Science Vs

Chiropractors: Are They Legit?

December 4, 2025

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  • For adults with back or neck pain, research suggests spinal manipulation performed by chiropractors may help reduce pain, although the underlying mechanism is unclear. 
  • There is currently no good scientific evidence to support the effectiveness of chiropractic treatments, including spinal manipulation, for any condition in pediatric populations. 
  • The foundational chiropractic concept of 'subluxation'—a spinal misalignment causing disease—is considered contrary to established physics and biology, with some chiropractors themselves acknowledging a lack of evidence for most of their treatments. 

Segments

Introduction and Pain Context
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(00:00:00)
  • Key Takeaway: Chiropractic care is sought by about one in ten adult Americans, primarily for neck and back pain relief.
  • Summary: Millions seek alternatives to drugs for back and neck pain, leading many to visit chiropractors. Around one in ten adult Americans visited a chiropractor in 2022, mostly for pain management. The episode aims to investigate the legitimacy of chiropractic claims.
Sawrey Family Chiropractic History
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(00:01:09)
  • Key Takeaway: Producer Kaitlyn Sawrey was taken to a chiropractor as a newborn following a traumatic birth, with parents reporting improved sleep.
  • Summary: Kaitlyn Sawrey’s parents were long-time chiropractic users, taking all their children for adjustments every six weeks. Her father used chiropractic care for injuries sustained from falling out of a tree and off a motorbike. The parents reported feeling more relaxed and less ‘grindy’ in their necks after visits.
Defining Chiropractic Practice
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(00:02:40)
  • Key Takeaway: Chiropractic’s main procedure is spinal manipulation, a quick thrust using hands or a tool to pop spinal segments back into place.
  • Summary: Spinal manipulation involves checking the spine segments to see if anything is out of place and then applying a quick thrust to correct it. This technique is distinct from massage, which involves kneading the back. The term ‘chiropractic’ translates from Greek as ‘a practice done by hand’.
Episode Goals and Skepticism
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(00:03:35)
  • Key Takeaway: The episode will investigate if chiropractors can treat pain, if they should treat babies, and what the associated risks are.
  • Summary: Skepticism on social media questions whether chiropractic is legitimate medicine or a scam, with some calling it dangerous. The hosts plan to address three core questions regarding chiropractic efficacy and safety. The episode updates research previously published several years ago.
Origin of Chiropractic Theory
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(00:04:51)
  • Key Takeaway: Chiropractic originated with D.D. Palmer in the late 1800s, who transitioned from magnetic healing to spinal manipulation after seemingly curing a janitor’s deafness.
  • Summary: D.D. Palmer, a Canadian magnetic healer, founded chiropractic after thrusting a janitor’s back, who subsequently reported hearing better. Palmer named the practice chiropractic, meaning ‘done by hand.’ He quickly expanded his focus from deafness to curing nearly everything by manipulating spines.
Subluxation Theory Explained
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(00:09:51)
  • Key Takeaway: D.D. Palmer believed 95% of diseases resulted from ‘subluxations’—spinal blockages interfering with nerve energy or tweaking nerves.
  • Summary: Palmer theorized that energy and life force flow through the spine, and misaligned joints obstruct this flow, causing sickness. For Carl Cleveland III, a subluxation is a joint that doesn’t move properly, potentially affecting surrounding tissues. Some practitioners claim subluxations can lead to conditions like asthma and high blood pressure.
Mainstream Acceptance for Pain
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(00:11:44)
  • Key Takeaway: Spinal manipulation is covered by US Medicare for subluxation treatment and was recommended by the American College of Physicians for back pain in 2017.
  • Summary: Despite mystical origins, chiropractic is gaining some credibility in mainstream circles for pain management. Medicare covers chiropractic treatment of subluxation in the US. The American College of Physicians included spinal manipulation in suggested treatments for back pain.
Evidence for Neck and Back Pain
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(00:12:12)
  • Key Takeaway: Low-quality evidence suggests multiple sessions of spinal manipulation can lead to less neck pain, sometimes proving more helpful than conventional medication over a year.
  • Summary: Researcher Anita Gross reviewed trials finding that patients receiving multiple chiropractic sessions tended to report reduced neck pain. One study indicated chiropractic care was more helpful than anti-inflammatory drugs, muscle relaxants, and opioids after one year. Physical therapists like Gross sometimes use spinal manipulation clinically when mainstream medicine lacks great options for pain.
Chiropractic Care for Children
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(00:15:44)
  • Key Takeaway: The American Chiropractic Association encourages treating children, but a major international review found no good evidence supporting spinal manipulation for any pediatric condition.
  • Summary: Chiropractic is a common non-traditional medicine for US children, treating issues from asthma to breastfeeding problems. A controversial video showed a chiropractor dangling and prodding a baby’s spine, leading to temporary bans in Australia. An international review concluded there is ’no good evidence’ for effectiveness in pediatric populations.
Contrasting Views on Pediatric Care
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(00:18:20)
  • Key Takeaway: Chiropractor Carl Cleveland III acknowledges the lack of formal research for kids but justifies care based on parental reports of satisfied, pain-free children.
  • Summary: Cleveland believes that satisfied patients seeing pain-free children constitute improvement, anticipating formal evidence will eventually support current practices. Kaitlyn Sawrey’s parents admitted they ‘got sucked in’ because everyone else was going at the time. They now recognize there is ‘pretty much no good science that it works for anything when it comes to kids.’
AI Segment: Mosquito Surveillance
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(00:20:39)
  • Key Takeaway: AI is being used to analyze citizen science photos to identify the malaria-transmitting mosquito species Anopheles stephensi in new regions.
  • Summary: The Anopheles stephensi mosquito is a highly effective malaria vector that thrives in urban areas and resists insecticides. Scientists trained an AI algorithm on confirmed photos to identify unique features, such as pigmented testes in male larvae. This AI application led to the likely first detection of this species in Madagascar, aiding malaria prevention efforts.
Subluxation Concept Debunked
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(00:28:19)
  • Key Takeaway: Neurophysiologist Marcello Costa asserts that the concept of subluxations causing systemic disease is ‘complete nonsense’ and physically non-existent.
  • Summary: Costa states that the belief system behind subluxations contradicts established knowledge of physics, chemistry, and biology. He confirms that subluxations, as described by Palmer, ‘simply do not exist physically.’ While conditions like a slipped disc are real spinal issues requiring medical doctors, subluxations are not the same.
Mechanism of Pain Relief & Placebo
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(00:32:57)
  • Key Takeaway: If chiropractors are not fixing subluxations, their pain relief for back/neck issues might stem from blocking pain receptors, reducing muscle tension, or the placebo effect.
  • Summary: Research suggests spinal manipulation might trigger events that block pain receptors or reduce muscle stiffness. Another explanation is that the expectation of feeling better from receiving care drives the positive outcome (placebo effect). Kaitlyn Sawrey’s parents confirmed they would continue going even if it were purely placebo because ‘it helps.’
Risks of Spinal Manipulation
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(00:34:10)
  • Key Takeaway: While minor side effects like dizziness and nausea are common after neck manipulation, rare but serious risks include arterial tears leading to death.
  • Summary: Studies show that after neck manipulation, some patients experience worsened pain, headaches, nausea, or dizziness, though these usually resolve. Very rarely, severe complications like bone fractures or tears in the neck artery can occur, sometimes resulting in death. These severe outcomes are rare, but they highlight that chiropractic care is not entirely risk-free.
Final Summary and Conclusion
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(00:36:43)
  • Key Takeaway: Chiropractic may help with existing back/neck pain, but the core theory of subluxation lacks evidence, and pediatric use is unsupported by science.
  • Summary: The evidence supports that spinal adjustment might help existing back or neck pain, though the reason why remains unknown. There is no good evidence supporting chiropractic care for children for any condition. The fundamental concept that spinal alignment dictates overall health (subluxation) is scientifically unsupported.