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Joe Rogan and chiropractic.
It’s been almost four years since Joe Rogan released an episode of his podcast that addressed why he thinks chiropractic is bologna.
My Take on the Joe Rogan Chiropractic Claims
Truthfully, I’m a bit late to the party and hadn’t listened to it until I decided to write this blog post, and I am so happy that I did.
An old, favorite article of mine, a transcription from a lecture, tackles why it is so important to disagree.
A disagreement between two individuals allows both parties to learn, gain perspective, and push forward new ideas.
So, Joe, I respectfully disagree with the majority of the claims made throughout your podcast.
I’m going to take this opportunity and this platform to address some of the more misinformed points that were made.
Joe Rogan Chiropractic Claim #1: The Chiropractic Education
Throughout the discussion on this episode, it’s clear that there is some confusion regarding the education received in chiropractic school.
The question is exasperatedly asked about the educational program “What the f*** could they possibly be teaching you for four years?”.
This will be a quick one to address.
The Council on Chiropractic Education (CCE) is the accrediting body for chiropractic schools across the United States and is recognized by the Department of Education.
Throughout a three-to-four-year chiropractic program (depending on the school), students can expect to spend a minimum of 4,200 hours receiving both didactic and clinical instruction.
These curricular hours are equivalent to any other ‘professional doctoral-level education in a health science discipline.’
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Throughout these hours, chiropractic students become competent in many topics, all falling under what the CCE refers to as ‘Clinical Education Meta-Competencies.’
There are eight of these meta-competencies: assessment and diagnosis, management plans, health promotion and disease prevention, communication and record-keeping, professional ethics and jurisprudence, information and technology literacy, chiropractic adjustment/manipulation, and inter-professional education.
These areas are all expanded upon more specifically here.
Chiropractic schools ensure that their students are not just knowledgeable in these areas but proficient.
Joe Rogan Chiropractic Claim #2: Podiatry
Next, I’d like to speak to the few minutes of the podcast where Joe compares chiropractors to podiatrists.
He goes through the gamut of explaining that podiatrists have a medical residency, states it is an actual science of studying the foot.
Further, it implies that the fact of podiatrists working in hospitals gives their profession more legitimacy.
This is not a jab at podiatry from me; I respect their profession and their scope of practice.
What I disagree with is the sense of false equivalence applied to the situation; Joe is comparing apples to oranges.
I want to take this opportunity to provide him with some more information about the current role and scope of chiropractors.
Since this episode’s initial airing, chiropractors have been integrated into numerous Veterans Affairs and Department of Defense facilities across the United States.
Additionally, the National Board of Chiropractic Examiners (NBCE) 2020 Practice Analysis of Chiropractic reported an almost 2% increase in chiropractic doctors who hold staff privileges at hospitals.
This may seem like a small percentage, but in the span of a few years shows incredible growth.
A study on chiropractic integration into a Minnesota hospital also had favorable results.
The authors reported that “within six months, the care system hired a second chiropractor because of increasing demand, patient volumes, and interest in expanding chiropractic services to a different geographic region”. (1)
Even further than hospital settings, integrated practice models are becoming increasingly popular amongst conservative care providers.
The same practice analysis from the NBCE showed over 15% of chiropractors report working in a multi-disciplinary healthcare facility.
Not only is the role of chiropractic becoming more apparent in different healthcare settings, but there is also organizational support from places like the American College of Physicians, the North American Spine Society, and the Food and Drug Administration.
Suppose recognition in these settings is how Joe measures a healthcare professional’s legitimacy.
In that case, this should surely suffice as enough evidence for him to recognize chiropractic’s current role in settings outside of private practice.
Joe Rogan Chiropractic Claim #3: Lobbying
With time, there has been a push for research regarding conservative care, especially in response to the growing prevalence of pain-related conditions and the still-growing opioid crisis.
Joe paints a mostly negative picture of chiropractic lobbying in the 1970s which pushed the AMA and other insurance companies to finally accept the chiropractic profession into the healthcare system.
Today, lobbying efforts still occur between the chiropractic profession and legislators, specifically regarding increasing access to care.
The treatment of low back and neck pain in the United States demonstrates a considerable and growing expense to the healthcare system (2, 3).
Within this system, patients with low back pain used to be sent for an expensive diagnostic test like an MRI or CT.
They were then further recommended to undergo costly surgical procedures or receive dangerous prescriptions to manage their pain (CDC on opioids, cost of low back surgeries).
Enter chiropractic.
With the ability to effectively diagnose patients with musculoskeletal low back pain and efficiently refer patients with more severe conditions, a Doctor of Chiropractic can offer less invasive care to patients and more cost-effective care.
One study surveyed more than 12,000 patients with low back and neck pain and used propensity scores to determine their healthcare expenditure.
Results showed lower costs associated with complementary and integrative care, including chiropractic, acupuncture, massage, or herbalism.
Authors noted that roughly three-quarters of these patients’ services included chiropractic care and did a further chiropractic-specific sub-analysis of the data—and found the same result: lower costs. (4)
From an ill-advised perspective, it may seem like chiropractors are pushing an ‘agenda,’ but I hope this offers some clarity.
Lobbying is not for our bottom line; it improves the health care system by reducing expenditure while offering patients less invasive and safer care options.
It really is a win-win for everyone.
Joe Rogan Chiropractic Claim #4: “The Pop”
Last but not least, let’s talk about the chiropractic adjustment.
Spinal manipulation.
The “crack.”
Joe expresses confusion about what this is, asking his guest, “What are they doing when your back pops? Is it nitrogen being released?”
To which the tentative response is given:
“I think it’s just moving around air bubbles…they are moving around your back in a way that it naturally moves.”
I want to point out that for all the cherry-picked information presented in this podcast, this is the one sentence that didn’t get it completely wrong.
It’s an extraordinarily watered-down version of what spinal manipulation is, but it’s not wrong, and it illustrates the inherent safety of an adjustment.
We’ve already touched on chiropractic education, which for most entails not just years of sciences but years practicing spinal manipulation under the watchful eye of experienced chiropractic clinicians offering advice and feedback.
The pop’s technical word is tribonucleation, and I won’t bore you with the nitty-gritty physiologic details.
Yes, it is air bubbles moving, just maybe not in the way you would think.
Several studies analyze the benefits of spinal manipulation to patients, including the stretching or disruption of adhesions formed around the joints in the spine, which can cause pain (5, 6).
Spinal manipulation, administered by DCs, DOs, and PTs alike, is described in another study as applying a force (varying in location, velocity, amplitude, and duration) by hand with therapeutic intent (7).
To summarize, using the Joe Rogan Chiropractic podcast’s words, spinal manipulation is moving around your back in a way that it naturally moves – but chiropractors help you do it better and with less pain.
As discussed in your podcast, frontal lobotomies and thalidomide were regarded as routine medical care until research existed showing the dangers.
Research supporting spinal manipulation and the chiropractic profession seems to be surfacing daily.
I assure you the profession is changing and is becoming more evidence-based than ever.
So, to Joe Rogan chiropractic claims …
Joe – If you read this, I do want to say that I’m sorry you had such a poor experience with chiropractic, and I would urge you to host a chiropractor on your show one day.