What are the red flags of chiropractic clinics in Singapore

I get that people love chiropractic. There are tons of videos of chiropractic adjustments online and they definitely do get a lot of traction. Before you decide to spend tens of thousands of dollars on a chiropractic package, you’d definitely want to know what makes a good chiropractor in Singapore. Today, we’ll share with you the red flags in chiropractic so you know what to avoid.

Sign up for a trial discount but realise it’s mostly a sales pitch

I am okay with chiropractic clinics offering trials at a cheaper rate. That makes sense. I mean, we are all in it to make money. If that’s going to help you get more business, then it makes sense to offer it. Right?

I  also get that sometimes people need to experience something first hand to know if it’s suitable for them. Back when I was looking for a personal trainers, I did attend a couple of trials. Nearly all of these trials are at a discounted rate, and I must say they did help me figure what I was looking for. So, yes. I do get the argument that sometimes people just need to try first.

The issue I have is when these paid trials are more of a sales pitch. I think it’s terrible to pay money to someone only for them to excessively exaggerate how bad your condition is, and why you definitely need treatments. I feel like I have paid money to you, I’d want a professional, fair, and balanced opinion. Not a sales pitch.

What usually happens at a hard sell chiropractic clinic in Singapore

During your initial session, you often would consult with a chiropractor who will assess your case. Following which, they would go through a presentation to explain in detail what will happen to you should you chose to not seek treatment. You can think of this as priming strategy. They want you to believe that your problem is truly terrible, and that you will never get better without them. You can expect fear mongering sales talk as well.

This is when they would usually advise you to go for an x-ray. Many of these chiropractors would also reject the chiropractic x-rays or  MRIs you have done with other doctors.

The highlight of the first session would be the final act when a “consultant” would come to you to try to hard sell their x-ray and chiropractic treatment packages to you.

These trials can last anything from 45 minutes to over 2 hours. The amount of time spent with the chiropractor to discuss your specific conditions is limited to 10 to 15 minutes. Most of the advice provided are generic that applies to everybody. Some examples are, your spine is out of alignment, you have interference in your spine that is affecting your nervous system. These narratives are used for 100% of the patients who walk through the doors.

The truth is that you are a unique person, and that such broad strokes advice is hardly beneficial for you. Sure, you do feel better after the chiropractic adjustments (the same set that everybody else in the clinic will receive). However, the results don’t last.

In our opinion, this doesn’t constitute allied healthcare. These clinics operate more as a chiropractic adjustment provider factory line.

It is no surprise their clients have to always keep coming back, and never truly achieve full recovery.

How do I know this?

I worked for one of these clinics before. I saw firstline how the chiropractors and the “consultants” work. When I spent more time with a client cos they had additional questions or issues, I got chided by the consultant.

The reason? Other clients will complain if I spend more time with one client but not them. Offering advice and exercise recommendations outside of chiropractic adjustments is also not part of the SOP.

Yes, they was a 100+ page SOP to follow. These clinics are designed to run so the chiropractors do not offer personalise. The reason is so the businesses the can retain their customers even if the chiropractor was to leave.

At one point, I was told that I should have sold harder on a 5k package to a janitor. The janitor already clearly indicated they had no money and I was chided for not going through credit card instalment options with them. Like, um, no thank you?

Treatments are all about chiropractic adjustments and lying in sleek-looking spinal decompression machines

The plus side of the open concept chiropractic clinics in Singapore is that you can see how other patients are treated. It’s a great opportunity to see what is being done for each patient. If the chiropractor takes less than five minutes to read the patient’s file, and ask little to no questions about the patient’s condition, it’s 100% a red flag.

Most of these clinics do not take notes with every treatment so it should be super obvious that it’s just a factory line setup. Most chiropractors today will at least ask some questions about the condition. The key is to observe if they do update the patient’s file. Because if they don’t, then they definitely aren’t tracking session-to-session progress (if any).

Short time with chiropractor, long time with machines

I mean, most chiropractic treatments in Singapore are ultra short. They last like two to give minutes with the chiropractor. Sure, there may be other treatments like heat therapy, spinal decompression, etc that will put your session at closer to 30 to 45 minutes in total duration.

The reason these treatments are highly popular and favoured among chiropractors is that they have really good ROI (return on investment). The machines may cost up to 20k to 30k each. Sounds expensive but if that means a chiropractor can spend less time with a patient, it means they can see a lot more patients and that is more revenue for the business.

Singaporeans are definitely more educated and on-the-ball now. It’s not possible to just do a 10-minute treatment and send a patient home. This is why clinics started to bring fancy equipment that don’t require a chiropractor to physically attend to the patient in. You get a stronger sense of that something is being done, and you feel like you are not wasting your money.

Most of these machines have questionable treatment efficacy

Virtually all clinical guidelines in the world do not support the use of such equipment. For example, for low back pain, the first line treatment is exercise, education, and advice to stay active. Spinal decompression therapy is not recommended.

This isn’t even news. In 2010, CBC in Canada ran an expose episode on spinal decompression therapy. They showed how a multi-clinic chain use exclusively spinal decompression therapy to maximise profits. Since these treatments don’t work, patients have to keep coming back and it’s kinda good for money.

I think there’s a bit a sunk cost fallacy involved. I’ve already spent a thousand dollars and I feel like maybe I am getting better. I just need to stick through with more sessions so I don’t waste the sessions I’ve already attended.

No, get out. Now.

Do not offer any kind of exercise treatment

I think any clinics that don’t offer exercise as a treatment option is 100% a red flag. Just leave. Unless you are happy to come back over and over again for the rest of your life, then by all means continue.

There’s nothing wrong with that of course. I do go for massages every so often cos they are indeed damn shiok. Sometimes I go when I am feeling sore after some intense workout. Sometimes I go when life is a bit stressful and I am feeling a little tense all over. Nothing wrong with that! But do I expect them to solve any of my problems? No.

It is so clear that exercise is the only treatment option that can consistently deliver long-term results for chronic pain. No, I am not saying it 100% can cure your pain but it definitely has the highest chance of doing so.

Let’s use getting good grades for exams as example. Let’s say you have a budget of $200 per month to spend for getting good grades. Do you think it will be better spent on tuition classes or on chicken essence?

Mind you, I am not saying chicken essence is totally useless. I am saying that between the two, there is a clearly superior option. When it comes to chronic pain, exercise is the superior crème de la crème. I sumpah (swear) I never bluff you.

Not all exercises are created equal

Since I’ve started posting content about how chiropractic adjustments along will not give long-term results, many clinics have started to offer some form of exercise in their treatments. Hurray!

But, there’s always a but, not all of these exercises are helpful. Some clinics are very half-hearted at prescribing exercises. The exercises are often generic and what you can find online. The chiropractor may also not provide personalised instructions to how you should do them for your unique case.

At Square One Active Recovery, we use exercises as the primary treatment. But we don’t just use exercises you can find on Instagram or TikTok.

Many of the exercises I prescribe are created on the spot for my clients. Even if they were a more conventional type of exercise, I will always make tweak and modification so they are personalised to what my clients need.

Honestly, if no expertise is required when it comes to using exercise for chronic pain recovery, then you can just follow an online video and be pain-free. I would quite literally be out of a job. Alas, there is no such foolproof fixes yet.

Your chiropractor is ONLY concerned with fixing the “interferences” to your nervous system

A lot of chiropractors in Singapore work within a chiropractic subluxation framework. In their vertebral subluxation complex ideology (or dogma), they think that correction of these interferences to your nervous system is the cure to all diseases.

In fact, they genuinely believe that it could be the key to all health conditions that some chiropractors (even in Singapore) did advertise getting adjusted regularly as an effective strategy to reduce your chance of contracting COVID. We find these pseudoscientific ideologies absolutely abhorrent, and the greater chiropractic community had published articles to refute these claims.

The problem with the subluxation, in our opinion, is that chiropractors cannot consistently find them in an experiment setting or that the tools that are used are not validated to be reliable. If subluxations do exist, that similarly trained chiropractors should be able to agree on where in the spine they are found. We don’t see that this is possible. Similarly, the instruments used to detect subluxations are not consistent in their readings.

We don’t deny that chiropractors can be super passionate when they talk about subluxation. They are very good at defining what a subluxation is and what it means for patients if you should to not address them. This doesn’t make subluxations real!

For example, what is a white horse-looking animal with a horn on its head? That people often associate with rainbows or purity?

You probably guessed it right. It’s a unicorn.

Just because we can define a construct very clearly and that others can also recognise it, doesn’t mean unicorns do exist!

Your chiropractor doesn’t track your progress

We alluded to this earlier. Most chiropractors simply don’t check in on the progress you are making. Some may ask how you are coming along in your recovery. Most just use their magic hands to decide how close you are to complete healing.

The problem with professionals that use their hand to diagnose or assess conditions is that everyone has at least one problem. When is the last time you heard a chiropractor or massage therapist say a person’s body is working very well?

Like how chiropractors think everyone has a joint fixation, massage therapists will tell you about your tight muscles and knots.

So, there’s no real tracking of recovery outcomes. There is no objective measures, that you can check on your own, to show that you are getting better.

Some chiropractors do use x-rays to assess the progress their patients are having. The problem with this approach is that it’s junk science. American Chiropractic Association is clear on that x-rays do not improve recovery outcomes. As they so eloquently put it, as evidence expands, our practice must involve.

We do things differently at our practice. We promise you that all of our clients can see objective week-on-week improvements in their strength, mobility and range of motion, function, and many more! Majority of our clients will leave lifting more than they have ever done in their lives!

One of the upsides to using exercise as a recovery tool is that you don’t feel better because it’s a good day, because we have done something to your spine. You are better because your body is physically better than before you came. This is our we help our clients attain their recovery goals.

Chiropractic treatment in Singapore

Despite chiropractic’s popularity in Singapore, there is still a lot of bad press to the chiropractic industry. This comes as no surprise as majority of chiropractic treatments here do not conform to best evidence practice in the world. Nonetheless, not all chiropractors are like this.

At Square One Active Recovery, we use an evidence-based approach to help our clients find freedom from pain.

The research is clear, exercise plus education is superior to all other known modalities. We added lifestyle change coaching into our programmes to help our clients develop meaningful health habits, so they can stay physically health without having to keep coming back to us.

If you have been trying chiropractic but you are not getting results, we highly recommend that you reach out to us for a consultation. We will be happy to discuss why you are not getting better despite treatments.