Inside Chiropractic: A Former Insider on Pseudoscience, Sales Tactics, and Finding Real Relief
Published: March 14, 2026
By J. Michael Menke (as reported and summarized)
Confessions of a Former Chiropractor: What the Profession Doesn’t Want You to Know
A former chiropractor turned statistician pulls back the curtain on chiropractic practice, revealing the gap between marketing and evidence, the high-pressure sales culture, and how patients can protect themselves while seeking real, lasting relief.
If you’ve ever been told you need “36 visits to fix your spine” or that a quick neck crack will cure everything from headaches to allergies, you’re not alone. Many people walk into a chiropractic office for a simple stiff neck or back twinge—and walk out with a long-term care plan, a pre-payment contract, and a head full of big promises.
In this article, we draw from the experience of skeptic chiropractor-turned-statistician J. Michael Menke, along with current research, to explore what really happens behind the scenes: the pseudoscience, the sales culture, the millionaire “practice coaches,” and why helping “50 percent of patients” is far less impressive than it sounds.
From Chiropractic True Believer to Data-Driven Skeptic
Menke entered chiropractic much like many of his colleagues: with the genuine desire to help people in pain. In the 1980s he, like many patients, first saw a chiropractor for a stubborn stiff neck that wasn’t improving. Enthusiastic testimonials from coworkers and friends sold the dream: non-drug, non-surgical relief that sounded almost miraculous.
Over time, Menke became not just a practitioner but a careful observer. As he moved into statistics and outcomes research, he began to compare what patients were told with what the data actually showed. The deeper he looked, the more he saw a troubling pattern:
- Big claims about what adjustments could do, with little high-quality evidence.
- Strong financial incentives to keep patients coming back for months or years.
- Coaching systems that prioritized revenue over realistic outcomes.
“When I ran the numbers honestly, it was hard to escape the conclusion: if half of my patients were getting better, that also meant half weren’t. Yet the profession was celebrating those results as if they were stellar.”
Menke’s shift from hands-on adjusting to data analysis didn’t make him anti-chiropractic. Instead, it made him deeply critical of claims that outrun the evidence and of a business model that can quietly nudge practitioners away from science and toward salesmanship.
The Core Problem: When Belief and Business Trump Evidence
Chiropractic exists on a spectrum. On one end, there are evidence-informed clinicians focused on short-term, pain-focused care—especially for lower back pain, neck pain, and some types of headaches. On the other end, there are practitioners who still lean heavily on century-old ideas about “subluxations” blocking vital energy and causing virtually any disease.
Menke’s critique focuses on several recurring themes that appear across the profession, especially in high-volume, sales-driven practices:
- Pseudoscientific claims
Spinal “misalignments” are often blamed for asthma, colic, immune problems, infertility, and more—without convincing evidence from rigorous trials. - Overtreatment and “lifetime care” plans
Patients with mild, self-limiting episodes are sometimes enrolled in months of care, told that stopping will lead to degeneration or serious illness. - Sales culture and practice coaches
“Millionaire coach” programs teach scripts, objection handling, and fear-based marketing that can overshadow honest, shared decision-making. - Selective use of statistics
Success stories and favorable numbers are highlighted, while non-responders and negative results are downplayed or ignored.
Pseudoscience in Chiropractic: Subluxations, Scans, and Scary Stories
One of Menke’s strongest criticisms targets the enduring role of the chiropractic “subluxation”—a supposed spinal misalignment that interferes with nervous system function and causes disease. Modern imaging and anatomy research have not validated this concept in the way it’s often marketed to patients.
Common pseudoscientific elements
- “Your X-rays show terrible degeneration”
While imaging can reveal structural changes, many findings (like mild disc bulges or age-related changes) are extremely common in pain-free people. Overinterpretation can create fear and dependence. - Thermography and “nerve scans” as scare tools
Some clinics use colorful thermal or surface EMG scans to “prove” widespread dysfunction, though these tools are often poorly validated for routine clinical decision-making. - Huge promises for non-musculoskeletal conditions
Claims that adjustments can treat conditions like infections, metabolic disorders, or autoimmune disease generally lack robust scientific support.
“People with back pain are often vulnerable, scared, and looking for hope. That’s exactly when the temptation to oversell benefits is strongest—and when honest science matters most.”
Inside the Sales Culture: How Patients Become “Long-Term Revenue”
Menke describes a system in which many chiropractors are trained not just to adjust spines, but to think like high-pressure salespeople. Practice-management seminars and millionaire coaches teach detailed systems for converting visitors into long-term, pre-paying clients.
Typical sales strategies you might encounter
- Free screenings and dinner talks
These events often highlight dramatic success stories and worst-case scenarios, priming attendees to feel urgency and fear. - Day 1–Day 2 “report of findings” scripts
New patients are sometimes shown alarming X-rays or scans, then presented with a pre-packaged treatment plan (e.g., 36 visits over 6 months). - Prepayment and “discounted” contracts
Patients are pushed to pay thousands of dollars upfront, often framed as a limited-time offer or special package. - Emotion-based objections handling
If someone hesitates, they may hear lines questioning their commitment to their health or emphasizing the risk of “doing nothing.”
“I realized I was being taught how to close deals, not how to have honest conversations about uncertainty, natural recovery, or alternative options.”
Why “Helping 50% of Patients” Is Not a Triumph
One of Menke’s most provocative observations concerns how chiropractors talk about outcomes. A clinic may proudly claim that “half our patients improve significantly,” framing it as solid proof that their approach works. But from a statistics standpoint, that’s not necessarily impressive—especially when many musculoskeletal problems improve on their own.
Understanding outcomes in context
- Natural history of pain
Many episodes of back or neck pain improve over weeks even without formal treatment. Any intervention during that window will “look” helpful. - Placebo and contextual effects
Hands-on care, a confident practitioner, and regular attention can all produce genuine symptom relief, even if the underlying theory is flawed. - Missing the comparison group
Saying “50% improved” means little without comparing to patients who received other care—or no care at all.
When Menke began analyzing real-world outcome data, he noticed that the profession often stopped short of asking the toughest question: do our methods clearly outperform simpler, cheaper, or safer alternatives?
What Chiropractic May Help With—And What It Probably Won’t
Despite the serious concerns Menke raises, there is a role for chiropractic-style care in modern healthcare—especially when it is stripped of grandiose claims and integrated into a broader, evidence-based approach.
Where evidence is reasonably supportive
- Acute and some chronic low back pain
Multiple guidelines and reviews (for example, from the American College of Physicians and various systematic reviews up to the mid-2020s) support spinal manipulation as an option for non-specific low back pain. - Some neck pain and tension-type headaches
Manual therapy, including manipulation and mobilization, can provide short-term relief for some patients. - Adjunct to exercise and education
Hands-on care may help people stay active and engaged with rehab exercises, which often drive longer-term improvement.
Where claims outrun the evidence
- Internal organ diseases (e.g., asthma, heart disease, diabetes).
- Immune “boosting” or protection from infections purely via adjustments.
- Developmental disorders or neurodiversity (e.g., ADHD, autism) as primary treatment.
High-quality randomized controlled trials in these areas are either negative, weak, or absent. When a chiropractor frames spinal manipulation as a near-universal solution, they are moving away from mainstream science and into ideology.
Red Flags in a Chiropractic Office: What Menke Wishes Patients Knew
Drawing on Menke’s insider experience and broader research, here are common warning signs that a practice may be driven more by ideology and income than by evidence and ethics.
Watch out for these patterns
- High-pressure prepaid plans
If you’re encouraged to sign a long-term contract with dozens of visits after just one or two sessions, pause and seek another opinion. - Fear-based messaging
You’re told that not following the plan will lead to arthritis, degeneration, or serious illness—even if your current issue is mild. - Grand, non-musculoskeletal claims
Adjustments are promoted as primary treatment for asthma, infertility, infections, or most childhood conditions. - Discouraging mainstream care
The chiropractor regularly disparages medical doctors, vaccinations, evidence-based medications, or imaging without nuance. - Minimal assessment, same treatment for everyone
Every patient gets nearly identical adjustments regardless of diagnosis, severity, or response to care.
“By the time I left practice, I realized the most ethical thing I could do for many people was simple: reassure them, encourage movement, and avoid putting them through a year of unnecessary visits.”
How to Find a Science-Friendly, Patient-Centered Chiropractor
Menke’s story doesn’t end with “never see a chiropractor again.” Instead, it’s a call to be selective and informed. Many chiropractors are moving toward evidence-based practice, focusing on short-term pain relief, functional improvement, and collaborative care.
Green flags to look for
- Clear, modest claims
They focus on back/neck pain, some headaches, and musculoskeletal issues—without promising miracle cures. - Short, test-and-see trial of care
They propose a limited number of visits (e.g., 4–6) to see if you respond before discussing longer plans. - Encouragement of movement and self-management
You receive exercises, education, and strategies to rely less on passive care over time. - Collaboration with other providers
They’re open to involving your primary care provider, physical therapist, or specialist when needed. - Respect for your autonomy
You feel free to say no to treatments, plans, or imaging without being shamed or pressured.
A Realistic Case Study: Stiff Neck in the 1980s vs. Today
Menke’s own journey started with a stubborn stiff neck in the 1980s that hadn’t improved for a month. A coworker swore by her chiropractor, insisting he had “fixed” problems that doctors couldn’t touch. That social proof—and his own frustration—made the decision easy.
The experience that followed was powerful: hands-on attention, a clear narrative about what was “wrong,” and a sense of hope. His neck improved, and the improvement seemed to confirm the story he had been told about subluxations and alignment. It felt like a revelation.
Looking back with statistical training and decades of research in hand, Menke offers a more nuanced interpretation:
- The neck pain might have improved on its own over the next few weeks.
- The placebo effect and therapeutic relationship likely contributed.
- Some specific aspects of manual therapy may indeed have helped mobility and pain.
The challenge, he notes, is separating the meaningful signals from the noise of natural recovery and expectation. For patients today, that means appreciating the short-term benefits of hands-on care without buying into unsupported long-term narratives or expensive contracts.
Practical Steps to Protect Yourself While Seeking Relief
Whether you’re currently seeing a chiropractor or considering your first visit, you don’t have to become an expert overnight. A few grounded habits can dramatically improve your odds of getting help without being misled or overtreated.
Before your first visit
- Check licensing and any disciplinary record in your region.
- Scan their website: do they claim to treat dozens of unrelated diseases?
- Ask friends or your primary care provider for recommendations to evidence-based clinicians.
During the visit
- Notice how much time is spent listening vs. selling.
- Ask about likely duration of care and specific goals (pain reduction, function, return to activity).
- Request plain-language explanations; avoid jargon-heavy pitches.
If you feel pressured
- Tell them you’d like to think over any long-term contracts.
- Seek a second opinion from another chiropractor, physical therapist, or physician.
- Remember you are never obligated to continue care that doesn’t feel right or helpful.
What the Broader Research and Expert Guidelines Say
Menke’s insider critique aligns with a broader scientific landscape that is cautiously supportive of some chiropractic interventions while strongly skeptical of others. Over the past decades, major guidelines and reviews have converged on a few themes:
- Manual therapy as one option
Spinal manipulation can be considered among several options for non-specific back and neck pain, usually alongside exercise and education. - Limited role for routine imaging
Unnecessary X-rays for simple acute back pain are discouraged by most guidelines due to limited benefit and small radiation risks. - Emphasis on staying active
Early return to normal activities, graded exercise, and self-management strategies often provide more lasting benefit than passive treatments alone.
Reliable overviews from organizations such as the Cochrane Collaboration, national health services, and specialty societies consistently point to a middle ground: chiropractic manipulation isn’t magic, and it isn’t useless—it’s a tool with modest benefits for some people in specific situations.
Moving Forward: Balanced Skepticism, Compassionate Care
Menke’s confessions are uncomfortable—especially if you’ve placed a lot of trust in chiropractic. Yet his goal isn’t to shame patients or paint all chiropractors with the same brush. It’s to highlight how easily good intentions can be hijacked by tradition, belief, and business models that reward volume more than value.
You don’t need to swear off manual therapy or feel guilty for past choices. Instead, you can:
- Keep using what genuinely helps, as long as it’s safe and affordable.
- Ask more questions about evidence, risks, and alternatives.
- Walk away from fear-based sales pitches and miracle claims.
Relief is a reasonable hope. So is honesty. You deserve both.
If you’re currently in care that doesn’t feel quite right, consider this your permission slip to pause, reflect, and explore other options. And if you’re a clinician reading this, Menke’s journey is a reminder that courage sometimes means looking at your own numbers—and being willing to change course when they don’t match the story you’ve been telling.
Next step: Take five minutes to list your questions and concerns about any current or planned chiropractic care. Bring that list to your next appointment—and notice how your practitioner responds. Their reaction will tell you almost as much as their treatment.
