Value of chiropractors questioned

[richard]

Richard,

So what is chiropractic? Please provide the scientific evidence for it. There must be plenty after more than 100 years.

I thought I had answered that. Chiropractors study the relationship between the structure of the spine and the function of the nervous system.

I would like to see more evidence. But every medical intervention is not supported by evidence, and I rely heavily on experience. I like this quote from David Sackett I think it was in the BMJ. Without clinical expertise, practise risks becoming tyrannised by evidence…. Without current best evidence, practice risks becoming rapidly out of date. David Sackett et al 2000

Because it gives direction to their employees who may be influenced by press reports.

Well then they have been miss informed about this study, if they have been told its about chiropractic as stated in Skeptic Fact Sheet.The NHS have been known to make a few mistakes in their time.


Do you have any idea why that study has been placed under “silly chiropractic research” in the humour section of Chirotalk – a skeptical chiropractic forum moderated by chiropractors?
http://chirotalk.proboards3.com/

Spine is not a chiropractic Journal, they published it. Its the largest study thats been done on the subject, I have not claimed it proves anything however its better than the evidence that says chiropractic is dangerous. Surely you not saying the chiropractor on chirotalk has more credibility than The Spine Journal?

If this guy is a chiropractor it is obvious he did not enjoy his time at chiropractic college. If I were to base my evidence on the opinion of one Chiropractor, I dont think you would take me very seriously, come to think of it you don’t take chiropractic seriously so I guess its a mute point.


First do no harm. The data on the safety of spinal manipulation, particulary neck manipulation, are not yet in. As you say “absence of evidence is not evidence of absence” and there are plenty of case reports to suggest that manipulation can be life-threatening.

Anecdotal, you dont like the Thiel study, fine perhaps Professor Ezard Ernst will do a better study more to your liking.

Would you please answer these ones then:

1.) Re Mr Dixon’s comments. Where is the sound scientific evidence that shows that the main treatments of chiropractic have been shown to be consistently more effective than treatment to which they have been compared?

I guess he is reffering to Meade, Manga, and the Beam study to name a few. He looks at the good ones you look at the bad ones . I don’t think that unusual, my patients judge me on results not evidence. If I was crap at my job I guess the practice would close and they could all come on the site and tell you how bad I was.

2.) What has the chiropractic profession done to limit the use of neck manipulation for neck pain when it is known that safer and less expensive treatments exist for the condition (e.g. exercise)?

Eat healthy, do exercise, drink clean water, reduce stress in life. I agree with you but people dont do all these things and their health lets them down. They seek help most go to Gps and if they are not satisfied they end up in osteopaths, chiropractors, acupuncturists etc. I have no experience of the dangers of chiropractic, I have only seen the anecdotal evidence you have seen, I dont agree that its dangerous. I use it everyday and see no reason to limit its use.

3.) Why doesn’t the chiropractic profession have an injury reporting system in place similar to the Yellow Card system that is used for reporting adverse drug reactions?

One is being put in place now the profession is much larger. Ten years ago there were only 600 chiropractors in the UK and adverse reactions would go through the associations and insurers. What can I say in my experience they are extremely rare.


4.) In the UK, drug medications contain Patient Information Leaflets which include advice on side effects. The chiropractic equivalent is to inform patients either orally or in writing of the risks associated with any procedure (and any available alternatives). This is a legal obligation. Why are large sections of your profession apparently ignoring their duty in this respect and what is being done about it?

If there was evidence of a significant risk of course I would warn people of a risk, in fact I would change to a light technique to stimulate mechano receptors. The risk of stroke is anecdotal and as your fact sheet states one should not attach much weight to anecdotal evidence. You can not have it both ways, on weight of anecdotal evidence to make points against the chiropractic profession.

You cant just accept evidence that supports your point of view, or can you?

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=1 7693332&ordinalpos=6&itool=EntrezSystem2.PEntrez.P ubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&li st_uids=15726031

Thats me for today, I had only intended spending 20 minutes on this and my kids are starving.

[Blue Wode]

Richard,

Chiropractors study the relationship between the structure of the spine and the function of the nervous system.

I would like to see more evidence. But every medical intervention is not supported by evidence, and I rely heavily on experience.

Around 80% of medical interventions are supported by evidence. Once again, please provide the scientific evidence for chiropractic.

[Re: NHS employees] Well then they have been miss informed about this study, if they have been told its about chiropractic as stated in Skeptic Fact Sheet.The NHS have been known to make a few mistakes in their time.

John Jackson (one of the founders of UK Skeptics) has addressed that point very adequately in post #15:

"Spinal Manipulation Therapy (SMT) is used by chiropractors and it's about the only thing they do that has any evidence to support its use.

Now that there's some doubt cast upon SMT compared to other interventions then it certainly is relevant to chiropractic.

SMT is not chiropractic as such but as chiropractors use it the link between chiropractic and SMT is highly relevant."

Spine is not a chiropractic Journal, they published it. Its the largest study thats been done on the subject, I have not claimed it proves anything however its better than the evidence that says chiropractic is dangerous.

If you’re not claiming that it proves anything, then why did you cite it in the first place?

Surely you not saying the chiropractor on chirotalk has more credibility than The Spine Journal?

No, I’m not saying that at all. I’m asking you why you think the chiropractors who operate that forum have allowed the post about the study to stay in their humour section.

If this guy is a chiropractor it is obvious he did not enjoy his time at chiropractic college.

That’s an assumption. If he is a chiropractor (and I believe he is) you don’t know why he’s sceptical about chiropractic.

If I were to base my evidence on the opinion of one Chiropractor, I dont think you would take me very seriously, come to think of it you don’t take chiropractic seriously so I guess its a mute point.

I won’t take you seriously until you produce some decent scientific evidence for ‘chiropractic’.

you dont like the Thiel study, fine perhaps Professor Ezard Ernst will do a better study more to your liking.

I stand by what I said. The chiropractic profession, as a whole, appears to take no cautionary attitude towards its practices - preferring, apparently, to spend its energies shouting down its critics (almost all of whom don’t have a vested interest in chiropractic) and cherry-picking studies in its support.

[Re Mr Dixon] I guess he is reffering to Meade, Manga, and the Beam study to name a few. He looks at the good ones you look at the bad ones .

You have that the wrong way round.

The Meade Trial was not the meal ticket that chiropractors made it out to be:
http://forums.randi.org/showpost.php?p=3149877&postcount=66

Regards the Beam study, this was the view of Professor Edzard Ernst (who, incidentally, has been trained in spinal manipulation):

"My reading of the results is that the data are compatible with a non-specific effect caused by touch: exercise has a significantly positive effect on back pain which can be enhanced by touch. If this “devil’s advocate” view is correct, the effects have little to do with spinal manipulation per se."

http://www.bmj.com/cgi/eletters/bmj.38282.669225.AEv1#88126

As for the Manga report, I am not familiar with it.

I have no experience of the dangers of chiropractic, I have only seen the anecdotal evidence you have seen, I dont agree that its dangerous

I take it, then, that you disagree with the conclusions of the latest systematic review on adverse effects of spinal manipulation:
http://www.jrsm.org/cgi/content/abstract/100/7/330

One [a reporting system for injuries] is being put in place now the profession is much larger. Ten years ago there were only 600 chiropractors in the UK and adverse reactions would go through the associations and insurers.

The profession was regulated over 6 years ago in order to protect patients, why has it taken so long to put one in place?

Would you please provide more details about the one that’s being put in place.

If there was evidence of a significant risk of course I would warn people of a risk, in fact I would change to a light technique to stimulate mechano receptors. The risk of stroke is anecdotal and as your fact sheet states one should not attach much weight to anecdotal evidence. You can not have it both ways, on weight of anecdotal evidence to make points against the chiropractic profession.

Are you saying you don’t warn your patients about the risk of stroke associated with neck manipulation?

[JJM]

Chiropractors study the relationship between the structure of the spine and the function of the nervous system.

What is that relationship, and why do you care? Any such relationship is not available to chiropractic manipulation:
http://www.chirobase.org/02Research/crelin.html

What, specifically, is chiropractic, and what do you treat? You dodged that question from Blue Wode. You can simply cite a web-page with a description you approve.

Specifically, what does the chiro neck-snap do that makes it necessary? When there is no benefit (that cannot be achieved more safely, otherwise) the risk/benefit ratio is an unacceptably large number. One stroke is too many from an unnecessary procedure.

I would agree there is a lack of scientific evidence to support the efficacy of chiropractic as an intervention beyond back pain. We are a small profession and dont have great resources. Absence of evidence is not evidence of absence.

Since chiro is irrational, it makes no sense to go ahead as if the evidence were there. In this case, absence of evidence is evidence of absence. The problem is not that you are a small group, there are around 65,000 chiros in North America, the problem is that the best research shows chiro to be ineffective- except for some headaches and acute low-back pain, where it is as good as massage.
I see I am cross-posting with B Wode.

[richard]

[quote=Blue Wode;23988]

Largest risk assessment study ever was recently published by Thiel and Bolton in Spine. I don’t have the actual reference to hand. (If you insist I will get it).You are not going to like the conclusion, but I guess scientific evidence is not designed to please.[/quote]

Here’s the link:

Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey by Thiel, Haymo W. DC, PhD; Bolton, Jennifer E. PhD; Docherty, Sharon PhD; Portlock, Jane C. PhD, Spine. 32(21):2375-2378, October 1, 2007

http://www.spinejournal.org/pt/re/spine/abstract.00007632-200710010-00016.htm;jsessionid=H7DN7v7h1sQnJYvqTvn1h22bhpq8t Q1VHpf3pXTQ1lYhc3zGLwCz!1600246195!181195629!8091!-1


Interestingly, the chiropractors on the Skeptical Chiropractic forum, Chirotalk, put it in their ‘humor’ section under the title “Silly chiropractic research”:

http://chirotalk.proboards3.com:80/index.cgi?board=humor&action=display&thread=119413 7405

It was two years ago, I had to document one hundred consecutive cervical adjustments, the patient filled out a form after the adjustment and on subsequesnt visits.They had to report any adverse reactions which are documented in the study. I had none to report.

You think its better to survey 30 neurologists and ask them if they recall if any of their stroke patients had recieved spinal manipulation prior to the stroke. If every 5 minutes someone in the UK has a stroke, chances are some of them will have been to a chiropractor, I read how a lady was having her hairwashed when it happened.

[richard]

The actual article cited was headlined: "Chiropractors may be no use in treating back pain, study says".

I think this is fair as Spinal Manipulation Therapy (SMT) is used by chiropractors and it's about the only thing they do that has any evidence to support its use.

Now that there's some doubt cast upon SMT compared to other interventions then it certainly is relevant to chiropractic.

SMT is not chiropractic as such but as chiropractors use it the link between chiropractic and SMT is highly relevant.

Your fact sheet states some Chiropractors also use a technique called Spinal Manipulative Therapy (SMT) for lower-back pain (although it is not recommended for the neck). This is not the same as Chiropractic itself, and should not be confused with it. Medical doctors and physiotherapists also use SMT.

Now because this study agrees with your view of chiropractic, you are "confusing" it with chiropractic. You should be consistant and say "some" chiropractors and the skeptic would qualify it by saying the technique used by the physiotherapists in this study is different from that used by chiropractors.

[richard]

Richard,

Around 80% of medical interventions are supported by evidence.
15 years ago David Eddy stated in the BMJ it was only 10%, I dont think you have any evidence for 80%. If you have it I will have to think again about my chosen profession.

Once again, please provide the scientific evidence for chiropractic.

The facet joints of the spine are innervated by mechanoreceptors, if these joints are not moving properly it affects the function of the nerves. I get them moving again, that’s all. Do you dispute this?

If you’re not claiming that it proves anything, then why did you cite it in the first place?

Unlike you skeptics I try not to interpret too much from one study. There is anecdotal evidence that people have been injured by chiropractors. I would not dismiss those claims on the basis of one study and a good study at that, a lot more subjects than any of the studies you have mentioned.


No, I’m not saying that at all. I’m asking you why you think the chiropractors who operate that forum have allowed the post about the study to stay in their humour section.

What he said was silly and untrue and like you guys he does not like chiropractors. So he pokes fun at a peer reviewed study which shows no evidence of a link to stroke. You dont always get the results you want.

I stand by what I said. The chiropractic profession, as a whole, appears to take no cautionary attitude towards its practices - preferring, apparently, to spend its energies shouting down its critics (almost all of whom don’t have a vested interest in chiropractic) and cherry-picking studies in its support.

The main critic we have in the UK is Edzard Ernst and while I think the quality of his studies could be improved, he is entitled to have his opinion as are you "skeptics". I hope you dont think I have come on the site to shout you down, I just dont understand why you are so anti what I spent five years studying. As for cherry-picking studies I dont think you can accuse me of that.

The Meade Trial was not the meal ticket that chiropractors made it out to be:
http://forums.randi.org/showpost.php?p=3149877&postcount=66

Regards the Beam study, this was the view of Professor Edzard Ernst (who, incidentally, has been trained in spinal manipulation):
"My reading of the results is that the data are compatible with a non-specific effect caused by touch: exercise has a significantly positive effect on back pain which can be enhanced by touch. If this “devil’s advocate” view is correct, the effects have little to do with spinal manipulation per se."
http://www.bmj.com/cgi/eletters/bmj.38282.669225.AEv1#88126

These are studies people interpret them how they want. There is an average person who will respond in an average way . I would be very surprised if you were able to get a better examination anywhere than you would get from me on your first visit. It takes time and knowledge to interpret the findings. Most of our tutors at college were medical people which may surprise you.

Seven guys out of my class at school choose medicine one of them is a well known surgeon, we are still friends, none of them have any antagonism towards chiropractic like you guys have.Chiropractic like all professions have problems however they are not of the magnitude being implied here.


I take it, then, that you disagree with the conclusions of the latest systematic review on adverse effects of spinal manipulation:
http://www.jrsm.org/cgi/content/abstract/100/7/330

Yes and I gave my reasons in another posting. You would not accept as evidence that a survey of 30 doctors showed that they remembered that their patients headaches were gone after they had been to the chiropractor.


The profession was regulated over 6 years ago in order to protect patients, why has it taken so long to put one in place? You would have to ask our leaders. However I know the BCA publishes this information every year for insurance purposes.

Would you please provide more details about the one that’s being put in place. The Anglo European College of Chiropractic is doing it, you can contact them if you are interested.


Are you saying you don’t warn your patients about the risk of stroke associated with neck manipulation?

I tell my patients that there is anecdotel evidence of a risk of stroke. There is no evidence of a causal link and to my knowledge, a patient of mine has never experienced a bad reaction to chiropractic treatment.

[richard]

What is that relationship, and why do you care? Any such relationship is not available to chiropractic manipulation:
http://www.chirobase.org/02Research/crelin.html

What, specifically, is chiropractic, and what do you treat? You dodged that question from Blue Wode. You can simply cite a web-page with a description you approve.

Specifically, what does the chiro neck-snap do that makes it necessary? When there is no benefit (that cannot be achieved more safely, otherwise) the risk/benefit ratio is an unacceptably large number. One stroke is too many from an unnecessary procedure.

Since chiro is irrational, it makes no sense to go ahead as if the evidence were there. In this case, absence of evidence is evidence of absence. The problem is not that you are a small group, there are around 65,000 chiros in North America, the problem is that the best research shows chiro to be ineffective- except for some headaches and acute low-back pain, where it is as good as massage.
I see I am cross-posting with B Wode.

I think I have answered a lot of your questions in my recent reply to blue wode, not that I think that it will satisfy anyone. I dont believe in miracles.

I did not have time to read the article its 2AM. You ask about what conditions I treat? I dont treat conditions, people with conditions somtimes come to my clinic, I palpate for symetrical movement in the spinal joints and where its lacking I move the joint which stimulates receptors in that joint.

You may think that is not important, I disagree. These receptors have a purpose if only to inhibit pain ( pain gate theory). Why in recent years have doctors stopped advising bed rest? they discovered something chiropractors had been advising for years.Movement, if the joint is not moving you will get compensation and degeneration else where in the spine. Twenty years ago they imobilised the knee joint after surgery for three months now its all about movement ASAP.The key is movement and however you achieve it is good for your health.
Good night

[JJM]

The facet joints of the spine are innervated by mechanoreceptors, if these joints are not moving properly it affects the function of the nerves. I get them moving again, that’s all. Do you dispute this?

The relevant question is- can you prove this? Can you prove that joints are not moving properly and that you can correct the problem (you know- medical literature citations)?

How is the functioning of the nerves manifest? In other words, what measurable changes occur in any bodily function after you are done? If you cannot demonstrate a difference (cite medical literature citations), there probably isn't one; as indicated in the article (by Crelin) which I cited.

[Blue Wode]

Richard,

[RE: Around 80% of medical interventions are supported by evidence] 15 years ago David Eddy stated in the BMJ it was only 10%, I dont think you have any evidence for 80%. If you have it I will have to think again about my chosen profession.

I would be interested to know what conclusions you reach after you have thought again about your chosen profession:

In recent years the claim that only 20% or less of standard Western medicine is evidence-based has been repeated widely by health professionals and others.[1] This assertion is perhaps most often made by proponents of unproven (‘alternative’ and ‘complementary’) therapies with the implication that, if true, it might somehow justify the integration of any number of unconventional modalities with a similar dearth of supporting scientific evidence into main-stream medical practice. It should be immediately noted that this line of reasoning is an example of the logical fallacy tu quoque (‘you did it too’): one party cannot criticize another because both parties are guilty of the same ‘sin.’ While this argument may be without merit, it is often made and widely held to be valid. Therefore, the authors of this paper have attempted to identify the sources of, and examine the evidence for, the ‘20% or less’ claim.

-snip-

In 1991, Dr David Eddy, at a conference in Manchester, UK, claimed that only 15% of medical practice was based on any evidence at all. He apparently based this sweeping conclusion entirely on his studies of treatments for just two specific conditions: arterial blockage in the legs and glaucoma.[10] Subsequently, Dr Eddy’s claim, rather than the much more conservative OTA ‘armchair estimate,’ has been widely cited as a criticism of mainstream medicine.

-snip-

Regardless of the origin or intent of the original assessments, critics of the ‘10 to 20%’ claims were originally unable to refute them because no solid evidence existed either in favor of or against them. That situation has changed in recent years. A growing body of evidence now exists regarding the extent to which medical practice is evidence-based.

-snip-

Evidence for evidence-based practice includes those listed in the box (q.v.).

• 96.7% of anesthetic interventions (32% by RCT, UK)[13]

• approximately 77% of dermatologic out-patient therapy (38% by RCT, Denmark)[14]

• 64.8% of ‘major therapeutic interventions’ in an internal medicine clinic (57% by RCT, Canada)[15]

• 95% of surgical interventions in one practice (24% by RCT, UK)[16]

• 77% of pediatric surgical interventions (11% by RCT, UK)[17]

• 65% of psychiatric interventions (65% by RCT, UK)[18]

• 81% of interventions in general practice (25.5% by RCT, UK)[19]

• 82% of general medical interventions (53% by RCT, UK)[20]

• 55% of general practice interventions (38% by RCT, Spain)[21]

• 78% of laparoscopic procedures (50% by RCT, France)[22]

• 45% of primary hematology–oncology interventions (24% by RCT, USA)[23]

• 84% of internal medicineinterventions (50% by RCT, Sweden)[24]

• 97% of pediatric surgical interventions (26% by RCT, UK)11

• 70% of primary therapeutic decisions in a clinical hematology practice (22% by RCT, UK)[25]

• 72.5% of interventions in a community pediatric practice (39.9% by RCT, UK)[26]

More…

The evidence for evidence-based medicineComplementary Therapies inMedicine(2000), 8, 123–126

http://www.vet-task-force.com/CTiM.htm

It’s a sad moment for British medicinewhen the chair of the NHS Alliance, Dr M Dixon, states that ‘only 10% of what doctors do in primary care is evidence-based’.1 The actual evidence shows that the figure is around 80%!2 But even if the 10% figure were correct, this would not lend itself, as Dr Dixon does, to the integration of more unproven treatments into the NHS. We first need to ensure that a therapy generates more good than harm and only subsequently should we consider it for general use. This course of action is not ‘integrated medicine’ but follows the principles of ‘evidence-based medicine’.

1. Times, 17 January 2004.

2. Gill P, Dowe AC, Neal RD et al. Evidence based general practice: a retrospective study of interventions in one training practice. BMJ 1996; 312: 819–21.

News, Focus Altern Complement Ther 2004; 9: 160

http://www.medicinescomplete.com/journals/fact/current/fact0902a09n06.htm

[RE: Providing the scientific evidence for chiropractic] The facet joints of the spine are innervated by mechanoreceptors, if these joints are not moving properly it affects the function of the nerves. I get them moving again, that’s all. Do you dispute this?

Yes. Once again, please provide the scientific evidence for ‘chiropractic’.

[RE: Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey by Thiel, Haymo W. DC, PhD; Bolton, Jennifer E. PhD; Docherty, Sharon PhD; Portlock, Jane C. PhD, Spine. 32(21):2375-2378, October 1, 2007] There is anecdotal evidence that people have been injured by chiropractors.

And what type of evidence are you using to justify administering ‘chiropractic’ treatment to your patients?

[RE: Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey by Thiel, Haymo W. DC, PhD; Bolton, Jennifer E. PhD; Docherty, Sharon PhD; Portlock, Jane C. PhD, Spine. 32(21):2375-2378, October 1, 2007 in the ‘humour’ section of Chirotalk under the heading “Silly chiropractic research”] So he pokes fun at a peer reviewed study which shows no evidence of a link to stroke.

I’d say that he’s poking fun at the dubious quality of the study.

[quote][RE: The profession not displaying a cautionary attitude towards its practices and cherry-picking favourable study results] I just dont understand why you are so anti what I spent five years studying.[/QUOTE]

Because so far you’ve refused to provide any references to scientific studies in support of what you’ve spent five years studying.

[RE: The Meade trial and the BEAM study] These are studies people interpret them how they want. There is an average person who will respond in an average way . I would be very surprised if you were able to get a better examination anywhere than you would get from me on your first visit. It takes time and knowledge to interpret the findings. Most of our tutors at college were medical people which may surprise you.

Seven guys out of my class at school choose medicine one of them is a well known surgeon, we are still friends, none of them have any antagonism towards chiropractic like you guys have.Chiropractic like all professions have problems however they are not of the magnitude being implied here.

Bearing in mind that chiropractors in the UK are legally obliged (i.e. must) provide care that’s evidence based, on what scientific evidence do you base your treatment interventions?

[RE: The findings of the latest systematic review on adverse effects of spinal manipulation] You would not accept as evidence that a survey of 30 doctors showed that they remembered that their patients headaches were gone after they had been to the chiropractor.

There is a great deal of information provided in the review to suggest the spinal manipulation (‘chiropractic’) may not be a safe therapy.


Here’s the review again (full text):
http://www.jrsm.org/cgi/content/full/100/7/330

[RE: The length of time chiropractors have taken to start thinking about putting in place an injury reporting system similar to the Yellow Card system that is used for reporting adverse drug reactions.] You would have to ask our leaders.

As far as I can see your leaders are not to be trusted.

[quote][RE: Providing more details about an injuring reporting system that’s apparently being put in place.] The Anglo European College of Chiropractic is doing it, you can contact them if you are interested.[/QUOTE]

As a practising, registered chiropractor, why aren’t you keen to find out more details about it?

[RE: Are you saying you don’t warn your patients about the risk of stroke associated with neck manipulation?] I tell my patients that there is anecdotel evidence of a risk of stroke.

Good!

[JJM]

{snip} I dont treat conditions, people with conditions somtimes come to my clinic,

That is a standard, unartful dodge. What kind of "people with conditions" do you treat?

I palpate for symetrical movement in the spinal joints and where its lacking I move the joint which stimulates receptors in that joint.

You may think that is not important, I disagree. These receptors have a purpose if only to inhibit pain ( pain gate theory). {snip}

Show me the clinical evidence (medical literature) for this.

It sounds to me as though you follow the original Palmer method. In that case, I know there is no support for your claims. Moreover, Palmer's notions have been refuted by many lines of evidence, including the Crelin paper.

In short, Crelin dissected spines out of cadavers and twisted them in a controlled fashion. He determined that the nerves exiting the spine were unaffected by any amount of force up to that which caused the spine to break. Your twisting and popping means nothing with regard to health.

[richard]

The relevant question is- can you prove this? Can you prove that joints are not moving properly and that you can correct the problem (you know- medical literature citations)?

How is the functioning of the nerves manifest? In other words, what measurable changes occur in any bodily function after you are done? If you cannot demonstrate a difference (cite medical literature citations), there probably isn't one; as indicated in the article (by Crelin) which I cited.

You have attached some importance to this Crelin article, so I sat down at lunch pen in hand to take notes.

“The Scientific Test of Chiropractic’s Subluxation Theory”. I get as far as the first line. Chiropractic is defined in the dictionary as “a therapeutic system based upon the premise that disease is caused by the interference with nerve function,” The skeptic in me is thinking what kind of dictionary would describe chiropractic like this?? Fortunately there is a reference;

The RandomHouse Dictionary of the English Language 1966. The year England won the World Cup. Eric Cantona was Born. Thalidamide was still a wonder drug. Man had not landed on the moon, colour TV was a dream, never mind mobile telephones.

This is your evidence to demonstrate the “theory of chiropractic is erroneous” The ICA definition is from 64, The ACA is 63. The definition of Subluxation is 62. The article was published in 1973. He questioned DD Palmer 1895 theory that a “luxation” was a bone out of place trapping a nerve. I don’t know of a chiropractor who subscribes to this theory today, certainly not in the UK, not for thirty years has anyone believed bone out of place. I have not said it, so why have you presented this as evidence. Where have you been since 1966 Do you have anything recent to support this view of chiropractic even something in the last ten years would be acceptable.

Now for something current if you are interested. The importance of joint motion is well described in the literature as illustrated by the fact it is very rare now to see joints immobilised in plaster. The joint is innervated by the nerves supplying muscles that cross the joint. If functioning normally they send sensory impulses in to the spinal cord which pass through the medulla to the sensory lobe of the brain.

The medulla is important because it houses the cochlear nucleus which receives input from the ear, just correcting another impression in the skeptics chiropractic fact sheet, that “the ear does not connect to the brain via the spine” It’s the spinal cord. If you give someone an audible fright they might jump in response for example.

Manipulation of the sacroiliac joints for the treatment of sacroiliac joint dysfunction has been described in chiropractic literature since the earliest textbooks. Ignored as a cause of back pain by traditional medicine after Mixter and Barr focused attention on disc herniation in1934. The sacroiliac joints until recently were not commonly considered to be mobile enough to cause significant dysfunction from restricted motion. The
slipped disc theory has been completely discredited as a cause of back pain, and sacroiliac dysfunction first described by “quack chiropractors” in 1906 is the generally accepted by most in the medical profession as a major cause of back pain.

I am not a medical therapist and I don’t understand why you insist on me producing “medical research” to validate chiropractic. The study you are all getting excited about clearly demonstrates that physiotherapists are not very skilled at spinal manipulation and you want me to validate what I do using these studies, be serious?? It would be ridiculous for me to say show me a chiropractic study which says orthopaedic surgeons are good at their job yet you are happy to set this standard for me. Perhaps I can find something from the 60s

But before you get too excited the work of British orthopaedic surgeon Gordan Wadell(Back Pain Revolution; Churchill Livingstone 2ed 2006) explains that the key concept for Chiropractic, Osteopathy is musculoskeletal dysfunction. He describes how this dysfunction arises in response to abnormal forces generated within the musculoskeletal system that relate to abnormal posture or abnormal joint movement (hypermobility, hypomobility) ,muscle dysfunction, connective tissue dysfunction, muscle imbalances, and neurophysiological changes that include abnormal sensory input and abnormal neurophysiological processing.

Clearly Waddells description of musculoskeletal dysfunction is nearly identical to what many chiropractors call the Vertebral Subluxation Complex, which has been described on the WHO and GCC websites. Another medical man Kirkaldy-Willis provides a similar description of pathological changes that occur in the spines of patients with back pain.

How do I know I move the joint, I can hear it, I can feel it, so can the patient. How does a doctor know he is listening to noises in the base of the lung and not the stomach, training and experience.

I know this must be annoying but I am very good at what I do and am happy to answer all of your questions as long as I have time. In fact the only error that has been pointed out is the date of the Parmacetamol study. I would appreciate if you would go over what I have covered, if you have any questions, before moving on to new questions.

[Blue Wode]

He [Crelin] questioned DD Palmer 1895 theory that a “luxation” was a bone out of place trapping a nerve. I don’t know of a chiropractor who subscribes to this theory today, certainly not in the UK, not for thirty years has anyone believed bone out of place. I have not said it, so why have you presented this as evidence.

Are you sure about that? There are several hundred McTimoney chiropractors in the UK and their association’s website says this:

“By correctly training hands as an instrument of innate intelligence, healing can be encouraged to take place by the detection and correction of bony subluxations (slight displacements)”.

http://www.mctimoney-chiropractic.org/mca_objectives.htm

Isn’t a bony ‘displacement’ a bone out of place?

And what is “innate intelligence” ?

Clearly Waddells description of musculoskeletal dysfunction is nearly identical to what many chiropractors call the Vertebral Subluxation Complex, which has been described on the WHO and GCC websites.

Well the GCC has a duty (incredibly, as part of the regulation of chiropractors) to “promote” the chiropractic profession so of course it’ll carry a vague description of the so-called Vertebral Subluxation Complex (VSC) on its website.

Regards, the WHO’s website, weren’t the majority of those who developed its ‘Guidelines on Basic Training and Safety in Chiropractic’ (which includes a description of the VSC) directly involved with either chiropractic or alternative medicine? See pages 35-37 here:
http://www.chiroeco.com/50/bonus/WHOguidelines.pdf

Hardly impartial, is it?

[JJM]

Richard,

You clearly cannot explain anything in concrete terms. Not even specifically what you do for people, even though you are “very good at it.” Of course you are not a medical practitioner. Then again, why do “people with conditions” seek you? Wait, I know- you are a pseudo-medical practitioner.

The reason I request citations to medical literature is that pseudo-medical “literature” exists, and it is worthless. The “research” is very low quality; yet chiros (and homeopaths, and ad infinitem) like to cite it for me. There are articles on chiro in medical journals (e.g., Archives of Internal Medicine), they are just not favorable. There is no reliable research of any sort that validates chiro, except in the magical thinking of proponents.

[JJM]

Indeed, what is innate intelligence? According to chiro literature:


Lon Morgan, DC, DABCO
http://www.jcca-online.org/Client/cc...F?OpenDocument
As a “magnetic healer” Palmer believed he was correcting an undefined fifth force in the body that is otherwise unknown to science. Palmer believed he could influence this fifth force, termed Innate Intelligence (II), and that it was the explanation for the presence or absence of health.

Today, II remains an untestable enigma that isolates chiropractic and impedes its acceptance as a legitimate health science. Palmer discovered chiropractic. As a cult, it is difficult to repudiate the founder’s notion. A rational group would simply reject the Innate Intelligence. Chiros dance around Palmer’s irrational notions.

World Chiropractic Alliance on “Innate”
http://www.worldchiropracticalliance...ens/green5.htm
This modern document is labeled “philosophy.” They can’t dump the Innate; but they can relegate it to, unimportant, philosophy.

“The Meanings of Innate”
Joseph C. Keating, Jr., PhD
(Homewood Professor, Canadian Memorial Chiropractic College.
Vice President, National Institute of Chiropractic Research.)
http://www.jcca-online.org/client/cc...%20Keating.pdf
Since the notion was first introduced by D.D. Palmer circa 1904, “Innate Intelligence” has been a source of inspiration, confusion and derision for chiropractors. …

Unlike the subluxation-complex, which is a potentially testable and falsifiable construct, II is one of those untestable principles in chiropractic. The latter comment is interesting because it omits the fact that the chiropractic subluxation is not just potentially falsifiable, it has been tested and it does not exist. When this was demonstrated in the 60s and 70s, the chiro cult could not give up their sublux- so they redefined it. Now they do the same with the II.

These articles make it clear that II is mere philosophy. It has no value in health care; but chiros won’t repudiate Palmer. Keating says that most chiros identify II with homeostasis; which is a blanket term referring to the body’s many mechanisms for maintaining limits on life functions (such as body temperature). Although this suggests II is related to something real, there is no evidence that chiro has any effect on any homeostatic system.

[Admin]

If anyone wonders what all the fuss about Chiropractic is, this article gives a layman's terms overview: Chiropractic.

For a more in-depth look at Chiropractic there's this excellent critique by Dr. Harriet Hall: Chiropractic, health or hoax?

I think it's important to look at theory behind Chiropractic as well as looking at the evidence base.

Alternative 'systems of medicine' are often based on very simplistic ideas that do not require one to possess a medical degree to understand. Chiropractic certainly falls into this category. The idea of Innate Intelligence being blocked by Subluxations being far too silly for (almost) anyone to take seriously.