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A quick post today. But before I get started, I just wanted to wish everyone a happy holiday from the folks at Science-Based Medicine. We really do appreciate our readers and the community that has developed around this effort over the past decade or so.

Several times in previous posts, and frequently on Twitter (@SBMPediatrics), I’ve discussed chiropractic marketing videos. Most of these have involved infants, but at least once that I can recall I included a link to a video demonstrating a terrifying trend that has popped up in adult chiropractic over the last few years where extremely aggressive spinal adjustments are performed with the goal of making as loud of a cracking noise as possible. In some of these videos, the chiropractor even places a microphone next to the patient’s neck in order to amplify the resulting crack.

There are at least two chiropractors, both of which are producing videos that attract millions of viewers, who will place a strap or towel around a patient’s head in order to augment the harshly applied pulling force. I almost want to describe them as comically aggressive maneuvers, but it really isn’t a laughing matter at all. It’s a grotesque theater that puts a patient’s health at risk in exchange for nothing more than the possibility of a nonspecific placebo response.

For viewers, it’s a voyeuristic experience. They can watch a patient seemingly come close to having their neck broken and vicariously share in the thrill. Another common aspect of these videos, and one which plays a large role in pulling in viewers, is that the patient/victim tends to have an intense emotional response. They usually have a look of shock in the period immediately after the adjustment, followed quickly by the expression of relief and then laughter. Sometimes they even start crying.

It’s understandable that a patient would have an intense emotional response. On a subconscious level they must realize that what they have just allowed to be done to their neck isn’t safe or a particularly good idea. It’s a bit like sitting down to a round or two of Russian roulette. Okay, that’s maybe a little hyperbolic. Regardless, it’s a thrill with a small but real risk of serious harm and people often have a visceral response to such things.

For these chiropractors, it’s a moneymaking scheme. They have channeled the human desire to face danger, even if safely watching it on a YouTube video from the comfort of a cubicle or living room sofa, into millions of hits and the resulting advertisement revenue. It also likely helps to keep their clinic appointments fully booked. It’s all just so…gross.

On December 6th, an article written by Paula Cocozza was published in The Guardian on the subject of these online chiropractic videos and their cult-like following. Cocozza is not a dedicated science or medicine journalist and it shows a bit. There are some really interesting/nauseating insights into this trend, but I don’t think she fully grasps how truly bad these videos and the people putting them out into the world are, and she falls short of providing the kind of skeptical analysis that a subject like this requires. Ultimately, it’s more personal interest fluff piece than Brian-Deer-level investigative journalism.

Cocozza does point out that there is not solid evidence to support what these chiropractors are doing, so there is that. She also does the shallowest of dives into the history of the profession, revealing only that its inventor, quack of all trades Daniel David Palmer, was essentially a religious nut. And to her credit she does briefly mention some high profile cases of death by chiropractor. But her cringe-inducing final paragraph unfortunately gives the featured chiropractor the last word, which ends up cementing the article as what essentially amounts to an advertisement for his practice:

Whatever the efficacy or otherwise of chiropractic treatment, it is clear that cracking videos do have something to offer. Maybe, as Cipriano puts it, like the Y strap, they simply provide “a complete pressure release”.

Ugh. The only thing these harsh adjustments release is a patient’s wallet.

See y’all next year.

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Posted by Clay Jones

Clay Jones, M.D. is a pediatrician and a regular contributor to the Science-Based Medicine blog. He primarily cares for healthy newborns and hospitalized children, and devotes his full time to educating pediatric residents and medical students. Dr. Jones first became aware of and interested in the incursion of pseudoscience into his chosen profession while completing his pediatric residency at Vanderbilt Children’s Hospital a decade ago. He has since focused his efforts on teaching the application of critical thinking and scientific skepticism to the practice of pediatric medicine. Dr. Jones has no conflicts of interest to disclose and no ties to the pharmaceutical industry. He can be found on Twitter as @SBMPediatrics and is the co-host of The Prism Podcast with fellow SBM contributor Grant Ritchey. The comments expressed by Dr. Jones are his own and do not represent the views or opinions of Newton-Wellesley Hospital or its administration.