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Stephen Barrett, M.D.
Many chiropractors advertise that various "danger signals" may indicate a need for chiropractic services. Unlike the American Cancer Society's "Seven Warning Signs of Cancer," which have a scientific basis and are always the same, the lists used by chiropractors have no scientific basis and vary from one practitioner to another. Most people who respond to such ads are told that their spine should be adjusted to relieve their symptoms and to prevent future trouble as well. Two ads from recent telephone directories are shown below.
Some chiropractors recruit new patients through postural checks and other free screening examinations at health expositions, shopping centers, or other places where there is heavy foot traffic. Some offer free screening at their offices. Most people screened are inappropriately advised to have further evaluation or treatment at the chiropractor's office.
Some chiropractors use x-ray films to persuade normal people that they have a "spinal curvature" (or not enough curvature, or too much curvature). After "treatment," the curvature "improves" because the patient is positioned differently for the examination.
These ads are misleading because: (a) most of the symptoms listed are unlikely to be caused by "pinched nerves," (b) most cases involving the listed symptoms are not serious, and (c) some of the symptoms (such as difficult breathing) are far more likely to be appropriate for medical rather than chiropractic evaluation.
Contour analysis, pictured in the ad below, is a procedure in which an angled light is passed through a grid to the surface of the patient's body to produce a moire effect that is photographed. The resultant picture resembles a topographic map. The greater the number of concentric lines, the greater the elevation from the furthest part of the body. Reproducible results can be obtained if the patient is positioned carefully, but even slight shifts in position alters the patterns. Contour analysis should be regarded as a marketing gimmick because no clinical use has been scientifically validated.
To what extent can chiropractors help people? Does it ever make sense to seek chiropractic care? If so, how can a reliable chiropractor be found? These questions -- which are not simple to answer -- are thoroughly discussed in Chiropractic: The Victim's Perspective (1995), written by George J. Magner, III, and Inside Chiropractic: A Patient's Guide (1999), by Samuel Homola, D.C. Both were edited by me and published by Prometheus Books. Together they provide the most detailed analysis of the chiropractic marketplace ever published. Comprehensive information is also available on Chirobase, our skeptical guide to chiropractic history, theories, and current practices.
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