Reply With QuoteAccording to an article written by Simon Singh and published in the Guardian, Edzard Ernst "has identified about 700 cases of serious complications among the medical literature". That's just published cases.Originally Posted by gsh341
The rest of what you have posted is all superflous as you probably know. However this strongly suggests that you have a conflict of interest to declare.
The art of medicine consists in amusing the patient while nature cures the disease. Voltaire
According to an article written by Simon Singh and published in the Guardian, Edzard Ernst "has identified about 700 cases of serious complications among the medical literature". That's just published cases.
"You got to use your brain." - McKinley Morganfield
I keep getting this terrible feeling of deja woo.
Is it? Perhaps you have more up-to-date information than this:“Although four possible scenarios were given by Dr. Bezold, it’s clear the worst case scenario, Scenario #2: Downward Spiral, is the most accurate now inasmuch he said 15% of DCs have quit the profession. Meanwhile, there has been a 39% drop in chiro education student enrolment from 1969-2002 and, while the use of CAM in general has increased, the largest decrease occurred for chiropractic (9.9% to 7.4%) according to the recent Eisenberg study. Indeed, there’s little to cheer about when faced with the hard facts about this profession.”
http://chirotalk.proboards3.com/inde...2967697&page=1
The source of the information in that quote comes from here (a non-skeptic site):
The Future of Chiropractic Revisited: 2005 to 2015 Report & Online Poll
http://www.altfutures.com/poll.asp
But isn’t that, for the most part, down to a combination of the effects of the adjustment being short-lived (thus requiring repeat visits/encouraging dependency), the cyclical/self-limiting nature of the patients’ presenting symptoms, and practice building/patient education tactics which tend to amount to little more than deliberate scare-mongering/brainwashing? I would also add that many people just want to feel cared for and chiropractors seem to be very skilled at exploiting that situation with their lengthy “wellness care” and “maintenance care” programmes (for which there is currently no scientific justification: http://www.chiroandosteo.com/content/16/1/3 )
Indeed, it would appear that chiropractors, out of necessity, have to treat almost anyone who walks through their door - young or old, symptomatic or asymptomatic - otherwise many of them would go out of business pretty quickly. The whole problem is put very succinctly by Stephen Barrett (Quackwatch) in the ‘Spine Salesmen’ chapter of the book, The Health Robbers: A Close Look At Quackery In America:
The quote you lifted which says…"If a chiropractor limited his practice to musculoskeletal conditions such as simple backaches, if he were able to determine which patients are appropriate for him to treat, if he consulted and referred to medical doctors when he couldn’t handle a problem, if he were not overly vigorous in his manipulations, if he minimized the use of x-rays, and if he encouraged the use of proven public health measures, his patients would be relatively safe. But he might not be able to earn a living." (p.175)
At one time the American Medical Association labeled chiropractic medicine as an unscientific cult. Since the 1970s, however, chiropractic therapy has grown in popularity and acceptance. Today chiropractors are licensed in all 50 states. Many health insurance plans and all government medical plans cover some treatment. It [chiropractic] is the third largest *primary care* profession in the world, behind only medicine and dentistry.
…is more than a little worrying - i.e., how can a primary care profession deliver reliable healthcare when it is riddled with quackery?
For example, in 2005, the World Federation of Chiropractic (WFC) held an international consultation on 'The Identity of the Chiropractic Profession' which produced a chart called “Perceptions of How the General Public Perceives the Chiropractic Profession”:
http://www.wfc.org/website/WFC/website.nsf/WebPage/IdentityConsultation?OpenDocument&ppos=2&spos=4&rs n=y
(Scroll down to "Survey Results - the survey report by the WFC's consultants, Manifest Communications Inc." Click on the link next to it, and then 29 clicks will take you to the chart.)
It illustrates the percentage of chiropractors who said that the following phrases described the profession “perfectly” (7 on a scale of 1 to 7) or almost perfectly (6):
“Management of vertebral subluxation an its impact on general health” - 65% of chiropractors said that the general public should perceive chiropractic that wayBut perhaps these views aren’t too surprising when you take into account the fact that state laws in the USA continue to define chiropractic as a method of adjusting “vertebral subluxations” and that, in the UK, the scope of chiropractic is not defined by law.
“Management of vertebral subluxation” - 57% of chiropractors said that the public should perceive chiropractic that way
In addition to the above, in a document entitled “Abstracts of Previous Relevant Research” which summarises past research sent to the WFC by members (and others), in the United Kingdom section under section C, no.2, it states:
"A strong majority [of UK chiropractors] considered the management of musculoskeletal conditions (90%), the management of organic or visceral conditions (69%) and the management of children (98%) to be within the scope of chiropractic practice."
That research was conducted in 2003.
In the same document, in the USA section under section E, no.6, it states:
"Approximately 9 in 10 [USA chiropractors] confirmed that the profession should retain the term “vertebral subluxation complex” (88.1%) and that the adjustment should not be limited to musculoskeletal conditions (89.8%). Subluxation is rated as a significant contributing factor in 62.1% of visceral ailments."
That research was conducted in 2003 as well.
In addition to that, it’s worth noting that section F of the USA section outlines some more research from 2003 that isn't very optimistic about the future of chiropractic:
http://www.wfc.org/website/WFC/website.nsf/WebPage/IdentityConsultation?OpenDocument&ppos=2&spos=4&rs n=y
(Scroll down to Additional Documents for Historical Review, and click on “Abstracts of the most relevant research” next to Background Research)
What you don’t seem to appreciate is that there’s a good chance that serious complications resulting from chiropractic treatment are going unreported due to the nature of some of the injuries. For example:
It’s also worth bearing the following newspaper report in mind from October 2008 regarding the ongoing Sandra Nette Class Action lawsuit,Sometimes the damage is immediate and the patient collapses on the chiropractor’s table. Sometimes mild symptoms start immediately and progress after the patient leaves the chiropractor’s office. Sometimes the tear is a small one and it clots over; then days later the clot breaks loose, travels to the brain and causes a delayed stroke. By this time, the patient may not connect his sudden collapse to the previous visit to the chiropractor.
-snip-
Chiropractors do not follow up on every patient. 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.
More...
http://www.sciencebasedmedicine.org/?p=94#more-94because it suggests that your assumptions could be wrong.The Nette's lawyer Daryl Wilson says dozens more Albertans are coming forward with similar health complaints after visiting chiropractors.
http://edmonton.ctv.ca/servlet/an/local/CTVNews/20081002/EDM_chiro_100208/20081002/?hub=EdmontonHome
That’s very true, and, after more than 100 years, the data are now in with the following being what prominent scientists Simon Singh and Edzard Ernst propose that all chiropractors be compelled by law to disclose to their patients prior to treatment:
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.Ref: Trick or Treatment? Alternative Medicine on Trial, P.285
Indeed Simon Singh, as many of us know, has gone a step further:
…if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
(See my signature line for the link.)
Or it could be, as UKS member, JJM, suggested on another chiropractic thread:
“…perhaps GPs unload intractable, self-limiting cases on chiropractors for placebo "treatments." That is not really an endorsement of chiropractic as much as an acknowledgment that they are repositories for people who really need no treatment (with the hope they will not harm).”
For those interested, an excellent summary of chiropractic can be found here:
http://www.ukskeptics.com/article.php?dir=articles&article=chiropractic.php
Last edited by Blue Wode; 18th January 2009 at 09:40 AM. Reason: To activate a URL
ebm-first.com
What alternative health practitioners might not tell you.
If you mean that believing in the benefits of chiropractic from the point of view of a person that has been visiting chiropractors on and off since the age of 12, then perhaps I do. Growing up on a farm, playing [American] football, ice hockey, snow skiing, water skiing and being in the military has provided ample reasons to see doctors for joint and back problems over my 41 years.
However, unlike you, I have experience with spinal problems dealt with by general practitioners, orthopedic specialists and chiropractors. From this I can draw a reasonable conclusion of which methods has provided the greatest relief and has worked the fastest.
Chiropractic has become my first choice for the small issues that come up.
Blue,
Might I recommend that the UK define the scope of a practice before they pass judgement on it? Not doing so is like saying that music sucks without defining what kind of music you're discussing.
Also, you found 700 documented cases where somone was injured or killed by chiropractic. I found proof of an approximate 160,000 annual deaths during surgery from causes not related to the initial reason for surgery.
I suppose I could find, if I looked long enough and in the right place, 700 documented cases of people being injured or killed by all sorts of things from toaster ovens to sex. Should we ban those too?
I believe that many of you are being alarmist over something you only know about from stuff you found on the internet. You might as well say you learned everything you needed to know about sex from those insipid films that you had to watch during sex education classes at school.
P.S. If you did learn everything you know about sex from those films, I have to tell you that not every woman has gonorrhea or crabs and sex is a lot more fun than those movies let on.
Ah! now I see, what you mean is that when you have problems you pester your physician to refer you to a quack, not that you have personally had request from physicians to refer on their patients.
In respect of your conclusions, I know many people who after a lifetime of experience will swear blind that only by praying to St Jude when life is looking very black, can they turn their 'fortune' around. The problem with individual experience is that confirmation bias leads to self fulfilling prophecies.
The point Blue was making was not whether the greater number are harmed by surgery, rahter whether we had an adequate information base to determine if the benefit substantially exceeded the risk. In the case of surgery this has consistently been shown to be the case (accetping that there are individual cases where this is evidently not so). The problem with chiropracty is that most practicioners happily use the technique where it cannot work (risk without benefit), and that where it can (back pain) there are alternatives with a known risk benefit ratio, which is not the case with chiropracty.
The art of medicine consists in amusing the patient while nature cures the disease. Voltaire
That would be the "TEETH" approach (or perhaps TTFO).Or it could be, as UKS member, JJM, suggested on another chiropractic thread:“…perhaps GPs unload intractable, self-limiting cases on chiropractors for placebo "treatments." That is not really an endorsement of chiropractic as much as an acknowledgment that they are repositories for people who really need no treatment (with the hope they will not harm).”
Alternatively, it could be a similar situation to that with homoeopathy in the UK. Homoeopaths love to quote statistics which say that over 50% of GP practices refer patients for homoeopathic treatment, as an apparent endorsement of homoeopathy. Research carried in connection with the closure of the Tunbridge Wells Homeopathic Hospital found that while this was the case, less than 1% of patients were referred, and it was almost always at the patient's request rather than as a result of a clinical decision by the GP.
"You got to use your brain." - McKinley Morganfield
I keep getting this terrible feeling of deja woo.
No, I have never sought a referral from a physician for chiropractic care. It is not needed here in the US as every health insurance plan I have ever had has recognized chiropractic as an accepted form of treatment and covered it without referral.
What I meant was that after having received treatment by a MD, the physician stated that in addition to the exercise and rest that he prescribes, he also recommended occasional chiropractic care to help maintain a healthy back.
And you have proof that they were incorrect?In respect of your conclusions, I know many people who after a lifetime of experience will swear blind that only by praying to St Jude when life is looking very black, can they turn their 'fortune' around. The problem with individual experience is that confirmation bias leads to self fulfilling prophecies.
That is a completely different topic though and should be left out of this one.
The risk/benefit ratio must be known, otherwise insurance companies would not cover it, would they? Insurance companies are VERY risk averse and also VERY stingy. As such, they would not pay for something they thought would possibly cause further injury to the patient and require further payments for more extensive (and expensive) medical procedures.The point Blue was making was not whether the greater number are harmed by surgery, rather whether we had an adequate information base to determine if the benefit substantially exceeded the risk. In the case of surgery this has consistently been shown to be the case (accepting that there are individual cases where this is evidently not so). The problem with chiropracty is that most practitioners happily use the technique where it cannot work (risk without benefit), and that where it can (back pain) there are alternatives with a known risk benefit ratio, which is not the case with chiropracty.
As for unwarranted use of chiropractic, most insurance companies only allow a certain number of chiropractor visits per year (mine is 24). Both the chiropractor and patients know this and don't wish to squander the covered visits. They also do this for dental insurance and other health maintenance care. This is a reasonable measure to prevent hypochondriacs and unscrupulous doctors from abusing the insurance company.
It is a fact that the precise risk/benefit ratio is currently not known. Indeed, some insurance companies' coverage of chiropractic could well change in the next year or two pending the outcome of the Nette class action lawsuit:
A Canadian woman who was paralyzed by a neck manipulation has filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem. The suit, which is seeking more than $525 million in damages, targets Alberta chiropractors who provide inappropriate spinal manipulations and regulators who have failed to curb their use. The plaintiffs are Sandra Nette and her husband David.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The vertebral artery is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining [1]. The lawsuit claim document states:
The lawsuit names three defendants:
- In 2007, Sandra underwent treatment that Edmonton chiropractor Gregory Stiles had recommended to correct "subluxations" and improve her health and wellness.
- The treatment was unnecessary and dangerous.
- Stiles manipulated Sandra's upper neck, rupturing both her right and left vertebral arteries, disrupting the blood flow to her brain and causing a cascade of strokes.
- As a result, Sandra has "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm [2].
-snip-
- The Alberta College and Association of Chiropractors, for allegedly failing to properly regulate the use of spinal manipulations, particularly to the upper neck.
- Gregory Stiles, and The Spa at Life Stiles, where Stiles works. Stiles has been an officer of the College's council and chairman of its quality assurance and marketing and promotion committees.
- The Alberta Ministry of Health, which is ultimately responsible for the health services offered to the public.
According to Stiles's Web site:
The suit charges that Stiles misrepresented the benefits and failed to adequately disclose the risks of spinal manipulation. The plaintiffs' lead lawyers are Daryl Wilson, Q.C. and Philip Tinkler, Esq., of Fraser Milner Casgrain LLP, one of Canada's largest law firms. In 2006, Tinkler, who heads the firm's Edmonton class-action group, negotiated a $100 million settlement in a suit against the Government of Alberta [5].
- Chiropractors find and release areas of the spine that are out of balance and putting tension on the nervous system. These areas are called subluxations. With an adjustment the nervous system will work with greater ease so you can perform and function better.
- A subluxations [sic] is a spinal misalignment that causes nerve interference between the brain and the body. When nerve function is interfered with-muscles, blood vessels and organs may malfunction. This can produce pain, restrictive motion, degenerative changes or ill health.
- Adjustments will release the subluxations in your spine.
- Chiropractic can be used as a treatment of a specific ailment or you can choose to use it as a way of maintaining and improving your overall health and wellness. The first choice limits your time and benefits. The second gives you the opportunity to experience greater health and well being over time [4].
The firm has set up a separate Web site that provides further information about the case and how to join the plaintiff class.
More…
http://www.chirobase.org/08Legal/nette.html
ebm-first.com
What alternative health practitioners might not tell you.
[quote=gsh341;51980]
And you have proof that they were incorrect?
That is a completely different topic though and should be left out of this one.
[\quote]
So now miraculous intervention of saints is possible! We need randomised controlled trials of prayer to each individual saint before we can say which ones work and which ones don't!
Your assertions of the benefit of chiropracty and evangalists' assertions of the power of prayer are based on identical approaches to evidence gathering and validation. Further you assert that only some chiropracters are effective, so one must test each individual practitioner to show that that individual is hopeless, not that this is true where tested. Just like the saints!
The only difference is that you wish to defend chiropracty only where it is used for back pain, not something most practicioners would recognise as so. They insist they can treat asthma etc, by treating imaginary subluxations.
The art of medicine consists in amusing the patient while nature cures the disease. Voltaire
I'm just poking a little fun at you and your obsessive need for proof by asking what proof you have that prayers are not answered and that God doesn't exist.So now miraculous intervention of saints is possible! We need randomised controlled trials of prayer to each individual saint before we can say which ones work and which ones don't!
Your assertions of the benefit of chiropracty and evangalists' assertions of the power of prayer are based on identical approaches to evidence gathering and validation. Further you assert that only some chiropracters are effective, so one must test each individual practitioner to show that that individual is hopeless, not that this is true where tested. Just like the saints!
The only difference is that you wish to defend chiropracty only where it is used for back pain, not something most practicioners would recognise as so. They insist they can treat asthma etc, by treating imaginary subluxations.
I can't prove that God does exist and you can't prove he doesn't.
In the same vein, the lack of extensive evidence for your side of this argument is just as bad as my lack of extensive evidence for mine.
Until a completely unbiased group is found to examine and asses the results of chiropractic care over an extended period of time (say 20-30 years or so) with a proper control and test groups measuring things such as cost of care, number of doctor visits, over all patient health, health of patients in the specific areas treated and so on, this will be little more than speculation on your part and personal opinion based on personal experience on my part.
I can understand your skepticism of chiropractic and appreciate the need for it. However you are not acting as a skeptic when you quit looking at the possibility of chiropractic having possible benefits and decide that it is bad and should be banned outright. You have chosen a side and refuse to be swayed.
I, as the party that believes in the value of chiropractic for spinal and joint problems through personal experience, can have a more solid stance, but even I draw the line at believing that chiropractic can cure asthma or even the common cold without substantially more proof.
Instead I believe that independent and exhaustive studies examining the entire chiropractic profession and it's claims would be beneficial. Until those studies have been done within a set of parameters, I have an open mind about the subject.
How do you know that none of us have experienced chiropractic?
It would not be time wasted if you were to read Simon Singh’s experience of acupuncture:
http://news.bbc.co.uk/1/hi/health/7436512.stm
ebm-first.com
What alternative health practitioners might not tell you.
I don't, but since I have not heard any of you reference you own personal experiences concerning chiropracticin this discussion, I can assume that you have none.
Simon Singh's acupuncture experience doesn't interest me much since he is not here to answer the questions I may have. Also, I'd much rather hear about YOUR experience with acupuncture as Simon may be full of crap and your experience may be vastly different than his.
Also, I don't care about acupuncture. I'm discussing chiropractic.
Last edited by gsh341; 20th January 2009 at 02:54 PM.
That is a big assumption.
If you read the report, you will learn that Simon Singh’s experience fully demonstrates the futility of presenting personal experience as evidence.
But we don’t know what his experience was - and, even if we did, it would tell us nothing of value.
ebm-first.com
What alternative health practitioners might not tell you.
If I were to say that I have had experience of chiropractic, and that it worked, or that it was totally useless, how would that be any help in coming to a conclusion? All it would add would be an unreliable and uncheckable anecdote, as do your claims. There is plenty of reliable research about chiropractic. It makes no sense to chuck it all out because a poster on an internet forum claims to have personal experience.
"You got to use your brain." - McKinley Morganfield
I keep getting this terrible feeling of deja woo.
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