We don’t think all chiropractors are quack. However, we know there are some who peddle half truths and quackery tarnishing chiropractic care in Singapore. Today, we want you to know the truth of how to find a good chiropractor.

1. Spinal Manipulation and Chiropractic Adjustments are one and the same.

Spinal manipulative therapy is an umbrella term for a variety of thrust techniques used in musculokskeletal care therapy.

Chiropractic adjustments are performed by chiropractors, osteopathetic manipulations are performed by osteopaths. Physiotherapists do too perform spinal manipulation (that’s their preferred term). In fact, Singapore General Hospital used to have a outpatient physiotherapy clinic called “Manual Clinic” which offers spinal manipulation.

The common misconception is that chiropractic doesn’t work because chiropractic adjustments – by extension spinal manipulation – doesn’t work. This cannot be further from the truth. CNA published an article spinal manipulation can help ease low back pain earlier this year in April 2019.

So, spinal manipulation works. Chiropractors use spinal manipulation as a treatment to help people get better. Chiropractors market their spinal manipulative techniques as chiropractic adjustments or spinal adjustments. However, they are all the same thing.

No research has compared chiropractic spinal manipulation against those administered by physiotherapists or osteopaths. While the “style” of adjustment is distinctively different between professions, they all achieve the same things – a transient pain relief and an increase in your range of motion.

For more information, check out our blog post on chiropractic adjustments.

Singapore Chiropractic Quack Pseudoscience Evidence-based
Dr Jerry Kennedy from Black Sheep DC having a go at subluxation-based quacks.

2. Chiropractic (vertebral) subluxation does not exist.

Research for the past hundred years does not support that subluxations exist.

Chiropractors can define subluxation and very convincingly explain the (false) relationship between subluxation and poor health. The reality is that subluxation is most likely a fear-mongering sales gimmick used to pressure or scare prospects into chiropractic care.

They will probably also argue absence of evidence is not evidence of absence. Well, it’s been a hundred years!

Pop quiz: What is the animal that looks like a pony with a long and white horn on its head? Hint – it’s usually associated with purity.

Get my point now?

The ability to describe a unicorn clearly and identify it does not translate to that unicorns exist in real life!

You can read more about the chiropractic subluxation at Subluxation: dogma or science?

Pro tips:

  • When looking for a chiropractor, go through their website and “control + F” for subluxation. Start with their about us or what is chiropractic page – you know what to do when you find it!
  • Sometimes chiropractors hide their subluxation theories behind “spinal misalignments”. The telltale sign is if they post photos of before and after adjustments in their chiropractic clinic or promotional materials.
  • Most clinics promoting chiropractic adjustments as a therapy to correct chiropractic subluxations tend to sell packages upwards of 40 sessions. It gets expensive fast.
  • These chiropractic clinics also tend to refer you for x-ray. They will justify their x-ray referrals as superior clinical care. However, research shows that x-rays and MRIs BOTH delay recovery and, as a result, increase your health care spending. It’s lose-lose for you.

3. Chiropractors can’t tell if your vertebra is out of place.

This is almost laughable. To learn more about the curious case of palpation pareidolia, read Palpation, is it a skill, an art, or an illusion? by Sports Physiotherapist Adam Meakins.

Essentially, chiropractors, physiotherapists, or osteopaths all cannot tell you if your spine is misalign or out of the place.

What they can do is make an educated guess – based on their training and expertise – and tell you which vertebral segment they think is out of place or stuck or not moving well.

If we get 100 clinicians and ask them to palpate different patients, you will find poor agreement between the findings of each chiropractor or physiotherapist. Essentially one chiropractor may say T2 is misaligned in a patient and another chiropractor or physiotherapist, who now palpates the same palpate, may find T2 aligned.

In short, they are all making educated guesses but their educated guesses often don’t match up with each other.

Don’t believe us? The next time some one tells you your spine is out of place, seek advice from a second chiropractor or physiotherapist in the clinic. See if their findings match.

My guess? They won’t even let you do this mini-experiment.

For the hard data fans:

“The results for interrater reliability were poor for motion restriction and pain. These findings may have unfavourable implications for all manual therapists who use motion palpation to select patients appropriate for spinal manipulation.”

Interrater Reliability of Motion Palpation in the Thoracic Spine, Walker et al 2015.

p.s. X-rays don’t improve clinical outcomes as well. More on that at our blog post on lower back pain – the complete guide.

4. Spinal manipulation does not work for everyone and may not always be the best

Remain active and education is first-line treatment for treatment low back pain.

The first-line treatment for both acute and persistent low back is education and to remain active (The Lancet, 2018). For chronic low back pain, exercise and cognitive behavioural therapy are the first-line treatments with manual therapy coming in after.

Note: Movement is medicine! Exercise wins.

Of course, spinal manipulation DOES NOT work for everyone. Anyone who says otherwise is just selling snake oil. Studies from as early as 2004 have looked into who benefits from spinal manipulation. Guess what? Not everybody. Lower back pain sufferers who meet four out of the five the criteria and received spinal manipulation has a 92% chance of a successful outcome (Annals of Internal Medicine, 2004).

Yes, spinal manipulation is awesome. No, it’s not magic.

Finding the right chiropractic clinic for treatment will maximise your chances of a positive outcome. It is crucial to discern those who can help you from those who cannot. Unfortunately, chiropractic is not regulated in Singapore and patients are left vulnerable to sales opportunists. If you need a second opinion or help with finding the right person, drop us a message. We promise to try stay honest and true.

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