I'm a Chiropractor, and I Owe You an Apology

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I'm a chiropractor, and I need to apologize. My profession has lied to you. A LOT.

• If you've ever been shown your X-ray and told your joints are out of place…

• If you've ever been told you need 36 visits to “fix your alignment”…

• If you've ever left feeling better, only for your pain to come right back two days later…

This one's for you. I'm sorry. You've been misled, and I want to set the record straight.

Whether you love chiropractors or you think the whole thing is a scam, the research I'm about to show you might save you thousands of dollars on treatment that just keeps you coming back forever instead of actually getting you out of pain. Let's dive in.

Chiropractic was founded on subluxation theory: a joint goes out of place, pinches a nerve, blocks your “vital life force energy,” and causes every disease in the body. Even asthma and cancer. One cause for everything.

Science made that look pretty silly, so chiropractors changed their theories many times - and that's a good thing. Every profession does this. Medical doctors used to prescribe bloodletting for everything. We all used to believe some very silly things.

The problem is that the chiropractic profession is divided. One faction is still trying to convince you that an adjustment will cure asthma or autoimmune conditions, while the other is working hard to embrace evidence-based practice. And as a patient, you have no idea which one you're walking into.

So let's go through the claims one by one - so you know when you're being misled, what you're actually paying for, and what the research says actually works for getting out of chronic pain.

In this article, I'll go claim by claim:

• “We can feel where your spine is out of alignment”
• “We can put joints back into place”
• “The crack means it worked”
• “You need X-rays before we can treat you”
• “You have a short leg, and that's causing your pain”
• “Adjustments treat asthma, colic, and even cancer”
• “We're breaking up adhesions and scar tissue”
• “You need adjustments for the rest of your life”
• Two bonus LIES debunked: applied kinesiology and the Y-strap “ring dinger”

What actually works - and where to go from here

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Claim 1: “We can feel where your spine is out of alignment”

Every chiropractor is taught palpation - we use our hands to try to feel joint position and stiffness. Sounds reasonable.

Researchers have been putting this skill to the test for decades. When two chiropractors examine the same patient independently, there's little to no agreement on the location of these so-called misalignments [1][2].

What usually happens in practice is the chiropractor feels around until the patient says “yep - that's the spot that hurts,” and the chiropractor hallucinates into thinking “oh yeah, I can feel that this joint is WAY out of alignment… let's crack it!”

Researchers even tested experienced clinicians' ability to reliably palpate the PSIS - one of the largest bony landmarks on the human body, visible through the skin on a lean person. Embarrassingly, even experienced clinicians couldn't agree on its location [3].

If we can't even reliably identify a massive, superficial bony landmark, how are we supposed to feel much deeper structures like a transverse process, which can be buried under five centimeters of soft tissue [4]? You can't feel that with your hands. Nobody can. If your chiropractor claims to feel misalignments, they're probably hallucinating.

Claim 2: “We can put joints back into place”

You've probably heard this one: your spine is out of alignment, and we're going to put it back. A few problems stack on top of each other here.

First - you can't target a single vertebra. Studies with sensors placed at multiple spinal levels found that when force is applied to one vertebra, movement happens above and below it too. The spine is like a suspension bridge, so force applied anywhere disperses throughout the whole region [5].

Second - you can't control the angle. Chiropractors are taught vectors; they try to aim an adjustment to move a bone at a specific angle. But research shows the interface between the skin and the underlying fascia is essentially frictionless, meaning no matter what angle you push at, the force transmits straight down [6].

Third - joints don't have one “correct” position. The whole premise assumes there's a single right spot you're restoring a joint to. But there isn't. There's a normal RANGE of motion, and all of those positions are good. The health of a joint isn't determined by its static resting position any more than a clock's value is determined by where the hand is frozen - it's determined by its ability to MOVE through a full range of motion. Remember, chiropractors can’t change joint position anyway [7].

Joints do not go “out of place” unless we're talking about a dislocation - in which case you'd be in the emergency room, not a chiropractic office. This is what an actual joint misalignment looks like: a spondylolisthesis. And even with that, most people live completely pain-free without ever knowing they have it [8].

Claim 3: “The crack means it worked”

When you hear a pop (we call it a cavitation) and immediately feel relief, it's easy to buy the story of joint re-alignment. It FEELS like that's exactly what happened.

But research shows that sound is just nitrogen gas releasing from the joint fluid - the same thing as cracking your knuckles. The pop is basically a “joint fart.”

Two studies placed sensors on the spine during adjustments to track exactly where the cavitation happened. In both, the location of the pop had no statistically significant relationship to the segment being targeted. The pop is random. It doesn't mean anything [9][10].

Chiropractors claim they need to target a specific segment, but research shows adjusting an area nowhere near the pain gets the exact same results. For example, if you come in with neck pain and we adjust your mid-back, you'd get the same pain relief as if we adjusted your neck [11]. Even comparing real adjustments to sham adjustments shows no real difference [12]. To be clear: spinal manipulation can provide genuine short-term pain relief. It's just not changing joint position.

Claim 4: “You need X-rays before we can treat you”

Clinical practice guidelines all say the same thing: do not get routine imaging (X-ray or MRI) for back pain or sciatica without red flags [13].

This might surprise you, because it's natural to assume that if we can see something abnormal on an X-ray or MRI, that finding must be the reason you have pain - and that to treat you properly, we need to know exactly which single tissue is to blame.

Here's the problem. Everybody has findings on their MRI, whether or not they have pain. Most people have disc degeneration, disc bulges, annular fissures, and other findings even with zero symptoms. Even things like spondylolisthesis and nerve compression are common, pain or no pain [14]. So unless you have red-flag symptoms - like partial paralysis of the foot or loss of bladder control - you probably don't need any imaging.

This matters because unnecessary imaging has real, harmful consequences. People who get early, unnecessary MRIs of their low back are about twelve times more likely to get pushed into a surgery they don't need [15]. On top of that, seeing your MRI is more likely to trigger fear-avoidance patterns, which we know lead to higher disability, higher pain levels, and worse outcomes long-term.

And the worst thing of all - this one is, in my opinion, completely unethical - is that some practitioners use X-rays as a sales tactic to scare you into believing your spine has something terribly wrong with it, then tell you it'll cost thousands of dollars to fix a “problem” that was never a problem to begin with.

One more thing: X-rays can't even show a disc herniation. You'd need an MRI for that. So with a routine X-ray you're getting unnecessary radiation exposure on top of wasting your time and money and getting scared into treatment you don't need.

Claim 5: “You have a short leg, and that's causing your pain”

You lie down, they hold your feet, and they announce that one leg looks shorter. Again, the explanation sounds reasonable: if one leg is shorter, it's going to cause compensations, muscle imbalances, wear and tear, and ultimately pain, right?

Here's what the research actually says. Nearly every human has a leg-length inequality - it's basically universal, and the average is about 5 millimeters. And it doesn't matter AT ALL until about 20 millimeters - roughly three-quarters of an inch. Even then it's not a strong predictor of pain, and you can't fix it anyway. If a bone is short, you can't change that.

Not to mention the tests used to measure leg length by eyeballing it are notoriously unreliable, so the tests don't even work in the first place [16].

Claim 6: “Adjustments treat asthma, ear infections, ADHD, and even cancer”

This one is embarrassing for the profession. This is where chiros earn the bad reputation. A fringe portion of the field still believes they can cure almost anything with an adjustment - because they claim nerves control everything.

Here's the problem with that logic: if nerves controlled everything, organ transplants wouldn't work. A transplanted kidney has zero connection to the recipient's nervous system. And it works just fine.

Let's look at two popular claims. First, asthma: the Cochrane Collaboration - the gold standard for systematic review - found zero benefit over sham [17]. Next, infantile colic: a randomized controlled trial found that when parents were blinded to whether their baby got a real adjustment or a sham, the benefit completely disappeared [18]. The improvement wasn't from the adjustment. It was from time - colic often gets better on its own.

And at its worst, some practitioners claim they can cure cancer with an adjustment [19]. At best that's wildly naive; at worst, those practitioners are preying on terminally ill people in the most frightening and vulnerable moment of their lives.

Real quick - what's the craziest thing you've ever heard a chiropractor claim? I read every comment, so tell me.

Claim 7: “We're breaking up adhesions and scar tissue”

Many chiropractors use hands-on tools like instrument-assisted soft-tissue mobilization and claim to be breaking up adhesions or scar tissue. The story is believable because you go in feeling tight and leave feeling looser, so “we broke up the scar tissue” makes intuitive sense.

Unfortunately, this is another case where the therapy can genuinely help short-term pain, but it's not doing what they claim.

The forces applied during hands-on therapy are far too low to disrupt connective tissue. A 2008 mathematical model found you'd need more than 8,000 Newtons of force - about the weight of a small car - to produce just 1% compression in fascia [20]. Your therapist's thumbs are NOT doing that.

What's actually happening - according to the best research on manual therapy - is a neurological response [21]. Any hands-on treatment can nudge your nervous system into a pain-gating, short-term pain-blocking reflex. That's why any hands-on treatment can provide relief. Rub it, pop it, crack it, poke it. Doesn't matter.

Claim 8: “You need adjustments for the rest of your life”

Some chiropractors will tell you that you need regular maintenance adjustments to keep your spine in alignment forever. Ah yes, subluxations - the silent killer. And if you think of your body like a car that needs regular maintenance, it's easy to buy in.

But the best maintenance on the planet isn't a chiropractic adjustment. It's learning to take care of yourself: exercising, managing your stress, eating well, and getting good sleep. The basics.

We've also already debunked the core premise. We showed that joints don't go out of place and that chiropractors don't alter joint position, so the idea of “checking your alignment” regularly doesn't make sense - your joints don't go out of alignment in the first place.

Still, let's see what the research says. The most-cited RCT on maintenance care - the Nordic program - found that patients receiving scheduled adjustments had about 12 to 13 fewer “bothersome” pain days per year [22]. Chiropractors love that number. Here's what they don't tell you:

• The study only enrolled patients who already reported significant improvement after multiple chiropractic visits - they cherry-picked their best responders.
• A TON of people dropped out - so many that the study was underpowered, meaning the statistics they quote barely mean anything. And why did those people drop out? Did they feel worse after adjustments? We don't know.
• There  was no real control group. Both groups received chiropractic care.  The only difference was that one group was scheduled proactively and the other was told to call when it hurt. In pain neuroscience, directing someone's attention toward scanning for bad days reliably increases their pain experience - so the group told to watch for painful days might have simply noticed more of them.

Short story: the best research available can't say anything meaningful about regular chiropractic care - and it doesn't matter anyway, because joints don't go out of place in the first place.

Real quick: if this has happened to you and you were pushed into a long-term treatment plan, I'd love to know - did you feel pressured, or scared into it?

A quick note before we keep going

If you're new here, I'm Dr. Anthony Davis. I had debilitating chronic pain for over a decade, so I know exactly what it's like - and it's a big part of why I get so fired up about practitioners who mislead people into useless care that goes nowhere. If you want to understand what the research says actually DOES work, and how to apply a lifestyle-based approach to overcoming chronic pain, watch our free masterclass: shapeshiftwellness.com/backpain-masterclass.

Bonus myth-busting #1: Applied kinesiology

Maybe you've seen this: the practitioner pushes down on your arm while you hold a supplement. Based on whether your arm tests “strong” or “weak,” they tell you whether your body needs that supplement or whether you're allergic to something.

This has been tested. A study had practitioners test patients with clinically confirmed wasp-venom allergies - people genuinely allergic to a literal poison in a bottle. If applied kinesiology works, that's the easiest possible test to pass. The kappa coefficient was 0.03. Statistically indistinguishable from a coin flip [23].

Researchers also reviewed seven years of applied kinesiology's own published research - 50 papers the field chose and funded itself. Not one met basic scientific standards. Not one included adequate statistical analysis. No valid conclusions could be drawn from any of them [24].

This is just a trick to sell you expensive supplements. Don't buy it.

Bonus myth-busting #2: The Y-strap “ring dinger”

If you've watched chiropractic adjustments on YouTube, you've seen the Y-strap, or “ring dinger” - the dramatic full-spine adjustment where the chiropractor wraps a harness around your head and yanks, sometimes nearly pulling people off the table.

Here's something almost nobody mentions: the Y-strap manufacturer's own guidance explicitly states that “regarding using high force and/or high velocity, we do not recommend this” [25]. In other words, the device was intended to give a patient a gentle, sustained stretch - but some people, maybe more concerned with going viral than with treating patients safely, are applying high-velocity, high-amplitude thrusts despite questionable safety.

This is NOT a standard chiropractic technique. It is NOT taught in chiropractic schools. There are no clinical trials supporting it. And some patients in those videos show up in the comments reporting adverse reactions that didn't show up on camera - likely masked in the moment by a massive adrenaline rush. There are much safer options if you genuinely enjoy hands-on treatment.

I apologize

So I apologize on behalf of my profession - for the blatant misinformation, for the unnecessary and expensive treatment, and most of all for the few bad apples who disregard patient safety in their own self-interest. Some of these things are rare, but they have such a negative impact that they tarnish the entire profession.

Let me be clear: chiropractors are NOT bad people. Even the ones on the fringe. Many were simply taught outdated techniques and are doing what they genuinely believe is best for their patients.

Progress is slow because it relies on individual practitioners challenging their own biases even when it costs them. It requires unity in a deeply divided profession. And it requires a massive overhaul of a medical establishment that doesn't support the kind of individualized care chronic-pain patients actually need.

I'm not saying I have all the answers. That's the whole point - nobody does. Every day we should be challenging our beliefs to keep improving how we manage chronic pain.

So what actually works?

Spinal manipulation, used appropriately, can provide short-term pain relief and improved range of motion. So if it feels good and you don't mind paying for it, go for it.

But think of manual therapy as a side dish to the meat and potatoes of chronic-pain rehab: sustainable lifestyle changes like exercise, stress management, sleep, and nutrition - plus the patient education that teaches you how to take care of yourself for the rest of your life. The real formula is simple: calm shit down, then build shit back up.

Your body is not fragile. You are not out of alignment. The degeneration and disc herniation on your MRI do not doom you to a lifetime of pain. You can return to an active life and overcome chronic pain - but it's going to take some real lifestyle changes.

Where to go from here

The biggest question I get, once people realize their MRI doesn't determine whether they'll have pain, is: “Well, then why DO I have pain?” That's exactly what our pain neuroscience mini-series answers. You can watch the whole series for free inside our community group - come join us here: shapeshiftwellness.com/freegroup-invite. I'll see you in there.

This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before making changes to your treatment plan.

References

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13. de Campos TF. Low back pain and sciatica in over 16s: assessment and management NICE Guideline [NG59]. J Physiother. 2017;63(2):120. doi:10.1016/j.jphys.2017.02.012. PMID: 28325480. View on PubMed

14. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173. PMID: 25430861. View on PubMed

15. Jacobs JC, Jarvik JG, Chou R, et al. Observational study of the downstream consequences of inappropriate MRI of the lumbar spine. J Gen Intern Med. 2020;35(12):3605-3612. doi:10.1007/s11606-020-06181-7. PMID: 32989711. View on PubMed

16. Cooperstein R, Morschhauser E, Lisi A, Nick TG. Validity of compressive leg checking in measuring artificial leg-length inequality. J Manipulative Physiol Ther. 2003;26(9):557-566. doi:10.1016/j.jmpt.2003.08.002. PMID: 14673405. View on PubMed

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18. Holm LV, Jarbøl DE, Christensen HW, Søndergaard J, Hestbæk L. The effect of chiropractic care on infantile colic: results from a single-blind randomised controlled trial. Chiropr Man Therap. 2021;29(1):15. doi:10.1186/s12998-021-00371-8. PMID: 33874955. View on PubMed

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20. Chaudhry H, Schleip R, Ji Z, Bukiet B, Maney M, Findley T. Three-dimensional mathematical model for deformation of human fasciae in manual therapy. J Am Osteopath Assoc. 2008;108(8):379-390. doi:10.7556/jaoa.2008.108.8.379. PMID: 18723456. View on PubMed

21. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531-538. doi:10.1016/j.math.2008.09.001. PMID: 19027342. View on PubMed

22. Eklund A, Jensen I, Lohela-Karlsson M, et al. The Nordic Maintenance Care program: effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain-a pragmatic randomized controlled trial. PLoS One. 2018;13(9):e0203029. doi:10.1371/journal.pone.0203029. PMID: 30208070. View on PubMed

23. Lüdtke R, Kunz B, Seeber N, Ring J. Test-retest-reliability and validity of the Kinesiology muscle test. Complement Ther Med. 2001;9(3):141-145. doi:10.1054/ctim.2001.0455. PMID: 11926427. View on PubMed

24. Klinkoski B, Leboeuf C. A review of the research papers published by the International College of Applied Kinesiology from 1981 to 1987. J Manipulative Physiol Ther. 1990;13(4):190-194. PMID: 2351880. View on PubMed

25. The Y-axis manipulation (“the ring dinger”): the clinical efficacy and associated patient safety explored-a clinical commentary. Journal of Parker University. Read the commentary

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