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Does chiropractic work?
Despite acceptance by many insurance companies, a number of studies don't confirm its effectiveness.
- With over 70,000 certified chiropractors in America, the modality has gained wide acceptance.
- Yet many studies do not show chiropractic to be more effective than placebo or pharmaceuticals.
- Some chiropractors treat newborns as young as two weeks to help alleviate "birth trauma."
The first chiropractic adjustment took place in 1896 in an Iowa office building. D.D. Palmer, a fan of magnetic healing and anti-vaxxer, ran into the building's janitor, who was suffering from back pain; he was also deaf. It's not quite clear exactly how Palmer adjusted the janitor's vertebral subluxation—a term unique to chiropractic that implies an undetectable spinal misalignment—as, with all origin stories, details are murky. Supposedly, Palmer claims the adjustment cured him of deafness; the second patient he treated apparently left with no more heart disease.
Palmer was a metaphysics fan and correlated physical symptoms with spiritual phenomena; chiropractic is based on the idea that energy flows block the "innate," which manifests in things like back pain. Not only did he believe chiropractic had a religious and moral purpose, he also claimed he "received" it from a deceased physician. He called chiropractic a religion; he even tried to use the freedom of religion clause to circumvent the fact that he wasn't a licensed medical professional, a move that got him jailed and fined. He ended up selling his school to his son, who apparently killed him in 1913.
While Palmer's emphasis on the nervous system was an early contribution to an important physiological discourse that doctors are still uncovering today, chiropractic is still considered pseudoscience. Regardless, this is America, where suspect folk remedies and metaphysical interventions are commonplace. Within three decades there would be over 80 chiropractic schools established in the United States. Today, there are over 70,000 certified chiropractors in this country.
I've seen chiropractors hundreds of times. When I had trouble getting out of bed in high school—a case of sciatica following a femur break—it seemed to be the only thing that had me walking without pain. I revisited a number of chiropractors over the decades for various reasons, including neck pain and a broken collarbone. Eventually a pattern emerged that caused me to stop going: pain relief offered by chiropractic never led to addressing the actual issue.
For example, going to a chiropractor 2-3 times a week for years alleviated my sciatica but never fully stopped it. That only happened when I began practicing yoga. Time and again, chiropractors provided temporary relief without ever pointing to the cause of the pain. Every time I found actual relief through a new exercise modality or physical therapy.
Are chiropractors worth it?
I recalled my chiropractic history after reading science journalist Kavin Senapathy's recent essay on infant adjustments. She writes about the small yet disturbing contingent of chiropractors that treat "birth trauma," a number that the International Chiropractic Pediatric Association pegs at 90 percent, but which is actually less than 3 percent. As with many forms of complementary or alternative medicine, positive studies usually appear in journals dedicated to the modality (see: acupuncture; see: homeopathy).
Senapathy opens her article with the case of an Australian chiropractor adjusting a two-week-old newborn. This includes hanging the baby upside-down by the ankles and "activating" his spine by pulsing his tailbone and neck. Given the fact that during a newborn's first month of existence every movement is a reflex action, how a spinal adjustment would do anything positive for the child remains a mystery. It also points to a deeper cultural issue.
This phenomenon of a baby needing an adjustment to treat trauma is really a reflection of the emotional temperament of our time, especially, it appears, in relatively affluent Western nations. "Trauma" has broadly become a signal to discuss personal issues. There is certainly plenty of actual trauma, as victims of rape and sexual harassment and soldiers returning from war know too well. Yet trauma has also become a buzzword that people apply to minor disturbances and grievances, which sadly takes the focus away from those who need it most.
Birth trauma is also real, yet the coddling of the child is its own modern issue. I refer to it as the playground problem. In the early eighties, all of the jungle gyms I played at had some form of dangerous obstacle: rusty pipes, nails, shoddy wood, questionable bridges, slides baking in the midday sun. No parent wanted their child to get hurt, but as a brave and dumb boy part of learning meant discovering my boundaries. Sometimes a scrape or bruise teaches lessons.
Today, jungle gyms are constructed of curved plastic with soft mats or sand at the bottom. We've removed the boundaries so that children no longer have an opportunity to discover them. There might be fewer injuries, but there's also less education. Falling onto something soft during play does not prepare anyone for life, and play is an essential skill throughout the animal kingdom for learning boundaries.
Tufts University School of Veterinary Medicine - Zephyr the dog gets a chiropractic assessment from Dr. Judith Shoemaker while the skeleton of a dog stands in the background on the classroom sidelines.
Photo by Mark Wilson/The Boston Globe via Getty Images
Education is essential, because the lessons you don't learn become their own limitations, only these prohibit growth. That's how the proliferation of pseudoscience began. There's little coincidence that two of our most important medical advancements—germ theory and vaccinations—greatly aided the explosion in human population. Millions of years of evolution led to one billion humans only in 1804; in just over 200 years, we're well beyond seven billion thanks to those two discoveries. Though life remains tenuous and prone to tragedy, we're better off now than ever before, which has led to the neurosis known as pseudoscience.
Enter "alternative" healing, a conglomeration of industries worth many tens of billions of dollars, many of which address the "innate trauma" we experience while basically just living. Chiropractic, admittedly on the tamer side of this industry, is like taking an aspirin. It treats symptoms and only treats causes by coincidence. There's also a good chance that what's actually aiding your muscles is the electro-stimulation and massage (if offered) more than spinal manipulation. And if your chiropractor is also offering vitamin infusions, you can be certain the business is a sham.
As with every modality, medicine that works should be investigated. Sadly, a lot of chiropractic studies show no benefit greater than placebo or painkillers. The best chiropractors I've seen offered massage before an adjustment, which makes sense: loosen the muscles pulling on the spine before adjusting the spine. But if you don't teach your patients how to strengthen those muscles on their own, they're only going to keep getting tight or weak, which is good for repeat business but terrible for healing.
Our bodies are the result of our individual movement patterns. As movement expert Katy Bowman says, no one is out of shape; we're all in the exact shape that we train for. If you don't train, that's the shape you're in. Manipulating vertebrae is a useless practice without addressing the entire muscular structure of a human body and how that body moves on a regular basis.
Which is not to say that chiropractic is without value. As mentioned, it has helped me. It just never cured me. As Senapathy writes, the real problem, especially when dealing with infants, is that it could stop you from finding a professional that can heal you.
"While it's reassuring to know that chiropractors are extremely unlikely to break an infant's neck or otherwise cause physical injury, the concern is that parents who take their children to a chiropractor will do so in place of seeing a traditional primary care physician, which could delay the diagnosis and treatment of potentially serious conditions."
That's a risk we should all consider before deciding which medical professional to visit next.
Why mega-eruptions like the ones that covered North America in ash are the least of your worries.
- The supervolcano under Yellowstone produced three massive eruptions over the past few million years.
- Each eruption covered much of what is now the western United States in an ash layer several feet deep.
- The last eruption was 640,000 years ago, but that doesn't mean the next eruption is overdue.
The end of the world as we know it
Panoramic view of Yellowstone National Park
Image: Heinrich Berann for the National Park Service – public domain
Of the many freak ways to shuffle off this mortal coil – lightning strikes, shark bites, falling pianos – here's one you can safely scratch off your worry list: an outbreak of the Yellowstone supervolcano.
As the map below shows, previous eruptions at Yellowstone were so massive that the ash fall covered most of what is now the western United States. A similar event today would not only claim countless lives directly, but also create enough subsidiary disruption to kill off global civilisation as we know it. A relatively recent eruption of the Toba supervolcano in Indonesia may have come close to killing off the human species (see further below).
However, just because a scenario is grim does not mean that it is likely (insert topical political joke here). In this case, the doom mongers claiming an eruption is 'overdue' are wrong. Yellowstone is not a library book or an oil change. Just because the previous mega-eruption happened long ago doesn't mean the next one is imminent.
Ash beds of North America
Ash beds deposited by major volcanic eruptions in North America.
Image: USGS – public domain
This map shows the location of the Yellowstone plateau and the ash beds deposited by its three most recent major outbreaks, plus two other eruptions – one similarly massive, the other the most recent one in North America.
The Huckleberry Ridge eruption occurred 2.1 million years ago. It ejected 2,450 km3 (588 cubic miles) of material, making it the largest known eruption in Yellowstone's history and in fact the largest eruption in North America in the past few million years.
This is the oldest of the three most recent caldera-forming eruptions of the Yellowstone hotspot. It created the Island Park Caldera, which lies partially in Yellowstone National Park, Wyoming and westward into Idaho. Ash from this eruption covered an area from southern California to North Dakota, and southern Idaho to northern Texas.
About 1.3 million years ago, the Mesa Falls eruption ejected 280 km3 (67 cubic miles) of material and created the Henry's Fork Caldera, located in Idaho, west of Yellowstone.
It was the smallest of the three major Yellowstone eruptions, both in terms of material ejected and area covered: 'only' most of present-day Wyoming, Colorado, Kansas and Nebraska, and about half of South Dakota.
The Lava Creek eruption was the most recent major eruption of Yellowstone: about 640,000 years ago. It was the second-largest eruption in North America in the past few million years, creating the Yellowstone Caldera.
It ejected only about 1,000 km3 (240 cubic miles) of material, i.e. less than half of the Huckleberry Ridge eruption. However, its debris is spread out over a significantly wider area: basically, Huckleberry Ridge plus larger slices of both Canada and Mexico, plus most of Texas, Louisiana, Arkansas, and Missouri.
This eruption occurred about 760,000 years ago. It was centered on southern California, where it created the Long Valley Caldera, and spewed out 580 km3 (139 cubic miles) of material. This makes it North America's third-largest eruption of the past few million years.
The material ejected by this eruption is known as the Bishop ash bed, and covers the central and western parts of the Lava Creek ash bed.
Mount St Helens
The eruption of Mount St Helens in 1980 was the deadliest and most destructive volcanic event in U.S. history: it created a mile-wide crater, killed 57 people and created economic damage in the neighborhood of $1 billion.
Yet by Yellowstone standards, it was tiny: Mount St Helens only ejected 0.25 km3 (0.06 cubic miles) of material, most of the ash settling in a relatively narrow band across Washington State and Idaho. By comparison, the Lava Creek eruption left a large swathe of North America in up to two metres of debris.
The difference between quakes and faults
The volume of dense rock equivalent (DRE) ejected by the Huckleberry Ridge event dwarfs all other North American eruptions. It is itself overshadowed by the DRE ejected at the most recent eruption at Toba (present-day Indonesia). This was one of the largest known eruptions ever and a relatively recent one: only 75,000 years ago. It is thought to have caused a global volcanic winter which lasted up to a decade and may be responsible for the bottleneck in human evolution: around that time, the total human population suddenly and drastically plummeted to between 1,000 and 10,000 breeding pairs.
Image: USGS – public domain
So, what are the chances of something that massive happening anytime soon? The aforementioned mongers of doom often claim that major eruptions occur at intervals of 600,000 years and point out that the last one was 640,000 years ago. Except that (a) the first interval was about 200,000 years longer, (b) two intervals is not a lot to base a prediction on, and (c) those intervals don't really mean anything anyway. Not in the case of volcanic eruptions, at least.
Earthquakes can be 'overdue' because the stress on fault lines is built up consistently over long periods, which means quakes can be predicted with a relative degree of accuracy. But this is not how volcanoes behave. They do not accumulate magma at constant rates. And the subterranean pressure that causes the magma to erupt does not follow a schedule.
What's more, previous super-eruptions do not necessarily imply future ones. Scientists are not convinced that there ever will be another big eruption at Yellowstone. Smaller eruptions, however, are much likelier. Since the Lava Creek eruption, there have been about 30 smaller outbreaks at Yellowstone, the last lava flow being about 70,000 years ago.
As for the immediate future (give or take a century): the magma chamber beneath Yellowstone is only 5 percent to 15 percent molten. Most scientists agree that is as un-alarming as it sounds. And that its statistically more relevant to worry about death by lightning, shark, or piano.
Strange Maps #1041
Got a strange map? Let me know at email@example.com.
Measuring a person's movements and poses, smart clothes could be used for athletic training, rehabilitation, or health-monitoring.
In recent years there have been exciting breakthroughs in wearable technologies, like smartwatches that can monitor your breathing and blood oxygen levels.
But what about a wearable that can detect how you move as you do a physical activity or play a sport, and could potentially even offer feedback on how to improve your technique?
And, as a major bonus, what if the wearable were something you'd actually already be wearing, like a shirt of a pair of socks?
That's the idea behind a new set of MIT-designed clothing that use special fibers to sense a person's movement via touch. Among other things, the researchers showed that their clothes can actually determine things like if someone is sitting, walking, or doing particular poses.
The group from MIT's Computer Science and Artificial Intelligence Lab (CSAIL) says that their clothes could be used for athletic training and rehabilitation. With patients' permission, they could even help passively monitor the health of residents in assisted-care facilities and determine if, for example, someone has fallen or is unconscious.
The researchers have developed a range of prototypes, from socks and gloves to a full vest. The team's "tactile electronics" use a mix of more typical textile fibers alongside a small amount of custom-made functional fibers that sense pressure from the person wearing the garment.
According to CSAIL graduate student Yiyue Luo, a key advantage of the team's design is that, unlike many existing wearable electronics, theirs can be incorporated into traditional large-scale clothing production. The machine-knitted tactile textiles are soft, stretchable, breathable, and can take a wide range of forms.
"Traditionally it's been hard to develop a mass-production wearable that provides high-accuracy data across a large number of sensors," says Luo, lead author on a new paper about the project that is appearing in this month's edition of Nature Electronics. "When you manufacture lots of sensor arrays, some of them will not work and some of them will work worse than others, so we developed a self-correcting mechanism that uses a self-supervised machine learning algorithm to recognize and adjust when certain sensors in the design are off-base."
The team's clothes have a range of capabilities. Their socks predict motion by looking at how different sequences of tactile footprints correlate to different poses as the user transitions from one pose to another. The full-sized vest can also detect the wearers' pose, activity, and the texture of the contacted surfaces.
The authors imagine a coach using the sensor to analyze people's postures and give suggestions on improvement. It could also be used by an experienced athlete to record their posture so that beginners can learn from them. In the long term, they even imagine that robots could be trained to learn how to do different activities using data from the wearables.
"Imagine robots that are no longer tactilely blind, and that have 'skins' that can provide tactile sensing just like we have as humans," says corresponding author Wan Shou, a postdoc at CSAIL. "Clothing with high-resolution tactile sensing opens up a lot of exciting new application areas for researchers to explore in the years to come."
The paper was co-written by MIT professors Antonio Torralba, Wojciech Matusik, and Tomás Palacios, alongside PhD students Yunzhu Li, Pratyusha Sharma, and Beichen Li; postdoc Kui Wu; and research engineer Michael Foshey.
The work was partially funded by Toyota Research Institute.
How imagining the worst case scenario can help calm anxiety.
- Stoicism is the philosophy that nothing about the world is good or bad in itself, and that we have control over both our judgments and our reactions to things.
- It is hardest to control our reactions to the things that come unexpectedly.
- By meditating every day on the "worst case scenario," we can take the sting out of the worst that life can throw our way.
Are you a worrier? Do you imagine nightmare scenarios and then get worked up and anxious about them? Does your mind get caught in a horrible spiral of catastrophizing over even the smallest of things? Worrying, particularly imagining the worst case scenario, seems to be a natural part of being human and comes easily to a lot of us. It's awful, perhaps even dangerous, when we do it.
But, there might just be an ancient wisdom that can help. It involves reframing this attitude for the better, and it comes from Stoicism. It's called "premeditation," and it could be the most useful trick we can learn.
Broadly speaking, Stoicism is the philosophy of choosing your judgments. Stoics believe that there is nothing about the universe that can be called good or bad, valuable or valueless, in itself. It's we who add these values to things. As Shakespeare's Hamlet says, "There is nothing either good or bad, but thinking makes it so." Our minds color the things we encounter as being "good" or "bad," and given that we control our minds, we therefore have control over all of our negative feelings.
Put another way, Stoicism maintains that there's a gap between our experience of an event and our judgment of it. For instance, if someone calls you a smelly goat, you have an opportunity, however small and hard it might be, to pause and ask yourself, "How will I judge this?" What's more, you can even ask, "How will I respond?" We have power over which thoughts we entertain and the final say on our actions. Today, Stoicism has influenced and finds modern expression in the hugely effective "cognitive behavioral therapy."
Helping you practice StoicismCredit: Robyn Beck via Getty Images
One of the principal fathers of ancient Stoicism was the Roman statesmen, Seneca, who argued that the unexpected and unforeseen blows of life are the hardest to take control over. The shock of a misfortune can strip away the power we have to choose our reaction. For instance, being burglarized feels so horrible because we had felt so safe at home. A stomach ache, out of the blue, is harder than a stitch thirty minutes into a run. A sudden bang makes us jump, but a firework makes us smile. Fell swoops hurt more than known hardships.
What could possibly go wrong?
So, how can we resolve this? Seneca suggests a Stoic technique called "premeditatio malorum" or "premeditation." At the start of every day, we ought to take time to indulge our anxious and catastrophizing mind. We should "rehearse in the mind: exile, torture, war, shipwreck." We should meditate on the worst things that could happen: your partner will leave you, your boss will fire you, your house will burn down. Maybe, even, you'll die.
This might sound depressing, but the important thing is that we do not stop there.
Stoicism has influenced and finds modern expression in the hugely effective "cognitive behavioral therapy."
The Stoic also rehearses how they will react to these things as they come up. For instance, another Stoic (and Roman Emperor) Marcus Aurelius asks us to imagine all the mean, rude, selfish, and boorish people we'll come across today. Then, in our heads, we script how we'll respond when we meet them. We can shrug off their meanness, smile at their rudeness, and refuse to be "implicated in what is degrading." Thus prepared, we take control again of our reactions and behavior.
The Stoics cast themselves into the darkest and most desperate of conditions but then realize that they can and will endure. With premeditation, the Stoic is prepared and has the mental vigor necessary to take the blow on the chin and say, "Yep, l can deal with this."
Catastrophizing as a method of mental inoculation
Seneca wrote: "In times of peace, the soldier carries out maneuvers." This is also true of premeditation, which acts as the war room or training ground. The agonizing cut of the unexpected is blunted by preparedness. We can prepare the mind for whatever trials may come, in just the same way we can prepare the body for some endurance activity. The world can throw nothing as bad as that which our minds have already imagined.
Stoicism teaches us to embrace our worrying mind but to embrace it as a kind of inoculation. With a frown over breakfast, try to spend five minutes of your day deliberately catastrophizing. Get your anti-anxiety battle plan ready and then face the world.
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