense of discomfort and tension, that comes and goes over years and then may begin to experience it on a more consistent and day-to-day basis, many back pain sufferers will often put it down to just “getting old”. On occasion their might be a sudden and extremely painful episode where the person is unable to move or function without significant pain, this can be a result of a mundane movement such as picking something light off the floor, coughing, house work, an exercise at the gym etc…

Where Low back Pain Is typically Located

Do you feel your pain similar to any of these images? Pain is often felt around the joints of the lower spine. There are several key postural muscles that attach directly on to the spine and may compress and aggravate the sensitive spinal joints and why chiropractors who don’t treat the muscles typically only produce short term relief. Click on image(s) below to get more detail on location of pain.

Causes & Aggravating Factors

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. Similarly, people who sit for extended periods of time may feel tension and discomfort in the postural muscles of the spine, once they get up and change postures the pain and tension will usually subside for the short term. Certain exercises, especially weighted ones may also aggravate back pain, sitting on soft/unsupportive couches or seats where the hips are lower than the knees such as driving, or they do something their not accustom to such as extra walking while on holiday, gardening, moving house etc…

“Shopping List” of Important Back Pain Muscles.

There are usually several key postural muscles associated with back pain, once chronic the body will distribute the tension to the muscles of the hips, low back and may aggravate the spine. This is why Kieran always performs extensive muscle and massage therapy prior to chiropractic. The adjustments are only as effective as the muscle work before it.

Success Stories

These are just a fraction of reviews taken from over 180, Sydney Chiropractic & Massage and previous location in Waterloo (closed down). There was no need for x-rays, scare tactics or corrective care plans (scams). Just a comprehensive hands on muscle and spine approach, evidence based and wholistic. Click to see reviews.

If you’re looking for effective treatment for low back and hip pain book online and claim your initial appointment offer today.

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.

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

Is low back pain preventing you from enjoying life? There is an answer, click here to find out more.

Click to book online and save $20 off your initial appointment.

Most people would be hesitant to pay $80-$90 for a 10 minute treatment that has you going back multiple times a week and regularly for months, you could take over the counter pain medication and get similar results at a fraction of the cost. The chiropractor may have to lie, deceive and scam their clients just so they commit to months of treatment that can usually be resolved in 2-3 weeks with the appropriate care.  Chiropractic adjustments are great for treating joint pain and dysfunction, but like all treatments it has it’s limits! The cracking sound is the joints being released, this is not your bones going back into place, it does not help your neck curve/rounded shoulders (which are muscle imbalances) or take pressure off nerves. Deceiving people for financial gain is bad enough, especially with the cost of living but to take advantage of people who are in pain only makes it worse.

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.

Cookie Cutter Treatments

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.

Is low back pain preventing you from enjoying life? Click here to see how I can help.

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.

References

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. Jarvik^c,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.