this is my general impression too, the origins of the practice is kinda bunk and it’s probably not worth the risk for a lot of people. I particularly dislike that a lot of people will see a chiropractor for pain before they’ll consider seeing a PT.
that being said, there are individual chiros out there that do good work. The main person I go to for non-chiro bodywork, who really knows her shit, sees a chiro herself and highly credits them for her recovery from pretty severe spinal issues. I’d probably see one only if I was referred from someone I trust.
but generally speaking there’s other alternative therapies I’d recommend over seeing just any random chiro. Acupuncture can be a game changer, and is starting to become less “alternative” as some PTs offer “dry needling” now. Craniosacral work can be great for some too, it’s a very gentle form of bodywork that can have a big impact nonetheless. Both of those are a lot less focused on manual adjustment, lowering the risk significantly.
“Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull’s bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery.[1][2] It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.[3][4][5]”
I’m significantly less convinced by the supposed mechanics of craniosacral therapy - adjustment of the fused cranial joints in particular - but more generally, gentle rhythmic manipulation of lumbar fascia and neurofascia is something I don’t see focused on often in traditional deep tissue massage and subjectively it’s had surprising effect, especially when done by someone who specializes in it. There are a lot of important nerve connections in both areas that gentle, surface-level manipulation can affect. The aspects of craniosacral therapy that are probably bunk are at least not going to hurt you, unlike chiropractic. Worst case, it just won’t do much. I am interested to see if some of the basic manipulation techniques are integrated into other modalities in the future, even though their origin doesn’t hold up to scrutiny. And yes, like other alternative therapies, anyone claiming CST can cure illnesses is a grifter.
You’ll find more study in the West of “dry needling”, a technique directly inspired by acupuncture. Here’s one recent review.
I see an acupuncturist because the results for me are great, she’s good at what she does, she does believe in germ theory, she practices in a sanitary way, and she doesn’t claim to cure illnesses. These are the norms for modern licensed acupuncturists. I’m not saying every acupuncturist out there is like this, hokey grifters do exist in alt medicine spaces, and that’s kind of my whole point. It really depends on the practitioner.
Many of those studies in that meta analysis show limited short term effects.
Because there is no widely accepted sham protocol for DN research, researchers should incorporate cognitive influences that extend beyond the mimicking of tactile sensations to create a believable simulation of active dry needling.
I also think there’s a serious question about what sham/placebo dry needling would be, and if inconsistent standards could impact results.
Several did show some positive short term effects, but it’s no surprise that several don’t. Dry needling isn’t going to cure pain on its own or work for everyone, much like other forms of bodywork. Individual results vary and it needs to be done over a long period of time alongside other work to restore stability and mobility. A supplementary treatment just needs to be low-risk, accessible, and possibly beneficial enough to try. The risks associated with dry needling are less severe than those of several common PT interventions such as corticosteroid injections. To say nothing of the risks associated with chiropractic.
The lack of a standardized placebo is a problem, yes. This study had pretty good results from using a blunted needle glued in an introducer. The patient feels the sensation of the introducer being pressed against skin and “pistoned” in, but the needle doesn’t actually make contact. In the group of people who had not received dry needling before, only one correctly identified that they had received the placebo.
this is my general impression too, the origins of the practice is kinda bunk and it’s probably not worth the risk for a lot of people. I particularly dislike that a lot of people will see a chiropractor for pain before they’ll consider seeing a PT.
that being said, there are individual chiros out there that do good work. The main person I go to for non-chiro bodywork, who really knows her shit, sees a chiro herself and highly credits them for her recovery from pretty severe spinal issues. I’d probably see one only if I was referred from someone I trust.
but generally speaking there’s other alternative therapies I’d recommend over seeing just any random chiro. Acupuncture can be a game changer, and is starting to become less “alternative” as some PTs offer “dry needling” now. Craniosacral work can be great for some too, it’s a very gentle form of bodywork that can have a big impact nonetheless. Both of those are a lot less focused on manual adjustment, lowering the risk significantly.
“Craniosacral therapy (CST) or cranial osteopathy is a form of alternative medicine that uses gentle touch to feel non-existent rhythmic movements of the skull’s bones and supposedly adjust the immovable joints of the skull to achieve a therapeutic result. CST is a pseudoscience and its practice has been characterized as quackery.[1][2] It is based on fundamental misconceptions about the anatomy and physiology of the human skull and is promoted as a cure-all for a variety of health conditions.[3][4][5]”
?
I’m significantly less convinced by the supposed mechanics of craniosacral therapy - adjustment of the fused cranial joints in particular - but more generally, gentle rhythmic manipulation of lumbar fascia and neurofascia is something I don’t see focused on often in traditional deep tissue massage and subjectively it’s had surprising effect, especially when done by someone who specializes in it. There are a lot of important nerve connections in both areas that gentle, surface-level manipulation can affect. The aspects of craniosacral therapy that are probably bunk are at least not going to hurt you, unlike chiropractic. Worst case, it just won’t do much. I am interested to see if some of the basic manipulation techniques are integrated into other modalities in the future, even though their origin doesn’t hold up to scrutiny. And yes, like other alternative therapies, anyone claiming CST can cure illnesses is a grifter.
Why would you let someone who doesn’t believe in germ theory put needles in your body?
There is no evidence justifying acupuncture.
You’ll find more study in the West of “dry needling”, a technique directly inspired by acupuncture. Here’s one recent review.
I see an acupuncturist because the results for me are great, she’s good at what she does, she does believe in germ theory, she practices in a sanitary way, and she doesn’t claim to cure illnesses. These are the norms for modern licensed acupuncturists. I’m not saying every acupuncturist out there is like this, hokey grifters do exist in alt medicine spaces, and that’s kind of my whole point. It really depends on the practitioner.
Many of those studies in that meta analysis show limited short term effects.
I also think there’s a serious question about what sham/placebo dry needling would be, and if inconsistent standards could impact results.
Several did show some positive short term effects, but it’s no surprise that several don’t. Dry needling isn’t going to cure pain on its own or work for everyone, much like other forms of bodywork. Individual results vary and it needs to be done over a long period of time alongside other work to restore stability and mobility. A supplementary treatment just needs to be low-risk, accessible, and possibly beneficial enough to try. The risks associated with dry needling are less severe than those of several common PT interventions such as corticosteroid injections. To say nothing of the risks associated with chiropractic.
The lack of a standardized placebo is a problem, yes. This study had pretty good results from using a blunted needle glued in an introducer. The patient feels the sensation of the introducer being pressed against skin and “pistoned” in, but the needle doesn’t actually make contact. In the group of people who had not received dry needling before, only one correctly identified that they had received the placebo.