Chiropractors are notorious for taking all opportunities to expand one of their mainstay treatments, spinal manipulation, to an increasing number of supposed health applications. Their alternative health field, known as “chiropractic”, has been doing this, not through scientific investigation, but rather through aggressive marketing campaigns. The chances are high that you know somebody who not only visits a chiropractor but swears that he or she has benefitted from chiropractic treatments. From a scientific standpoint, however, there is no basis for the claim that chiropractic treatment is helpful for much of anything that may ail you. One could write a book about how and why the multitude health claims put out by chiropractic marketers are not true, but since we focus on pregnancy issues here on The Pulse, today we’ll look at just one claim in particular that is out there, in the world of alternative health beliefs, namely that chiropractors can treat infertility, or make your fertility better than it is. They absolutely cannot do this for the simple reason that the main factors influencing your fertility are hormones, the endocrine glands that produce those hormones (the pituitary, the ovaries, the testes, the gross and microscopic anatomy of the uterus, various physiological functions, and drugs and nutrition —none of which is influenced significantly by somebody pulling, twisting, and otherwise manipulating your spine. This goes for male infertility as well as female infertility.
Over the past several decades, fertility treatment has advanced dramatically as a result of improved understanding of physiology, biochemistry, cell biology, and endocrinology, and of advances in hormonal pharmacology, and the advent of in vitro fertilization and embryo transfer. Chiropractors do not have clinical training in any of these areas, nor are they educated much, if at all, in the basic medical sciences relevant to fertility, such as biochemistry, physiology, embryology, cell and molecular biology, histology, pathology, or pharmacology. As for why many people go to chiropractors, there is some weak evidence that chiropractic treatment may relieve lower back pain. Possibly the result of the fact that any kind of massage can relieve lower back pain (a partner or a friend giving you a casual massage could relieve your discomfort as well), this is enough to generate positive stories about chiropractic spreading by word of mouth. On top of this, chiropractic makes use of aggressive marketing campaigns, and chiropractors frequently present themselves as authority figures on all things related to the body. They love calling themselves doctors —chiropractic training programs, after all, award a kind of doctoral degree— plus they take X-rays and use a lot of medical and scientific words in the course of their explanation. Often, the rationale that they present using such word salad does not square with modern understanding of basic medical sciences, but the terminology and the authoritarian presentation fools many lay people. This is a hallmark of pseudoscience, but the image of authority and knowledge that chiropractic —a multibillion dollar industry— attaches to itself melts away as one delves into the history and underlying belief system of chiropractic.
One word that you will hear chiropractors say often is “subluxation”. In real medicine, this term refers to a full or partial dislocation of a body part, but chiropractors use it to mean a mispositioning of a vertebra (or of more than one vertebrae) that may or may not be demonstrable with non-chiropractic, objective methods, such as imaging. The concept of chiropractic subluxation and manipulations to “correct” it have their origins in the year 1895. If this year rings a bell for you in terms of the history of health care, you have the right idea, for 1895 is the year in which physicist Wilhelm Roentgen discovered X-rays. Within a few years, Roentgen’s discovery would revolutionize medicine, but in1895 the founder of chiropractic was living in a world in which no technology for imaging inside the body yet existed. Consequently, chiropractic was claiming that its methods could detect something inside the body at a time when it was fairly difficult to determine whether what was claimed to be detectable was real —although, even in 1895, there were some clues that the scientific direction that actual medicine was beginning to take was not an approach that chiropractic was likely to embrace. One major such clue was the founder of chiropractic claimed to have learned his methods from a dead man who had transmitted the information somehow from the grave.
Alright, so chiropractic has ridiculous origin and its benefits are limited and questionable at that, but many people go to chiropractors, so why shouldn’t you? Well, you also need to consider the negative consequences. Many people experience adverse effects from chiropractic treatments. Most such effects are benign, such as soreness or mild tissue, injury, but, more rarely, chiropractic spinal manipulation can produce severe damage, one extreme example being dissection of one of the vertebral arteries —a pair of major arteries running along the neck— which can lead to severe stroke and death. The rate of occurrence of vertebral artery dissection and other severe effects resulting from chiropractic manipulation is a matter of controversy, requiring study, but chiropractic methods can involve rather brutal forces on and within the spine and on related structures through which important nerves run. Severe adverse effects of chiropractic treatment may indeed be rare, but set against weak evidence for any benefit at all, not to mention the tendency for chiropractic to make all sorts of claims that its methods can treat various conditions involving internal organs, it makes little sense to waste your time and money on such a venture.
If you suffer from infertility, discuss it with your gynecologist or your primary care physician and ask for referral to a fertility specialist, meaning an obstetrician gynecologist who has done special training in fertility issues.