Talk:Chiropractic

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How can we improve this article

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I've had family members who have joint dysfunction who benefitted from seeing Chiros, and I've been a sort of amateur Chiro myself to some uncles with "bad backs". I don't know precisely how to make this article better, but I wish I did. Lots of people get drug-free pain relief from "back cracks", it's not scientific, but it does work. But I also have seen deeply unscrupulous practitioners who would probably milk clients for every penny if you gave them the cance. So this is a hard article, but I wish there was a better article. Just as one random example, I'm not sure how much the "straights and mixers" discussion is relevant to modern readers, I think it's more about who sided with B.J. Palmer in the 1930s and paid dues to him. (But I honestly don't know, I haven't read up on this.) Feoffer (talk) 11:41, 23 March 2025 (UTC)[reply]

Physical therapy works. Chiropractic often has that as a component and adds woo. It's the woo which makes Chiropractic what it is. There's also quite a bit of history to cover. Bon courage (talk) 11:47, 23 March 2025 (UTC)[reply]
I know lots of Chiros still are woo, and that's why this is such a hard topic. Bad chiros are INCREDIBLY DANGEROUS, vultures who would prey upon the ignorant and illiterate people. But GOOD chiros are really awesome people who just fix joint dysfunction and never pretend to do anything more. I realize this is an incredibly hard article to get right and we SHOULD lean in favor of warning readers of the dangers of the bad ones.
But I don't feel like the current article is that good at helping readers distinguish responsible practitioners from snake oil salesmen. It just feels like a really old and dated article that's a little in denial of the modern reality that millions of people get some measure of drug-free pain relief from 'back cracks'.
But also, it's easy for me to sit back and thrown stones and say "this article should better". I don't honestly know how it should be better. Feoffer (talk) 12:18, 23 March 2025 (UTC)[reply]
It's not Wikipedia's role to act as a consumer guide or give medical advice. All we can do is summarise what decent sources are saying, giving due consideration to this being one of the WP:FRINGESUBJECTS. Bon courage (talk) 12:21, 23 March 2025 (UTC)[reply]
I don't disagree with you, I just, as a reader, wish the article was better but honestly don't know how to improve it right now. But just off the top of my head, do 21st century readers really benefit from Straights and Mixers? Aren't they just some BJ Palmer franchise thing? Aren't both of them FRINGE, compared to 21st century practitioners? Shouldn't the article be more about scrupulous vs unscrupulous? Not some antiquated thing?
But again, I'm first to admit I don't know what I'm talking about. I have NOT read up on the RSes on Chiropractic, this is just me talking as a reader. Feoffer (talk) 12:31, 23 March 2025 (UTC)[reply]
Chiropractic is WP:FRINGE today. There is a rich history to the topic which also needs to be covered. I don't really know what to say: are there some great sources on this topic which have been missed? Perhaps a push to GA could be worth it? Bon courage (talk) 12:34, 23 March 2025 (UTC)[reply]
I appreciate that this isn't the kind of POV-pushing from woo-proponents that we usually get, so thank you for acknowledging that we should not oversell this. In order to be encyclopedic, I think it's good to include odd stuff from the history of the topic, so I don't think we should remove things because they no longer get used. I don't know whether there might be some more recent high-quality sources that distinguish between unscrupulous and otherwise, but I'd be willing to consider such additions. (Emphasis on high-quality.) --Tryptofish (talk) 20:19, 23 March 2025 (UTC)[reply]
Agreed. My concerns about straight and mixers is more about what we don't cover. Is that still a distinction Chiros make in 2025? I honestly don't know. Were one side or the other more scrupulous than the other according the truly high-quality 2025 sources? I don't know.
My instinct, having studied a lot of early 20th century new religious movements, is that "Mixers" was a term made by BJ Palmer to stigmatize the people who didn't pay him a franchise fee? but I don't know that true.
The article really should reflect that, in some nations at least, it has a genuine benefit, even if patients would be better of getting that treatment from a science-based provider. By analogy, I think of Traditional Chinese Medicine, which is not at all scientific but is still promoted by mainstream sources and does have a measure of benefit. (but with effect sizes on the magnitude of chicken soup). But in 2025, Chiro isn't exactly homeopathy, it's covered by mainstream medical insurance programs in a lot of nations as a way to prevent opioid use for musculoskeletal pain. Our current article makes it seem as if the admittedly pseudoscientific practice is utterly without value, but millions of readers know firsthand that it has SOME merit, even if it's tainted with gobs of dangerous pseudoscience. Feoffer (talk) 13:05, 24 March 2025 (UTC)[reply]
Found some answers. Feoffer (talk) 11:41, 25 March 2025 (UTC)[reply]
That's 20 years old. Guy (help! - typo?) 17:47, 7 June 2025 (UTC)[reply]
Chrio being covered by insurance isn't a sign of it's effectiveness. It's a sign that it's cheaper than physical therapy. 96.18.176.178 (talk) 15:50, 26 July 2025 (UTC)[reply]
I think the biggest opportunity is in the introduction - it's too long and goes into too much detail better suited for the appropriate subsections. I've identified several lines that provided information that was really specific tot the US without being labeled as such and moved to the relevant US/Canada subsection. Also, the intro doesn't summarize the chiropractic profession worldwide and the varied levels of legal/medical requirements and regulations. I'm working on a draft of that now. WCNo47 (talk) 04:53, 4 June 2025 (UTC)[reply]
I've reverted those changes, because they significantly alter the page in terms of making chiro sound more like a legitimate form of healthcare than what the consensus on this talk page currently supports. I think you changed too much at one time, and we need to examine and discuss these changes in talk in more detail. --Tryptofish (talk) 19:58, 4 June 2025 (UTC)[reply]
Which changes specifically? I've cited everything from reputable sources including NIH. Reference to D.C in the intro paragraph is also US centric and should be in the appropriate section. Please clarify. WCNo47 (talk) 03:13, 5 June 2025 (UTC)[reply]
Especially in light of WP:ONUS, I'd like to suggest that you propose individual changes here in talk, one by one, instead of asking other editors to go through the entire group of changes and break them down one by one. Also, where sourcing is subject to WP:MEDRS, sources generally should not be primary sources, but rather, secondary. As for not making the page US-centric, I agree with that. Finally, please keep in mind all of the discussion above. --Tryptofish (talk) 19:36, 5 June 2025 (UTC)[reply]
Thank you, I'm relatively new to editing, so appreciate the guidance. My motivation here is only to provide a more balanced presentation of the subject based on facts. I am in no way trying to legitimize or equate the practice to that of internal medicine. However, it seems there's consensus here that the article needs some help and is outdated in some key areas. Personally, I don't feel the article appropriately summarizes some key areas including the range of regulation and requirements worldwide, or the extent of practice which I think would be helpful for people trying to learn about the subject. As mentioned previously, the introduction is too long and has us-centric framing. Below is the summary of proposed changes:
1. Introduction - Move the second paragraph (starting w/ third sentence) to the US/Canada as the references to degrees and positioning as primary care is specific to US.
2. Within US/Canada, I propose the following:
a) indicating that Chiropractic is a licensed form of healthcare and covered under most major healthcare insurance providers - these are both factual statements, supported by multiple sources including NIH which is not a primary source. This may be viewed as legitimizing it, but it's a factual statement that can be further qualified if others feel necessary.
b) Practices - As others have noted with the article being outdated, I think it's important to highlight the extent of acceptance in some countries over the years. For example, some top healthcare networks in the US, including Northwestern University Medical Center in Chicago have chiropractors on staff. Understanding that there is a range of philosophies, I think it's important that people are aware of qualified practitioners focusing vs. the ones that claim that chiropractic can cure allergies.
3) More coverage of the range of government regulation across the world. WCNo47 (talk) 03:22, 6 June 2025 (UTC)[reply]
That's my read as well. By 2025, in major US medical systems, Chiropractors are essentially mainstream physical therapists who have training in manual therapy. But you don't have to search too hard before finding a chiropractor who will test your blood for toxins. Feoffer (talk) 12:59, 6 June 2025 (UTC)[reply]
I can see some value in keeping some of the second-paragraph material in the lead section, because a perennial complaint about this and related pages has come from new editors who simply want to argue that chiro should be treated as equivalent to medicine because "its practitioners have degrees". As for insurance coverage, that's not the same thing as licensure to practice. For me, that comes down to the details of how we word it. If insurance coverage is a fact, then I'm OK with stating a fact, but I want to avoid language that implies anything that goes beyond the fact. I'm in favor of making the page more global, and being more specific about what happens where. So for me, a lot of what comes next boils down to what the specific language would be. --Tryptofish (talk) 19:42, 6 June 2025 (UTC)[reply]
The language I used in my original edit was factual amd why I sought clarification originally. Nothing should have implied more than the facts which are, (supported secondary sources) 1. chiropractors are in staff at major healthcare institutions such as the VA and Northwestern Medical Center (and others) 2. it is a licensed form of healthcare per NIH and state licensing boards - all 50 states have licensing requirements. Agree it's not the same as insurance but that wasn't my point - but related is 3. Is covered by all major medical insurance. This would accurately represent the topic.
Happy to edit in smaller sections and note each. WCNo47 (talk) 01:57, 7 June 2025 (UTC)[reply]
To expand on what I meant about discussing specific language, I'd rather not go back and review the language in your original edit. As you can see from the many comments below, that earlier language doesn't stand a chance of getting consensus. So, instead, I'd like you to take that previous language, revise it thoughtfully based on the feedback other editors have already given, and then propose revised language, specific wording, section-by-section, here on the talk page. It will almost certainly need to be revised further in talk before being ready for mainspace. It's a slow process, but it should not be circumvented. --Tryptofish (talk) 19:37, 7 June 2025 (UTC)[reply]
Sure, I understand. However, I don't see anything in the comments below that is specific to my edits. That's said, here's my most recent edit that was reverted. I felt this added more of a global perspective than the prior and clarified the intent - to distinguish between DC and MD/DO by limitations. It was flagged as using a 'chiro source', but I cited several sources that were not.
This was for the second paragraph after the 3rd sentence:
Chiropractors typically hold a professional degree in chiropractic, such as a Doctor of Chiropractic (D.C.), and may be referred to as "doctor" in clinical settings. However, their training and scope of practice differ significantly from that of medical or osteopathic physicians. Chiropractors are generally not authorized to prescribe medications or perform surgery, though limited prescribing rights exist in a few jurisdictions. While some chiropractors identify as primary care providers, their clinical education typically does not meet the internationally recognized requirements for comprehensive primary medical care. WCNo47 (talk) 21:31, 7 June 2025 (UTC)[reply]
About the comments below, those directly below, from JzG/Guy, were directed at you specifically, and the subsequent talk sections raise issues that are generally relevant.
So for that edit about the second paragraph, you made this edit: [1], which was reverted: [2]. I personally don't have any issues with the wording you reproduced above, but I can't speak for other editors. The changes you made were relatively minor. But the edit summary for the revert indicated that the issue was the changes you made in cited sources, not in the text. I see that you removed a source from the Science-Based Medicine website, which I see as a mainstream source, which is good, but a blog, which is less good as a source, so that's kind of a wash. You replaced it with a source from the Journal of Allied Health (a minor journal, but to my knowledge not a predatory one), and I see that as neither better nor worse. You added a source from the Journal of Pain and Symptom Management, which I think is fine, and one from Chiropractic & Manual Therapies, which I think triggered the revert, because it's a within-POV source, especially because that one replaced another one from Science-Based Medicine, which you removed. You then added sources from the World Federation of Chiropractic and Chiropractic & Manual Therapies, so, on balance, yes, you shifted the sources strongly in the direction of chiro-promoting sources, and I think the revert was valid for that reason.
Today, you made this edit: [3]. You cited this source: [4]. You wrote the citation template with NIH as the publisher and PubMed as the website. That's not a POV problem, but you just did it wrong. The journal is actually Chiropractic & Manual Therapies, not PubMed, which is just the website for searching. The authors are at various universities etc., not NIH (click on "author information" at the source). I just made this edit, to correct the citation: [5]. I suggest that you look at what I did there. --Tryptofish (talk) 17:51, 8 June 2025 (UTC)[reply]
Got it, thanks for the clarification, I'll take another look and update with that in mind. WCNo47 (talk) 04:57, 9 June 2025 (UTC)[reply]
A lot of that is years of back and forth between believers and the reality-based community. Guy (help! - typo?) 17:48, 7 June 2025 (UTC)[reply]
The best way to make the article better is to ensure that no in-universe claim is taken at face value. The basis of chiropractic is 19th Century quackery. The fact that there is some legitimacy to manual therapy does not validate the claims of innate, ability to cure organic disease, or obscure the dangers of the chiropractic hangman's twist, to name but a few issues.
No, chiropractors are not "mainstream physical therapists". There are two worlds of chiropractic: straights and mixers. Straights are quacks, pure and simple. Mixers are sometimes not quacks. But virtually all are trained at schools that teach innate and other obvious nonsense. Guy (help! - typo?) 17:43, 7 June 2025 (UTC)[reply]
Agree, I think we can acknowledge the facts I noted below without acknowledging that chiropractic is 'mainstream'. While there could be arguments that it's more mainstream in some counties than others and get into back and forths about what constitutes 'mainstream', the term itself may unintentionally equivocate the practice to other, established, evidence-based mainstream medical practices. WCNo47 (talk) 19:31, 7 June 2025 (UTC)[reply]
There are a couple of ways this page could be improved.
1.Broaden the evidence base
More peer-reviewed chiropractic research needs to be added. Include chiropractic university-led studies that meet WP:RS (reliable source) standards. Wikipedia allows specialty journals if they are peer-reviewed and indexed in PubMed. Especially recent systematic reviews, RCTs, and observational studies from reputable chiropractic journals (JMPT, Chiropractic & Manual Therapies, Journal of the Canadian Chiropractic Association).
Incorporate studies with positive or mixed findings on outcomes like: Low back pain, neck pain, certain headache types, rehabilitation adjuncts, and cost-effectiveness in integrated care models. Currently, those exist in the literature but are either missing or minimized here.
2. Improve balance in tone
Reduce over-reliance on skeptic opinion commentary without counterpoints from credible chiropractic or multidisciplinary reviews.
3. Update with recent evidence & guidelines
Incorporate post-2018 systematic reviews and clinical guidelines from:
World Federation of Chiropractic, NICE (UK,) Canadian Chiropractic Guideline Initiative, American College of Physicians recommendations on non-pharmacologic back pain care.
This would make the page more current and show where chiropractic aligns with mainstream musculoskeletal care.
4. Clarify internal diversity within the profession
The topic of "Straights versus Mixers" is very outdated and would be better placed in the "history" section. The source that is cited makes that clear. All of the CCE accredited schools teach an "Evidence-based" (musculoskeletal focus, guideline-driven care) curriculum.
5. Better integrate educational and institutional perspectives
Use more citations from chiropractic colleges, accreditation bodies, and chiropractic researchers to describe: education standards, clinical competencies, research priorities, and international regulation.
This would counterbalance the fact that much of the current “education” section uses external descriptions, sometimes from critical sources and misquotes the sources it does use.
For example "The curriculum content of North American chiropractic and medical colleges with regard to basic and clinical sciences has little similarity, both in the kinds of subjects offered and in the time assigned to each subject. (175)" Whereas the actual source states "Considerable commonality exists between chiropractic and medical programs. Regarding the basic sciences, these programs are more similar than dissimilar, both in the types of subjects offered and in the time allotted to each subject. The programs also share some common areas in the clinical sciences. Chiropractic and allopathic medicine differ the greatest in clinical practice, which in medical school far exceeds that in chiropractic school. The therapies that chiropractic and medical students learn are distinct from one another, and the settings in which students receive clinical training are different and isolated from one another."
6. Expand “current research and developments” section
Highlight areas like:
Integration into multidisciplinary care teams
Role in sports medicine
Geriatric and pediatric guidelines (with proper evidence caveats)
Ongoing debates about prescribing rights in some countries
This shows chiropractic as a living, evolving profession rather than a static 1895 philosophy. TokenChiropractor (talk) 23:27, 10 August 2025 (UTC)[reply]
Wow, thanks for that! I would love to see your changes implemented. Feoffer (talk) 03:20, 11 August 2025 (UTC)[reply]

Concerning changes

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I am concerned at recent changes to this article by Feoffer, first undercutting reliable sources on lower back pain, and now adding material cited to www.mastermindbehavior.com, which appears to be a company selling controversial autism 'treatments'. As a reminder, this article is a WP:CTOP. Bon courage (talk) 13:13, 11 August 2025 (UTC)[reply]

I was just on my way to talk after seeing you had reverted me.
  • I've commented out the recent addition you object to, even though tags made clear the sourcing was temporary and not to be trusted.
  • undercutting reliable sources on lower back pain Certainly not my intention. In this edit today, you cited this study as evidence that there no evidence for the efficacy of chiropractic in treating low back pain. But the study clearly states it found "low level of evidence to support its efficacy".
Feoffer (talk) 13:49, 11 August 2025 (UTC)[reply]
Which is a polite way of saying it doesn't work. As the article itself concludes "Chiropractic manipulation was not shown to be effective in management of low back pain, migraine, or neck pain". We cannot cherry pick stuff out of a table to arrive at different conclusions to reliable sources, especially when it is 180° in opposition to them.[6] The addition of old/primary research compounded the problem. Bon courage (talk) 13:55, 11 August 2025 (UTC)[reply]
I get what you were going for. But "no good evidence" isn't found in the source, we just made that verbiage up ourselves. My current understanding is that some mainstream healthcare providers recommended chiropractors who they claim are evidence-based. If my understanding is correct, that's a nuance that's getting lost in the current version. As the recent commenter noted, for better or worse chiros are increasingly integrated into health systems where they field referrals from more-mainstream teammates. Feoffer (talk) 14:13, 11 August 2025 (UTC)[reply]
It's paraphrasing since Wikipedia absolutely requires we use our own words; and it's a good paraphrase of the source not "verbiage". Bon courage (talk) 14:53, 11 August 2025 (UTC)[reply]
But it makes it look like Chiropractic for neck pain or radiculopathy is more established than Chiropractic for LBP. But doesn't the evidence suggest if chiro has ANY benefit, it's probably for LBP, not neck? Feoffer (talk) 15:02, 11 August 2025 (UTC)[reply]
No, there's no good evidence for any of these things per reliable sources. Bon courage (talk) 15:46, 11 August 2025 (UTC)[reply]
Well that's a problem, because the current text ("no good evidence") makes it appear there's evidence for radiculopathy but not LBP. Feoffer (talk) 04:29, 12 August 2025 (UTC)[reply]

WP:V issue?

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About this[7] edit, which is now WP:OVERCITED to four sources two of which are exclusive to the lede: what text in these sources verifies the "many chiropractors falsely claim" text? Bon courage (talk) 04:09, 12 August 2025 (UTC)[reply]

Are you looking for a source to neatly verify text, or do you think that's the wrong direction? Ie, Are you questioning whether it's true that many chiropractors claim to treat non-musculoskeltal conditions, or are you questioning whether they actually can? Feoffer (talk) 04:33, 12 August 2025 (UTC)[reply]
Your wording doesn't make good sense, but the immediate point is WP:V is a core policy and you're editing the lead of a high-traffic article on a WP:CTOP, where editors are expected to adhere to certain standards if they don't want to end up at WP:AE. Bon courage (talk) 04:55, 12 August 2025 (UTC)[reply]
Well happy to self-rv. I thought my wording was equivalent to the extant text. When we say Chiros claim to treat "general health", don't we mean ailments like diabetes, asthma, etc? And when they claim that chiropractic can treat general health, isn't that claim 100% false and provably so? Feoffer (talk) 05:04, 12 August 2025 (UTC)[reply]

Reversion

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And in fact, reviewing many recent edits I think they are all worsening the article by giving it an odd/poorly-sourced US focus and sprinkling in undue one-off opinions from marginal sources, all tending in a WP:PROFRINGE direction. Hence, reverted.[8] Bon courage (talk) 06:42, 12 August 2025 (UTC)[reply]

So, there were 26 intermediate revisions in there -- what specifically are your concerns? Nothing I wrote was intended to be pro-Fringe of course. Feoffer (talk) 07:00, 12 August 2025 (UTC)[reply]
As I said. Also things like removing all the antivaxx material from the lead. None of this helps the article. Bon courage (talk) 07:16, 12 August 2025 (UTC)[reply]
Okay, good feedback. That version explicitly warned readers about chiros spreading vaccine misinformation in the lede. In 2025, most readers know that "vaccine misinformation" means "falsely claiming vaccines aren't effective, when really they are", but there's no harm in spelling that out explicitly for readers in lede. I'll take care no to re-introduce that change. Most of the changes were fairly anodyne polishing -- is there anything else that jumped out at you as problematic or having the effect of promoting fringe. Feoffer (talk) 07:41, 12 August 2025 (UTC)[reply]
I don't think the article should be more US-centric. I don't think we want random opinions from people indulging in fallacies of future vindication. I don't think we should be using (probably misleading) chiropractic sources. And I don't think we should be using unreliable/marginal sources like medpagetoday. I do think policies should be strictly observed and that sentences should make clear sense. Bon courage (talk) 07:52, 12 August 2025 (UTC)[reply]
All sound good to me, though I'm not certain what precisely you mean. Which part of the text is "fallacies of future vindication"? Is there a particular chiropractic source that was used in a misleading way? Not using Medpagetoday is easy, not focusing on US is easy. Obviously, we all want our sentences to make sense :) -- good feedback. Feoffer (talk) 08:11, 12 August 2025 (UTC)[reply]
Adding unsourced narrative framing like

By the 2010s, chiropractors were increasingly noted for collaborations with providers of mainstream medicine

is a problem. Then quoting the remarks of an unspecified "professor of Medicine" when you're actually quoting an assistant professor who is a known promoter of altmed is a likewise a problem.[9] Bon courage (talk) 11:43, 12 August 2025 (UTC)[reply]
Always thankful for specific feedback like this! Time (2016) attributed the opinion to "Dr. Ronald Glick, assistant professor of psychiatry, physical medicine and rehabilitation at the University of Pittsburgh School of Medicine". The quote hasn't been added back, but is there some reason we shouldn't use the Glick quote about US physicians now collaborating with US chiros? Feoffer (talk) 12:05, 12 August 2025 (UTC)[reply]
How is the primary opinion of a junior academic promoting fringe subjects useful for reflecting accepted knowledge about chiropractic? Bon courage (talk) 13:20, 12 August 2025 (UTC)[reply]
It's not PRIMARY, it's a direct quote from a RS -- Time Magazine in 2016. Feoffer (talk) 13:32, 12 August 2025 (UTC)[reply]
Of a view, relayed without analysis. Hence, primary. Bon courage (talk) 14:43, 12 August 2025 (UTC)[reply]
Well, that's fine. I think you probably mean that you worry it's UNDUE or pro-FRINGE. We don't have to use the quote. For it to be PRIMARY, it's have to be a quote from PRIMARY source. A doctor being quoted by a journalist and published in a RS isn't OR/Synth/Primary. Feoffer (talk) 06:27, 13 August 2025 (UTC)[reply]
This is a common misconception. Primary material remains primary if it is just relayed, by however many sources, without commentary/analysis, such sources are just WP:LINKSINACHAIN. Bon courage (talk) 06:32, 13 August 2025 (UTC)[reply]