What is a Reasonable Chiropractic Treatment Plan?

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I have been contemplating all day… scratch that, my entire career now, (which is coming into it’s 14th year as a chiropractor) how to gently break the news to those patients who come to me who have been misled into believing that the “corrective” care plan they were under with certain chiropractors of 4, 6, 8, 12, or even 18 months at 3x/ week which was said to be “needed” or “necessary”, was actually completely and utterly bogus.

I am sad to say that the empathetic physician in me has failed at finding a way to gently confer that message. I have struggled with that through my career, as the reality is no one wants to hear that they have been duped. It sucks. It’s painful. And perhaps what’s worse is that it’s not even illegal, just deeply questionable. Caveat emptor is Latin for “Buyer Beware.” It is utterly reprehensible in my opinion that caveat emptor should even play into healthcare at all. But it very sadly does. While over-treatment and unnecessary expensive treatments are certainly not isolated to chiropractic, since I am a chiropractor I will keep my focus in this discussion on my field.

Even if a chiropractor promoting these care plans is a “good” person and really believes in what they are doing, they are duping themselves and their patients. That self-duping could be a failure of their education or it could be a failure of their morals. The fact is though that there is not a shred of good evidence that those types of care plans make good sense, other than financially for the people providing them.

I can tell you as a clinician and as a chiropractic patient myself, with a multitude of injuries from my Marine Corps service and a very active athletic life, I have to advise you very frankly, extensive “corrective care” plans are utter BS. Run away. I have had every style of care there is. The simple truth is, that if you are not being empowered to take control of your own health, encouraged to change your lifestyle and habits, and given a multifaceted approach to healing and rehabilitation from injury… something is missing.

Don’t get me wrong. Chiropractic care is extremely effective for many musculoskeletal conditions. We have a strong and continually growing body of evidence that we positively affect and resolve many musculoskeletal issues that plague society. We also have a ton of anecdotal evidence that chiropractic care may be useful for certain other conditions with certain patients. I absolutely love my work. I love seeing my patients walk out of my office every day feeling better, with less pain and being more functional than when they came in. It drives me and it is huge part of my passion for my career.

However, it is equally as gut wrenching for me to have someone come in with a rotator cuff disorder who has been under a “corrective care” plan for six months for cervical “subluxations,” which was completely ineffectual and yet still they have to wrestle with a pointless $3000 bill for that “care.” The quagmire of the multitudes who have shown up in my clinic over the years, suffering with ongoing pain, jaded by misdiagnosis and inappropriate treatment, and having the visible shadows of the dollar signs from other chiropractors burned into their eyes, and so subsequently their perception of me… That is always painfully sobering, no matter how many people I help.

If you have been misled to believe these types of long-term care plans make sense, talk with me. Send me an email. Call. Let me help you understand why they don’t.

I have no agenda, other than educating you. Throughout my career I have always been a clinician and an educator. It is what I do and who I am. If you want to see me as a patient, that’s fine. If you don’t, that’s fine too. I am happy to assert that the majority in my profession are chiropractic physicians, looking out for the best interests of their patients and I am more than happy to send you to them.

There are still though a very small minority of very vocal, very visible, and very wealthy (wealthy off of your backs, literally) chiropractors who would try to enroll you to be dis-empowered into their long-term care plans and try to convince you only they can keep you healthy. That is completely bogus. Don’t buy it. Chiropractic care can change your life for the better. I know that for a fact and I wholeheartedly know that is true. Just not that way.

Look for short-term, limited treatments plans. Decreasing care over time in any given treatment plan. Multifaceted, concurrent care with other types of treatment if necessary. Referrals out to other providers if you are not getting better. Most of all, look for a healthcare provider who is interested in empowering you to take control of your healthcare. That is the most important part. Healthcare is about you.

In health, Dr. Neely

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28 thoughts on “What is a Reasonable Chiropractic Treatment Plan?

  1. Dr. Neely,

    I am an advocate of regaining mobility in joints, and absolutely agree that joints being “out” and put back “in” is very rare and a poor analogy.
    That being said I am very disappointed to read what you wrote following that part of your article. I have an office where I provide CORRECTIVE care. The results in care plans that require more visits are extremely effective and the results are in the follow up x-rays. After reading your article, I can only assume you have not witnessed this in any practice, or maybe you just were not informed.
    Let me explain: In my practice I can reduce scoliosis curvatures, restore postural curvatures, and most amazingly…..increase disc size in those who have lost significant disc height!
    I started as a symptomatic chiropractor who addressed pain and informed the patient that care was no longer needed after pain diminished. That type of care is great and better than no chiropractic care, yet if any asymmetry or lack of postural curvature is still existing…the patient is most likely going to have to return in the future.
    We both agree that MOVEMENT is the most fundamentally important part of joint health. That is why chiropractic is so effective.
    What is also important to grasp is the concept that an asymmetry in the spine creates poor weight distribution….as does lack of postural curvatures.
    When a CORRECTIVE care plan is recommended, it is in hopes to restore positions of the malleable spine to create a long term function, as a result of better positioning!
    These corrections in position simply CANNOT happen in 10-15 visits.
    It does require more. Each patient is recommended different amounts based off of the xray, history, and age. I also believe it to be a far more advanced and laborious care plan for the practitioner to deliver. Yet, I know what can happen as I see these results daily in my practice. It is worth the extra work.
    So when I read your comments saying, “bogus” or “BS” it really makes me wonder if you have seen any results from corrective care.
    I can show you them at any time as I have hundreds of them in my office in the form of digital pre and post x-ray studies.
    When you see a disc grow in size, in the cervical spine, and also see a lordotic neck curve restored along with it…..which will ensure longer lasting movement within that spine, you will probably be wondering why you aren’t doing this kind of chiropractic work yourself.

    Dr. Sean Miller

    • Hi Sean, thanks for your comments. It’s best to never make assumptions. I have seen corrective care plans all over the profession, I’ve seen results, (but have a problem with a shotgun approach to healthcare – everyone gets the same cookie cutter plan) and I know what your are referring to. I am not specifically referring to your care plans, as you didn’t elaborate on them, just in general. I am planning on writing a longer blog post elaborating on this theme some more, but I’ll address the main ideas here briefly.

      First, let’s first differentiate between the chiro who enrolls everyone walking in into a “corrective care” plan of say 60-120 visits versus someone working with specific conditions, like scoliosis. For the sake of argument, lets stick with idiopathic scoliosis that has not progressed to a structural scoliosis.

      You may agree that some with no significant issues, with no significant findings on x-ray, (who likely didn’t even need x-ray’s in the first place) does not need to come in 60-120 times? I would guess from your response, you may agree with that. Maybe not, but then if you don’t agree with that, we can just stop right there with this discussion, as that is the primary point of my post.

      In regards to scoliosis, I would not disagree that you can get the results you are talking about with how you are providing care. However, the question is are we providing patient-centric care or doctor/ technique-centric care?

      You asserted that you cannot get postural changes in 10-15 visits. I know that is not entirely true, from clinical experience. I used to have this exact argument with one of the heads of CBP on the ACA list serve many years ago, when he asserted just what you are saying. I’m not promoting any magic technique, it’s just that a combination of many things besides just a long-term manipulation-based care plan can and does provide the kinds of results you are talking about.

      The CBP doc I was arguing with said confidently, it was a minimum of 40-60 visits to make corrective changes in posture, up to potentially 240 visits or more with their protocol. I pointed out to him that my friend who is an Advanced Rolfer and I dramatically straightened a 16 year old girl’s 40+ degree thoracic curve to the point it was clinically insignificant with 12 visits each, of chiropractic manipulation and Rolfing. He was indignant. I couldn’t figure out why he was indignant. I made less money, had a full practice, and wasn’t trying to promote my business or anything like that. It was because he was operating from a technique-centric viewpoint, not a patient-centric viewpoint.

      It’s also been shown that cervical curves can be corrected by appropriate exercises alone, if we can motivate the patient to empower themselves enough to take care of themselves. I imagine that it is quite likely a faster process in conjunction with some manipulation, but it can be done without. So should we enroll them in long term chiropractic care plans or teach them to take care of themselves? Maybe a short term care plan with a heavy emphasis on empowering them to do the exercises? Or at least co-treat with other providers so that things move along faster? And any of those potential routes for care is given that there is a clinical correlation between there cervical curve issue and problems they are experiencing.

      The patient-centric answer is that we should minimize care as much as possible and empower the patient as much as possible. There are no cookie cutters in healthcare. There certainly are cases where people need more care, just because of the nature of what they are suffering from. Cookie-cutting everyone into a long-term corrective care plan “just because” though… that is doctor-centric and is bogus and BS. Healthcare is about the patient, not our preferred way of practicing.

      Thanks for reading and commenting. I look forward to more discussions in the future.

      Michael

  2. Hello,

    I am currently a student in chiropractic school trying to sort through the vast amount of different techniques and theories to figure out what works and what doesn’t. I have read your latest blog on Movement vs. Misalignment and I couldn’t agree more with this. However, I would like more information on why corrective care doesn’t work. Also I go to a school where everything is due to a subluxation and I see your subluxation unicorn can you also elaborate on that? I have a very open mind and am not for or against a technique like CBP I just want to learn about it before I get into the field. Also I feel like the subluxation is a copout for chiropractors that don’t want to take the time to find out what is actually going on. I would appreciate any feedback.

    Thanks,

    Andrew

    • Hi Andrew, thanks for the questions. In terms of the corrective care plans, please see my response to Sean above. There is more I could say, but I think I covered most of the bases, between the post and the response I gave.

      Who am I kidding?!? I am a yapper! One thing I could add to what I have already said is, what exactly is the point of the “corrective care” plan? Rid the body of subluxations? Fix posture? Prevent future pain and disease?

      I addressed the posture part in my response to Sean above, but the idea of prevention of future pain and disease, as well as the ridding the body of subluxations, create a very neat and tidy way to foster a never ending cycle of dependent care. Not to mention it doesn’t work long term. People hurt, it’s part of living.

      Over the years good studies have been done to see if there are any measurable long term benefits of long term care plans, in terms of morbidity and mortality. They have not found that people who go through them have any statistical difference in any long-term quality of life outcome measures, in terms of pain and/ or disease.

      So x-rays may look different. That’s interesting. Seriously, from a scientific standpoint, but that’s about as far as it goes right now. In terms of how it affects our patients, the real question is how do those x-ray findings translate into how a patient or patient base feels and experiences life? It doesn’t. At least long term. You lay down money for 6 months of care, feel good during, then get 6 months or a year or so of relief, maybe. Then you have to keep coming back, and back, and back.

      The American College of Radiology has been telling docs (MD’s, DO’s, and DC’s) for a long time now to stop referencing arbitrary findings of arthritis on x-rays as a likely pain generator. Because they aren’t, unless there is an osteophyte sitting on a nerve root. I have seen elderly people with horrific osteoarthritis, severe DDD and DJD throughout their spine, with little to no pain. I have seen young people with healthy, big discs and no arthritic changes who are suffering in agony.

      So discs change, curves change. Would they if someone were doing yoga daily, given proper corrective exercises, and perhaps were getting manipulation when they need it to deal with intermittent, episodic flare-ups? Maybe. But then, if they can do everything they want to do in life and are strong and stable, do the x-ray findings matter?

      Did they 100 years ago, 200 years ago, or 400 years ago when people didn’t have access to x-rays and chiropractic care, but many still lived active lives? X-ray findings are just that, findings that are interesting at this point, (unless they are pathological) until and if we come up with and ask different questions that result in different conclusions than those we know from the research currently.

      Our moral and ethical imperative as healthcare providers is to attempt to get people back to living their lives, as independent of us as they possibly can be. It is absolutely not to rope them into a care paradigm where they believe they need us for optimal health. We can help and even be a key aid in helping and directing them, but they have to take the reigns and responsibility for their own health.

      For the record, the ideas behind CBP are reasonable. The application of the practice of it, as I have seen it, is a little myopic. The argument that everyone needs 60-240 visits to get somewhere is essentially taking the route of “I have a hammer and I am going to smash everyone into my box.” Not to mention years ago when I was on the ACA list serve, many high quality researchers in our profession tried to help Harrison improve study design flaws, which were as I understand it, were ignored. Bummer, because he has put a lot of work into it. Seriously.

      My mascot Sammy the Subluxation Unicorn is the topic of an upcoming post, as it is probably the single most polarizing topic in the chiropractic profession and I want to do it justice. I will give you a sneak preview though. You are on the right track with the last comment you made, but I think in most cases it’s not so much a copout as a question of education (not necessarily a lack there of, but what the education was) and the fact that there are a whole lot of really great DC’s out there who are more interested in caring for people than debating academics. However, there are many smarmy one’s who use subluxation as a tool to create dependence in patients. Those are the people I’m after and I am driven to educate the public about. Anyway, I’ll probably have the post done some time this week, so keep an eye out.

      Thanks for the questions Andrew. Please share my site and posts widely. More soon.

      Michael

      • Thanks for the reply. So as I read in your post above you can get good results as far as postural change goes with manual therapy and chiropractic in a shorter amount of time than just chiropracitic. What approach do you take when you feel that the patient may need increase curvature of the cervical spine? I thought it was interesting that you can change the curvature of the spine with appropriate exercise alone. I have another question related to your movement vs. misalignment. How exactly do we lose motion in the joint and how does it stay that way? In other words what is holding the bone in a position that doesn’t allow optimal motion between joint complexes? With the misalignment theory it makes sence why the joint is stuck but I am having a hard time visualizing what is going on with the movement theory. Thanks.

        • Sorry for the delay in reply Andrew, busy week. Rather than go into the exercises myself, I’ll share a (sarcastic) comment on Facebook from last year by one of my close friends, Dr. Phillip Snell who was fed up last year and posted about the cervical curve exercise issue:

          “Dear local chiropractor, I know your school debt is high. I know that your “practice management” company gave you all kinds of sales techniques to “close the sale” on your “review of findings”. I know that the finding of loss of cervical lordosis on lateral C-sp X-ray is correlated with neck pain. When you suggest a discounted “package” of visits to “correct” the cervical curve with 3X weekly treatments for months if the concerned patient signs a pre-paid treatment plan so that you can pay your school loans quicker, then you are part of the problem in public health rather than part of the solution. That’s putting nicely. You’re really a self-serving SOB who deserves to lose your license, but it would not be nice to say that in social media would it? Some of us have learned from the 120ish peer-reviewed articles from Gwen Jull (@ PubMed, search G Jull and neck pain) that a simple assessment and neck up exercise typically is highly effective at improving the cervical curve and reducing neck pain without 3X treatments, but with free home exercises. Your patient is now my patient because she now knows how to help herself. There’s a practice management tip. Do good work. Treat others as you would like to be treated. Get good at performing new patient exams…because they will talk about the work that you do. Thanks for reading, and for the referral.”

          I’ll talk more about movement, lack of movement, theory etc, in future blog posts. The reality of the current research is that we are not entirely sure what is going on in specific detail, but we have some ideas. We do know that manipulation works for a lot of conditions. More later, but now I have to be off to work!

  3. I also have a great deal of difficulty with these ridiculous treatment plans…the problem is, we have a multitude of chiros graduating from chiro colleges with enormous debt…I have served my profession as a volunteer board member for a number of years and dealt with public complaints and I can tell you that almost without exception, the vast majority of complaints are to do with chiros that are hooked in with practice management companies advocating obscene treatment plans…it really bothers me. It lessens the profession in the eyes of the public…we can produce amazing research time after time and all the goodwill that is built up with our colleagues in other professions and the public alike, is washed away by one single scammer that wants to report back to his buddies at the next convention that he is up to 500 patient visits per week..in the meantime, his greed has hurt the rest of us brutally…

  4. Dr. Neely, I do not suffer from chronic back pain but I was recently involved in a minor auto accident that has left me mild to moderate lower back muscular pain. I was recently provided a 48 visit treatment plan extending a 4 month period and $ 3,600 from a ocal Chiropractor. Can you please recommend a Clinical Chiropractor with morals and care modalities similar to yourself in my area Please email me and I will give you more info on my case and my exact goegraphic location. Sincerley, Nearly Taken

    • Hi Nearly, Very sorry you had to deal with that and glad you stopped that before you started. Regarding sending me more information on your case, I don’t do case consultations over the internet, so no need to send me details of your case. However, I’m more than happy to try to help you find someone in your region. I’ll private message you after replying here. Also, I’ll be putting up a post with more information around similar questions in the near future.

  5. I am currently dealing with a Chiropractor who presented a “Plan” who never mentioned the word contract for 37 weeks of treatment for neck pain i was having …I thought i could stop at any time if i felt it was not helping me…. I made a decision to stop going after i was getting worse & worse seeing him ..i informed him i cannot continue getting worse and trying to go to work all day …He said i still have to pay him for the remaining 25 weeks i have left on this plan ..I would have NEVER signed such an thing had he told me i could not opt out in any case …My question is , am i by law in debt to this person or can i stop payment ..i have cancelled my cards so he cannot draft my account which he tried this morning …he was drafting my HSA & my debit because my insurance only paid a little bit …..Thank you so much for your help

    • Hi Eric,

      I’m not an attorney, so I can’t give you legal advice, but I will tell you what I suggest. The first thing is that if you have not signed a contract and he cannot produce a document that you did sign something agreeing with what he is saying, he has no way of holding you to anything. It’s unfortunate that he has any of your cards on file in the first place.

      Depending on what state you are in, any care contract without an option to prorate back unused visits to the patient can be illegal. Again, this varies state to state. In Washington State, any provider utilizing care contracts with patients has to give the option to prorated back any funds not used if care is discontinued. That doesn’t always happen though, because many patients are not aware of that.

      Ultimately, this kind of thing does not get better unless patients file complaints. Complaints from other providers often only go so far, because they can be seen as competing interests, rather than valid complaints. With that, I always encourage patients to take the lead, as more gets done. I would recommend getting a hold of the Department of Health for your state and file a formal complaint, as well as with the Insurance Commissioner’s Office. Your state should also have a chiropractic licensing board, who also should be formally notified.

      I’m very sorry you have to deal with that and best of luck rectifying the situation.

  6. Thank you very much for your response back to me . When i was told i after a month of seeing this Dr that i signed forms he called a “Discounted treatment plan ” for 37 weeks for $2529 i was shocked …He told me from the first consultation and taking 4-5 x-rays he had 2 plans for my neck pain & dizziness ..one was at a discounted rate for 9 months 37 weeks were he would debit my card because it made it easy on his staff eliminating paper work OR pay month to month at the full rate …I choose the discounted plan , big mistake ..in 4 small lines above my signature it say s that “i agree to pay the TOTAL ABOVE if i cancel my care “..that is what he is hinging his whole argument on & now i have been notified a week ago that after 90 days & no payment from me for the next 5 payments he says i owe him , he will send this to collections or take me to court .
    I have told him after 3 months of treatment & getting worse & worse the last 3-4 weeks before i stopped seeing that i could not keep coming back , BUT he never told me i owed him for the next 6 months NO MATTER WHAT …he finally said i bought a PLAN for 9 months or 37 weeks , whether i went only one week or the whole 37 weeks …he kept saying i signed for the “PLAN” which i feel is a contract & i owe him $2529 no matter what was going on with me be it good or bad …..I have him saying in a email he does not offer contracts but how could this Not be a contract …Thank you again for any help regarding this …We are not a rich family & this has put a sever strain on my wife and kids …Again , any help is Greatly appreciated

  7. I wanted add Dr Neely that i paid this Dr on the day i went to see him $281 on 28 Aug & then about 13 days later he drafted my card another $281 & there after every month on the 10th ….He seen me just short of 3 months …he debit my card for 4 months

    He is completely paid up , in fact owes me for one month I never saw him …So just letting you know i owe him nothing , in fact he owes me $281

    Thanks again Dr Neely

  8. I absolutely love this guy. I’m a chiropractor myself and was taught all the bs treatment plans that you’re supposed to do to achieve a “correction”. I could never do it since I would never go to someone like that myself. I’ve read all the research as well and know it is possible to reverse a bone spur or osteoarthritis but Dr. Gonstead proved it back in the 60s in 9 adjustments over 2 1/2 years. It just takes that long. So in reality we really don’t have any idea how many times its gonna take. I’ve also seen someone that was adjusted 100 times in a year by someone else and it didn’t change at all. If we can improve that person’s daily life and functionality then that’s what I’m all for. Not just x-ray evidence.

    I really love it when I find other like minded chiropractors out there! I love what I do but I find myself saying the same thing to my patients everyday and they really love me for being honest. Dr. Neely is right on point with our profession and should teach at a Chiropractic college to bring some sanity back in chiropractic!

  9. Hi – thanks for the article.

    I agree with majority of it.

    Having tried the corrective path and wellness, I also came to the conclusion that it is BS. Yes for relief, maintenance and performance enhancement – this can be tested and measured, really helping people.

    It just boils down to finding the right plan for the patients (shock horror – there is no standard one size fits all) and educating them. NOT SUBLUXATION, but function. People get that.

    Oh – I forgot to say I threw subluxation out as well. Christianity and Chiropractic philosophy do not work together, so one had to go.

  10. Dr Neely,
    Thank you for this post. I found your blog as a result of almost being duped by chiropractors down here in Australia. Never having consulted with a chiro before and being scared from what I have heard, I have looked everywhere else for healing sports injuries.
    Of late, I am experiencing different kinds of pain, or perhaps the same but cannot ignore it any longer and am considering chiropractic work. You mention buyer beware, and I appreciate this. We have to research and investigate as much as we can before committing to anything or anyone. Not knowing where to look, I headed to google and found this blog after meeting with a chiro business that seemed.. a little off.
    What you say, and how you explain things make more logical sense to me. I am a direct practical person and have no time for fluff. I believe I met with a company who is money hungry, dramatic and dis-empowering thanks to your explanations in your blog. My gut said something was a-miss but you don’t know what you don’t know- and now I know: I was right.
    Thank you for replying to my email despite you being thousands of miles away and unable to consult with me. You have helped steer me in a better direction and one more congruent to my logical self.
    If there were more health practitioners with your integrity, we would be in a better place. Thank you for your blog.

  11. Such a helpful and insightful blog. I was so impressed by the honesty. There are too many practitioners that are interested in making as much as they can instead of doing what is right for the patient.

  12. There’s a problem in the profession where there are people who know and understand the research, and people like yourself, who are completely ill-informed. There are some people who practice unethically and simply try to run up a patient’s bill. That’s true in any profession. My wife had a dentist that told her she had four cavities and got a second opinion and was told she didn’t have any.

    We can agree that some people misuse corrective care plans. To pretend like there’s no logical basis for corrective care is completely wrong. Again, you’re simply ill-informed. It’s not a disagreement, you’re just wrong. Corrective care plans are based on knowledge of ligament hysteresis, creep and plastic deformation of soft tissue structures. The only way to create a lasting change in the spine is force, time and repetition.

    It’s easy to find the research to support corrective care. It’s been available for at least 25 years. Here’s a good starting point…

    Harrison DD, Jackson BL, Troyanovich SJ, Robertson GA, DeGeorge D, Barker WF. The Efficacy of Cervical Extension-Compression Traction Combined with Diversified Manipulation and Drop Table Adjustments in the Rehabilitation of Cervical Lordosis. J Manipulative Physiol Ther 1994;17(7):454-464.

    • That’s an entertaining anonymous commentary anyway. One of my jobs is working with the Chiropractic Advisory Committee for WA State where we work with an epidemiologist reviewing research and compiling best practice resources. The resources we publish entail exhaustive reviews of the literature for every subject we cover. While you clearly do not agree with me, I am anything but ill-informed, wrong, or just wrong, as you so professionally put it.

      First thing I would point out is that you are citing old research, which even at the time was highly criticized. Then there is the simple fact that CBP research has been pointed out to be flawed in many facets for a very long time. Many researchers in our profession have tried to help correct design flaws over time, but as I understand it, they have been ignored. When you have a moment:

      J Can Chiropr Assoc. 2006 Jun; 50(2): 97–102.
      Flawed trials, flawed analysis: why CBP should avoid rating itself
      Robert Cooperstein, MA, DC,* Stephen M Perle, DC, MS,** Brian J Gleberzon, DC,† and David H Peterson, DC††
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839992/

      Your argument that, “The only way to create a lasting change in the spine is force, time and repetition,” presumably only through a long-term chiropractic care plan, is simply not accurate. The Rolf Institute has a library of literally many, many thousands of photos of structural changes in the posture through 10-12 session treatment plans which can last for years or longer, only from those initial sessions. Those have been around since the 1960’s. Not to mention specific, self-directed postural exercise regimens have been shown to restore cervical curves, help with idiopathic scoliosis, and more. So, no, the only way to create lasting change in the spine is not just through long-term chiropractic care plans.

      It may be useful to look outside of the paradigm of how you practice from many different angles to see if the validity of what you are promoting holds up. Thomas Kuhn pointed out that many people practicing what they believe is a scientific approach rarely actually utilize a scientific approach to their own work anymore. The tendency is to bolster ideas with a good amount of confirmation bias and review only the research that supports a given approach. The correct way, scientifically speaking, is to actively try to prove it wrong, forever. If no one can find holes, then maybe it’s a good approach. Long-term corrective care plans have a ton of holes, including but not limited to: the existing research, in terms of quality; the exorbitant expense of the care plans; the rationale of why they are theoretically “necessary”; and the frequency of care potentially creating psychological dependence, ligamentous laxity, and more.

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