A chiropractic schism?

A chiropractor who also has a master’s degree in immunology is in trouble because she posted an op-ed that favored vaccines.

The article she posted by the New York Times was titled “Underselling the Vaccine” and described how experts were being overly cautious when reporting their success rate.

With a master’s degree in immunology, Weiss thought the article was interesting and wanted to pass it along to her many Facebook friends, which include immunologists and scientists, she told CBC News.

A fellow chiropractor — whose identity remains a secret to this day — saw it and reported her to the Manitoba Chiropractors Association, the regulatory body for her profession.

Apparently, some chiropractors believe in an evidence-based approach (then why are they still chiropractors, I wonder?) and others believe in subluxation, which is garbage pseudoscience.

At the core of this divide in the profession is subluxation — a diagnosis used by some chiropractors to measure the health of someone’s spine.

If someone has a “subluxation-free spine,” there are some in the profession who believe that you don’t need vaccines or other medical interventions, explained Brian Gleberzon, a Toronto-based chiropractor and former professor at the Canadian Memorial Chiropractic College.

“This would be a very traditional belief, and they would hearken back to the developers of the profession,” he said.

The subluxationists are out for Carolyn Weiss’s (the offending believer in vaccinations) blood, sending cease-and-desist letters and demanding the her op-eds be removed and threatening her license to practice chiropractic. They’re kind of nuts. They police what members say on the net.

It led to the association subscribing to a web scraper tool in 2021 that crawls through the professional websites and social media accounts of chiropractors and flags keywords such as “vaccines.”

The word “evidence-based,” “principled,” “honest,” and “ethical” were also flagged, as the association felt they could be used to make one chiropractor appear superior to another, according to an undated memo from the association to chiropractors obtained by CBC News.

The chiropractic association even has a rule that you can’t discuss vaccination because it is not within the scope of chiropractic practice. Well, yeah. But nothing medical is within the scope of chiropractic. I agree that chiropractors shouldn’t be dispensing any medical advice, any more than I should, but they are silencing this one thing for all the wrong reasons.

I’ve never understood why people go to chiropractors — I suspect it’s because they’re cheaper than real physical therapy, they’re desperate for relief from chronic pain (and haven’t discovered opioid abuse yet), and chiropractors make wild promises. We have a quack here in Morris who implied that his chiropractic shop would help cure cancer — he seems to have adopted a lower profile since I highlighted his sleaze.


  1. gijoel says

    I saw a Four Corners documentary on chiropractors quacks a few years ago. One of the quack’s patient said that she prefers to see the quack as “they can have a good, long chat, but the doctors are too busy for that.”

  2. wzrd1 says

    The bear of it is, subluxation is a very real and fortunately, fairly rare injury. Unlike what the quackery vitalism ridden crowd hawk, it’s easily detected with a plain x-ray and requires immediate surgery to hopefully maintain spinal cord patency. It’s a very real medical emergency, unlike the bullshit that they hawk. As Christopher Reeve could attest to, were he still alive.
    Chiropractors in civilized nations are prohibited from practicing vitalism based quackery, but are valued for physical therapy based approaches and that’s all purely evidence based. Then, we have the US and our third world medical system. Where TCM, chiropractic vitalism and homeopathy are hawked as real medicine, to the detriment of millions.

    Just saw another gem pop up in the news feed, more bullshit about lab leak theory with COVID. Also, some information of concern regarding the Wuhan lab and protocols not being adhered to.
    I’m still not inclined to lend credence to the lab leak nonsense, way too many moving parts for it to work and zero evidence to support the theory, but not following protocols can endanger lives and as bad, research via cross-contamination.
    One item described, but not examined by the correspondent was workers collecting specimens in the wild without PII, risking exposure and cross-contamination. How do you tell a predominant strain in a specific population when the worker is now contaminated with multiple strains and going from site to site?! That alone can render tens of thousands of man hours worthless! It was also discovered during investigation of the lab leak theory, so China at least did investigate and did have findings incidental to the investigation and is acting upon them.
    I’d suggest regular reviews to ensure that protocols are adhered to in the future, to protect the investment of time and resources of the lab.

    As for chiropractors, if their self-policing now prohibits support for evidence based medicine, their self-policing role can be replaced by legislated policing instead.

  3. wzrd1 says

    gijoel @ 1, I can’t disagree with that patient’s complaint. Physicians share it, as the insurance companies force physicians to curtail time with patients in order to bums rush more through, to the detriment of quality care. It’s literally impossible to collect a good history in 5 minutes, despite insurance company claims to the contrary, save if one is less than a week old.

  4. silvrhalide says

    People go to chiropractors because some of them provide quality healthcare.
    I had an excellent one for years (before she retired) and she would be crystal clear about what a patient could expect.
    She would also limit the time period in which she would treat a patient–if the patient wasn’t getting better, she would recommend a medical specialist. She was also an excellent (and licensed) EMT. Her practice was mostly firefighters and some police who just wanted their back spasms taken care of.

    I’ve never understood why people go to chiropractors — I suspect it’s because they’re cheaper than real physical therapy, they’re desperate for relief from chronic pain (and haven’t discovered opioid abuse yet)

    Opioid abuse starts with crappy MDs who prescribe opioids like candy, with an added bonus of having the patient having to come back for prescription renewals and mandatory office visits. The ones with the “billable service” dollar signs in their eyes.

    I’d like to point out that I went to HSS (Hospital for Special Surgery) in NYC for my domestic violence injuries. The orthopedic specialist (MD!) took some X-rays, didn’t find any broken bones and promptly wrote a prescription for OxyContin. Which I refused to fill. No follow up services, no referrals to another doctor or specialty to find out what was actually wrong, just a prescription for legalized heroin.

    Crappy healthcare providers are everywhere, not just in chiropractic.

  5. whywhywhy says

    Chiropractors serve a role in the US medical ‘system’. They thrive in underserved areas (think rural America). The quality control within the profession is a train wreck. It is tough to get folks to police themselves when doing so severely undercuts the basic business model.

  6. rietpluim says

    With all due respect, but I think that Weiss is demonstrating some cognitive dissonance.

  7. robro says

    I’ve never understood why people go to chiropractors — I suspect it’s because they’re cheaper than real physical therapy, they’re desperate for relief from chronic pain (and haven’t discovered opioid abuse yet), and chiropractors make wild promises.

    “Desperate for relief from chronic pain” is the main reason for me. Many years ago I saw a chiropractor because of chronic and sometimes sever back pain. I didn’t buy the hocus-pocus about chiropractics curing every thing, and the chiro didn’t push that aspect. The adjustments helped, but they never “cured” me. I continued to have chronic back pain…still do…just easier to live with.

    I wouldn’t say the chiro treatments were cheap. I eventually quit going because it was expensive (only about half covered by our insurance), and my partner and I were trying to afford the new member of our family.

    Since those days, I have had massages and physical therapy which also helped…temporarily. In fact, a physical therapist did the closest thing to a miracle for me by making a simple change in the alignment of my joints to relieve the discomfort in a knee that was so painful I could barely walk.

    I haven’t tried opioid abuse. I’ll wait for the hospice care folks to prescribe that in a few years. I have it on good authority that it works wonders if you’re not expecting to get out of the situation alive anyway.

  8. silvrhalide says

    @5 Agreed.
    Also, everything you have written applies equally to the MD crowd. A former boyfriend’s brother became a psychiatrist precisely so he could write himself prescriptions for party drugs all day long AND make a living. The only saving grace in that situation is that the guy isn’t a surgeon. Because I know the brother well enough to know that he would perform surgery stoned out of his mind and not care.
    The big white wall of silence is just as real as the blue wall of silence.

  9. silvrhalide says

    @2 Do you have a link for the Wuhan lab link thing? Most of what I’ve seen points out that there are actually TWO separate lineages for Covid 19, with different timelines, along with other strains found in the wild, including in Laotian fruit bats, who apparently are carrying a strain that is closer to the original Covid 19 strain than anything found in Wuhan. This link is a couple of years old but still valid.
    Also, if the lab leak theory was credible, where are all the missing other protocol breaches? Did the Wuhan lab employees all wake up one morning and say “fuck it, it’s casual Friday, let’s throw caution to the wind”? If the lab practices were sufficiently crappy, there should be other documented incidents and I have yet to see any.

  10. says

    I wonder two. The uni I went to as an undergrad had a sizable geology building and half of it was devoted to geophysics. When the Vatican posted the senior professor to run a seismic observatory in Chile they moved the rest into the physics department and handed the building over to the School of Chiropractic. Thats when unis went from teaching evidence based science to teaching what brought in the money.

  11. KG says

    Do you have a link for the Wuhan lab link thing? Most of what I’ve seen points out that there are actually TWO separate lineages for Covid 19, with different timelines, along with other strains found in the wild, including in Laotian fruit bats, who apparently are carrying a strain that is closer to the original Covid 19 strain than anything found in Wuhan. – silverhalide@9

    This is all so confused it’s hard to know where to start. First, samples containing the actual SARS-CoV-2 virus have been collected from the Huanan seafood market in Wuhan, so the viruses found in Laotian fruitbats can hardly be “closer to the original Covid 19 strain than anything found in Wuhan”. Bats of the kinds most likely to harbour close relatives of SARS-CoV-2 apparently do not have roosts near Wuhan – which is why its sample collectors go to Yunnan, hundreds of kilometers away. The Laotian viruses are apparently closer to SARS-CoV-2 than RaTG13, which was among those held by WIV (Wuhan Institute of Virology) before the pandemic, and was suggested early on as a possible progenitor of SARS-CoV-2 (there are some mysteries about RaTG13, which was actually reconstructed at WIV using metagenomic analysis, and “could potentially be an in-silico chimera”, i.e., not exist at all in nature).

    Also, if the lab leak theory was credible, where are all the missing other protocol breaches? Did the Wuhan lab employees all wake up one morning and say “fuck it, it’s casual Friday, let’s throw caution to the wind”? If the lab practices were sufficiently crappy, there should be other documented incidents and I have yet to see any.

    Concerns about safety at WIV were raised well in advance of the pandemic. And do you really think the Chinese authorities are going to be up-front about any protocol breaches if they can possibly avoid doing so? (I would say much the same about authorities in other countries, but we know the Chinese authorities lie on a huge scale, e.g. about the large-scale repression going on in “Xinjiang” (West Turkestan).) Moreover, WIV is not the only lab in Wuhan that was working on bat coronaviruses: the Wuhan Center for Disease Control (which is much closer to the Huanan Seafood Market) was also doing so, and according to a BBC podcast released just today, there were pre-pandemic reports (from Chinese state media) of sample collectors from there getting covered in bat urine, without protective clothing. And the original SARS virus escaped from labs several times, including at least twice in China (although not from WIV or any other Wuhan lab).

    There are also reports today that as part of this BBC series of podcasts, George Gao told the BBC a lab leak origin could not be ruled out. The interview with him must be in a later podcast in the series, so I don’t know exactly what he said, although he did apparently say that a Chinese government investigation of WIV did not find any protocol breaches – but anyway, what does he know? He’s just the former head of the Chinese Center for Disease Control and Prevention, so he’s probably a conspiracy theorist and an anti-Chinese and anti-science bigot.

  12. says

    One of the things that keeps chiropractors going is BigPharma/BigMed’s refusal over the years (encouraged by the overmoral overrestrictions in 21 U.S.C. § 812 and the implementing regulations that made research near-impossible for about four decades) to develope reasonably effective alternatives to opioids. Tolerating pain in silence is a manly thing, and therefore something that all real ‘murikans do. <sarcasm> Wimps who complain that pain impairs higher cognitive function, or even daily function? They just need to pray harder. </sarcasm>

    Do not get me started on the VA, and how its developing system and macho attitudes contributed to that. (And don’t jump out of any perfectly good airplanes.)

    For many patients, chiropractic care is a least-bad choice among chronic pain, addiction, and quackery-with-not-much-continuing-effect. It’s merely a different place on the scale of “torture gets people to talk to make the pain stop.”

  13. silvrhalide says

    @11 Ah. That does clarify a lot of things. Thanks for the links.
    I was wondering how I missed the initial WaPo article in your link, then looked at the date… 4/14/20… the Better Half’s dad died from Covid 19 on 4/15/20. We were all busy with other things when the WaPo article posted. I misstated–I should have said “closer to the original Covid 19 virus in humans”.

    Yes, the Chinese authorities lie about everything. How to tell if they are lying? Check to see if their lips are moving.

    Well, the provenance waters are certainly muddied. No way to tell if lab workers were infected in the wild or in the lab. Or from contaminated food.
    (A friend of mine went full-on vegan during his 5 years in the Peace Corp in Tanzania–the local wet market (understandably) freaked him out–the wet markets in China have a lot of live animals but the wet markets in Africa are mostly dead animals–dead animals that are hanging in the stalls devoid of refrigeration and functioning as a landing strip for flies. His letters home were mostly “SEND CANNED FOOD”.)

    I’d also like to point out that just because the Wuhan wet market didn’t sell bats (that we know of–black market wildlife dealers aren’t exactly aboveboard) doesn’t mean that the Covid 19 virus (or one of them) wasn’t present at the Wuhan wet market. Those animal cages aren’t exactly sterilized between uses and they generally aren’t limited to just one type of animal in the cage per use either. An animal cage could have held bats one day, civet cats the next and some random mammal the third day. We all know how easily Covid jumps between species–the Covid 19 virus is now endemic to the North American whitetail deer population, who were likely infected by eating infected human garbage. So yeah, it’s a species jumper and truthfully, we don’t even know that it originated as a bat virus, only that samples of the virus were collected from bats.

    He’s just the former head of the Chinese Center for Disease Control and Prevention, so he’s probably a conspiracy theorist and an anti-Chinese and anti-science bigot.

    Never underestimate the PRC’s ruling party’s willingness to throw one of their own into a woodchipper feet first. Look at the way they dealt with Dr. Li Wenliang. A clear warning to anyone else who would speak out.

  14. answersingenitals says

    “…Brian Gleberzon, a Toronto-based chiropractor and former professor at the Canadian Memorial Chiropractic College…”

    I would never go for any medical treatment or advice from someone associated with “the Canadian Memorial Chiropractic College”. It’s very revealing to combine ‘memorial’ with anything medical.

  15. Kagehi says


    My skepticism about the “leak” comes down to the fact that it took less than a month to trace the “theory” not to “experts”, who only started babbling about it after the fact, but to a single rando guy posting conspiracy theories and using as “evidence” things like how some guy who spent a few months, years earlier, working with Chinese bat experts, was claimed to be one of the first victims, but rather like the supposed, “kid who died from D&D”, in another famous bullshit story from the past, was alive and well studying totally different bats in Europe during the entire time in which this leak was supposedly happening.

    I find the fact that almost anyone could have gone into actual caves in the area, to look for bats, and part of the food market, and been directly exposed that way to be far, far, far more credible. Also – the “lab leak” theory has been heavily pushed with the idea that it was being experimented with in the lab, in ways that would show clear genetic engineering, not just that they had some of it in a petri dish and dropped it, or something – and since no evidence has ever shown that it to contain “engineered” characteristics, instead of signs of evolving “inside live organisms”…

    It just seems to me that people who claim the lab leak version are using a combination of distrust (how ever warranted) and a need for over complicating things, to convince themselves it makes sense.

  16. wzrd1 says

    @9 https://www.bbc.com/news/world-asia-65708746
    That’s the starting point. Concerning was the lab not following protocols, not from the perspective of the pandemic, but from a perspective of potentially contaminating specimens in wholesale quantities.
    Didn’t see anything specific on lab procedure breaches, only in collection being mentioned. But, if one end has slop, the other end likely has deficiencies as well and all suggest poor supervision to ensure standards are adhered to.

    As for two sources, what I’ve read was that it was pretty much a toss up as to which of two locales was the source. Which actually suggests it may have originated elsewhere, at a location yet to be discovered and unlikely to be discovered this long afterward. And in reality, given the ubiquity of the virus, isn’t exceptionally relevant anyway.

    @KG, Gao was one source of information, but not ruling something out does not rule it in either.
    I’ll suffice it to say, if one were to successfully trace the virus to one of the labs property, it’s as likely that the origin was a hole near the roof that a wild colony nested in as anything else. There’s just that little data available and honestly, given that whole pandemic emergency thing, researching the source really isn’t a priority.
    Let’s say we find an exact, precise source for the virus, to within 1 meter. Is there to be litigation against that source, be it nature or a lab assistant fucking up? Maybe sue mother nature? I know, nuke the site, be it a remote jungle or lab building! What relevance, beyond if there was a lab leak, is there as to the source, as the virus itself is ubiquitous in nature?
    An example, we tend to look toward Asia for influenza strains each year. Know where the Spanish Influenza pandemic has been most closely traced to? A farm in Kansas. Other pandemics traceable to Kansas, none. That virus is ubiquitous as well.
    Ebola this ain’t, so it’s not isolated to some specific regional caves as an origin point.

  17. birgerjohansson says

    We should set up one chiropractice pope in Rome and an antipope in wossname that French town.

  18. says

    On which note, my doctor put me on gabapentin and it’s fucking brilliant. I’ve literally gone from “don’t even breathe on me” to tolerating some light touch and being able to move around again. I’m not completely pain-free, I do still have flare ups, but for the most part, I’m comfortable and able to function somewhat normally.

  19. Jazzlet says

    WMDKitty — Survivor
    Gabapentin is good stuff, and when it isn’t doing enough, if yours is a condition that worsens, there is pregabalin which is supposed to be six times stronger. I’ve been on pregablin for about five weeks now (having been on gabapentin for years before), I need to talk to my doctor about the dose as I’m basically asleep or barely awake, far lower levels of pain, but I can’t do anything and am having real problems thinking. Or typing or anything.

  20. silvrhalide says

    @15 I never bought into the “weaponized the Covid 19 virus” as a theory precisely because no one ever found any of the standard markers for genetic engineering in any of the genetic assay samples. My question, which was answered by KG, was why people thought that the lab leak was ever a legit possibility. I still think it’s a lesser possibility and think that the prime cause is likely a wet market or poacher rather than a lab leak, but I have to admit there is a nonzero chance that it was in fact a WIV leak. For all anyone knows at this point, it could have been a lab technician that ate a diseased wet market animal, got sick, infected everyone else in the lab (pretty easy, if everyone in the lab is NOT wearing protective equipment–you only have to be within coughing distance or the same room as an infected person) and it “emerged” from the lab that way. At this point, tracing the origin to patient zero is pretty unlikely.
    Note to PRC: No more bat lunches and no more raw marmot snacks either.
    Just one of the many problems brought on by quack science…

    @16 The most useful part of finding the exact origin of Covid 19 is that there is the possibility of finding a cure or at least a treatment. A disease (or other biological injurious agent, like venom, for example) that is specific to one area will often produce organisms that have resistance to the disease or other agent. Case in point: Veroa mites in bees. The mites originated in Asia and resistant bee populations are found there.

    For that matter, favored prey species of venomous predators often have a certain level of resistance to said venom.
    So finding the source might also find resistant organisms that might provide a cure or clues to how Covid 19 works, which would be the first step in figuring out an actual cure.

    BTW, Kitum Cave/Mt. Elgon is no longer thought to be the origin & sole source of Ebola. Evidence now suggests that it might be endemic to the Megatransect or all/most of equatorial Africa. A disquieting thought…


  21. silvrhalide says

    @19, 20 WMD Kitty, are you not experiencing side effects from gabapentin? The second doctor I saw (Columbia Presbyterian) tried to put me on the stuff and I wasn’t having it–not a fan of tardive dyskinesia, thank you very much. And Jazzlet, what you are describing is exactly why I didn’t want to take the stuff in the first place either. Right now I’m just living with the pain.

    Why doesn’t the MD crowd put that MD to actual use and fucking explore other possibilities for the source of the problem instead of just prescribing pills like they are goddam candy? I didn’t seek medical treatment so I could legally rack up frequent flyer miles, I sought help for a cure or at least treatment. Not to become an OxyContin zombie, sleepwalking through my life.

    Candidly, I think that’s the real reason so many people flock to quack science and treatments–shitty, dismissive attitude from MDs and a pain prescription–in my case, one that is totally inappropriate. You are not supposed to be prescribing opioids for long term pain treatment, if only because resistance builds up pretty rapidly and the analgesic effects disappear rapidly.

    @18 Yeah, you weren’t the only to notice the dismissive contempt implicit in that statement.

  22. chrislawson says

    This is a big topic, but trying to keep it succinct… OK, this is way too long. Feel free to skip. Only posting in case some people are interested.

    [1] Chiropractic was not built on a scientific background

    [2] Neither was a lot of medical practice at the time chiropractic was founded, and there is a movement within chiropractic to adopt an evidence-based approach

    [3] When PZ used the word ‘schism’ in the header, that was spot on. It’s the word used within chiropractic circles.

    [4] The problem for the evidence-based chiropractors is that it pushes them into clinical territory currently occupied by physiotherapists and OTs, who have been evidence-based for decades.

    [5] The problem for the traditionalist chiropractors is they want the cachet of evidence-based medicine without the evidence. In Australia, they got what they thought they wanted when professional health provider boards were moved under a single umbrella organisation (AHPRA) and chiropractors were admitted alongside medical practitioners, nurses, psychologists, physios, etc. Even though each profession still has its own board, the parent body sets some the base rules…which came back to bite many chiropractors when investigators showed that a significant percentage had dngerously misleading anti-vaccine pamphlets in their waiting rooms, and many promised that chiropractic treatment made all immunisations unnecessary (including the childhood schedule vaccines). Obviously AHPRA did not find this acceptable and the chiropractic board had to warn its members about it, and they ended up suspending the registration of at least one of the more vocally intransigent members.

    [6] Again, I stress that there are a significant number of chiropractors who are working towards establishing a good evidence-based approach.

    [7] Which means that practically speaking, if you have a chiropractor you find helpful, especially for a problem that is mostly about the symptoms (e.g. pain), then I would not advise you to stop seeing them…unless they spout dangerous antiscientific rubbish in which case find a better one or try a physio or EP.


    [8] Subluxation is not rare or even harmful in most cases. All subluxation means is that a joint is not in its normal anatomical alignment but is not fully dislocated. Many of our joints sublux as part of normal activity. Some joints even require it to function (if your temporamandibular joint won’t sublux, you’ll be eating dinner through a straw). Obviously subluxation can cause pain and other physiological adversities, and anyone who has previously dislocated a shoulder has probably experienced unpleasant episodes of subluxation from time to time due to ligament laxity.

    [9] Spinal subluxation in chiropractic is, quite simply, N-rays for medicine. The spine is a complex region with multiple joints and pseudojoints like the discs. Chiropractors diagnose subluxation by taking plain film XRs of the spine in lateral, a.p., and sometimes oblique views, usually the whole spine from cervical to lumbar, and then carefully measure the angles between vertebrae. If any of them vary by more than a few degrees, then subluxation is diagnosed and treatment recommended. The glaring problem here is that (a) there are so many vertebrae being checked, (b) the spine is dynamic and should not be expected to be sitting in a perfectly neutral position at any time, and (c) spines naturally have forward and backward curvature, so if the person being XRed is even a couple of degrees off perfectly lined up with the XR plate, curvature will appear in the XR and subluxation will be diagnosed. How do we know this? Because clinically concerning subluxation was identified by chiropractors in 97% of ‘young, healthy pilot aspirants of the German air force’. Now, anyone with their head screwed on right would see this as case of massive overdiagnosis. But not traditionalist chiropractors. Not only did this paper argue that screening chiropractic XRs should be routine, subsequent authors representing the International Chiropractors Association have referred to this figure as justification for ignoring new, evidence-based clinical guidelines that spinal imaging should only be performed for patients with ‘red flags’ or failure to improve within 6 weeks, pretty much the guidelines used by doctors, physios, and exercise physiologists.

    [9] And it gets worse. One amazing paper even argues that chiropractors should embrace subluxation theory because it’s good for business. I wouldn’t normally quote at this length, but here is the conclusion just to show I’m not making this up: ‘When a profession’s identity is not clear with respect to its area of interest and mission, then the public may be less inclined to seek its services. Identifying the chiropractic profession with a focus on vertebral subluxation would give the profession uniqueness not duplicated by other health care professions and, therefore, might legitimatize the existence of chiropractic as a health care profession. An identity having a focus on vertebral subluxation would also be consistent with the original intent of the founding of the chiropractic profession.’ This, btw, is from 2016 and not the distant reaches of time and is, I repeat, a published paper and not something said over breakfast at a convention.

    [10] There is also a really interesting paper that shows that even chiropractic students who believe in evidence-based practice use cognitive dissonance to allow traditional practices that are not evidence-based.

    [11] Now at this point, it may look like I’m ripping into the entire field of chiropractic, but I’m not. I think there is a place within modern evidence-based practice for it, and most the papers I have read criticising traditional practice have come from within chiropractic itself. Also, there are papers showing benefits in some instances. Here’s one example on functional gain after stroke. It’s not earth-shattering, and I wouldn’t be making sweeping national-level changes to funding based on this alone, but there are plenty of medical papers of this quality or lower that people take seriously. And I would also point out that in recent COVID years the medical board has had to deal with several doctors spreading anti-vaccine malarkey, so it’s not fair to blame chiropractic for having antivax practitioners (although the proportion is way higher).

    [12] I won’t get into the opioid crisis because it is a huge topic except to say that, yes, it is an entirely industry-generated problem and the general principle is that opioids should not be prescribed to manage chronic, non-cancer pain. (Not opioids, but gabanergic drugs like Lyrica are also problematic and overprescribed and should be limited to genuinely neuropathic pain…and even there the evidence isn’t exactly convincing.) I still find it extraordinary that Purdue lied so blatantly about oxycodone’s addictive potential, even more extraordinary that the people who concocted that lie have yet to face serious consequences (the chickens are finally coming home to roost for Purdue, but it must be said that the chickens should have arrived years ago and should be a lot bigger), and I also find it extraordinary that so many doctors fell for it. A non-addictive opioid is almost a contradiction in terms as the very receptors opioids bind to are known to activate addictive behaviours. Such claims need overwhelming evidence. Which means multiple large, well-designed and well-conducted studies from several independent investigators, not a few hand-picked, selectively reported studies from the manufacturer.

  23. wzrd1 says

    When I blew out a lumbar disc, doctor put me onto hydrocodone immediately and prescribed a “muscle relaxer” that was a CNS depressant (its function literally relied upon that, some aren’t, but interfere with signaling instead). I never filled the latter, as opiates and opioids are CNS depressants by nature. Never needed a muscle relaxer for that reason, well, save when I have spasms and all the CNS depression in the universe isn’t going to help end that easily, it’s caused by nerve root compression.
    I loathe opiates and opioids, I value and respect them for most patients, just not for me. My mast cells dump big time, giving me symptoms just shy of anaphylaxis. So, I feel like I’m dying taking the damned things, even if they do give pain relief.
    Moved back to PA, where a series of prosecutions of physicians resulted in precisely zero pain management in this region.
    So, we instead get god botherers telling us that pain builds character (the last one to tell me that had some character building of his own via bruised shins) and the dismissive “tough it up” crowd, none of whom want to repeat such an idiotic thing once asked what they said.
    But, just to make things interesting, proprioception is fairly hit and miss in one leg. So, when things really act up, I literally can’t tell what position or pressure my legs are exerting at one knee, resulting in my getting unceremoniously dropped to the floor if distracted from keeping that knee locked.
    Because, nothing’s more fun than pain, save pain and falling without warning. Or as entertaining as, when I first started using a cane to keep from those falls, occasionally accidentally kicking my own cane out from under me. Or once, the cat did it for me, leaving me on the floor unable to rise, as I was laughing at the ridiculousness of the situation far too hard to regain my feet. The poor cat was so confused, it came over to try to figure out what was so funny.

  24. chrislawson says


    I can’t comment on the specifics of your case, but the general rule for acute back pain is (1) exclude red flags, (2) gentle mobilisation, (3) lower-risk analgesia such as acetaminophen or NSAIDS (which is not to say zero risk, but they’re a lot better than opioids, benzodiazepines, or gabanergics for the vast majority of people), and (4) consider physiotherapy when the pain subsides enough. Despite this, there will occasionally be situations that warrant upscaling the analgesia, but not often.

    Sadly, I am old enough to remember when the regime you describe was standard practice.

  25. wzrd1 says

    chrislawson @ 26, I could even see analgesics initially, but perhaps 72 hours, a week at the outside, with rest with low movement (not a fan of total immobilization, which creates its own complications), soaks and NSAIDs for inflammation, then PT. Again, as you said, barring any red flags. I was shooting up skyrockets though, as I felt what is best described as 440 volts going down both cheeks to the balls of both feet at the time of injury.
    But, such things can resolve with conservative treatment, rather than going hog wild with opioids only, which my primary was content to do.
    More conservative treatment did win the day for a handful of years, although now I do need to use a cane, as proprioception is dicey in my right leg around the knee. I’ll not go into the suckage that is a major barometric pressure change from a storm, suffice it to say, I loathe spring.
    Now, I’m just holding out for a full body transplant. Holding out, as they keep trying to pawn one off on me with a brain. ;)

  26. KG says

    silverhalide@15, wzrd1@16,
    It seems to be a consensus that SARS-CoV-2 originated in bats (which tolerate viruses better than terrestrial mammals), and the closest relatives found in the wild were in bats (although that could be because that’s where everyone’s been looking!). I don’t think the fact that right-wing conspiracy nuts have promulgated “lab leak” (and indeed, “fiendish oriental mad scientist”) ideas should affect our judgement about whether one of the Wuhan labs working on bat coronaviruses was somehow responsible for the virus getting into the Wuhan population (which is whence it certainly seems to have spread, despite contrary ideas floated by the Chinese authorities). Tedros Ghebreyesus, DG of the WHO, has also said recently that the possiblity of a “lab leak” is still open. Nor is it necessary for there to have been any conspiracy involved, even post-outbreak. Early on I suggested, both here and in an email to Peter Daszak (which he did not answer), that a sample collector could have been (perhaps asymptomatically) infected while sampling and then visited the wet market (where it could have spread both to people and to members of other susceptible species), without the virus ever being held in a lab at all. The strongest – purely circumstantial – evidence one of the labs was involved is simply that the pandemic started in one of very few cities in the world where work on bat coronaviruses was being carried out (a search of Web of Science or similar with the terms “China” + “bat” + “coronavirus” indicates that the vast majority of papers returned have authors based at WIV). As for whether it matters, yes it does. Apart from the importance of truth in itself, knowing the virus’s origin might well help discover when, where and how it evolved, and identify possible future threats. However, the need both to suppress the trade in live wild animals (for multiple reasons including animal welfare and the protection of vulnerable species, as well as public health), and to tighten and internationalise surveillance of the biosecurity of labs dealing with potentially dangerous pathogens (everywhere, not just in China) will remain whatever the truth, and whether we discover it or not.

  27. wzrd1 says

    KG, perhaps I was unclear.
    The only potential I see for a Wuhan lab leak really is that there was a hole in the fucking roof that went unpatched ant bats nested in it.
    Most likely was the wet market, where livestock from pretty much everywhere was present. Been in such markets, most westerners haven’t, so they literally cannot imagine the diversity of livestock on offer.
    I use the term livestock specifically and intentionally, not as a political item, but physical reality for the culture in question.
    I figure lab leakage of a pathogen that was designed, accidentally or intentionally, as right up there with nanu-nanu conspiracy theories.
    The roof leak being even more probable, albeit far less probable than a comedy of errors that’s followed humanity since its inception.
    And that’s from an outlier in Western views, as I quite enjoy goat meat and some other meats on occasion. With a jaundiced view toward potential pathogenic contact, while realizing, avoid all pathogens, do that dead thing.

  28. KG says


    No-one here has suggested SARS-CoV-2 was designed. Nor disputed that the wet market was important in spreading it. The question is: how did the virus get into the wet market? Yes, could be it was brought there in livestock. But also, could be that its arrival was a result of the activities of one of the labs researching bat coronaviruses, in one of the very few cities around the world where that is going on. Lab leaks are not particularly rare.