Is Chiropractic a Dangerous Pseudoscientific Scam? (Evidence Review)

[0:00] Kathy: Okay, Jason, calm down. Jason: What? Kathy: Chill out, brother. Jason: Kathy, what are you talking about? Kathy: I’m just preparing you because you always get a little bit triggered when we talk about this topic. Jason: Oh, no. Kathy: Yep. Today, we’re talking about whether chiropractic is a dangerous pseudoscientific scam. Jason: Okay, here we go. Kathy: Or is it a cult started by a guy who was seeing ghosts? All right. So, we’re going to do this, but I’m also gonna give listeners a way that they can fact

[0:30] check as they go. Jason: So, it is a scam. I knew it. Kathy: All right. You’re about to find out. This is the PTCH. Jason: What happens when a chiropractor and a physical therapist get together to make a health and wellness podcast? Kathy: Chiropractors and physical therapists don’t like each other. Jason: Oh, think again. Kathy: I’m Dr. Kathy Lynch, physical therapist who likes to help people move and get stronger. Jason: I’m Dr. Jason Young, an evidence-based chiropractor who uses humor just as much as adjustments to help people get better. Welcome to the PTCH Podcast. Remember, there’s no “I”

[1:00] in PTCH. And welcome back to the PTCH Podcast. I’m Dr. Jason Young. Kathy: And I’m Dr. Kathy Lynch. Jason: And today, let’s get ready to rumble. Kathy: Oh my gosh, what an inflammatory title to this — to this episode. Jason: I know, we’re getting after it in 2026. I feel attacked. So yeah, I guess like this episode is really about

[1:32] man, I just — I do battle on the social media. Kathy: I bet you do. Jason: And so many comments. And so part of this is just a shortcut for me so that I don’t have to keep typing the same thing over and over. It’s like I can just be like, watch this whole freaking episode or I don’t want to talk to you. Okay. So, yeah. And it’s going to be very therapeutic, I think, for me. Kathy: I think this is a therapy session for you. Jason: Yeah. Kathy: Yeah. So, in this episode, we’re going to respond. I’m going to respond. She’s

[2:02] going to accuse, right? We’re going to respond to some of the criticisms, the most common criticisms that chiropractic gets. And we’re going to let the evidence tell the tale. Kathy: Yes. Jason: Right. And I’m going to give you, before we start, a way that you can fact check on the fly. Kathy: Okay. Jason: There is a really good AI resource that will help you look up medical literature, peer-reviewed things, and you can even

[2:32] ask questions about it, because the average person can find a study, but it’s really hard to know what it means. And so the AI portion of this really makes it easy to ask some questions and it’s going to help you from kind of going astray. So, one of the best resources I think for this is a website called openevidence.com. Have you used it before? Kathy: You told me about that. Jason: Yeah, Open Evidence is great. Kathy: It’s really good. Jason: Yeah. So, there’s a couple versions of it. There’s a free version which anybody can use and it’s a really

[3:02] great resource, and then there’s a version for healthcare providers. So, if you’re a healthcare provider, you go to openevidence.com. It’s a great way to keep up to date on the latest research and everything like that. And they have healthcare provider accounts. So, if you want to listen to this and have that Open Evidence window up and you hear something that sounds like BS, just pause the show, put it in, and see if we’re getting the answers right or not. Kathy: Yes. See what scientists have written.

[3:34] See what the science says, right? Because it really doesn’t matter like if I think it’s true or not, right? I’m just going to come right out and say it. I’m biased. Kathy: 100% biased. Jason: 100% biased. Right. I own — oops, goodness. I’m pushing over microphones now. I own a chiropractic clinic. Kathy: You do? Jason: I went to chiropractic school. Yeah. Kathy: I’ve been a chiropractic patient my whole entire life. Jason: Yeah. I’ve sat on chiropractic boards, licensing boards, boards of chiropractic companies. You know, you’re all in.

[4:04] Jason: I’m all in. Yes. So, I’m definitely definitely — Kathy: This was a career choice. Jason: Yes. But I’m also very well read on it, and I am not deceived about what is and is not out there in terms of evidence. And so for this episode, I cherry-picked some of my favorite social media questions and comments. And some of them are funnier than others. Kathy: Yeah. And this is going to be great for me because I get to read them. Jason: All right. Kathy: Okay. Round one.

[4:34] Jason: Round one. Number one. Kathy: Okay. Jason: There is a reason hospitals don’t refer you to chiropractors. They refer you to actual specialists like neurosurgeons. And this comes from Marie J. Jason: Thank you for your comment, Marie J. So first of all, the problem with the comment is that it assumes that medical doctors and hospitals don’t refer to chiropractors, which actually is not true. It’s never

[5:05] been more not true than it is today. In fact, so we’re in Oregon, and the preeminent medical school in the state of Oregon is — Kathy: Western. Jason: No, not the state school. No, it’s OHSU, Oregon Health Sciences University. Yeah, that’s the med school, right? So, OHSU up until recently had a chiropractic clinic in it. Kathy: Oh,

[5:35] did you know that? Kathy: I did not know that. Jason: Yeah. So, Dr. Jordan Graham was the chiropractor there. The only reason they don’t have one right now is because she moved away. Kathy: Oh. Jason: Right. So, yeah. And so, but yeah, for years she operated a chiropractic clinic in that hospital. Kathy: An actual hospital. Jason: Yeah, in the hospital at the medical school. Kathy: No. Jason: So, you know, I can tell you all day long that I get referrals from medical doctors, and I do. Kathy: I have medical doctors who come see me. Jason: This week I have seen a paramedic,

[6:06] a firefighter paramedic. I’ve seen about five or six nurses. In the last couple months I’ve seen primary care doctors. I’ve seen physician assistants. I have a patient who’s a neurosurgeon. They come see us and they refer patients. Kathy: Yeah. Jason: And so, when you say there’s a reason that they don’t refer, I don’t think that you know what you’re talking about. Kathy: I would agree with that. What is that reason?

[6:36] Jason: Yeah, so I don’t know what that reason is. No. Yeah. And I think it’s a good kind of to set some of the groundwork, the basis of this, is that chiropractic and mainstream medicine has a messy history, all the way from the very beginning of chiropractic early on. And I think I’ve said this before on the show — when you were a chiropractor it was a common experience

[7:07] to be thrown in jail for practicing medicine without a license, because these were two very competitive factions. Throughout like the ’50s, ’60s, ’70s, there was an active campaign by the American Medical Association to — quote — contain and eliminate chiropractic. I say quote because the AMA described it as containing and eliminating chiropractic. And so one of the tactics that they used for that was that they poisoned the waters whenever

[7:37] it came to physicians’ perception of what’s happening with chiropractic. And so you have a generational bias against some of those things, which is fortunately going away as there’s more and more evidence. But one of the most difficult aspects of that was chiropractors were barred from research. And so when people wanted to call us a pseudoscientific cult, man, it really held up. Kathy: Yeah. Jason: Chiropractic was pseudoscience.

[8:08] Kathy: Right. Jason: And the reason — because the definition of pseudoscience is it is a practice for which there is no scientific evidence, or it’s a practice of which the scientific evidence goes against. And so when you prevent people from doing science, they will be pseudoscience. Pseudoscience. It’s a guarantee, right? And so, that was one of the important things about a landmark case that went all the way to the Supreme Court

[8:38] which barred the AMA from trying to destroy chiropractic. Kathy: Would you like to hear a funny but interesting side story about this? Jason: So, this case originally — it’s the Wilk versus AMA. Originally the chiropractors who were suing the AMA lost. Kathy: Okay. Jason: And then on appeal there was more information that was obtained.

[9:08] Kathy: Oh. Jason: And this information basically blew the case wide open in terms of — it supplied the whole paper trail, the documentation, the plans in which they were fabricating statistics or deaths that chiropractic was causing, the sanctions against chiropractors or doctors who collaborate with chiro— the whole playbook was exposed. And the crazy thing is who exposed it. Do you have a guess? Kathy: I don’t. Jason: Okay. You’re not going to

[9:38] believe this. It was the Church of Scientology. Kathy: What? Jason: Yes. Kathy: How did they get involved in this? Jason: Yeah. The Church of Scientology torpedoed the AMA’s campaign to destroy chiropractic. Why? Kathy: Yeah. Were they making money off of chiropractic? Jason: No. So, here’s the thing. If you know anything about Scientology — and I’m not an expert on Scientology. Kathy: No. Jason: The Scientology practice — well, they don’t like —

[10:10] I think psychiatry, right? They don’t like psychology. So they have — it’s kind of their own brand of psychiatry, right? And like personal motivation, wellness and things like that. And so they too got kind of branded with this practicing medicine without a license. Kathy: Oh, I see. Jason: Yes. Uh-huh. And so the higher-ups in Scientology were very paranoid and they were sure that the AMA

[10:40] was investigating them and building a case against them. And so the Scientologists decided that they were going to infiltrate the AMA. Kathy: Whoa. Jason: Yes. And they did this — there’s a really good book out there called Contain and Eliminate. Let’s see if I can remember the name of the author. Howard — geez. Let me see if I can find it. I’ve met him before. He’s — oh yeah. Howard Winsky wrote this book called

[11:12] Contain and Eliminate: The American Medical Association’s Conspiracy to Destroy Chiropractic. Very well sourced, very good book. And yeah, so that’s where all this information comes from, so I’m not making this up. But so the Scientologists, they planted all these people in the AMA

[11:43] working as secretaries, janitors, all kinds of stuff. Yeah. Cleaning the building. So at night when everything would shut down, all the little Scientologist spies would infiltrate the AMA building and they’d start going through records and making copies and everything. Kathy: Whoa. Okay. Jason: So what they found — well, what they didn’t find was a conspiracy to destroy Scientology,

[12:13] right? What they did find was a conspiracy to destroy chiropractic. Kathy: Wow. Jason: Yes. And so all these documents got into the hands of Wilk’s lawyers. In fact, the source is super secretive — like you know about Watergate and like how Deep Throat that thing up. So in this story they call the informant Sore Throat. But yeah, revealed that this whole conspiracy — got the documents out of there. So this all made it into discovery. So then whenever the Wilk case gets appealed all the way to the Supreme Court, the AMA gets caught with their pants down. They were trying to eliminate chiropractic and

[12:43] they got busted in an antitrust lawsuit, and the injunction was that they were to stop doing that. They could not do things to bar other medical professionals from collaborating with chiropractors or anything like that. Kathy: Wow. So that’s why we’re about 60, 70 years behind on the research. Jason: How has Tom Cruise not made a movie about this? Kathy: Yeah, I know, right? And

[13:13] like I mentioned, Howard Winsky — really passionate guy about this, really good writer — and he wants this to be a movie so bad. Kathy: Oh yeah, Jason: so bad. Yeah. And I like — Sore Throat. Kathy: Yeah. I think it would be pretty cool. So yeah, that’s why — but in the early days, yeah, you’re thinking about chiropractic and heck yeah it was pseudoscience because we weren’t allowed to participate in science. And some of the early tenets of chiropractic, like the — what’s called the monocausal theory of

[13:43] Jason: That was debunked long, long time ago — like, not even long after it came out, right? And it was this idea that subluxations in the spine, or bones out of place in the spine, cause all human disease. Kathy: Right. Jason: So it didn’t last long because, well, it’s not true. It’s not true. Kathy: Yeah. Jason: Yeah. So now whenever people are like, “Oh, chiropractic was started by a guy who believed in a ghost.” And it’s like, okay. Kathy: Yeah. Jason: But that doesn’t have any bearing on

[14:14] today. So if your biggest criticism is something that happened 130 years ago, Kathy: I think you’re on shaky ground, because I have a whole bunch of science that I can stand on now, Jason: which is a lot more comfortable than talking about somebody who has been dead for over 100 years. So, Kathy: because now you can do science. Jason: Yeah. Yeah. So, what did I — did I answer the question? What was the question? Kathy: The question was there’s a reason hospitals don’t refer to chiropractors. Jason: Oh yeah. So I think we blew that out

[14:45] of the water. Like, there are so many chiropractors that have worked their way into what we now would call integrative medicine. In fact, I went on Pacific Source’s website because we have Lily, who was on the show before — she’s now my associate, right? Kathy: And we’re just waiting for her to be in network. And it’s kind of interesting. So they’ll — I’m searching for it. So I was like, “Come on, can we start seeing Pacific Source patients?” And when you go and you look at Pacific Source, they have a section for

[15:17] complementary and alternative medicine, or alternative medicine. And I’m looking under there — chiropractic doesn’t appear. Kathy: Chiropractic is in the medical specialty. Jason: Oh. Oh, we’ve moved up in the world. Kathy: Nice. Jason: So, and you know, we’re recognized by Medicare. The pandemic was actually a big time for us because we got recognized as essential healthcare. Kathy: Essential — Jason: essential healthcare. Kathy: And oh, I think the most controversial thing lately is the whole

[15:48] “who is a professional” thing whenever it comes to student loans. Jason: Yeah, we need to do an episode on that. Kathy: We need to do a whole episode on that. Jason: Yeah. Kathy: Whole — ‘cause that’s the problem. Jason: And I understand where they’re coming from, but it’s just — from a public opinion standpoint, it’s really kind of a hurtful thing to say these people are professionals and these people are not. That being said, we’re professionals. Kathy: Of course we are. Jason: Yeah. Kathy: Are you ready for insult number two? Jason: Yes. Okay. Bring it. Kathy: Okay. Jason: What you got? Kathy: This comes from Ride for Fun.

[16:19] Jason: Ride for Fun. He didn’t even put his name — he or she didn’t put their name. Kathy: Most of these people don’t. Jason: “Ask me how many patients I’ve treated for a vertebral artery stroke after seeing a chiropractor. Going through medical school, I thought this was something I would only read about in textbooks. Nope.” Kathy: Okay. So I’m assuming that this is a medical doctor. Jason: Sounds like they are a medical doctor — for fun. Kathy: Yeah. And this is such a very, very interesting

[16:50] argument that we see a lot of times, because we could put out there the facts about how common or rare it is to have a serious adverse event with a chiropractic adjustment, Jason: such as a stroke. Hang on, somebody’s trying to call me. Oh, it’s spam. Kathy: It was probably Ride for Fun. Jason: I think it’s Ride for Fun. Kathy: Yeah, he’s like, “Oh, my ears are burning. This is it.” “I’m going to get on the show.” Jason: Yeah. But somebody — to have a serious

[17:20] adverse event — and that is things like a fracture, Kathy: a dislocation, paralysis, a stroke — Jason: extremely rare. Extremely rare. Okay. And in the show notes, I’m going to have links to studies. I’ll talk about some of them here in a second. But this is kind of a good way to progress from the conversation we had about what evidence is out there. Kathy: Yeah. Jason: Um,

[17:50] up until the early 2000s, it was really common to see in the medical literature — you would have some medical doctor write an opinion about chiropractic being dangerous, that it can hurt people, it can kill people, right? And so that was what just existed in the medical literature. We didn’t have the epidemiological data and everything like that on how often these things happen. Kathy: Now we have a good amount of epidemiological data, and it shows that

[18:20] overwhelmingly chiropractic is very safe. Jason: Yes. Kathy: Okay. To the point where when you bring that up, the only thing that other people tend to have to go on is this. Jason: Yes. Kathy: So what kind of evidence is this that he’s giving? Jason: Anecdotal. Kathy: This is anecdotal, right? So he’s like, “Well, I went to medical school and I learned that this was very rare.” Jason: And then I started practicing, and guess what I saw?

[18:50] Kathy: Unbelievable. Jason: I saw somebody get hurt by it. So let me get to what the data says. Okay. See, which one do I want to use? Uh, let’s see. Okay. This — I don’t think this is the best study, but for this conversation it’s a very good study, because we’re going to use a source that if it should be biased, it would be biased. And this is

[19:20] the Journal of the American Medical Association. Kathy: What? JAMA. Jason: JAMA. Yes. And so this is a study from 2017, and the title of it is “Association of Spinal Manipulative Therapy with Clinical Benefit and Harm for Acute Low Back Pain.” Okay. So low back pain is just one aspect that we can look at. And in this — let me get to the thing that they say. Um,

[19:53] oh, this isn’t even the one that I wanted to get to yet. This is the one that I wanted to talk about more in terms of efficacy. So we’ll come back to this one. Let’s hit the pause button on this. But oh goodness, I had all these laid out perfectly. Now I don’t know. Oh, here we go. This is the one I’m looking for. This is a study from 2009, and this is in the journal Spine, which

[20:25] In my sector of healthcare, Spine is a very reputable journal. It’s highly referenced, highly cited. This is a literature review. So, this is a systematic review where they’re not just looking at one study or a couple of studies. They’re looking at the body of evidence that’s out there. A systematic review, when we’re looking at evidence, is one of the highest quality, best forms of evidence out there. This article is called “Safety of Chiropractic Interventions: A

[20:55] Systematic Review,” as I said. Okay. And here’s what they say. Most of the adverse events that were reported — when they looked at — oh geez, I can’t see where — they identified 376 potentially relevant articles and they ended up using 46 of those articles. Based on those 46 articles, there was

[21:25] randomized control trials, case control studies, prospective studies. If those don’t mean anything to you, that’s fine. But if they do, then you know what I’m talking about. Okay?

Kathy: If you know, you know.

Jason: So, most of the adverse events that are reported in chiropractic — so most of the bad things that can happen — they described as benign and transitory. So, benign is the opposite of malignant. So, if you have a tumor, you want the benign one.

Kathy: You want the benign one,

Jason: right? And transitory means that it goes away really quickly. So the way

[21:56] they define transitory is: if you’re going to have a complication, it’s usually gone within 24 hours to 48 hours. Okay? And most of these bad things were things like soreness or a headache or maybe some stiffness, something like that. Okay. And that can happen 33% of the time in a low estimate, or 60% of the time in a high estimate.

[22:27] Kathy: Okay.

Jason: Which — is that great? Well, I don’t love that people are sore maybe 30 to 60% of the time,

Kathy: but does the benefit outweigh

Jason: having 24 hours of soreness,

Kathy: right?

Jason: When what did you probably come in with?

Kathy: Soreness. Yes. So yeah, it’s like a mild flare-up to get to where you’re going. And the rate of that actually is pretty comparable to a lot of treatments. So in fact, physical

[22:59] therapy has the same rate.

Kathy: 100%.

Jason: Yeah.

Kathy: I want everybody walking out sore.

Jason: Yeah. Right. So physical therapy has a really similar rate of adverse effects, but they’re benign and transitory. Right. Medication has a really similar rate. Right. So, but what they really want to talk about — what he really wants to talk about — is how often are we getting something that’s really bad, really serious.

Kathy: Yeah.

Jason: So, they said there are reports of

[23:30] complications that were life-threatening, such as arterial dissections,

Kathy: myelopathy, which is like a spinal cord injury,

Jason: vertebral disc extrusion, and epidural hematoma. So while the frequency of the adverse events was between 33 and 60.9% — actually 61 — somebody’s going to take me to task. Why don’t you —

Kathy: I love when people are like, “Why are you lying?” I’m like, what? Like

Jason: it doesn’t say 16,000. It says 16,500.

[24:02] Like, okay. Anyway, so 61%. There you go. Okay. The frequency of serious adverse events varied between five strokes per 100,000 manipulations

Kathy: to 1.46 serious adverse events per 10 million manipulations

Jason: and 2.68 deaths per 10 million manipulations.

Kathy: Very rare.

Jason: Yes. But some people are going to look at that.

Kathy: Yeah.

Jason: And they’re going to say it should be freaking zero.

[24:32] Kathy: It should be zero.

Jason: Yeah. And I agree, I guess, but if you look at the data, serious adverse events are incredibly rare. I think — let’s see — when I look at my career, I think there was one serious adverse event.

Kathy: Mhm. And that was a rib fracture.

Jason: And it was a rib fracture that was undisclosed to me

Kathy: that had already been fractured.

Jason: One of those.

[25:02] And adjusting it made it worse.

Kathy: Yeah. Hey, by the way.

Jason: Yep. I broke my rib. Forgot to tell you.

Kathy: Yes. And that’s almost verbatim what happened. So I adjusted this person and obviously something was wrong. I was like, “Holy crap.” Right. And they’re like, “It’s okay. It’s not your fault. It’s not your fault.” And I’m like, “What are you talking about? It’s not my fault? This feels like my fault.” So,

Kathy: totally did this.

Jason: He’s like, “No, no, no. I should have told you — I broke my rib last week.”

Kathy: And I was like, “Bro, get out. Get out of my clinic. Yes, you should

[25:33] have told me.

Jason: Yes, you should have told me.” So, for me, like when I did the exam on that person, I’m palpating a lot of tenderness. There’s a lot of tenderness. It’s like, “Okay, so maybe we work around that.” And I didn’t even adjust that area. I adjusted near it and it was bad enough that it reaggravated a fracture. Oh yeah. So it’s like —

Kathy: for sure.

Jason: So sometimes stuff like that happens. I will say sometimes malpractice happens.

Kathy: Yeah.

Jason: Yeah.

Kathy: Absolutely.

Jason: Where people know that they should have done something different

Kathy: and they didn’t do the right thing

[26:04] anyway.

Jason: But that’s not just chiropractic. That’s everybody. I used to be on the state licensing board and I know how often these things happen, because when there’s malpractice, there’s also a board complaint too. And I will tell you, serious complications like that — extremely rare. I think we’re going to get into that a little bit more later, so I’m going to stop talking about it now.

Kathy: I feel like — I don’t understand how, you know, these people that send these nasty

[26:35] grams to us about chiropractic — they want zero risk when it comes to treatment. Yes. However, these people will go in and have a surgery and will be okay with much greater risk. Of dying from any surgical intervention, you have a risk of dying. Yes. Infection — and these surgical interventions are necessary. Absolutely.

Jason: You know, but they will assume this huge risk

Kathy: without batting an eye. They’ll sign

[27:06] their life away. Well, and so here’s the thing though is sometimes people do point that out. And I think that some of them have a fair point in that it’s kind of apples and oranges because when people come to a physical therapist or a chiropractor, it’s not for something that’s life-threatening. Right. Right. If I got to go have open heart surgery. Yeah. Okay. Right. The odds are against me as a patient to begin with. But let’s eliminate all those. What if we just look at cosmetic surgery, elective surgery, those types of things?

[27:37] Is it more dangerous to have a hernia repair or to get a chiropractic adjustment? See, I did this with the ibuprofen — that’s where a lot of — I did this with the ibuprofen. Well, how many people are taking, you know, ibuprofen? And so, I won’t compare them. All right. Okay. Are you happy? Mhm. I won’t compare them, but you have to acknowledge that to your point, there’s risk with everything. Yeah. Whether you’re going in for wellness

[28:07] care or you have something that’s really bad, risk — it just comes along with it. Knee surgery, back surgery, there’s no guarantee you’re going to feel better after that surgery. Yeah. And sometimes you might be worse. Yeah. Like sometimes people go in — there is — geez, I was reading a book, Crucial Conversations — good book — and one of the things that they reference was a case where somebody went in, I think it was for gosh,

[28:37] it was maybe like a throat surgery or something like that, and the physician cut off part of the person’s foot. What? Yeah. Whoa. Yeah. So what’s that? That’s malpractice, right? And that happens. Yeah. Okay. It happens with everybody. And chiropractors commit malpractice. They do. I heard a crazy one where there’s an anesthesiologist — I can’t remember where this is, but I mean, you could Google it and find it. This guy was poisoning bags of Ringer’s solution.

[29:08] Yes. Which is that saline that you put in — and he had gone in and injected them and was going to kill people. Mhm. And it’s like, I don’t hold medicine responsible for that because that’s just a straight murderer or a bad guy, right? And sometimes you get doctors that aren’t as good or are lazy and stuff, and we have those too, but it’s not fair to look at our worst and compare them to your best, right? And vice versa. Same. So

[29:38] there is — it’s wild — and I think it got made into a miniseries on Hulu or something — a podcast called Dr. Death. Dr. Death. Oh my god. It’ll knock your socks off if you haven’t listened. It was Netflix. It was Netflix, I think. So, with like Josh Jackson, that guy. Yeah, that guy. Yeah. Uh-huh. That was crazy. And it’s a 100% true story. It is. Yeah. Yeah. It’s wild what this guy, this doctor got away with. Crippled people. Crippled his best friend. Yes. Yeah. It’s disgusting.

[30:09] Yeah. And so, I mean, and of course, like I’m saying, that’s not an indictment of medicine. It’s just to say there’s some people that aren’t as good at their job, and unfortunately, people get hurt because of it. And then sometimes stuff just happens. Like I know chiropractors who have had patients who have had a stroke in their clinic. Sure. And let me clear something up about that, too. Because sometimes people are like, well, look at this. Yeah, this person went in for an adjustment

[30:39] and they came out paralyzed, right? And it’s like, yeah, that’s terrible, but why are we talking about it? We’re talking about it because it’s a freaking anomaly. It’s news, right? Why don’t we talk about when that happens in medicine, like when somebody goes in for back surgery and then they can’t walk anymore, right? We don’t talk about it because it’s not really news, right? It happens more often than it should, right? And again, that’s not saying bad job doctors, but when you see these

[31:09] stories about, hey, this person in this state or this country, they went in, they got adjusted and now they can’t walk anymore — it’s like the reason you’re hearing about that is because that is the anomaly. That is the one in 10 million. You also read about people who win the lottery, right? And you read about people who lose the lottery as well. But it’s very sensational. It’s very easy to share on social media. It generates a lot of clicks. It generates a lot of comments. And so that’s why you

[31:39] know about it. So probably a good time to take a break and do this thing. Yes. All right. I’ve got ADHD, which means that my brain is incredible at — terrible at staying in one lane. So for most of my life, focus is something that I’ve had to fight for. And then I found Brain FM. No exaggeration. It feels like someone installed a performance upgrade in my brain. Brain FM uses music engineered with neuroscience to guide your brain into specific states. Deep focus, flow,

[32:11] relaxation, even sleep. It’s targeted input for how your brain actually works. When I turn it on, it’s like my mental noise drops and my attention locks in. I can work for longer without burning out. Writing, clinic work, podcast prep — stuff that used to feel scattered suddenly feels organized. For my ADHD brain, it’s basically a superpower. So right now, you can try Brain FM for free for 30 days. Use our affiliate link in

[32:41] the description. The free trial costs you nothing and it supports the PTCH Podcast. Gives you a chance to see what your brain can really do with the right tools. So if you’ve got ADHD like me, see if Brain FM can help unlock your superpower instead of struggling with willpower. Can you talk about how chiropractors are blamed for strokes? Yeah. Yeah. So yeah, that is one of the most common things where people are like, well, tell

[33:11] me how many strokes chiropractors are causing, you know. So here is the data on strokes. There was — like probably the gold standard study — and this is a systematic review and meta-analysis of all the data, all the studies that are out there, took the case reports and everything like that. This was not a study that was just done by chiropractors. This is done by — it’s a multidisciplinary study. It’s called the risk of vertebrobasilar stroke and

[33:42] chiropractic care results of a population-based case control and case crossover study. It’s by David Cassidy et al. and buddies. And buddies, so it also included PhDs, there’s MDs that were in on this study. So this is not just chiropractic propaganda. Okay. Also published in the journal Spine. This is February

[34:13] 15, 2008. The reference will be in the comments. And here’s what they found. In those aged under 45, cases were about three times more likely to see a chiropractor before their stroke than controls. Okay. So that is how most people read the literature in terms of do chiropractors cause strokes, right? Okay.

[34:43] And that is almost what it says. Yeah. Okay. But that’s not the truth. Here’s what it says. It says in their study there was 1,800,818 VBA strokes hospitalized in a population of more than 100 million person years. In those aged under 45 years, cases were about three times more likely to see a chiropractor. Here’s the part that I skipped before. Or a primary care provider before their strokes than controls.

[35:14] So the big thing about this study is what they found is that when they controlled for neck pain, yeah. Which is a symptom of a vertebrobasilar artery dissection. What they found was that when they took into account did that person have neck pain or not, you have the same rate of strokes for people who go see chiropractors as well as people who go see primary care in this under 45. They are three times

[35:45] more likely to have seen a chiropractor or their primary care. Interesting. And so what that tells us is that when you look at this, it might not be the manipulation. Right. Right. Because are primary care doctors doing manipulation? Probably not. Probably not. Right. But those people are still having the strokes. And so what they concluded with this is that

[36:15] people are having the dissection. And one of the main symptoms of a dissection is neck pain. Okay. There are other symptoms that go along with it that make it look really weird, right? And so you can’t always spot it when it’s happening, but there are some other things that might make you think, “Ooh, this is off, right? Like that person might also have some dizziness. They might have some peripheral symptoms. They might describe having the worst headache of their life, right? And

[36:45] so they go and they see a chiropractor. Now, the other thing they found is that sometimes because people have these symptoms, which are the type of symptoms that you go to the chiropractor for, people go to the chiropractor and the chiropractor is like, no, this ain’t it. You can’t be here. We got to get you to the hospital, which is the right thing to do if you see that kind of thing. We can always adjust you later. Let’s get you to the hospital. Those people are having strokes. But what happens a lot of times in the data is you look and you’re like, that person went to a chiropractor and so the

[37:16] chiropractor caused it. And I actually have friends who have caught people who are having that stroke. They sent them — sorry, they sent them to the emergency room and they were referred by the chiropractor. And so the emergency room doctor, the writeup says they went to the chiropractor, the chiropractor caused a stroke. No. Yeah. No, they didn’t even do the adjustment. They were like, “Hey, you’re having a stroke.” Like, “Nope, get out of here. Don’t tell them I sent you.” Yeah. Right. Right. Exactly. And so there’s some of

[37:48] these that people are like, “Oh, you saw the chiropractor.” And so then it’s like, “Oh, well, you know, I had a patient who I sent to the hospital because he had really high blood pressure and he had neck pain. He had some other things I’d normally see him for and I’d probably adjust him for, but the blood pressure was super high.” Yeah, but I was like, “No, this is the bigger issue.” So I sent him to the hospital and he had an unstable upper cervical fracture that he’d been walking around with for a month. If I would have adjusted him,

[38:19] that would have been a problem. The best outcome would have been paralysis, right? The worst outcome would have been death. My goodness. Yeah. And so he went up there, they caught it, they got him into surgery and alive and well today. Wow. But he called me up and he’s like, “You saved my life.” Yeah. And I was like — and I thought the blood pressure was high because he was in so much pain. Yes. They gave him a shot for the pain, the blood pressure went right down. But then they go and they evaluate and sure enough.

[38:49] Wow. And so that’s the thing too, is sometimes people are like in these comments they’re like, “Well, what about hypermobile people and what about people with this? What about people with that?” And it’s like, “Okay, so you somehow know about the risk factors. You assume that I don’t, right? I’ve studied this. This is all I do every single day. I do this. So how do you think that? Do you think they just glazed over that in chiropractic school? And so you have millions of chiropractors out there just stroking people out all the time. No, we’re

[39:19] trained to help people to avoid it. However, you can’t avoid it 100% of the time. And that is if you’re a chiropractor or if you’re a primary care doctor. And so we just have to be fair on that, right? The other thing too that they determined in this is that there is no causal link between chiropractic and strokes. And what that means is that there is no evidence or no proof that these artery dissections are

[39:50] being caused by the manipulation. We don’t have a way to go back and see what was there before an adjustment, what was there after. And so in order to do that, you have to do a randomized control trial where you take people who are at risk and you adjust some of them and you pretend to adjust some of them and you see how many people get strokes. That’s not ethical. You can’t do that. And so for people like this who are like, “Oh, I’ve seen chiropractors cause strokes.” My question to you is how do you know? Yeah. Right. How do you know that they were

[40:21] having the dissection after the manipulation and not before? Jason: Not before. Yeah. Kathy: Yeah. And how do you explain that you also see that from people who are referred to you from their primary care doctor and they were given an aspirin or, you know, or something like that? It’s just one of those extremely rare things. Thankfully it’s extremely rare things that happen and what is good for everybody is if we continue to study it and we find better ways to help detect it

[40:51] and save people’s lives and livelihood. So I’m done with that. Can I drop this microphone on the ground? Can I just push it off the table? Kathy: No. You’ll charge us for that. Jason: Yes. Kathy: Okay, never mind. Jason: Mic drop. Kathy: Never mind. You got any more for me? Jason: I do. One last one. Kathy: One last one. Oh, do the big one. Jason: The long one. Kathy: The long one. Jason: Oh, man. Okay. And I’ll do my best to just address this one so fast. Kathy: Oh, good. They put their name on

[41:22] here. Yeah. This one is from Mark Steven42770. Jason: Okay. Kathy: Okay. Mark. Mark says, “Sorry, I’m going to keep a straight face when I —” Jason: This is amazing. Kathy: “The risk of stroke is increased by 76% in patients who have recently undergone neck manipulation by a chiropractor. Chiropractic adjustments cause 62% of all reported iatrogenic

[41:52] injuries.” Jason: Iatrogenic means injuries caused by medical providers. Yes. Kathy: Or healthcare providers. Jason: 62% — Kathy: 62%. Yes. Jason: Between 2014 and 2018, there were over 1,000 lawsuits filed against chiropractors for malpractice, negligence, and fraud. Wow. I wonder how many PTs — Kathy: Jason: Chiropractic care is associated with 40% increased risk of injury compared to primary care physicians.

[42:22] The most common injuries reported from chiropractic care include herniated discs, nerve damage, and stroke. In some cases, chiropractic adjustments have resulted in paralysis and even death. A 2012 study found that 30% of chiropractic patients reported adverse effects such as increased pain, numbness, and headaches. Kathy: Okay. Boom. Boom. Boom. Jason: So, the only thing he got right was that last part. And we already talked about that study. Kathy: Yeah. It happens in PT, too.

[42:52] Jason: Yeah. So, we know what those adverse effects are. And I’m surprised that he didn’t go with the 60.9%. You know, let me help you make your point, Mark. Yeah. So, we know what those are, right? Let’s go to that first one — that 76% — “the risk of stroke is increased by 76% in patients who have recently undergone neck manipulation by a chiropractor.” Kathy: Yes. So I want to talk about where that comes from. Jason: Yeah. That is somewhere very far up this gentleman’s butt.

[43:26] That’s not true at all. Kathy: That’s a completely made-up number. Jason: I searched so hard. Yeah. I searched so hard for that. I looked in PubMed. I used AI. I, you know, I hired teams of like private investigators. That is a completely fabricated number. Kathy: That seems like a made-up number. Jason: My suspicion is he might have gotten his hands on some old pamphlet or some weird anti-chiropractic blog. But totally made up. So I can’t address it. Kathy: Yeah, he can’t even — Jason: And we already actually even talked about it, though. I mean, I gave you the

[43:57] information from the systematic reviews. The highest level of evidence says that it is like a one in 10 million shot that you’ll have that — to put it in perspective, that’s like flipping heads on a coin 20-plus times in a row. So yeah. Kathy: Okay. What’s the next paragraph again? Jason: “Chiropractic adjustments cause 62% of all reported iatrogenic injuries.” Kathy: That’s absolutely ridiculous. Jason: 62%. Kathy: Yeah. And here’s one of the reasons that you know that this is BS. There is no

[44:28] database that we’re reporting that to, right? So, like, where would you even get that data? Right? There’s no database like that for chiropractors, which maybe there should be. That would be a cool thing. I would be down with that, because I want to know how to better protect patients, but there’s no database where that’s reported, right? And there’s no database where medical doctors are doing it, too. There’s like hospitals that track that stuff and report it, and people that study it, but that’s also completely made up. And you’ve got to

[44:59] be freaking kidding me if you think that chiropractic is more dangerous than medication and surgery. Kathy: Yeah. So have you heard of MRSA? Like, people go into hospitals for routine things and they get MRSA infections and you’ve got to get something cut off. Jason: Yes. Kathy: Yeah. That’s way more common than somebody getting a serious adverse event from a chiropractic adjustment. So, sorry Mark, I can’t comment on your statistic there because it’s completely made up.

[45:29] Jason: Okay. “Between 2014 and 2018, there were over 1,000 lawsuits filed against chiropractors for malpractice, negligence, and fraud.” Kathy: Yeah, that’s awesome. Yeah, Jason: that’s really great. Yeah, that’s 250 lawsuits a year. And the data with that is 70% of the time the chiropractor is exonerated in those. Okay. Because there’s all kinds of reasons to file malpractice suits. One of the most common reasons is a

[45:59] dissatisfied customer. Jason: Yes. Kathy: Okay. And chiropractors aren’t special in that. I think that with medicine, it’s right around like 65–70% of those malpractice claims the doctor is exonerated. Now, let’s talk about volume, though, because 250 — now granted, there are more medical doctors out there than chiropractors, but, you know, I’m sure somebody with a calculator out there can figure out the per capita, right? But there are approximately 85,000 medical malpractice lawsuits filed every

[46:29] single year in the United States. So, yeah. Okay, cool. I accept that. I accept that. Kathy: I’m gonna go with that one. And I’ll give you a reference for that. It’ll be in the show notes, but that is from — Jason: JAMA Surgery. Oh, sorry. No, no, sorry. Kathy: This is from the journal Neurosurgical Focus, 2020. That is LeFever et al. Jason: Oh, yes. So I’m not just making up statistics like Mark. Okay. Go ahead.

[47:00]

Jason: Chiropractic care is associated with 40% increased risk of injury compared to primary care physicians.

Kathy: Yeah. Also completely made up.

Jason: It can’t be true.

Kathy: No. I — I — I don’t even know how to comment on that because —

Jason: No.

Kathy: There’s no reference for it. There’s no reference point. So if it’s true and somebody has that data, I would love to see it, because it’s going to help me to be a safer practitioner if I can understand where that little gem came from.

Jason: Please leave a comment if you have the — if you have the source of that. Okay.

[47:31] The most common injuries reported from chiropractic care include herniated discs, nerve damage, and stroke.

Kathy: Incorrect. Incorrect.

Jason: Okay.

Kathy: The most common are — we already talked about it. Soreness. Yes. Soreness. Maybe get a headache.

Jason: Maybe, you know, you can’t pee standing up — I’m just kidding. I made that one up. No, those are — those are the most rare. Those are extremely rare. Yes. Right. The most common things are: I feel a little bit sore, or, you know, I had a headache.

Kathy: Yeah. And I’ve experienced those after an adjustment, right?

[48:02] Jason: And yeah, that’s just — that’s just — I think that we put that one to bed. But —

Kathy: Here’s a frustrating thing, though —

Jason: — is you look at a social media post, and I had some person that’s like, “Oh, I bet this isn’t going how you thought it was in the comments.”

Kathy: And it’s like — there were like 400 comments.

Jason: Yeah. A third of those are mine, making some sort of snarky response or emojis to people’s comments. And so he looks at that and he’s like — and all those comments are just like these, where it’s like people who

[48:32] all they have is their opinion. They have no data. And when I’m like, “Oh, that’s interesting. Can you provide some data for that?” — “No. The burden of proof is on you.”

Kathy: No, it’s not. I gave you the data. I’ll give you the studies. I’ll give you all the studies you want.

Jason: Yeah. Right. And if I don’t have a study, I’m going to tell you I don’t have a study. Right? When you go and you make up statistics and you’re like, “Oh yeah, this is what it is and this is what chiropractors really do” — and it doesn’t matter what you say — “And here’s my anecdotal evidence against your systematic reviews.” It’s like, yeah, thanks, but no thanks. And so — oh jeez, where was I even

[49:04] going? I just — you told me in the beginning to set it down, and here I go.

Kathy: Chill out. Chill out.

Jason: But so — but this is the thing. You know, people make these comments and they see other people with these comments, and it emboldens them to be even stupider than the person before them, right? And they’re like, “Look at how dumb this comment was. I bet you I can do better,” right? And so then they go throw stuff out, and of course you’re not going to go and, you know, referee somebody who’s also doing bad behavior and not paying

[49:36] attention to evidence or science or anything like that. So he’s like, “Yeah, I bet this isn’t going how you thought it was.” And I’m like, it’s going pretty good, because every time you comment, it pushes out my good information to the public and it’s got five times as many likes — which, if you agree with something because you understand it and I gave you the evidence, you’re just going to say, “Oh, like” — you’re not going to go to the comments and be like, “Oh my gosh, you’re so right.”

Kathy: So right.

Jason: Yeah. That’s what the like button is for.

Kathy: Yeah. So I’ll just tell you: when you’re looking at the comments and you see people piling on, if they don’t have

[50:08] evidence, if they’re not willing to quote evidence to back up their viewpoint —

Jason: Yeah.

Kathy: — be very suspicious. Yes.

Jason: Be very suspicious about what they’re saying. I’m not going to tell you that they’re wrong.

Kathy: No.

Jason: Be very suspicious.

Kathy: It’s so easy to link a study. I mean, if you can write a comment —

Jason: So easy.

Kathy: — if you can write a comment on here, you can link a study, too. We’re happy to review it.

Jason: Absolutely. And here’s all that I want. When you’re in these conversations and somebody makes a claim — I don’t care which side of the equation they’re on — if it’s a chiropractor who’s like, “That’s not what it is. It’s really

[50:38] this” — ask them for a source. And if they give you a source —

Kathy: Believe it.

Jason: Yeah. Right. And if somebody is on the opposite side of that and they’re like, “Well, chiropractors are just out there killing people” —

Kathy: And they give you a source. Okay —

Jason: Believe it, right? They got a source. But also recognize if somebody’s like, “Well, my cousin got hurt” —

Kathy: Okay.

Jason: Okay.

Kathy: Believe them.

Jason: Yes. But one cousin

[51:08] Kathy: does not

Jason: Yes.

Kathy: overrule a systematic review or anything like that.

Jason: So, evidence-based medicine, evidence-based approach for chiropractic. We have the evidence on our side now. I think the other one that came up is people who are like, “Oh, chiropractic doesn’t do anything.” And so of course it’s not hurting people. It’s like you can’t have it both ways. It’s either like dangerous and it’s killing people, or it’s completely benign — it’s like —

Kathy: Useless.

Jason: Yeah. It’s water. Right?

Kathy: And there is evidence out there. That — that JAMA article that

[51:40] I got to — and it says that there’s moderate level evidence to support chiropractic care for lower back pain, right? Same with neck —

Jason: Same with headaches. There’s — I’ll link another article that goes through a whole bunch of different types of claims. There are guidelines that recommend spinal manipulation. The thing that there’s the worst evidence for with chiropractic is not neuromuscular skeletal things —

Kathy: Right.

Jason: — and so, can you adjust away autism? No.

[52:12] Allergies? No. Asthma? Uh-uh. Endometriosis? Sorry. You know, it’s like — those kind of peripheral things — not good evidence for, right? And so I don’t think the chiropractor should be out there claiming that —

Kathy: Right.

Jason: — but that doesn’t mean that the rest of it isn’t pretty darn good. They’re like, “Well, it shows that it’s equal to physical therapy.”

Kathy: Cool.

Jason: Yeah —

Kathy: Physical therapy is good, too.

Jason: Well, it’s equal to NSAIDs. Also awesome.

Kathy: Yeah. And safer than NSAIDs.

Jason: Yeah. Prove me wrong on that.

[52:43] Jason: No. Freaking prove me wrong. Come. Nobody’s giving me any evidence to show that NSAIDs are safer than chiropractic. Lots of people were like, “Well, you can’t compare the deaths.” Okay, fine. We won’t compare the deaths. Show me any evidence that NSAIDs are safer than chiropractic adjustments. Kathy: Well, they’re not giving people strokes. Jason: Okay, well, chiropractors aren’t killing people, so I’ll — I’ll see your strokes and raise you a death. Kathy: All right, Jason. Jason: All right. This was a good therapy

[53:14] session for you. Should we play a game? Kathy: Yeah, I think we need it. Jason: That’s probably a good way to like kind of chill out. Kathy: Yeah. All right, Raul, are you there? Oh, there you are. Okay, great. Raul, let’s play speed-fire — speed round style. True or false. Do you know your facts about chiropractic in a game that I call Crack or Cap? You ready? Jason: Crack or Whack? Kathy: Ready? Okay. I don’t know if

[53:45] we need a timer. Oh jeez, we’re almost out of time anyway. So, here we go. Ready? Round one. I guess they’re all round one. Here we go. Chiropractic was originally influenced by vitalism. True or false? Raul: I don’t know what that is. I’m going to say true. Kathy: It’s true. Right. It was this idea that if you get adjusted, it’s going to unlock your life. Right. All right. D.D. Palmer claimed that chiropractic could cure infectious disease. True or false? Raul: True. Kathy: That is true. Modern chiropractic education still teaches that disease is

[54:15] caused by subluxations. True or false? Raul: Again, I’m not sure what that means. I’m gonna go false. Kathy: It is false. Yes. So in chiropractic schools, you can teach that disease is caused by subluxation, but only from a historical standpoint. You can’t teach that it’s true. You can only teach that once upon a time, some guys thought that it was true. All right. Early chiropractic training was shorter than modern medical school. True or

[54:45] false? Raul: I’m gonna go false. Kathy: It’s true. Jason: Yes, it was shorter — and it is shorter. Nobody gets more training than medical doctors. How about this one? Serious adverse events from spinal manipulation are common. True or false? Raul: False. Kathy: You are correct. Jason: Yes, he listened. Kathy: Yes. Mild side effects like soreness or headaches are relatively common after adjustments. True or false? Raul: True. Kathy: That is true. Neck pain and headaches can be early symptoms of cervical artery dissection before a treatment occurs.

[55:17] True or false? Raul: True. Kathy: That is also true. Chiropractic care has been shown to have higher stroke risk than primary care visits for neck pain. True or false? Raul: False. Kathy: It’s absolutely false. Okay. I’m going to give you three more. All right. Ready? Which ones do we go for? I don’t think we talked about that. Okay, here we go. Adjustments put bones back into place. True or false?

[55:47] Raul: False. Kathy: That is false. Very good. If chiropractic worked, hospitals would universally refer patients to chiropractors. True or false? Raul: False. Kathy: That is also false. Okay. And last one. Oh, wait. We got to do two more because this is one that you love. Seeing patients who worsen after care proves that chiropractic caused the injury. Raul: False. Kathy: That is false. And last one — Kathy’s favorite. Yawning and chiropractic

[56:18] have the same evidence base. Raul: False. Kathy: Oh man, you got it. He got it. Jason: He won again. Kathy: He did. Jason: He keeps cheating. Kathy: Tell them what he won. Jason: Kathy? Kathy: You win this half-drunk bottle of water Jason: and our respect. We’ll give you a chiropractic adjustment afterwards. Okay. Anyway, all right, Kathy. Kathy: Yes. Jason: Take over. Kathy: Oh, man. I don’t even know where to begin. Jason: I know. We should just

[56:48] Kathy: But I think what I take away is that all chiropractors cause strokes. Jason: Yes. Oh, and we’ve come full circle. Yes, the evidence has prevailed. Yes. And what I’ve taken away is that there’s no stroke like a chiropractic stroke. Oh my goodness. Okay. So, here’s your call to action. If you learn something and you’re in the comments,

[57:18] just link somebody to this episode, okay? Let me do the arguing for you. And please hit up the show notes. I will have references to these articles and more. None of you are going to read them. Kathy: Nah. Jason: Yeah. None of you are probably even still watching at this point, right? So but I think there is one just vital piece of information that everybody needs at this point. Kathy: There’s no “I” in PTCH.