It’s a common scenario: someone you know seeks relief from back pain and ends up at a chiropractor’s office. Maybe they report feeling better after spinal adjustments, and perhaps they even mention the chiropractor using the term “doctor.” This might leave you wondering, especially if you value conventional medical advice, what do doctors really think of chiropractors?
To understand the medical perspective, it’s important to first clarify the differences between chiropractic and medical doctor training and approaches to patient care. While both professions aim to help patients achieve better health, their methods, scopes of practice, and underlying philosophies diverge significantly.
Doctors, or medical doctors (MDs) and Doctors of Osteopathic Medicine (DOs), undergo extensive medical education. This includes four years of undergraduate study, followed by four years of medical school, and then a residency that can last from three to seven years depending on the specialization. This rigorous training provides them with a deep understanding of anatomy, physiology, pathology, pharmacology, and surgery. They are trained to diagnose a wide range of medical conditions, prescribe medications, perform surgeries, and develop comprehensive treatment plans. Their approach is rooted in evidence-based medicine, relying on scientific research and clinical trials to guide their practice.
Chiropractors, on the other hand, pursue a Doctor of Chiropractic (DC) degree. Their education is focused primarily on the musculoskeletal system, particularly the spine. Chiropractic philosophy centers around the belief that misalignments of the spine, termed “subluxations,” interfere with the nervous system and lead to various health problems. Chiropractic treatment primarily involves spinal manipulation and adjustments to correct these purported subluxations. While chiropractors receive training in areas like anatomy and physiology, their education is less broad than that of medical doctors, with significantly less emphasis on areas like pharmacology, infectious diseases, and surgery.
From a medical doctor’s perspective, several points of concern often arise regarding chiropractic care:
Limited Scope of Practice and Diagnostic Capabilities: Doctors are trained to consider a broad differential diagnosis for any given symptom. For back pain, for instance, a doctor would evaluate for musculoskeletal issues, but also potentially for kidney infections, aortic aneurysms, or even cancer. Chiropractors, with their narrower scope of training, may not be equipped to identify or manage these broader medical conditions. They cannot prescribe medication or perform surgery, limiting their options for patient care.
The Subluxation Theory: The central concept of “subluxation” in chiropractic philosophy is not supported by mainstream medical science. Extensive research has failed to demonstrate the existence of subluxations as chiropractors define them – spinal misalignments that cause disease. Medical doctors view the benefits some patients experience from chiropractic manipulation as likely stemming from other mechanisms such as muscle relaxation, pain modulation, and the placebo effect, rather than the correction of subluxations.
Lack of Robust Scientific Evidence for Many Chiropractic Claims: While spinal manipulation can be effective for certain types of acute low back pain, the evidence for chiropractic treatment for other conditions, such as asthma, allergies, or digestive issues, is weak or nonexistent. Doctors prioritize treatments backed by strong scientific evidence, and for many conditions claimed to be treatable by chiropractic, this evidence is lacking.
The Title “Doctor”: The use of the term “doctor” by chiropractors can be confusing for patients. While they do earn a doctoral degree, it is not equivalent to a medical doctorate (MD or DO). This can lead patients to believe that chiropractors have the same level of medical training and expertise as medical doctors, which is not the case. This confusion is especially concerning in situations where patients might forgo or delay seeking necessary medical care from an MD or DO, thinking their chiropractor can address all their health concerns.
Why Some People Report Feeling Better After Chiropractic Care:
It’s crucial to acknowledge that many individuals do report feeling relief from pain after visiting a chiropractor. This can be attributed to several factors that are recognized within the medical community:
- Pain Modulation and Muscle Relaxation: Spinal manipulation and massage techniques used by chiropractors can indeed provide short-term pain relief by affecting the nervous system’s pain pathways and relaxing muscles.
- Placebo Effect: The placebo effect is a well-documented phenomenon in medicine where a patient’s condition improves simply because they believe they are receiving effective treatment. A chiropractor’s confident demeanor, hands-on approach, and explanation of the problem can contribute to a strong placebo effect.
- Natural History of Pain: Many conditions, particularly acute back pain, are self-limiting and will improve naturally over time, regardless of treatment. Patients may attribute this natural improvement to chiropractic care, even if it is coincidental.
- Patient-Provider Interaction: Chiropractors often spend more time with their patients than medical doctors in a typical consultation. This increased attention, listening, and empathy can be therapeutic in itself and contribute to a patient feeling heard and cared for, which can positively influence their pain perception.
When to Seek Medical Advice:
Doctors generally recommend consulting a medical doctor (MD or DO) for the diagnosis and management of any health condition. For musculoskeletal pain, particularly back pain, initial recommendations often include:
- Consulting a medical doctor: To rule out serious underlying conditions and receive evidence-based treatment recommendations.
- Physical Therapy: Doctors frequently prescribe physical therapy for musculoskeletal issues. Physical therapists are experts in movement and rehabilitation and can develop tailored exercise programs to strengthen muscles, improve flexibility, and reduce pain.
- Pain Management Strategies: Medical doctors can recommend appropriate pain relief strategies, which may include over-the-counter or prescription pain relievers, and guide patients on safe and effective pain management.
- Lifestyle Modifications: Advice on weight management, exercise, posture, and ergonomics are often key components of a doctor’s approach to musculoskeletal health.
In Conclusion:
What Do Doctors Think Of Chiropractors? The medical perspective is generally one of caution and skepticism regarding the core principles and broad claims of chiropractic. While acknowledging that some patients may experience short-term pain relief from chiropractic manipulation, doctors emphasize the importance of evidence-based medicine, comprehensive medical training, and the need to rule out serious conditions. For patients seeking care for musculoskeletal pain, consulting a medical doctor for a thorough evaluation and evidence-based treatment plan is generally recommended. It is crucial for patients to be well-informed about the differences between chiropractic and medical care to make informed decisions about their health and well-being.
