26/01/2026
The "No Crack Chiro": Why I'm leaving manual therapy behind...
For a long time I have been unimpressed with the results we see from manipulating the spine. In my day to day clinic I noticed that it would work sometimes for some people for certain things but the effects would usually wear off after a day or two. For some people it made things worse. It was very often getting in the way of spending time trying to work out what was really causing the problem.
The latest evidence we have for the actual effect of what manipulating the spine actually does is underwhelming to say the least. We can now prove that for some people it provides some temporary pain reduction and a feeling of reduced stiffness but for some it does nothing. So it wasn't just me.
There's also enough evidence out there to suggest that manipulating the neck can be catastrophically dangerous for some people, so offering that became less tempting very quickly.
I noticed a marked change in the expectations that new patients would have when coming to see me post pandemic. Tik Tok, and social media in general, has created an astonishingly unrealisitic version of what chiropractors can do by clicking spines. Plenty of newbies were only willing to come for one visit to magically fix a long term health issue. Added to this is a rise in keyboard warriors, happy to trash the reputation of businesses online by leaving scathing reviews rather than having adult conversations. So to try and keep people happy by providing a treatment I had doubts about only to then get a digital kicking was getting beyond boring.
And yes, I got older. I changed my mind and wised up about a few things. I now know that back pain doesn't come from bad posture, or uneven leg length, or a bad mattress or misalignments in the spine or a weak core. I especially know that pain is a complicated phenomenon that most often reflects what is going on in your life and not just your spine. If we are to make a real difference to people whose life is blighted by pain, then we need to get real about this.
In winter of 2024 I decided I would pack it all in and start afresh. As what I had no idea. So I gave notice to my governing body and associations and planned to walk away. And indeed I did. In June of last year I registered as a non-practicing chiropractor without any intention of coming back. But then a chance encounter with a colleague - who I had mentored as a student and who had now become the head of one of the chiropractic colleges in the UK - urged me to re-think my decision. So after much deliberating I am getting back into clinic as a non-manipulating chiropractor. A no-crack chiro. I want to use my 23 years of experience to help get alongside people with pain to try and make sense of their problem. To offer advice, to offer a second opinion, to coach someone through pain and to help get them to the right specialist if things don't seem right - to work with people, not on them. It takes longer than just getting you on the bed and cracking your bones, but it's what I believe in.
OK. Long post over. My plan is to use this page more over the next few weeks and months FWIW and to try and dispel some of the guff that's out there surrounding back pain in a way that I hope helps someone.