Value of chiropractors questioned

[richard]

I like the sound of that. "Arrogant," I might have to start wearing a cravat.

The general rule is that magazines written by and for quacks are peer-reviewed by quacks. Hence, they are not worth noticing. Let's face it, if a chiro ever did a proper study and got an exciting result- why publish in a quack magazine? Why not aspire to convince the medical world?


By all means, provide more; just make sure it is high-quality, clinical data (not speculation).

What was wrong with Spine Journal again or Gorden Wadell. Have we been here before? Many times, you are not interested in anything that does not agree with your beliefs,fair enough.

Come on admit it JJM and Blue Wode you are dissbelievers not true skeptics.

[JJM]

What was wrong with Spine Journal again or Gorden Wadell. {snip}

What?

Come on admit it JJM and Blue Wode you are dissbelievers not true skeptics.

In 112 years, nobody has ever provided reliable, clinical evidence in favor of chiropractic. What do you expect me to believe?

Belief is all a person can have in the absence of evidence. After 112 years, the "absence of evidence" may be taken as "evidence of absence" of proof in favor of chiro. You have not helped, with your feeble attempts at proof.

Think how exciting it would be if you were to present the first incontrovertible, clinical evidence in favor of chiro.

[Admin]

Come on admit it JJM and Blue Wode you are dissbelievers not true skeptics.

You chiropractors have been given a fair crack of the whip here and plenty of opportunity to provide evidence that what you practise has some evidence to back it up both for skeptics and for those who are reading out of interest.

We've generally been met with two tactics:

1) Obfuscation.

It's notable that chiropractors, when asked for supporting evidence of their claims, resort to quoting studies that have nothing to do with chiropractic's claims. It's no good quoting, as Nick did, a paper because what they are investigating sounds like what some chiropractors might describe as a subluxation!

Let's have the evidence, the clinical studies, showing what subluxations are, how they can be detected, which subluxations cause which particular problems, and how they are put right.

Fair enough, the skeptics here have you over a barrel because we know (and so so you) that no such evidence exists (!)

2) Ad Hominem points, insults and ridicule.

A constant theme with the chiropractors is that instead of dealing with the topic in hand (providing evidence etc.) they spend a lot of their time trying to discredit their opponents in any way they can.

Resorting to ridicule and making desperate attempts to belittle skeptics merely shows that the chiropractors cannot defend their practise and so resort to the fallacy of: don't like the message? Then shoot the messenger.

This is the tactic used by those who know they can't defend their position. If you had evidence to support you, you'd use it.


I think the important thing for people to understand with chiropractic is that:

• it a system of alternative medicine (they're not doctors);
• None of its basic tenets, particularly the 'subluxation', have ever been proven;
• Although they have an image as being 'back doctors' that is not what they are. Yes, they may well treat backs, but they treat backs not just for the likes of road traffic accidents, they manipulate spines for everything;
• They use Spinal Manipulation Therapy (which is not chiropractic) for lower back problems, and although this has been supported with evidence in the past, new evidence is emerging that it is not as useful as once thought nor is it better than other conventional treatments;
• Their neck manipulation can cause strokes in their patients. Although chiropractors deny it, this is known to be true and, if anything, an even more serious problem than is recognised because of under-reporting of the problem;
• They also tend to be into other forms of quackery such as 'applied kinesiology' (muscle testing) to diagnose food allergies etc. and then they sell you the supplements;
• They also tend to be vehemently anti-vaccination proponents. This, like most everything else they do, goes against science, evidence, and government medical policy.

They want to treat you, and your children. Everything and anything that goes wrong with anyone in your family will be treated with spinal manipulation - even babies and children (who may well be X-rayed in the search for imaginary subluxations).

OK, they're offering a placebo treatment like many other alternative medicine practitioners, but as they do not offer real cures for anything, is it worth the using this form of treatment when the risks are so potentially high?

Unfortunately chiropractic is legal, so it's a case of Caveat Emptor!

[Admin]

Here's professor Edzard Ernst's paper weighing up the benefits and risks of spinal manipulation:

http://www.ukskeptics.com/documents/spinal_manipulation_benefits_risks.pdf

Prof. Ernst is one of the very few people in the world who is assessing alternative medicines and applying scientific rigour to them.

This is exactly the sort of testing that skeptics have been crying out for for years. Let's apply the scientific method to the claims of alternative medicines and find out once and for all which things work and which ones don't.

Ernst does find that some things work (various herbs for example) but one thing that doesn't fare at all well is Chiropractic.

[Giddy]

Hello to you all. I have just recently be shown this forum by my wife and thought I'd like to take part in your discussions. My avatar probably gives away the fact that I am a practising chiropractor.

I have been involved in the profession for 21 years now after starting my chiropractic degree in Melbourne Australia (5 years human medical sciences).

I now currently work in Sunderland and if you are interested in commenting on my web site you can visit it at www.sunderland-chiropractic.co.uk It has been set up to give prospective clients a chance to investigate us in advance.

The questions and challenges to provide proof of the scientific validity of chiropractic in this forum are not surprising for me. I have been asking them myself constantly over my years of work.

Hopefully I'll be able to put my opinion out there and develop a dialog that examines the strengths and weakness of my profession.

[Blue Wode]

Hello Giddy, welcome to the UKS forum, and thank you for inviting us to view your website.

The questions and challenges to provide proof of the scientific validity of chiropractic in this forum are not surprising for me. I have been asking them myself constantly over my years of work.

Hopefully I'll be able to put my opinion out there and develop a dialog that examines the strengths and weakness of my profession.

Perhaps, for starters, you could answer the following questions:

The General Chiropractic Council (GCC) claimed in its 9th November 2007 press statement regarding the Hancock study that:

"The main treatments of chiropractic have been shown consistently in reviews to be more effective than the treatments to which they have been compared. Chiropractic intervention is safe, effective and cost-effective in reducing referral to secondary care."

http://www.gcc-uk.org/files/page_file/LANCET%20Australian%20study%20statement9Nov07.pdf

Bearing in mind that chiropractors in the UK are required by law to provide care that is evidence based, would you:

1. Please cite the scientific evidence to support the GCC’s claim that “The main treatments of chiropractic have been shown consistently in reviews to be more effective than the treatments to which they have been compared”.
2. Please cite the current safety data for ‘chiropractic’ including those for ‘chiropractic paediatrics’.
3. Please cite the current scientific evidence for chiropractic’s effectiveness.
4. Please cite the current scientific evidence for chiropractic’s cost-effectiveness.

Thank you.

[Raph78]

ernst's beliefs and resume about the safety and effectiveness of spinal manipulation have been well scrutinised and evaluated by bronfort et al http://www.chiroandosteo.com/content...1340-14-14.pdf

his methodology has been described as poor and misleading relying on anecdotal evidence.

your cited enst paper, john, is not the gold standard when it comes to the safety and effectiveness of spinal manipulation. he just quotes himself - not good evidence at all.

read the prospective national survey by thiel et al from 2007 http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

they have estimated that there are 4.000.000 neck manipulations in the uk alone each year. if it was causing stroke: where are the case reports in the literature describing this phenomenon in the uk? and wheres the evidence establishing cause and effect for the stroke claim?

a bit of soreness for a day after a musculoskeletal treatment is likely all you may have to endure.

you may all read this to inform yourselves abit more. this, after all was what got the discussion started. the hancock study was just proving that physio-manipulation does not work.

[seren]

If you don't mind me sticking ma sticky beak in, I've been following this thread for a while now. I'm a layperson, having no medical or scientific qualifications. I could, however, well be/have been a patient of a chiro, and as such I feel qualified to comment. I hope Raph78 that you will agree with me!

Until recently I had no idea chiropractic was a sham. Really. I just assumed because it was so common and you hear such a lot about it that it was legitimate. Therefore I was rather skeptical of skeptic's claims to the contrary when I first heard them.

This thread has totally changed my mind.

Raph, I would like to take your last post as an example of why, I hope you don't mind.

You have linked to a short paper whose purpose is to refute the study done by Ernst that John linked to. But Raph, that doesn't help me.
Firstly, it does nothing to prove that chiropractic is real. In other words:
It says nothing about the validity of chiropractic.
It's not a study of the efficacy of chiropractic.
It is not evidence that chiropractic works.
Secondly, it was written by a qualified chiropractor and published in chiro journal! It's completely and utterly biased. Of course he's going to disagree with someone who doesn't find in favour of his profession. Why should I listen to him?

That kind of thing just doesn't help the case for chiropractic. It just prolongs the debate while people have to say everything I just said and ask again for evidence showing that chiropractic actually works.

I thought we were going to get somewhere with Nick's MM Panjabi article, until that turned out to be not about chiropractic, and only supposition in any case.

I was confident that someone would be able to pitch up with a whole mound of good research that is:
1. Robust and scientific in approach
2. Unbiased (ie not written by chiropractors or for chiro journals)
3. Actually about chiropractic. One defining characteristic of the non-biased research we've been offered is its tangential nature. Not one has been an actual study of chiropractic.

After 112 years I can't believe you lot haven't come here and torn the place apart with sheaf after sheaf of proof that chiropractic has been researched and found to work.

I join Blue Wode in welcoming Giddy and hope that he will provide the evidence that's been so missing here. As I said, I'm a layperson but even I can see that nothing concrete has been provided yet. I urge you to answer Blue Wode's questions with good research and get this all cleared up for me, cuz I've got a sharp pain in my back needs looking at....

[Blue Wode]

ernst's beliefs and resume about the safety and effectiveness of spinal manipulation have been well scrutinised and evaluated by bronfort et al http://www.chiroandosteo.com/content...1340-14-14.pdf

his methodology has been described as poor and misleading relying on anecdotal evidence.

If you scroll down to the end of this link, you’ll see Ernst’s response to some of his critics regarding that systematic review:
http://www.osteopathy.org.uk/uploads/Letters_on_Ernst_and_Canters.pdf
There’s a particularly interesting comment about Breen et al in Ernst’s final paragraph.

With regard to Ernst’s ‘adverse effects’ systematic review, you can see his very considered and revealing response summarised here:
http://forums.randi.org/showpost.php?p=3018741&postcount=76

your cited enst paper, john, is not the gold standard when it comes to the safety and effectiveness of spinal manipulation. he just quotes himself - not good evidence at all.

So what ‘good’ scientific evidence can you provide for the safety and effectiveness of spinal manipulation?

read the prospective national survey by thiel et al from 2007 http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

they have estimated that there are 4.000.000 neck manipulations in the uk alone each year. if it was causing stroke: where are the case reports in the literature describing this phenomenon in the uk? and wheres the evidence establishing cause and effect for the stroke claim?

a bit of soreness for a day after a musculoskeletal treatment is likely all you may have to endure.

But can it be taken seriously? As previously posted, Chirotalk, the skeptical chiropractic discussion forum (operated by a chiropractor, and moderated be several) has left the abstract of the study in its ‘humor’ section under the title “Silly chiropractic research”:
http://chirotalk.proboards3.com/index.cgi?board=humor&action=display&thread=119413 7405


As you’ll see from post #69, several instances have been cited where chiropractic was the cause of a serious adverse event:
http://www.skeptics.org.uk/forum/showpost.php?p=24456&postcount=69
That post also posed a very pertinent question about the Thiel and Bolton study which, so far, hasn’t been answered by any of the chiropractors posting to this thread.

you may all read this to inform yourselves abit more. this, after all was what got the discussion started. the hancock study was just proving that physio-manipulation does not work.

The General Chiropractic Council’s formal complaint to the Press Complaints Commission has already been thoroughly examined in post #125, and, once again, several questions about it remain unanswered:
http://www.skeptics.org.uk/forum/showpost.php?p=24870&postcount=125

[MischiefMonkey]

I thought I understood Chiropractic but I am now totally confused.

I thought it only dealt with back pain, an alternative or complement to physiotherapy. But bed wetting and vaccine advice?

I have back problems and to refer to the original post & the report it referenced I have to say I am more concerned that diclofenic has been shown not to have a beneficial effect.

Giddy, I had a good look at your web site. You reference research that, to me a lay person, seems to at best equate some chiropractic practices with physio but mostly dismiss chiropractic interventions. As physio is free on the NHS and has been shown to be as effective or more effective, why should anyone (in the UK) pay for Chiro treatment?

[nick]

Good evening

Just a little thought, do the skeptics out there have the same issues with osteopathy or physiotherapy as they so clearly do with chiropractic?

Similarly are you not skeptical about all the estimated 75 000 artifical chemicals that we are exposed to each day and the various drug interactions that take place that no one really knows whats happening with. (see new scientist 1st Sept 2007 p44).

Does doubt not enter your minds when the four leading killer in the US in 1994 was medications (see journal of the american medical association 1998; 279 1200-1205)
http://youtube.com/watch?v=rHXXTCc-IVg

Are heads not scratched with all that unnecessary low back surgery.
http://www.newyorker.com/archive/200.../020408fa_FACT

Or is that ok?

Chiropractors like Richard, Ralph and myself may have a different set of philosophical beliefs to you but that does not mean that our belief system is wrong just different.

Sweat dreams

[Admin]

Just a little thought, do the skeptics out there have the same issues with osteopathy or physiotherapy as they so clearly do with chiropractic?

Actually this was an issue I was thinking of raising. Particularly Osteopathy. Which as far as I can tell is just as wacky as Chiropractic but seems to get by without much critical appraisal.

I seem to remember wanting to appraise it but there's very little information on it at all!

Similarly are you not skeptical about all the estimated 75 000 artifical chemicals

I'd be more concerned if we were being exposed to chemicals that were harmful if we were exposed to a harmful dose. Whether they are artificial or not is irrelevant.

Sweat dreams

Same to you.

[Admin]

Until recently I had no idea chiropractic was a sham. Really. I just assumed because it was so common and you hear such a lot about it that it was legitimate.

I think that's true of most people.

That's why I highlighted the point about people thinking that they're 'back doctors'.

Fortunately with these crackpot ideas about health and healthcare (unlike with real medicine) a layperson can read the theory behind it and recognise it for the stupidity that it is.

Everything that we (UKS) say about Chiropractic theory is not just supported by people who think like we do (i.e. scientifically) but anyone can research the system of chiropractic put forward by D.D. Palmer himself and realise that we're only presenting the same theory that he did!

When it comes to alternative medicines, I always say to people: read their theories of how it's all supposed to work and see if you still believe it.

The theories behind things like Chiropractic are so inane that anyone with an ounce of rationalism in them will see them for the crazy ideas that they are.

[JJM]

I thought I understood Chiropractic but I am now totally confused.

I thought it only dealt with back pain, an alternative or complement to physiotherapy. But bed wetting and vaccine advice?

I do not know if chiros learn as much as physiotherapists. I do know chiros imagine they are qualified to diagnose (physios do not, they work with doctors who diagnose). As for bed-wetting, the chiros say they cannot treat it; but, they have anecdotes ... In other words, they refuse to make claims (which they know are unsupported); but they like to work as if the unspoken claims are legitimate.

{snip}

[JJM]

{snip} Just a little thought, do the skeptics out there have the same issues with osteopathy or physiotherapy as they so clearly do with chiropractic? {snip}

A little thought, indeed. This is irrelevant to your claims of efficacy; which claims we wait for you to assert and justify.

Chiropractors like Richard, Ralph and myself may have a different set of philosophical beliefs to you but that does not mean that our belief system is wrong just different. {snip}

Beliefs are all you can have when you have no data. We have been asking you for data.

Some people believe that prayer can cure type-1 diabetes, they die. Some chiros believe they can cure epilepsy, they kill people. Are their belief systems wrong, or just different?

Your "belief system" is wrong. I can state that with confidence despite you dodging the question of what you think chiro treats successfully.

Chiro does not have any theoretical basis, it has an uneducated notional basis. I have read all about it. If you do not follow Palmer, you are not a chiro, and Palmer was wrong.

I look forward to your actual claims of efficacy, and the reliable, supporting evidence.