Chiropractic with a hammer
This infamous video showcases a dramatic form of spinal “adjustment” with a hammer and blunt “chisel,” and the crazy is right in the title: “CRAZY Barbershop Therapy fixes 20 YEARS SHOULDER PAIN.” If you can’t spare 16 minutes for this gem … after a good spinal thwacking, the patient can finally lift his arm. Raparo! 🪄
If nothing else, this is an amazing example of social media algorithms favouring extremes: 12,000,000 views, 135,000 likes, 6,600 comments. That’s engagement on a scale no thoughtful analysis can come close to matching. Impressive! And depressing.

Chiropractic? That’s up for debate, especially because it closely resembles Thai tok sen massage, but it is indeed perpetrated by a chiropractor, and the intention of what he’s doing is “adjustment,” very chiropractic-in-spirit — exactly what people think chiropractic is about, whether they should or not. More below on what this technique actually is.
Can it possibly be effective, whatever it is?
If it’s not just faked, like a faith healing, then it is still excellent “therapy theatre” — whipping up a good batch of placebo analgesia with strong story and sensations. The video charismatically and competently sells the concept to both patient and audience. This comment captures the simplistic appeal:
“I need someone to bang on me with those tools, like I’m a broken down Chevy.”
Honestly, I get it. There are days when I want the hammer treatment too. Which raises some awkward questions.
Is therapy theatre therapeutic?
If you can persuade a nervous system to do this, even temporarily, isn’t that a good thing?
I am torn, because this hammer business is probably just a more dramatic and stylish way to deliver exactly the same non-specific active ingredients that are the reason so many of us enjoy manual therapy … and not for nothing. Maybe it can create “window of opportunity” for improved recovery. And maybe a sensation-enhanced placebo can be dialed up quite far.
But I also don’t “want to go to there” thanks to a nonsense narrative about what’s going on! Among other aesthetic turn-offs.
Many studies have shown that spinal manipulation does not work well … not even for back pain (let alone shoulder pain). Placebo analgesia is notoriously minor and fleeting, which is (partly) why it’s unethical to lean into it. So this line of inquiry generally leads straight to that ancient mystery: is it okay to prescribe placebos? Mostly no, “officially”: the medical ethics have always been pretty clear that baffling people with bull is not cool … and that goes double when it’s also used as marketing.
So I think this is more like theatre than therapy. Faith healing is the most obvious comparison, but maybe stage hypnosis is better: a weird phenomenon, but no one is really being “controlled,” anymore than anyone is being “healed” with hammers. The video is entertainment — not video documentation of a secret weapon against pain that only manly chiropractors have figured out.

Sharing this here for no particular reason …
Chiropractic or massage? (An addendum a week after publication)
The technique in the video closely resembles a form of Thai massage, tok sen, which uses a wooden mallets and wedges of various shapes. Despite that resemblance, it is also thoroughly chiropractic in character.
Tok sen could also be called “hammer acupunture,” because (of course) it is based on the vitalistic concept of restoring the normal flow “energy” — exactly like acupuncture and traditional Chinese medicine. But don’t make the mistake of thinking that this means tok sen has nothing to do with chiropractic! Because chiropractic is deeply rooted in energy medicine. A century ago most if not all chiropractors assumed that they were manipulating spines to restore “energy” flow — not making much distinction between “energy” and “nerve impulses” — and modern chiropractic is still rotten with vitalism (especially Applied Kinesiology is Bunk, a chiropractic favourite).
Banging imaginary points and pathways by any means also looks an awful lot like the chiropractic “activators” — a little tool that looks a lot more modern and medical but is barely different in principle, simply delivering a little tap, and for all the same reasons. So tok sen, despite usually being described as “massage,” is right at home in chiropractic. It may not be what good chiropractors do, but it is most assuredly something many do, for the same kinds of reasons as they’ve ever done anything.