Beware the Spinal Trap

The following is a reprint of an article by Simon Singh that appeared in the Guardian last year. It is highly critical of significant aspects of chiropractic. As a result the British Chiropractic Association decided to sue Simon Singh.

The article is being posted and reprinted today on many blogs and in magazines as a sign of solidarity with Simon as he fights this misconceived libel case. His lawyers have edited several sections that are at the heart of the BCA claim. As you can see, the substantive article remains – that chiropractors lack evidence for their treatments. I believe it is in the public interest that such criticism is not allowed to be stifled by the legal actions of vested interests.

 

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.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

On this theme…

8 Comments on Beware the Spinal Trap

  1. Where "re-published? At a fence? 😛
    I don't see still that Guardian (or other similar newspaper) has republished this text (even edited!.

    I think that this step is useless. It will give nothing.

  2. I has asked why the article was edited. Our reasonable Dr. Aust has explained me, why it was done so:

    http://draust.wordpress.com/2009/07/12/of-conferences-5-yr-olds-and-professors/#comment-2090

    Good explanation.

    And here is my answer:

    "Wild nonsense!
    And if 15000 bloggers re-published this article in its ORIGINAL version, would these 15000 people be punished for their "committing frank contempt of court, as well as repeating the defamation"??!
    Idiotism.

    I shall leave original text in my blog surely. I don't intend to respect the stupid laws. I was not taught this in my native country! 😛 "

  3. One of my proudest accomplishments is that I managed to steer two female co-workers away from chiropractors who were seriously hurting them.

  4. Fact: If a caregiver of any kind can devise and implement a systematic approach to improving the mobility and integrity of the spinal column and adjacent tissues using manipulation the resultant reduction of mechanical stress on the whole system not only reduces pain but improves health in ways that are not always testable. Why do your toes curl when you have a tooth pulled if something being done to one end of your body has no effect on the whole. I always like to point out that the French proved the importance of human spinal integrity centuries ago with the development of the guillotine!!! Oh, by the by, the first chiropractic adjustment was given in 1895 by Palmer, but think of the horrors that were taking place in Medicine at that time. No matter what kind of jealousy has driven you to slander the popularity of Chiropractic, you will have to resign yourself to the fact that the profession has grown and strengthened world wide for more than a century without the help of any third party lobby from any such giants as the pharmaceutical industry. The 50+ patients that beat my door dowm every day for the last 20 years ( without advertising) would bury your sight with positive comment if I were foolish enough to give you that sort of attention. Good Fun. Chiropractic Multimillionaire, Dr. Ethan Hagen

  5. Not bad money,50+ every day,let’s say £35 per average visit-£1,750 per day and £8,750 per week,48 weeks a year £420,000 not bad wanga

    • Narcotraffic produces much money and both activities are antiéthical because do not produces something
      Get thousands of dollars lieing to sick and desperade patients are antiethical, but is legal.

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