Picking a Bone - Busting the Myth that are "Bone Setters"

The very title of my column (that I write for in the Health Newspaper Magazine) means to have somewhat of a grievance to settle with someone or a certain party. Sometimes this means one would have to get their hands dirty or to grind some gears so to speak. 

In the field of medicine, and when I say medicine, I mean modern medicine that is backed by extensive research and training, there is very little you could find to criticize your colleagues with. However, outside of modern medicine, there are a lot of hocus-pocus that is done in the name of medicine. While some are legitimate alternative or traditional medicine, there is one group of that I just can’t seem to wrap my head around. These are the so-called bone setting experts.

To begin with, the very term bone setting is wrong. These guys don’t do anything to “straighten out” your bones. It is impossible to. Not unless they break it. What they do in their so called manipulation is to merely move your joints a little bit. With this slight movement, they claim to be able to set your bone back to its original position.

But hold up, was the joint even displaced to begin with? In Orthopaedic surgery, joint displacement is generally described in two ways. Its either partially displaced, which we term a subluxation or completely displaced (whereby the two bones that are supposed to be articulating are no longer in contact), which we term dislocation. These conditions are diagnosed through meticulous examination and imaging as well. If any subluxation or dislocation of joints are diagnosed, reduction of said joint is done with sedation and painkillers. There are also patients who present with stiffness in joints that are not displaced. These again can be treated with manipulation, but always done under anaesthesia.

These and only these are the reasons for any medical practitioner to perform any sort of manipulation of the joints. So how these "bone setters" are first of all diagnosing any sort of joint dislocation is beyond me. And for them to perform any sort of manipulation is baffling.

There are also those who treat postural problems like scoliosis, shortening of the leg or even foot deformities. Scoliosis is a condition commonly seen in young teenage girls, whereby there is an S-like deformity of the spine. This condition needs to be treated promptly with either bracing or surgery depending on the child’s age and the severity of the deformity. There have been countless times where these patients unfortunately sought help from “bone setters” first before visiting the doctors. Any manipulation to the spine by these people is not only useless, but worst still could bring harm to the patient as it is delaying the treatment and could cause the deformity to worsen.

I have also seen cases of patients who apparently had difference of length of the legs and were cured after a visit to the "bone setters". In orthopaedic surgery, we define limb length as true or apparent, and we do it with objective measurement. Apparent length basically means the length of your limbs in a position that is natural to the patient. Images that are shown by chiropractors can be easily manipulated by simply repositioning the body. In no way can manipulative adjustments of any joints cure true limb length discrepancy in one visit. And just FYI, its normal for the general population to have a difference in the length of their lower limbs of about 1-2cm.

Some may argue that they have seen videos of patients who were in a great deal of pain and couldn’t move their joints before. And after, they can miraculously move, apparently pain free. Have you noticed, that in every video, they always cause pain to the patient beforehand. There’s a very simple explanation to this. It is called the pain gate theory. A simplified explanation of this theory is pain receptors send signals to your brain and in response, the brain sends signals back to the receptor to inhibit this pain signals. This will cause the patient to feel like as though they have a reduced pain sensation. But in fact, excessive pain have caused the brain to close the gate to more pain signals. This is the body’s natural defence mechanism and the pain relief will last only momentarily.

There are so many other examples I can give. I have seen it before in my own patients. I had an unsuspecting patient who visited a "bone setter" for back pain and after some manipulation she became paralyzed. Turns out she had a cancer that she was not aware about that had spread to her back bone, making her bone soft and vulnerable to fractures. Not only did the manipulation break her bone but the broken bone then pressed onto the spinal cord and paralysed her. I have also read cases of neck manipulations causing patients to have a stroke and become paralysed.

As medical graduates, we take an oath. The first thigh we pledge by is to do no harm. Alternative medicine has a role to play, but it cannot be reckless. If you feel you have some bone pain or some a sore muscle, visit your doctors. Physiotherapist will do a way better job in relieving some of your symptoms. Patients should be made aware that proper treatment usually takes time, and one should never seek “short term fixes”.  One should be aware of the treatment you are receiving, get it from qualified professionals.