Chiropractors: Are They Legit?

Summary

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Podcast Summary: Science Vs – "Chiropractors: Are They Legit?"

Host: Wendy Zuckerman (Spotify Studios)
Date: December 4, 2025

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Episode Overview

This episode of Science Vs investigates the legitimacy of chiropractic care: Does it work for back and neck pain? Should babies and children visit chiropractors? Are there risks? Host Wendy Zuckerman, with input from experts, patients, and family anecdotes, explores chiropractic’s history, the science supporting or rejecting its claims, and potential dangers—cutting through myths to pit chiropractic care against medical evidence.

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Key Discussion Points & Insights

1. Background: Family Anecdote & Prevalence

• Anecdote: Producer Caitlin Sori and her family have visited chiropractors for years—for both adults and children—leading to personal stories of relief after treatments.
• Prevalence: One in ten adult Americans went to a chiropractor in 2022, mostly for pain.
  • (00:23–02:40)
  • Quote: “My muscles feel a lot more relaxed and my neck feels like it's not so grindy is the best way to describe it.” – Chris, Caitlin's mother, (02:19)

2. What Do Chiropractors Actually Do?

• Spinal Manipulation: Chiropractors perform quick thrusts to the spine to realign segments, claiming to address “misalignments” or “subluxations.”
  • (02:44–03:10)
  • Quote: “It's not like a massage... It's like pop back into place.” – Caitlin, describing sessions (02:44)

3. Chiropractic Origins & Philosophy

• Dee Dee Palmer: Founded chiropractic in the late 1800s, originally claiming spinal adjustments could cure deafness and later, nearly all diseases.
  • (05:53–10:15)
• Subluxation Theory: Palmer theorized that blockages in the spine disrupt nerve energy ("life force"), causing disease.
  • Current chiropractors define subluxations variably, from “joints that don’t move properly” to “bones out of place” affecting nerves, muscles, and more.
  • (08:50–09:58)
• Mainstream Acceptance: Despite mystical origins, U.S. Medicare covers some chiropractic services; American College of Physicians lists spinal manipulation as a potential back/neck pain treatment.
  • (10:27–10:55)

4. The Evidence: Does Chiropractic Help with Pain?

• Neck and Back Pain:

  • Anita Gross (physical therapist/researcher, McMaster University) reviewed 40 studies on chiropractic spinal manipulation:
    • Evidence is “low quality” (small, poor studies), but for some people, multiple sessions may reduce neck and back pain.
    • At least one study found spinal manipulation more helpful over a year than medication.
    • Exercise in combination with manipulation is often more effective.
  • (11:18–14:52)
  • Quote: “So the studies are showing that spinal manipulation actually does help. It's valuable, yeah.” – Anita Gross (12:15)

• Placebo Effect:

  • Relief may be partly due to the placebo effect or the therapeutic experience of being cared for.
    • (30:15–31:17)
  • Quote: “It's all about whether it feels good for you.” – Chris, Caitlin's mother (31:10)

5. Chiropractic for Babies & Children

• Anecdotes and Practices:
  • Techniques for infants are much gentler, involving small manipulations or gentle swinging.
  • Katie was taken to a chiropractor as a newborn (for "misaligned bones" after forceps delivery), reportedly slept better afterward.
  • (14:52–15:20)
• Controversy & Lack of Evidence:
  • Viral videos and medical backlash have prompted bans—e.g., Australia prohibits under-twos from chiropractic manipulation.
  • A comprehensive international review found “no good evidence to explicitly support the effectiveness of spinal manipulation for any condition in pediatric populations.” (16:30–17:13)
    • Quote: “Currently, there's insufficient research to either support or refute the use of manual therapy in children.” – Carl S. Cleveland III, chiropractor (17:13)
  • Parents express a sense of being “sucked in” by prevailing beliefs and community practices around chiropractic for kids.
    • (18:42–19:11)

6. Questioning Chiropractic’s Core Beliefs

• Subluxations Under Scrutiny:

  • Many chiropractors still focus treatments on “fixing subluxations” for general health, but neurologist Marcello Costa argues there’s no evidence these “misalignments” exist outside certain actual spine injuries.
  • (25:32–29:24)
  • Quote: “The subluxations simply do not exist physically.” – Prof. Marcello Costa (28:18)

• Wider Claims (Asthma, High Blood Pressure):

  • Dismissed as scientifically unfounded. Spinal manipulation has no proven effect on conditions like asthma.
  • (27:04–27:58)
  • Quote: “There's no basis whatsoever that can cure asthma. This is a complete nonsense.” – Prof. Marcello Costa (27:37)

• Within-Chiropractic Dissent:

  • Some in the field call subluxations “an albatross around our collective necks.”
  • (28:30)

7. Risks and Side Effects

• Minor Risks:
  • Worsened pain, headaches, nausea, or dizziness; typically resolve on their own.
  • (31:17–33:11)
  • Quote: “The manipulation happens so quickly then. Ah, you got that dizziness.” – Anita Gross (32:38)
• Rare but Serious Risks:
  • Dislodged blood clots, arterial tears, strokes, and deaths are documented but extremely rare (1 per several million manipulations).
  • Some cases (e.g., Katie Mae) have led to fatalities following neck adjustments.
  • (33:11–33:34)
  • Quote: “Yeah. A young person... gets their neck manipulated and then they die. Like we've had a few cases like that.” – Anita Gross (33:11)

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Notable Quotes & Memorable Moments

• “It's a bit like religion. You gotta filter out the bull, I reckon.”
  – Bill, Caitlin’s dad (34:46–34:51)
• “The science behind it is simply not there. The belief system is entirely contrary to our knowledge of physics and chemistry and biology.”
  – Prof. Marcello Costa (27:04)
• “If it's making people feel better, what is the problem here?”
  – Wendy Zuckerman, host (31:17)

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Timestamps for Key Segments

• Chiropractic family anecdotes and prevalence: 00:23–03:26
• History and origin of chiropractic: 05:53–10:15
• Current scientific evidence for spinal manipulation: 11:18–14:52
• Pediatric chiropractic: practice, controversy, and evidence: 14:52–18:42
• Core beliefs (subluxation) and their scientific validity: 25:32–29:24
• Risks: minor to fatal: 31:17–33:34
• Verdict and summary reflections: 34:32–35:04

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Conclusions & Takeaways

• For Adults with Back/Neck Pain:
  • Spinal manipulation by chiropractors can relieve pain in some people (“low quality” evidence), mostly for back/neck issues—not as a cure-all.
  • Why it works is unclear; may partly be placebo or release of tension.
• For Children:
  • No “good evidence” supports chiropractic for any pediatric condition. Potential risks, though rare, make it controversial and in some places prohibited for young children.
• Core Theory of Subluxation:
  • No scientific basis for subluxations (“misalignments”) causing general illness; concept is disputed even within the chiropractic community.
• Risks:
  • Minor side effects are common, but serious consequences (stroke, death) are extremely rare but not impossible.
• Final Thought:
  • Chiropractic may offer relief from some musculoskeletal pain, but core claims about treating a wide array of health conditions are unsupported. As host Wendy points out, “If it's making people feel better, what is the problem?”—but users should be aware of limitations and rare risks.

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Transcript

[A]

Hi, I'm Wendy Zuckerman and you're listening to Science Versus. This is the show that pits facts against.

Ah, the satisfying sound of a back being cracked. Because today on the show, chiropractors are they legit.

Millions of people have back and neck pain and it can be pretty hard to treat. There are drugs that can help, but they can also have some pretty nasty side effects. And so people are desperately looking for other solutions, like going to the Cairo around. One in ten adult Americans went to the Cairo in 2022, mostly for pain. That's according to the National Institutes of Health. And of course, it's not just Americans going to the chiropractor. Several years ago, producer Caitlin Sori called up her parents who are big fans of going to the Cairo.

[B]

Katie, how is New York going?

[A]

It's good.

[C]

So you're still riding your bike to work?

[D]

Yeah, I do. Don't worry, I'm safe.

[B]

Your mother is worried.

[A]

Katie's mum is Chris and her dad is Bill. And the whole Sori family had been going to the Cairo for years. So Katie, tell us all about it.

[D]

Yeah, so my parents have been going to the Cairo for ages and I actually didn't know about this until we called them up to talk to them about it, but I was actually taken to the chiropractor as a newborn baby.

[A]

Wait, why did they want to take you to the chiro?

[D]

Because my delivery, my birth was really rough. They had to really yank me out and so the idea was that maybe my bones were misaligned so they wanted to take me to the chiropractor to see if it could help.

[C]

Yeah, because you had such a traumatic.

[B]

Birth, you know, like you had huge marks around your face where the forceps grabbed your cheeks. So you didn't look to terrific for the first few days because of that.

[D]

And mum says visiting the Cairo seemed to be good for me. I slept better. And so when my brothers were born, they were also taken off to the Cairo. And my parents still go for neck and back pain. Dad has smashed himself a fair bit over the years.

[C]

So I've fallen out of a tree. I've fallen off a motorbike.

[D]

Yeah, Dad's been thrown off a motorbike. He's fallen off a ladder. So the chiro makes him feel better. Same with mum.

[B]

My muscles feel a lot more relaxed and my neck feels like it's not so grindy is the best way to describe it.

[A]

Wait, so do you remember going as a kid?

[D]

Yeah. So the whole family, we went right up until I was 18. All five of us, every six weeks or so.

[A]

Okay, so I've never been to a Cairo. What do they actually do when you get in there?

[D]

Yeah, so the main thing that chiros do is this thing called spinal manipulation. So they're basically checking your spine, all the little segments in your spine, to see if anything's out of place. And then they're popping it back into place. And they can use a little tool or they can use their hands, but it's a quick thrust. It's not like a massage where you're kneading, kneading your back. It's like pop back into place. Anyway, it was just a thing the whole family did.

[C]

We'd skip out. Happy little vegemites.

[A]

We're happy little Vegemites. As bright as bright can be. We all enjoy our vegemites.

[D]

We were happy little Vegemites coming out of the chiropractor's office. It's an Aussie thing.

So is this thing that we did throughout my childhood. Total bs.

[B]

So tell us about the science. Come on.

[A]

Because not everyone out there reckons that going to the Cairo will make you a happy little vegemite. People on social media have been calling them out for being dangerous, for having a strange mystic history, and they're really starting to question whether this is legitimate medicine or a scam. Why am I only just learning that chiropractors are not real doctors? Yeah, Letting a chiropractor touch your neck is a threat to your life.

[E]

I don't believe in chiropractors at all. I think it's 98% horseshit.

[A]

We at Science Versus first looked into the science of chiropractors several years ago. But we've cracked open this episode once more updated the research and today we are going to find out. One, can chiros help your back and neck pain? Two, should you take your baby Katie to the chiro? And three, what are the risks here.

When it comes to chiropractors?

[C]

There's a lot of happy little vegevice.

[A]

But then there's science.

Science versus chiropractors is coming up.

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[A]

Welcome back. Today we've got a cracking episode for you. We are looking at whether chiropractic can help treat pain. And yes, chiropractic. It sounds like an adjective, but it's actually a noun. It bothers us, too, but moving on. So why did chiropractors think they could help little baby Katie and everyone else in her family, too? Well, it turns out that you can trace it back to one guy who lived in Iowa more than 100 years ago. You are in Iowa. And to get this story, we spoke to chiropractic royalty, Carl S. Cleveland iii. Yes, Carl comes from a long line of chiropractors.

[E]

My great grandmother was a chiropractor. My grandfather and grandmother were chiropractors, and my mother and father were chiropractors. As a child, I thought everybody grew up to be a chiropractor.

[A]

And he's the president of Cleveland University, Kansas City, which was founded as a chiropractic college. In fact, his family started it. And so Karl told us about the birth of chiropractic. It began with a man called Dee Dee Palmer.

[E]

He was Canadian, appeared to be a stocky man, had a full beard.

[A]

Dee Dee Palmer was a magnetic healer in the late 1800s. So he thought he had a personal excess of magnetic energy that he could channel through his fingers to treat people. It was a thing back then. But something changed for Dee Dee Palmer, and soon he would switch from magnetic healing to back cracking. Here's basically how the legend goes. Dee Palmer met this janitor who was hard of hearing and also had a hump on his back. And Dee Dee Palmer thought he could help. So he pushed the janitor's back with a big thrust. And a few days later, the guy came back with some very curious news.

[E]

Saying, Mr. Palmer, I hear the racket of the wagons in the street.

[A]

A new profession was born. And Dee Dee Palmer named it chiropractic, meaning in Greek, a practice done by hand.

[E]

And Palmer then thought he found a cure for deafness, put out a sign. Dee Dee Palmer Healer of the deaf.

[A]

Soon, Dee Dee shifted away from just curing deafness by manipulating spines. He now wanted to cure practically everything.

And this brings us to the theory behind chiropractic. Basically, Dee Dee Palmer started to think that the spine was the key to health. And here's what he thought was going on. Dee Dee believed that there was energy flowing through the spine to keep us healthy.

[E]

He was a spiritual man and he saw that when spinal joints didn't move right and that that in some way obstructed the flow of nerve energy and life force through those nerves to the body parts.

[A]

That is, he reckoned that these kind of blockages in the spine, or what he called subluxations, could make you sick by interfering with that mystical energy. At other times, he said those subluxations tweaked people's nerves. Didi ultimately thought that 95% of diseases were the result of subluxations. And in fact, he wrote that it was unjust to blame germs for disease. And today, Didi Palmer's term subluxation is still used by a lot of chiros. The word means slightly different things to different chiropractors. For Carl, a subluxation is basically a joint that doesn't move properly and that.

[E]

Could result in pathological changes that affect nerves, muscles, ligaments, the vascular tissue in the area as well as the connective tissue.

[A]

And some other chiros even say that this could lead to things like asthma and high blood pressure. For Carl, he reckons that people need to visit the chiro not just when something's sore, but for regular checkups, kind of like how you go to the.

[E]

Dentist, a periodic spinal checkup to maintain posture, to maintain function and mobility of those joints. We think that's important.

[A]

Despite the mystical origins of chiropractic, it is actually starting to get some real cred. In fact, in the US, Medicare, the federal health insurance program covers the chiropractic treatment of subluxation. And in 2017, in the search for better ways to fight back pain, the American College of Physicians included spinal manipulation on their list of suggested treatments.

Which brings us to this question of how good is the evidence that chiros can help you treat your pain? And specifically, let's look at back and neck pain, which is why most people go to the chiro. To get some answers, we called up Anita Gross, a physical therapist and researcher who specialises in neck and back pain at McMaster University in Canada.

[G]

Hello.

[A]

How are you? Several years ago, Anita and her team combed through almost 40 trials looking into whether Spinal manipulation, the thing that chiros do, can actually help with neck pain. And a lot of what she found were crappy trials.

So, for example, many of them were small, often involving no more than 30 people. And by the way, in science, you don't officially call these studies crappy. Instead you call them low quality. Low quality actually is not the worst. The worst is very low quality.

[C]

So low quality, believe it or not.

[A]

Has a little bit of hope in it. And she did find some hope. Anita found that for people who had multiple sessions with a chiro, well, they actually did tend to have less pain in their neck. And one of the studies she looked at even compared spinal manipulation to conventional medication, like taking anti inflammatory drugs, muscle relaxants, and even opioids. And it ultimately found that going to the chiro turned out to be more helpful than drugs. That is, after a year, the people going to the chiropractor had less pain than those who are on the meds. Now, we do need more data here to see if this holds up, but for now it sounds pretty impressive. So the studies are showing that spinal manipulation actually does help. It's valuable, yeah. And just this year in 2025, another review on whether spinal manipulation helps neck pain came out. And ultimately they found the same thing. Low quality evidence that for some people it helps. So those were studies in neck pain. And then when you look at back pain, the research is pretty similar. So again, we don't have great studies, but what we do have some suggests that spinal manipulation can help. And when patients walk through Anita's door, she'll sometimes give spinal manipulation a go. So it's something that I use clinically.

[C]

In my own practice.

[A]

Since you do these big reviews and you find that there's low quality evidence that it helps, how come you give it to your patients? To do nothing with your patients isn't of any value either. You're getting them better in their everyday life, their function, and being able to actually do their activities. Ultimately, Anita says that mainstream medicine just doesn't have a lot of great options for treating this kind of pain. And so spinal manipulation is sometimes useful. And she did point out that she typically doesn't just use spinal manipulation on its own. She also likes to combine it with these other exercises that can help make people stronger and move their bodies better. So going to the Cairo might help you with pain along your spine, but some Cairos reckon that it should be used for way more than that. And one of the most controversial claims is that even kids should be going to the Cairo. The American Chiropractic association openly encourages this. And according to the National Institutes of Health, chiropractic is one of the most common forms of non traditional medicine used in kids in the us which takes us back to little baby Katie getting her tiny little spine aligned.

[D]

Can you describe how they did it? Like what was actually happening?

[B]

Kind of just massaged your head and then they, they would just lift you up by your ankles and just swing you, but just really gently, really, really gently and then just lay you back down again.

[D]

I'm so nervous. For me, in retrospect.

[B]

They recommended I did that every day, which I did for about three months, I think.

[D]

And then why did you stop at three months?

[B]

Because you were getting a bit heavy. And I was like, hmm, this is not good.

[A]

And recently there's been quite a bit of controversy about taking kids to the Cairo. A few years ago, a video of an Australian chiropractor holding a baby up from its ankles and using a tool to manipulate its spine started making the rounds on social media and in the news. A two week old baby squirms as he's dangled upside down before. A spring loaded instrument is used to prod the newborn's neck. And we're gonna come into here.

The video sparked widespread condemnation, particularly from the medical community.

[C]

If I had a child in this age group right now, I would not let this happen to them.

[A]

It caused such a scare that Australia temporarily banned spinal manipulation in kids. While experts tried to figure out what the hell was going on here, they ultimately came to the conclusion that there just isn't any good evidence that supports taking your kids to the Cairo. And while they pointed out that really scary outcomes from doing this are very rare, they still didn't think it was worth the risk. And right now in Australia, there is a ban on kids under two going to the Cairo.

And it's not just Australia that's having this conversation. An international team of researchers, including Anita Gross, recently did this big review looking at chiropractic treatments for kids on a bunch of conditions from asthma to autism to breastfeeding difficulties, excessive crying, bedwetting, and ultimately concluded that there is, quote, no good evidence to explicitly support the effectiveness of spinal manipulation or mobilization for any condition in pediatric populations, end quote. And when I asked Carl about that study, he acknowledged that when it comes to kids in Cairo, the research is not there.

[E]

Currently, there's insufficient research to either support or refute the use of manual therapy in children.

[A]

But if there's limited evidence that chiropractic can help, why Would you take your child to a chiropractor for those things?

[E]

Because those patients respond to care. And I think it's a matter of time before we have formal evidence. But from a practical standpoint, where the satisfied patient that sees the child that is pain free, that's improvement, it's just a period of time before those studies, in my opinion, that those studies will be completed.

[A]

So it's also possible that in the future, as we do clinical trials, those trials will show that it doesn't help.

[E]

That's a possibility. This is an area where we require additional research.

[A]

Karl told us that since the risks for children are low and, you know, if kairos are doing this gentle manipulation, the risks are low. And since Carl told us that a lot of parents report being happy with the chiro they get for their kids, he reckons there's still a role for chiropractic in kids. But we spoke to Katie's parents about the research here. Do you want the science on the kids? Do you want to know that?

Yeah, it pretty much. There's pretty much no good science that it works for anything. When it comes to kids, we've got sucked in.

What did your dad just say?

[D]

He said they got sucked in. They just trusted the chiropractor.

[B]

Back in the day, everyone was going so, like, everyone was the same sort of thing. So we didn't question as much. It feels a little bit like you're sort of sucked into this vortex almost of believing everything they say.

[A]

After the break, we go further into the vortex.

[G]

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[F]

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[G]

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[F]

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[G]

Not only does Anopheles stevensi really thrive in urban places, but it's also resistant to insecticides and temperature extremes.

[F]

Anopheles Steven Tsai is the perfect malaria supervillain.

[G]

And this mosquito has been spreading. It's native to South Asia and the Arabian Peninsula, but it's been popping up in parts of Africa. So scientists like Ryan have been trying to keep track of it. And one way they do this is through citizen science apps. These are apps where people post photos of animals or bugs or other stuff they see in nature. But it can be hard to identify mosquitoes from just a photo. And the naked eye, like Ryan's colleague, came across an old photo of a mosquito larva taken in Madagascar. They suspected it was Anopheles stevensi, but there had been no recorded sightings of it there before.

[F]

Plus, multiple entomologists couldn't identify the photo to species. And since the specimen was long gone, it was AI to the rescue. AI was really our only hope of cracking the case.

[G]

So Ryan and his team started training in AI by feeding it thousands of confirmed photos of the Anopheles Steve and.

[F]

Sai, where we'll flip and rotate and modify the images as well to give some variability to the data set. And then the algorithm essentially figures out what the features or patterns are that are tied to each species. So basically says, okay, this image is classified as an awfully Steven size. These are the pixels that were most important in making that prediction.

[G]

And the AI did end up identifying pixels unique to this species. Like one area that really stood out were these tiny dots in the male larvae, which turned out to be pigmented testes. And. Well, with the final models, Ryan's team identified the mystery larva as very likely to be Anopheles stevensi, which they say would be the first detection of the species in Madagascar.

[F]

Now we have our artificial intelligence algorithms running on a daily basis for all of the citizen science platforms looking for any potential Stephenside that may come up.

[G]

They hope that finding more of these mosquitoes will help activate malaria prevention efforts and ultimately save lives.

[F]

That is the goal. That is exactly what we're trying to do.

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Welcome back. So today we're talking about chiropractors and this thing they do called sports spinal manipulation. And we just heard that it may help with back and neck pain, but there's no good science behind taking kids to the chiro. Now we're going to dive right into the core beliefs of chiropractic to see if the idea of spinal manipulation holds up.

Now, a lot of people might have heard about a spine being out of alignment or misaligned, and that's why you go to the chiro. But what exactly is a misaligned spine? Well, to understand that, we have to go back to old Iowa.

Dee Dee Palmer, the guy who came up with chiropractic, thought that a lot of our health issues could be traced back to a misaligned spine. And the thing that was making your spine misaligned was what he called subluxations. Now, at one point, he thought these subluxations could block a mystical force that flowed through the spine, causing disease. Now that's clearly not science, but Didi also had this theory that's shifted a little but has basically stuck around today, and that is that subluxations are bones out of place or some say stiff joints that then squish against our nerves in some way making us sick. And this could lead to things like asthma or high blood pressure.

And now not every Cairo thinks this way anymore, but a lot of them still do. A study of several hundred Canadian chiros found that almost one in five thought fixing a subluxation was the key to health.

[C]

The science behind it is not likely to come because the science behind it is simply not there. The belief system is entirely contrary to our knowledge of physics and chemistry and biology.

[A]

That's Marcello Costa. He was a professor of neurophysiology at Flinders University in Australia. And Marcello says that there's no good evidence that problems with your spine are to blame for many of the diseases that some chiros claim to fix. So let's take asthma for example. We don't know exactly what causes asthma. It's been linked to genetics and immune reactions. But, but here's the important thing. We don't have any good evidence that manipulating the spine could have any effect on asthma.

[C]

There's no basis whatsoever that can cure asthma. This is a complete nonsense. There's no, not only there's no evidence that one can believe, but there's no reason whatsoever to assume that manipulating the spine will help the asthma of a young child. And so in the sense it's a complete bongus, it's a complete nonsense.

[A]

And maybe this asthma thing is low hanging fruit, like it kind of seems obvious that it's a bit bonkers. But Marcello says that even if you just zoom out to this idea that a back could be misaligned and afflicted with subluxations, well, he says that even that concept is spineless.

[C]

And the subluxations simply do not exist physically.

[A]

They don't exist at all.

[C]

They don't exist at all. It's simply just telling you a complete fib. The fact that some of them believe this is even more worrying and some.

[A]

Of them actually don't believe it and they want to ditch this idea of subluxations altogether. Several papers have now been written by Kairos acknowledging that there is no good evidence behind subluxation. One paper called it an untested hypothesis and said that it was like, quote, an albatross around our collective necks, end quote.

Now Marcello says that there are clear Cut. Medical conditions that affect your spine, like a slipped disc, that's where the jelly, like, stuff in between the bones of your spine push against the nerves. And this can hurt. But that's often not what chiros are talking about when they talk about misalignments or subluxations. And Marcello says that if. If you do have these conditions, you.

[C]

Do really need a proper doctor and not a pseudo doctor.

[A]

And if Marcello sounds particularly narky, it's because he hates that chiros have this veneer of legitimacy around them, like they call themselves doctors even though they don't have a medical degree. And so here's a kind of fun fact about chiropractors. A survey of more than 1,000 chiros found that one in four of them agreed with this statement. Quote, there is a lack of evidence from clinical trials to support most of the treatments I use in my practice. Yeah, one in four thought that. But still, there is evidence that going to a chiro might help you with back and neck pain. But if chiros aren't fixing subluxations, then what are they doing to help with your pain? Well, scientists aren't quite sure how spinal manipulation works. Research into this very question says that it could be that that sharp thrust triggers a chain of events that might block pain receptors, or it could reduce muscle tension or stiffness. And then there's another explanation, that it's not to do with pain receptors or stiffness, but actually it's just about someone taking care of you. And from that, you're expecting to feel better. It's that thing we call the placebo effect. We put this to Bill and Chris, Katie's parents. Would it matter to you if it was placebo and it wasn't sort of aligning your back and, you know, whatever they say it might be?

[B]

No, no, we'd still go, why?

[A]

Why?

[B]

Because it helps the pain. Yeah. It's all about whether it feels good for you.

[A]

Fair point. Right. If it's making people feel better, what is the problem here? Well, there are some risks, and we talked about them with Anita Gross, the physical therapist from the start of the show, because while she was doing her big assessment on the evidence around chiropractic care and neck pain, she also looked at the risks here. Because getting a spinal manipulation, particularly the kind that twists and cracks your neck, it does seem scary. And what Anita found is that sometimes people said that their neck pain actually got worse after a spinal manipulation. Other people would get headaches, nausea, or even dizziness. Here's Anita. The manipulation happens so Quickly then. Ah, you got that dizziness. Now we don't know how often this happens because many studies actually don't record the side effects. Either way, those things that Anita talked about, they tend to go away on their own. But very rarely there are more serious problems that can happen. Bones can fracture, a twist or a push to the neck can actually dislodge a blood clot or even cause a small tear in the artery. And there are cases where people have actually died. May was seeking treatment for what she said was just a pinched nerve and less than a week later she was dead. Several years ago, Katie Mae, a 34 year old model, died soon after going to the Cairo and her family blamed the treatment. This year, a report came out into another death after a 29 year old woman died after a chiropractor adjusted her neck. Now, we didn't talk about those cases specifically with Anita, but she did tell us that this kind of thing, it's rare, really rare, but it can happen.

Yeah. A young person between the age of 20 and 40, something goes, gets their neck manipulated and then they die. Like we've had a few cases like that. Oh my gosh, what are they dying of? From aneurysms or the vascular system just.

[C]

Being torn in the neck and then.

[A]

They get bleeds into the head. So what are the chances that this will happen to you if you go to the Cairo? Some say that one out of every few million manipulations could lead to a death. Others say it's more common. And some even question whether chiropractors caused these deaths or something else did. So when it comes to science versus chiropractors, does it stack up like a nice healthy spine? Well, for people with back or neck pain, the research shows that getting a spinal adjustment from a chiropractor might help, but we don't really know why. As for taking your kids to the chiro, there's no good evidence that it will help them. And what about the whole point of chiro? That our spines need to be aligned for our overall health, that subluxation thing? Well, there's no good evidence that it's real.

And finally, this isn't a totally risk free option. Very rare, but very serious consequences can occur from spinal manipulation.

[G]

Bill.

[A]

Sorry. Katie's dad sees it this way.

[C]

It's a bit like religion. You gotta filter out the bull, I reckon.

[A]

Wait, what did your dad just say?

[D]

He said chiropractors are a bit like religion. You've got to filter out the bull, Bill.

[A]

Sorry.

[D]

I know he's so Sassy.

[A]

That's science versus chiropractors.

[G]

We all adore our vision.

[A]

My feet put a rose in every tree.

This episode has 137 citations in it. If you want to see them, go to our show notes and click on the link to the transcript. They're all there. If you want to get in touch with us, we'd love it. If you want to say hello, let us know what you thought of the episode. We're on Instagram sciencevs. I'm also on TikTok. Wendy Zuckerman. We interviewed Marcello Costa for this episode in 2017. We really appreciated his help and we just wanted to note that he died last year.

This episode was produced by Rose Rimlar with help from me, Wendy Zuckerman, Caitlin Sorey, Aketti Foster Keys, Shruti Ravindran and Heather Rogers. We're edited by Blythe Turrell. Fact checking by Michelle Harris. Sound design by Martin Peralta and Bobby Lord. Music written by Bobby Lord. Recording help from Asher Griffith. For this episode, we also spoke to Dr. Richard Dayo, Professor Tim Mertz, Professor Gregory Whitcomb, Dr. Adam Chifu and Julie Knack. Thank you for your insights. An extra big thanks to Rachel Ward, Emma Morgenstern, Christina Sullivan, Jasmine Romero and Phoebe Flanagan, as well as Alex Ward, Russell Gragg, Fiona Krall and Judy Adair. Also, a shout out to the Sorries. Thank you, Bill and Chris. I'm Wendy Zuckerman. Back to you next time.

[D]

It's a new bike. It's a good one. It's got two brakes on it.

[C]

Okay.

[B]

That has nothing to do with cars colliding with you, though. Caitlin. It doesn't matter.

[D]

The bike you have means I can stop more quickly.

[B]

What about your helmet?

[D]

Yep, new helmet. Okay, we've got to go. We'll let you go. Okay, I better.

[B]

Okay.

[C]

Nice time with you all night.

[F]

Limu Emu and Doug.

[A]

Here we have the Limu Emu in its natural habitat, helping people customize their car insurance and save hundreds with Liberty Mutual.

[E]

Fascinating. It's accompanied by his natural ally, Doug.

[A]

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[F]

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[A]

Liberty.

[G]

Liberty.

[C]

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[F]

Liberty Savings Ferry unwritten by Liberty Mutual Insurance Company and affiliates. Excludes Massachusetts.