I get anonymous chiropractic mail, I do!
A few weeks ago, I was sent a copy of the 12 August edition of the Southend Echo, which carried an advert for a chiropractic clinic in Westcliff-on-Sea, Essex. The paper was folded to expose this advert for the Cliffs Chiropractic Clinic Ltd:
What was strange about this was that it was sent to me anonymously. Through the post. To my home address.
Questions have to be asked: who sent it, why and how did they know my home address?
Since a relative, friend or fellow sceptic would have at least mentioned it in passing, I can only assume it came from someone who got my address from the General Chiropractic Council when they sent out letters to all the chiropractors I had complained about.
We already know that the chiropractic ‘profession’ is riven with disputes between the various ideological factions. These particular advertisers are all British Chiropractic Association members. We also know that many chiropractors consider the BCA’s libel against Dr Simon Singh to be A VERY BAD MOVE.
So perhaps someone from a different faction wanted to create trouble? Maybe there is a chiropractor out there who now understands why scientists think it is woo. Or perhaps someone working for a chiropractor has a conscience that is now bothering them? Perhaps it’s a simple attempt to disrupt the business of a competitor? We’ll probably never know (unless the person wants to identify him/herself?).
Claims
Just look at the claims being made:
- Back pain
- Joint stiffness
- Sports injuries
- Infantile colic
- Headaches
- Whiplash
- Frozen shoulder
- Pregnancy back pain
- Shoulder/arm pain
- Leg pain sciatica [sic]
- Neck pain
- Hip/knee pain
One stands out in particular: infantile colic.
I complained to the ASA.
When the ASA contacted the chiropractors concerned, they said they would not use the advert again without removing the offending claims and getting it vetted by the ASA’s free Copy Advice team.
But you have to wonder, in the light of the intense focus and scrutiny there has been on chiropractic claims in the last six months, why any chiropractor would bother to try to make claims so obviously out of kilter with the ASA’s acceptance criteria. Did they think no one was watching?
It would, of course, have been open to the advertiser to present evidence for their claims: the ASA are — as scientists are — open to new robust evidence. I can only assume the advertiser could not provide that robust evidence.
Scientific evidence?
Is there any scientific evidence for, say infantile colic? That’s one of the claims that they will have to remove from any future advert (as well as whiplash, headaches, etc — I’ve already detailed what the ASA will and will not accept).
The BCA’s plethora has already been totally demolished, but the International Journal of Clinical Practice published a paper by Prof Edzard Ernst in their September 2009 issue: Chiropractic spinal manipulation for infant colic: a systematic review of randomised clinical trials (pdf).
This concludes:
Some chiropractors claim that spinal manipulation is an effective treatment for infant colic. This systematic review was aimed at evaluating the evidence for this claim. Four databases were searched and three randomised clinical trials met all the inclusion criteria. The totality of this evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials.
In conclusion, the current evidence from RCTs does not show that chiropractic spinal manipulation is an effective treatment for infant colic.
Nope. Not a jot. This adds to the knowledge the ASA already holds that claims about chiropractic treatment for infant colic are misleading and reinforces their guidance.
Because the advertiser didn’t contest my complaint, the ASA decided to make this an informally resolved complaint. It therefore doesn’t go before the ASA’s Council for a formal adjudication. But the chiropractors still get a special mention on the ASA’s website (click on Informally Resolved Complaints).
Another crisis for the General Chiropractic Council?
While you’re there, look at the list of other complaints. A little further up from the Cliffs Chiropractic Clinic, you’ll see something even more interesting. This time, a complaint made by the inimitable Simon Perry, co-scourge of nonsense chiropractic claims, against the General Chiropractic Council itself for their Patient Information Leaflet. I’ll let Simon Perry tell the whole sorry story in his own words.
However, I see that even though the ASA ruled against the GCC’s leaflet, they still have it on their website (where the ASA have no jurisdiction)!
This is their revised leaflet: the GCC decided to tone down their leaflet earlier this year. It used to say:
Chiropractors mainly treat:
- back, neck and shoulder problems
- joint, posture and muscle problems
- leg pain and sciatica
- sports injuries.
You may also see an improvement in some types of
- asthma
- headaches, including migraine; and
- infant colic
The ‘watered down’ version says:
Chiropractors mainly treat
- back, neck and shoulder problems
- joint, posture and muscle problems
- leg pain and sciatica
- sports injuries
There is some evidence, though more research is needed, that you may see an improvement in some types of:
- asthma
- headaches, including migraine and
- infant colic.
Note the woolly weasel words. Now it seems even this is too much for the ASA!
What if the GCC leaves those claims on their website for all to see? Remember that it is against the GCC’s own rules for a chiropractor to claim anything that is not in line with the ASA guidance. If there was any doubt before, there certainly can’t be any doubt now about what the ASA thinks of such claims. So if the GCC leaves the claims there, are they not encouraging chiropractors to do something that is against their very own Code of Practice?
What an interesting situation that would leave them in.
67 Responses to “I get anonymous chiropractic mail, I do!”
On Monday 12 October 2009 at 00:26 David wrote: “I do not accept that the manipulation done by chiropractors is more dangerous than that done by others. It looks to me as if your graph shows a higher incidence of side effects from chiropractic neck manipulation purely as a consequence of the fact that chiropractors perform much the greatest percentage of manipulations that are done. It does not suggest a greater incidence of adverse side effect per manipulation performed.
I disagree. Apparently the vast majority of neck manipulations done by chiropractors are unnecessary. Bearing in mind that around 60-70% of UK chiropractors admit to chiropractic philosophy (subluxation theory) being important to their practices, the following is lifted from a recent article by Samuel Homola, DC:
http://www.sciencebasedmedicine.org/?p=1037
That hardly paints a reassuring picture, does it?
On Monday 12 October 2009 at 00:26 David wrote: “By virtue of the extended training that chiropractors receive, and the practice they get, I believe that they are the people best placed to manipulate all areas of the spine.”
But how can they be “best placed” when only a minority of them are committed to evidence based practice? Just to remind you, in a 2007 survey, 76% of UK chiropractors deemed traditional chiropractic beliefs (chiropractic philosophy) to be important and that same survey gave a figure of 63% for chiropractors who considered the fictitious ‘subluxation’ lesion to be central to chiropractic intervention. Interestingly, it also revealed that the responding chiropractors considered asthma (64%), gastro-intestinal complaints (61%) and pre-menstrual syndrome (PMS) (70%), as conditions that could benefit from chiropractic management (although opinions on the treatment of osteoporosis (43%), obesity (26%), hypertension (42%) and infertility (30%) were less conclusive). As for childhood musculoskeletal and muscular conditions, infantile colic, otitis media and asthma, they were perceived to benefit from chiropractic intervention by more than 50% of the respondents. The results of the entire survey can be read here:
[Ref. Aranka Pollentier and Jennifer M. Langworthy, The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic, Volume 10, Issue 3, Pages 147-155. September 2007]
BTW, you still haven’t answered my question: How do chiropractors think it is possible for members of the public to determine which chiropractic treatments have scientific evidence supporting them, and which ones are bogus?
On Monday 12 October 2009 at 00:26 David wrote: “Remember, the majority of chiropractors spend all their time practicing evidence based care in the treatment of musculoskeletal disorders. Bearing this in mind, one could reasonably extrapolate your theory to suggest that ALL GPs should be retrained because a few practice theories that you’re not happy about.”
But it’s not “just a few” practice theories that blight the chiropractic industry in the UK (and elsewhere, for that matter). Once again, I refer you to the survey quoted above.
On Monday 12 October 2009 at 00:26 David wrote: “Your quote regarding the risks of spinal manipulation: “Not substantial risks, but according to a recent systematic review of adverse effects of spinal manipulation, mild to moderate adverse effects do occur in a large proportion (30-61%) of patients receiving spinal manipulation:” What the quote actually says, is only “mild” adverse effects. These mild adverse effects are akin to someone feeling a little sore or achy after having been to the gym and exercised. Mild and transient. Also, you should bear in mind that, by definition, the area being worked on will already have been uncomfortable; the very reason it was being treated in the first place.”
I’m not quite sure what your point is here. On the subject of spinal manipulation for back pain, did you read the following which was contained in another one of the quotes I gave?
It’s pretty damning stuff.
On Monday 12 October 2009 at 00:26 David wrote: “Your quote from this study: http://www.ncbi.nlm.nih.gov/pubmed/19444054 regarding the adverse effects of chiropractic reads: “further investigations were *urgently* needed to assess definite conclusions regarding this issue.” Of course, the sentence before your extract reads “There is no robust data concerning the incidence or prevalence of adverse reactions after chiropractic.” and even the figures quoted in this study suggest only a very low risk exists. What you’ve chosen to do is highlight and dramatise the word “urgent” in order to imply greater risk.”
That is correct. As we know that complications related to chiropractic treatment are under-reported, in the interests of patient safety, until the data are in, shouldn’t chiropractors be erring on the side of cautioning and abandoning cervical manipulations as an intervention when there are equally effective, cheaper, more convenient, and safer options available?
On Monday 12 October 2009 at 00:26 David wrote: “With respect to your remarks about the McTimoney College, I’m afraid that I am unable to comment. As a registered chiropractor, I would draw your attention to clause F1.1 in the Code or Practice: “Specifically chiropractors: must not discriminate against, or unjustly criticise, a colleague or other health professional.””
And I would draw your attention to clause E1.3 in your Code of Practice (p.21 in the pdf, p.18 of the actual document):
http://www.gcc-uk.org/files/link_file/COPSOP_Dec05_WEB(with_glossary)07Jan09.pdf
On Monday 12 October 2009 at 00:26 David wrote: “You said: “it’s interesting that we still don’t know why two of the survey’s authors, JE Bolton and HW Thiel, claimed that in the UK alone there were an estimated *four* million manipulations of the neck carried out by chiropractors each year, and yet, six months earlier, in October 2007, in a letter to the Journal of the Royal Society of Medicine, they claimed that the figure was “estimated to be well over *two* million cervical spine manipulations”.” This is a red herring. To infer that this apparent change is some sort of attempt to hide anything is ludicrous and would certainly qualify as an ad hominem attack. Both Dr Thiel and Professor Bolton are known to me personally and I can assure you that their integrity is beyond reproach. They certainly possess at least the same credibility as Professor Ernst, on whose writings you rely so much.”
Your vouching for the integrity of Dr Thiel and Professor Bolton is irrelevant. The fact remains that their estimate of the number of neck manipulations carried out in a year in the UK doubled in under 6 months, and that can only leave them open to accusations that they may be trying to play down the risks. Also, let’s not forget the other criticisms of their study:
http://www.medicinescomplete.com/journals/fact/current/fact1301a07g04r01.htm
David said:
Monday 12 October 2009 at 08:27
“BSM,
You said: “If you define ’subluxations’ out of chiropractic then you are some sort of physiotherapist”
No, I continue to be a chiropractor, advancing my skills and treatment through evidence-based care.”
David, I’m sorry to say that your repeated assertion of this carries very little weight until you address Blue Wode’s comments.
That said, I am particularly disappointed to see you trying to deflect criticism by trying to dance around the issue.
You said;
“With respect to your remarks about the McTimoney College, I’m afraid that I am unable to comment. As a registered chiropractor, I would draw your attention to clause F1.1 in the Code or Practice: “Specifically chiropractors: must not discriminate against, or unjustly criticise, a colleague or other
health professional.”
It is pretty clear that criticism of chiropractic practice that is based on mythical subluxations is absolutely not “unjust” and, indeed, as Blue Wode has made clear to you, you are under an ethical obligation to do something about it.
And to return to the issue of chiropractic beliefs, your definition of chiropractic as being independent of belief in ‘subluxations’ is obviously a minority view in chiropractic and without it I think most other people would wonder what you think chiropractic is.
Blue Wode,
This is going to be my last posting on this issue because I have other things to do.
You said: “Apparently the vast majority of neck manipulations done by chiropractors are unnecessary.”
That is an opinion only, and one that is open to any amount of debate.
Your quote: “When the RAND (Research and Development) organization published its review of the literature on cervical spine manipulation and mobilization in 1996, it concluded that only about 11.1% of reported indications for cervical spine manipulation were appropriate…”
That’s a pretty random quote, the accuracy, relevence or significance of which I have been unable to verify. However, here’s another RAND organisation quote for you from 2001, five years later:
“For half a century, the American Medical Association waged war against chiropractic, an intervention that relies on spinal adjustments to treat health problems. Chiropractors were regarded as the modern-day equivalent of snake-oil salesmen.
Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. AMA policy now states that it is ethical for physicians not only to associate professionally with chiropractors but also to refer patients to them for diagnostic or therapeutic services.” http://www.rand.org/pubs/research_briefs/RB4539/
You said: “Manipulation of the upper cervical spine should be reserved for carefully selected musculoskeletal problems that do not respond to such simple measures as time, massage, exercise, mobilization, longitudinal traction, or over-the-counter medication…”
Chiropractors have the knowledge and skill to give treatment that is appropriate to the person and problem that they are treating. As I have said before, manipulation is only one of the tools that chiropractors have available to them. The others include, but are by no means limited to: massage, exercise, mobilization and longitudinal traction. Also, there is currently a consultation process to decide whether chiropractors should be given limited prescribing rights.
The definition of chiropractic that you quote from the Association of Chiropractic Colleges, and the description of chiropractic practice you give, has nothing to do with how chiropractic is taught in the UK. I’m going to say for the last time: I do not and never have, used the term subluxation to describe dysfunction in the spine.
Why don’t you try the definition of chiropractic given by the British Chiropractic Association:
“Chiropractic is a primary health-care profession that specialises in the diagnosis, treatment and overall management of conditions that are due to problems with the joints, ligaments, tendons and nerves of the body, particularly those of the spine.
Treatment consists of a wide range of manipulative techniques designed to improve the function of the joints, relieving pain and muscle spasm.”
Your quote from Edzard Ernst regarding the prospective study of neck manipulation reads:
“The sample of this survey was sizeable but not large enough to exclude rare events… The picture gets more complicated when considering the 698 treatment consultations of patients who failed to return for their next treatment. Theoretically some or most or all of these patients could have died of a stroke. Overlooking even one single serious adverse event would change the estimated incidence rates from this study quite dramatically. In my view, the most confusing aspect about the results of this survey is the fact that the incidence of minor adverse events is so low. Previous studies have repeatedly shown it to be around 50%. The discrepancy requires an explanation. There could be several but mine goes as follows: the participating chiropractors were highly self-selected. Thus they were sufficiently experienced to select low-risk patients (in violation of the protocol). This explains the low rate of minor adverse events and begs the question whether the incidence of serious adverse events is reliable.”
The reply from the authors reads:
“Ernst talks about ‘certainty’ in research studies and a sample size that was not large enough to exclude rare events. Just what is ‘large enough’ to achieve certainty? Choosing the worst risk estimate (˜2 per 10 000 treatment consultations), Ernst infers that this is a cumulative risk as well as for a patient instead of a single treatment. There is no evidence to suggest that the risk is cumulative and increases with repeated exposure. Even if this was the case, our design would have accounted for this by including not only the first but subsequent treatment consultations. Of course, Ernst is correct in saying that an adverse event could have occurred in those patients lost to follow-up. However, by any reckoning 1.4%, particularly in a sample of 50 000 treatments, is not only acceptable but, in our view, strengthens rather than weakens the credibility of the risk estimates. Ernst uses the difference in this study’s rate of a single minor side-effect with those reported in others to argue that the recruitment of chiropractors and patients was biased and therefore could have resulted in an underestimation of risk.
When taking into account all minor side-effects observed in this study, this difference diminishes considerably. In endeavouring to provide research evidence and in debating its limitations, we should not lose sight of the bigger picture. In the UK alone, there is an estimated 4 million manipulations of the neck carried out by chiropractors each year. In the absence of any significant numbers of reported serious events (i.e. stroke or death), including those in which a causal link is based on extremely weak evidence, there can be little doubt that the risk is very low. In failing to find a serious event, the risk was estimated based on sample size. It can therefore be argued that this risk estimate is a conservative one, and that had it been possible to achieve a ‘large enough’ sample, we might then have been ‘certain’ of a very rare event.”
Take your pick but, given Prof. Ernst’s unremitting negative attitude towards chiropractic, I know who I regard as the more objective.
Anyway, we could carry on trading punches for ever. The point is this, chiropractic IS safe and effective and the research has shown as much for the treatment of many musculoskeletal disorders such as back pain, neck pain and headaches.
It is true that there is a mixture of beliefs within chiropractic and you may consider that the research evidence for the treatment of some disorders is not yet good enough. However, that is not a justification for damning the whole profession.
David said;
“Why don’t you try the definition of chiropractic given by the British Chiropractic Association:
“Chiropractic is a primary health-care profession that specialises in the diagnosis, treatment and overall management of conditions that are due to problems with the joints, ligaments, tendons and nerves of the body, particularly those of the spine.”
Funny you should cite the BCA, they take those asserted principles and claim that they form a basis for the treatment for a whole host of non-skeletal problems A claim for which there seems to be rather less than a jot of evidence that is what we have a problem with and why your attitude is a problem.
On Monday 12 October 2009 at 20:16 David wrote: “Your quote: “When the RAND (Research and Development) organization published its review of the literature on cervical spine manipulation and mobilization in 1996, it concluded that only about 11.1% of reported indications for cervical spine manipulation were appropriate…” That’s a pretty random quote, the accuracy, relevence or significance of which I have been unable to verify.”
If you have been unable to verify the relevance or significance of the quote, then in the interests of patient safety, it must surely follow that you should err on the side of caution and not administer neck manipulations until you do.
On Monday 12 October 2009 at 20:16 David wrote: “However, here’s another RAND organisation quote for you from 2001, five years later: “For half a century, the American Medical Association waged war against chiropractic, an intervention that relies on spinal adjustments to treat health problems. Chiropractors were regarded as the modern-day equivalent of snake-oil salesmen. Today, chiropractors are the third largest group of health care providers, after physicians and dentists, who treat patients directly. AMA policy now states that it is ethical for physicians not only to associate professionally with chiropractors but also to refer patients to them for diagnostic or therapeutic services.” http://www.rand.org/pubs/research_briefs/RB4539/
Didn’t that ‘war’ waged by the American Medical Association end with the Wilk v AMA case? The upshot of it was as follows:
Quote:
“In 1987, federal court judge Susan Getzendanner concluded that during the 1960s “there was a lot of material available to the AMA Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious.” The judge also noted that chiropractors still took too many x-rays. However, she ruled that the AMA had engaged in an illegal boycott. She concluded that the dominant reason for the AMA’s antichiropractic campaign was the belief that chiropractic was not in the best interest of patients. But she ruled that this did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public. *Although chiropractors trumpet the antitrust ruling as an endorsement of their effectiveness, the case was decided on narrow legal grounds (restraint of trade) and was not an evaluation of chiropractic methods.*”
http://www.chirobase.org/08Legal/AT/at00.html
As for chiropractors being the third largest group of health care providers, after physicians and dentists, that is a classic argumentum ad populum. Chiropractic largely owes its growth to relentless marketing and political lobbying. In other words, it seems that chiropractors have managed to dupe legislators, and the public, both of whom are generally not well-versed in scientific matters. However, in the US, at least, chiropractic’s future is not looking as bright as you might portray. Apparently 15% of DCs have quit the profession and there has been a 39% drop in chiroprictic education student enrolment from 1969-2002. In addition to that, while the use of CAM in general has increased, the largest decrease occurred for chiropractic (9.9% to 7.4%).
Ref: The Future of Chiropractic Revisited: 2005 to 2015 Report & Online Poll http://www.altfutures.com/poll.asp
On Monday 12 October 2009 at 20:16 David wrote: “You said: “Manipulation of the upper cervical spine should be reserved for carefully selected musculoskeletal problems that do not respond to such simple measures as time, massage, exercise, mobilization, longitudinal traction, or over-the-counter medication…” Chiropractors have the knowledge and skill to give treatment that is appropriate to the person and problem that they are treating. As I have said before, manipulation is only one of the tools that chiropractors have available to them. The others include, but are by no means limited to: massage, exercise, mobilization and longitudinal traction.”
And as I’ve said before (see previous page of comments by scrolling to the bottom of this page), anything that isn’t a ‘specific spinal adjustment’ is not real chiropractic. Furthermore, as we have already learned, the vast majority of adjustments are likely to be contra-indicated by responsible risk/benefit assessments.
On Monday 12 October 2009 at 20:16 David wrote: “Also, there is currently a consultation process to decide whether chiropractors should be given limited prescribing rights.”
Presumably if they were given prescribing rights then that would mean that they would no longer be able to promote themselves as a natural alternative to drugs. For example the British Chiropractic Association’s website says “Chiropractic does not involve the use of any drugs or surgery”.
http://www.chiropractic-uk.co.uk/default.aspx?m=3&mi=19&ms=9&title=What+is+chiropractic%3f
On Monday 12 October 2009 at 20:16 David wrote: “The definition of chiropractic that you quote from the Association of Chiropractic Colleges, and the description of chiropractic practice you give, has nothing to do with how chiropractic is taught in the UK.”
Nonsense. The McTimoney College of Chiropractic’s current prospectus for its Integrated Masters in Chiropractic (MChiro) says the following:
Quote
“By correctly training the hands as an instrument of our innate intelligence, healing can be encouraged to take place by the detection and correction of bony subluxations (slight displacements). The basic principle of chiropractic is that disturbances of the nervous system, resulting from subluxation of the bones of the spine and other parts of the body, are a primary or contributory factor in the pathological process of many common human and animal ailments.”
http://www.mctimoney-college.ac.uk/UserFiles/File/MChiro%20prospectus.pdf
I would also venture that it would be very easy for chiropractors to treat patients based on their training/belief in “subluxation theory” while pretending they’d abandoned it.
On Monday 12 October 2009 at 20:16 David wrote: “I’m going to say for the last time: I do not and never have, used the term subluxation to describe dysfunction in the spine.”
Irrelevant. The use of the term ‘subluxation’ is widespread throughout the chiropractic industry in the UK. A Google UK search for ‘chiropractic’ and ‘subluxation’ confirms it.
On Monday 12 October 2009 at 20:16 David wrote: “Why don’t you try the definition of chiropractic given by the British Chiropractic Association: “Chiropractic is a primary health-care profession that specialises in the diagnosis, treatment and overall management of conditions that are due to problems with the joints, ligaments, tendons and nerves of the body, particularly those of the spine. Treatment consists of a wide range of manipulative techniques designed to improve the function of the joints, relieving pain and muscle spasm.””
IMO, that statement is vague to the point of being meaningless.
On Monday 12 October 2009 at 20:16 David wrote: “The reply from the authors reads: “…In endeavouring to provide research evidence and in debating its limitations, we should not lose sight of the bigger picture. In the UK alone, there is an estimated 4 million manipulations of the neck carried out by chiropractors each year.”
The fact remains that their estimate of the number of neck manipulations carried out in a year in the UK doubled in under 6 months, and that can only leave them open to accusations that they may be trying to play down the risks.
On Monday 12 October 2009 at 20:16 David wrote: “In the absence of any significant numbers of reported serious events (i.e. stroke or death), including those in which a causal link is based on extremely weak evidence, there can be little doubt that the risk is very low.”
But isn’t part of the “absence of any significant numbers of reported serious events” due to a Reporting and Learnings System http://www.cpirls.org/ only very recently having been implemented by the College of Chiropractors – and, even at that, not universally utilised? I also comment on it here:
http://www.layscience.net/node/566
The “absence of any significant numbers” could also be due to this:
Quote
“Patients who have delayed strokes may never see their chiropractor again, so chiropractors would naturally tend to underestimate the risk. Many of these diagnoses are missed because the vertebral arteries are not typically examined on autopsy.”
http://www.sciencebasedmedicine.org/?p=94
Also you mention that any causal link is “based on extremely weak evidence”. Isn’t it exactly that sort of evidence that, in many cases, chiropractors rely on to promote their services? It’s a point that’s addressed in paragraph 146 of the Statement of Claim of tetraplegic chiropractic victim, Sandra Nette. It asserts that many chiropractors, as well as their regulators and professional associations, seem to find it acceptable to promote anecdotal or weak evidence were it supports chiropractic treatment, but where similar, or more robust evidence suggests that serious complications can result form it, they are known to be quick to dismiss it. Paragraphs 85 and 193 of the Statement of Claim are also worth a read as they appear to very closely describe the way in which chiropractic is regulated in the UK:
http://www.casewatch.org/mal/nette/claim.pdf
On Monday 12 October 2009 at 20:16 David wrote: “Take your pick but, given Prof. Ernst’s unremitting negative attitude towards chiropractic, I know who I regard as the more objective.”
And I know who I (and many others who like to follow what the science tells them) regard as the more impartial and safety conscious.
On Monday 12 October 2009 at 20:16 David wrote: “The point is this, chiropractic IS safe and effective and the research has shown as much for the treatment of many musculoskeletal disorders such as back pain, neck pain and headaches.”
The point is that the value of chiropractic continues to be questionable. Once again, I quote a summary of chiropractic which can be found on page 285 of Simon Singh and Edzard Ernst’s recent book, ‘Trick or Treatment? Alternative Medicine on Trial’:
Quote:
“WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”
On Monday 12 October 2009 at 20:16 David wrote: “It is true that there is a mixture of beliefs within chiropractic and you may consider that the research evidence for the treatment of some disorders is not yet good enough. However, that is not a justification for damning the whole profession.”
There is no place for beliefs in medicine. Further, after more than 100 years, most of the data are in for chiropractic, and, apart from some evidence of short-lived pain relief in a sub-group of low back pain sufferers (which can be provided by other therapists who are more evidence-based), there appears to be very little going for it, and a great deal going against it. Indeed, UK Skeptics sum it up very succinctly:
Quote
“A healing system that is based on a mystical life-force that gets blocked by imaginary subluxations, and that relies on anecdotal evidence, special pleading, the placebo effect, and subjective diagnoses is clearly an irrational concept no matter how much credence is given to it with qualifications and self-regulation.”
http://www.ukskeptics.com/article.php?dir=articles&article=chiropractic.php
BTW, it’s disappointing that you chose not to answer my question: “How do chiropractors think it is possible for members of the public to determine which chiropractic treatments have scientific evidence supporting them, and which ones are bogus?”
Blue Wode, it’s been nearly a week, I think you broke it. Chiroquacktors are amazingly fragile when subject to a bit of robust use. It’s a pattern seen in CAMsters everywhere. I think it’s a basic design flaw.
… but then again it was an amazingly dull post.
.., I am willing to try it, anything that can help me with my migraine..
It’s good to see a blog where we can see patients testimonies.. i am searching for it…
That is the better way, if you see a patients testimonies that is great that you got the right idea of doing the right purpose and don’t the wrong.
I see you’ve been doing the rounds of several other blogs that have been discussing chiropractic and trying to pretend you’re from the USA or Canada rather than your real location of the Philippines. (I’ve removed the spam links you gave to US chiro websites.)
However, patient testimonies may be interesting, but, where people’s health is concerned, they are a very bad way to decide whether or not chiropractic works or is the best treatment for any condition. The best way is proper controlled and blinded trials. In all the good ones that have been done, chiropractic fares pretty badly.
Had a couple of these comments with links, too. Meh, you’d think that before pasting your links all over teh interweb you’d at least go to the effort of putting together a decent website…
This same individual, based in Manila in The Philippines has been littering a number of blogs with his/her nonsense, including Skepticat.com and LDBlog – Dr John Lloyd believes it is a blog commenting service, paid for, presumably, by a bunch of chiros or a chiro trade association in the US/Canada to promote chiropractic. They should demand a refund.
Ouch – so this is a ‘professional’ service? Sigh.
Its amazing people that have no knowledge of the chiropractic profession …continue to bad mouth it because of their ignorance…I guess they are mad because they are not educated ….and their life stink…..Chiropractic no longer needs to be proven….they are reconized primary care physicians….so that argument is over…..look at the MDs…according to the townsend letter review they are the leading cause of death in the US.(from Iatrogenic causes) 783,000 per year! and US surgeon General, General C. Everett Coop stated that ” 68% of all diagnoses in the US are wrong”
So when people with no education and no facts and no experience want to talk badly about the chiropractic profession…..it is really a joke.
Look at the allopathic profession …if 68% of the diagnosis are wrong according to the surgeon General…and 783,000 people die a year from Iatrogenic causes making it the leading cause of death in the USA…then complaining about Doctors of Chiropractic (especially with no research or statistical facts ) is just plain Ignorant!
Tim
You’re completely wrong on several counts, but I’ll pick up on just a few and ignore most of your ill-informed diatribe.
Why is you think that chiropractic ‘no longer needs to be proven’ and that the ‘argument is over’ when the Bronfort Report (written by chiropractors) came up with so little good evidence for so few of the conditions that many chiros claim to treat?
How does the number of mis-diagnoses or even deaths allegedly caused by conventional medicine affect the dearth of evidence for chiropractic?
Can I just say that one good thing has come out of all this scrutiny and that is the public statement by the GCC and the Chiropractic Colleges that Subluxation is a historical concept with no evidence to support it. It was taught that way to me 19 years ago for 1 hour per week for 1 term of a 4 year degree in Chiropractic Contextual Studies (ie. putting chiropractic into the context of modern medicine). Sadly it is an all too convenient marketing tool that can be abused in private practice.
One of the postives to come out of these blogs and the scrutiny chiropractic profession has brought on itself, is that it must move away from its stupid and outdated theories and look at an investigate plausible mechanisms by which manipulation might work. Hopefully it should broaden its scope to encompass techniques from other manual therapy professions where evidence dictates.
It does annoy me somewhat the constant dearth of evidence tag. I have diagnosed a Burst Fracture, Type 2 Dens Fracture, Mets on several occasions, ABC C1, Cerebellar Tumour, (Referred to me by GP as Sciatica), Cervical Facet dislocation all of these patients had either been seen by their GP, or been to casualty, or indeed been x-rayed and missed. Most Chiropractors do a very worthwhile job, and whilst we cant claim to me more effective than any other manual therapy, except arguably for subacute back pain, we have not been shown to be be any worse either. If our diagnostic skills are up-to-scratch, we are indeed providing a worthwhile service.
Some chiropractors oppose vaccination and water fluoridation, which are common public health practices. Chiropractors’ attempts to establish a positive reputation for their public health role are also compromised by their reputation for recommending repetitive life-long chiropractic treatment.