Wednesday, July 29, 2009

Guns don't kill people, Chiropractors with guns kill people

Here is an article by Simon Singh. Leah went to a chiropractor once and my impression was that we were meeting the smarmiest snake-oil salesman ever. He actually told Leah that if he didn't adjust her 80 more times she would just become paralized.

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results - and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that "99% of all diseases are caused by displaced vertebrae". In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer's first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying - even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world's first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: "Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck."

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

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.



  1. I don't know too much about chiropractors, but we did take Jazz to one, and his colic went away completely after two visits. We were at our wit's end, and a friend suggested it after saying it worked with her baby. SO, for us, it actually worked. We were also lucky in that the guy who did it was super gentle, explained every step to us, and actually didn't even charge us.

  2. at last, something we agree upon unequivocally. because of my MS, i have someone recommend i see their chiropractor at least once a thanks. i have enough smarmy snake oil salesmen in my life already!

  3. Thanks to your blog, I had weird alternative medicine dreams last night. Last time I read your blog before bed....

  4. While I agree that many chiropractors are definitely on the smarmier side of things, there are actually some that do care about the patients (not just their money), and who know what they're doing. And there are cases where they are more suited to a medical situation than general practitioners. When I was in high school, I woke up one morning and stretched with my arms over my head...annnd POP! My neck popped and I could no longer turn my head or move my right arm and I was in excruciating pain. I went to the chiro who managed to pop it back into place, and while the pain was not immediately relieved (I didn't expect it to be, as the muscles had tensed up completely afterwards and didn't relax for almost a week) it was much, much better. I spoke to my doctor afterwards, and he admitted that he wouldn't have been able to do anything to help me besides prescribing pain medication, which wouldn't have helped the root of the problem.
    I've also had experience with a baby that had colic and was helped by chiro treatments. The way he explained it made sense to me: that going through the birth canal is not so easy and tends to twist their spines. They just use pressure points to relieve some of the muscle tension, they don't go cracking baby's backs or anything.
    So, I think that lots of people tend to rely on chiropractors for things that they aren't really qualified to do, but I also think there ARE cases where you would need a chiropractor...namely anything to do with the back, which doctors will admit they can't do a heck of a lot about.

  5. there are good chiropractors and bad ones, just like everything else. my chiropractor's aim has always been, to my face anyway, to eventually have it so that only the odd adjustment, once in a blue moon, is necessary.
    I had a really, really nasty fall in roller derby training that kept me off skates for 3 months. I went to the chiro right away (as I bypassed my butt and actually managed to land right on my lower back...ugh), and got relief right away. my doctor supported her care, and in fact sees a chiropractor himself.
    at least, if your back is injured, go to the back doctor. they actually have to go to accredited schools for a long period of time to become a DC.