Can You Get Addicted to Chiropractic?

How long will I need to keep going to the chiropractor?

Nobody wants to be an addict. Dependency on anything is a miserable experience. It can be very disempowering to “need” something to feel good. So, can you get addicted to chiropractic?

The top three concerns about starting chiropractic care that I hear are:

  • It’s going to be too expensive if my insurance doesn’t cover it and I’m not sure it will work anyway. I don’t want to risk my hard earned cash and free time to do this without knowing for sure that it will work.
  • Someone told me it’s dangerous and I am worried it will hurt or injure me. 
  • I’ve heard that once you start chiropractic care you need to keep going for the rest of your life.

This post is going to address that third concern. Is chiropractic addictive? Does chiropractic create dependence? 

Does Chiropractic Create Dependence?

Even when something is good and healthy for us, dependence on it isn’t. When you ask a chiropractor if chiropractic can make you dependent on itself, you’re probably going to get something similar to the following metaphor. It goes like this 

“When you go to the gym you don’t get in shape in a single session, it takes time. Once you are in shape, you’ll get out of shape if you don’t go back to the gym from time to time. It’s similar with chiropractic. It takes time and repetition to get your spine back in alignment and once it’s there you’ll need follow up care to maintain that alignment. It’s not that your body is dependent on the gym or chiropractic. You feel better after each of them because our bodies need regular maintenance.”

It’s a nice metaphor. It’s fairly accurate. But it doesn’t tell the whole story and it doesn’t work for everyone. 

The gym/working out is something anyone can do anywhere. I could get in a workout in the bathroom of the Starbucks where I am writing this post. You don’t even need weights, just a little bit of knowledge and motivation. 

Chiropractic is a semi-luxury service that requires a chiropractic practitioner. 

I can tell someone that exercise is important and they will need it multiple times a week for the rest of their lives with zero ethical concerns. They can do it themselves. They do not need me or anyone else for it. And it is free.

That’s not the case with chiropractic. They will need to pay a chiropractor for adjustments and take time out of their day to get adjusted each time they receive a chiropractic service. To recommend someone start doing this if it will require they need it for the rest of their lives would be unethical unless absolutely necessary. So is it necessary and does it create dependence? As it is with most things, a simple yes or no doesn’t answer the question completely.

Is lifetime care necessary and does it create dependence?

It depends… What are your health goals and how self directed are you? What does your past health history look like? There is nothing that the chiropractic adjustment does that fundamentally changes the way the body works so that adjustments are necessary going forward. It’s not like drugs or alcohol that the body can become physically dependent upon to function. So it is not physically addictive and does not create dependence.

The truth is that whether lifetime chiropractic care is necessary or desirable depends upon many factors. Some of these are the personality and goals of the patient and the scope of care the practitioner offers.

Low Motivation Patients

Some people aren’t very motivated to take an active role in their healing. Even presented with home care options they chose to remain passive in their healthcare. These people will always need regular chiropractic care to maintain a modicum of spinal well-being. Even the best chiropractor in the world cannot bring these peoples spines to a high level of health expression. It’s impossible to have a healthy spine without a regular movement and exercise practice. 

But I can usually keep those people out of pain for decades if they see me at regular intervals. Some of them are 100% ok with that. Are they dependent upon chiropractic? Not really. But they do lack the discipline and or motivation to keep their spine healthy at home. They need something or someone to help patch up the problems their inactivity creates. That might be a PT, chiropractor, massage therapist, or surgeon. They aren’t dependent on chiropractic in specific. They are dependent upon any passive modality that mitigates their poor lifestyle choice. 

This patient also has a high potential to become frustrated with needing care so frequently just to feel good. The frustration comes from wanting a quick and long lasting cure to a problem that took years to develop. It’s going to take time to correct it and active effort to truly heal through it for the long term. These frustrated patients are a common source for the rumor that once you start going to the chiropractor you need to keep coming back. 

Sometimes this type of Dr. Patient relationship becomes codependent. The practitioner needs a steady source of income. The patient needs someone to mitigate the consequences of an inactive lifestyle. It’s a codependent match. The two will see each other every week or two for decades. The doctor gets paid and the patient can feel decently ok for a very long time without having to take an active role in the process.

Highly Damaged Patients

Some people have horrific health histories that involve extensive damage to their spine. Some of these people will never regain pre-injury status. It doesn’t matter how much rehab they do, or how motivated and disciplined they are. They will always need a combination of active and passive modalities by a variety of practitioners to enjoy life as much as possible. Again, they are not dependent upon chiropractic in specific. They need a whole team of people for the rest of their lives realistically. So there’s no chiropractic dependence here either.

Highly Motivated and Self Directed Patients

These people have the highest capacity for autonomy and self direction. They are motivated to recover and take an active role in the process. These people are a phenomenal fit for chiropractic offices, but not all chiropractic offices. These patients often progress very well early in care. They quickly arrive to a place where they are feeling better than they have for years. But, if the practitioner isn’t the right fit for this type of patient they will get frustrated soon after.   

This patient is the opposite of codependent. They place a high value on independence and will put in the work to attain it. So, if they find themselves in a chiropractic office dominated by codependence, they get frustrated and wonder why they need to keep coming. This may even create problems with self image. The patient may begin feeling irreparably broken or disempowered. 

The problem here is a mismatch between the type of patient and the type of practitioner. This type of patient needs a doctor who is willing and able to share information and strategies that empower the patient to take control of their own health as much as possible. 

If this patient comes across a chiropractor that teaches active and personalized spinal care strategies, its a match. The patient will feel empowered in their healing process and feel seen and heard. It’s thrilling for the chiropractor to see the patient achieve their goals. 

There are even chiropractors who work in a progressive achievement model. These chiropractors help this type of patient achieve higher levels of health than they have experienced before. Rather than returning the patient to a previous baseline they help them past it. This might be through developing novel central nervous system strategies, and or movement and lifestyle coaching. The highly motivated and self directed patient will at this point begin seeing the practitioner as a guide or coach. 

I describe this practice model as a progressive practice model.

How does a progressive model work?

Number one, the goal of a progressive care model is not to simply get patients out of pain. It’s about reversing the spinal degeneration process through the restoration of function. Pain relief is a side effect. It’s about building resilience into the body so it can support us throughout our lives in whatever we do. 

When I practiced in a progressive model I followed a four step process for working at the physical level. The process was borrowed from Czech neurologist Vladimir Janda.

The four steps are:

  • Normalize the periphery
  • Restore muscle balance
  • Increasing reflex stabilization
  • Build endurance into the now functional spine. 

Chiropractic adjustments are great at step one. The enhance interoception and stimulate mechanoreception. To break that down a little, interoception is the brains ability to sense what is happening within the body. It requires energy and attention. Often we are exteroceptively focused – meaning focused on what is happening outside of us. Being exteroceptive dominant usually happens when we are experiencing something stressful or stimulating.

Step 1:

When we are in environments our brain perceives as stressful or stimulating, we allocate attention resources to the outside world. This is detrimental to our body in the long term. Fine tuned posture requires a lot of attention on the control of small muscles and joints. When we are exteroceptively dominant we shift our postural focus to crude movement strategies that use large muscles. This places us at risk for injuries, leads to joint degeneration, and alters our posture and mobility. 

Chiropractic helps to break that outside focus and shift attention back to fine tuned cotnrol of posture and movement. 

Chiropractic helps create the possibility for step two. Chiropractic can even be a part of the process during step two. In fact, because it can enhance interoception, which all of these steps need, it can be useful throughout the process. 

Step 2:

Restoring muscle balance is an active process on the part of the patient that is safely accelerated by a practitioner. This is where specific postural exercises, physiotherapy, and yoga etc, come into play. Having a practitioner who understand functional and dysfucntional movement patterns can be invaluabe in this stage. A chiropractor in a progressive model may help with this, or find someone who can. 

Step 3:

Increasing reflex stabilization involves adding proprioceptive challenges to the the body. In essence it is the balanced integration of interoception and exteroception together. It’s like teaching the brain how to multitask efficiently. It helps to create fine tuned balance and control while still managing to interact with a complex and demaning outside world. This can look like work on a balance ball, eyes closed work, challenging but fine tuned movement such as dance or martial arts etc. 

Step 4:

Building endurance is about increasing the capacity built in step three. It’s not about strength here, it’s about endurance, because fatigued muscles behave neurologically like damaged muscles. It looks just like step three, but the amount of work done is more.

This type of practice works for the motivated patient because most of the work can be done by the patient at home. When someone has things they need to do or accomplish in life, this type of practice gets the job done. It gives that type of person a solid background support system to move forward from. Having a healthy spine is essential for us to easily and fully access the gifts of an optimal form/structure/posture. Almost anything we do, we do better when our spine is healthy and functioning optimally.

Interdependence

Evolutionary biology is something else to keep in mind when we ask this question “can you become dependent upon chiropractic?”

Human beings are social apes. Social apes engage in social grooming behaviors. They take care of each other. They pick bugs off of each other, they groom hair etc. These apes receive health benefits from engaging in this practice. As we evolved into humans we developed this social grooming practice into the healing arts such as massage and other forms of bodywork, herbalism, and medicine.

We literally evolved to be interdependent for our health and wellbeing. You aren’t weaker or insufficient because you need help sometimes. It’s a part of being human. Being open to receiving that gift from people you can trust, who care for you, or fulfill the role of healer/health practitioner as a career, is something that will enrich your life in the long term.

This interdependence is different from dependence or codependence. It is something that enriches us and enhances our experience of life. What determines the difference is the mindset and resourcefulness of the practitioner and the client. When both are approaching a health concern from a place of high resourcefulness the practitioner becomes an assistant to the client on that clients own journey towards health and healing. It is not something the practitioner gives to the client passively.

It is teaching someone to fish rather than feeding them one meal at a time. That might mean feeding them a few meals and setting them up with fishing gear and the know-how to use it for a while. But that is very different from giving out meal, after meal, after meal. That is the difference between dependence/codependence in the healing relationship vs interdependence.

In conclusion

Whether or not a patient is satisfied with the type of care plan their chiropractor is offering, and whether they get the long term results they are looking for, often depends on the type of person they are, and what their chiropractor is offering. If there is a mismatch between the personality of the patient and chiropractor, or what that chiropractor is offering in their practice, the patient may perceive that they are being trained into a dependence on chiropractic. Clear communication about goals, and knowledge about your level of self motivation are very important when choosing a chiropractor.

And, to reiterate once again, you aren’t dependent upon chiropractic to keep feeling good, you’re dependent upon the effort and discipline required for any biological system to maintain itself in a state of high wellbeing. You can educate yourself and put the effort in to maintain yourself in a high state of wellbeing, but at some point you will need assistance. It is part of being human. We are social apes, we are interdependent, we heal each other, and that is something beautiful we should celebrate.

Photo credit Photo by Joyce McCown on Unsplash

thewildchiro

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