My friend Paul briefly dated a chiropractor once, a few years ago. We all went out to dinner one night and I basically asked her as many questions as I could about what it was like to be a chiropractor without crossing the line into being annoying. (At least, I hope I didn’t cross the line!).
I was just so curious– after all the chiropractors I’ve met and been treated by… what is the actual deal?
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I learned something really fascinating from her, that I feel should be more common knowledge:
What she said is that there are two main schools of thought within chiropractic. She called them “straight” and “mixed.” Personally, I feel these terms are somewhat strange, and I apologize for any other connotations they may bring up. But in the spirit of relaying to you what Paul’s chiropractor friend explained to me:
“Straight” has to do with the original, old-school brand of chiropractic. It’s “more similar to how it was when it was first developed– and more “out there.” This is where you’ll find the chiropractors who claim that their treatments can fix just about anything, and that so many different health conditions and diseases within the body, including little things like ear infections, can be caused by “subluxed” joints.
“Mixed,” on the other hand, refers to the approach to chiropractic that is more closely linked with traditional mainstream medicine. “Mixed” chiropractors are more likely to consult with doctors and read x-rays. They aren’t as into the idea that adjustments can fix just about anything, and are a little more straightforward about using their treatments to improve function and reduce pain. (They aren’t going to tell you they can cure a sore throat or an ear infection).
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Now that I understand what the two approaches are about, I can look back and see that I have seen chiropractors who practice in both schools of thought. The only one that I would recommend– with reservations– is “mixed.”
Generally speaking, I found that the “straight” chiropractors are the ones who predict you’ll need a really high number of visits. It’s not that I think they’re all charlatans– generally speaking, chiropractors aren’t like used car salesmen.
But I think it has more to do with the school of thought they’re in, thinking they can cure so much in the body just by adjusting it.
And I also think they try too hard to fix every single little postural defect, when the truth is (I’ll write about this more later) not every anomaly or imperfection in the body is actually causing a problem, or needs to be corrected. No one has perfect, textbook posture– it isn’t a necessary or attainable goal.
And of course, I never actually got results from any of the “straight” chiropractors I saw. In fact, the first time went to a “mixed” chiropractor was actually shocked that I felt pain relief right away, after the first visit. The “straight” chiropractor had had me coming in for 25+ visits, and I never actually felt any better. He had told me to expect long-term improvement, but when I compared it to the instant pain relief from the “mixed” chiropractor, I realized I’d been wasting my time.
So I only recommend “mixed” chiropractic. Sort of.
I had one main chiropractor that I went to for most of my struggle with sacroiliac joint dysfunction– Dr. K. As time went on I saw a couple of others, mainly for scheduling and location reasons. Ultimately I had three chiropractors that I went to semi-regularly over this five year period.
These mixed chiropractors– let’s call them the good chiropractors– were all much more limited in the scope of what they promised me they could achieve for me. All three recommended I keep going with physical therapy and strengthening, and explained that the key to staying better would be to develop more muscle strength to hold my joints in alignment.
I definitely do have my critiques of this approach as well.
As I mentioned in my last post, I wish they hadn’t phrased things in a way that made me feel as though I had to rely on adjustments. What I really needed to do was build up my muscles, so that I could reply on them.
I feel as though my appointments were always too rushed. I could have asked so many more questions each time. However, they were only being paid by my insurance company to perform adjustments, so when mine were over, it was on to the next patient.
So much of what I learned, I had to learn in bits and pieces. I don’t have a formal way to evaluate everything they told me, but based on my experience as a patient, and also cross-checking everything they told me with PT’s and on my own reading– I believe the explanations they gave me of the SIJ were generally scientifically valid. I would walk in not having ayn idea which way my hips were rotated, and each time, they would be able to evaluate me and (temporarily) unlock whichever joint had locked up.
However, that leads me to my next point…
The SI joint adjustments backfired.
As I have mentioned in so many places previously, it turned out that chiropractic adjustments to my SI joints were actually making things worse, not better.
This is because, although they were technically moving my bones into the right place, the process of moving them was putting too much stress on my sprained ligaments, making it harder for them to heal.
I discovered this by accident when I was travelling and couldn’t receive adjustments. However, by then I’d learned to perform the Muscle Energy Technique on myself, which is much gentler. I switched over to using that exclusively, and things got a lot better.
I have had adjustments on other parts of my back as well, and to my knowledge, no other area has reacted that way. I think that’s possibly because no other part of my back had ligaments that had been sprained. Regardless, this is why I generally recommend people not receive chiropractic adjustments to the SI joint if they have any alternative. Or, if there’s no alternative, make really careful observations of how their joints behave in the days afterward.
Ultimately, I think the more medically-oriented forms of chiropractic do have something to offer. Even if it isn’t always the adjustments themselves.
I no longer receive chiropractic adjustments to my SI joints, but that doesn’t change the fact that I think my “good” chiropractors were right when they diagnosed which way the joints were rotated, etc.
I think mixed chiropractic does have something to offer. When you read the literature on the SI joint from doctors and physical therapists, there seems to be a lot of confusion on how to diagnose the SI joint (and then some people claim that since we can’t accurately diagnose it, the dysfunction can’t actually be real!).
Of course, you and I both know that it is most definitely real, and we deserve help.
I believe we’d get a lot further if mainstream medicine had some better developed ways to evaluate the SI joint. And that’s where I feel some of the techniques of medically-oriented chiropractic could come in handy. Because, again, I do feel my “good” chiropractors were able to accurately identify which way my hips were rotated, even if the adjustments themselves were too destabilizing.
PT’s can perform somewhat similar adjustments.
Long ago, (pre-SI joint dysfunction) I used to have PT adjust my neck, and he said what he was doing was a Grade 3 adjustment– like a chiropractor but gentler.
So, to the people who’ve looked at me like I was crazy over the years for going to a chiropractor… well, I don’t think it can be that crazy if PT’s are also giving adjustments.
I don’t really know a ton about how the two forms of adjustments compare, but this brings me to my next point:
Something I hope to do as a PT is to combine some of the useful aspects of chiropractic with the science-based knowledge of physical therapy.
For example, I would love to be able to evaluate and diagnose patients with SI joint dysfunction, using some of the same tools for analysis that chiropractors taught me… while also knowing that the adjustments themselves might not be a great idea.
I think, ultimately, for the SI joint, chiropractors’ greatest offering might be their ability to identify what’s going on in that part of the body. As a patient I really came to feel that my good chiropractors were able to accurately pinpoint things and (temporarily) reduce my pain. The problem just lay in the aftermath of my ligaments then being weaker.
But I’d love to somehow borrow some of the useful aspects of this, and use it to create a more productive, more gentle style of diagnosis and treatment.
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Okay, I guess we’ve reached that point in my post (like we do in so many of my posts) where I’ve probably covered enough ground and should stop for now!
However…. here is a post about chiropractors I wrote over on Sunlight in Winter. It talks about some of the potential risks from chiropractic adjustments, which I didn’t go into here, so you might want to check it out.
Hope you enjoyed this post– feel free to let me know your thoughts!
My Sacroiliac Joint Saga 