August 31, 2017
Podcast from: https://bengreenfieldfitness.com/2017/08/are-chiropractors-really-bullsht/
[05:04] About Jason Jaeger
[8:00] What Jason Thinks of Yvette's Statement About Chiropractors as Séances
[11:42] Daniel David Palmer
[22:40] The Difference Between evidence Based chiropractic Care and “Quacks”
[30:40] Josh Axe, Billy Demoss, and Eric Berg
[41:00] Medicine and Supplements That Fit into Jason's Practice
[47:00] Infant Chiropractic Care
[52:05] Good or Bad Chiropractic Doc
[1:00:29] End of Podcast
Ben: Hey, folks. It's Ben Greenfield. It's not often that I release a special podcast episode on a Tuesday but, yeah, I'm doing it because of this idea and controversy out there about whether or not chiropractors are really [censored] and you’re gonna find out in today's show. Now here's the deal. Not only do you get an interview today on the podcast, but I am also releasing a very special article written to you by a friend of mine named Dr. Patrick Gentempo, and Patrick broke down this whole idea behind the chiropractic industry possibly being full of a bunch of quacks. Whether or not that's really true, whether or not the origin of chiropractor is steeped in quackery and a whole lot more. So, if you go to bengreenfieldfitness.com/chiro, not only are you getting get access to that article that Patrick wrote, you're gonna get the ability to be able to leave your questions and your comments and weigh in on this whole controversy. But you’ll also get the show notes for all of the things that Jason and I talk about in today's show as well. Along with a link to The Joe Rogan Podcast that set all this off and a lot of other episodes that I've done related to the SciBabe, the food babe, chiropractors, and plenty more. So check all this out at bengreenfieldfitness.com/chiro No other commercials or anything for today's show; just pure freaking content. Alright, folks. Enjoy.
In this episode of the Ben Greenfield Fitness Show:
“The current three causes of mortality in the United States, in this order, are heart disease, cancer, and pulmonary function. In the UK it flips. Number one is cancer before heart disease, but the CDC leaves out iatrogenic death but when they report the numbers, really, third is iatrogenic death; pulmonary is fourth.” “If you go back to the Arthur Schopenhauer quote of truth passing through three stages, we’re in that violently, vehemently opposed phase. You’re supposed to question authority. You’re supposed to question standard practice.”
Ben: Hey, folks. It’s Ben Greenfield and last week, a podcaster and also a comedian, Joe Rogan, interviewed this woman who calls herself “The SciBabe,” Yvette d’Entremont. I don't know if I pronounced your name quite correctly, but anyways he interviewed her about this juicy, controversial, attention-grabbing article that she wrote for this website called The Outline. And the article is called Chiropractors Are Bullshit. And don't get me wrong, this “SciBabe” gal has some interesting ideas and I appreciate her willingness to question some of the more radical aspects of alternative medicine and potential quackery which she does on her website. And I also admire her ability to keep us all on our feet and wary of being duped by potentially ineffective therapies, and she's even been on my podcast before. We had an episode called, Is The Food Babe Really Full Of Sh*t? You can listen to that and I’ll put a link over to the Joe Rogan episode if you go to bengreenfieldfitness.com/chiro, that’s bengreenfieldfitness.com/chiro where you can go read all the show notes for this episode you’re listening to right now.
Anyways though, I personally see a chiropractic doc. Some of my dear friends are chiropractors and from a sacroiliac joint issues that I used to get when I was racing Ironman triathlon, to neck pain, to digestive problems, and my pelvic floor realignment and all sorts of different issues. I’ve had chiropractors fix my body many a time. I’ve even gotten to these chiropractor conventions where I've had freakin’ like a balloon stuck up my nose for inner bone therapy for my face and it had complete clearance of any sinus issues or clogging, and all sorts of cool things in myself working with chiropractic medicine. So I wanted to give somebody, from the chiropractor community, a chance to speak up on the actual science and the actual evidence-based research, if there is any, on chiropractic medicine. So I was able to hunt down a chiropractic doc named Jason Jaeger. Actually Jason, you pronounce your name Jaeger or Jaeger?
Ben: Jaeger. See. Second time’s a charm. Jason Jaeger. Doctor Jaeger has been practicing since 1999. So he’s been in this awhile. He works at Advance Spine and Posture in Las Vegas and he is the administrative director of the Aliante Integrated Physical Medicine which is one of Nevada's leading integrated physical medicine practices. And he's trained in a bunch of different chiropractic procedures like one called biophysics, ideal spine, the universal tractioning system and he also teaches all over the world in terms of chiropractic research and therapies. He's got a bunch of different positions at different universities like Southern California University in Cleveland Chiropractic College, Park University, Palmer Chiropractic University which is one of the universities discussed in that Joe Rogan episode in this article by SciBabe. So we’ll probably get into that too. He's been a past board member for the Nevada Chiropractic Association. He’s a current board member of the Nevada Chiropractic Council. He’s been deemed an expert by the courts in the state of Nevada. He’s got a pretty big resume. I’ll put the whole thing in the show notes at bengreenfieldfitness.com/chiro but ultimately, the dude knows chiropractic medicine inside and out from what I can gather because I've vetted a whole bunch of people before choosing him to come on the show. So that all being said, Doctor Jaeger, Jason welcome to the show, dude.
Jason: Ben, thanks for having me. I really appreciate it and I appreciate the opportunity to be able to have an evidence-based debate about some of the topics that SciBabe brought up and some of the experiences that Joe Rogan had.
Ben: Yeah. For sure. Did you read this article? The “chiropractors are bullshit” article?
Jason: I did. I read her article and I listened to the podcast with her and Joe Rogan and certainly had an opportunity to dig in and take some notes and analyze some of the things they said. As with anything, you need to be a critic of yourself and your profession. You need to be open minded to critique and open minded to grow. That's science, right?
Ben: Yeah, yeah. Totally. Alright, well, let’s delve into this thing, man. One of the first things that she gets into in her articles about the whole history of chiropractic medicine. She starts by talking about how chiropractic medicine was born when this guy named Daniel David Palmer, a magnetic healer in Iowa, healed some deaf janitor named Harvey Willard. And she describes Palmer in terms of kinda his whole approach is being little more than the buffoonery of a 19th century lunatic who derive most of his medical theory from séances. So, it appears that the entire field of chiropractic medicine was founded by a kook based on which she saying. So I'm curious. What is the history of chiropractic medicine? I mean, is that true?
Jason: So, that's the allegation and if you dig into the research on Doctor Palmer back in the day there's data where he says that some of his influence was from osteopathy and he still was a medical doctor who conceptualized and developed what is now the doctor of osteopath degree. And there are similarities in the hypothesis that was proposed at that time. The osteopathic hypothesis proposed that a bone misalignment or a bone joint dysfunction affected blood flow. Palmer went on to say that he thought it affected nerve flow. So, I understand the critique. However, hypothesis is a process to vet out an idea. And so do we discount a hypothesis because one person's credentials are less than another's. When we fast forward through this conversation today, we’ll look at the preponderance of evidence and the peer-reviewed literature on chiropractic and then we have the benefit of hindsight to say Palmer was right.
Ben: Okay. So, you're saying that even though he had some, I guess, controversial or potentially questionable views that he was kind of on to something when it came to some issues being related to the alignment of the bones and that affecting nerve flow or blood flow.
Jason: He was on to something. I mean there's a field now. If you look on Medicare's website and you look at what the definition of a physician is, I think this will blow everybody's mind. A medical doctor, an osteopath, a podiatric doctor, a dentist, and a chiropractic physician are all considered physicians. And you know as a chiropractic physician myself, I've been in situations where I’m face to face with a colleague from another discipline and they'll look at me and say that they’re a real physician and they'll insinuate that I'm not. It's funny because that's opinion where the law, federally and certainly in the state of Nevada, is that a chiropractor is a physician and you look again at the research, just a quick PubMed search of the term “chiropractic”; it yields 7163 studies on chiropractic research.
Ben: Interesting. Okay. So this Daniel David Palmer guy, he basically invented chiropractic medicine and then from there went on to open up a bunch of chiropractic schools. Is that correct?
Jason: Yeah, that is correct. You started with Palmer and then after some controversy happened between he and his son, DJ Palmer, Palmer senior went west and ended up opening two or three schools.
Ben: Now, is he actually respected within the chiropractic medical community or do people think that he is a quack who just got lucky enough to have had that kind of like a good theory that turned out to be potentially true when it comes to being able to adjust someone and have an improvement in blood flow or release of nerve pain or something like that.
Jason: You know, it's interesting and I think as with any discipline there's varying opinions within the discipline itself. I think that you would be very hard pressed to find any chiropractic physician in the United States or in the world that would want to refer to somebody within their own discipline as quack. Certainly it's a sensitive word. It was a word that was developed in the late 1800s referring to people who were practicing health care medicine without proper credentials or who were making statements that were grossly false. I think you can find that quackery transcends any type of profession. Personal training, auto mechanics, teachers, medical doctors, DOs, chiropractors.
Ben: Right, but that doesn't make it right.
Jason: That's right. It doesn't make it right and it happens, but I mean you call that bullying or even prejudice of the interest going back to the fact that there's a definition legally of what a physician is. You know, after the civil war the laws changed about equal rights amongst Americans of different color yet the actual practice didn't change. There was still that prejudice and those issues in race. You can really, to a lesser degree, extrapolate that to today in health care.
Ben: Okay. Got it. So when it comes to this idea behind subluxations, one of the main things that the SciBabe gets into in this article after questioning the origin of chiropractic medicine coming from this guy who’s basically kind of like a controversial figure, is the fact that it's based on this idea of subluxations or what she calls vertebral subluxations. So my question for you is, first of all, what is a subluxation based on the definition that chiropractic medicine would give it and then is that true? I mean is chiropractic medicine kind of founded on this concept of subluxations?
Jason: Chiropractic medicine is founded on subluxation. That's the genesis of where it came from and it is a medical term. It's a term that basically means a partial dislocation instead of a full or complete dislocation of where two bones articulate, or a joint. The association at chiropractic colleges, which represents chiropractic colleges and universities worldwide, 22 to be exact, in the world and 18 in the US alone. All of the chiropractic colleges, Palmer college included, different disciplines and ideologies within our field; some more conservative, some more liberal, they agree on the definition and it's that chiropractic focuses on the relationship between the body's main structures, the skeleton, the muscle, and the nerves, and how that relates to patient health. Chiropractors believe that health can be improved and preserved by making adjustments to these structures, particularly adjusting spinal column. They do not prescribe drugs or perform surgical procedures although they do refer patients to those types of providers. I think that’s a reasonable definition.
Ben: Okay. So a subluxation, and when I was taking strength conditioning and athletic training and anatomy courses in college, it would just mean that part of my body would pop out of the socket or like a shoulder bone would pop out of the socket. Is that really the same thing or are they like two different forms of subluxations?
Jason: You know. so there's going to be a more focused, conservative medical version where it's a joint that’s popped out of the socket. So you've had that happen, Ben?
Ben: Yeah. That’s happen to my shoulder before.
Jason: How did it feel?
Ben: I mean it hurts. It pops back in.
Jason: It hurts?
Ben: I mean it’s kind of like smarts for a little while, but it's not like a full on dislocation where it stays out. It just kind of pops out and comes back in. That was back when I used to do a lot of tennis in high school before I discovered things like rotator cuff strengthening and crossover symmetry and all these different ways you can strengthen the shoulder. Yeah, the joint would just pop out.
Jason: Right. So, it would partially dislocate or it would sublux and it would hurt because there's ligaments and there’s tendons and there’s muscles and there's nerve endings, and then whether it fell back into place on its own or you needed some assistance whether you did it yourself or somebody helped you, it typically made the joint feel better, right?
Jason: And that it’d function better and so this is the premise. Now, you delve into, “how does that affect a symptom?” well, it certainly affected you symptomatically in that subluxed position and then when you look at the spinal cord there are some more critical structures moving through the center of the spinal column than, say, your AC joint or you're glenohumeral joint. There's your spinal cord and then there's exiting nerve roots that go to every muscle, every tissue, every organ in the body so as we get into the chiropractic subluxation and that definition gets broadened, there’s different position on what else gets affected by not allowing that electricity to flow to that body part. If you really chunk it down and you say that you don't get proper electricity to your bowel, could that affect your bowel’s ability to function at its optimum? And I think it's a reasonable, logical assertion of anybody that's had college science courses that that makes sense. It could.
Ben: Now, when you say electricity what exactly do you mean?
Jason: So, the brain is basically conducting electrical impulses, comes down the spinal cord, your central nervous system, and it exits out into exiting vertebral nerve roots that go off into various body parts in the upper extremity, in the trunk, and lower extremity.
Ben: Okay. So you're essentially talking about the conduction of nerve signals or muscle signals.
Jason: That's it.
Ben: Okay. Got it. And when something is out of alignment like if a vertebra has moved just slightly it could put pressure on a nerve or put pressure on a vessel and affect the actual electrical signal that would travel to a muscle or cause something like pain.
Jason: Right. That's the premise. So you can get pain or you can get numbness or you can get weakness, you can get atrophy of the muscle. Certainly, I would expect if you get atrophy of an organ.
Ben: Okay. Now, when you say, “atrophy of an organ” what do you mean by that?
Jason: Well, you need to have nerve flow. You need to have blood flow to every body part and I'm chunking this down and making it just very rudimentary and simple, but in the absence of having either a brain signal or blood going to tissue, the tissue will certainly not function properly. It may atrophy. It could die in extreme cases, right?
Ben: Okay. Got it. So when you're making an adjustment to, let's say, my neck or like that's a really popular one. You go in. The chiropractic doc puts their hands around your neck. They say, “Oh, this is off.” “That’s off.” And then they pop your neck and it actually feels pretty good like even just the popping sensation itself, frankly, feels pretty good. I’ve even gotten to the point now where I have one of these neck traction devices hanging in my house that I’ll hang from and actually one of my friends, Isaac Jones, who’s been on this podcast before, he’s a chiropractic doc, he gave that to me. It’s like a (19:25) ______ cervical neck traction device. So I like pop my neck every morning and it feels great, but I'm curious. Is that an example of a sublux, or I guess what I'm trying to ask you, Jason is, is every adjustment that I get a sublux or are there things other than subluxations that a chiropractic doc is doing when they're manipulating you?
Jason: So, there’s various schools of thought and we could just pause on that question and probably talk for two hours, and then it could be so controversial. It would generate 20 other podcasts with different doctors from different perspectives, but you know, you get into the objective analysis of a chiropractic subluxation. How do you determine that? Some schools of thought in older times, it was palpated. You would feel it. You would look for motion; increased motion, decreased motion. There are x-rays that we look at. Certainly, I prefer the objective analysis of imaging, x-rays and MRI, but there must be a measurable normal that must be an agreed upon measurable normal in scientific community and then there must be an agreed upon deviation from that normal which would cause subluxation. So when you get in and you hang from your traction machine and if you get that release with that capitation maybe at a partial dislocation of that joint. maybe you're simply gapping that joint and it's causing a nociceptive response, a pain relieving response. It releases endorphins. You feel better. You function better.
Ben: What’s the difference between gapping a joint and fixing a subluxation?
Jason: (chuckles) It's one of heavy debate and I think that, again, we could have a lot of dialogue on that, but I want to go back to what's normal alignment, what's abnormal alignment, and what sort of vectors and interventions and tools do we use to try to restore that patient to, first, structurally normal alignment which then should result in, functionally, a normal functioning human being.
Ben: Okay. Got it. So when it comes to this idea behind some chiropractors being full of bull or being quacks in the article SciBabe kind of gets into a whole bunch of things that go above and beyond just like manipulation of the spine or manipulation of a subluxation. And it kind of gets into different aspects of chiropractic care that I've personally experienced like the little thing that you, what’s the little thing that you push against the muscles that kind of like pops against the muscles like a trigger? You know what I’m talking about?
Jason: So you could be talking about the activator or the impulse (22:14) ______ device?
Ben: Yeah, like the activator is one or there's like these scans that they'll do where they’ll do like… there's this one guy I went to that did like a full body scan and then he had like eight different supplements I was supposed to take based off of the scan results and then, of course, there's a whole bunch when it comes to everything from supplements to nutrition advice to all sorts of things that go above and beyond just like fixing subluxations. So where is chiropractic medicine in terms of either policing or keeping track of or even like drawing a difference between what might be considered evidence-based chiropractic care and kind of more quackery or things that are less established in science?
Jason: Right. So from a regulation standpoint, and we didn't talk about it in the intro, but I'm the Secretary Treasurer for the Nevada Chiropractic Physicians Regulatory Board. So the association supports the rights and promotes chiropractic as profession and then the regulatory board really polices the chiropractic profession and our mission statement is to look out for the health in the best interests of the public. So with evidence based medicine we need to see all healthcare practitioners operate within best practices. Now, I love this saying, “We all practice.” We're practicing and so practice isn’t perfect. It’s practice and things of all over time. If you go back and you look at the history of a physician, the physician school of practice used to be separate from surgeons and barbers. You would get a surgeon and barber degree. You would cut hair, you would cut skin, and then eventually a hundred years down the road after much, much infighting between the professions. The college of surgeons left the college of barbers and the surgeons joined the physicians.
So, I like this saying, “All truth passes through three stages.” It’s first ridiculed and then it’s violently opposed before being accepted as self-evident. Chiropractic is in this place. I mean even with SciBabe. She, if not violently, she vehemently opposed some of the basis of chiropractic in her article and in her podcast with Joe. You need to be critical of everything that we do, but we need to fall back on evidence based practices. You then develop what's considered a standard of care. A chiropractic doctor must practice within the standard of care of health care. What's in our scope? We can do spinal adjustments. We can do different physiotherapy interventions, posture reeducation, exercise physio therapy. We do traction. You've talked about doing decompression traction of your neck or your back that’s a long axis distraction. You can do two and three-point bending traction to restore lordosis or reduce dangerous hyperkyphosis or scoliosis. There's literature to support that. It’s in very solid medical journals. So there's a lot of different subspecialties, if you will. Chiropractic is historically called the technique, but we're starting to see it develop that subspecialty terminology and one chiropractic physician may focus on nutrition. Another may focus on spinal manipulation solely or only. Some like to integrate therapeutic interventions with it, with the adjustment. That's really once you get your degree you have to pick up half of a technique or a subspecialty.
Ben: Okay. Now, when it comes to these subspecialties and when it comes to things like nutrition and supplementation advice and a lot of these things that many chiropractic docs are doing, what's the educational look like? Because I know for an MD, for example, they get maybe, if they're lucky, like two to four weeks of nutrition instruction at a typical medical school as far as like the standard curriculum for medical school. What did your education look like when it came to your schooling in chiropractic medicine?
Jason: One of my best friends is my partner in my medical physical therapy in chiropractic practice in our group in Vegas and we talk about this at length. He went to USC and they had very limited nutrition education. In our early years, we would have fun and dialogue and debate because he felt that the carb from a Dr. Pepper was not any worse and not any better than the carbohydrate from brown rice. I think and I'm seeing out in the world that we're seeing a turn of perspective with our medical and our DO practitioners towards the use of food and nutrition as medicine. If you do a compare-contrast to the academic hours between a chiropractor, a DO, an MD, and a naturopathic doctor, chiropractic doctor has 3606 in classroom hours, but about 1,023 clinical hands-on hours. You contrast that with an MD. An MD only has 2600 academic hours, but they have more than double the clinical hours, 2200. A DO is just behind the MD, 2145 academic hours, 2520 hours clinically. A naturopathic doctor has more academic hours than both a DO and an MD, 3348 with about 1400 clinical hours. In my education, I went to a school in southern California where their curriculum was developed with the assistance of Harvard Medical. We did an integrated curriculum. We were taught and trained to be able to integrate with the other disciplines. I had pharmacology. I had minor surgery. We had…
Ben: Really, you had minor surgery?
Jason: We had minor surgery in our training. Now, at a regulation level it's not in our scope. We can't do it, but I had it in my curriculum,
Ben: What is minor surgery?
Jason: We were taught how to do stitches.
Ben: Okay. Gotcha.
Jason: Right? So entry level stuff, but we had substantial biochemistry as it relates to nutrition. We had quite a bit of a nutritional background and, at least, back in earlier days in the medical education was considered unnecessary, right? Because a carb is a carb.
Ben: Interesting. Okay. So you did actually get some nutrition education, but what did it looks like in terms of graduation? Because I know that the SciBabe talked about how Palmer, for example one of the universities that you're associated with, like you pretty much just have to enroll and you're guaranteed to graduate. I don't know if that’s exactly how she said it, but she said it's basically very, very easy to pass your schooling at something like Palmer College of Chiropractic. Is that true?
Jason: It's patently false. I mean it's just a ridiculous assertion. If she knew how to go on to Google and if she could look at the academic requirements for any of the 22 universities I talked about, or if she would even go on to PubMed and then typed in the word chiropractic-to chiropractor, a big bulk of her critique would’ve been negated. As I mentioned earlier, the preponderance of peer reviewed literature in both medical and chiropractic journals, it's a lot, right? And it's not an enroll and pass scenario. It's a very intensive course. I’d be surprised to know better or to tell the public that many of our professors are MDs.
Ben: Like what kind of MDs?
Jason: Medical pathologists, general practitioners, anatomists, neurologist, but I would say, shooting from the hip, 50 percent of my instructors at the university I went to for chiropractic school were medical doctors.
Ben: And where’d you go to school?
Jason: It's now called Southern California University of Health Sciences. So that's the university and then they have a College of Chiropractic in the university called Los Angeles College of Chiropractic.
Ben: Okay. Gotcha. Interesting. I did not know that so many MDs taught at chiropractic facilities or chiropractic universities.
Ben: So when it comes to this problem of quackery in chiropractic care, kind of returning to all these things that go, obviously, beyond subluxations fixes that docs are doing, she talks about people in the article. People like Josh Axe, who's also been on my show before and his website where he talks about reversing cavities, and fixing UTIs, and stuff with essential oils and things along those lines, or he talks about this guy named Eric Berg who discusses how to work on adrenal fatigue or on the adrenal glands or Billy Demoss who believes there are better alternatives to vaccinations, things like that. What's your opinion on this? I mean, do you have any opinions on any of these people that she mentions or on this idea behind like quackery in general being a problem within the chiropractic industry? Not that I'm saying that any those people I just mentioned are quacks, but those are some of the examples she gives when she's talking about quackery.
Jason: Yeah. I mean, my interest and my love is in clinical biomechanics. So, you know, as I got my chiropractic degree and I decided what direction I wanted to go with my career, that's the direction I went. You mentioned, was it Eric?
Ben: Eric Berg, I think, is one of the people she mentions when it comes…
Jason: It’s the first time I’ve heard of him which doesn't mean anything good or bad about Eric.
Ben: Apparently, he has 472,000 YouTube subscribers. So you're not spending enough time on YouTube, man.
Jason: I know. Where have I been? I mean, I need to get on YouTube more and certainly I’m aware of Josh Axe and Billy Demoss. Listen. I think that nutrition is important. I think nutrition is something that we need to intervene in. As I was spending time in doing research before I came on to the show with you, one of the things I looked at was the American Medical Association's website and I did a search on nutrition on their website. A top nutrition intervention that the MDs are talking about is D3 and critical levels of D3 being too low and a little less critical on the high end, but nutrition is coming into the purview of all health care providers. And if somebody like Josh Axe or somebody like Billy Demoss, if they're really practicing below the standard of care, if they were doing quackery, there's regulatory boards for that. And so instead with SciBabe, it's just talk? And you know if there’s really an issue, there's a regulatory board that can step in and police that.
Ben: And if I could just give my opinion on a lot of this stuff. I mean, for me, I’ll use myself as an example. I'm a personal trainer and I'm a nutritionist and I will for example, with some of my clients, look at something like heart rate variability. And that's not necessarily something that you would think would fall inside the defined scope of practice with someone like a personal trainer who should be writing out workouts, or a nutritionists who should be giving someone their carb, fat, protein, macronutrient percentages and looking at their micronutrient, or their vitamin intake and things like that. But along my journey of learning what can actually make somebody's body or brain better, I’ve discovered that something like heart rate variability is a great way to actually test the body in the morning, to see what the sympathetic nervous system is doing, and the parasympathetic nervous system is doing based on the difference in the time intervals between the beats of the heart.
I don't think that me going outside of what might be the generally accepted scope of practice for something like a personal trainer or a nutritionist in incorporating something like that is quackery. I think it's just basically engaging in better living through science and identifying things that I wasn’t originally educated in, but things that have turned out to make my clients lives better. When you look at somebody like Josh Axe, I'm sure he learned, in the same way that you did, how to do something like an adjustment on a spine or a neck to fix a subluxation. But I also know that that he's taking a deep dive and everything from like kefir and grass-fed yogurts to essential oils and herbal medicine, and all sorts of other things that I respect when it comes to making other people's lives better, and folks like Billy Demoss questioning the popularity of vaccinations. I really don't think there's anything wrong with that. I don’t think that makes someone quack at all. And in my opinion, a lot of these people are actually discovering things that would be considered to be extras on top of generally accepted chiropractic care or chiropractic scope of practice, but I don't think that makes them complete quacks. That’s my opinion.
Jason: Yeah, I agree with that. I don't think it does either and the trend in nutrition, I think that if you go back to the Arthur Schopenhauer quote of “truth passes through three stages”, we’re in that violently, vehemently opposed phase. You're supposed to question authority. You're supposed to question standard practice. It's how we develop and we grow. It’s how we got to the moon. “We do the things that are hard, not the things that are easy.” Kennedy said that. We need to keep pushing those envelopes and nutrition is within the scope of chiropractic physician. Radiology isn’t within the scope of chiropractic physicians. Exercise is within the scope of chiropractic physicians and they've developed an interest and they're exploring a path. Hopefully, if they find that a direction that they’ve gone maybe is a dead end or it's not accurate then they admit it freely in a public forum and then they attempt to retest a new hypothesis. There’s nothing wrong with that and I agree with you fully.
Ben: Yeah, and I don't think, at least from what I understand, that the number of, like in the US for example, the number of adverse events caused by something like chiropractic medicine, the number of people being hurt, or maimed, or killed even comes close to what happens in hospitals or what happens under the care of MDs or even like freaking like dentists. I mean, from what I understand like both of those professions that have been shown to kill more people, or to maim more people, or to harm more people, again, not that I'm saying that MDs or dentists are going out of their way to hurt people, but at the same time I think chiropratic medicine is pretty small piece of the pie when it comes to people being hurt during medical procedures.
Jason: This data will blow your mind. So there's what we perceive in the public and there’s opinions on left, right, and the middle and then here's the data. So when you do a Medline search and you look up the published incidents of death secondary to chiropractic adjustment, the Medline search which did a meta-analysis of all the data available. So there's 26 ever. PubMed only came into existence in 1996 and certainly there's been peer reviewed literature much longer than that. So an entire Medline, meta-analysis, 26. The paper goes on to say, “We believe there should be a few more.” So let's have fun with that. A few is three, so we’ll take the 26 and we’ll make it 29 and then it says, “we believe that the state is grossly underreported.” Now, grossly underreported is a very subjective comment. So I have some fun. We’re gonna double the 29 or triple it or how about, why don’t we go 10 times and we’ll make 29 to 90. In the lifetime in the history of their profession that's about 100 years old.
So, now contrast it with the 2014 data on iatrogenic death and it's funny how we as doctors, we put funny Latin words on things to make it sound better, but iatrogenic means doctor caused. So in 2014, iatrogenic death was 241,000 people in that year alone. And then when you go to the CDC's website, the current three causes of mortality in the United States in this order are heart disease, cancer, and pulmonary function. In the UK it flips. Number one is cancer before heart disease. But the CDC leaves out iatrogenic death, but when they report the numbers, really, third is iatrogenic death, pulmonary is fourth. But there's no SciBabe reporting on that. Joe Rogan’s not talking about that or maybe he is. It's not on any of the news media stations. We hear, “On cue public dies of medical error or complications during surgery and we all go, “Oh my gosh. Poor John. What about his wife Betty?” There's none of this uproar about the genesis of surgeons and barbers and physicians and leaching coming in and out of vogue. It's interesting.
Ben: Yeah, and there's actually another pretty comprehensive article that kind of brings up some of the things that you just brought up over on the medium website called, The Sci Babe is Neither Scientist Nor Babe: She’s Bullshit. It’s a pretty entertaining article, but it actually gets into this idea behind the… well, it is kind of dizzying. The statistics about the number of MDs who actually practice versus do not practice evidence-based medicine and the harm done by the medical profession in addition to some of the issues with the history laid out in that Joe Rogan episode with the SciBabe. But I want to ask you, and I’ll link to that by the way for those of you listening in. Just go to bengreenfieldfitness.com/chiro. For you, Jason, where do medicine and supplements fit into your practice versus just pure adjustments and anatomical work?
Jason: So, in our group, and I believe that it's fair to say were considered one of the nation’s centers of excellence, we've brought in MD and physical therapists and chiropractic physicians together to work in a unified setting. Just seeing that be the way to go and the combining interventions working together.
Ben: Yeah. That was actually, I didn’t tell you this, but that's actually, so I ran personal training studios and gyms for about 8 years. Here in the Spokane and Coeur d’Alene area and each of our facilities, well my facility in Coeur d’Alene was an MD, a nutritionist, a chiropractic doctor, a physical therapist and me as a personal trainer and nutritionist and then my Spokane facility, it was a sports medicine MD physician, a DO, two chiropractic docs, a whole team of physical therapists, massage therapists, and then me as a personal trainer. We also had a whole biomechanics facility along with high speed video cameras, biomechanical analysis, EKG analysis, all sorts of things. It was basically like this integrative approach to the human body that brought a lot of these folks who specialized in certain aspects altogether. So the chiropractic doc would be doing SI joint adjustments and fixing these subluxations and then the sports medicine physician would be analyzing someone's knee and perhaps you know, referring it to an orthopedic surgeon and the physical therapists were assisting with rehab or biomechanical evaluation. So, I mean I absolutely appreciate the efficacy of a facility. It sounds like what you have in Las Vegas.
Jason: It's such a fulfilling environment to work in and we work as a team, we work as family. We leave the ego at the door, we all realize where we have strengths and limitations and we always challenge ourselves to grow. In my group you're required to get postgrad certifications in biomechanics. My group, you're required to publish. When we were putting our medical group together my partner said, “Okay. Well, what prescriptions are we gonna prescribe?” and we sat there and thought about it and I suggested, “how about none?” and he went, “Well, what about, say, an anti-inflammatory or if somebody's in pain, an opioid or what about a muscle relaxer?” and I say, “We accomplish that with the therapies that we do and if we really, really just think we need that why don’t we refer to somebody that that's their specialty like a pain management medical specialist?” and he kind of put his head to the side and he said, “Wait a minute. You mean I'm not gonna get these calls at midnight asking for more Lora tab or oxy?” “How does that feel?” and he goes, “I love it. I mean we're gonna be doing real medicine.” And then we’re thinking and there's this funny thing in the public's eye in mind that to be a “real doctor”, and here we get back into that prejudice, a real doctor means you prescribe drugs and as the pendulum swings right now where opioids are really finally, it's being exposed what they're doing to us in Nevada, Governor Sandoval said, “One person every day is dying.” Chiropractors, instead of trying to attain legitimacy by getting prescriptive drug rights through legislation, why don't we stay in our wheel house, keep doing what we're doing, the pendulum swings back to us. The governor said chiropractic was the number one early intervention solution to the opioid crisis. Number two, he said, was acupuncture. Number three, he said, cognitive behavioral services. He didn't say physical therapy. I think physical therapy needs to be on that list, but what an interesting time as the truth is passing through the three stages, right?
Ben: Yeah. Interesting. So you guys really don't have like your big glass cupboard full of supplements and stuff like that when people are coming in to get a chiropractic adjustment or do you carry?
Jason: You know, I do. I’ve got a multivitamin. I like Metagenics. I like integrated therapeutics. There’s a couple supplement companies we work with like Apex. We do multivitamins. We recommend omega 3 fish oil, D3's a critical recommendation for us. Age dependent chondroitin and glucosamine. There’s some limited research on its benefits for knees and low back. So we do have that glass cabinet that has the list and the host of supplements. I'm probably one of the largest consumers of vitamins and supplements and minerals in my practice.
Ben: How do you vet those because what the SciBabe says it that the supplements that most of these chiropractors hawk are hardly regulated.
Jason: It's interesting. So you take a company for example like Metagenics, they regulate themselves, and by the way they're MDs, DOs, PhDs, and chiropractic physicians. They regulate and conduct themselves as if the FDA were regulating them. They test, they verify bioavailability. They certify the highest grade of nutrients in their supplements. Just like we talked earlier, is there good and bad in the supplement industry? Yeah, of course there is. We use top notch, top brand supplement companies.
Ben: Okay. Got it. Now, what do you think about infant chiropractic care because that's another thing that was brought up in this article was this idea. She actually talks about Billy Demoss and says, “This is a man who wants you to trust him with your infant’s still undeveloped skeleton.” and then she goes on to talk about how he’ll recommend frequent chiropractic treatment of infants to help with muscular relaxation or breastfeeding or quieting the baby, et cetera, and she describes it as, “cracking the undeveloped skeleton of a fragile human.” What's your opinion on infant chiropractic care? Is that true?
Jason: She spun it in a way to just make it sound horrible as if you’re cracking to the bone.
Ben: It does sound pretty bad.
Jason: Yeah, it sounds terrible the way she lays it out. So let me start with a story. Two children that were in my practice in around 2007 had to have to chiropractic care their whole life and they had presented to my office for chiropractic care. They wanted to use their health insurance. Their health insurance approved it, but it required an MD referral from their primary physician. So, I actually reached out to the doc personally because he told the parent that the American College of Pediatric Medicine doesn't support chiropractic care for kids. He said, “I'm not doing the referral.” So I called up the doc and said, “Hey doc, how you doing? I understand what you shared with my patient’s parents and I've got somewhere around 172 papers and peer reviewed literature detailing chiropractic intervention for pediatrics. If I sent you links to all the papers would you consider looking Adam and talking about him if you like and if it’s viable, would you consider making the referral.?” And I sent him the studies and he made the referral and those patients have continued to be under chiropractic care for another 10 years since then. That pediatrician happened to be my kid's pediatrician. We've had really good open dialogues about it. You go back to the three stages of truth. Where is chiropractic in its place and evidence and research in the healthcare field and certainly medicine is probably ahead of us in the research field, but chiropractic is coming along and were seeing good data for it.
Ben: Okay. So if you had a baby you would bring a baby in for chiropractic care? and I guess my follow up question for that is why would a baby need that? like how do their spine and stuff be messed up?
Jason: Well, for sure. So there a funny chiropractic saying, “If a tree was real bent and crooked, did it start that way when it was a sapling?” And still I’m not saying it is. I'm saying is it possible that a subluxation can occur in a young one. I mean, how many times does a baby fall learning to walk? If you fell now for the next two years of your life as much as a baby fell in the first two years of their lives, what would your spine feel like? What would it look like? So the premise that a baby's joints can go out of alignment just like an adult’s joints makes good sense. Is birthing a trauma? It certainly could be, right? We’ve seen, again, good data and the literature to support chiropractic intervention. Now, is the big, strong chiropractic man or woman gonna grab a baby’s neck and wrench it? No! It's ridiculous. You look at, say, for contrast to surgeon. A surgeon heals a person with a knife. Freddy Krueger hurts a person with a knife. Its application. It's the sensitivity of your art and that got left out by SciBabe.
Ben: Okay. Got it. So when it comes to infant based chiropractic medicine is there actual evidence behind that?
Jason: There's evidence. There’s evidence in the peer reviewed literature. I pulled up a recent the data analysis and if you can bear with me while I get the study up. It was published in 2014, I believe. It's called “Best Practices for Chiropractic Care of Children: A Consensus Update.” I'd like to give you the link so we can put this into podcast.
Ben: Yes! Send it over. I’ll put it in the show notes. bengreenfieldfitness.com/chiro for those of you listening in.
Jason: The conclusions in the paper were there are only two statements from previous set of recommendations didn't reach an 80 percent consensus on the first round and those were revised. All the seed statements and the best practices for pediatric chiropractic reached a high consensus level. There's a general framework for what constitutes evidence based and reasonable approaches to chiropractic management of infants, children, and adolescents that came out of the National University of Health Sciences in Chicago which is considered a rather conservative evidence based school and had involvement also at Harvard and the inception and conception of their curriculum.
Ben: Interesting. Okay. So, infant chiropractic care is not necessarily something that involves taking a fragile skeleton and ripping it apart.
Ben: That’s what you’re saying. Send me the link. I'll put it in the notes. Just email it over to me. So, is there a good way for people to know if they're getting a good versus a bad chiropractic doc? Because I mean there obviously are and I’m just gonna come around and say I don’t know this Eric Berg guy and I do think that there's like an over hype of adrenal fatigue like SciBabe talks about on that article. I think, personally, adrenal fatigue is a myth and that there are other underlying causes of it and that's actually exactly when I had another chiropractic doc, Doctor Isaac Jones, on the show and I’ll link to that episode.
We talk pretty comprehensively about everything from lime to mold to a lot of these issues that Isaac, as a chiropractic doc, helps people out with, is pretty efficacious with but he doesn't necessarily like paint everything with that adrenal fatigue brush. But then there's other people that she talks about in that show who are, admittedly, they are friends of mine. Like Josh is a friend of mine and so is Billy. And I don't think that these guys are quacks because I’ve talked with them. They're very intelligent and what they do is based on evidence, but I do think that there probably are some quacks out there. I do think there probably are some harmful people out there. So how can people vet a chiropractic doc properly if they say, “‘my neck hurts” “my back hurts” “I think I want to go try this out and at least see if it makes a difference.”
Jason: I agree with you. I mean, if you take the term of her article which is [censored] and she pulled that from Penn and Teller who did a show called or do a show called [censored], and they did a show about chiropractic and when I watch that show I was embarrassed because there are outliers in every field that aren’t practicing within the standard of care. So, what's good or bad? I think you’re gonna get a lot of varying opinions on this. Who decides it? Who defines it? Some chiropractors would say that your bad if you do anything but adjust. Some chiropractors would say if you only adjust that that's also not good. So there's really varying opinions. My opinion. I'm gonna see a doctor chiropractic that practices within or above the standard of care within their field. I want to a DC use best practices.
There's several best practices out there. Our state association has adopted and recognized certain best practices. If you ask my opinion, the idea of putting your hands on somebody’s spine, their neck, mid back, around their spinal cord and moving that joint with your hand without lifting up the hood first a.k.a. imaging, I don't like it. I think it’s unsafe and it concerns me. It scares me. Could I put my hand on your back and make your back make a popping sound? Yeah, but then I'm just a cracker, right? I'm not doing good medicine, good chiropractic health care. So I like imaging. I think imaging is important and I'm gonna tell you there's people that are gonna strongly disagree with what I say about that. My practice in the middle of a town in Vegas is in the same building as a neurosurgeon. He’s one of the top medically published neurosurgeons in the world and I'm there at his invite and he said, “Jason, if you consider cracking a spine without doing an x-ray or an MRI or a CT scan, you’re nuts!” Yeah, absolutely nuts and you know, again, there's gonna be critics of the state, “well, you can do this orthopedic test.” “you can do this neurological test” and maybe they can, but not for me.
Ben: So, is there like a database online or a certifying body to look for or if someone like if I were, again, to look for a chiropractic doc in Spokane I could go google “chiropractic docs Spokane” and use like search nearby function on Google maps and find somebody convenient, but is there a better way to do things like a better search engine or a better way to look for a chiropractic doc who you know is going to actually not be a quack, for example?
Jason: You gotta dive into your subspecialties. So, first of all, I think a really appropriate thing to do is first going to the state’s regulatory board website and look for somebody that has complaints or convictions against them. That would be a good way to eliminate people that have practiced below the standard care. Then what you have to do is decide what your technique or your subspecialty interest is. If you're interested in doing the restoration of your cervical curve, putting the neck curve back in, you may look at idealspine.com, the patient portal and it’ll list everybody with any sort of biomechanics training in the entire world. If your interest is in functional medicine, you can look on those websites or doc's that focus in nutrition. So you’ve got to part it down and parse it down a little bit then look for those that have additional postgrad training and don't have regulatory actions against them.
Ben: Well, if there's any directories or anything like that that you want to send me to include in the shown notes that would be helpful for people to be able to do a search. I’m aware of like the functionalmedicine.org website is one example of a good place to search. That’s one website I’ll send people to and I’ll link to that one in the show notes for sure, but if you have some others that you like feel free to send them over, Jason, and I’ll put them in the show notes for people to access.
Jason: Absolutely. Yeah. I'll be sending you a few links. Probably a few different research links and then some different technique and specialty sites that we can put in.
Ben: Okay. Cool. Sounds good. Well, for those of you listening in and I know you probably have a lot of questions about this, but the big picture is that I think that what the Science Babe said was blown a little bit out of proportion. I agree that it appears that this guy, Daniel David Palmer, seemed to have a few issues, but created something that seems to have helped a lot of people and seems to have been taken over, so to speak, by a lot of very scientifically minded people like Jason who have kind of taken some of the little things that Doctor Palmer developed and brought those to the next level when it comes to research based and evidence based practices that actually analyze the human body and go above and beyond when using something like you know séances or some of the other things SciBabe talks about in that article. I don't know. You a séances guy, Jason?
Jason: (chuckles) No. But I did another funny Medline search and I searched on PubMed for the prevalence of religion whether it's Judaism, Muslim religion, Christianity in healthcare in the United States. And it was 2000 doctors surveyed, recent study, and it was about 55 prevalence of being religious. So, take religion. You got prayer, you have meditation. Is prayer and meditation a séance of it all, may be closely related? Does somebody believe in a higher power? Well, the research said most doctors do. So I think that SciBabe slanted it in a way that was a bit cringe worthy and I get it, but if you come back and approach your religion like I just said, it's interesting.
Ben: Yeah, it is interesting and this is a super compelling podcast. I’ll put a lot of stuff in the show notes for those of you who want to listen in and I also have another article coming down the pipeline on this written by a friend of mine that I’ll link to in the show notes as well. I’ll put everything that you need to know about this whole chiropractor controversy including the original article by SciBabe in the podcast that she did with Joe Rogan all over in the show notes at bengreenfieldfitness.com/chiro where you can leave your comments and your questions as well. Jason, thanks for coming on the show, man.
Jason: Hey, thank you so much, Ben. I appreciate the time and I look forward to what develops next.
Ben: Awesome and next time I’m down in Vegas maybe I’ll come and get my back cracked and get some fringe quack supplements from you.
Jason: There we go. I love it.
Ben: Alright. Cool, folks. Well, I’m Ben Greenfield along with Doctor Jason Jaeger from bengreenfieldfitness.com/chiro signing out. Have a healthy week.
Last week, podcaster and comedian Joe Rogan interviewed (click here to watch or listen) a woman who calls herself the “SciBabe” (Yvette d'Entremont) about her juicy, controversial, attention-grabbing article on The Outline entitled “Chiropractors Are Bullshit“.
Now don't get me wrong – Yvette has some interesting ideas and I appreciate both her willingness to question some of the more radical aspects of alternative medicine and potential quackery, as well as her ability to keep us all on our feet and wary of being duped by ineffective therapies. She's even been a podcast guest on my episode “Is The Food Babe Really Full Of Sh*t?“.
At the same time, I see a chiropractor regularly. Some of my dear friends are chiropractors. From sacroiliac joint issues to neck pain to digestive problems, chiropractors have fixed my body many a time. So I wanted to give someone from the chiropractor community a chance to speak up on the actual science and evidence-based research of chiropractic medicine.
Enter Dr. Jason Jaeger, DC, FCBP.
Jason is a chiropractic physician at Advanced Spine & Posture in Las Vegas.
He has practiced since 1999 and has been a chiropractic physician in Las Vegas since 2001 where he has brought his passion for health and wellness to the community that he and his family have called home since the late 1940’s. He is the Administrative Director of Aliante Integrated Physical Medicine, one of Nevada’s leading integrated physical medicine practices.
Dr. Jaeger is one of only approximately 1000 chiropractors around the world trained in Chiropractic BioPhysics®, a technique which corrects and restores the spine back to alignment, and one of only 19 instructors for the CBP technique. Dr. Jaeger is also Board Certified in Nevada in CBP®. He is the developer of the Universal Tractioning System (UTS) and received the “2014 Researcher of the Year” award for the Advancement of Chiropractic Science at the Annual Chiropractic BioPhysics® Research Symposium held in New York City.
Dr. Jaeger attended the University of Nevada, Las Vegas (UNLV) during his undergraduate program and graduate school at Southern California University of Health Sciences (SCUHS). As class representative and Student American Chiropractic Association Vice President SCUHS chapter, he successfully lobbied in Washington D.C. for such issues as Medicare and HMO reform. Dr. Jaeger participated in a rotation through Cal State Northridge’s prestigious Physical Therapy program where he successfully integrated neuro-musculoskeletal therapies on paralysis and stroke victims.
Dr. Jaeger currently holds adjunct faculty positions at Southern California University of Health Sciences in Whittier, CA; Cleveland Chiropractic College in Kansas City, KS; Parker University in Dallas, TX; and Palmer Chiropractic University in Davenport, IA. He is the Secretary of the International Chiropractic Association’s (ICA) Research and Guidelines committee (FACTS). Dr. Jaeger is a professional speaker and has lectured throughout the United States, Europe and Australia on spinal biomechanics, research and the clinical work he has performed. He is a published author in the peer-reviewed literature on clinical biomechanics. Dr. Jaeger is a literature-reviewing doctor for the International Chiropractic Association’s Best Practices Guidelines, a guideline recognized & accepted federally by the National Clearinghouse of Guidelines. He is a past board member for the Nevada Chiropractic Association (NCA), is a current board member for the Nevada Chiropractic Council (NCC) and has been deemed an expert by the courts in the State of Nevada.
During our discussion, you'll discover:
-What Jason thinks of Yvette's statement that “little more than the buffoonery of a 19th-century lunatic who derived most of his medical theory from séances”…[8:00]
-Whether those in chiropractic medicine actually respect Daniel David Palmer, founder of chiropractic medicine…[11:42]
-Whether it is true that “The defining principle of chiropractic is that health is a state that can be either maintained or lost due to vertebral subluxations”…[13:30]
-The type of chiropractic care Jason practices, and the difference between evidence based chiropractic care and “quacks”…[22:40]
-What Jason's schooling looked like, and whether it is true that 100% of chiropractic docs graduate from their institution…[26:20]
-How big of a problem is “quackery” in chiropractic care, and Jason's thoughts on some of the people Yvette discusses in her article, like Josh Axe, Billy Demoss, and Eric Berg…[30:40]
-Where medicine and supplements fit into Jason's practice, and whether his supplements are regulated…[41:00 & 45:50]
-What Jason thinks about infant chiropractic care…[47:00]
-How you can know if you're getting a “good” vs. a “bad” chiropractic doc…[52:05]
-And much more!
Resources from this episode:
–The Joe Rogan podcast in which Joe interviews SciBabe Yvette d'Entremont about her article “Chiropractors Are Bullshit“.
-Ben Greenfield's previous interview with Yvette: “Is The Food Babe Really Full Of Sh*t?”
–Article: The Sci Babe is Neither Scientist Nor Babe: She’s Bullshit
–Dr. Isaac Jones podcast interview on 5 hidden causes of fatigue
–Functional Medicine Practitioner directory
–Ideal Spine Practitioner directory
–Best Practices for Chiropractic Care of Children: A Consensus Update.
But the podcast ain't all…
…in addition to the interview with Jason, my friend and chiropractic physician Dr. Patrick Gentempo penned his own response to the Joe Rogan interview. Over the course of three decades Dr. Gentempo has built one of the most reputable and recognized names within all of Chiropractic by leveraging tenacity of conviction and unrivaled business acumen. His name has become synonymous with innovation, a mindset which has spawned a myriad of liberating business ventures that all work toward a legacy level goal – to elevate chiropractic in a way never before attempted.
Dr. Gentempo has taken a hands on role and has shaped the core business strategy and market entry approach. His direct involvement has been critical for establishing operating philosophies and aligning partnerships that facilitate a purpose driven business model which will ultimately inspire more doctors to serve more people. He is the Chairman on Circle of Docs, a website dedicated to chiropractors.
Here's what Dr. Gentempo had to say…
The Case for Chiropractic: An Appeal to Open and Rational Minds in Healthcare
Doctors of chiropractic practice throughout the world and in the U.S. are licensed to practice in all 50 states. Although the basic science and clinical science research supporting chiropractic is robust and very compelling, the overwhelming number of patient testimonials regarding their experience with chiropractic care is truly remarkable. Most pro sports franchises have team chiropractors. Many celebrities, entertainers and rock bands travel with chiropractors. I have personally taken care of celebrity athletes and have toured with a very famous rock-n-roll band.
However, the chiropractic profession, even after over 100 years of extraordinary results serving countless millions of people, remains the target of illiterate controversy and imbecilic attacks. Many in the profession believed that after a United States federal court in September of 1987 found the American Medical Association guilty of Anti-Trust as it conspired to “contain and eliminate the chiropractic profession”, that these unfounded and malicious attacks would end. Although many medical doctors regularly refer patients to chiropractors and personally utilize their services, the attacks and misinformation continues.
Let me say that this article is not meant to be an anti-medicine rant, although since the practice of medicine is the standard that many use to judge chiropractic, certain data must be brought to light.
I appeal to the reader to, for a few moments, suspend conventional, indoctrinated thinking relative to healthcare so that perhaps a new and better understanding can emerge. In many respects, chiropractic is for the pioneer, the forward thinker, the person who has a bias toward a more natural approach to life and healing.
It is indisputable that for over 100 years, chiropractic has radically and positively transformed the lives of many, many people throughout the world. The question is: why?
Volumes of books have been published to more fully answer this question. My attempt here is to give a brief summary that organizes the logic and thinking around a truly unique and powerful service to humanity, chiropractic.
History Of Chiropractic (Was D.D. Palmer A Quack?)
The birth of chiropractic occurred in 1895 after the founder of chiropractic, D.D. Palmer, had given what he described as a specific spinal adjustment to a partially deaf man named Harvey Lillard, resulting in the restoration of his hearing. Many detractors refer to this as a myth and incorrectly cite that there is no physiological basis for this account.
In fact, there are many published cases of improved hearing after chiropractic care. These reports, published in refereed, peer-reviewed scientific journals come from around the world. Here is a link to a review article published in a trade publication by Dr. Christopher Kent, who has assembled some of these references and proposes some of the neurological mechanisms.
On a personal note, in my own practice experience, I have had patients with hearing deficits experience marked improvement in their hearing as a result of chiropractic adjustments. One story I’d like to share occurred within my first year of practice. A gentleman in his late 60s, let’s call him Stan, came into my office with primary complaints of low back and neck pain. He had hearing aids in both ears and had a significant hearing deficit for over 10 years. After Stan’s first adjustment, he left the office.
A few minutes later he came walking back in. He had tears in his eyes. I saw him in the reception room and quickly approached to see what happened. He asked, “Is it possible that what you did cured my hearing loss?” I replied, “Yes, as a matter of fact, that is the first case chiropractic was founded on.” He sobbed as he said, “Normally in my car, I have to turn the radio volume all the way up to hear it. I just now barely cracked the knob and I heard it clearly!” He then hugged me with quite a bit of force (he was a big guy), turned and left. Now, this is an ‘anecdote’ and some may say, “it doesn’t matter”. But I will tell you, it mattered to Stan. And it mattered to me.
We can debate the probability of a chiropractic adjustment being able to restore hearing deficits and it is a worthy debate. But personally, I have zero tolerance of fools who shrilly cry, “there is no plausible explanation for the Harvey Lillard story”.
Like any healthcare profession, chiropractic consists of a philosophy, science and art. And in fact, the philosophy leads the science and art. So let’s break some of this down.
Philosophy Of Chiropractic (And Why Medicine Isn't Really “Healthcare”)
I have always subscribed to Ayn Rand’s assertion that when you have contradictions in your basic philosophical premises, the only possible result is destruction. The amount of destruction is relative to the level of the contradiction. We are in the midst of what is described as an unprecedented healthcare crisis. In the United States we spend over $3 trillion per year on what we call healthcare, yet we are getting sicker, using more drugs, and some predict that the current generation is the first generation that will have a lifespan less than that of their parents.
I assert that the biggest contradiction in our culture today is calling medicine “healthcare”. The practice of medicine is not healthcare, it is sick-care, and when you take sick-care and give it to a culture as healthcare, you end up with a sick society. And no matter how much money you spend, you will never solve the problem.
In contrast, what are some of the foundational premises chiropractic is based upon?
- A living body is a self-healing, self-regulating organism. Cut your hand, it heals. Right now, your heart is functioning, kidneys, liver, digestion, etc. All this happens without you taking anything or thinking about it. It is an innate/inborn process.
- The nervous system is the master system and controller of your body coordinating and controlling all the functions of the body. This is universally understood although there could be debate over some of the nuances and details. But let’s stay big picture for now.
- Based on numbers 1 and 2 above, it stands to reason that if you interfere with nervous system function, you necessarily interfere with the ability for the body to heal and regulate.
- Stress in 3 dimensions, physical (how you use your body), biochemical (what you put into your body) and psychological (the mind/body connection), beyond what your nervous system can adapt to and dissipate, leads to patterns of vertebral subluxation (more on this in a minute) which diminishes the ability for the nervous system to function, thereby resulting in a state of declining health.
Are Vertebral Subluxations For Real?
Critics of the chiropractic profession try to assert that there is no evidence of this phenomenon referred to as vertebral subluxation. The term subluxation describes a bone that is moved out of place, but is not dislocated. So, a vertebral subluxation, in the chiropractic culture, refers to spinal segments that due to stress are misaligned, causing interference of nervous system function and reducing the body’s ability to heal and regulate.
The goal of chiropractic is to identify these vertebral subluxations and apply adjustments to the spine for the purpose of restoring alignment and improved nervous system function. To be clear, technically speaking there is much more to this. However, for the purposes of this paper which is to be read by the general public, I offer a simplified explanation.
I have heard ‘skeptics’ erroneously say that “there is no evidence that vertebral subluxation exists”. This is absurd. Personally, I have co-developed technology which I hold patents on and has been registered with the FDA for the purposes of helping to characterize the structural and neurological components of vertebral subluxation. It is being utilized by thousands of chiropractors throughout the world. Further, myself and others have authored and co-authored numerous articles in peer-reviewed, indexed journals outlining operational definitions of vertebral subluxation.
The Association of Chiropractic Colleges unanimously adopted a position paper with reference to much of this that can be accessed here. Some may attempt to disagree with the conclusions relative to all this, but only a fool would assert that “there is no evidence”.
Below is a graphic that helps one understand the healthcare continuum in the chiropractic paradigm:
Many falsely accuse chiropractors of making claims about ‘curing’ diseases like cancer or diabetes. Let’s be clear… chiropractic is not the treatment of any limited number of diseases. Through the correction of subluxation, the body’s own recuperative powers are unleashed, resulting in the ability for the body to increase the potential to heal, regardless of disease. There are numerous randomized controlled clinical trials published in peer-reviewed research journals demonstrating that subjects with a wide range of conditions respond positively to chiropractic care.
As a partial list, these conditions include ulcers, headaches, infantile colic, dysmenorrhea, visual impairment, high blood pressure, middle ear infections and a host of others. What is important to understand is that there is not a headache adjustment versus a high blood pressure adjustment versus an infantile colic adjustment. There is just the adjustment of subluxation which gives the body the best opportunity to heal.
It is, of course, true that many patients, especially those who have failed in the medical system, have sought chiropractic care in hopes of relief from a particular set of symptoms or conditions. And many times they attain the desired outcome. But unlike medicine, which has a different drug or intervention depending on the condition they are treating, chiropractic aspires to harness the innate healing power of the body regardless of condition. In my practice, I have seen a good number of patients with debilitating and sometimes terminal conditions. Some patients completely recovered. Some didn’t. All had a better quality of life as a result of the care.
Right now the skeptics are saying, “this is unproven, unscientific, even unethical! All doctors must practice evidence-based care!”
This debate, which I have been in for many years, boils down to one critical question: what will you accept as evidence? And this is a philosophical question that stems from the second branch of philosophy, epistemology – the theory of knowledge.
Many try to contend that the gold-standard of evidence is the randomized controlled clinical trial (RCT). And although this certainly is a part of a composite for evidence, it has some very well documented shortcomings. This is how, for example, a drug like Vioxx can go through RCTs, get approved by the FDA, and then have as many as 60,000 people die as a result of adverse reactions (according to David Graham, M.D. of the FDA). Further, an article published in the Journal of the American Medical Association (JAMA) cited that over 100,000 people per year die from adverse drug reactions when the drugs are ‘properly prescribed’…meaning that this doesn’t include negligence. All these drugs were cleared by the FDA after submitting RCTs for safety and efficacy.
In the meantime, many decry the “risk” of chiropractic due to this perceived lack of evidence and proper testing. This is on its face ridiculous. Two things (and again, this isn’t about medical bashing, I wouldn’t want to live in a culture where medical care wasn’t available – it is about getting the facts and comparisons straight):
- Medical errors are the 3rd leading cause of death in the United States ahead of stroke, diabetes and many other conditions. All the details are here.
- The real measurement of risk is malpractice rates. The actuaries don’t care about politics or opinions. They simply run data. Chiropractic malpractice rates are incredibly low because the risk of a law suit is incredibly low. Rates for the highest coverage available are typically under $2,000 per year. Contrast that to medical rates for varying specialties that can be 10 to 100 times that amount. It is indisputable that chiropractic is a much safer form of care than medicine.
In my view, there are four major forms of evidence to substantiate efficacy of care. None by themselves are adequate. They must be taken in concert. They are:
- Deduction: Using one’s knowledge of anatomy, physiology, biology, etc. and applying logic to draw conclusions.
- Induction: In health research applications, this is the randomized, controlled clinical trial.
- Outcome Assessment: Measuring parameters on individual patients longitudinally as they receive care. I spent much of my career in this area.
- Case Research: This is taking actual patients being cared for by actual doctors in the real world. These cases are written up in detail, go through peer-review and are published.
By looking at these four things as variables in the evidence equation, chiropractic stands very proud and strong in the realm of evidence.
I think it is important to point out that chiropractic, based on its philosophy and understanding of the deeper principles of life and nature, has taken controversial positions throughout the decades.
For example, chiropractors quite some time ago raised concerns about the widespread indiscriminate use of antibiotics. Logic being that human-beings aren’t the only organisms on the planet that adapt. Microbes do too, and they do it faster. So if you are constantly killing off microbes, it is the weaker ones that die, leaving the stronger ones to evolve. In the meantime, our human immune systems get weaker as we don’t have the opportunity to strengthen immunity naturally. We find ourselves today in a full-blown crisis as we have now created antibiotic-resistant ‘super-bugs’.
The World Health Organization and the CDC anticipate that if nothing is done by the year 2050, the yearly deaths due to antimicrobial resistance worldwide will be about 10 million and will have a global cost of $70 trillion! With a little logic and humility (we can’t arrogantly think that we can just wipe out all disease-causing microbes without consequence), we wouldn’t have this mess.
The Art of Chiropractic & Why Some Chiros Are Different Than Others
Chiropractors vary in their modes of practice. Some choose to limit their practice to back and neck pain only. Some not only adjust and correct spines, but they also get into general lifestyle wellness protocols. Others specialize in particular health challenges as they have special expertise there.
All of this does create brand confusion for sure. There is not one definitive mode of service practiced in the marketplace. However, I think this is true of many allied health professions and the diversity breeds choice.
The art of chiropractic rests in the delivery of the chiropractic adjustment. And there are many ‘techniques’ practiced by doctors of chiropractic. Some focus in specific areas of the spine. Some use very low force. Some use instruments. Here’s what I know: they all work. For sure, some patients prefer or respond better to technique approaches. But there are many effective chiropractic technique approaches that help people. The key is finding the one that best suits you.
There is no doubt that there are some bad actors out there in chiropractic. But of course, the same must be said for medicine, law, tax accounting and any other professional service. An expression about babies and bathwater comes to mind when considering this.
In summary, the chiropractic profession offers a very unique and powerful service to humanity. People benefit most when pro-actively engaging in chiropractic care to upgrade their health expression as compared to waiting until there is a problem and then trying to deal with it. Chiropractic truly shines in this area.
Unfortunately, there are still many ignorant voices out there spewing nonsense and dissuading people from seeing chiropractors. But fortunately, there is less of them every day, while more people of influence become public about their incredible experiences with chiropractic care.
As a cardiologist once said to a patient of mine, “chiropractors must be doing a lot of good out there, otherwise how could they have possibly lasted this long?”.
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