Chiropractors at War with their Regulator, the GCC

jointstatmentFrom Richard Lanigan’s blog, we learn that the head of the four chiropractic associations have written to the GCC to state that their members have no confidence in their regulatory abilities. Richard Brown, President of the British Chiropractic Association has written the letter, co-signed by Ross McDonald, Kevin Proudman and Bernadette Martin, the Presidents of the Scottish Chiropractors, the United Chiropractic Association and the McTimoney Chiropractors respectively.

The letter notes that the BCA recorded a vote of no confidence in the GCC at their AGM. The Scottish Chiropractors also passed a vote of no confidence, and the others held an online survey to judge their members feelings.

The GCC is a statutory regulator. That is, anyone wishing to practice as a chiropractor in the UK must be registered and abide by their code of ethics and practice. So, what is causing this concern?

Well, a big part of it is that hundreds of chiropractors are now under investigation by the GCC for making misleading claims on their websites. This was a direct result of Richard Brown and the BCA deciding to sue the writer Simon Singh for libel after he wrote in the Guardian that the BCA were “happily promoting bogus treatments” for children’s ailments. The law suit ended in humiliation for the chiropractors as they were forced to back down and repay Simon’s costs mounting to hundreds of thousands of pounds.

That was not the only bad effect of this misconceived legal case. The abuse of law outraged thousands of people and it is now likely that the law will change as a result of this. (Buy your Geek Calendar to support the libel reform campaign here.) A number of individuals decided that so many BCA chiropractors were making these unfounded and exploitative claims that they submitted hundreds of official complaints to the GCC about their conduct. Those complaints are now under investigation. The complaints caused mass panic amongst chiropractors with the associations ordering their members to take down their web sites for fear of their bogus claims being complained about.

Richard Brown, the President of the BCA, is also under investigation for presenting misleading information to the public about the effectiveness of chiropractic in children.

And with the new formation of the Nightingale Collaboration, which sets out to deliberately challenge misleading claims from practitioners of alternative medicine through regulation and legal means, the other chiropractors must be quaking in their boots that they will essentially be silenced from pretty much any form of advertising or risk a disciplinary hearing.

And so, the regulator, which has given the chiropractic trade the so-much-desired air of respectability, is being directly attacked by its own registered members. This is not surprising. It was a big mistake to give official state recognition and regulation to a discredited, superstitious and pseudoscientific form of medical treatment in the first place. Chiropractic theory has been shown to be nothing but mystical whimsy and the effectiveness of their special back rubs has now only been shown to be marginal for lower back pain – about as good as a few paracetamol. So, when the demands of an evidence-based regulator are brought down on a cult-like pseudomedical trade, only tears could follow.

What is ironic here is that when regulation was first proposed for chiropractic, one of the conditions was that the trade should be unified and have a single voice, as is characteristic of a profession. That unified voice never really appeared and the resultant agreements were a political fudge in order to gain the prize of state recognition. There were many issues, but they boiled down to all mainstream chiropractors hating the McTimoney’s, and the progressives hating the conservatives. That is why there are four associations that represent chiropractors and not just one. Probably, for the first time we are seeing all UK chiropractors acting with one voice: and it is against the regulator that they so desired twenty years ago.

The House of Lords recommended that in order for chiropractors to be suitable for statutory regulation, the following conditions should apply:

    • The profession must be mature
    • It must have one governing body
    • It must be based on a systematic body of knowledge
    • It must have recognised courses of training
    • It must be able to demonstrate efficacy. (Hansard, 1985).

It is hard to say that key conditions were ever met. It is not a mature profession as it cannot even agree on what the essential nature of their profession is. The core concept of the chiropractic subluxation, that drives their philosophy and practice, has been rejected by the regulator,

There is no clinical research base to support claims that the chiropractic vertebral subluxation complex is the cause of disease or health concerns.

This has indeed caused much anguish amongst the trade and is almost certainly at the root of their disquiet with the GCC, as many of them have a near religious belief in subluxations.

The “systematic body of knowledge” has also been shown to be derisory. At the heart of the BCA claim against Simon Singh was that there was a ‘plethora’ of research to demonstrate that chiropractors could treat childhood ailments such as colic. When this was finally published, this ‘plethora’ was quickly shown to be nonsense by the BMJ, where the editor, Fiona Godlee said “[The] demolition of the 18 references is, to my mind, complete.”

Subsequently, the GCC commissioned a report into the evidence base for chiropractic so that it could determine what claims they would be allowed to make. The Bronfort report showed that for a vast range of common claims for chiropractic treatment, the evidence base was very shoddy.

The Universities, who underwrite the degree level courses that allow chiropractors to be regulated should be ashamed of their money grabbing complicity in the deception that is much of chiropractic. For example, the University of Wales provides the academic accreditation for the McTimoney College in Abingdon – a college that offers MSc’s in paediatric chiropractic and also in Animal chiropractic, where completely unsubstantiated claims run unfettered. Students, who enrol in these courses, are misled into believing that what they are learning has an academic status that cannot be justified by reason or evidence. A prominent member of the Education Committee at the GCC is also the Principle of the McTimoney College and was recently honoured with the first University of Wales Personal Chair for her work at the college and so can now call herself ‘Professor’.

Now, this blog has opposed the statutory regulation of superstitious medical practices, such as homeopathy, and it would be hypocritical of me if I thought chiropractors should be an exception. Even if it would be harder to police the claims of chiropractors, were they to be de-regulated, at least they would lose their imprimatur of state recognition and probably the degree level courses underwritten by the universities.

In the long run, I think that would better protect people. There would be fewer reasons to confuse them with medically trained professionals. And students might not be drawn into their educational courses, wasting tens of thousands of pounds on a pseudoscientific education.

Perhaps it is time to rethink the whole idea of regulation of chiropractors.

550 comments for “Chiropractors at War with their Regulator, the GCC

  1. November 1, 2010 at 2:58 pm

    Thanks for such an excellent, perceptive post.

    lecanardnoir wrote: “…were they [chiropractors] to be de-regulated, at least they would lose their imprimatur of state recognition and probably the degree level courses underwritten by the universities”

    With regard to losing chiropractic degree level courses, the sooner that happens the better, not least because at a GCC meeting held on 12th May 2010, council members noted the content of the Minutes of the Education Committee (17 November 2009):

    Quote
    “…in particular that as a result of the chair’s contact with the Council of Deans of Healthcare network, several institutions had expressed an interest in exploring the development of a chiropractic degree programme.”

    Members also noted the contents of the Minutes of the Education Committee (13th April 2010):

    Quote
    “…in particular that representatives of two institutions in north west England had visited the Welsh Institute of Chiropractic. The purpose of the visits was to inform the early stages of their exploration of the feasibility of developing chiropractic degree programmes.”

    See C-120510-17(a) and C-120510-17(b) here:
    http://www.gcc-uk.org/files/link_file/C-120510-Open1.pdf

    lecanardnoir wrote: “It was a big mistake to give official state recognition and regulation to a discredited, superstitious and pseudoscientific form of medical treatment in the first place. Chiropractic theory has been shown to be nothing but mystical whimsy and the effectiveness of their special back rubs has now only been shown to be marginal for lower back pain – about as good as a few paracetamol. So, when the demands of an evidence-based regulator are brought down on a cult-like pseudomedical trade, only tears could follow.”

    Interestingly, it looks like there could soon be tears in the US as well:

    Quote
    “October 25, 2010 — The recently concluded comment period during which individuals and chiropractic organizations were afforded the opportunity to comment on proposed changes in the Council on Chiropractic Education (CCE) educational standards for accredited institutions yielded an unprecedented wave of responses. Nearly 3,000 individuals and organizations submitted comments on the proposed standards changes. In previous comment periods on proposed changes in standards only 100 to 200 comments have ever been received by CCE.
    -snip-
    ICA (the International Chiropractic Association) strongly urges the decision-makers in CCE to appropriately respond to the current wave of concerns and the deep and compelling reasoning behind such comments, restoring the key definitional elements the proposed removal of which can only serve to blur and weaken the chiropractic profession in every arena on the points where chiropractic’s identity seemed to be most seriously eroded, including:

    • A proposed accreditation category of “equivalent” to the DC degree
    • The removal of the “Purpose of Chiropractic Education Statement” from the current standards which eliminates a strong statement defining chiropractic as a drugless and non-surgical profession,
    • The elimination of “subluxation” language as a key clinical component of chiropractic education, and the deletion of the current clinical competencies which provide a strong focus on the adjustment and the detection and correction of the subluxation,
    • The proposed modification of the definition of “Chiropractic primary care physician”

    http://tinyurl.com/3x79wnr

    It seems that the writing is well and truly on the wall. Chiropractors must surely know that they can’t postpone their day of reckoning forever.

  2. Muscleguy
    November 1, 2010 at 5:06 pm

    I don’t see why we should do away with regulation. The regulator can, with some downsizing, cope with a tiny rump of ‘scientific’ chiros after the rest have been regulated away. We just need to enforce all the requirements, for a start the unanimity displayed in this letter should be turned against them as evidence that they can work together as one, so they damn well should.

    Sadly we will not get rid of chiro degrees until we get rid of box ticking accreditation at universities and a better way of funding than simply bums on seats regardless of quality. Sadly I can’t see this one happening any time soon as academic standards have been sacrificed on the altar of mammon in too many academic institutions.

  3. Enough Already
    November 1, 2010 at 9:33 pm

    There is no way to get rid of box ticking accreditation when you have an organisation like the OIA protecting them. Their website indicates that they clearly pride themselves in forming a barricade between students and the box ticked institutions.

    It can easily take more than a year to get a complaint heard, that’s after it has taken 6 months for the initial appeal. It is an insult that the barristers there get paid so thousands more to read the cases than the victims get for suffering them. They should not be above the law.

    The only hope of weeding out poor institutions is, as fees increase, so students’ expectations will increase. They won’t be so quick to believe the spin. They won’t be able to afford to.

  4. Mick
    November 1, 2010 at 10:52 pm

    This is an excellent summary of the utter shambles that is the chiropractic pseudoprofession.

    The situation here in Australia is worse, if anything. Chiropractors have largely succeeded in mainstreaming themselves politically and socially despite the fact that their academic credentials and integrity are a joke, their journal a hilarious pastiche of serious professional communication and their ludicrous claims protected by the difficulty of making complaints about them. An Australian chapter of the Nightingale Collaboration is sorely needed…

    • DrPhil
      November 3, 2010 at 4:35 pm

      The Australian situation is depressing indeed. From 1st July this year, the Australian Health Practitioner Regulation Agency (AHPRA) came into being. See http://www.ahpra.gov.au/
      It is responsible for regulating 10 different health professions, including doctors and chiropractors, supporting each national board.

      Thus, I am now registered with the Medical Board of Australia, instead of the relevant state board, and in bed with the chiroquacks.

  5. November 2, 2010 at 12:30 pm

    Really good article, lovely to see continued disarray in the chiropractic realm. I still find it strange that a profession based entirely on pseudoscience would have a regulator in the first place!

  6. November 2, 2010 at 1:38 pm

    So this where you lot come for hugs and backslaps!
    Hilarious really what you call skepticism…
    Firstly those comments referring to chiropractic being based on “pseudoscientific” principles are just plain silly. There is plenty biological and neurophysiological basis for some of the assertions, just no scientific proof or rationale to justify predictions. That is not “pseudo-scientific”, but rather “without scientific evidence to stake any claim”. The difference is a poignant one as it negates the use of the term “pseudo” which is inherently used to denigrate, which is nor accurate, nor “skeptical”.
    Secondly the observations made (GCC, infighting and ASA issues) are separate. However unfortunate they are and will always remain separate. After all, the GCC is trying to regulate a profession that can’t even agree on what it does… who could blame them for making cock-ups really? Professional infighting is rife in any healthcare profession. It’s a bit like the Belgians, they need to argue about the Flemish and the Walloons just to feel they exist.
    Which then brings me to the crux of the matter: having a stick (ASA regulations) to beat the chiropractic profession with over their misbehaviour (making claims without scientific evidence) is NOT the equivalent of being able to dismiss it altogether.
    You’ll have to come up with better reasoning and argumentation to make the position valid and tenable.
    These rgetorical mistakes seem so obvious to me that some of the posters on this blog should hang their heads in shame,… skepticism my “derriere”. Then, that said, when people comment on things they know little to nothing about, that is quite likely to occur.
    So when you speak of “opposing regulation of superstitious medical practices” then just make sure you are aware that you are opposing the practice of making unfounded claims (a little like you did there really…) rather than the clinical practice and theory of the profession.
    All very pseudo-skeptical really…

    Stefaan Vossen

    This is only just beginning

    • jplechago
      November 2, 2010 at 7:38 pm

      Stefaan,
      You miss the point. Skeptics need proof. Biological or neurophysiological basis means nothing if it cannot be tested. Evidence is key. All you did was complain about criticism rather than really addressing it. Show us the “plenty biological and neurophysiological basis”. Not to mention, you said yourself; “just no scientific proof or rationale to justify predictions.” That is exactly the point that the skeptics are making!
      Proof and rationale are exactly what you need to justify your claims. But you use the lack of proof or rationale as a defense?
      You also say; “‘That is not ‘pseudo-scientific’, but rather ‘without scientific evidence to stake any claim'”.
      Science need evidence! That’s the whole point of it!
      So it is indeed “pseudo-scientific” when you make a “Scientific” claim without evidence. And finally, a practice “without scientific evidence to stake any claim” is open to criticism like anything else. If you take issue with that you just make the practice sound religious.

      • November 2, 2010 at 8:41 pm

        Hi JP,
        a) what make you think that I don’t agree with some of the things “the skeptics” are saying?
        b) what makes you think that there is no room for the fact that some of what they’re saying is “daft”?
        c) basis does mean something,… it represents plausibility
        d) pseudo means false, or farudulent or words to that effect. Ergo: when there is no science, there cannot be “pseudo”-science
        e) the fact that the science is lacking (in big chunks imo) means that claims can’t be made (yes, I am agreeing, you just seem adamant on thinking that I, and many of my collegaues couldn’t possibly be agreeing with SOME of what you’re saying, but we do. No really, we do). It does however NOT mean that there is nothing to it. That would otherwise be tantamount to saying that “if there is no evidence, then it doesn’t exist”. And that would be daft now, wouldn’t it?
        Regards,
        Stefaan

  7. Phil V.
    November 2, 2010 at 5:48 pm

    Stefaan, if you have only just discovered the Quackometer then you must be very new to countering the complaints of skeptics and probably don’t realise who you’re dealing with.

    Please do some research into who follows the blog and makes comments here before making bold claims like “there is plenty biological and neurophysiological basis…” because we will call you on it, as we have many many times with others in the past.

  8. November 2, 2010 at 6:32 pm

    Hi Phil,
    that’s cute. I reckon I will call your bluff (as I have done with your acolites many, many times over).
    Secondly, why do I need to research who makes claim on this blog? Knowing who writes something doesn’t make something daft any more or less daft.
    Regards,
    Stefaan

  9. Gazzer
    November 2, 2010 at 8:01 pm

    “Knowing who writes something doesn’t make something daft any more or less daft.”
    Exactly, this is the central tenet of science which you seem to have stumbled upon without noticing (and seems to be strawman anyway). No one’s asking you *who* wrote something: we’re asking you to provide in which respected peer-review journal has a claim been published, and preferably replicated, and more preferably with a meta-study.

    So yes, call our bluff and provide this. This review system by the way is central to science, and claims outside of it tend to be called ‘pseudo-science’ if they remain outside of it.

    • November 2, 2010 at 8:16 pm

      Hi Gazzer,
      the “who wrote something” referred to Phil’s point of having to research the people who write here, which is irrelevant when what is said is daft, it is just, plain, simple daft. Regardless of who wrote it.
      Secondly: are you actually really stating that anything that has not been published in a respected peer-reviewed journal (at least) can only be considered pseudo-scientific? Really? I am just asking because that’s what it looks like and that would just be silly wouldn’t it?
      I guess you couldn’t possibly be, but just to reassure me, could you tell me what you would like to see these reviews for? What would it prove to you and what would it change. My comment was after all only in regards to the concept of pseudo-science and its use and abuse by your penpals, wasn’t it?
      Stefaan
      PS. I did notice… give me some credit would you?

  10. Muscleguy
    November 2, 2010 at 10:18 pm

    @Stefaan Vossen

    Well simply the Cochrane Collaboration found that even when it comes to back pain Chiro is no better than any other intervention other than perhaps physio with exercise therapy (hard to get people to comply though). That is the largest, best study yet done. So Chiro can’t even demonstrate effectiveness in its core area. It most certainly can’t demonstrate it in any area outside of therapy for bad backs. When you add in that many Chiros are against vaccination, insist on costly and unnecessary repeat visits and that neck manipulation has been shown to erode the vertebral arteries, particularly in women. Then Chiro not only doesn’t have an evidential leg to stand on it is actively dangerous as practised.

    • November 2, 2010 at 11:42 pm

      Hi Muscleguy,
      I will leave the comments (those generalising, unfounded and purely derogatory ones which are pointed out by Neil) for what they are but one point you say is that the Cochrane Collaboration “found that even when it comes to back pain Chiro is no better than any other intervention other than perhaps physio with exercise therapy (hard to get people to comply though). That is the largest, best study yet done.”…Ehm, it doesn’t. “chiro” is not spinal manipulation. It’s a package of care which is tailored around remedying the causal mechanism to the spinal dysfunction. Manipulative therapy is really only a small part of that (statistically speaking). As the studies you refer to DO NOT reflect this integrated approach, you will find that the studies you refer to DO NOT reflect “chiro”. Treating back pain as if it is all caused by spinal dysfunction is just idiotic. If you thought that “chiro” IS spinal manipulation, then I am not surprised you think it is idiotic, but unfortunately you’re wrong in that assertion. Some back pains (actually quite a lot of it) is caused/aggravated/polyfactorial and you will find that any study that reflects the evaluation of a monocausal approach to a polycausal problem is ALWAYS going to be statistically (and logically so) disappointing.
      We might not have an “evidential leg to stand on”, but personally I am ok with that. I see 500 new patients per year and the ones I take on pretty much all get better. Of course it may be placebo or hypnosis but let’s even say that it is… regardless of this being such a statistically implausible position, I ask you the question “are you arguing that they should be denied these results “just because there is no evidence”?
      Seriously? Go and explain that to my patients who have attended clinics who provide “proven treatments”! Ludicrous and untenable.
      Stefaan

      • Badly Shaved Monkey
        November 3, 2010 at 9:07 am

        Stefaan

        What is a vertebral subluxation?

      • Muscleguy
        November 3, 2010 at 11:38 am

        Stefaan

        I have this vision of you frantically dancing around in front of a patient waving your arms in a distracting manner chanting ‘this isn’t chiro, this isn’t chiro’. In a scree of verbiage you spent much time telling me all that chiro is not and not one telling me what it is. All this nebulosity is not suited to the practical violence of a spinal realignment, what you describe seems more suited to a description of Reikki to me.

        But you keep wriggling and obfuscating when challenged with evidence. The performance is really rather funny.

      • Skeptic Barista
        November 3, 2010 at 11:51 am

        Stefaan,

        I agree with you when you say that chiro is more than spinal manipulation alone.

        A big part of any percieved benefit people may claim to feel from seeing a chiropractor probably has more to do with a measure of the placebo effect brought about by person-to-person interaction and the laying on of hands.

  11. neil
    November 2, 2010 at 10:52 pm

    @ muscle guy

    Can i ask a favour? can you supply the EVIDENCE that chiropractors (i love the sweeping generalisation) are against immunisation?? I for one am not against it and I know of very few (well in fact none to my knowledge) who are?? perhaps people were in the past, but the constant attack on what chiropractors did or believed many many years ago is ludicrous.

    I would also be interested to read the evidence on eroding of vertebral arteries if you could supply that too?

  12. Le Canard Noir
    November 3, 2010 at 9:35 am

    From J Health Serv Res Policy 2009;14:186-187

    UK chiropractic: regulated but unruly

    Edzard Ernst

    Since 1994 chiropractic has been regulated by statute in the UK. Despite this air of respectability, a range of important problems continue to bedevil this profession. Professional organizations of chiropractic and their members make numerous claims which are not supported by sound evidence. Many chiropractors adhere to concepts which fly in the face of science and most seem to regularly violate important principles of ethical behaviour. The advice chiropractors give to their clients is often dangerously misleading. If chiropractic in the UK is to grow into an established health care profession, the General Chiropractic Council and its members should comply with the accepted standards of today’s health care.

    In this paper, a survey noted that “19% advised against immunization.”

    The reasons can perhaps be seen here:

    PEDIATRICS Vol. 105 No. 4 April 2000, p. e43
    Chiropractors and Vaccination: A Historical Perspective

    • November 3, 2010 at 11:39 am

      Andy, you have a problem here. If you actually look at the paper you will find that it offers no evidence for any of its assertions in regards to the UK chiropractic profession’s stance in regards to vaccination. It just makes assertions. I quote from the article you reference:
      Campbell and Busse start off quite badly in their abstract: “chiropractic philosophy…considered disease the result of spinal nerve dysfunction caused by misplaced (subluxated) vertebrae.” NO reference- and as I will point out later that is poo anyway.
      “Although rejected by medical science, this concept is still accepted by a minority of chiropractors”-NO reference.
      “Opponents include some religious organizations, citizens’ groups, and practitioners and followers of alternative health care systems, including chiropractors” This latter part (ref chiropractors) is referenced to Ernst’s paper (in which, by means of example of his poor understanding of chiropractic and chiropractic theory (the same mistake Campbell and Busse make) he states-without reference- that “Chiropractors believe that misalignment of the vertebra is the
      cause for many diseases.” For your information: they don’t and that is utter codswollop) He (Ernst) THEN cross-references (wrongly) to DD Palmer’s writings to state that”CONSEQUENTLY(to the previous, erroneous assertion), re-adjustment of
      the defect can bring about the cure” there and then abusing and decontextualising the reference. He (Ernst) then produces two FALSE references (Kent and Koren) (i.e. they do not yield any support to the assumptions or interpretations one could make from them, but funnily enough searches for these references ONLY elicit Ernst papers in return and the Kent paper discusses the statistical analysis of the polio vaccine, doing none other than question the value attributed to the polio vaccine? Funny that) in support of his statement: “It (the literature) repeatedly points out that immunisation is hazardous and ineff€ective.” Ehm, no, those two references don’t even do that… The Peet and Durrant references Ernst produces too are fabrications (in that they are NOT supporting the assertions made), nor are the Colley and Swenson references which he calls upon to assert that “Other sources claim that immunisation is useless and harmful”. Those are HIS words and the references are NOT supportive of his words. Questionable practice. Finally, and dare I say crucially the strongest statements are elicited from Ernst’s 1995 reference on AMERICAN chiropractors (Colley and Haas). 15 years ago. In the States. Need I say more?
      The Cambell and Busse go on, far more elegantly and eruditely than Ernst, with 7 arguments. 7 Arguments which are by-and large built on an assumption of understanding of the chiropractic philosophy. Are they (Campbell and Busse) wrong on all accounts/ Certainly not. There was a time when DD, and his son BJ were talking shite. But this was a time where surgery was performed in plain clothes and antiseptic was rainwater.
      What you are missing is that the chiropractic philosophy is one of utopic proportions. It idealises a wonderful world where all are genetically sound, happy, loved, fed well and sheltered from harm. At the same time as idealising they failed to make it clear that that is what they were doing and were carried away by their mission-like position. I understand why you are interpreting things in the way you do, but cut a boy some slack, this was eons ago, in medical dark ages, voiced by very passionate people who were maybe not always so great at keeping things in perspective. that said I will quite gladly punch any chiropractor (or other healthcare practitioner) in the nose who advises against immunisation. And you will find this to be true for the vast majority of chiropractors in the year 2010. Unless of course we, as a UK profession, in your eyes don’t have the right to evolve and refine.
      I am not blaming you or anyone thinking that we’re all tossers. we have been tossing around for some time now. But I think that throwing baby out with bathwater is just the act of a simpleton. Critical analysis of what may be of value and think about how to embrace that value to move forward is what an intelligent and mature persons do.
      kind regards,
      Stefaan Vossen
      This is only the beginning

  13. November 3, 2010 at 11:04 am

    @ neil

    You might be interested to know that Stefaan Vossen (who is commenting here) guest blogs at http://chiropracticlive.com/

    In case you are unware, that blog is operated by former UK chiropractor, Richard Lanigan, who also operates this ‘Vaccination’ website:
    http://www.vaccination.co.uk/

    If you look on left-hand side of that ‘Vaccination’ site you’ll see that it says “Dr Tedd Koren, DC, has played a major role in the content of this site through his books and lectures and support”. Below the text, you’ll find a link to Koren’s website.

    For the benefit of readers who might not know, Tedd Koren, DC, is a notorious anti-vaccination chiropractic lecturer, researcher, and publisher who lives in Pennsylvania, USA. It’s well worth clicking on the ‘Vaccination Information’ link on the left menu bar of Koren’s site and taking a look at the products he’s pushing.

    Even more interesting is that when Richard Lanigan was an elected member of the General Chiropractic Council (GCC), under his name on the GCC’s published list of chiropractors’ ‘non-pecuniary interests declared’ it said “campaign of awareness of adverse events from vaccinations”, and under ‘direct pecuniary interests declared’ it said “European distributor for Koren publication patient education materials”.

    Perhaps even more worrying than the above (and the 19% figure quoted by lecanardnoir), is that there are likely to be influential chiropractors who don’t make their anti-vaccination views public.

    • Skeptic Barista
      November 3, 2010 at 12:07 pm

      Ted Koren also published a leaflet that suggested an infant who had suffered ‘Shaken Baby Syndrome’ should immediately see a chiropractor!

      To most people and the ASA ‘shaken baby syndrome’ is a form of physical abuse and needs serious and immediate action …. not a chiropractor!

      Although Koren is a US chiro, his leaflet was being distribluted by UK chiros.

      http://www.asa.org.uk/Complaints-and-ASA-action/Adjudications/2009/10/Koren-Publications/TF_ADJ_47143.aspx

    • November 3, 2010 at 12:36 pm

      I think you might like to know that Richard’s association to Ted Koren Inc has seized some time ago for very good reasons.
      Secondly you may have to rethink your understanding of the sentence “campaigning of awareness of adverse effects” you seem to imply that this would be the same as “campaigning against”. that would of course be as ludicrous as claiming that BA in its expressed desire to take down security measures at airports is pro-terrorism.
      Stefaan

  14. Bruce
    November 3, 2010 at 11:15 am

    Dear Andy

    I have cut and pasted a respond of someone directed at you from the chiropracticlive site.

    It may actually say it all. The initial question was based on the skeptics requirement of RCT’s to prove efficacy of treatment. The Bronfort report did as you suggest ‘ showed that for a vast range of common claims for chiropractic treatment, the evidence base was very shoddy’

    However what your bias has prevented you from reporting is that there were many musculoskeletal conditions that were designated medium to high positive in the report, thus supporting the efficacy of this profession. My understanding is that ‘the report’ is now being accepted as being robust.

    The response your readers may be interested on when you discounted this is below:

    ‘Dr Bilbo Baggins on October 31, 2010 at 1:19 pm
    @fed up/ Andy

    Yes, sadly it would seem that when the cry is for RCT’s, because the ‘ skeptics’ believe chiropractors don’t have any, that is ok

    When chiropractors give them RCT’s that are weak, they climb all over them

    When a reasonably robust review shows chiropractic has medium to high positive evidence in the treatment of some disorders, the skeptics talk of drugs and risk.

    To put it all in perspective drugs, yip a safe option…. Who isn’t reading the research now.

    Risk, compared to many drugs and medical procedures, the risk involved with chiropractors is very low eg.

    Colonoscopy, a normal and accepted medical procedure done 1000 times a day up and down the country, carries a 1/1000 risk of complications and of those complications a 1/300 chance of a fatality. Puts it all in perspective possibly.

    So Andy, you actually sound reasonable on occasion and as if you could, with evidence, change your mind. But it seems it will never be good enough. That’s not skepticism that’s bigotry. I hope I am wrong, otherwise as both Richard and myself mentioned earlier, their is no real point in continuing with any dialogue. Of course where is skeptic barista, he throws in a biased statement, then goes. How is that adding to any debate.

    Finally, not certain you are right about the demise of chiropractic, but that will be for the chiropractic profession to rise to the challenge, and I think they will.’

    I get the impression that an attack on chiropractors is based simply on prejudice rather than skepticism, especially when the same author highlighted the General Mexical Councils response on the evidence required to practice, you will note that medium to high RCT’s are not even mentioned.

    This was in a post directed to you and Skeptic Barista ( who I believe isn’t a Barrister but runs a coffee shop) as the name may, to the less well informed or educated of the general public, imply. I am always skeptical of people who may use names that could possibly mislead the public, aren’t you?

    ‘May I remind you of what the GMC stated in the Guardian, July 5th 2010, when asked what level of evidence they require medical doctors to use and it states: ‘We do not require doctors to use only evidence based treatments in any form of medical care, but we do expect doctors to do their best to ensure that any treatment they offer is in the patient’s best interests. This will generally mean that any known risks of the treatment are outweighed by the potential benefits to the patient’.’

    I think your readers may be under the impression that your skepticism is built on what you feel is in the publics best interest, however it is obvious that the concerns others have posed with regards bigotry, may open a valid discussion. There is a possibility that your qualifications on IT may not give you the insight onto fairly judging a health care profession, when you cherry pick what you seem do do or say.

    Your repulse to the GMC statement on the Sackett thread on Chiropracticlive was laughable, but why?

  15. Muscleguy
    November 3, 2010 at 11:29 am

    Merçi Mr Duck.

    @Neil

    http://www.cmaj.ca/cgi/content/full/166/1/40

    Hope that suffices.

    • November 3, 2010 at 12:07 pm

      From your reference:
      “Six such reports were found in a recent systematic review;6 in total they included over 2000 patients. Not a single case of a serious adverse event was reported. However, about 50% of the patients experienced mild and transient adverse effects (e.g., local discomfort, headache, tiredness and radiating discomfort) after the procedure.”
      So are you saying that mild and transient adverse effects are a serious issue? For a muscle guy you don’t go to the gym all that much then do you? Chiropractic care is about improving motion patterns. So logically (and all patients are warned of this) these “adverse effects” are going to happen. I am even surprised about the “50%” quote. My personal experience is more like 75%. Not sure whether “adverse effect” is really the right term…
      Stefaan

  16. November 3, 2010 at 11:55 am

    @muscleguy
    you’re sweet but didn’t actually ask me a question. Ask me a question (and please do take the time to respond to those you have been asked in regards to some of your assertions) and I will answer as soon as I can.
    @badly shaved monkey
    My understanding of the vertebral subluxation (and you need to appreciate that there are other types of subluxation) is a vertebral source of dysfunctional movement which may have physiological and neurophysiological effects which predispose or cause pathophysiological changes in the local or distal motion unit. Side-effects that result from such changes can include pain, degenerative changes, adaptation/compensation (which in themselves can produce pain and predisposition to injury) and neurological stress (due to the nociceptive and proprioceptive “noise”).
    Chiropractors believe they are good at remedying such vertebral subluxations but provide a package of care which aims to cover and remedy as many such stresses as possible in the hope to reduce them significantly, thereby aiming to facilitate a return to normal motion patterns, the extraction of excessive and anomalous stresses and consequently eliciting a return to normal or even optimal states of well-being.
    I hope that answers your question.
    Kind regards,
    Stefaan Vossen

    • Badly Shaved Monkey
      November 3, 2010 at 11:16 pm

      @Stefaan

      @badly shaved monkey
      My understanding of the vertebral subluxation (and you need to appreciate that there are other types of subluxation) is a vertebral source of dysfunctional movement which may have physiological and neurophysiological effects which predispose or cause pathophysiological changes in the local or distal motion unit.

      Significant amount of unwarranted speculation there, Stefaan. A subluxation has a perfectly well-defined meaning. It is the partial dislocation of a joint. Do you wish to differ from that definition?

      1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
      2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
      3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

      • November 4, 2010 at 1:21 pm

        Dear Badly Shaved Monkey
        You did not ask the definition of a subluxation, you asked me directly: “What is a vertebral subluxation?”. Which I assumed you asked me so you could have MY understanding and appreciation of it. This was an assumption of mine but one based on the fact that if you wanted the definition you could go onto wikipedia (which seems to be what you boys and girls generally use as a reference) and wouldn’t have asked my directly. So my apologies for misunderstanding the meaning of your question. I promise I will take classes from Mr. Derren Brown next time I need to read minds.
        I replied:”My understanding of the vertebral subluxation (and you need to appreciate that there are other types of subluxation) is a vertebral source of dysfunctional movement which may have physiological and neurophysiological effects which predispose or cause pathophysiological changes in the local or distal motion unit. Side-effects that result from such changes can include pain, degenerative changes, adaptation/compensation (which in themselves can produce pain and predisposition to injury) and neurological stress (due to the nociceptive and proprioceptive “noise”).”
        You answered your own question then by stating: “It is the partial dislocation of a joint.”
        Firstly: it’s not. A vertebral subluxation is a partial dislocation of a vertebral joint. Not just any joint.
        Secondly you say that “there is a significant amount of unwarranted speculation here” Where is the speculation? Could you please identify so I can respond constructively without wasting either of our time.
        Then you refer to me three points.
        In summation:
        Evidence of partial dislocation please
        Evidence of such in asthma and back pain asthma
        Evidence that removing partial dislocation relieves symptom please
        Can you confirm that you are asking these questions in reference of vertebral subluxations please?
        Finally can you confirm that you understand that unlike a luxation, a subluxation is not a passive entity (i.e. one articular surface does not meet the other because they have been ripped appart) but rather an active process (i.e the paraspinal musculature is reducing the quality of the full articular surface apposition, ie. the “fit”).
        Regards,
        Stefaan

      • Badly Shaved Monkey
        November 4, 2010 at 4:47 pm

        Stefaan

        Evidently we agree that the generic definition of “subluxation” is partial dislocation of a joint and it was in that generic sense that I gave the definition. But, you are a chiropracter, so you think you deal with partial dislocations of vertebrae and obviously I want examples of vertebral subluxations, not hip, patella or thumb. You want to further qualify the definition by adding the notion of “active” or dynamic subluxation, versus a “passive” or static subluxation. That doesn’t bother me.

        All I want is for you to answer the three questions without further prevarication.

        1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
        2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
        3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

        If you wish to present evidence of an “active” subluxation in your answer then please do so.

        You asked, “Where is the speculation?” in your previous post.

        “vertebral subluxation…is a vertebral source of dysfunctional movement”

        Speculative until you answer question 1.

        “which may have physiological and neurophysiological effects which predispose or cause pathophysiological changes in the local or distal motion unit. Side-effects that result from such changes can include pain, degenerative changes, adaptation/compensation (which in themselves can produce pain and predisposition to injury) and neurological stress (due to the nociceptive and proprioceptive “noise”).”

        An answer to Q2 may stop this being mere speculation.

        “Chiropractors believe they are good at remedying such vertebral subluxations”

        Indeed this is what they believe, but that belief is speculative without evidence.

        “but provide a package of care”

        Sure, you might provide a package that includes more than just back-cracking, but we are talking about the back-cracking at the moment.

        “which aims to cover and remedy as many such stresses as possible in the hope to reduce them significantly, thereby aiming to facilitate a return to normal motion patterns, the extraction of excessive and anomalous stresses and consequently eliciting a return to normal or even optimal states of well-being.”

        You might aim to do many things, but give a proper answer to Q3 and show that you can.

        These should not be difficult questions. They address your supposed core competency. A failure to answer properly would itself be very revealing.

  17. November 3, 2010 at 12:26 pm

    Hi SB,
    you may very well be right. Although I have no idea why you think that your version of things is more probable than that they get better because they are moving better. I am am perfectly comfortable with acknowledging that some of what I do comes down to patient management, inspiring confidence and offering guidance. I think it is fair to say that this is true to one degree or the other for most forms of healthcare bar for a very small slither of it.
    But if you bear in mind that the success rate is very high, the chronicity of presenting complaint is pronounced, and the frequency with which presenting patients have attended other/conventional/proven treatment modalities with limited success is very high, then I am sure you will appreciate that I am calling into question the proportion of improvement which is to be attributed to placebo and the laying on of hands solely.
    It is of course just gut feeling and what I choose to see, and as such inherently prone to be flawed, but just on likelihoods and plausibilities I think you’ll agree there probably is more to it than that.
    Regards,
    Stefaan Vossen

    • Skeptic Barista
      November 4, 2010 at 2:23 pm

      Stefaan,

      I perhaps should have made it clear that the view of the customer-therapist interaction and the laying on of hands benefits (Placebo) are not mine, even if I agree with them. They are actually a view expressed publically by the WOrld Health Organisation in their 2003 bulletin on Lower Back Pain (Vol81-No9).

      This is the same document where they say that most cases of acute back pain will imporve regardless of what treatment option is chosen, it also states that manipulative therapies are amongst the most expensive option for treatment.

      The WHO issued a document entitled “What is the best way to treat back pain”. This document doesn’t give even a passing mention to manipulation, chiropractic, subluxation or similar. This may seem odd, considering how often chiroprators quote the WHO, however it can easily be explained. The document is based on health care ‘evidence’ …. this instantly puts chiropractic at a disadvantage!

      Regards
      Skeptic Barista

      • November 4, 2010 at 5:18 pm

        Hi SB,
        personally I don’t rate intervention as a treatment option for acute back pain. I personally feel that value only resides in intervening in chronic back pain. But that is just me.
        Hope you’re well
        Stefaan

    • Badly Shaved Monkey
      November 4, 2010 at 4:53 pm

      ” healthcare bar for a very small slither of it.”

      The word is “sliver”. A frequent confusion even among native speakers and one of my pet linguistic hates. Oddly it seems to be most frequent in people who would say “f/v” instead of “th” routinely then suddenly want to avoid using the f/v sound in this word in case it makes them sound ‘common’. Oh, the wonderfully fine distinctions of English class snobbery.

      • November 4, 2010 at 5:08 pm

        No worries, I am married to the daughter of an English teacher. If she finds out she will kill me! lol
        Take care,
        Stefaan

  18. Enough Already
    November 3, 2010 at 12:44 pm

    *blows half time whistle*

    Andy was questioning regulation of a vocation for which he suggests should not have been regulated in the first place. The internal unrest reflects this mass instability. It’s palpable – so much so that practitioners are extremely defensive and their argument continues here ^^^.

    We now observe a vote of no confidence from members towards their regulator. Something has got to give. It is not just the patients who risk being out of pocket. Students are people too. This would not happen in another profession because regulated professions are by nature stable.

    UK students of chiropractic pay £25k+ to study at colleges for up to 5 years which they believe are of the usual British quality for higher education. That is just the college fees. In the first year they will easily have spent £10k in fees and expenses for a private accredited course and that is without investment of their time and aspirations. There is an abundance of courses open to students these days – they should not be led to believe that all professions are the right choice just because they are regulated.

    The question posed was should the profession be de-regulated until there is enough cohesion to warrant degree level courses in the subject?

  19. Phil V.
    November 3, 2010 at 3:39 pm

    Bruce said >>> This was in a post directed to you and Skeptic Barista ( who I believe isn’t a Barrister but runs a coffee shop) as the name may, to the less well informed or educated of the general public, imply. I am always skeptical of people who may use names that could possibly mislead the public, aren’t you? <<<

    Hmm. Someone calling himself a Barista (not Barrister – note the spelling) on an informal blog, and making no claims to the contrary; and someone calling himself Doctor (note the spelling) in order to extract money from the ill, desperate and infirm in return for cracking their joints is very very different. It's intensely worrying that you can't see a difference here.

    • November 3, 2010 at 6:39 pm

      Sense of humour failure here!
      Stefaan Vossen Doctor of Chiropractic

    • Skeptic Barista
      November 4, 2010 at 2:33 pm

      (I missed this) :-D
      Bruce said: “This was in a post directed to you and Skeptic Barista ( who I believe isn’t a Barrister but runs a coffee shop) as the name may, to the less well informed or educated of the general public, imply. I am always skeptical of people who may use names that could possibly mislead the public, aren’t you?”

      (Huge Grin) Oh please!
      Bruce, next time you need some legal advice or a decent espresso, please, please ensure you understand the difference between ‘Barista’ and ‘Barrister’!

      ;-D

  20. Bruce
    November 3, 2010 at 8:22 pm

    Oh come on Phil, lighten up even you guys must have a sense of humour. This was said, tongue in cheek. Remember humour before you joined the British Institute of Great Orators, Thinkers and Skeptics.
    I believe this is how you like to see yourselves?

    Of course you have worked out already that that is Bigots for short and I believe that’s how many others are beginning to see you guys.Sad really!

    • Badly Shaved Monkey
      November 4, 2010 at 7:41 am

      Bruce

      Re: your post at November 3, 2010 at 11:15 am

      Please answer the questions I have addressed to Stefaan. Show us that subluxated vertebrae underlie a range of medical conditions and that correction of the subluxations successfully treats those conditions.

      Thanks

  21. Enough Already
    November 4, 2010 at 6:17 am

    @ Myself. I’ll take that as a no then. Posters obviously didn’t spend any money on their education and therefore had no risk.

    If I’d gone on another board to talk about spending say my hard earning on a badly built house extension which building regs wouldn’t pass because it was so poor, and I couldn’t sell my house as a result, people would not be so accepting. Bad builders are brought to boot, bad health education providers simply are not.

    • November 4, 2010 at 1:40 pm

      Hi Enough
      why do you feel that chiropractic education in the UK is provided by bad health education providers?
      Regards,
      Stefaan

  22. Enough Already
    November 4, 2010 at 6:22 am

    ^ Correcting typos ‘If I’d gone on another board to talk about spending my hard earned’

  23. Phil V.
    November 4, 2010 at 1:05 pm

    Perhaps you could explain just how hilarious it all is to the wife of my friend who died from an easily-treated cancer because he sought help from a “doctor” instead of seeing a doctor until it was too late.

    I can’t stop laughing. How about you?

    • November 4, 2010 at 1:27 pm

      Phil V.
      Who was this “doctor”?
      What was his/her profession?
      In what country did this occur?
      I am very sorry to hear this happened, regardless of any discussion we are currently having.
      This is also yje unfortunate and sometimes difficult to stomach reality of clinical life. That said, I am very sorry to hear that.
      Regards,
      Stefaan
      ps how about a reply on the points made prior?

    • November 4, 2010 at 1:46 pm

      No Phil I’m not laughing what so ever and havent since I was admitted to hospital on the 13th November 2008 with 11.5cm tumor wedged between my spine kidney and bowel which turned out to be inoperable and over the period of 3 moths also led to septicemia, peritonitis the loss of over 7 stone (from 14stone to 6.5) and the ability to walk..

      My point here is that this may well of been avoided if my DOCTOR (GP) had listened to the information that had be passed on to him by myself in accordance with the information my chiropractor had given me also the letter that my chiropractor had written to him and FOUR visits made to the DOCTORS prior to being admitted and being told it was nothing to worry about.

      Sorry forgot to mention my Chiropractor was in fact DOCTOR STEFAAN VOSSEN who I can safely say i owe my life and recovery to.

  24. Bruce
    November 4, 2010 at 2:00 pm

    @ badly shaped Monkey

    Sorry, can’t help you there mate, subluxation is not in my vocabulary. In fact of the Chiros I know, I am not sure it is in their vocabulary either. Barking and wrong tree spring to mind. But hey why would that stop the members of B.I.G.O.T.S, it never has in the past.

    • Badly Shaved Monkey
      November 4, 2010 at 4:58 pm

      When did it drop from your vocabulary and that of your colleagues in the long path from DD Palmer to yourselves?

      What do you want to say to Stefaan for whom the word is very much part of his vocabulary?

      With what have you replaced that word to still call yourselves chiropracters instead of massage therapists or physiotherapists?

  25. November 4, 2010 at 2:08 pm

    @ James

    That is a two-way street. There are victims of chiropractic injuries, misdiagnoses, and delayed diagnoses who owe their lives to medical science.

    • November 4, 2010 at 3:05 pm

      From my point of view if it is a two way street then what is the problem??

      On the other hand i think it necessary to point out that if we were to look at the amount of misdiagnosed made by DOCTORS (GP’S) in comparison to miss diagnose made by chiropractors, osteopaths, physios and others (to pay forms of health care) i believe that the GP misdiagnosed will far out weight the other!!

      I think it also necessary to point out that you & others refer to people using the name doctor to take money for patients well in my case when seeing Stefaan Vossen he did in fact only charge me for half of my appointments when trying to find out what the cause of such pain could have been!!

      Going back to the GP misdiagnoses if you really want to go into this i could find you one hell of a lot more patients that have been misdiagnosed by there doctors..

      James.

      • November 4, 2010 at 3:18 pm

        “i believe” isn’t good enough.

        Besides, you cannot escape the fact that any *thorough* evaluation of the *scientific* evidence for chiropractic will conclude the following:

        Quote
        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. p.285 ‘Trick or Treatment? Alternative Medicine on Trial’, by Simon Singh and Edzard Ernst.

      • November 4, 2010 at 3:32 pm

        So what proof do you have to substantiate your quote?? out of how many people treated by a chiropractor on a weekly, monthly and yearly basis has this happend to and can it be proved??
        However i can give you a fact, tablets – temazepam, diazepam and other forms of medication given to me by my GP will not find or remove the tumor wedged between my spine and kidney nor will it actually help try to find out what the problem is!!

  26. November 4, 2010 at 3:20 pm

    Just Returning to your comment of it being a two way street and in your view as you have already pointed out both seem to make mistakes then would it not be a good idea for both to work closer together to make sure misdiagnoses dont occur??

    I will make it at very clear at this point that i beliebe the GP service to be a complet joke that is more focused on targets and the number of patients they can sign up and clearly does not work, it in fact will not take responsibility for its mistakes and i dont believe ever will.

    My chiropractor (Stefaan Vossen) knew my body and knew me as person to my GP i was a number!!

  27. November 4, 2010 at 3:31 pm

    James wrote: “…would it not be a good idea for both to work closer together to make sure misdiagnoses dont occur??”

    Yes. IMO, there should be a compulsion on chiropractors to report their examination findings and proposed treatments to their patients’ GPs.

    • November 4, 2010 at 3:40 pm

      You are clearly not reading my responses as i have already pointed out that my chiropractor not only gave me information to pass on to my GP but also wrote to my GP informing him of the situation to which the GP’s response to me was “I dont see how he can come up with that, thats a strange diagnosis” well in fact Stefaan was CORRECT and the turmor was exactly where he had said that problem came from. (certainly within the region he had said to check)

      So what i think you meant to say is there should be a compulsion on all health care specialists to follow up information provided by one another!!!!

      Who know me better my GP or my chiropractor?
      Who took more time to get to know there Patient?
      Who clearly had a higher duty of care?

      I know the answer to that you clear just want to argue it!!

      • November 4, 2010 at 3:47 pm

        From what you say, your GP was wrong. They are not infallible. I would also add that your apparent anger about the situation is understandable, as is the anger of those patients who have endured adverse events at the hands of chiropractors.

      • November 4, 2010 at 4:04 pm

        There is no anger here.. I love life and enjoy everyday.

        you are clearly unable to substantiate any of your claims as you have not responded to my question, i think what can be take from this is that both chiropractors and doctors and dentist and everybody else in the health care service make the occasional mistake unfortunately on a very rae occasion this my lead to the lost of life but instead of trying to work together and make the services better all around for everyone you would rather try to blame everybody else. I guaranty i can give you more people that have been misdiagnosed by their GP than have died from being treat by a chiropractor!!!

        I would like to leave you with this. I didn’t just see one doctor i saw two at the same practice and neither of them even sent me for a blood test, my fiend was told the lump in her breast was hormones she was told this twice! she now has stage 4 cancer. one of my girl fiends was told her headaches were due to lack of water she died three weeks later of a brain tumor.

        Good day to you sir

  28. November 4, 2010 at 3:49 pm

    James wrote: “So what proof do you have to substantiate your quote??”

    The references used for that quote will be available here soon:
    http://www.trickortreatment.com/references.html

    • November 4, 2010 at 4:06 pm

      There are no proven statistics!!

    • November 4, 2010 at 5:28 pm

      I actually wrote “So what proof do you have to substantiate your quote?? out of how many people treated by a chiropractor on a weekly, monthly and yearly basis has this happend to and can it be proved??

  29. November 4, 2010 at 4:13 pm

    James wrote: “I guaranty i can give you more people that have been misdiagnosed by their GP than have died from being treat by a chiropractor!!!”

    And I think it’s probably a fairly safe bet that you know more people whose lives have been saved by GPs than by chiropractors.

    • November 4, 2010 at 5:29 pm

      You seem to have the need to continually change the point you are trying to prove and seem have all the answers of everything and nothing!!
      In my none medical experience surrounding friends and family, GP’s provide and poor and unreliable service. Myself and others that have been recommended to none GP services (that mean not just chiropractor) have found answers / solutions to there problems a lot quick and have more than been satisfied.
      I would be amazed if you actually were albe to give a clear and straight answer from this i can only come up with one notion you are either a GP or politician

  30. November 4, 2010 at 4:36 pm

    You seem to have the need to continually change the point you are trying to prove and seem have all the answers of everything and nothing!!
    In my none medical experience surrounding friends and family, GP’s provide and poor and unreliable service. Myself and others that have been recommended to none GP services (that mean not just chiropractor) have found answers / solutions to there problems a lot quick and have more than been satisfied.
    I would be amazed if you actually were albe to give a clear and straight answer from this i can only come up with one notion you are either a GP or politician

    • Badly Shaved Monkey
      November 4, 2010 at 5:14 pm

      James, part of the answer is that GPs deal with a wide range of cases including real and serious diseases which can present difficult diagnostic challenges. When they make mistakes there is a risk they will make them with serious diseases because that in part constitutes their caseload.

      Chiropracters and the various other pseudomedical hangers-on largely deal with the worried-well and patients coming to them with diseases that, by their well-established chronic fluctuating character, are almost always non-life-threatening. Chiropracters will therefore meet few genuinely serious diseases, so their opportunity for making fatal errors is small. If, acting as another pair of eyes, they pick up on something that has been missed elsewhere then that must be good, but on a population-basis having a class of pseudomedical practitioners feeding the populace with erroneous ideas and selling falsely based treatments still means they are overall more of a menace than an aid to society.

      Nonetheless, I take it that you have received medical treatment for your inoperable tumour and I wish you well with that.

      • November 4, 2010 at 5:27 pm

        I have indeed.. it was a long and pain full 9 months of my life but with the help of Macmillan and dare i say on here (for fear of what i call neg ferrets) Stefaan i made a good recovery and then rode across america in june of this year until i was hit by a truck in Louisiana however yet again Stefaan has seriously help with yet again another recovery and will be heading back out the states in January to do the ride again.

        I full take on board your points and agree with many of them, i just feel that is all professions worked closer together we would benefit after all were all in it for the same reason “public health and happiness” thanks again.

  31. November 4, 2010 at 5:02 pm

    I actually wrote “So what proof do you have to substantiate your quote?? out of how many people treated by a chiropractor on a weekly, monthly and yearly basis has this happend to and can it be proved??”

  32. Enough Already
    November 4, 2010 at 5:19 pm

    Hi Stefaan, would you like a neurophysiological answer to why I feel the way I do or is a straightforward opinion based on considerable experience acceptable?

    • November 4, 2010 at 5:48 pm

      Straightforward opinion is acceptable. I am genuinly of the opinion they do an OK job, with some departments even doing an excellent job. The problem is; you can lead horse to water and all that…
      Coming from a large family into healthcare I might have taken things a little more seriously than others, but I think we can be distracted by the few who make dirty big booboos to make assumptions about teh many who do a grand job.
      Regards,
      Stefaan

  33. Bruce
    November 4, 2010 at 6:26 pm

    I think the problem that most level headed, thinking individuals have with all this repetitive nonsense is that your expectations of chiropractic is not mirrored in your expectation for medicine.

    There are many procedures used within medicine, where evidence in relation to medium or positive high RCT’s is seriously lacking and yet they are still used, arthroscopy springs instantly to mind. Yet I get the impression that, that must be ok with you B.I.G.O.T.S.. How can that be a viable position. The difficulty in all this is that stupidity and arrogance takes over. When Singh was asked what evidence there was for Physiotherapy during his road show in Yorkshire, I am advised his answer was, physios are main stream. Absolute nonsense if accurate. Of course that is the reason that no one is asking the physios or the medics to comply to the standards you people have set for chiropractic. This of course explains the GMC’s answer in the guardian ( see above in a previous post). You guys should be careful what you wish for, it may come back to bite you in the derriere.

    The chiropractors were asked for RCT’s they produce the same (Bronfort et al 2010) rated medium to high positive, yet these aren’t good enough. Its a little like having the wrong rain during a drought, yip I know there is evidence that ……..?

    You guys don’t want evidence, that is pretty obvious,you want the demise of chiropractic, well that’s a choice but please have the balls to admit to it. All you would be doing is confirming what many people believe. It’s ok to come out from under the bed, no one will shout at you. Really, they may laugh, shout no.

    Blue Woad, what can you say, he/she ask for RCTs, tries to use big words and pretends to understand what is going on, yet quotes the Ernst and Singh book as if it was foolproof. But then don’t you all. Sad really

    • Badly Shaved Monkey
      November 4, 2010 at 9:03 pm

      Bruce, you are failing to grasp an essential point.

      Proof of efficacy is paramount. Chiros lack that for almost all that they do.

      But, crucially, they also lack a coherent mechanistic understanding of the body. So, they cannot base their treatment on rational extrapolation from the known into the less well known.

      There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely. No system is perfect. It’s all to do with making best use of partial information. Chiros work from false information so they are not comparable with physios.

      • November 4, 2010 at 11:35 pm

        What do you understand the chiropractor’s “mechanistic understanding of the body” (what does that even mean?) to be?
        You’re just to be appear making things up now.
        I was a physiotherapsit prior to studying chiropractic. it seems to me you have little understanding of either.
        Stefaan

  34. Bruce
    November 4, 2010 at 6:33 pm

    @ badly shaped monkey

    What do I have to Stefaan about subluxation, well nothing really.

    Sorry, you’ll have try and get your kicks elsewhere.

    • Badly Shaved Monkey
      November 4, 2010 at 9:06 pm

      OK.

      Chiro A does not have the word “subluxation” in his vocabulary and refuses to comment on Chiro B for whom the concept is central to his practice.

      This, fellas, is what it looks like to be up shit-creek bereft of propulsive implement.

      • November 4, 2010 at 11:25 pm

        that’s very assumptive of you is it not? chiro b only uses the word to continue constructively the discussion that bigot a started…
        think about it and come out with something meaningful
        Stefaan

  35. Enough Already
    November 4, 2010 at 6:41 pm

    Sounds like we are getting closer to answering the original question posed (way too much philosophy being taught in chiro colleges these days).

    Stefaan – given that chiropractors can detect tumours and other ugly stuff that elude GPs, were I to send a person presenting with oncological symptoms to a random chiropractor or two or three (lets go one from each college) in England, they could all detect that tumour with confidence, just as you did, or might one have to be selective?

    • November 4, 2010 at 8:04 pm

      Who said chiropractors can detect tumours?
      Stefaan

      • Mojo
        November 5, 2010 at 8:43 am

        James.

  36. Badly Shaved Monkey
    November 4, 2010 at 9:10 pm

    p.s. I’m newer to the world of chiro than to homeopathy. I am seeing very similar patterns of dunderheadedness and obfuscation to avoid dealing with the glaring holes in the theory and evidence-base.

  37. November 4, 2010 at 10:35 pm

    Accepting holes in evidence base, but where are the holes in the theory?
    Stefaan

    • Badly Shaved Monkey
      November 5, 2010 at 7:58 am

      Stop stonewalling, Stefaan. I have asked you 3 clear and direct questions. Please answer them.

      To answer your question, you have not shown that vertebral subluxations exist, you have no plausible mechanism to connect these unproven features to the wide variety of medical conditions chirps claim to help. I could say that evil pixies live in the spine and interfere with how the body works. As we stand currently, I have just as much theoretical and evidential support for my assertion as you do for yours.

      I will now append a fourth question. Why have you not answered the first three?! Read the Charles Darwin thread on this blog and see how similar your approach is to Dana Ullman’s. That is not a good thing.

  38. Enough Already
    November 5, 2010 at 12:14 am

    @ Stefaan James said “well in fact Stefaan was CORRECT and the turmor was exactly where he had said that problem came from. (certainly within the region he had said to check)”

    You diagnosed James’ tumour. Is that a gift of all chiropractors trained in the UK or just you and perhaps a handful of others.

    Chiropractic is a generic term. Can we expect the same results from all?

    • November 5, 2010 at 1:05 am

      I must say i really do like the way that some of you on here try to use a quote from a previous quote and either only use half the quote.. or maybe you actually only read half the quote which is why there are so many responses and arguments
      This also leads me to question that if some of you are GP’s questioning the chiropractic networks of the UK, have chiropractors actually written to you and you have jalso only read half of what is written?? or you just chose to believe what you think you want it to say???
      What i actually stated was
      “my chiropractor not only gave me information to pass on to my GP but also wrote to my GP informing him of the situation to which the GP’s response to me was “I dont see how he can come up with that, thats a strange diagnosis” well in fact Stefaan was CORRECT and the turmor was exactly where he had said that problem came from. (certainly within the region he had said to check)”
      No where have i said that Stefaan found my tumor!! (CERTAINLY WITHIN THE REGION HE HAD SAID TO CHECK)
      In fact!! – I had known and seen Stefaan for a couple of years but follow recent serve back pain i hed been seeing him every week for a couple of weeks, he sent me to my doctor assuring me that this wasn’t a back problem and was something more serious telling to ask my GP to look at a number of areas including my “digestive track, kidneys and pancreas” my GP’s said straight away as i have already said “I dont see how he can come up with that, thats a strange diagnosi” “this is just muscular pain and nothing to worry about and gave me pain killers and sleeping tables”
      On my next vist to Stefaan he inquired what had happend at the GP’s to which i responded nothing!!
      Stefaan then wrote “as i have already stated” to my GP who on my next vist just increased my pain killers… another 2 visits to my GP over three weeks and two weeks after the fourth visit i find myself in hospital with a 11.5cm abnormal mass between my spine, kidney & Bowel!!!!!

      Later to be told it was cancer

      I hope this is now very clear and easy to understand??

      • Bruce
        November 5, 2010 at 8:59 am

        Hi James you are so right.

        This is the modus operandi of all the members of B.I.G.O.T.S or skeptics a they like to be known. The use half truths, make assumptions, jump to composting, misquote and where ‘evidence’ is concerned, use it or don’t use it to suit themselves.

        They ‘assume’ because I challenge them that I am a chiropractor. They may of course be right, but equally they may be wrong, however once again the choose the side that makes their argument, they don’t seek the truth.

        They talk of medical and physiotherapy procedures based on sound principles and chiropractic not being, why, because it supports their views on the way the perceive life should be. Yet do not challenge the lack of evidence in both groups, especially physiotherapy. It is also interesting to note that both professions started in the early half if the 1890’s the physios came from nurses of course, and yet physios, without a great deal of evidence, if any, to support what they do are ok. Ridiculous, the more these people spout off the more readers can see how pathetic they are. They ignore , Bronfort whose report is being seen in many quarters as being robust, and who states there is strong evidence to support chiropractic, they ignore the statements that many chiropractors in the UK don’t even use the word subluxation and whose tools and treatment protocol extend beyond adjusting the spine and into the realms if musculoskeletal disorders as a whole and were taught the same at either AECC or WIOC. They ignore that comparing the education with chiropractic education, chiropractors probably have a far more intensive grounding in the health sciences, a far better understanding of functional disorders and the treatment of the same. They cry ‘evidence’ but won’t get off their armchairs to look at both side of the argument critically.

        More and more people are finding out that the ‘skeptics’ and I use the words very loosely are not skeptics but simply individuals, whether medically trained or not, who are after the demise of a profession.

        Is it all bad, no, chiropractic is being forced to stand up for itself in both the research field and the professional field. It helps millions if people a year where medicine or physiotherapy has failed, and these peoplewant to take that choice away from people in pain, good luck to them.

        Like most individuals, I want transparency, evidence where available but to paraphrase the General Medical Council who said ‘ that in the eyes of the doctor, the benefit should outweigh the risk to the patient, whether evidence exists or not’ and I fully support that statement. But I want all health care profession to be treated equally both in regulation and in the requirement to produce evidence, no health care profession wants a negative result, not all medics are shipman surely?

        So James welcome to reality, these people don’t want debate they want genocide and as hard as they try to roll out the same old questions which have all been answered in the past, and as hard as they try to get people to view chiropractic and contain them in the B.I.G.O.T.S narrow vision of practice, they are being found out and in many cases, ignored.

        Enjoy your weekend, but I am sure your experience in the blog of Blinkered Vision will either make you laugh or shocked, I prefer the former. As Stefaan pointed out on another blog, there is a little bit of Skeptic baiting going on. We all watch the auditions of x factor, well it’s not dissimilar when posting here. Don’t take it too seriously, I remember from another blog where someone described this as, watching clowns performing in a circus., interesting concept really and they are there to make you laugh after all.

  39. Enough Already
    November 5, 2010 at 8:34 am

    @ James Stefaan was monitoring the progression of his treatments and because you were not responding as expected, he referred you back to your GP who, with the additional information, took a closer look.

    Stefaan has said that he was trained as a physiotherapist first. I would fully expect him to have been suspicious. It sounds like he helped you in his capacity as a physiotherapist, possibly not as a chiropractor.

    Incidentally, a very large proportion of my clients have a history of ineffective chiropractic treatments (and often conservative medical treatments) which I have been able to resolve in every instance. That does not give me a massive ego boost, it makes me think there is something that is not taught fully.

    • November 5, 2010 at 11:25 am

      Can you show some evidence of this? How do you measure treament outcomes? How did you compare these to chiropractor’s treatment outcomes? What is your success rate? Do you see the enormous level of idiocy that could be perceived in your statement?
      Also can you answer my question about who said that chiropractors can detect tumours?
      Could you also reduce the condescendence? My training as a chiropractor was far superior to my training as a physiotherapist but I still won’t speak ill of physios or GP’s or others, because I know we need a certain level of knowledge to work with certain levels of complexity. We all have a place and a role to play, but you seem to think that you have all the answers. That is something called denial or idiocy. Which one is it?

  40. Badly Shaved Monkey
    November 5, 2010 at 8:41 am

    James, don’t answer this if you don’t want to, but are you saying that you went to your chiro first for this new pain problem? Is the timescale also that you saw your GP over a period of 5 weeks in total (t=0, + 2 visits in 3wks, + 4th visit 2wks later)?

    Now this is a delicate one. Could you accept that going to your GP with what does actually come across as a slightly odd diagnosis from a chiro might have reinforced the GP’s tendency to frame the assessment in terms of the established pattern of visiting a chiro for back pain?

    Conversely, I had a canine patient with a fairly obvious acute disc protrusion who went to a chiro because the owners didn’t like my advice to rest the dog. In the day or so after the chiro’s manipulation of that dog’s spine it became paralysed. Now, maybe it would have deteriorated anyway, I cannot tell, but forcibly manipulating the region of a prolapsed disc is not what I would regard as a good idea.

  41. Badly Shaved Monkey
    November 5, 2010 at 8:47 am

    Because of the way these exchanges develop, my three questions to our chiros now sit about half-way up the thread. Here they are again for Stefaan to see them clearly and publish his reply among the most recent posts.

    1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
    2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
    3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

    • November 5, 2010 at 9:45 am

      Dear BSM,
      I am working on your reply but I also have a very busy practice making better lots of people.
      Because you couldn’t be arsed answering my questions by assuming that it’s stonewalling on my behalf I am having to write a small opus to answer the question as you obviously know very little about spinal mechanics and need to include descriptions of basic anatomical facts to facilitate your education.
      You won’t have to wait too long. Promise
      Doctor Stefaan Vossen, Chiropractor

      • Badly Shaved Monkey
        November 5, 2010 at 3:04 pm

        I await your opus. We’ll judge in due course whether it was worth the wait or whether this is just more prevarication and bluster.

  42. Bruce
    November 5, 2010 at 9:10 am

    And for the same reason as ‘ monkeys’ I post again;

    Hi James you are so right.

    This is the modus operandi of all the members of B.I.G.O.T.S or skeptics a they like to be known. The use half truths, make assumptions, jump to composting, misquote and where ‘evidence’ is concerned, use it or don’t use it to suit themselves.

    They ‘assume’ because I challenge them that I am a chiropractor. They may of course be right, but equally they may be wrong, however once again the choose the side that makes their argument, they don’t seek the truth.

    They talk of medical and physiotherapy procedures based on sound principles and chiropractic not being, why, because it supports their views on the way the perceive life should be. Yet do not challenge the lack of evidence in both groups, especially physiotherapy. It is also interesting to note that both professions started in the early half if the 1890’s the physios came from nurses of course, and yet physios, without a great deal of evidence, if any, to support what they do are ok. Ridiculous, the more these people spout off the more readers can see how pathetic they are. They ignore , Bronfort whose report is being seen in many quarters as being robust, and who states there is strong evidence to support chiropractic, they ignore the statements that many chiropractors in the UK don’t even use the word subluxation and whose tools and treatment protocol extend beyond adjusting the spine and into the realms if musculoskeletal disorders as a whole and were taught the same at either AECC or WIOC. They ignore that comparing the education with chiropractic education, chiropractors probably have a far more intensive grounding in the health sciences, a far better understanding of functional disorders and the treatment of the same. They cry ‘evidence’ but won’t get off their armchairs to look at both side of the argument critically.

    More and more people are finding out that the ’skeptics’ and I use the words very loosely are not skeptics but simply individuals, whether medically trained or not, who are after the demise of a profession.

    Is it all bad, no, chiropractic is being forced to stand up for itself in both the research field and the professional field. It helps millions if people a year where medicine or physiotherapy has failed, and these peoplewant to take that choice away from people in pain, good luck to them.

    Like most individuals, I want transparency, evidence where available but to paraphrase the General Medical Council who said ‘ that in the eyes of the doctor, the benefit should outweigh the risk to the patient, whether evidence exists or not’ and I fully support that statement. But I want all health care profession to be treated equally both in regulation and in the requirement to produce evidence, no health care profession wants a negative result, not all medics are shipman surely?

    So James welcome to reality, these people don’t want debate they want genocide and as hard as they try to roll out the same old questions which have all been answered in the past, and as hard as they try to get people to view chiropractic and contain them in the B.I.G.O.T.S narrow vision of practice, they are being found out and in many cases, ignored.

    Enjoy your weekend, but I am sure your experience in the blog of Blinkered Vision will either make you laugh or shocked, I prefer the former. As Stefaan pointed out on another blog, there is a little bit of Skeptic baiting going on. We all watch the auditions of x factor, well it’s not dissimilar when posting here. Don’t take it too seriously, I remember from another blog where someone described this as, watching clowns performing in a circus., interesting concept really and they are there to make you laugh after all.

    As an addendum, the physio who sees pts when chiropractic has failed is easily seen in reverse, the vet or canine dentist who admits the manipulation may not have caused the paralysis, yet tries to blame a chiropractor ( sadly it also shows their ignorance, chiropractors in the uk are registered as being able to treat humans not animals, those who use the title ‘chiropractor’ when treating animals, will be using it illegally and if they are treating animals without a Vets permission, my understanding is that is also illegal). The physios input is interesting, they get EVERYONE better where the chiropractor has failed, where is the evidence, in fact where is the evidence to support physiotherapy?

  43. Bruce
    November 5, 2010 at 9:12 am

    In case you missed this from my rather long diatribe James;

    ‘As an addendum, the physio who sees pts when chiropractic has failed is easily seen in reverse, the vet or canine dentist who admits the manipulation may not have caused the paralysis, yet tries to blame a chiropractor ( sadly it also shows their ignorance, chiropractors in the uk are registered as being able to treat humans not animals, those who use the title ‘chiropractor’ when treating animals, will be using it illegally and if they are treating animals without a Vets permission, my understanding is that is also illegal). The physios input is interesting, they get EVERYONE better where the chiropractor has failed, where is the evidence, in fact where is the evidence to support physiotherapy?’

    Ye, let’s all look at physiotherapy eh, interesting thought but not in the gameplan I guess?

    • November 5, 2010 at 11:00 am

      Aah, sweet.
      Dear Bruce,
      Don’t you just love the arrogance and condescendence of those who believe they have the magic bullet?
      Many kind regards to you Bruce
      Stefaan

  44. Alison
    November 5, 2010 at 11:33 am

    It is semantics, not ignorance. The McTimoney College of Chiropractic offers courses in animal spinal manipulation based on the same beliefs in subluxations and essentially the same techniques as the human version, despite even less evidence that this is effective or appropriate for those with four legs than it is for those with two. Graduates of these courses apparently can’t register with the GCC and, I think, can’t advertise themselves as chiropractors, but that doesn’t stop them using the term to describe themselves to their clients’ owners. And whether it’s legal or not, ‘the chiropractor’ is the term that owners of horses and dogs use to refer to such a person.

    It certainly is illegal to treat animals without a vet’s permission, but that doesn’t mean it doesn’t happen.

  45. Enough Already
    November 5, 2010 at 1:06 pm

    @ Stefaan. If you are referring to me as the one with the magic bullet, I don’t consider that I have one at all, just a first class BSc(hons) with sports science content. The course remit was not only to be able to rehabilitate but primarily to improve sports performance. That is a clear expectation. My clients know exactly what I do. I get on and do it. I am comfortable in my professional skin.

    I know I would not be if I had been on a course which did not actually teach me what I was actually doing, on a biophysical level.

    Stefaan, I was being complimentary towards what you had done for James when I used the word diagnosis yet you pick up on it negatively. I don’t think you do your profession any favours by being so insulting towards me when unprovoked.

    Yours is exactly the attitude I encountered at a chiropractic college – if you were a non believer you were deemed to be an idiot in denial. I find it frightening that therapists can behave in this way towards another professional.

    ‘First do no harm’?

    • November 5, 2010 at 3:22 pm

      Enough,
      having an accolade or being a “professional” is no excuse. Remember that. It will stand you in good stead.
      You made comments that are of low standing and if the comments you have made to my colleagues at institutions were of a similar manner I would understand you being denounced as being in denial or an idiot.
      I think you may wish to examine your comportment towards your fellow professionals prior to playing the victim role. A little introspection in regards to your statements concerning your ability to help people who failed with chiropractors and GP’s, in regards to the quality of institutions and in regards to cancer diagnoses (which can only be done by tests and biopsy) may refresh you and facilitate a return to your senses and maybe a little mea culpa would not go amiss.
      This has nothing to do with you being a non-believer, but rather someone who doesn’t actually listen to the arguments and questions put in front of him/her. What you believe is your prerogative, how I allow people to treat me is mine.
      Stefaan

  46. Enough Already
    November 5, 2010 at 1:28 pm

    Hi Alison

    You are right. It is common for pet owners to heap all practitioners into the same pigeon hole because they are unsure about what each of them do.

    The issue of universities accrediting courses that teach unfounded techniques, even though students may study science in other modules, is of even greater concern when applied to animal care and their owners’ trust.

  47. Alison
    November 5, 2010 at 1:47 pm

    Yes, but in this case the McTimoney graduates from the animal course really *are*, and think they are, chiropractors, whether or not they are officially allowed to use that term to describe themselves.

    To quote from one of their websites: “Animal Spinal Therapy is a form of chiropractic manipulation”.

    Veterinary CAM is of great concern not just because of the unfounded techniques but also because of the unfounded assumptions that are made about animal biology and behaviour.

    • Bruce
      November 5, 2010 at 1:59 pm

      Ah Alison

      I don’t think it is simple semantics although I can see why you would say that but;

      1) Chiropractors are regulated by statute to treat humans. Simples. It is illegal for anyone else to call themselves a chiropractor who isn’t on the register, it is also illegal for ‘chiropractors’ to treat animals. It is not in their remit.

      2) With regards the animal course run at the McTimoney College on Abingdon, the animal course is not ‘Chiropractic ‘ and is delivered by the MCC and accredited by the University of Wales as I understand it.

      Number 2 does not and cannot supersede the facts of number 1. This is like saying that, having done a postgraduate course in say diagnostic ultrasound to MSc level from a med school, accepting that this technique is used by medics, that I can become, or link myself with or call myself a medical doctor. If I did then is that everyone elses fault or mine for making the statements. This is ludecrous surely but then I am sure you are just having a laugh. Yes/no?

      It’s almost like saying that when a GP or a Surgeon or a Physio manipulates, that if it goes wrong, it was a ‘chiropractic technique’ but if it goes right it is down to the skill of the practitioner. That could never happen, could it? Sadly yes.

      Anyway, show me the evidence that it was a qualified chiropractor, practicing as a chiropractor who adjusted the animal and not a physic etc.

      Show me the evidence that there is evidence to support physiotherapy, whether with animals or not.

      And finally, and you skeptics love this stuff, show me the evidence that the manipulation of the animal by whoever, actually caused the paralysis.

      • November 5, 2010 at 2:17 pm

        Bruce wrote: “With regards the animal course run at the McTimoney College on Abingdon, the animal course is not ‘Chiropractic’…”

        I don’t think I’m the only one to find what you’re saying utterly confusing, especially when the first sentence of the UK College of Chiropractors’ Animal Faculty states “World-wide, chiropractic for animals is already a strongly established form of chiropractic…”
        http://www.colchiro.org.uk/default.aspx?m=21&mi=139&ms=55&title=Animal+-

        It’s worth clicking on the ‘More here’ link within that link and counting how many times the word ‘chiropractic’ is used in relation to treating animals.

        Not convinced.

  48. Bruce
    November 5, 2010 at 2:19 pm

    Interesting titbits from the chiropracticlive website;

    Garland Glenn on November 5, 2010 at 11:37 am
    “The British Medical Journal’s “Clinical Evidence” analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found:

    13 percent were found to be beneficial
    23 percent were likely to be beneficial
    Eight percent were as likely to be harmful as beneficial
    Six percent were unlikely to be beneficial
    Four percent were likely to be harmful or ineffective.
    46 percent were unknown whether they were efficacious or harmful”

    Mmmmmmm, how does the song go……. ‘makes you wonder?’

    • Mojo
      November 5, 2010 at 2:49 pm

      Has it ever made you wonder why they did this?

  49. Bruce
    November 5, 2010 at 3:28 pm

    @ blue woad

    You being not convinced, how does that not surprise me. But the legality of it all rains the same.

    @mojo

    So you got the song in o e, good stuff?

    So why did they do it, one would hope it was done to improve the service, but does that therefore mean that the treatments offered by the NHS on the medium and high classification would have dropped by say, let’s be kind, around 54% based on what would be deemed ‘beneficial’ to the public. Of course the standards and evidence required as set by the B.I.G.O.T.S. for one profession eg chiropractic, obviously will not extend to another. Skepticism or bias, that is the real question?

    By opening a can of worms, make sure they can be easily contained. You guys set the rules but struggle to abide by them. But maybe that is in the code of practice of the British Institute of Great Orators, Thinkers and Skeptics eh?

    Of course not, so please at least attempt to bring something to the debate.

    • Mojo
      November 5, 2010 at 6:33 pm

      The BMJ Clinical Evidence figures are often cited as part of a a tu quoque aimed at medicine. What they are intended to do, however, is not to assess the degree to which medical practice is evidence-based (or, for that matter, to indicate that it’s OK to not have evidence), but to identifiy areas in which more research is needed. They are part of a solution, not part of the problem, and to attempt to use them to defend treatments that may not be supported by good evidence is to seriously miss their point. As far as I’m aware they don’t take into account how often the treatments are used. It is quite possible that a far greater proportion of the treatments that are actually used are supported by decent evidence. I’m also not sure that the BMJ figures are limited to”conventional” medicine – it’s quite possible that some of those treatments categorised as “unlikely to be beneficial” or “unknown whether they were efficacious or harmful” are treatments that would normally be described as CAM. I wonder where, for example, chiropractic treatment of colic in babies would be categorised.

      Studies evaluating the evidence base of treatments actually used in practice have been carried out. For example an overview from 2004 can be found on pages 316-317 of this excerpt form the British Journal of General Practice. The percentages of treatments actually used in practice that are supported by evidence would appear to be significantly higher than suggested by the figures you cite.

      • Bruce
        November 5, 2010 at 11:43 pm

        Of course it does :-)

      • Bruce
        November 6, 2010 at 12:06 am

        And of course there is this response by a surgeon on skeptic baristas site ;

        d tolson says:
        October 16, 2010 at 12:26 pm
        As a doctor i am hugely encouraged by your watchful eye on some of these therapies. It seems the chiropractors were daft to cross Simon Singh. The Osteos are seeming now to sort their house out and only advertise evidence based claims, it does take time to change websites though!

        My concern is, as a surgeon (28 years) , there are MANY things i do daily that are yet to have an evidence base behind them….. but they save lives!

        Good to be vigilant, but most pioneering techniques within surgery and medicine have little evidence behind them…..just a thought,

        D Tolson

        But I guess you new that…… Come back and bite in the derriere was mention before I think.

  50. Alison
    November 5, 2010 at 4:46 pm

    Blue Wode

    Thanks for that link, which makes it abundantly clear that animal chiropractic not only happens but is endorsed by the UK College. Another quote:

    “Under the UK Chiropractors Act 1994, the regulation of chiropractic, by definition, is restricted to humans as animals are not mentioned. However, some registered chiropractors perform chiropractic adjustments on animals.”

    There is no hint that the UK College of Chiropractors considers this illegal or even undesirable. They have an Animal Faculty, for starters … and are evidently keen to inform people about ways to become an animal practitioner, and to reassure them that it is within the law as long as the animal’s vet has given permission.

  51. Bruce
    November 5, 2010 at 5:27 pm

    Yes, it is within the law to manipulate animals as we have both said, with a vets permission. They are however as the College of Chiropractors states, excluded from the 1994 act and as such are not chiropractors. Simples. Doesn’t matter what slant you put on it, facts are facts.

    I also notice that in your usual way of attempting to deflect the debate away from what you do not wish to talk about, or in fact know about, which seems to cover a vast array of subject matter, that you failed or were unwilling to discuss the BMJ paper on the evidence for medical practices or on fact the evidence for physiotherapy, strange huh, but not unexpected by those who know you. Reputations huh?

  52. November 5, 2010 at 8:16 pm

    For Badly Shaved Monkey’s attention:
    These were the questions posed:
    1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
    2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
    3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

    As points 2 and 3 are impossible to answer conclusively without giving good response to point 1, it will be my primary aim to provide conclusive response to this prior to continuing on with 2 and 3:
    1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.

    The subluxation as defined in the prior discussion is described as a partial dislocation. Annotation added were that this entity, as opposed to a full dislocation is an active and dynamic process. By the very definition of a subluxation it is understood that it can be rephrased in its longer form as;
    an incomplete and abnormal apposition of the joint surfaces.
    As this discussion focuses on the interpretation and value allocated by chiropractors a further subdivision is required into vertebral and non-vertebral subluxations. The point in discussion is the vertebral subluxation.
    Therefore a vertebral subluxation can now be discussed as an incomplete and abnormal apposition of vertebral joint surfaces. These joint surfaces include: vertebral facet joints (bilateral and anatomically symmetrical) suboccipital facet joints and sacro-iliac joints. Secondly there are the discal joints which exist between two vertebrae and are positioned midline. All of these joints are synovial joints, are functionally restricted by the anatomical dimensions of the ligamentous, discal, capsular and muscular structures. These limit the theoretical passive anatomical range of movement to what is termed “the physiological range”. The physiological range is then further limited by muscle tone and mass to what is described as the “functional range”.
    The anomalous nature of the interrelationship of the vertebral joints in the vertebral subluxation is therefore determined by anomalous muscle tone. This means that when the coordination of muscle firing patterns (which is the pace and intensity with which individual muscle fibres and consequently sections of the muscle contract) that produce the relationship between one joint surface and another is anomalous, then the relationship of one joint surface and the other will, consequently, be anomalous. So far we are talking no more than basic musculo-skeletal functional anatomy. So when discussing the vertebral subluxation concept we are in fact talking about the consequences of anomalous muscular firing patterns.
    In consequence, when asked to prove that subluxations exist, I am effectively being asked whether such anomalous firing patterns exist in human vertebral motion units. Other issues that revolve around this, but are not primary to this issue are whether the other passive structures would allow or even facilitate the occurrence of anomalous firing patterns. The literature extensively describes adaptations of such a nature in facetal structures, ligamentous structures and discal structures, not to mention facetal structures (facet joint hypertrophy). The normal viscoelastic condition of spinal system ligaments will allow for the normal mobility of the spinalcolumn and will also enable the ligaments to participate in absorbing and dissipating external forces. The health of a joint is greatly dependent upon the ability of its connective tissue to effectively “load” and “unload” within its paraphysiological space. Intrusive forces or loads of prolonged duration can push the joint beyond its physiological capacity and may result in connective tissue injury or altered joint function. When this happens, the dysfunctional joint loses its ability to return completely to its normal resting position. This hysteresis is accompanied by the inability of a joint to move through its full range of normal motion. Alternatively, when discussing the discal or facetal structures one can refer to the extensive list of cadaveric studies. These however do not conclusively prove that anomalous firing patterns are the cause of anomalous apposition of vertebral joint surfaces, just that abnormal motion occurs and that physiological changes occur in consequence.
    What does however conclusively prove this is that the changes can occur due to abnormal apposition. Therefore, the only remaining question is: what creates abnormal apposition? The answer: motion patterns. What causes motion patterns? Muscular firing patterns influenced and limited by the anatomical parameters (which may be abnormal due to trauma, surgery or congenital factors and may aggravated by nutritional and genetic factors).
    Ergo abnormal apposition between the vertebral joint are at times and in part the result of abnormal firing patterns.

    Because adaptation to abnormal apposition exists, abnormal apposition must exist. Therefore vertebral subluxations must exist.
    Let me know how you got on with that and I will answer your next questions.
    Stefaan Vossen
    This is only the beginning

  53. November 5, 2010 at 8:42 pm

    ps in re-reading my post I realised that I left a stone unturned:
    I state that changes occur due to abnormal apposition and left that for obvious. Due to the knowledgbank of the readership I must add that this has been described extensively in both cadaveric and invivo studies. It is commonly understood to be so obvious that it needn’t be mentioned but thought it best to iterate this point clearly, even if belatedly.
    Stefaan

  54. Badly Shaved Monkey
    November 5, 2010 at 10:26 pm

    Stefaan

    All you’ve really said in that bout of verbal diarrhoea is that muscles move joints, so if a joint is out of position then its associated muscles must be acting abnormally. Your verbiage merely serves to hide the circularity of your argument.

    You have not characterised any specific example that would lead to a falsifiable prediction about its clinical significance. You have not even defined what you mean by abnormal position and how it can be distinguished with high specificity from normal position.

  55. Bruce
    November 6, 2010 at 12:09 am

    @mojo

    In case you missed it, or other readers did;

    And of course there is this response by a surgeon on skeptic baristas site ;

    d tolson says:
    October 16, 2010 at 12:26 pm
    As a doctor i am hugely encouraged by your watchful eye on some of these therapies. It seems the chiropractors were daft to cross Simon Singh. The Osteos are seeming now to sort their house out and only advertise evidence based claims, it does take time to change websites though!

    My concern is, as a surgeon (28 years) , there are MANY things i do daily that are yet to have an evidence base behind them….. but they save lives!

    Good to be vigilant, but most pioneering techniques within surgery and medicine have little evidence behind them…..just a thought,

    D Tolson

    But I guess you knew that…… Come back and bite in the derriere was mention before I think. But then your expectation for chiropractic supersedes that of medicine or in fact physiotherapy doesn’t it. You guys need to stop, your making a fool of yourselves.

    • Badly Shaved Monkey
      November 6, 2010 at 9:03 am

      Bruce, it would help if you read the posts and absorbed their content. 

      This has already been addressed. 

      “Badly Shaved Monkey on November 4, 2010 at 9:03 pm
      Bruce, you are failing to grasp an essential point.

      Proof of efficacy is paramount. Chiros lack that for almost all that they do.

      But, crucially, they also lack a coherent mechanistic understanding of the body. So, they cannot base their treatment on rational extrapolation from the known into the less well known.

      There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely. No system is perfect. It’s all to do with making best use of partial information. Chiros work from false information so they are not comparable with physios.”

      Yours is not.a deep insight but a trite statement of the bleedin’ obvious. It’s why medicine is not a final and complete body of knowledge so that the book can be closed on further investigation. 

      The difference between real medicine and SCAM is that SCAM is almost entirely bollocks and shows itself to be incapable of identifying that which is bollocks and closing it down. 

      Chiros probably help with sore backs, though probably no better than the other rather useless treatments for this frustrating condition. The theoretical underpinnings for this are probably bollocks, as exemplified by Stefaan’s blustery nonsense, but whacking a painful pack may help it even if the theory behind the exact whacking is wrong. Chiros almost certainly do not help for any other problem and that is absolutely because their theoretical underpinnings are bollocks; this error leads them to extend their practice into conditions for which they cannot provide useful treatment. 

      • phayes
        November 6, 2010 at 10:51 am

        “There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely.”

        Tolson was referring to life or death outcomes too.

      • November 6, 2010 at 11:22 am

        BSM said:
        “Chiros almost certainly do not help for any other problem and that is absolutely because their theoretical underpinnings are bollocks”
        What would help a great deal is what you understand the “theoretical underpinnings” of “chiros” to be. I suspect that the information you are working is inaccurate and that this is why you a) hold this view and b)keep missing the meaning of the information that is being put in front of you.
        I have asked you this question before in order to shed light on this and reduce the likelihood of either of our time being wasted. Could you please respond to that question in return?
        Stefaan

  56. November 6, 2010 at 12:23 am

    “All you’ve really said in that bout of verbal diarrhoea is that muscles move joints, so if a joint is out of position then its associated muscles must be acting abnormally.”
    That’s right! Good, now that you understand the basics we can move further ahead, slowly but surely so you don’t get too confused.
    Onto your clever synopsis: “if a joint is out of position then its associated muscles must be acting abnormally”. As I also stated within my discussion there is evidence of abnormal joint function causing abnormal loading of tissues which is secondary to abnormal function. As this function is largely caused by abnormal muscle action it therefore follows that… suspense,… drumroll… yes ladies and gentlemen: joints can be out of position!
    So do you agree that joints can be out of position?
    If so I have proven point 1 and laid the foundations for your second and third questions.
    The rest of your last point is irrelevant as it was not the question you originally asked. Unless of course you now feel your question was poorly spec’ed and would like to ask it in another way?

  57. Badly Shaved Monkey
    November 6, 2010 at 8:46 am

    Stefaan

    As I have already said, you will need to define “out of position” in a meaningful way. So far you have not said anything that allows prediction, testing and falsification. My question was well enough specified, you have simply failed to provide an example, or even show that you have the basis for providing an example, of a “well-characterised subluxation”.

    • November 6, 2010 at 10:24 am

      Would you like me to define “out of position” for you?
      These are all new questions which you haven’t asked before. Please be clear about what you would like to know from me.
      Your question was:
      1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
      Do you agree that you have been given evidence that subluxations exist in vertebral joints?
      Stefaan

      • Badly Shaved Monkey
        November 6, 2010 at 2:15 pm

        “Do you agree that you have been given evidence that subluxations exist in vertebral joints?”

        Only in such general, vague and circularly defined terms as to amount to very little. You have not defined abnormality of position at all. All you have done is argue that such a thing might exist in principle, but that doesn’t get us very far unless you show normality and abnormality in a specific example and relate it to actual pathology and its resolution with chiro treatment.

  58. Bruce
    November 6, 2010 at 9:20 am

    @bsm

    Or alternatively you failed or chose not to understand what he said. I get the impression that in an attempt to intellectualise, or rationalise you fail to see the wood for the trees, or simply fail to see.

    With the levels of evidence and depth of lnowledge you seem to require to accept/ understand/ consider chiropractic as a visble option in health care, you have failed to comment on the lack of evidence for physiotherapy or medicine which is also in this thread. Is that because you have failed or chose to understand that information as well is it maybe getting a bit close to home?

    You harp on about the subluxation and what a subluxation is, a great many chiropractors don’t even use the words. You harp on about risk and safety, yet fail to recognise that every intervention carries risk, and the chiropractic profession has shown to carry less risk than most. I am certain that you are aware, based on the research out there that there is very little evidence for physiotherapy and in fact it would seem many medical procedures, oh and I nearly forgot the risk factors involved in simple and common procedures such as colonoscopy and according to the research prescription drugs kill over 450k every year in the US alone. So please get a grip and a life.

    To summerise, the stance of the ‘skeptics’ or B.I.G.O.T.S. as you are now known, that chiropractors ‘ treat the subluxation to treat disease’ is ridiculous but helps you in your goal. You really need to ‘research’ what a chiropractor does, what they are trained to do and what benefit they offer, or you can apply the same principles you are ‘currently’ applying to chiropractic and apply them to medicine and physiotherapy and let’s see where that bunfight takes us? But of course you won’t, will you, as that would be against all that B.I.G.O.T.S stand for, you are unable or unwilling to even comment, will you? You see that is why the GMC made their statement in the Gaurdian( posted previously) and Mr Tolson, the surgeon ( posted above) made his comments on evidence). So please post your comment BSM?

    • Badly Shaved Monkey
      November 6, 2010 at 2:44 pm

      I didn’t realise that you wanted a specific comment about physiotherapy. From my limited experience and small knowledge obtained from employing a physiotherapist I can see sound biological principles being applied, though I don’t know whether their evidence base shows that their interventions are better than doing nothing or better than other possible interventions.

      Crucially, physiotherapy is not based on a fanciful connection between an alleged vertebral malposition and medical diseases remote from the axial skeleton.

      To summarise, physiotherapy is not obviously bollocks. Chiropractic, when applied to conditions not of the axial skeleton, is obviously bollocks. Chiropractic relating to the axial skeleton may also be bollocks insofar as it may be based on a fallacious understanding of the underlying pathology even if the outcomes from treatment still beat placebo. In this respect, chiropractic would resemble acupuncture. Meridians are obvious tosh, but it may be that sticking needles in can be beneficial through mechanisms that are only dimly related to the metaphysical construct of a meridian.

      ” that chiropractors ‘ treat the subluxation to treat disease’ is ridiculous but helps you in your goal. You really need to ‘research’ what a chiropractor does, what they are trained to do and what benefit they offer,”

      Don’t be obtuse, Bruce, it’s bloody obvious that many chiropractors suppose they treat luxations to treat disease. The fact that they can’t manage an internally consistent and coherent account of themselves is not my problem but theirs. In this thread, you’ve already been given examples. I suspect you are now simply pulling our plonkers by pretending not to understand this.

      I’ve asked chiros what they do if they want to distance themselves from the idea of subluxations as this concept has looked more dodgy. I’ve not obtained a meaningful answer. But, here’s your chance to speak up for them. What defines chiropractic if you entirely drop the idea of subluxations? Do that and we can compare what you say with what Stefaan is saying.

      ” you can apply the same principles you are ‘currently’ applying to chiropractic and apply them to medicine and physiotherapy and let’s see where that bunfight takes us? But of course you won’t, will you, as that would be against all that B.I.G.O.T.S stand for, you are unable or unwilling to even comment, will you?”

      What? I’ve already repeated a post to answer the same point. The principles I am describing are universal in medicine and I have explained to you the context in which they sit: theory and evidence feed off each other; no system is perfect. Just because you don’t think that medical practitioners think about this stuff doesn’t mean it isn’t happening. Is that clear enough? You seem to be making the same mistake I have seen in many advocates of SCAM, judging medicine by your own strawman model of it; displaying more chip-on-shoulder and naivety than real insight into what practitioners of real medicine actually think. Many SCAM practitioners seem to be motivated by a desire to play doctor without having to take on its obligations or responsibilities (or academic standards).

  59. November 6, 2010 at 4:04 pm

    “Only in such general, vague and circularly defined terms as to amount to very little. You have not defined abnormality of position at all. All you have done is argue that such a thing might exist in principle, but that doesn’t get us very far unless you show normality and abnormality in a specific example and relate it to actual pathology and its resolution with chiro treatment.”
    Now you know how difficult it is sometimes to get to anything meaningful or informative when people are asking bad, wrong or incomplete questions.
    Now that you accept that subluxations exist I can continue (as I said I would in the first post) to add meaning by adding information. This is the problem, many people who wish to converse or critique something like chiropractic theory, make so many assumptions and fail to understand or appreciate the nuances which occur with every layer of complexity.
    Chiropractic theory is extremely complex but extremely simple at the same time and I doubt that you, and many people on this and other forums, understand it.
    There is no shame in this, but there is great shame in assuming that you do and consequently are perceived by those who do to be arrogantly, blindly and pig-headedly asking for evidence, results of tests and acceptance of theoretical construct assuming this to be far more straight forward than it really is.
    So please answer my question; do you agree that subluxation exist?
    Simple yes or no answer will do.

    • Badly Shaved Monkey
      November 6, 2010 at 4:23 pm

      I would not know from what you have posted. Your explanation was circular and you have not provided the actual examples for which you were asked.

      I know atlantoaxial subluxation exists in toy breed dogs, but I do not depend on you for that information.

      • November 6, 2010 at 4:28 pm

        You did not ask for examples. Would you like to ask for examples?
        From your posting I understand that you don’t know whether or not subluxations (in your definition as a partial dislocation) exist even with the information I provided you. Is this correct?

      • Badly Shaved Monkey
        November 6, 2010 at 4:33 pm

        Oh, come off it, Stefaan, stop being sily.

        Let me remind you again what the questions are.

        1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
        2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
        3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

        You need an example of a subluxation to answer the questions.

  60. November 6, 2010 at 4:10 pm

    Now that is interesting!
    “Crucially, physiotherapy is not based on a fanciful connection between an alleged vertebral malposition and medical diseases remote from the axial skeleton.”
    Nor is chiropractic theory

  61. Badly Shaved Monkey
    November 6, 2010 at 4:31 pm

    Well, Stefaan, you have not shown otherwise so far and your delaying and prevaricating speak for themselves.

    • November 6, 2010 at 4:38 pm

      Have I not? Or have you just been choosing to see things this way? I don’t personally even use the term subluxation as I find it redundant and impractical, but you asked a question, I asked you to define it further and I answered your question as you asked it. I have AT NO POINT intimated that subluxations cause disease and you have NO references that chiropractic theory does. You have examples that some dimwitted people do, but NONE that chiropractic theory does. So stop thinking you have one over, because really you don’t. You just seem unable to answer the question put in front of you. I am not trying to trick you I am trying to take you through a thought exercise.
      So: do subluxations exist in the human spine? Yes or no

      • Badly Shaved Monkey
        November 6, 2010 at 8:58 pm

        Yes. Now, get on with it.

        Why is the term, subluxation, that you have sought so laboriously to explain “redundant and impractical”?

  62. November 6, 2010 at 4:58 pm

    ps you now want examples to convince you that subluxations exist. Is this correct?
    The example I provided you with is that djd occurs with abnormal apposition. The logic I employed is that therefore abnormal apposition occurs if djd exist. Djd exists, therefore abnormal apposition exists. Abnormal apposition is the same as subluxation therefore subluxation exist.
    We can debate the finer points, limiting factors of assumption and comorbidity factors later, but is the above assertion true/false as an absolute?

    • Badly Shaved Monkey
      November 6, 2010 at 8:54 pm

      True, but not relevant to the current discussion unless you show otherwise.

      • November 6, 2010 at 9:29 pm

        Excellent and thank you for your time. I will respond further later tomorrow.
        Regards,
        Stefaan

  63. Badly Shaved Monkey
    November 6, 2010 at 9:26 pm

    I’m bored of your games, Stefaan. You know full well the position of “subluxations” in the chiro belief system, please give up your faux naïveté.

    You’ve fulfilled my expectations completely.

    Perhaps you should reflect on this before you say any more.

    http://www.jvsr.com/researchupdate/detail.asp?ID=976

    “In a survey of North American Chiropractors completed by the Institute for Social Research at Ohio Northern University and published in 2003 their research found that:

    1.                  88.1% of chiropractors stated that the term vertebral subluxation complex should be retained.

    2.                  89.8% stated the adjustment should not be limited to musculoskeletal conditions.

    3.                  The respondents rated the subluxation as a significant contributing factor in 62.1% of visceral ailments.

    4.                  93.6% recommend maintenance/wellness care

    5.                  76.5% Teach a relationship between spinal subluxations and visceral health

    6.                  88.6% stated thermography was appropriate for use in practice

    They further concluded:

     “The profession as a whole presents a united front regarding the subluxation and adjustment.””

  64. November 6, 2010 at 11:19 pm

    I am not a statistic.
    You are assumptive. There is an ass in assumptive.
    I am paying attention to my darling wife, which is why not much time is available to pay attention to the issue at hand in our discussion, for which my apologies but there are more pressing matters at the present time.
    Speak soon
    Stefaan

    • Badly Shaved Monkey
      November 7, 2010 at 9:09 am

      That’s irrelevant. You know full well what is believed in the wider chiro community. If you were to make honest attempts to answer the questions you have been given then you would acknowledge those beliefs whether or not you share them.

      Hey, ho. I’m quite used to SCAMsters playing silly semantic games to avoid tricky problems. As I’ve already said you are conforming to a familiar type, but it’s your own choice whether to continue in this manner.

  65. Badly Shaved Monkey
    November 7, 2010 at 9:19 am

    p.s. I like to be able to spot and name fallacies. It’s a meta-game I play while watching to.
    So far, we’ve had No True Scotsman and Circular Reasoning. Bruce has deployed the Tu Quoque fallacy with gay abandon. There’s been Ad Hominem as well.

    Anyway, the score currently stands at 4 unless I’ve missed some examples that others want to point out.

  66. Badly Shaved Monkey
    November 7, 2010 at 9:24 am

    Oops, thick thumbs deleted part of a sentence. That should have opened with;

    p.s. I like to be able to spot and name fallacies. It’s a meta-game I play while watching to see what SCAMsters will say next.

    p.p.s. In case anyone here is unfamiliar with it, I’ll take this chance to point out that the acronym SCAM stands for Supplementary, Complementary and Alternative Medicine. I find this to be a helpfully wider net in which to catch foolish therapies.

  67. Btuce
    November 7, 2010 at 10:13 am

    But surely by bringing ‘tu quoque’ into the argument you are admitting that you yourself are playing a part in that fallacy or criticism, which is exactly my point, look in the mirror. You choose an argument but fail or are unwilling to consider the weaknesses of your own narrow stance on the issue. As a side issue, you previously state that chiropractic has very little evidence for what it does, ok so that means there is evidence? Also the Bronfort report which is now being recognised outside the chiropractic profession SS being robust and fair, suggests there are quite a few conditions that there is medium to high positive evidence for. Surprisingly these are the conditions that most UK chiropractors treat?

    Going back to your approach to all this, and i know you think you are very clever and astute ( see final statemet) at the start of this thread it relates to the uk profession yet you quote a survey in the states that you has a small survey cohort specific in its grouping, compared to the amount of US chiropractors in practice. In defence of the use of the subluxation in the states, the word is enshrined in use law brought about by the success of the Wilks trial, so that may help you in your understanding of the situation over there rather than offering silly and banal generalisations.

    In simple terms there was a huge exclusion, yet you state this as if it was a fact of lifeto suit your own ends. If the role was reversed you would criticise the chiropractic profession with exactly the same argument, and if the survey was taken in the UK or the northern European countries the stats may and probably would be different. The first clue is that the stats in your surveys are not 100%, now are they?

    Let me give you an example; if a survey was presented to BIMM on using acupuncture techniques on their patients, which is what most chiropractors in the uk use, shock horror, not just manipulation, you would get a positive response on whether it should be used. If you surveyed the Manipulating Physios on whether, manipulation had it’s place you would also get a different response to the question than normal physios. It’s all in the write up. Interestingly, if my memory serves me well, the Cochrane Collaboration reviewed the studies published in the BMJ and concluded that well over 90% had weak methodology affecting the outcomes. One could therefore argue the same for Bronfort, but I get the impression this has already been looked at and is considered good research. But let’s just say for arguments that ALL/ or well over 90% of health care research has poor or weak methodology/ researcher bias/ finacially or political motive/ ego etc which do in fact affect the outcomes, then that would make you guys look very silly and bigoted in your current attacks, now wouldn’t it?

    With regards the subluxation, your favourite word, you have been told and are being told again that not all chiropractors use the term subluxation, I don’t know any who would claim to affect an actual visceral pathology. There are obviously some, are they the majority, I would question that. But hey you’re enjoying yourself.

    As alluded to previously, you’re statement ‘I like to spot and name fallacies’ is simply your own perception of your skills, and doesn’t make it accurate. It’s sad really but I feel the same about clowns, so we have something in common.

    Anyway, rather than avoiding the issue which you guys are past masters at, what are your comments on the level of evidence required for medicine or physiotherapy and does it currently exist in copious amounts?

    • November 7, 2010 at 11:56 am

      Btuce wrote: “…the Bronfort report which is now being recognised outside the chiropractic profession SS being robust and fair, suggests there are quite a few conditions that there is medium to high positive evidence for.”

      It is apparent that what counts for favourable evidence with Bronfort does not pass muster in scientific circles:
      http://forums.randi.org/showpost.php?p=5671829&postcount=32

      Btuce wrote: “…at the start of this thread it relates to the uk profession yet you quote a survey in the states that you has a small survey cohort specific in its grouping, compared to the amount of US chiropractors in practice.”

      Here are some better figures. The newly-formed Alliance of UK Chiropractors (AUKC) incorporates three out of the four existing UK chiropractic associations, representing around 50% of UK chiropractors – and that is a conservative figure since the British Chiropractic Association (BCA) has recently joined the AUKC in a vote of no confidence in the GCC. It should be noted that the AUKC’s stated intention is to “create a vitalistic chiropractic model of health”. Indeed, it represents chiropractors “who stand behind the founding principles of chiropractic as a vitalistic drug free profession based on the identification and reduction of vertebral subluxations”. See this blog post and comments:
      http://www.chiropracticlive.com/?p=842

      Interestingly, the above would appear to support the results of a recent survey of UK chiropractors which revealed that traditional chiropractic beliefs (chiropractic philosophy) were deemed important by 76% of the respondents, with 63% of them considering the (fictitious) chiropractic subluxation to be central to chiropractic intervention. The survey is well worth a read:
      http://tinyurl.com/599vfs
      [Aranka Pollentier and Jennifer M. Langworthy, Clinical Chiropractic, Volume 10, Issue 3, Pages 147-155. Sept. 2007]

      Btuce wrote: “…In defence of the use of the subluxation in the states, the word is enshrined in use law brought about by the success of the Wilks trial”

      It’s worth remembering the following about the Wilk v AMA case:

      Quote:
      “In 1987, federal court judge Susan Getzendanner concluded that during the 1960s “there was a lot of material available to the AMA Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious.” The judge also noted that chiropractors still took too many x-rays. However, she ruled that the AMA had engaged in an illegal boycott. She concluded that the dominant reason for the AMA’s antichiropractic campaign was the belief that chiropractic was not in the best interest of patients. But she ruled that this did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public. Although chiropractors trumpet the antitrust ruling as an endorsement of their effectiveness, the case was decided on narrow legal grounds (restraint of trade) and WAS NOT AN EVALUATION OF CHIROPRACTIC METHODS.”
      http://www.chirobase.org/08Legal/AT/at00.html

      Btuce wrote: “…With regards the subluxation, your favourite word, you have been told and are being told again that not all chiropractors use the term subluxation”

      Is that because they have dozens of substitute terms for it?
      http://www.skepticforum.com/viewtopic.php?p=173955#p173955

      Readers might be interested in the following paper which explains why, no matter what alias is used for the term ‘subluxation’, chiropractors are struggling to be accepted into mainstream healthcare:

      Can Chiropractors and Evidence-Based Manual Therapists Work Together? An Opinion From a Veteran Chiropractor
      http://jmmtonline.com/documents/HomolaV14N2E.pdf

  68. Btuce
    November 7, 2010 at 10:17 am

    @ BSM

    Yip, I have the same problem with thumbs and B.I.G.O.T.S, so there is another couple of things we have in common. The last post was for you by the way, Monkey boy :)

    • Badly Shaved Monkey
      November 7, 2010 at 1:22 pm

      And Blue Wode has responded admirably to it. Perhaps you’d like to address yourself to his comments.

      Your use of the Tu Quoque fallacy remains fallacious when you make criticisms of real medicine as if they support chiro. Even then, it has been explained to you repeatedly that your criticisms of real medicine are ill-founded being both qualitatively and quantitatively different from those directed at SCAM and chiro in particular.

      Well done. You have joined Stefaan in his effort to construct strawmen. But he got there before you so the aggregate fallacy count of this thread still stands at 4.

  69. Badly Shaved Monkey
    November 7, 2010 at 1:06 pm

    @Bruce on November 5, 2010 at 2:19 pm
    “Interesting titbits from the chiropracticlive website;

    Garland Glenn on November 5, 2010 at 11:37 am
    “The British Medical Journal’s “Clinical Evidence” analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found:

    13 percent were found to be beneficial
    23 percent were likely to be beneficial
    Eight percent were as likely to be harmful as beneficial
    Six percent were unlikely to be beneficial
    Four percent were likely to be harmful or ineffective.
    46 percent were unknown whether they were efficacious or harmful”

    Mmmmmmm, how does the song go……. ‘makes you wonder?’”

    http://scienceblogs.com/insolence/2010/04/the_return_of_dana_ullman_2010.php

    Orac’s blog gives a bit more detail than Mojo’s response to Bruce. As can be seen, that BMJ commentary is probably more damaging to the claims of SCAM than it is to those of real medicine. That has not stopped dimwitted SCAMsters plastering it across the interweb in the usual manner of DUllman; using evidence that is actually hostile to the case they make because they never bother to assess the material for themselves. 

    • Mojo
      November 7, 2010 at 7:19 pm

      Thanks BSM – I was looking for that, but couldn’t remember where I’d seen it.

    • November 7, 2010 at 9:35 pm

      “Probably”? Where is your “evidence” for that?
      Good grief

      • Badly Shaved Monkey
        November 7, 2010 at 10:56 pm

        Stefaan

        Read the link to understand why the word “probably” applies.

        Still waiting for your substantive answers. The odd thing is that you seem to be taking so much time over this. You’re the chiropractor. You’re the expert. These were not meant to be hard questions. If you had good answers you should have been able to write them in a fraction of the time that you have spent complaining about the framing of the debate. But, I do acknowledge that you have at least made the effort. Bruce just seems to exhaust himself whingeing before he disappears again.

  70. Badly Shaved Monkey
    November 7, 2010 at 1:28 pm

    Bruce, let’s give you a task while Stefaan is doing his homework. 

    Since you dislike the concept of “subluxations”, please explain when, on the historical path from DD Palmer to today, did the concept of subluxation turn out to be false? What piece or collection of evidence led to its falsification? For extra points, you can comment on Palmer’s alleged cure of deafness by apparent correction of a subluxation. Which part of that seminal episode of chiropractic’s founding myth is untrue?

  71. November 7, 2010 at 9:36 pm

    Stefaan is not doing “homework”, he’s doing “house work”. Condescending prick

  72. bruce
    November 7, 2010 at 9:51 pm

    Ah Monkey boy, giving people tasks, homework, classing medical research or the lack of it as being negative towards CAM. I presume because of the way this thread is based, that you mean really mean chiropractic.

    See once again you have shown that you really are a member of the B.I.G.O.T.S, but then that was taken as granted. What isn’t is that maybe you arrogance actully supersedes your intelligence. Maybe we should change your name from badly shaved monkey to badly painted wondow, as we can see right through you. Anyway, good luck with the opposable thumbs, you’ll get the hang of them, evolution takes time you know, as of course does understanding without bias.

    Still not answered my questions though, good at throwing them out, not good at doing the homework ?

    @Stefaan

    Pricks, have uses, this guy is only here because his playstation is broken….. Roll on Christmas monkey boy, excited ? ;-)

    • Badly Shaved Monkey
      November 7, 2010 at 10:47 pm

      Bruce

      I’ve answered your questions.

      Let me repeat;

      Since you dislike the concept of “subluxations”, please explain when, on the historical path from DD Palmer to today, did the concept of subluxation turn out to be false? What piece or collection of evidence led to its falsification? For extra points, you can comment on Palmer’s alleged cure of deafness by apparent correction of a subluxation. Which part of that seminal episode of chiropractic’s founding myth is untrue?

  73. Badly Shaved Monkey
    November 7, 2010 at 11:09 pm

    OK, I just checked back through all the posts. Bruce’s only questions to me centre on his rather silly Tu Quoque challenge about the standards of evidence underlying SCAM and rational medicine. I’ve answered that point repeatedly. It seems that Bruce doesn’t bother to read the answers. Of course, it is easy to sustain a foolish belief if you don’t open your mind or your eyes to awkward truths.

    As I have said before, the pattern is a familiar one

  74. bruce
    November 8, 2010 at 12:32 am

    Oooooh monkey boy

    Testy, huh. :-)

    Once again I would like you to answer my question, not with a fallacy but with a fact.

    Of course they both seem to be based on opinion and perception. The fact that your opinion suggests you have answered the question, is not my perception of things. Give me evidence not opinion. With regards the sustenance of foolish beliefs, surely once again your arrogance is starting to slip through again and includes a misconception that you actually know what I believe. But you don’t do you, you just really bribe you do, sad really.

    But not long until Christmas though!

    • Badly Shaved Monkey
      November 8, 2010 at 7:28 am

      Bruce

      If you think I have not answered your question then please repeat it, so we can actually see what your question is.

      “includes a misconception that you actually know what I believe.”

      You’ve been very coy about what you actually believe. If you were to answer my question about subluxations then we could see what you believe and you would demonstrate that are are an honest participant in the discussion.

      Let me repeat again;

      Since you dislike the concept of “subluxations”, please explain when, on the historical path from DD Palmer to today, did the concept of subluxation turn out to be false? What piece or collection of evidence led to its falsification? For extra points, you can comment on Palmer’s alleged cure of deafness by apparent correction of a subluxation. Which part of that seminal episode of chiropractic’s founding myth is untrue?

  75. Bruce
    November 8, 2010 at 9:29 am

    @monkey boy

    So now you admit you have no idea what I believe, well it’s a start, but you really need to stop obsessing about ‘subluxation’?

    I also get the impression that you see yourself as a quizmaster or wannabe schoolteacher, that you get frustrated when you can’t control others, good grief, have you seen anyone about this, a psychotherapist or a councillor, for instance? Of course, evidence?

    To try and keep it simples monkey boy my old mate, my questions to you and the other B.I.G.O.T.S. out there,  and I will try and spell them out, are;

    1) what level of evidence to you feel is required for medicine and physiotherapy?

    2) would you feel that the level of evidence that you have set for chiropractic should be used as a base line for both physiotherapy and medicine?

    3) where is it?

    4) if there is none or the evidence is weak, should the procedures stop to protect the public?

     Remember according to your own rules, that of B.I.G.O.T.S. Of course, there needs to be high quality evidence for EVERYTHING they do, no evidence or weak evidence, no deal. :-)

    With regards the medical study conducted about evidence in the NHS published in the BMJ,  I get the impression that the study was commissioned by the NHS for the NHS about the NHS, yet you in your infinite wisdom try and link that with chiropractic, good grief, how do you take yourself seriously, or more importantly, how do others?

    I am just intrigued at what the outcome would be if 3000 p….d of chiros started writing complaints to the ASA/trading standards about claims made on websites/advertising relating to medicine and physiotherapy information, asking for evidence?  What would the results be, do you think, I assume they would have to deal with the complaints in the same way they are dealing/ have dealt with the Chiropractic profession. 

    If nothing else it would clog the system up for years and bring both groups under scrutiny.  I suppose i meant ASA/trading standards but in retrospect it could also mean medicine and physiotherapy. No one is immune from bad press I guess?

    But you see, like most people on the planet, I appreciate skepticism,  but as i am sure some readers will agree, i don’t appreciate bigotry, bias for personal, financial or political agenda or worse still attempts at genocide for the same. I am too long in the tooth to accept this, history has shown us a way forward, not a way back?

     Could the complaints thing happen, as the chiropractors have learnt from the B.I.G.O.T.S, it doesn’t require many people, so I am not sure.   

     My impression and experience in life has shown that bullies don’t always win, they continually make the mistake of underestimating their opponent :-) 

    So if you guys are making the rules, they need to apply to everyone. Yes/no.

     Oops sorry, there is another question for you?

    I await your answers and thus this debate getting on a fair footing. Good luck with that though. 

    If you struggle with understanding any of this, see if your Pater will help. Or alternatively you can admit either defeat or the questions are too hard or not viable as it would detrimentally affect your agenda to answer. ( I think our American cousins call it taking the 5th).

  76. Sam McMurdo
    November 8, 2010 at 9:44 am

    Bruce:
    “1) what level of evidence to you feel is required for medicine and physiotherapy?”

    Monkey can answer or ignore your questions as he sees fit in your, er, “debate”, but I can tell you one significant component of the acceptance of procedures in real medicine or physiotherapy is scientific plausibility.

    Outside spinal conditions, chiropractic is based on nonsense. Only an ignoramus could buy into subluxations and the associated drivel. The scientific adage that “extraordinary claims require extraordinary evidence” applies just as it does with homeopathy. You guys are making claims that fly in the face of scientific knowledge and you don’t have any decent evidence for those claims at all. None. Absolutely none. A few fairy stories, that’s all.

    I reject chiropractic for spinal conditions too on the basis that anybody who is idiotic enough to buy into that nonsense and fraudulent enough to sell it to the unsuspecting public should not be allowed anywhere near my or anybody else’s spine.

    • Bruce
      November 8, 2010 at 10:09 am

      @ sam

      Of course monkey boy can ignore my questions, they have that option.

      Sadly your response regarding medicine and physiotherapy being founded on solid scientific plausibility is not evidence. You guys made the rules and should apply them to everything or is this not a sign of bias, even bigotry? Your only way out of any argument is the ‘subluxation’. You no rissen?

      Have you any idea what is taught at either the AECC or WIOC, have you any idea of the education a graduate comes out with or even what they do, how they treat? Obviously not, you guys talk evidence but just keep jumping on the bandwagon because it’s an easy ride? Bullies are bullies wherever they are found yes/ no?

      So please, as you have entered the debate, maybe you will be happy to answer the questions posted above, you can use the 5th if you want, if needs must, it may help you out the hole that is appearing.

      From a post on chiropracticlive;

      Inquiry into neglect at hospitals begins

      “Appalling standards put patients at risk and between 400 and 1,200 more people died than would have been expected in a three-year period from 2005 to 2008.”

      A possibility of 1200 people died in only 36 months because of poor standards or could we read poor ‘evidence’ into that?

      • November 8, 2010 at 11:31 am

        Bruce wrote: “Have you any idea what is taught at either the AECC or WIOC, have you any idea of the education a graduate comes out with or even what they do, how they treat?”

        FYI, a British scientist recently wrote to the Welsh Institute of Chiropractic (WIOC) at the University of Glamorgan to express his concerns about the claims and information available (or not, in some cases) on its official website. He requested clarification as to the website’s accuracy/intent. You can read his letter here:
        http://tinyurl.com/3yv2t8b

        Apparently the WIOC’s reply, which hasn’t been published, was wholly evasive in that it sent a run down of the modules taught, but not what was actually in them.

        One wonders if the WIOC has something to hide.

      • November 8, 2010 at 11:54 am

        BTW, here’s an interesting critique of a recent chiropractic ‘perspective’ piece, praising chiropractic, which was written by Professor Alan Breen, one of the most senior academics at the Anglo European College of Chiropractic (AECC):
        http://apgaylard.wordpress.com/2009/07/03/in-praise-of-chiropractic/

        It’s worth mentioning that Professor Breen recently became the professor in chiropractic at the University of Stavanger, and will be jointly responsible for chiropractic PhD students:
        http://www.ecupresident.org/2010/10/nca-introduces-new-president.html

      • November 8, 2010 at 12:17 pm

        Further to my comment related to the AECC, readers might be interested to note that there seems to be a pattern in Professor Breen’s apparent failure to produce evidence for his claims.

        The following is the last paragraph of the authors’ reply the responses to a 2006 systematic review of systematic reviews of spinal manipulation (Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. J R Soc Med2006; 99:192 -6):

        Quote
        “Several comments note that our conclusions are not in line with current guidelines. We also make this point in our article and suggest `… that these guideline be reconsidered in the light of the best available data’.1 Surely this is sensible? Yet Breen et al. categorically state `… there is enough evidence about manipulation in the back pain area’, providing no reference in support of this statement. One could therefore be forgiven for concluding that it is more the result of wishful thinking than of critical evaluation.”

        http://jrsm.rsmjournals.com/cgi/content/full/99/6/279

    • Bruce
      November 8, 2010 at 10:27 am

      Addendum

      Before you guys think I am an anti medicine or physiotherapy nut ( that’s bigot for short) I am most certainly not. I have great respect and friends in these professions. But then I didn’t make the rules in this debate, you did?

      My questions are simple, try and answer them or alternatively you could use the old ‘subluxation’ as your get out clause, you know, your deflection strategy :-)

  77. Le Canard Noir
    November 8, 2010 at 9:55 am

    Just dropped in after a little while on this debate.

    As for Bruce’s question about levels of evidence – I have written about this ,a href=’http://www.quackometer.net/blog/2008/03/should-cochrane-call-for-more-research.html’>here.

    It is principally about homeopathy – but applies to all claims. For chiro, lesser evidence is required for claims directly related to the back – but for wild claims, such as colic, you are going to have to stump up with some goodies. No double standards here.

    What is amazing in this thread is how it is impossible to tell chiropractors apart from homeopaths – both apply the same techniques.

    Most dispicably, is how name calling easily drops in. Bruce with his absurd BIGOTS (homeopaths have recently started using the daft ‘denialist’). We also have Stefan who is transparently engaged in gamesmanship. It’s all rather unbecoming.

  78. Bruce
    November 8, 2010 at 12:40 pm

    @ le canard noir.

    Wow some serious assumptions, back to the, we are right and you are obviously wrong stance eh?

    There has never been any mention of colic in my posting, evasive action number 2, I guess. Any comments relating to chiropractic and the evidence supporting it are based on Bronfort. Simples.

    With regards referencing your own posts, if i felt satisfied with the information i wouldn’t have posed the questions. So once again in a simple format, your previous postings do not answer my 4 questions posted previously, now do they old bean? It has all got to do with evidence and the quality of evidence you guys have set the bar at and how that relates and functions within medicine and physiotherapy or doesn’t as the case may be?

    By the way great Avatar, I am starting to believe in superheroes. One more and we will have the fantastic 4. We currently have the ‘black duck’, ‘monkey boy’ and the ‘blue paint’ ( or blue woad as they are commonly known), hey you can wear badges and outfits and that, how cool would that be. Am I envious, no not really.

    Jesting aside, you guys set standards, you have set rules for how you treat and berate chiropractors, yet don’t apply them outside your personal agenda? Then there is Sam whose hatred and venom towards chiropractors in general is almost palpable. No bias there then and a bit scary if this person has any responsibility for other peoples lives, let’s hope the function as many if you do in the enclosed world of IT?

    Of course there is blue woad, well her Harry Potter cloak of invisibility works for me.

    But another very simple question once you have answered the rest, is it unfair for some to class you as bigots and can you see why they would? Or have we gone a full circle and you are happy with ‘ you’re right, so the are wrong’?

    I look forward to you answering the questions posed?

  79. Badly Shaved Monkey
    November 8, 2010 at 3:23 pm

    Bruce, I keep answering your question. You don’t seem to like the answer.

    You are [still] failing to grasp an essential point.

    Proof of efficacy is paramount. Chiros lack that for almost all that they do.

    But, crucially, they also lack a coherent mechanistic understanding of the body. So, they cannot base their treatment on rational extrapolation from the known into the less well known.

    There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely. No system is perfect. It’s all to do with making best use of partial information. Chiros work from false information so they are not comparable with physios.

    I don’t know why you have a problem with that answer. It makes clear that the playing field is level and there is a single standard set for all. Chiros fall below that standard because what they do lacks underlying theoretical plausibility. If they help backs it is not because of their theories, but only because their version of manipulative therapy is no worse than anyone else’s and none are any better than a variety of rather useless non-manipulative interventions for a problem where nothing much works very well.

    Perhaps you think chiros do have a strong theoretical base. But, I keep asking you about it and you keep evading the question and would prefer to descend to rather silly name-calling.

    So, here we go again.

    Do chiros have a good theoretical basis for what they do?

    Since you dislike the concept of “subluxations”, please explain when, on the historical path from DD Palmer to today, did the concept of subluxation turn out to be false? What piece or collection of evidence led to its falsification? For extra points, you can comment on Palmer’s alleged cure of deafness by apparent correction of a subluxation. Which part of that seminal episode of chiropractic’s founding myth is untrue?

    It is very curious that in a debate about chiropractic you keep wanting to talk about medicine or physiotherapy and the one thing you do not want to talk about is chiropractic theory. I’m not so daft as to preclude the potential for you just to be a troll engaged in a pythonesque permanent naysaying of everything your opponents say but unwilling or incapable of presenting actual arguments in support of your own position. But, for the moment, I have the time available and watching you dance around the gaping hole in your position is enough entertainment for now. The whole ‘I won’t show you mine until you show me yours’ routine that I see “David” engaging in with Blue Wode over at Skeptic Barista’s blog is similarly unedifying, but the longer it goes on the more likely it is that the perpetrator really doesn’t have any evidence or argument to support their own position but they are just too scared or stupid to admit it.

    Anyway, it’s over to you again. Will you answer about subluxations or just smear your hands with more poo and fling them at the crowds?

  80. Bruce
    November 8, 2010 at 4:27 pm

    @ monkey boy

    I  knew you had time on your hands, I alluded to it earlier. But Christmas is only a few weeks ahead so chin up. Or maybe the manual labour for the unemployed will get you out into the real world.  Meet a few people, it will be good for you.

    With regards your concept of level playing fields, if that were the case then medicine would not be carrying out procedures that had no, very little,  or weak evidence and neither would physiotherapy without you characters kicking off.  If you really are concerned over public safety and finance, why are you not jumping up and down in your little fez, banging your cymbals and making a noise about that. It’s because that’s not on the agenda, nothing to do with skepticism, public safety, or saving the public from themselves, it is just simple, arrogance, bias and bigotry.

    Oh, and before you get your playstation replaced, answer the questions. Simple answer will suffice, it is generally  better than BS for most people, try it.  

    • Le Canard Noir
      November 8, 2010 at 5:08 pm

      Did you ever condescend to actually read my post on what constitutes good evidence for various interventions?

      Let me remind you. This blog post is about the standards and levels of agreements within the chiropractic trade. You have to have darn good reason to demand discussions outside of that scope. You are failing badly.

      Richard Lanigan will love this, but you are a classic case of ‘what-about-ism’. You wish to discuss anything but the subject at hand.

      Transparent.

  81. Badly Shaved Monkey
    November 8, 2010 at 6:06 pm

    Bruce, I see you have chosen the poo-flinging option again.

    A false assumption you have made is that I don’t challenge conventional medicine. I do that in appropriate forums. This is not one of them. Quackometer is a forum for challenging quackery. Chiro is looking and smelling more and more quacky with every post made by its appointed defenders.

    Coincidentally, I was just reading through something I wrote that was published last week in a forum where such opinions carry some weight dealing with the evidence-base for an aspect of conventional medicine. Sorry, do remind me, was that you who pointed out that there was an “ass” in assumption? But, carry on arguing with the model of me that you have created if you wish; it doesn’t bother me. I’d just like you to answer the questions that relate to the current topic.

    So, to return to what this blog discussion is actually about;

    You’ve been very coy about what you actually believe. If you were to answer my question about subluxations then we could see what you believe and you would demonstrate that are are an honest participant in the discussion.

    Let me repeat again;

    Since you dislike the concept of “subluxations”, please explain when, on the historical path from DD Palmer to today, did the concept of subluxation turn out to be false? What piece or collection of evidence led to its falsification? For extra points, you can comment on Palmer’s alleged cure of deafness by apparent correction of a subluxation. Which part of that seminal episode of chiropractic’s founding myth is untrue?

  82. Bruce
    November 9, 2010 at 12:41 pm

    @Monkey boy

    There are a number if things in relation to your last post. Firstly, I think someone needs to show you how to pose questions in a manner than is not viewed by the recipient as being patronising and arrogant however, just to get it out the way and as i appreciate i have been obtuse with you on occasions, my answer would have to be;
     I have no earthly idea. I do know that the AECC has not taught subluxation as a pathological entity for at least 25-30 years. I also know that it was mentioned simply in a historical sense. I am also aware that WIOC have never taught subluxation as a pathological entity. My comments on the Abingdon college would only be based on information on their website. Having answered, your question, please answer the 4 I gave you.

    With regards my own experience relating to my own personal health, I have had chiropractic treatment of and on over the last 20 years for various musculoskeletal complaints and injuries, where physiotherapy has failed miserably and the only solution from medicine was popping pills. We know what the research says about prescription drugs killing in excess of 450,000 people in the US alone? So I don’t choose to take drugs unless I have to.

    With regards medicine, physiotherapy and chiropractic,  I have friends and contacts in all three disciplines, and I know what works for me, works for many other people. I know many people who refer to medics as ‘quacks’ and many people who see physiotherapy as worse than useless.  This if course explains my comment to the rather naive physio who ‘claimed’ to cure every failed chiropractic patient they saw.  However I do appreciate that there are cases where not everyone is helped by chiropractic, but as alluded to
    that is the same for all health care professions

    You suggest that you comment on medicine on other forums and you believe this forum only to be there to discuss ‘quacks’. As I have said previously what you guys are doing is trying to control and limit the debate to attacking chiropractic. My argument is, the rules and levels of evidence you have set for chiropractic should be global to include ALL health care professions including medicine and physiotherapy and the lack of good evidence for the same. Based on that, as in good research, comparisons should be made and discussed. Only through an inclusion of medicine and physiotherapy in this debate can chiropractic, it’s evidence, it’s patient satisfaction scores and it’s outcomes be discussed fairly for better or for worse.

    To let you understand my mindset in all of this, I dislike bigots, fools and bullies and I hate having my life choices being dictated by the same. Whatever the evidence relating to medicine, physiotherapy and chiropractic, I cherry pick, depending on results, past experience and who I perceive will deal with my complaint best. I believe that to be the same for the great majority of the general public when given a choice. 

    The litmus test is simple; if a patient  consults a medic or a physio, and they resolve the problem, sorted, they don’t go anywhere else. If they fail to get relief or resolution of there symptoms, they will go to someone else eg a chiropractor. So as the majority of patients first contact is a GP, and if deemed a appropriate a physio, then they have the chance to help the patient. Their failure to do so sits squarely on their shoulders, maybe this is where the lack of evidence and their closeted approach to healthcare comes in? You know, if we can’t fix it no one can mentality?

    Anyway would I see a chiropractor for arrhythmic tachycardia,MS or shingles, of course not. Would I and have I seen one successfully for femoral nerve entrapment, planter fasciitis, whiplash and headaches or lateral epicondylitis, yes! 

    So basically I would see a chiropractor,  but not  totally for,  the contents of the Bronfort report, as my own experience includes symptoms that are not included but do mirror conditions where medium or high positive evidence exists eg sciatica/ femoral nerve entrapment.   I also understand that Bronfort has a good reputation within the scientific community for producing fair and robust research, this report included.  Personally comparing Bronfort against the ‘esteemed scientist’ , continually quoted on these sites, I know where my preference lies. 

    I am also aware, based on research by the Cochrane collaboration with regards the BMJ, the current report of NHS standards and evidence, and the ‘quality’ of evidence produced by professor Ernst, that all is not as simple as you guys would have your readers believe.

    As a patient, no chiropractor I have ever been treated by has mentioned subluxation in any context, but then that isn’t what you want to hear?

    You said; 
     ‘You’ve been very coy about what you actually believe. If you were to answer my question about subluxations then we could see what you believe and you would demonstrate that are are an honest participant in the discussion’. 

    My response to that is; 
     I get the impression that the definition of an ‘honest participant, in these discussions’ is simply one who abides by your rules, answers your questions, yet does not question the lack of the same in return nor in fact the abuse and bigotry if questions are answered.

    So based on the facts that i do not trust your neutrality nor in fact your ability to look at things from a fair or reasonable viewpoint, I will lose no sleep over your acceptance or lack of the same, in my continuing in this debate. However,  having answered you’re question/s with honesty, albeit not as you hoped, please answer mine.

    As a byline I think your choice of the word for faeces is quaint, maybe you just need a hug:-) 

  83. Badly Shaved Monkey
    November 9, 2010 at 3:26 pm

    So, Bruce, a sensible post. Thanks for that.

    What it boils down to is you don’t know where “subluxations” got lost or why. You could have said that some time ago. It doesn’t sound as if you would be able to define a “subluxation”, but if you are not yourself a chiropractor then I would not expect you to be able to do so.

    You attend chiropractors only for musculokeletal problems where they feasibly can help, though not necessarily better than anything else.

    You have inferred a causal relationship between chiropractic treatment and symptom amelioration. Though, formally, such an inference is not valid I can see why you perceive there to be a causal connection, but obviously if you state it any more strongly then you are into the territory of the Post Hoc Ergo Propter Hoc fallacy and the score for this page rises to 5.

    As to your questions, my answer remains the same.

    Proof of efficacy is paramount. Chiros lack that for almost all that they do.

    But, crucially, they also lack a coherent mechanistic understanding of the body. So, they cannot base their treatment on rational extrapolation from the known into the less well known.

    There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely. No system is perfect. It’s all to do with making best use of partial information. Chiros work from false information so they are not comparable with physios.

    I will expand on that slightly. Where I said “Chiros lack that for almost all that they do.”, what I mean is almost all by count of problems that they claim to treat, not actual amount of time spent treating those problems. In the UK, especially, I suspect that their time is largely devoted to back problems, which skews any assessment of their activity. This is exactly the point made about that BMJ review: by count of treatments there are areas lacking in evidence (with SCAM over-represented in that), but by amount of patient contact the weaker areas are less prominent. No, I have not quantified this, but I think it is a reasonable inference.

    Your final point, should the public be protected from treatments having weak evidence? That’s a bit ‘motherhood and apple pie’, one can’t possibly answer in the negative. The question arises as to how it should be done. There is no perfect system, but there are checks and balances while commercial interests and professional inertia act to undermine those processes. SCAM almost completely lacks those checks and balances as has been made obvious by the shambles of homeopathy and chiropractic.

    You said;

    “As a patient, no chiropractor I have ever been treated by has mentioned subluxation in any context, but then that isn’t what you want to hear?”

    It’s not a matter of wanting to hear it or not. It’s a plain fact that historically this concept was central to their belief and that huge swathes of their profession still employ it. If they use it they should be able to defend it, which I have seen no one able to do. If they do not use it then my follow-up question is what defines chiropractic and why does it deserve a legally protected title that permits people who are not doctors to intervene in patient’s health, allowing them, for instance, the legal right to take radiographs.

    It seems to me that, as one-trick ponies, their real problem is that if they admit the deficits in their evidence-base they have great difficulty working out what is left that is valid.

    Finally, I would say an ‘honest participant’ is one who answers reasonable questions with reasonable answers or admits they don’t know the answer and who does not play games to evade questions and avoid admitting awkward truths or lack of knowledge.

    • Brce
      November 9, 2010 at 6:31 pm

      Monkey boy

      You wrote; 
      But, crucially, they also lack a coherent mechanistic understanding of the body. So, they cannot base their treatment on rational extrapolation from the known into the less well known.

      My response would be; 
      what a positively ridiculous statement which makes me wonder just how much nonsense is on your head relating to the chiropractic profession. Do you genuinely know or understand the level of education in the health sciences UK chiropractic graduates have under their belt, their knowledge of anatomy/ physiology/ biomechanics/ general diagnosis makes them well placed to treat a vast array of musculoskeletal disorders. Please monkey boy try at least to get your facts straight and stop the BS, please.

      You said; 
      There is much in medicine that is not backed by RCT and certainly some things are done that later turn out to be wrong, but a good theoretical underpinning makes that less likely. No system is perfect. It’s all to do with making best use of partial information. Chiros work from false information so they are not comparable with physios.

      My response; all you are doing, rather than impressing me, is you are turning into everything I thought you were. 

      Surely knowledge of anatomy and function is knowledge of anatomy and function. I think you are allowing you’re bias to prevent you seeing the facts and thus, how silly your statements are.

      On each occasion when I have seen both a physio and s Chiro for the same problem, except for one case where the physio was so far off to left field it was scary, both clinicians tested  using roughly the same orthopaedic tests, although  in all fairness the chiropractor did also check beyond the area of pain.  Both clinicians diagnosed the exactly the same pathology. The difference was the Chiro fixed it. Two different chiros and two different physios. The conditions were frozen shoulder ( adhesive capsulitis) and tennis elbow ( lateral epicondylitis) 

      For both myself and for many people out there, I am sure the person that got the gold star for ‘theoretical underpinning’ was the Chiro. 

      Also you cannot surely be serious in comparing undergraduate chiropractic education with that of physiotherapy. For goodness sake man, get out the house and talk to people. 

      You really need to come onto the 21st century with your attitude and knowledge base instead of trolling the sites. I really am disappointed, but not surprised. 

      Sorry monkey boy, and you were doing so well. What a let down.

      • November 9, 2010 at 8:08 pm

        Brce wrote: “…you cannot surely be serious in comparing undergraduate chiropractic education with that of physiotherapy.”

        FYI, not so long ago one UK chiropractic academic did compare chiropractic education with that of physiotherapy – unfavourably, whilst also acknowledging the paucity of evidence for chiropractic techniques. He was Edward Rothman, a senior lecturer at the AECC:

        Quote
        “Many of us whine, moan, and complain about the irrational, unethical, and stagnant state of chiropractic. NACM set out to make some changes but was not effective. Mainstream organizations, like the ACA, are made up of people without the intestinal fortitude to stand up to wacky technique gurus, DCs with fake PhDs, sleazy practice builders, and ridiculous “diagnostic” methodologies (subluxation station, sEMG scanning, etc). They are unwilling to admit that more than half of the schools in the States should be closed down and those left, undergo serious reform…
        I am not sure that anything can be done because it is my perception that there are very few rational chiropractors willing to leave, what I have termed, the ritual induced placebo of our manipulative techniques, the monotherapeutic nature of the profession, and the unethical practice building. Though I have argued with a PT on the other forum on behalf of the profession, I often wonder why — when PHYSICAL THERAPISTS CONTINUE TO IMPROVE THEIR EDUCATION, delving into differential diagnosis, and limited perscription rights, e.g., the new DPT programme.
        What does our profession do? We try to legislate to stop PTs from manipulating — further proof of our irrational behaviour, insisting on our monotherapeutic approach to treat everything. I am an American currently working at a chiropractic school in England. For me, AECC has been a little utopia because of the talented and dedicated people I work with. However, in the four years I have been in England, I have seen a change come over the profession there as more and more people take on American practice building methods and are attracted to irrational, illogical techniques and treatment pursuits, e.g., “occipito-sacral decompression in chiropractic paediatrics” (don’t even try to understand that one). Some of us can ban together and discuss these issues but will chiropractic/chiropractors ever change? What hope do we have of making the radical changes to the profession that is needed to attract rational scientific people into the field, considering the general state of the profession and the historical and current stance of the ACA?”
        http://tinyurl.com/32l9o5e

        Pretty damning stuff.

        Apparently, however, not all academics at the AECC share Edward Rothman’s integrity. For example, in the recent past Professor Edzard Ernst questioned the methodology used in a 2007 survey that attempted to look at the safety of chiropractic neck manipulation (Thiel HW, Bolton JE, Docherty S, Portlock JC – Safety of chiropractic manipulation of the cervical spine: a prospective national survey. Spine 2007 Oct; 32(21): 2375-8). He highlighted the very real problem of “having to rely on the honesty of participating therapists [chiropractors] who could have a very strong interest in generating a reassuring yet unreliable picture about the safety of their intervention”. See here:
        http://onlinelibrary.wiley.com/doi/10.1211/fact.13.1.0020/full

        Interestingly, in their response, two of the survey’s authors, JE Bolton and HW Thiel (both of the AECC), claimed that in the UK alone there were an estimated four million manipulations of the neck carried out by chiropractors each year. Yet, six months earlier, in October 2007, in a letter to the Journal of the Royal Society of Medicine…
        http://jrsm.rsmjournals.com/cgi/content/full/100/10/446
        they claimed that the figure was “estimated to be well over two million cervical spine manipulations”. How that estimate could double in under six months is anyone’s guess, but it leaves them open to accusations that they may be trying to play down the risks.

        Add the above to my previous comments about the elusive content of the degree course at the Welsh Institute of Chiropractic, and Professor Alan Breen’s apparent habit of failing to cite evidence in support of his positive assertions about chiropractic, and the picture one gets of chiropractic education is far from reassuring.

  84. Andy Lewis
    November 9, 2010 at 6:39 pm

    I do think it is so sweet the way chiropractors think they have had a thorough education. And they get so tetchy when you question it.

    • Badly Shaved Monkey
      November 9, 2010 at 9:39 pm

      Perhaps they can receive spinal manipulation to help them bear the enormous chips sat on their shoulders.

      Really it’s all of a piece with the usual SCAMster dependence on and love for Authority.

  85. Brce
    November 9, 2010 at 8:59 pm

    Oh Andy

    You presume to much

  86. Badly Shaved Monkey
    November 9, 2010 at 9:36 pm

    Bruce, if their education is so marvellous, what then possesses them to start claiming they can treat asthma and a host of other non-spinal conditions? Zeno found many hundreds of these. Were the chiros you know free of this taint?

    By the way, we’ve seen in Stefaan’s verbose rhetoric much that would impress the gullible, but nothing to impress anyone with a serious knowledge of medical biology.

  87. Bruce
    November 9, 2010 at 10:02 pm

    Hey monkey boy

    I am certain the chiros I know would not claim to treat asthma. I have had that discussion and my understanding that by treating the thoracic cage and muscles of respiration, the would try and help the patient to breath. So mechanical function yes, pathology, no.

    • Badly Shaved Monkey
      November 9, 2010 at 11:20 pm

      Well, that’s just wonderful. I expect they fully support childhood vaccination as well. It’s such a shame that so many of their professional colleagues invite them to be painted as numpties.

      I wonder what evidence they would have for “treating the thoracic cage” of asthmatics. That sounds like a load of bollocks.

    • Mojo
      November 10, 2010 at 9:35 am

      “I am certain the chiros I know would not claim to treat asthma. I have had that discussion and my understanding that by treating the thoracic cage and muscles of respiration, the would try and help the patient to breath.

      So, in other words, they would claim to treat asthma.

  88. David
    November 9, 2010 at 10:49 pm

    @ Le Canard Noir

    Just a small, but significant correction to your post, and apologies if this has been pointed out in the comments left so far; I’m afraid I haven’t read them.

    The vote of no confidence that was passed at the BCA AGM was not a vote of no confidence in the GCC. It was a vote of no confidence in the “process, interpretation and proportionality of the General Chiropractic Council (GCC) in its regulation of the chiropractic profession”.

    I do not believe that the BCA (or any of the other associations) has any desire to see the dissolution of the GCC. The vote of no confidence related to the apparent inconsistency of the manner of the regulation.

    As is well known, there have been a good number of complaints leveled at chiropractors recently, mostly for the content of some of their websites, and the GCC has been rigorous in its execution of these complaints.

    However, the GCC appears to be exerting a higher standard on chiropractors for their marketing material than it had apparently applied to itself at the time the complaints were made. We therefore face a situation where registrants may be found guilty of professional misconduct for behaving in a manner no less professional than the regulator. I believe it is this fact that led to the letter being sent to the GCC.

  89. Enough Already
    November 9, 2010 at 11:38 pm

    Don’t forget to tune into BBC Wales at 10.35pm tonight – channel 972 – which is probing the University of Wales’ validation activities. Wonder if this will ultimately affect the McTimoney College.

  90. Badly Shaved Monkey
    November 10, 2010 at 7:08 am

    Bruce, thinking a bit about your personal impressions of chiros, can you clarify, please, for your tennis elbow and plantar fasciitis did they manipulate your spine or manipulate the affected area and give other advice?

  91. Bruce
    November 10, 2010 at 11:10 am

    @ monkey boy and mojo

    You guys are great ;-) 

    Firstly, as I understand it from both conversations and reading, if someone has difficulty in expiration due to an asthmatic episode. The respiratory muscles become hypertensive. Surely by loosening things off by whatever means, it may help the patients breathing? Well of course not to clowns, but normal thinking people yes. 

    Mojo, mojo, mojo, you really havent a clue, even I can understand that treating function is not necessarily treating the pathology itself. You are a silly boy sometimes?

    Back to you Monkey boy, I am not sure it is relevant how I was treated, the physio failed and the chiropractor sorted it out. Stop clutching at straws. 

    There are moments when I read your posts that there is a glimmer of a fair man behind the bias and drivel but then you run and hide in the dark side again;-)

    @Andy

    Have you ever compared chiropractic and physiotherapy undergraduate education? I get the impression based on a rather banal statement, that you haven’t.  Comment on what you understand. As it goes, this is not a bad forum, don’t stink the place up with BS

    You could also be forgiven for choosing to forget what the conclusion of researchers at Warwick University was about physiotherapy. It would seem there is ‘no real evidence to support it’  tut tut. Oh the rules, the rules. Derriere biting time again.

    On a final note @ monkey boy

    As stated before, I know members of all three professions ; medicine, chiropractic and physiotherapy who have concerns about vaccination and members of all three professions who support it. One thing BIGOTS need to realise is the world is not full of nodding, blinkered dogs. Step outside your communication bubble and you will see that life is not as simple as you maintain.

    eg by the laws of probability
    chiropractic ; not all bad
    Medicine and physiotherapy; not all good

    In both treatment, attitude, evidence and standards. Yes/no

    • Mojo
      November 10, 2010 at 11:33 am

      @Bruce: “Mojo, mojo, mojo, you really havent a clue, even I can understand that treating function is not necessarily treating the pathology itself.”

      I can see through your weasel words. If they say that, faced with a patient presenting with asthma, they can “help the patient to breath” then they are claiming to be able to treast asthma. Incidentally, this is certainly the interpretation used by the ASA. Note that the GCC Code of Practice states that in advertising their practice, chiropractors must “follow … guidance issued by the Advertising Standards Authority” (GCC Code of Practice and Standard of Proficiency, section C4.1).

  92. November 10, 2010 at 12:04 pm

    Back for more
    Ignoring a few posts (most recently mojo equating improving thoracic function to “treating asthma” which is not only ridiculous but simply dangerous) I would like to take the time to answer Badly shaved monkey’s questions posed earlier.
    Now that we have established that “subluxations” exist we need to go ahead and start by recognising its limited identified value and put in place a few semantic and contextual nuances. The concept of subluxation in the way outlined by myself in an earlier post was referred to as impractical and redundant. BSM queries why I feel this way. The simple answer is that it has, in my opinion, very little use or relevance due to its lack of parameters and predictors. This is why I don’t use it other than when people who call themselves sceptics rant on about it and pull it about out of context whilst applying it without discretion or deference.
    I think it is worthwhile at this stage to explain that in my view the term subluxation was used in a slightly but crucially different context by the originators of chiropractic theory now more than a century ago. I have written about this on other blogs but in short it is my opinion that the term, which I will from now on refer to as the chiropractic subluxation concept, or CSC for short differs from the subluxation as discussed earlier in that the CSC is firstly a philosophical concept from which secondly a clinical entity may emerge.
    I know lots of people here turn their nose up at philosophy but they are in my opinion just being delusional and condescending ignorami. Think of the philosophy as the idea and the clinical entity the reality. The two relating to one another is the identified through science. It is not a case of one, or the other, but rather of whether it is one because of the other.
    So what is it about the philosophical concept that makes chiropractic great and interesting? Amongst others that it takes great pains to emphasise that the important bit is not the injury in itself but the inability to heal. Shoulder pain after a fall onto the outstretched arm is one thing. Not having recovered from a soft-tissue injury after 6 months is another.
    That when it looks at the concept of injury it doesn’t focus on the diagnosis but on the presence of predisposing factors which, had they not been present, might have avoided the injury occurring in the first place. Hurting your knee after a bad tackle is one thing. Hurting your knee just going from jog to sprint is quite another.
    It looks at, and takes great pains to, emphasise the fact that in an ideal world lacking in genetic defect, congenital anomaly, limited levels of population migration (reducing mismatched exposure to environs and food supplies to which the genome had not had time to adapt to) and equal access to resources, in such an idealised, fantastical and non-existent world, the main source of lack of wellness (dis-ease) would be those things which suppress our ability to heal and repair from normal, day-to-day assaults we all sustain.
    Yes, things went off the rail for a while and people within chiropractic forgot to note these exclusions and parameters. Some of them even started talking about disease. This was a fallacy, should never have happened and should never happen again. But not completely. Disease CAN be multifactorial. The biopsycho-social models refer to it. Looking at heart disease without looking at dietary habits or smoking is idiotic. It isn’t when someone is having a heart attack but it is when the government is trying to save money on cardiac procedures. Nobody in chiropractic is saying to fatty who is having a heart-attack: “lose weight fatty” they are saying watch your diet so you don’t need it (allegorically and simplistically speaking). I said “nobody in chiropractic…” I know that’s not true. There are some idiots who may do (I don’t know who they are but you boys and girls seem to drag them up and well-done for exposing these dim-witted liabilities-I extended my gratitude to all involved in these efforts already on multiple occasions) but these people DO NOT represent chiropractic theory, philosophy or practice. They represent idiocy and liability.
    What I am also saying is that in a healthcare world hunkering for refinement and preventative methodology the ideas proposed in chiropractic philosophy are actually quite clever, as long as we all understand that such refinement requires clear parameters and solid enforcement of these parameters. And this is the only problem the chiropractic theory has. It is a big problem but not so big that it isn’t possible. Nor is it clever to bin it all just because there is a problem. The clever thing is to start looking at solving that problem. Regulation was an attempt to start this process. Improving educational standards was too. Considering that this process is very much still ongoing and that the conceptual issues involved in chiropractic are really rather complex and consuming, I think those people who dare to call themselves sceptics but in fact just mudsling without much knowledge of what they are slinging, at are failing to comprehend the context and meaning of what they are doing.
    I sincerely hope this will help somewhat, even if it does not answer the questions, in the knowledge that the questions are being asked too early. I understand why the questions are being asked too early: because the claims were being made to early. And that is something the chiropractors who made those claims and the regulator that facilitated the culture of voicing such claims need to be held accountable for. But chiropractic theory is not being held to task here, just human fallacy and idiocy.

    Regards
    Stefaan Vossen
    This is only the beginning

    • November 10, 2010 at 1:13 pm

      According to the Alliance of UK Chiropractors (AUKC): “Chiropractic is a separate, distinct healing profession that emphasises the inherent recuperative power of the body to heal itself, without the use of drugs or surgery, with particular focus on the subluxation.”

      However, a recent, thorough, scientific review of the evidence for chiropractic suggested that its healing capabilities are hardly enough to merit its existence as a distinct profession:

      Quote
      “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. p.285 ‘Trick or Treatment? Alternative Medicine on Trial’, by Simon Singh and Edzard Ernst.]

      But now we’re being told “the questions are being asked too early”.

      In view of the evidence that’s already in (after some 115 years), what’s the point in asking any more questions?

      What am I missing?

    • Badly Shaved Monkey
      November 10, 2010 at 1:28 pm

      Stefaan, Please get back to us when you are able to come up with the actual example of a subluxation that you can reliably detect, reliably remove in association with clinical improvement.

      • November 10, 2010 at 1:36 pm

        @BSM
        so is this your next question? And are you talking about subluxation of CSC?

      • Badly Shaved Monkey
        November 10, 2010 at 1:42 pm

        Stefaan, use your term CSC if you wish. If you show evidence that it can be reliably detected and treated then it might not be rhetorical bullshit.

  93. Bruce
    November 10, 2010 at 12:50 pm

    @mojo

    Initially I had you down as someone with a lack of ability to reason logically, thanks to your last post, there is no doubt.

    No one is talking of treating ‘asthma’ they are talking of trying to help an asthmatic patient breath better. Do you not understand the difference. One is a biomechanicsl approach to function, the other and I guess what you have stubbornly kicked in on is a disease process.

    Actually you should have used homer as an avatar, more appropriate I think.

    • Mojo
      November 10, 2010 at 1:25 pm

      You appear to have fallen down a rabbit hole into a land where “trying to help an asthmatic patient breath better” is not treating asthma. Give my regards to the White Rabbit.

      • November 10, 2010 at 1:31 pm

        Well, quite frankly, if you can’t understand the practical differences between the two it is not the White Rabbit, but the Magic Dragon you need to worry about. Can I ask what your academic and professional background is?

    • Bruce
      November 10, 2010 at 5:31 pm

      @mojo

      Do you really understand what you’re saying or do you just open your mouth and hope what comes out may represent rational thought.

      Let me try and simplify it for you, sadly I will have to type it as to explain it you in pictures would take too long and even then you’re inability to think may prohibit understanding, but let’s try.

      When I was a child there were still a few cases of polio about. These kids had a pathology. To assist with function they were fitted with a leg brace to try to help them walk. The brace didn’t cure or treat polio, the pathology, but it helped with function. A bit like the chiropractor treating the thoracic cage to try and help with breathing, If you don’t understand the difference now, then it’s back to your playstation because debating with adults really isn’t your thing.

    • Mojo
      November 12, 2010 at 1:14 am

      While I’m sure it would be entertaining to watch you trying to redefine asthma so that breathing difficulties are not a defining symptom, I’ve thought of a better way to settle the question of whether “helping an asthmatic patient breath better” is considered to be treating asthma. If Stefaan publishes a leaflet saying that chiropractic can “help asthmatic patients breath better”, and sends a copy in to the Quackometer, it can be submitted to the ASA for adjudication.

  94. November 10, 2010 at 1:34 pm

    @BW
    “However, a recent, thorough, scientific review of the evidence for chiropractic suggested that its healing capabilities are hardly enough to merit its existence as a distinct profession”
    That’s right, the available evidence doesn’t really warrant it. But clinical life and reality do not revolve around the available evidence, and they on the other hand, do warrant it.
    You may want to get your head round the difference between real life and data-bases.

    • November 10, 2010 at 2:17 pm

      What you say is regrettable. However, fortunately others are not so unperturbed by the over-formalisation of CAM therapies such as chiropractic imposing great harm by placing clinical experience ahead of scientific evidence:
      http://dcscience.net/colquhoun-follies-nhe-nov-dec-2008.pdf

      I would also add that if “clinical life and reality do not revolve around the available evidence”, then chiropractors can’t complain when anecdotal evidence for neck manipulation as a cause of stroke is given serious consideration by the scientific media.

      • November 10, 2010 at 2:50 pm

        “However, fortunately others are not so unperturbed by the over-formalisation of CAM therapies such as chiropractic imposing great harm by placing clinical experience ahead of scientific evidence:”

        -what does over-formalisation of CAM therapies mean?

        -how can clinical experience NOT be placed ahead of scientific evidence if there is no scientific evidence?

        -have you got evidence that great harm is being imposed?

        -have you got scientific evidence regarding the non-efficacy of chiropractic as practised per the theory, rather than per human folly?

        In regards to strokes… I think there are other concerns too which get little attention. Rib fractures and spinal fractures due to missing osteolytic metastases amongst others. Strokes have to be considered. I wrote a blog-post about that on chirolive entitled “consent is sexy”.
        I think the point your missing is that your big friend, Prof Ernst is considering but certainly representing as evidential an event which looks like it might be related (after all, the biggest dimwit might concede that fast manipulative manoeuvres to the neck might cause tearing of the vertebro-basilar artery) but there are two problems with this notion. Cadaveric research has already shown that there is really too much flexibility in the arterial organisation for that to be the case (after all manipulative therapy should not take the cervical range of motion beyond its physiological range-you know the on it has evolved to have and which allows large movement within the neck?)
        Secondly the occurrence seems to be lower than the occurrence of “spontaneous artery dissection”. But even if this may be due to under-reporting, you still need to get past the first point raised by cadaveric research to lend probability or even cause beyond emotive or intuitive feeling to this assertion.
        Finally, I wouldn’t say I am unperturbed. I would like to do some more work on the evidence dispelling or confirming the chiropractic theory as I understand it, but it is taking a lot of time (very little of it being available due to a great many people wanting to seek treatment from me, a chiropractor able to guarantee outcome measures.)

      • Bruce
        November 10, 2010 at 5:35 pm

        @ stefaan

        Why anyone ever attempts to validate this clown by giving them time and credence by answering them I will never no. But your time your call. For me their cloak of invisibility still works fine.

  95. Badly Shaved Monkey
    November 10, 2010 at 1:40 pm

    @Stefaan

    “most recently mojo equating improving thoracic function to “treating asthma” which is not only ridiculous but simply dangerous)”

    And yet, here are the conditions a number of chiros claim to treat.

    “asthma, stomach disorders, spastic colon, and arm, hand, and leg pain that’s due to
    dysfunction of the neck or lower back, asthma and emphysema”

    “infantile colic, nocturnal enuresis (bedwetting), sleeping and feeding disorders, childhood asthma”

    “asthma, colic, hyperactivity, bedwetting”

    “birth trauma, infant colic, sleeping and feeding problems, asthma, ear infections and hyperactivity”

    “colic, middle ear infections, hay fever, asthma, eczema, bedwetting, hyperactivity”

    • November 10, 2010 at 1:43 pm

      And your point is? Like I said, silly people do silly things. Sometimes through idiocy, sometimes through laziness.
      Nevertheless, what is your point?

  96. November 10, 2010 at 2:10 pm

    BS-m
    “Stefaan, use your term CSC if you wish. If you show evidence that it can be reliably detected and treated then it might not be rhetorical bullshit.”
    I was hoping that it was clear enough to you that there is quite a big difference between the two. I was also hoping that you would treat people who take the time to answer your questions with some deference. I am sure that Andy Lewis would concur that on his blog rhetorical bullshit may very well occur but it would be pointed out to be bullshit by virtue of flaws being pointed out in the rhetoric. I concede it may very well be bullshit but would you be so kind as to point out what it is about the rhetoric which makes you think that it is no more than bovine excrement?
    On the understanding that you manage to comprehend the difference between subluxation and CSC:
    -examples of CSC in the biomechanical arena:
    1)spinal dysfunction e.g Sacro-Iliac joint dysfunction (palpation and observable muscle adaptation)
    2)gait dysfunction e.g unilateral pes planus (observable)
    3)descending tmj dysfunction (observable)
    -there are of course examples of CSC in the nutritional/chemical arena and in the emotional/psychological arena to consider too, but I take it from what I understand of your view that you are primarily interested in the biomechanical stuff (as are most chiropractors). In answer to your question about reliable detection and treatment: I cannot offer you RCT-level evidence in support or in contradiction, although some studies have shown that certain detection methods have low inter or intra-evaluator reliability.
    Is that a problem to you?

  97. November 10, 2010 at 2:51 pm

    As this blog post is about the standards and levels of agreements within the chiropractic trade, the following is worth noting.

    A new systematic review of randomised controlled trials of osteopathy for musculoskeletal pain patients concludes “the notion that OMT alleviates MSP is currently not based on the evidence from independently replicated high quality clinical trials”:
    http://www.springerlink.com/content/h344x346m6u34284/fulltext.pdf

    Bearing in mind that we already know that the only good evidence for chiropractic lies in the relief of pain in a subgroup of persistent low back pain sufferers (and even then conventional treatments are usually equally effective and much cheaper), the AECC recently signed a Memorandum of Understanding with the British School of Osteopathy. See page 5 of this document:
    http://www.aecc.ac.uk/cms/site/docs/AECC%20newsletter%20for%20website.pdf

    Based on the information given in that AECC link, it would appear to follow that a combined total of nearly 10,000 UK osteopaths and chiropractors will have to acknowledge the new systematic review’s findings.

    • November 10, 2010 at 3:07 pm

      Stefaan Vossen wrote: “how can clinical experience NOT be placed ahead of scientific evidence if there is no scientific evidence?”

      In the case of chiropractic, a responsible risk/benefit assessment cannot be anything other than unfavourable, as highlighted by a critique of the recent NICE guidelines for the treatment of back pain:

      Quote
      “The risk of mild to moderate adverse effects is undisputed even by chiropractors: about 50% (!) of all patients suffer from such adverse effect after spinal manipulations. These effects (mostly local or referred pain) are usually gone after 1-2 days but, considering the very moderate benefit, they might already be enough to tilt the risk-benefit balance in the wrong direction.
      In addition, several hundred (I estimate 700) cases are on record of dramatic complications after spinal manipulation. Most frequently they are because of vertebral arterial dissection. Considering these adverse events, the risk-benefit balance would almost certainly fail to be positive. It is true, however, that the evidence as to a causal relationship is not entirely uniform. Yet applying the cautionary principle, one ought to err on the safe side and view these complications at least as possibly caused by spinal manipulations.
      So why were these risks not considered more seriously? The guideline gives the following reason: ‘The review focused on evidence relevant to the treatment of low back pain, hence cervical manipulation was outside our inclusion criteria’. It is true that serious complications occur mostly (not exclusively) after upper spinal manipulation. So the guideline authors felt that they could be excluded. This assumes that a patient with lower back pain will not receive manipulations of the upper spine. This is clearly not always the case.
      Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them. And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment of spinal manipulation for back pain.”

      [Ref: Ernst, E. Spinal manipulation for the early management of persistent non-specific low back pain? A critique of the recent NICE guidelines. Int J Clin Prac, Vol 63, No10, Oct 2009, pp.1419-1420]

      Stefaan Vossen wrote: “-have you got evidence that great harm is being imposed?”

      You can find a round up of harms here:
      http://www.ebm-first.com/chiropractic/risks.html

      • November 10, 2010 at 3:43 pm

        “In the case of chiropractic, a responsible risk/benefit assessment cannot be anything other than unfavourable, as highlighted by a critique of the recent NICE guidelines for the treatment of back pain:”
        If I understand the rhetoric correctly this means that you feel that in certain cases lack of scientific evidence in conjunction with the potentiality of discomfort or even on rare occasions harm should be enough reason to override clinical experience…
        From that I understand that if there is no evidence of benefit and there is no evidence of lack of benefit, and Ernst states that in the face of a lack of evidence either way, one should consider the draw-backs of potentiality of discomfort or even hurt or harm then I agree with you and Ernst. These things should be considered and the risks should be informed and the patient should be left to make an informed choice. Secondly I feel that there is also not enough evidence to make much of a claim on governmental funds (at this stage) as I believe in a government that spends wisely and considerately and that these considerations should be made based on evidence.
        What that does not mean is that you, or Ernst or any other entity should be left unchallenged when they are trawling out implausible horror stories that are not connected to reality or at least have not been connected to reality in an equally scientific manner to the manner in which I feel I need to provide connection between theory and practice prior to being able to put my hands on public funding or being able to make claims. That is a level playing field for each game.
        I was asking for some evidence not some assumptive stories on a silly website. Something that proves beyond reasonable doubt that chiropractic manipulation causes strokes above and beyond what would have occurred anyway. If you haven’t got that, then be a tad more elegant in your statements and pioneer a constructive debate rather than some uber-populist scare tactic. No better than Andrew Wakefield if it wasn’t for the fact that patients perceive and receive clear benefits from their care and are comfortable with the fact that their doctor of chiropractic naturally, as all physicians must do, theorise and assume certain things from the readily available clinical information and tests, and as such are liable to occasionally make mistakes and secondly that in the process of improving function and form some musculo-skeletal discomfort will logically and in consequence to the former occur in consequence in the form of a normal and common process called delayed onset muscle soreness, or DOMS for short.

  98. Badly Shaved Monkey
    November 10, 2010 at 3:18 pm

    Subluxation “in the nutritional/chemical arena and in the emotional/psychological arena”.

    I’m afraid you have now departed the realm of rational discourse.

    Mojo has reminded us of the white rabbit. You now wish to introduce us to Humpty Dumpty.

    ‘When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean – neither more nor less.’

    • November 10, 2010 at 3:50 pm

      Yes, I suspected that might confuse you a bit, you don’t seem to be at your brightest today. Hohum, we move along. I would suggest you go back to what was actually written and consider I never used the term subluxation in the nutritional, chemical context. You cleverly placed the quotation marks outside “subluxation” and tried, but failed. It was about in relation to CSC, go back and read what CSC is and then use your brain to think it through.
      It will help you. No really, it will.
      Rationality is also about cohesion of argument. Just remember that. that too will help you in life.
      Stefaan

      • Badly Shaved Monkey
        November 10, 2010 at 6:32 pm

        Chiropractic subluxation complex “in the nutritional/chemical arena and in the emotional/psychological arena”.

        It’s still gibberish.

        Evil pixies “in the nutritional/chemical arena and in the emotional/psychological arena”.

        Yep, that has the same predictive and interpretive power.

      • Badly Shaved Monkey
        November 10, 2010 at 6:40 pm

        Let’s try that in a larger piece;

        Back for more_Ignoring a few posts (most recently mojo equating improving thoracic function to “treating asthma” which is not only ridiculous but simply dangerous) I would like to take the time to answer Badly shaved monkey’s questions posed earlier._Now that we have established that “evil pixies” exist we need to go ahead and start by recognising its limited identified value and put in place a few semantic and contextual nuances. The concept of evil pixies in the way outlined by myself in an earlier post was referred to as impractical and redundant. BSM queries why I feel this way. The simple answer is that it has, in my opinion, very little use or relevance due to its lack of parameters and predictors. This is why I don’t use it other than when people who call themselves sceptics rant on about it and pull it about out of context whilst applying it without discretion or deference._I think it is worthwhile at this stage to explain that in my view the term evil pixies was used in a slightly but crucially different context by the originators of chiropractic theory now more than a century ago. I have written about this on other blogs but in short it is my opinion that the term, which I will from now on refer to as the chiropractic evil pixies concept, or EPC for short differs from the evil pixies as discussed earlier in that the EPC is firstly a philosophical concept from which secondly a clinical entity may emerge._I know lots of people here turn their nose up at philosophy but they are in my opinion just being delusional and condescending ignorami. Think of the philosophy as the idea and the clinical entity the reality. The two relating to one another is the identified through science. It is not a case of one, or the other, but rather of whether it is one because of the other._So what is it about the philosophical concept that makes chiropractic great and interesting? Amongst others that it takes great pains to emphasise that the important bit is not the injury in itself but the inability to heal. Shoulder pain after a fall onto the outstretched arm is one thing. Not having recovered from a soft-tissue injury after 6 months is another._That when it looks at the concept of injury it doesn’t focus on the diagnosis but on the presence of predisposing factors which, had they not been present, might have avoided the injury occurring in the first place. Hurting your knee after a bad tackle is one thing. Hurting your knee just going from jog to sprint is quite another._It looks at, and takes great pains to, emphasise the fact that in an ideal world lacking in genetic defect, congenital anomaly, limited levels of population migration (reducing mismatched exposure to environs and food supplies to which the genome had not had time to adapt to) and equal access to resources, in such an idealised, fantastical and non-existent world, the main source of lack of wellness (dis-ease) would be those things which suppress our ability to heal and repair from normal, day-to-day assaults we all sustain._Yes, things went off the rail for a while and people within chiropractic forgot to note these exclusions and parameters. Some of them even started talking about disease. This was a fallacy, should never have happened and should never happen again. But not completely. Disease CAN be multifactorial. The biopsycho-social models refer to it. Looking at heart disease without looking at dietary habits or smoking is idiotic. It isn’t when someone is having a heart attack but it is when the government is trying to save money on cardiac procedures. Nobody in chiropractic is saying to fatty who is having a heart-attack: “lose weight fatty” they are saying watch your diet so you don’t need it (allegorically and simplistically speaking). I said “nobody in chiropractic…” I know that’s not true. There are some idiots who may do (I don’t know who they are but you boys and girls seem to drag them up and well-done for exposing these dim-witted liabilities-I extended my gratitude to all involved in these efforts already on multiple occasions) but these people DO NOT represent chiropractic theory, philosophy or practice. They represent idiocy and liability._What I am also saying is that in a healthcare world hunkering for refinement and preventative methodology the ideas proposed in chiropractic philosophy are actually quite clever, as long as we all understand that such refinement requires clear parameters and solid enforcement of these parameters. And this is the only problem the chiropractic theory has. It is a big problem but not so big that it isn’t possible. Nor is it clever to bin it all just because there is a problem. The clever thing is to start looking at solving that problem. Regulation was an attempt to start this process. Improving educational standards was too. Considering that this process is very much still ongoing and that the conceptual issues involved in chiropractic are really rather complex and consuming, I think those people who dare to call themselves sceptics but in fact just mudsling without much knowledge of what they are slinging, at are failing to comprehend the context and meaning of what they are doing._I sincerely hope this will help somewhat, even if it does not answer the questions, in the knowledge that the questions are being asked too early. I understand why the questions are being asked too early: because the claims were being made to early. And that is something the chiropractors who made those claims and the regulator that facilitated the culture of voicing such claims need to be held accountable for. But chiropractic theory is not being held to task here, just human fallacy and idiocy.
        Regards_Stefaan Vossen_This is only the beginning

        There we go. You can swap the phrase ‘evil pixies’ for subluxation and ‘EPC’ for ‘CSC’ without materially altering what you say.

        Are you familiar with the Flying Spaghetti Monster? You should become so.

  99. November 10, 2010 at 3:50 pm

    Stefaan Vossen wrote: “I was asking for some evidence not some assumptive stories”

    I take it, then, that the precautionary principle isn’t a priority with you in your dealings with customers.

    • November 10, 2010 at 4:00 pm

      Here we go again with the assumptions! Good grief BW! No wonder you get so much wrong, you don’t read what’s written!
      Have a look at what I state about consent.
      ps they’re not customers they are patients. people who are unwell and receive treatment and then get better (probably by default rather than by causation as per your argumentations so far, but you have no evidence for that either, do you now?) are called patients.
      pps the precautionary principle is a principle, not evidence. A much misused principle at that, but in this case it is perfectly reasonable to be cautious. The problem you have is that the majority of my patients have tried other treatments before visiting me and as such are looking and under my guidance considering other options available to them. They appreciate me for that and are really pleased with their results and from a financial perspective they feel quite safe too because if they don’t get better they will get their money back. My consent process is very extensive and covers far more risks than stroke, even if I am only employing caution as a reason to include these, rather than evidence.
      Lastly evidence is evidence. Opinion is not evidence. Stories are not evidence. I asked for evidence you refer to opinion and stories. Can you give me evidence? Or can you not?

  100. November 10, 2010 at 4:08 pm

    @ Stefaan Vossen

    You have already been given sufficient evidence. You are not fooling me, even if you are fooling yourself.

    • November 10, 2010 at 4:21 pm

      Ok, so where is the evidence then? Not Stories, and not opinion, but evidence.
      Show me a link with evidence please that shows, beyond reasonable doubt that there is a link between stroke and manipulation.
      I would have no problem with that as I already warn for strokes anyway as I have stated before, but show me it rather than pretend you have it. I have sought for it and haven’t found it. I have no problem with you finding it but let me know where it is so I can.
      have you got it or have you not got it? For further clarification: stories and opinions do not count. No scaremongering just evidence. That’s all I am asking for.
      No better than Andrew Wakefield
      Stefaan

  101. Bruce
    November 10, 2010 at 5:56 pm

    @ mojo

    Do you really understand what you’re saying or do you just open your mouth and hope what comes out may represent rational thought.

    Let me try and simplify it for you, sadly I will have to type it as to explain it you in pictures would take too long and even then you’re inability to think may prohibit understanding, but let’s try.

    When I was a child there were still a few cases of polio about. These kids had a pathology. To assist with function they were fitted with a leg brace to try to help them walk. The brace didn’t cure or treat polio, the pathology, but it helped with function. A bit like the chiropractor treating the thoracic cage to try and help with breathing, If you don’t understand the difference now, then it’s back to your playstation because debating with adults really isn’t your thing.

    • Badly Shaved Monkey
      November 10, 2010 at 6:48 pm

      Were there technicians fitting surgical appliances who advertised that they treated polio?

      If you can find an example then you have made a valid point.

      • November 10, 2010 at 7:47 pm

        It’s a valid point regardless as the argument was not about advertising or claiming things but pointing out the difference between treating underlying pathology and treating people with pathology. Bruce was not advocating that chiropractors ought to be allowed to advertise treating something they aren’t but rather that when the discussion turned to asthma it was idiotic for mojo to not allow for the inclusion of differentiating criteria. i.e. treating causal pathology vs treating some of the effects to make patients life better. Really need to follow discussions with greater attention BSM.

  102. Badly Shaved Monkey
    November 10, 2010 at 6:46 pm

    @Stefaan

    “examples of CSC in the biomechanical arena:
    1)spinal dysfunction e.g Sacro-Iliac joint dysfunction (palpation and observable muscle adaptation)
    2)gait dysfunction e.g unilateral pes planus (observable)
    3)descending tmj dysfunction (observable)”

    Um, these are disparate clinical signs. You assert that their underlying commonality is this thing you call a CSC. I assert that the underlying commonality is the work of evil pixies.

    Please describe to me a test that will show that there is such a thing as a CSC so we can all be sure that evil pixies are not at work in your patients.

    You have seemed to need prompting when the next challenge has been set. Take this as your prompt.

  103. November 10, 2010 at 7:05 pm

    @BSM
    Regarding evil (or good) pixies comment above: if this is your understanding of what I wrote I will have to help you a little more. Think not of pixies (even if the band was really worthwhile listening to), but rather of the meaning I attempted to extend to the CSC and how it differs from a subluxation, the way we both understand it. Here is a sample of how it could go:
    Understanding those factors which cause functional and physiological strain “in the nutritional/chemical arena and in the emotional/psychological arena” in order to improve over-all health in the non-pathological/congenital part of the healthcare spectrum is important.
    Does that make it slightly more comprehensible for you?
    Or do I have to spell it out to you even further?

    Bad moving=bad for you
    Bad eating=bad for you
    Bad thinking=bad for you

    understanding bad moving, bad eating and bad thinking=important
    improving the way we eat and think=good

    It is just another system but the same rules apply for bad movement, which is the ones we discussed.
    If you would like to understand more about bad thinking and bad eating then I am sure that a clinical nutritionist and a cognitive behavioural therapist will be happy to explain further. They are not my field of expertise.
    The important bit is to realise that thinking, moving and eating are pretty important functions and interact. Bad thinking can cause bad moving and bad eating can cause bad thinking etc etc ad nauseam. This is why chiropractic theory at the time was discussed and described as vitalistic. With the ascension of the biopsychosocial model the concept has become considerably less airy-fairy although BJ Palmer did have the tendency to refer to deities to express his awe at evolution and nature in general, and screwed it up a little for us in the 21st century. But as nothing of the theory was riding on the existence of a deity it doesn’t actually really matter.
    Now you understand? I hope so because it is getting farcical. I can only assume you didn’t read or I didn’t write properly.
    Next time when you don’t understand something how about you come down from the Chair of Condescension and ask an explanation like a real grown up?
    Stefaan

  104. November 10, 2010 at 7:13 pm

    ps yes, they are essentially different clinical signs, but they have similar effects on the patients’ body when anomalous: they stress the tissues involved, create nociceptive input, create compensatory motion patterns distally and predispose to injury locally.
    And that is the point of the CSC concept

  105. Enough Already
    November 10, 2010 at 7:40 pm

    What about sufferers of scoliosis or cerebral palsy? Are they severely ‘dis-eased’?

    I’m more convinced that the body adapts spectacularly well to chronic spinal deviation. (Fonsela, S.T., Holt, K.G., Saltzman, E. and Fetters, L. (2001) A dynamical model of locomotion in spastic hemiplegic cerebral palsy: influence of walking speed. Clinical Biomechanics 16 (9) 793 – 805)

    • November 10, 2010 at 7:54 pm

      Severely diseased? As in what?
      I have a patient who started care three weeks ago who suffered a stroke age 6 and shows significant neurological, anatomical and functional adaptation. She is now a teenager. She is very happy because she is walking better and her hip doesn’t give away any more. Her parents are very pleased because she is more confident and happy now. She received physiotherapeutic care for years. Is she severely diseased? No.
      But why do you ask it in this way?
      Would you be able to give an answer to my previous question please?

  106. Bruce
    November 10, 2010 at 8:40 pm

    Hey boys and girls

    I know how much monkey boy, the invisible man ( BW), mojo and Andy like quoting drugs as an alternative to chiropractic ‘ because you reckon it’s safer’ try this.

    Oh my goodness can this be possible that maybe weighing up benefit and risk that drugs aren’t safer, is it possible. If they have this effect in pregnancy, are there other serious side effects?

    Wasn’t it not long ago that a paper was published that suggested drugs such as ibuprofen killed around 2500 people per year in the UK?

    Anyway enjoy;

    http://www.scotsman.com/news/Painkillers-in-pregnancy-may-affect.6617875.jp

    • November 11, 2010 at 12:11 am

      Bruce wrote: “Wasn’t it not long ago that a paper was published that suggested drugs such as ibuprofen killed around 2500 people per year in the UK?”

      I don’t think that is a very sound argument considering that the risks associated with NSAIDs don’t seem to be preventing UK chiropractors’ from currently attempting to secure (limited) prescribing rights. Also, a comparison of chiropractic spinal manipulation with NSAIDs would have to take into account the following:

      Quote
      “No prospective randomized trial conclusively demonstrates that chiropractic management reduces the incidence of serious NSAID complications, such as fatal gastrointestinal bleeding. NSAIDs taken at recommended doses for a short time are generally very low-risk for appropriately selected patients — particularly the relatively young not on corticosteriods, anticoagulants, alcohol or tobacco and without a history of ulcers or severe comorbid illness. Many patients continue to take NSAIDs while undergoing spinal manipulation. Moreover, spinal manipulation can frequently cause an exacerbation of pain, which might cause some patients to increase or initiate NSAID therapy. [Ernst E. Prospective investigations into the safety of spinal manipulation. Journal of Pain and Symptom Management, 21(3): 238-242, March 2001]. Herbal recommendations seem to be common among DCs; some remedies have actions similar to NSAIDs, while others directly affect bleeding per se. A recent set of reports by the North American Spine Society includes an 18-page reference chart listing approximately 70 herbs with their uses, potential side effects, and (known) potential interactions.
      http://www.chirobase.org/18CND/03/03-03.html

      It’s also worth remembering that packets of NSAIDs contain patient information leaflets detailing risks. However, recent surveys have revealed that not all chiropractors warn patients about the risks associated with their manipulative treatments.

      I would also venture that because the rate of people taking NSAIDs is bound to be massively higher than those receiving spinal ‘adjustments’, NSAIDs are likely to be far safer (in addition to the fact that they work). More here:

      Quote
      “It is, of course, important to present any risk-benefit assessment fairly and in the context of similar evaluations of alternative therapeutic options. One such option is drug therapy. The drugs in question—non-steroidal anti-inflammatory drugs (NSAIDs)—cause considerable problems, for example gastrointestinal and cardiovascular complications. Thus spinal manipulation could be preferable to drug therapy. But there are problems with this line of argument: the efficacy of NSAIDs is undoubted but that of spinal manipulation is not, and moreover, the adverse effects of NSAIDs are subject to post-marketing surveillance while those of spinal manipulation are not. Thus we are certain about the risks and benefits of the former and uncertain about those of the latter. Finally, it should be mentioned that other therapeutic options (e.g. exercise therapy or massage) have not been associated with significant risks at all.”
      http://jrsm.rsmjournals.com/cgi/content/full/100/7/330

      • Bruce
        November 11, 2010 at 1:12 am

        @ BW

        I wouldnt normally give you the time of day, but in case there are other readers stopping by who dont know you,I felt the need to clarify who you keep quoting as if they really mattered in all of this.

        So let us all guess….. were these papers written by, mmmmm this is a difficult one oh yes, your favourite ‘esteemed scientist’, the very humble, fair-minded and highly respected professor Edzard Ernst.

        Sadly, I like many out there, take his writings as seriously as they take your input to any debate on chiropractic, with a huge pinch of salt.

        Now please ‘ get ye behind me’.

    • Mojo
      November 11, 2010 at 12:23 am

      Bruce, that is what is known as a “straw man” argument. I certainly haven’t ever claimed that “drugs” have no side effects, and I very much doubt that anyone else has. If a treatment has no side effects it will only be because it has no effects at all.

      • Bruce
        November 11, 2010 at 12:59 am

        @ mojo

        Of course, and this must also apply to chiropractic yes/no? So you therefore must agree that if there is a risk/ side effect ( which you BIGOTS are always shouting about) then there must be a positive effect to chiropractic care ( which you BIGOTS fail to accept). Positive/ negative, evidence/ no evidence, a bit like medicine really or in the case of physiotherapy, no evidence, no side effects, and therefore by your reckoning, potentially no effect at all, have I got this right?

        ;-)

      • Mojo
        November 11, 2010 at 11:24 am

        “So you therefore must agree that if there is a risk/ side effect ( which you BIGOTS are always shouting about) then there must be a positive effect to chiropractic care…

        …have I got this right?”

        No, you haven’t. “A follows from B” does not necessarily mean that B follows from A.

        You would be using precisely the same arguument if you claimed that that because there is a risk associated with being shot in the head, being shot in the head is beneficial.

  107. Enough Already
    November 10, 2010 at 8:46 pm

    ie. Has anyone in this group drawn any conclusions about inherent or chronic spinal disorders which result in abnormal geometry of the spine?

    If an optimally loaded spine represents optimal health, what biophysical problems are apparent in people with adapted spinal geometry?

  108. November 10, 2010 at 10:20 pm

    @Enough
    conclusions about inherent or chronic spinal disorders resulting in abnormal geometry of the spine? Ehm, spinal disorders often result in abnormal geometry of the spine. Symmetry itself is quite a prize-pony but I am not sure that’s what you meant?
    If an optimally loaded spine represents optimal health, what biophysical problems are apparent in people with adapted spinal geometry? Why does an optimally loaded spine represent optimal health?
    Stefaan

  109. Enough Already
    November 10, 2010 at 11:28 pm

    …because an optimally loaded spine would require no adjusting – all the nerves would be working optimally. In theory, a grossly deformed spine must therefore be dis-eased in some way. I would be interested to know what harm, if any, has come to people with gross spinal geometry.

  110. Andrew Gilbey
    November 11, 2010 at 12:14 am

    @enough already

    “…because an optimally loaded spine would require no adjusting…” Hmmm, that wouldn’t necessarily stop someone from being signed up for a course of chiropractic treatement

    • November 11, 2010 at 8:39 am

      @AG
      Why do you say this? I occasionally see people who have no real issues underlying the presentation and believe that they should be left alone to let the natural progression of their presentation do the work.
      This is the benefit of knowing what you’re looking for, rather than just being lead by a symptom.
      Regards,
      Stefaan

  111. Badly Shaved Monkey
    November 11, 2010 at 12:32 am

    Stefaan, what we have seen in your recent posts is the utter hollowness of your chiropractic theories. The “chiropractic subluxation complex” has zero explanatory power.

    I’d not really appreciated this before and couldn’t understand how chiros came to believe so many bonkers things about what they can treat. It’s obvious now that it’s because you have this fictional concept that you extrapolate without reference to evidence and logic wherever you wish to apply it.

    I’ve actually learned something new and it’s been a long time since I could last say that of something related to SCAM.

  112. Bruce
    November 11, 2010 at 12:49 am

    @monkey boy in response to your question re skepticbaristas site:

    Would I let a chiropractor treat my Children’s neck,  actually one of my kids was treated for colic. Seemed to work but no neck manipulation was done. I’m guessing the technique used for a child would be different to that of an adult. Once again, it would  depend on the problem and benefit to risk ratio. But I honestly haven’t thought about it. 

    But based on your last post to me, let me understand what is being said here.

     The problem isn’t with chiropractic/chiropractors treating musculoskeletal conditions, you are saying this is accepted and acceptable. You are also not concerned over the risk of chiropractic treatment of the same to include cervical manipulation, based on the level of risk in say medicine for instance? My understanding of the research out with that ‘ eminent scientist’ that blue woad likes to refer to,   would support that
    stance. 

    The ‘skeptic’ concerns are therefore quite simply  the treatment of children/ infants/ babies with/and non musculoskeletal conditions, if this is the case then that is a different ball game.

     The discussion should therefore revolve around that rather than like some in the blogs such as  blue woad et al,  the total destruction of the chiropractic profession.  As I said I don’t like bullies, fools and bigots, that’s why I post.

    Can you therefore clarify?

  113. Badly Shaved Monkey
    November 11, 2010 at 1:12 am

    Bruce, you have it roughly right. 

    1. The underlying theory of chiropractic is utter cock, as I commented just above. 

    2. It so happens that despite their underlying theory chiros do no worse than other therapies for back pain, but this is probably to the extent that what they actually do in this regard has become divorced from the tenets of their founding myth. 

    3. But that mythological element remains and is very important to a depressingly large percentage of chiros. Zeno’s complaints were against 523 chiros of the BCA out of a total membership of, I can’t remember properly, something like 1,500. In other words, far too many chiros treat their myth as fact and act upon it. 

    4. I can’t judge the risk:benefit ratio very well, others have more familiarity with the data. What seems obvious is that the benefit is quite small and probably zero in many applications of chiro so that ratio gets to be big even if the absolute rate of adverse events is small. 

    That’s it in a nutshell. 

    Defining feature of SCAM is that they have an underlying theory or philosophy that is usually just plain wrong, but may be barking mad. Typical practitioners are very proud of their theory and I have seen it touted on the internet that a major strength of homeopathy is the fact of its having an underlying theory. This is dangerously deluded. Real medicine has no such unified theory. It’s much more pragmatic and simply uses what works as best as we can tell guided by the best available understanding of the underlying processes. No single theory. No one-trick ponies. This is why real medicine and real science are cool and interesting and SCAM is mostly infantile junk betraying the narrow worldviews and insecurities of its adherents. 

  114. Bruce
    November 11, 2010 at 1:36 am

    Hey monkey boy

    Be careful we may actually be a bit closer that you think, although I believe your basic premise regarding ALL chiropractors and the way they work may be wrong. I said the guys I know treat the function of the body using biomechanics and standard orthopaedic and neurological testing. So for me a musculoskeletal disorder is a musculoskeletal disorder whether diagnosed in medicine, chiropractic or physiotherapy. With this in mind, my experience would wholeheartedly support chiropractic retaining a place in our health care system.

    I too have problems with esoteric concepts but coming from an engineering background I do appreciate function and a chiropractors ability to influence that fir the better.

    • Mojo
      November 11, 2010 at 11:26 am

      “…coming from an engineering background…”

      Salem hypothesis, anyone?

      • Bruce
        November 11, 2010 at 3:57 pm

        @ mojo

        Where do you get them from, yip I know the straw box. Some serious clutching going on there, or was it an attempt at humour, either way, no more late nights for you.

        The Salem hypothesis, are you bright enough to get the pun if I say it is a serious leap of faith? No, probably not. Never mind eh?

  115. Badly Shaved Monkey
    November 11, 2010 at 8:48 am

    By the way Bruce, I’ve already said I play some meta-games in these discussions, like Fallacy Counting (and Post Hoc Ergo Propter Hoc and No True Scotsman and recently been added to the list), but I also see how other participants play with my internet pseudonym. Obviously when I adopted it, I envisaged a number of plays that could be made on it. The game is to see whether other participants choose to use the more childish ones. Guess which column you have ticked most.

    • Bruce
      November 11, 2010 at 4:00 pm

      Hey monkey boy

      That’s great, you count and can tick boxes. Wow, cal David Attenborough quick. I’m sure there is a paper on there somewhere. See I told you given time you would get the hang of the whole opposable thumb thing. Well done mate, big clap for monkey boy.

  116. Badly Shaved Monkey
    November 11, 2010 at 8:49 am

    Oh, forgot. Ad Hominem is on the fallacy list as well.

  117. Bruce
    November 11, 2010 at 9:02 am

    @ monkey boy

    Sorry on a side note you said;

    ‘Defining feature of SCAM is that they have an underlying theory or philosophy that is usually just plain wrong, but may be barking mad. Typical practitioners are very proud of their theory and I have seen it touted on the internet that a major strength of homeopathy is the fact of its having an underlying theory. This is dangerously deluded. Real medicine has no such unified theory. It’s much more pragmatic and simply uses what works as best as we can tell guided by the best available understanding of the underlying processes. No single theory. No one-trick ponies. This is why real medicine and real science are cool and interesting and SCAM is mostly infantile junk betraying the narrow worldviews and insecurities of its adherents.’

    My response;
    As alluded to in previous postings, not all chiropractors fall into the category of being ‘ one trick ponies’, with either treatment or underlying theories’  and i must base that on how they are being educated. So accepting this, then  surely based on current evidence for medicine or physiotherapy where you suggest that ‘ real medicine and science are cool’ that doesn’t change anything?  Surely without the standard of evidence you have set for chiropractic, it is totally irrelevant how cool it is.

    Both  chiropractic, medicine and in fact physiotherapy are just working in the hypothetical state, at least on some levels, some more than others,  as can be seen from the research. But the evidence is lacking for all three.

     Sadly, and as I support all three professions and really haven’t had much dealings with the subluxation, but playing the devils advocate, then surely without evidence it is all hypothetical. The pain gate theory, albeit viable, if  my reading is up to date,  is still hypothetical. 

    This doesn’t take away the robustness of the model, just the inability of current understanding, tools and research methodology to evaluate that particular model. I am not defending the concept of a ‘ one trick pony’ I am however defending the right for a profession, any profession to be viewed in it’s entirety and not as a patchwork quilt stitched up to give the BIGOTS a stance.

    Writing back, please don’t put one is based on gobbledy hook and the other on sound principles as this doesn’t hold water. Based on the standards set by BIGOTS, no evidence, no way?, 

    If we can agree that there are many chiropractors who treat musculoskeletal conditions successfully using an array of treatment protocols and methods for the benefit of the public, that not all chiropractors are frauds, untrustworthy, rip off merchants in the same way not all medics are murderers, egotistical and business people then we have a base to discuss further.  But that should be the basis of all future debate and clearly stated as such.

    Without that monkey boy you are just as much a BIGOT as others who post here, only after the demise of a profession for whatever sick and obscure reason,rather than serious debate. 

    If you are comfortable with that, that’s ok, but you guys need to own it rather than trying to come across as some superhero group set up to protect the public against its right to choose.

    The first and last letters of BIGOTS springs to mind my friend.

  118. November 11, 2010 at 9:25 am

    BSM
    What about teh theory is “bonkers”?
    Stefaan

    • Andrew Gilbey
      November 12, 2010 at 2:21 am

      Hmmm, it may take rather a long time to answer that one. Perhaps we should reframe your question so it reads: What about the theory is not “bonkers”?

  119. November 11, 2010 at 9:45 am

    @BSM
    do you keep track of your own fallacies too? They are quite something you know.
    Stefaan

    • Badly Shaved Monkey
      November 11, 2010 at 11:53 pm

      Stefaan, please show a single example of a fallacy that I have perpetrated.

      • November 12, 2010 at 8:45 am

        In response to the explanation I gave about CSC and how it is a theoretical concept with in itself little clinical legs you replaced both “subluxation” and “CSC” for “evil pixies”, thereby creating a solipsistic and tautological logically fallacy in your argument as it was key to the discussion that I differentiated the two terms to be different and distinct. One being a clear and obvious clinical entity, which you agreed exists, and the other being a theoretical construct underpinned by beliefs.
        How about you let me know what about the theory is bonkers, plus if possible give a reference that these statements you make are actually based in the theory rather than the interpretation by some individuals.
        Stefaan

      • Badly Shaved Monkey
        November 12, 2010 at 3:16 pm

        Not a fallacy, Stefaan. I was simply showing you could replace either or both terms with an arbitrary alternative, which shows you are explaining nothing.

  120. November 11, 2010 at 10:27 am

    @ Bruce

    I have responded to your comments about Professor Edzard Ernst here:
    http://tinyurl.com/2ufcnp2

  121. November 11, 2010 at 10:41 am

    @BW
    how about you answer here a question posted here?
    The one about providing evidence rather than opinion and stories?
    No? Nothing to show?
    Because if you don’t have it, then that would make you a liar, wouldn’t it?

    • November 11, 2010 at 10:47 am

      How about acknowledging chiropractic’s unfavourable risk/benefit profile? It is based on a sound understanding of the precautionary principle.

      • November 11, 2010 at 10:54 am

        Hang on sailor! I am not the one stating there is evidence that chiropractic manipulation causes strokes.
        Don’t change the point of discussion.
        Are you, or are you not lying?
        After that we can discuss risk/benefit ratios if you would like that.

  122. Bruce
    November 11, 2010 at 4:32 pm

    Hey monkey boy and young mojo

    Here’s one for you. Accepting the level of evidence for physiotherapy, good or otherwise that is out there, your attack on chiropractors and the level of evidence you reckon they require to practice and your beef with regards the chiropractic profession treating babies, then what about these guys:
    That Association of Paediatric Chartered Physiotherapists.

    http://www.familiesonline.co.uk/Topics/articles/physiotherapy-for-the-baby.

    Or try;

    http://www.therapy4kids.co.uk/4.html

    Or even 

    http://www.manchesterneurophysio.co.uk/physiotherapy-services/paediatric-physiotherapy

    Or last, but on the net certainly not the least as there is 62,600 results for paediatric physiotherapy.

    http://stephanieso.webs.com/ourservices.html.

    All are private physios, all claim to treat a vast array of disorders other than musculoskeletal, yet no evidence. 

    The last one, which is listed at paediatricphysiotherapy talks of offering treatment for diseases such as;

    Developmental delay
    Cerebral palsy
    Cystic fibrosis
    Torticollis
    Acute chest conditions ( could that include asthma)
    General orthopaedic conditions.

    So comparing chiropractic (colic childhood asthma) and physiotherapy in this instance and I don’t have a real problem with either, are the professions treating the disease as mojo claims, or are they assisting in the function of in an attempt to ease the symptoms of the disorders. Both professions have used the word ‘treat’?

    You see the problem you BIGOTS have is you are backing yourself in a corner, because all professions do a good job. Evidence is NOT available for everything medicine does, and none that I am aware of for physiotherapy,  yet here we have three groups of physios making claims to treat, their words not mine, non musculoskeletal conditions on children with NO evidence and making money from it?

    Interesting thought?

    • Badly Shaved Monkey
      November 11, 2010 at 10:58 pm

      Bruce, you clearly have a grudge against physiotherapists. I don’t know enough about them to have an authoritative opinion about all they do, but I’ve only expressed a casual opinion on them.

      Chiros are easier to have an opinion about. If they believe in subluxations they are loons. If they don’t believe in subluxations I don’t know how they define themselves as chiros except by checking the brass plate outside their offices.

      I’m mainly interested in what’s funny. Homeopaths are funny. Chiros are funny. Reflexologists are funny.

      Physiotherapists might be wrong in some of what they do but they’re not actually funny.

      • Mojo
        November 12, 2010 at 1:07 am

        I haven’t even mentioned physiotherapists, so I don’t see why I should be expected to defend them.

      • November 12, 2010 at 8:26 am

        But still you refuse or are unable to say what it is about chiropractic theory that you think is such “bollocks”. So do you actually have an idea of what is bollocks or are you just saying that because you fancy it?
        Funny things is,… you’re funny too!
        Let’s all have a laugh together at how you boys and girls make statements of evidence but then are doing nothing but base your premises on perceptions, stories, tall tales and base lies.
        Still no evidence Blue Wode?

  123. Bruce
    November 11, 2010 at 9:31 pm

    There is nothing louder than the sound of silence when BIGOTS don’t know where to go next. Simples, comment on and evaluate paediatric physiotherapy with the same standards of evidence required for chiropractic. My goodness was that a pin dropping?

    • Badly Shaved Monkey
      November 12, 2010 at 8:06 am

      Not the sound of a pin-dropping. It was the sound of sceptical typing.

  124. November 11, 2010 at 9:43 pm

    You’ve got a response from me over on Skeptic Barista’s blog:
    http://skepticbarista.wordpress.com/2010/10/24/subluxations-who-said-what/#comment-943

  125. November 12, 2010 at 2:09 am

    sbm wrote
    “But that mythological element remains and is very important to a depressingly large percentage of chiros. Zeno’s complaints were against 523 chiros of the BCA out of a total membership of, I can’t remember properly, something like 1,500. In other words, far too many chiros treat their myth as fact and act upon it.”

    And Zeno was only complaining about chiros who’d made myth-based claims on their websites. Neither of the two chiropractors who examined me made such claims on their websites and so they were not complained about. Yet both espoused the theory that vertebral misalignments (one called them ‘subluxations’, the other just called them ‘misalignments’) were the cause of a variety of ailments, which could be treated by making “adjustments” to the spine and that degenerative disease could be prevented by coming for regular adjustments. This “keeps the nervous system healthy”. That is the underlying theory of chiropractic in a nutshell, according to the chiropractors I saw. And wiki, come to think of it. I see no coherent alternative theory of chiropractic being offered here, in spite of your repeated requests for same. (I see you’ve got the measure of Stefaan, who is a master of obfuscation).

    sbm wrote
    “Bruce, you clearly have a grudge against physiotherapists.

    If this is true then Bruce should be very pleased because I have been looking at a few websites promoting private physiotherapy services and have seen a number of claims being made that should certainly be challenged, including one that described massaging the thoracic cage to treat asthma. (Nothing about that treatment here: http://www.csp.org.uk/director/public/whatphysiotherapistsdo/conditions/asthma.cfm) This could be one for Nightingale.

    But I don’t actually think Bruce does have a particular grudge against physios. He trolled my blog a number of times saying similar things about osteopaths. Bruce’s whole argument amounts to this:

    ‘There is a lack of evidence for any number of therapies, both mainstream and scam. By picking on chiropractors and ignoring others, skeptics are bullies and bigots.’

    In other words, he doesn’t have an argument, he simply believes that chiropractic works and hates people challenging chiropractors. In spite of his constant reference to the lack of evidence for other treatments, he is apparently not concerned that vulnerable people may be being conned out of their money by practitioners of these treatments. On the contrary, we learn from his last but one post that he thinks that “all professions do a good job”. So, it is reasonable to infer that Bruce thinks all ‘professions’ should be able to make whatever claim they like, regardless of whether there it is scientifically plausible, let alone supported and anyone who objects to being lied to and complains about it is a ‘bigot’, according to Bruce’s understanding of the word.

    In short, there is really no argument to be had with Bruce. We will continue to try to protect the public by challenging misinformation in adverts and Bruce will continue to call us bullies and bigots for doing so. So what?

    I must say I have very much enjoyed watching you and others run rings round the chiro apologists here. It hasn’t gone unnoticed that, even though Bruce continues to address you as ‘boy’ – which is pathetic – and tries his best to pack as many childish insults and put-downs into his comments as possible and even though Stefaan is the most consistently condescending poster I have ever seen on the web, you have not once resorted to ad hominems nor any other fallacies in your responses. There is no doubt who are behaving like schoolyard bullies here. What amazes me is that they don’t seem to realise they’ve been whipped, pureed and stomped on, to borrow a phrase from the eloquent Orac.

    TTFN

    Thanks for the entertainment.

    • November 12, 2010 at 8:30 am

      “In other words, he doesn’t have an argument, he simply believes that chiropractic works and hates people challenging chiropractors.” I don’t think that’s actually true is it? He is challenging (quite rightly so) some of the more floaty and lofty ideas that some chiropractors have developed over the years. I think that your statement would ammount to an ad hominem…
      Stefaan

    • November 12, 2010 at 9:14 am

      ps
      I am saddened you feel I am being condecending. I certainly don’t mean to be. It is important to be specific about what one is debating I feel, in order to not confuse oneself or the audience. If I am being particular, it is out of respect for the debate. Something which is regularly lost in some of the posts here. Sometimes people even put words in other people’s mouths in order to make an entirely fictitious and assumptive point. That is not only rude but also counterproductive.
      Stefaan

  126. Andrew Gilbey
    November 12, 2010 at 2:27 am

    “…whipped, pureed and stomped on..”?

    I bet (a course of) chiropractic can treat that!

  127. November 12, 2010 at 2:27 am

    Oops – by ‘sbm’ I meant ‘bsm’, of course.

  128. November 12, 2010 at 9:10 am

    Stefaan wrote:

    “I don’t think that’s actually true is it? He is challenging (quite rightly so) some of the more floaty and lofty ideas that some chiropractors have developed over the years. I think that your statement would ammount to an ad hominem…”

    Nonsense.

    • November 12, 2010 at 9:28 am

      What is the “nonsense” The fact that Bruce challenges lofty ideas and therefore shouldn’t be deemed to be apologist or teh fact that your statement amounts to an ad hominem?

  129. Bruce
    November 12, 2010 at 9:15 am

    @ skepticat

    You wrote:

    ‘In other words, he doesn’t have an argument, he simply believes that chiropractic works and hates people challenging chiropractors. In spite of his constant reference to the lack of evidence for other treatments, he is apparently not concerned that vulnerable people may be being conned out of their money by practitioners of these treatments. On the contrary, we learn from his last but one post that he thinks that “all professions do a good job”. So, it is reasonable to infer that Bruce thinks all ‘professions’ should be able to make whatever claim they like, regardless of whether there it is scientifically plausible, let alone supported and anyone who objects to being lied to and complains about it is a ‘bigot’, according to Bruce’s understanding of the word.’

    My response
    Well, out of the basket and into the debate skepticat.  One thing I have noticed that when a skeptic, for want of a better word, is cornered, a ‘ gaggle’ of skeptics appear on the attack in the hope of dissuading any ‘ non-believer’ in there attempts to go against the gospel according to them. Sadly, as can be seen hear it is with half-truths, assumptions and in some case real anger at being challenged. 

    Skepticat, how you ever managed to assume that I believe that as all professions are doing a good job, they can say or do what they want. Try putting your dolls down and concentrate on the information within the postings. If you get stuck on any big words, give me a shout or ask monkey boy, he has a host of them in his ‘ look at me bag’.

    To reiterate, I don’t have any problem with osteopathy, physiotherapy, chiropractic or medicine. I am genuinely glad they exist on behalf of those they help. The treatment they offer, evidence or not, works otherwise, as previously stated, patients wouldn’t go to them.

    As I said quite clearly before I have a real problem with bullies, bigots and fools and based on that all I have challenged, or argued if you prefer, is that based on ‘your’ rules when dealing with one profession eg chiropractic, if used fairly across the board to include medicine, it would prevent a host of treatments not being used, which wouldn’t meet the evidence criteria you have set, but are used because they work. It is simple; benefit supersedes risk irrelevant of the BS that is perpetrated by the members of BIGOTS on this site. 

    However, sadly we do have one thing in common, if lied to, I prefer to challenge.

    You use the Nightingale Collaboration as a badge of honour, well we will see? You posture and drop titbits as if we should be impressed that you are ‘looking into’ private physios. Get a grip girl. 

    You are choosing to or are unable to see any opinion but your own. Your bias prevents you seeing that even in the NHS there are a host of procedures that do not meet your evidence rules. So unless you tackle all healthcare in the same way, using the same criteria, both inside and outside the NHS, you may just be missing the point, and if you do you may just be throwing the baby out if the bathwater through arrogance and self-righteousness. Catch 22.

    So one thing you have shared with us is what many if us have known for a while, you guys cherry pick targets,  you go for private concerns rather than the establishment as you feel they are easier targets. Possibly, possibly not. If you continued to poke a hornets nest, don’t be surprised when you get stung. 

    Anyway I hope this post clarifies my position and helps. If any you guys and gals in BIGOTS still fail to grasp what I mean, please don’t assume by guessing, just ask, except for you BW, as i said i don’t suffer fools gladly. Thanks for all the posts, saying absolutely nothing, you guys do that a lot when you are cornered don’t you?
     

    • Badly Shaved Monkey
      November 12, 2010 at 10:15 am

      Argumentum ad Populum.

      I knew we’d get there at some point.

      • November 12, 2010 at 10:21 am

        Tosseratum ad Wankeratio
        I’ve put you a reply about the fallacies you’ve made higher up in the post for your information.
        How about you let me know what is “bollocks” about what chiropractic theory is? You seem reluctant to answer a simple question. Not unlike Blue Wode in regards to whether he is lying or not about the level of evidence and Skepticat in responding to my pointing out the way she fabricates statements and infers meaning where no meaning exists.

      • Badly Shaved Monkey
        November 12, 2010 at 7:05 pm

        What’s bollocks about chiro theory? I’ve already shown you. The fact that you can replace the key concept with an arbitrary word without altering its explanatory utility shows it’s bollocks.

  130. Badly Shaved Monkey
    November 12, 2010 at 10:20 am

    Strawman x False Dilemma.

    Interesting. A compound fallacy

    • November 12, 2010 at 10:30 am

      Argumentum ad Ignoratiam

      • Badly Shaved Monkey
        November 12, 2010 at 3:12 pm

        Don’t be silly, Stefaan. Cite the example you think you’ve seen.

    • Bruce
      November 12, 2010 at 10:31 am

      Ah monkey boy,

      when you guys don’t have either an answer or an argument, sometimes just keeping quiet is the best policy. So to help you out, here’s what you should say; nothing. It may just improve your street cred eh :-)

  131. November 12, 2010 at 10:57 am

    Stefaan wrote: “Still no evidence Blue Wode?”

    Whilst we wait for Stefaan to work out what the precautionary principle means, readers might be interested in the following situation in the US…

    Quote
    “… the National Quality Forum lists 28 ‘never events’ healthcare mistakes that should never happen and need to be reported. Death or serious disability from spinal manipulation is listed as no. 16. But chiropractors do not have to report this because they have a loophole. The National Quality Forum demands it of clinics and hospitals but no reporting is mandated for individual doctor’s offices where 99% of spinal manipulation is done. Chiropractors generally do not practise in hospitals or clinics. Therefore, there is no accurate reporting for injuries that occur as a result of spinal manipulation. Yet we have hundreds of victims who have suffered needless injuries due to a stroke as a direct result of a chiropractic manipulation, and they are horrible, permanent injuries and they happen to mostly young healthy people under the age of 45 years.”

    http://onlinelibrary.wiley.com/doi/10.1211/fact.15.1.0025/full

    Despite the above, the American Chiropractic Association has just announced that it has managed to persuade Kaiser Permanente Mid-Atlantic States and Mid-Atlantic Permanente Medical Group (Kaiser) to *suspend* its recent decision to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage, having claimed in a letter to Kaiser that there is a “large body of clinical research supporting the effectiveness and safety of cervical manipulation”. The ACA President, Rick McMichael, DC, has also claimed in a public statement that, if allowed to stand, the restriction would be “harmful to chiropractic patients and doctors”.

    Scandalous.

    • November 12, 2010 at 11:01 am

      The link to the report on the American Chiropractic Association’s claims made to Kaiser:
      http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55016

    • November 12, 2010 at 11:08 am

      Stefaan knows what the precautionary principle means (speak of condecendence) and is eagerly awaiting:
      “is Blue Wode a liar or not?”
      Is Blue Wode in fact no better than Andrew Wakefield in the scare-mongering? Is there evidence to back up the claim that there is a link between cervical manipulation and stroke above and beyond what could be coincidental? Or is Blue Wode a fabricator and maker-upperer of facts as much as fiction? Can Blue Wode be trusted or not?
      So Blue Wode, for the umpteenth time: do you or do you not have evidence to the effect outlined?
      Or are you in fact a liar?

  132. Enough Already
    November 12, 2010 at 11:29 am

    And still no chiropractor answers my question about why, if mild abnormal spinal geometry is ‘bad’, why isn’t scoliosis terminal?

    • November 12, 2010 at 11:44 am

      A chiropractor did respond to your question and the answer revolved around asking you what makes you think that there is a correlation between abnormal assymetry and disease? (I assume you mean “terminally” ill). Chiropractic theory never said this.
      Stefaan

    • November 12, 2010 at 11:47 am

      I’m still waiting for an answer to the following on Skeptic Barista’s blog:

      The question that David (a chiropractor) seems reluctant to answer:

      David wrote: “It should be remembered that a manipulation is a “chiropractic manipulation”, or more properly a “chiropractic adjustment”, only when it is performed by a fully qualified chiropractor. Otherwise it is only a manipulation and should not be confused with chiropractic.”

      Does that mean that chiropractors abandon the ‘chiropractic adjustment’ and resort to ‘only manipulation’ when GPs refer patients to chiropractors based on NICE’s recommendations? Presumably they do.

      Please confirm that NICE was careful to make a clear distinction between ‘manipulations’ and ‘chiropractic adjustments’ when it developed its recent guidelines recommending *spinal manipulation* for lower back pain – as provided by osteopaths, chiropractors, physiotherapists, and other qualified practitioners.

      • November 12, 2010 at 12:06 pm

        If a chiropractor performs it, it is a chiropractic adjustment. Anyone else performs a manipulative manoevre. Regardless of who refers or pays for it. No real challenge there.
        Can you now tell me wheter Blue Wode is a liar? or whether there is indeed evidence to claim beyond reasonable dount that there is a causal relationship between chiropractic adjustments of eth neck and the incidence of strokes? Or was it all just a fabrication Blue Wode? Some base scare-mongering?

  133. November 12, 2010 at 12:19 pm

    So a chiropractic adjustment and a manipulation are exactly the same thing then? They just differ in name only. Is that correct?

  134. November 12, 2010 at 12:31 pm

    No,
    One is done by a chiropractor, a person who is far better trained and experienced in these therapeutic procedures. The other is not. In that sense it is also a measure of standard on top of being a clinical procedure. A chiropractic adjustment is basically a high-quality manipulative manoeuvre.

    Are you a liar and a scaremongerer Blue Wode?

    • November 12, 2010 at 12:39 pm

      That is highly confusing to say the least. Please confirm that NICE was aware of the following when it decided to recommend spinal manipulation in its new guidelines for low back pain:

      Quote
      “The chiropractic profession, which began with a founding father in 1895, is identified primarily by its use of manipulation. But chiropractic is based upon a vertebral subluxation theory that is generally categorized as supporting a belief system. The words “manipulation” and “subluxation” in a chiropractic context have meanings that are different from the meanings in evidence-based literature. An orthopedic subluxation, a partial dislocation or displacement of a joint, can sometimes benefit from manipulation or mobilization when there are joint-related symptoms. A chiropractic subluxation, however, is often an undetectable or asymptomatic “spinal lesion” that is alleged to be a cause of disease. Such a subluxation, which has never been proven to exist, is “adjusted” by chiropractors, who manipulate the spine to restore and maintain health. The reasons for use of manipulation/mobilization by an evidence-based manual therapist are not the same as the reason for use of adjustment/manipulation by most chiropractors. Only evidence-based chiropractors, who have renounced subluxation dogma, can be part of a team that would research the effects of manipulation without bias.”

      http://jmmtonline.com/documents/HomolaV14N2E.pdf

      • November 12, 2010 at 2:46 pm

        “There is just no scientific evidence suggesting that a visit to a chiropractic physician for CMT causes any higher incidence of stroke than a typical visit to a primary care medical physician.”
        What is your view Blue Wode? Is there any such evidence to the contrary of this statement? A statement you denounce as “scandalous” Is there ANY evidence at all for the assertion that chiropractic manipulation of the neck causes strokes?
        Because if you haven’t we would need to seriously consider the truthfulness of some of your statements…

  135. November 12, 2010 at 12:44 pm

    Some people are more easily confused than others. What are you confused about Blue Wode? And are you a liar and a scaremongerer?

  136. November 12, 2010 at 4:46 pm

    “There is just no scientific evidence suggesting that a visit to a chiropractic physician for CMT causes any higher incidence of stroke than a typical visit to a primary care medical physician.”

    Stefaan, if that quote is based on the conclusions of the Cassidy et al study, please remember that the authors said “our results should be interpreted cautiously…we have not ruled out neck manipulation as a potential cause of some vertebrobasilar artery stroke”.

    Therefore…

    Quote:
    “The most benign interpretation of the totality of the evidence is as follows. There is an association between chiropractic and vascular accidents which not even the most ardent proponents of this treatment can deny. The mechanisms that might be involved are entirely plausible. Yet the nature of this association (causal or coincidental) remains uncertain. The cautionary principle, demands that until reliable evidence emerges, we must err of the safe side. Considering also that the evidence for any benefit form chiropractic neck manipulations is weak or absent, I see little reason to advise in favour of upper spinal manipulation.”

    Ernst, E. Vascular accidents after chiropractic spinal manipulation: Myth or reality?, Perfusion 2010; 23:73-74
    http://tinyurl.com/37ejj22

    • Bruce
      November 12, 2010 at 8:31 pm

      Good Grief Stefaan

      Surley that’s not BW quoting that rather spiffing and very ‘eminent scientist’ Edzard Ernst again is it.  Lol 

      What a surprise, or not as the case may be. :-)

    • November 12, 2010 at 9:10 pm

      No, it was the quote provided by your link “dynamicchiropractic”. Unlike you, Cassidy et al are very wise people who don’t rule things in or out unless they have evidence to do so. Unlike you really, who basically just lies his way through biased and bigoted commentary with unsupported statements, puts snazzy titles on meaningless articles and then has no content to back it up. Quite the desperate way to keep a job isn’t it really?
      Sensationalist research, tabloid science.
      Like I said, you’re no better than Wakefield and should hang your head in shame. Start making some reasoned, structured and nuanced comments. It will look a lot better on the old CV when you’re looking for a new job. Can’t be far away really, even Stevie Wonder can see how desperate times must be. First it was Charlie’s fault, who will it be next big boy? Always the others, never the self. There was an actually famous Viennese who said something about that, wasn’t there? Oh wait wasn’t it Freud, and wasn’t the term “denial”? Didn’t she classify denial as a mechanism of the immature mind, because it conflicts with the ability to learn from and cope with reality? Yes that would be quite consistent with an unnatural dissociation from reality and an evangilisation of research, data and research, wouldn’t it.
      Good luck mate, if you can’t answer the simple question whether you’ve lied in so far that there is no actual evidence, just stories, just opinion, then you are well and truly in denial.

      Dr. Stefaan Vossen, Doctor of Chiropractic, fixer of chronic back-pain which did not resolve with relaxation, exercise, conservative or pharmacological strategies but are not suitable for surgical strategies, Master of one trade and jack-ass of none-other.
      This really is only just the beginning big boy!

      • November 12, 2010 at 10:01 pm

        Stefaan Vossen signed off: “Dr. Stefaan Vossen, Doctor of Chiropractic, fixer of chronic back-pain which did not resolve with relaxation, exercise, conservative or pharmacological strategies but are not suitable for surgical strategies, Master of one trade and jack-ass of none-other.”

        …or, in other words, very possibly an expensive layer-on of hands – as suggested by the WHO’s 2003 bulletin on Lower Back Pain:
        http://skepticbarista.wordpress.com/2010/10/24/subluxations-who-said-what/

      • November 12, 2010 at 10:27 pm

        very possibly, but at least not a liar, fabricator and scare-mongerer. At least I am humble enough to recognise that I may be wrong, but accept that as long as my patients value my services, I have reason to exist.
        Straw-clutches-breaking

      • Le Canard Noir
        November 12, 2010 at 10:44 pm

        Stefaan – you are crossing the line calling someone a liar.

      • November 12, 2010 at 11:37 pm

        @Andy
        liar: disseminator of untruths
        I think you can agree that I have asked BW enough times to provide evidence for his statements. He makes significantly negative statements at the address of the chiropractic profession, yet refuses to provide any evidence to back these statements up. Do you feel that this is appropriate?
        Do you genuinely feel that this is a constructive and appropriate strategy for debate? How would you feel if I used your blog for the dissemination of false information? How would you feel if I said “chiropractic cures asthma” every five seconds on your blog? Would you feel that that is a good use of your efforts?
        Regards,
        Stefaan

      • Le Canard Noir
        November 13, 2010 at 12:54 pm

        You have something of a cheek Stefaan when one of your first acts on this post was to question whether chiropractors are frequently anti-vaccination. It looks like nothing but simple game playing.

        Calling someone a liar implies dishonest motives. You are tolerated to makes such claims as it only shows you an even more ridiculous light.

      • November 13, 2010 at 7:36 pm

        And are they frequent anti-vaxxers? Because that was the implication wasn’t it? Chiropractors are not frequent anti-vaxxers and certainly not in the UK. Anyway, I think that Badly shaved monkey would call that a tu quoque fallacy.
        According to wikipaedia a liar is someone who tells a lie and a lie is (again according to wikipaedia) a known untruth.
        It is an untruth to say that there is evidence that chiropractic manipulation of the neck causes stroke. Blue Wode stated that there is evidence to say that chiropractic manipulation of the neck causes stroke. This is an untruth. Therefore Blue Wode stated an untruth. Thus far it is only an untruth and not a lie, as it is not established that it is known by Blue Wode to be an untruth. I however have asked Blue Wode for the evidence repeatedly and on a multitude of blogging sites. It is therefore safe to assume at this stage that Blue Wode is aware of the untruthfulness of the statement. Therefore it is quite probable that Blue Wode is a liar.
        Stefaan

  137. November 12, 2010 at 4:56 pm

    As you can see, Bruce has confirmed everything I said about him in my earlier post. We can but speculate why he feels the need to repeat for the umpteenth time the same “argument” in full when I had helpfully encapsulated his point in one sentence but the pattern seems to be that he gets wound up easily and, as he doesn’t have anything new to say, he’ll just say the same thing again but he’ll pad out his posts with as many ad hominems as possible to make himself feel better.

    Bruce wrote:

    “So unless you tackle all healthcare in the same way, using the same criteria, both inside and outside the NHS, you may just be missing the point, and if you do you may just be throwing the baby out if the bathwater through arrogance and self-righteousness. Catch 22.”

    I knew I was being a bit charitable when I characterised his “argument” as that we should challenge both unsupported mainstream as well as scam therapies because that sounds like quite a reasonable position to take. It is the “both inside and outside the NHS” qualification that shifts it from being quite reasonable to quite absurd, and it indicates that it is Bruce, in fact, who is missing the point. The point being, of course, that what skeptics challenge are the false claims made in the promotion of therapies. I’m sure we all agree that if any orthodox physicians in private practise are selling their services by making unsupportable and implausible claims on the web or in advertising, then they should be challenged just like the chiros, the homeopaths and anyone else. The purpose of challenging false claims is to stop people wasting their money and, in some cases, endangering their health. But if no claims are being made in the public arena then there is nothing that most of us are in a position to challenge.

    The tu quoque fallacy is much favoured by apologists for scam. I usually respond to challenges like ‘what about all those harmful mainstream treatments’ by asking them for a specific example and to tell me what they think I can do about it that will actually make a difference. I’ve never yet had an answer.

    • Bruce
      November 12, 2010 at 8:51 pm

      @skepticat

        I don’t have the time or inclination to trawl through all your usual patronising drivel, nor will this be a long post as I know it’s Friday night and I am sure you’ll have the shopping to put away before making dinner. So here goes;

      You wrote;
      ‘I’m sure we all agree that if any orthodox physicians in private practise are selling their services by making unsupportable and implausible claims on the web or in advertising, then they should be challenged just like the chiros, the homeopaths and anyone else. The purpose of challenging false claims is to stop people wasting their money and, in some cases, endangering their health.’

        I think if you had read my posts then you may just answered my questions.

        I presume we can all take from the statement above that you, the Nightingale Collaboration, will be holding EVERY health care profession, including medicine, physiotherapy etc  accountable for advertising treatments without high quality evidence. (the same standards of evidence you guys have set for the chiropractic profession)? 

      If this is the case, then I believe that the Nightingale Collaboration may have a solid foundation. If it ends up being a cherry picking exercise to throw stones at one profession, then it won’t be.

      All I have asked for is a level playing field and appreciating we will have to wait and see how this plays out, well done for the good intentions. 

      • Badly Shaved Monkey
        November 12, 2010 at 11:19 pm

        Bruce, you don’t seem to mind sounding like a dick, but do you really want to sound like a sexist dick?

      • Mojo
        November 13, 2010 at 2:10 pm

        I think he must, otherwise he wouldn’t have posted it twice.

  138. David
    November 12, 2010 at 7:27 pm

    Skepticat wrote:

    “We can but speculate why he feels the need to repeat for the umpteenth time the same “argument” in full ……………….. but the pattern seems to be that he gets wound up easily and, as he doesn’t have anything new to say, he’ll just say the same thing again but he’ll pad out his posts …………… to make himself feel better.”

    I honestly thought you were talking about Blue Wode there………

  139. November 12, 2010 at 8:37 pm

    David wrote,

    “I honestly thought you were talking about Blue Wode there………”

    which would seem to confirm my long-held impression that you don’t actually read the links Blue Wode posts.

    I could have just as easily been talking about you, come to think of it.

  140. November 12, 2010 at 8:41 pm

    @Skeptlticat
    it is about time you learn the correct meaning and use of the tu quoque (not to mention the ad hominem fallacy you are often guilty of but keep on referring others to be guilty of). In order for one to be guilty of the tu quoque fallacy, one has to be base one’s reasoning on the fact that others are doing it therefore it must be right. It is indeed and apologist strategy. However your application of the tu quoque fallacy in the context of Bruce’s argumentation is inaccurate. You would find that no such apologist argument exists in his postings. Bruce’s argument is that it is wrong, biased and bigoted for a person to single out another person or group of persons on a premise (regardless of whether this premise can reasonably deemed accurate) if that premise is not applied to other persons or groups of persons to whom it would apply in equal measure. Some of the points may very well be accurate, but that is entirely irrelevant if the point being made is that the same standards must apply to all parties equally guilty of the misdemeanours. Failing the actual application across the board (as your last post commented you could not do) one can and should, in order to not be seen to be bigoted or biased, apply it in principle across the board. Hence why Bruce asks the question regarding other professions who express the same weakness and error as the chiropractic profession.
    The fact that you do not understand the difference is the very reason that the posting is having to be repeated, with ludicrous frequency. All in all, all you and your gang should have done is gone “Yes, Bruce, we could understandably be construed to be biased against the chiropractic profession at this time and recognise that many others are guilty of the same error. Due to limited resources, we are however not in a position to action a fair and equal process but will endeavour to do so in due course.”
    Anything short of this would, indeed be bigoted.
    Good luck

  141. Bruce
    November 12, 2010 at 9:05 pm

    @skepticat

      I don’t have the time or inclination to trawl through all your usual patronising drivel, nor will this be a long post as I know it’s Friday night and I am sure you’ll have the shopping to put away before making dinner. So here goes;

    You wrote;
    ‘I’m sure we all agree that if any orthodox physicians in private practise are selling their services by making unsupportable and implausible claims on the web or in advertising, then they should be challenged just like the chiros, the homeopaths and anyone else. The purpose of challenging false claims is to stop people wasting their money and, in some cases, endangering their health.’

      I think if you had read and understood my posts then you may just have answered my questions.

      I presume we can all take from your statement above that you, the Nightingale Collaboration, will be holding EVERY health care profession, including medicine, physiotherapy etc  accountable for advertising treatments without high quality evidence. (the same standards of evidence you guys have set for the chiropractic profession)? 

    If this is the case, then I believe that the Nightingale Collaboration may have a solid foundation and potentially a good future. If it ends up being a cherry picking exercise to throw stones at one profession, or only CAM then it won’t have the credibility it could have by looking at all healthcare. 

    All I have asked for is a level playing field and appreciating we will have to wait and see how this plays out, well done for the good intentions. 

    @ Stefaan
    Thanks for the support but these guys need to feel they are winning the argument and as I alluded to before the only people they impress is themselves. 

    They’ll be sitting with their cocoa, huddled around the Friday night jigsaw, thigh slapping and giggling to each other about their petty point scoring.
     :-)

    However Skepticat and the Nightingale Collaboration have a real opportunity to do something positive here. The ball is now in their court. It would seem that I may have achieved all I wanted ;-)

    • November 12, 2010 at 9:16 pm

      @Bruce
      Fully agreed on the latter comment, not sure on the former…I suspect self-flagellation to be more prominent than cocoa… :)
      Kind regards,
      Stefaan

  142. November 12, 2010 at 9:49 pm

    [INTERLUDE]

    I would just like to remind readers that despite all the arguing by chiropractors and their proponents here, they still cannot escape the fact that a recent, thorough, scientific review of all the evidence for chiropractic suggested that its healing capabilities are hardly enough to merit its existence as a distinct profession:

    Quote
    “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. p.285 ‘Trick or Treatment? Alternative Medicine on Trial’, by Simon Singh and Edzard Ernst.]

    [/INTERLUDE]

    • Bruce
      November 12, 2010 at 10:36 pm

      Oh no let me guess where you get your reference from, no please it would be too obvious, it’s not is it, my goodness yes it is folks, its that ‘eminent scientist’ (drum roll), the wonderful, the one and only ( huge applause) Edzard Ernst (crowd go crazy with adoration). Oh please!

      You come across as a rather sad sycophant, but hey maybe you are?

      • Mojo
        November 13, 2010 at 2:08 pm

        That’s a very impressive guess. It would be even more impressive if the reference hadn’t been in the post you were replying to.

      • Bruce
        November 13, 2010 at 5:55 pm

        @ mojo

        You are either not extremely bright, are unable to function in the realms of reality, have no sense of humour or you were just pretending to be Sherlock Holmes on a wet weekend, I will let the readers decide. 

         My goodness, I  really cannot believe you came back with that nonsense, and sadly I would bet you thought it was a sharp and clever observation and you were scoring a point?  Jeez you really need to get out more mate. 

        My advice, put the game console down, get a life and go and have a kick around with some other humans. They may even take to you, you never know unless you try, now will you.:-)

  143. November 12, 2010 at 10:00 pm

    No more than Andrew Wakefield.
    Scare-mongering without evidence and causing lots of people to suffer unnecessarily (he wishes, as if anyone actually cares), in fact it is exactly like Wakefield!
    You should get into stand-up
    Stefaan

  144. November 13, 2010 at 8:10 pm

    Stefaan Vossen wrote: “It is an untruth to say that there is evidence that chiropractic manipulation of the neck causes stroke. Blue Wode stated that there is evidence to say that chiropractic manipulation of the neck causes stroke. This is an untruth. Therefore Blue Wode stated an untruth. Thus far it is only an untruth and not a lie, as it is not established that it is known by Blue Wode to be an untruth. I however have asked Blue Wode for the evidence repeatedly and on a multitude of blogging sites. It is therefore safe to assume at this stage that Blue Wode is aware of the untruthfulness of the statement. Therefore it is quite probable that Blue Wode is a liar.”

    Stefaan, may I remind you that you contributed to the comments on Skeptic Barista’s most recent blog post about chiropractic. However, it would appear that you overlooked this comment of mine:
    http://tinyurl.com/33kl4fb

    I would also remind you that even if there wasn’t evidence that neck manipulation *caused* stroke, the association is still strong enough not to recommend it as a treatment due to other more convenient, safer, and cheaper options being available.

  145. Bruce
    November 13, 2010 at 8:37 pm

    I would disagree, you guys use evidence like a big stick when you want to and ignore it when it doesn’t quite fit the agenda. The evidence of chiropractors causing stroke by cervical manipulation is just not there, irrelevant what that ‘eminent scientist’ says. I believe there has been trials in Canada over many tears which has shown that there is more chance of having a stroke after seeing a GP than a chiropractor which does not support your theory of causation.

    You also choose to forget the risk to benefit ratio as used by Medicine and I remind you of a simple and common procedure such as a colonoscopy. 

    You suggest that there are other more convenient, safer, and cheaper options available. What are they, and where is the evidence to support that statement and the evidence that supports a reduced risk?  If you use Ernst, the conversation stops as I will be unable to take you seriously. 

    • Le Canard Noir
      November 13, 2010 at 8:49 pm

      It is very convenient for you not to take Ernst seriously, isn’t it?

      • Bruce
        November 14, 2010 at 1:30 am

        @ Black Duck

        No Andy, it is is not simply convenient, it is very realistic and reasonable. Once again, his reputation and quality of research, if others are to be believed, goes before him. The only people who seems to think his research may have merit, or in fact credibility seems to be you guys.

        I may be wrong of course, but it would take a lot to convince me. Let’s apply the same stringent analysis to Ernst’s publications, that you would for chiropractic, with of course the magic ingredient of prejudice………. Interesting huh. Alternatively you could just accept it at face value:-)

      • Mojo
        November 14, 2010 at 10:40 am

        “The only people who seems to think his research may have merit, or in fact credibility seems to be you guys.”

        I suppose that would explain why his department was funded by Sir Maurice Laing, a proponent of “alternative medicine”, and, for example, he’s on the editorial board of Homeopathy.

      • Bruce
        November 14, 2010 at 11:57 am

        @ mojo

        I thank the good lord every day for your existence (in case you’re a humanist as well), there aren’t enough laughs out there in this present climate. lol

        Once again, half truths, smoke and mirrors. You really remind me of  a second rate, punch drunk boxer, who just can’t quite get it right. Throw in a punch, miss, get hit, another missed punch, hit again, another miss etc, but you are good at it mate, so well done for that.

         Back to your comments; Yes his chair was paid for by the Laing foundation, who I believe may have regretted it ever since? Now that their tenure is coming to a close, I am led to understand that the money will stop/ has stopped.

        I know the new Tour of Duty or whatever its called is out but please try and keep up. 

        Haven’t you read the plea in the Guardian about Ernst losing his job,  the bleating that is being published that he is being picked on by Prince Charles and his mates, truly pathetic. 

        The guardian also seems to think CAM should chip in and help pay to keep his position. Yip, I can see them rallying support and doing that because his fair and unbiased approach to research is renowned throughout the scientific community, he is after all, as BW keeps telling us an ‘eminent scientist’ :-)

        Less and less people seem to be taking him or his work seriously, at least that is my understanding. Having read a few of his works and reflected on its content, where the reference list is made up mainly if his own writings, well, what can one say? It’s hardly a gospel, now is it, or maybe if you are a humanist you could argue it is ;-)

  146. November 14, 2010 at 12:40 pm

    Bruce wrote: “Yes his [Ernst’s] chair was paid for by the Laing foundation, who I believe may have regretted it ever since? Now that their tenure is coming to a close, I am led to understand that the money will stop/ has stopped. I know the new Tour of Duty or whatever its called is out but please try and keep up.”

    FYI, Maurice Laing died in 2008. The following is lifted from his obituary in the Times Higher Education supplement:

    Quote
    Interestingly, while much of the research carried out by Professor Ernst was at odds with Sir Maurice’s strongly held belief in the value of alternative medicine, he never pulled the plug on the post, instead stumping up yet more money when it was needed.

    After ten years, the £1 million endowment ran out and Professor Ernst turned to him for more funding after promises of money from other sources fell through. Sir Maurice sent a cheque in the post for another £500,000, made out in his name.

    “It took him no time at all to comprehend and respect that I had no plans to promote anything and was devoted to scientifically testing these treatments,” Professor Ernst said. “He began to hear from numerous sources that I was not sufficiently supportive of the field, but he kept encouraging me to do the rigorous science.

    “Never once did he seem bothered when our results did not match his expectations and that, I think, shows the greatness of the man. In that way he has done more for determining the truth about alternative medicine than anyone else I know.”

    http://tinyurl.com/2ul8sc8

  147. Badly Shaved Monkey
    November 14, 2010 at 12:42 pm

    Bruce, do homeopathic remedies work (beyond placebo effect)?

  148. November 14, 2010 at 12:47 pm

    Bruce wrote: “Haven’t you read the plea in the Guardian about Ernst losing his job, the bleating that is being published that he is being picked on by Prince Charles and his mates, truly pathetic.”

    Readers are invited to make their own minds up about the apparent detrimental influence of Prince Charles on Edzard Ernst’s research group by reading the March 2010 links listed here:
    http://www.ebm-first.com/a-close-look-at-alternative-medicine/prince-charles-cam-news-items.html

  149. Mojo
    November 14, 2010 at 1:15 pm

    “Having read a few of his works and reflected on its content, where the reference list is made up mainly if his own writings, well, what can one say?”

    That a wide variety of medical journals take him seriously.

    • Badly Shaved Monkey
      November 14, 2010 at 1:25 pm

      And that the SCAMsters themselves are singularly reluctant to conduct any serious critical appraisal if their own activities.

  150. Bruce
    November 14, 2010 at 4:01 pm

    Love it, the gaggle has returned. Still with no real argument, still not convincing.

    Sorry 3/10, try harder :-)

    Sadly, I have just reflected on the time I have spent reading nonsense and responding. As much as I have enjoyed it, it is time I will never get back again. How do you guys keep it up, how can you spill out the same drivel, ignoring questions, trying to score banal points. Does it not do your head in, oops sorry silly question really based on your postings. Enjoy.

  151. November 14, 2010 at 5:53 pm

    Just for clarity sake: I personally feel (for what that’s worth to you) that a chair on CAM is a great thing, and many posthumous recognition to Sir Laing for his support to this enterprise. I acknowledge that it is riddled with issues which any person taking up the chair cannot avoid. Some of these challenges reside in the sometimes ungracious and ungrateful attitude, behaviour and beliefs held by the very people under examination in this exercise. Another issue which dramatically complicates the exercise is the sheer lack of evidence available for review in healthcare in general but CAM specifically (as it is CAM that is under review under the Laing chair, and not conventional medicine).
    The fact that Ernst is facing those issues is one thing. The fact that he is not managing to resolve them, another (for which my full comprehension, as it is a truly daunting task and unlikely to be resolved under one tenure). The fact that he seems to do it with such poor grace and without recognition of the weaknesses of his work is very much another, yet again.
    Again for the sake of clarity: my personal issue with the likes of Ernst or Blue Wode does not reside with the two former aspects of his work, but wholly and solely with the latter.
    I think that it is never unfair to expose the weakness of the work. In fact I think it quite gracious if a person does so of their own work. I think that not doing so and refusing to recognise the weakness is a wide-open invitation for justifiably calling such a person biased and bigoted.
    And that, and that alone, is the issue that I have with Blue Wode/E.Ernst.
    Ernst has in a nutshell done three things, regardless of how many skirts he dresses it up in:
    1)Ernst has shown that as it stands, at this very moment, very little academically valuable material has been written in regards to CAM and that on review of this small amount of material CAM has rarely been shown to be of significant value.
    2)He has brought to attention that there may be risks associated to procedures but has no evidence to show anything more than a coincidental relationship.
    3)He has employed the precautionary principle to base that:
    because of a simplified understanding of the first finding (lack of evidence in support) correlated with a simplified understanding of the second (there may be risks) it becomes unjustifiable to expose the public to a form of treatment.
    In the process it must be noted that he flagrantly ignores (as I would not call him an idiot-and only an idiot would not be aware of this) that:
    a)the benefits are under-studied for a number of reasons and rarely show that there is evidence against a procedure
    b)the relevant risks (as calling muscle aching after chiropractic treatment to be a risk is as ludicrous as calling muscle ache after a gym work-out a “risk) are ill-defined and (in the case of chiropractic manipulation of the cervical spine) never been shown to be above coincidence
    c)the precautionary principle can be used against any form of treatment without solid evidence base, as long as one can fabricate a plausible risk of harm.

    In consequence it follows from points a) and b), and from the ease with which anyone can translate their bias into public-protection measures, that some of Ernst’s work is easily perceived to be product of bias.
    Whether this is fair comment or not is of no consequence to me, although I would generally lean towards leniency. That he does so with so very little elegance whilst resolutely being vocal about the findings despite the weaknesses of points 1) and 2) raised above, on the other hand is of consequence. It is of consequence because it completely falsifies the true meaning of the work he produces and in consequence creates a discussion about evidence which in fact is a non-discussion.
    There is no evidence.
    Is that good enough? Is that the right “attitude” to have? Of course not! But does anyone here really actually think that you’re onto something with this perennial squabbling? Does it actually change anything in a truthful fashion?
    As the cat said to the dog: “I think not little puppy”
    In consequence of all this the only thing Ernst often can do is say: “there is not enough evidence for me to say anything”. But that would effectively be the death of his chair. And as such it is conceivable that some people, me included, perceive him to be heavily invested in maintaining that there is a point to his existence as professor in alternative medicine that goes above and beyond putting the heat under CAM to do some more research. He has done much to show how much he has given up to be there, and that my dear sceptics is where it’s at as I see it: he has too much to loose to admit that there is, at this stage, very little for him to do that is of much use.
    Plenty of reason to call such a person, in such a situation, typified by such actions, as biased and bigoted, don’t you think?
    Regards,
    Stefaan
    This is only the beginning

    • Le Canard Noir
      November 14, 2010 at 6:10 pm

      Despite your handwaving bluster, it is quite possible and indeed quite rational to have opinions about alt med to the effect that they are superstitious and nonsensical, without specific effects. Despite your assertions, there is a huge amoount of basic science that shows, for example, that homeopathy is absurd. To remain quiet in the face of such evidence would not be in the best interest of patients.

      It is quite clear that Stefaan and Bruce would like nothin better than Ernst to shut up. Frankly, your attitudes here mark you out as nothing but cheap quacks. The only people who find a fundamental problem with what Ernst is doing are those with vested interests in rubbishing him. For so called health professionals, your attempts to smear and denigrate are damning.

  152. November 14, 2010 at 6:50 pm

    Yes, I would agree that having a chair of alternative medicine is a great thing. I agree that CAM should not be allowed to have an easy ride and not support their claims with evidence (which holds true for everything else, not just CAM). I agree with these points and have said as much in my post you commented on. What it is specifically that makes me a cheap quack (as far as I am aware Bruce is not one) evades me in your post. The fact that I point out the failings of some of the work of Ernst? The fact that I feel the conclusions he makes do not match the content of the work?
    Sounds like I am a better sceptic than you.

    • Badly Shaved Monkey
      November 14, 2010 at 8:15 pm

      Black Duck, you have no evidence that Stefaan is a cheap quack unless you would like to tell us what his fees are.

    • phayes
      November 15, 2010 at 12:37 am

      “The fact that I point out the failings of some of the work of Ernst? The fact that I feel the conclusions he makes do not match the content of the work?
      Sounds like I am a better sceptic than you.”

      Heh! How ironic. http://www.sciencebasedmedicine.org/?p=8198

  153. Badly Shaved Monkey
    November 14, 2010 at 8:16 pm

    Again, Bruce, do homeopathic remedies work (beyond placebo effect)?

  154. Andrew Gilbey
    November 14, 2010 at 9:48 pm

    @Bruce

    What qualifications do you have to attack the work of Professor Ernst? He (EE) is an MD, PhD, and full professor. He has something in excess of 600 publications and is extremely well respected! Were you to meet him face to face, EE would run rings around you in a debate. Get real, man!

  155. Bruce
    November 14, 2010 at 10:59 pm

    @AG

    What in those sandals, don’t make me laugh

  156. Bruce
    November 15, 2010 at 9:21 am

    I am also advised that Professor Ernst has been invited by the AECC and the BCA to speak at conferences and take part in debates with other researchers in the past, who may be seen to have less biased views shall we say, but to date has declined or failed to respond?

    Interesting huh, you would think that if he was that sure about his research and the accuracy of he same, that the quality of his evidence was so robust, and that his knowledge base so extensive, he would relish taking on the chiropractors, but, if my information is accurate, he backed away?

    I would have thought that bring the ‘eminent scientist’ you guys say he is, he would have jumped at he chance, wouldn’t you, i suppose we can let the readers decide for themselves eh?

    • November 15, 2010 at 10:09 am

      Bruce wrote: “I am also advised that Professor Ernst has been invited by the AECC and the BCA to speak at conferences…”

      FYI, Professor Ernst attended one of the GCC’s meetings in August 2005, and the following is what the GCC chose to write about his visit in its open minutes of that meeting:

      Quote
      “A copy of Professor Ernst’s presentation is attached as Appendix A to these Minutes. Questions to Professor Ernst in the subsequent debate included:

      • Are you familiar with the work of Herzog et al regarding the physical characteristics of cervical spine manipulation and its effect on the vertebral artery?
      • How do you rationalise your view of the chiropractic profession as responsible for most serious adverse affects when osteopaths, some physiotherapists and other professionals also engage on a global basis in manipulation of the cervical spine?
      • Why do you say that osteopaths use mobilisation, which is inherently safer and chiropractors only manipulate, which carries more risk?
      • Where is your evidence of “serious adverse events, such as stroke (sometimes fatal) are regularly reported”?”

      http://www.gcc-uk.org/files/link_file/C-040805-Open1.pdf

      What is particularly interesting about this meeting is that Appendix A, and the minutes of the ensuing debate, seem to be for chiropractors’ eyes only. Considering that the GCC prides itself on being a transparent and helpful regulatory body, what reasons could it have for not publishing such important information?

      It’s worth noting that at the time of that meeting one of the GCC’s main duties (now withdrawn) was to promote the profession of chiropractic. Perhaps publishing Ernst’s input would have shown chiropractic in too negative a light – in which case it is unlikely that the AECC and BCA would manage to be impartial.

      • November 15, 2010 at 10:10 am
      • Bruce
        November 15, 2010 at 1:06 pm

        A copy of a presentation does not necessarily act as evidence. My understanding, is the the GCC may not have been as convinced as Dr Ernst was or makes us believe.

        I have been to many presentations, I have agreed either fully or in part with some and disagreed fully or part with others.

        Please help me out here, experience would dictate that a presentation is based on an opinion and the individuals understanding of the evidence, which can be biased by agenda or prejudices would that be accurate?

        You guys keep quoting this man as if everything is fact. Sadly or luckily there are many who disagree with him. The GCC may in fact be in that category.

        So what about that debate at AECC or at a BCA conference. Would be interesting?

  157. Mojo
    November 15, 2010 at 10:07 am

    “Interesting huh, you would think that if he was that sure about his research and the accuracy of he same, that the quality of his evidence was so robust, and that his knowledge base so extensive, and that his knowledge base so extensive, he would relish taking on the chiropractors, but, if my information is accurate, he backed away? ”

    Well, it seems to be robust enough to be published in a wide variety of peer-reviewed journals, which is a better place to present scientific evidence and argument than a public debate. Perhaps the chiropractors could try reading some of it.

  158. Bruce
    November 15, 2010 at 11:35 am

    @ mojo

    This is simple, let him pick up the gauntlet and debate his views in open form at say a BCA conference.

    Not lecture you understand, debate.

    It really is that simple :-)

    • Mojo
      November 15, 2010 at 1:24 pm

      Why? His work is published “in open form” for all (not just the BCA conference) to see.

    • Mojo
      November 15, 2010 at 1:29 pm

      And as I’ve already pointed out, a debate is not a terribly good way of resolving this sort of discussion – it is more likely to simply decide who is the better debater, who is more popular with the audience, or who is prepared to fresort to a “Gish gallop”. Let the BCA engage with the published research in the appropriate venue (after all it worked out so well last time).

      • Bruce
        November 15, 2010 at 4:25 pm

        @ mojo

        Enough said, I was told Ernst would nit br keen.

        So thr debate is finished on this issue for me thanks, a no show, is a no show.

      • Badly Shaved Monkey
        November 15, 2010 at 6:10 pm

        I’m confused. When did the credibility of the case that says chiros believe in fairy-tales and occasionally fatally wring people’s necks in pursuance of that belief resolve to the willingness of Edzard Ernst to debate the AECC and BCA?

        I watched some parts of the Prime Ministerial election debates. They did not seem to result in truth being sifted from nonsense.

      • Mojo
        November 15, 2010 at 6:36 pm

        Possibly around the time that they noticed what happened to their evidence when they presented it in a forum in which it could be adequately scrutinised.

  159. November 15, 2010 at 1:55 pm

    Bruce wrote: “A copy of a presentation does not necessarily act as evidence. My understanding, is the GCC may not have been as convinced as Dr Ernst was or makes us believe.”

    Irrelevant. As it is crucial to understand both sides of an argument, the GCC should have attached Appendix A to the published Minutes of its August 2005 Council Meeting. It has, after all, made public the Appendices relevant to its forthcoming Council meeting:
    http://www.gcc-uk.org/files/link_file/C-181110-Open.pdf

  160. November 15, 2010 at 1:56 pm

    Bruce wrote: “So what about that debate at AECC or at a BCA conference. Would be interesting?”

    I can’t see why Professor Ernst wouldn’t make time for the AECC and BCA, but, to ensure fairness, only in the way that Mojo has described above.

    BTW, apparently Professor Ernst likes heated discussions:
    http://forums.randi.org/showpost.php?p=2699727&postcount=11

  161. Bruce
    November 15, 2010 at 4:34 pm

    Sounds good, all Ernst would now have to do is offer to debate at either AECC or at a BCA conference. He has the address of both groups, I am sure.

    I understand he has been invited in the past but declined. Making the move himself as an ‘ eminent scientist’ would put the ball squarely on the chiropractors half.

    I won’t hold my breath though.

    • November 15, 2010 at 10:04 pm

      Perhaps Professor Ernst doesn’t envisage a debate between himself and a chiropractic self interest group as having any serious impact beyond the closed doors of such an encounter.

      Besides, judging by the unprofessional attitudes of the chiropractors and their apologists posting here, it could be that the chiropractors’ real agenda would be to roll out Ernst as some sort of Aunt Sally for chiropractors to vent their anger at – as opposed to engaging in respectful and constructive argument.

  162. Bruce
    November 15, 2010 at 11:37 pm

    Shock horror, Ernst no show. That really is a surprise. :-)

    Anyway you can leave him on the bench for me. No one for a minute believed he would be willing or possibly capable of defending his views in a debate with the chiropractors and of course with your usual spin, you try to blame them rather than Ernst for failing to pick up the gauntlet.

    It’s still there, glinting, as proof of what the real situation is.

    If he ever wants to pick it up, I am sure by contacting AECC or the BCA, they would rip his arm off for the opportunity of a debate. I don’t mean that literally of course :-)

    • Le Canard Noir
      November 15, 2010 at 11:58 pm

      Do you have no introspection on how your rather stupid attacks on this academic come across?

    • November 16, 2010 at 8:38 am

      @Andy Lewis
      Have you no introspection how your rather thinly vailed dogmatic following of Ernst comes across?
      Far from sceptical I would say.
      Point is that he has certain good points which are in my view valid and strong, and others which appear to be weak and biased. Sifting through them to come to some debate is surely what both parties should want. Unless you just “assume” that chiropractors don’t want the chiropractic profession to progress or “assume” that whatever Ernst says is right? Speaking only for myself but also urging you to reflect on what Bruce is actually saying, I would say that all that’s been done by those you scathingly call “apologists” is Ernst’s and Blue Wode’s weaker points have been pointed out. That is a fair thing to do. Or isn’t it? I have asked a multitude of times what is so wacky/strange/fairy-tale like about chiropractic theory. Nobody would answer me. You know or at least should know damn well that chiropractic theory never said that removing subluxation (and no I don’t herald the term-it’s just a theoretical concept-remember?) cause disease. But you boys and girls keep on banging on about things without defining what you’re actually talking about and when I discuss matters in well-defined terms you don’t like it much and call me pedantic or denounce it as game-playing! Grow up, really. What is it that is so implaisible about chiropractic theory ayway? Do you even know what it is? Do you even comprehend what it stands for?
      Do you maybe deem that only people outside of a profession can be sceptical of what they do? I really value the input and thought process, I value the time and effort some people put into their scepticism, but I don’t think that this brand of dogmatic scepticism you on occasion employ is honouring the principles of the Skeptikoi…do you?

  163. Bruce
    November 16, 2010 at 9:31 am

    @ Andy or do you really prefer le cunard noir, I suppose it does add an air if mystique to your posts?

    I suppose, based on the rules of engagement here, I could have to ask you the same question, but relating to chiropractic. Surely it has all got to do with the concept of debate, there has to be at least two sides/ opinions otherwise all you have are ‘nodding dogs’. 

    I do get the feeling that there are people on these sites who would prefer the debate/ argument all went one way. However, as Professor Ernst is a component in this debate, and his findings/ opinions do not have universal support in the scientific community, though you guys would like the readers to believe otherwise, and the chiropractors have invited him to debate in an open forum at AECC or a BCA conference, both comments being fact, then his opinions and thus his unwillingnes or lack of confidence in his views to walk into the ‘lions den’, are for me simply part of the general ‘chiropractic wrong- you guys right’ debate and the latter, eg refusing a debate, to be less than honourable. 

    He may actually find that many in the chiropractic profession would be willing to listen and based on the debate, judge for themselves. What interests me is the skeptics’ almost and ‘racist’ is the wrong word, total willingness to condemn a whole segment of society/ healthcare with your less than complimentary comments about not only the evidence, but the chiropractic profession  in general and their individual  professional,moral and ethical values.  There really is something sinister there. But hey, that’s your call and your opinion, it is not mine and not that of many others?

    But back to our ‘eminent scientist.  If the evidence is as irrefutable as you guys, to include Ernst, suggest, then the truth, based on that evidence would come out in a debate. If it is biased, with information cherry picked to put over a point, as some strongly suggest, then that would also come out. 

    The comments of the BIGOTS that I should debate with Ernst is therefore both an easy option and because of that, ludicrous. He needs to debate with someone who would have his alleged level of understanding and knowledge base for the debate to be seen to be fair. One of the posters previously suggested he loved a heated debate, but against whom and where? That is the question and of course you guys have given us the answer and on a very public forum. I, and many others thank you for that. Now we can let the readers decide.

    • Mojo
      November 16, 2010 at 11:22 am

      “If it is biased, with information cherry picked to put over a point, as some strongly suggest, then that would also come out.”

      http://www.bmj.com/content/339/bmj.b2782.full
      http://www.bmj.com/content/339/bmj.b2766.full
      http://www.bmj.com/content/339/bmj.b2783.full

    • Andy Lewis
      November 16, 2010 at 6:59 pm

      Bruce – if you debated the results and conclusions of Ernst then I would have no problem. But you appear to think the most appropriate strategy is to denigrate, name call and bluster. Your fixation with his failure to engage in a debate is typical quack thinking. Elevating the trivial as if it is significant. There are many good reasons why someone may decline a debate, not least a diary clash. But most importantly, you fail to recognise that debates are mere pantomime. The real discussion and argument goes on in the journals. Ernst is one of the few prepared to step up to that mark with alternative medicine. And all those whose beliefs are challenged attack the man rather than what he says.

  164. Bruce
    November 16, 2010 at 12:18 pm

    Oh Mojo

    The Cochrane collaboration have already commented on the credibility and robustness of well over 90% of the papers published in the BMJ. It would seem they used the same intense criteria as the skeptics have used for chiropractic. As you can guess it really wasn’t a very good result. The good news, under 8% was found to be ok it would seem.

    But you knew that, as I am certain your back room boys have that info. See you are just cherry picking again, it would seem.

    But don’t have a tantrum, it really is ok :-)

    • Mojo
      November 16, 2010 at 1:10 pm

      “The Cochrane collaboration have already commented on the credibility and robustness of well over 90% of the papers published in the BMJ.”

      [citation needed]

    • Mojo
      November 16, 2010 at 2:29 pm

      By the way, do you have any comment on those particular three articles, rather than hypothetical percentages?

  165. Bruce
    November 16, 2010 at 4:26 pm

    Ok fair point mojo my old son.

    Up to my ears at present.

    Good grief is this nonsense all you guys do. Someone must be paying the piper.

    I wonder who?

    • Badly Shaved Monkey
      November 16, 2010 at 5:01 pm

      Are you implying your opponents are paid shills of Big Pharma? Are you a paid shill of Big Cracka?

      If we edited out the tedious ad homs from your posts they’d be very much shorter.

  166. Badly Shaved Monkey
    November 16, 2010 at 4:50 pm

    @Stefaan

    ” I have asked a multitude of times what is so wacky/strange/fairy-tale like about chiropractic theory. Nobody would answer me. ”

    I’ve answered you repeatedly. Your theory is laughable because it invokes a concept that confers no predictive or explanatory power and one for which you cannot show any correlation between its presence and the presence of disease or a correlation with treatment.

    • November 16, 2010 at 5:17 pm

      @BSM
      a)What is, you think, the concept it (chiropractic theory)invokes?
      b)It does not need to show any correlation with any disease as it never defined itself as relating to or causing any disease.
      c)You’re wrong, it’s very predictable, but let’s find out together why you’re wrong, shall we?

  167. Badly Shaved Monkey
    November 16, 2010 at 7:06 pm

    Stefaan

    Is there an abnormality of the “chiropractic subluxation complex” in cases of back pain or eczema?

    Reference to a single case history could illustrate your answer.

    • November 16, 2010 at 7:15 pm

      @bsm
      a)What is, you think, the concept it (chiropractic theory)invokes?

  168. Badly Shaved Monkey
    November 16, 2010 at 9:00 pm

    The “chiropractic subluxation complex”

    • November 16, 2010 at 9:14 pm

      What do you think the “subluxation concept” is?

      • Badly Shaved Monkey
        November 16, 2010 at 9:43 pm

        I have no idea. You have been unable to define it of show it exists in any concrete example.

      • Badly Shaved Monkey
        November 16, 2010 at 9:45 pm

        Typo. Should have said-

        I have no idea. You have been unable to define it or show it exists in any concrete example.

  169. November 16, 2010 at 11:34 pm

    So, in essence you post:
    “Your theory is laughable because it invokes a concept that confers no predictive or explanatory power and one for which you cannot show any correlation between its presence and the presence of disease or a correlation with treatment.”
    but you don’t actually know what the concept underpinning the premise is?
    I am glad you can find something you don’t understand to be laughable. On the other hand I worry a little about you as that tends to be typical of simpletons.
    The premise that underpins what I do as a chiropractor is in fact extremely simple: I look at performance. I look primarily at biomechanical performance but admittedly the chiropractic model includes and covers a wider remit than biomechanical function. But just so you can follow: I am interested in one thing only: the source of dysfunctional movement patterns. The three major (but not the only ones) contributors are gait, spinal and TMJ dysfunction. They cause anomalous motion patterns (I think that’s quite obvious but let me know if you struggle with that). Anomalous motion patterns are stressful to the structures involved. The nature, amount and duration of these stresses defines adaptational patterns and result in injury, predisposition to injury or inability for recovery. Removing the source of the dysfunctional movement patterns should (when the tissues are not too badly affected) result in recovery, reduction in likelihood for injury or facilitation of injury.
    Now think about the sources of anomalous thought-patterns and anomalous dietary patterns in addition to biomechanical motion patterns and you have the chiropractic theory licked.
    Now you also know why the RCT’s that have been designed to study “chiropractic” don’t do anything of the sort.
    Problem is; very few chiropractors actually practice the chiropractic theory and it would in essence require the chiropractor to become a case-manager and cooperation with psychologists, nutritionists, podiatrists and dentists. It’s quite the job you know, but done well, the results are very predictable and very good.
    Hope this helped you out a bit. Next time ask yourself teh question whether you actually understand what you are saying is laughable and nonsense and if the answer is “no” then ask someone who knows the answer. It helps.
    Stefaan
    This is only the beginning

    • Le Canard Noir
      November 16, 2010 at 11:49 pm

      You keep saying that ‘this is only the beginning’, but I must say it really does feel like the end.

      • November 16, 2010 at 11:52 pm

        But at least you’re humouring me. It is much appreciated.
        Stefaan
        This is really only the beginning
        next time try qualifying your statements. It makes them look/sound more intelligent

  170. Badly Shaved Monkey
    November 17, 2010 at 12:31 am

    Oops, my mistake, you wrote “chiropractic subluxation concept” not “complex”. Obviously it makes no difference, since you may have well have “evil pixies” or “fairy dust”.

    Stefaan, it’s very simple. I can laugh at your ideas, because, as I keep repeating you invoke a concept that offers no predictive or explanatory power. It’s not merely thatI don’t understand it, nor do you, nor does anyone else because it is incomprehensible.

    I repeat, show me a concrete example of your “chiropractic subluxation CONCEPT” at work.

    Of course, the results of chiropractic are very predictable. When you deal with chronic fluctuating or self-limiting conditions any fool can predict the patient will improve provided you monitor them for a while.

    You are the self-proclaimed expert in chiropractic. Display that expertise.

    • Le Canard Noir
      November 17, 2010 at 12:38 am

      It is quite clear by now that Stefaan is not going to reveal his hand as it is obvious he is holding a busted flush.

      He has no option now but to resort to bluffing and bluster. He is hoping we tire before he does.

      • Badly Shaved Monkey
        November 17, 2010 at 12:57 am

        Yep, he does seem to be circling the drain now. He writes such a lot and says so little.

    • November 17, 2010 at 8:59 am

      Hi BSM,
      you guys are ever so sweet. I am genuinely trying to explain something to you clearly don’t understand, and rather than letting you make complete fools of yourselves over something you clearly don’t understand (but regardless of that fact still have an opinion on) and you just think it is about playing games. I don’t play games, I educate. I am after all a doctor.
      “Stefaan, it’s very simple. I can laugh at your ideas, because, as I keep repeating you invoke a concept that offers no predictive or explanatory power. It’s not merely thatI don’t understand it, nor do you, nor does anyone else because it is incomprehensible.” So, as I said before you laugh at that which you don’t understand; that is something simpletons do. It is really quite simple and although I try my best to help you not look like a simpleton you can’t help yourself… I have clearly over-estimated you and will spell things out a little more clearly for you. PS, can you show me ANYTHING which fulfils the test you posed at 12.45am?

      • Andrew Gilbey
        November 17, 2010 at 9:45 pm

        @Stefaan

        “I educate. I am after all a doctor”

        Whom do you educate? Popping a few joints and giving a couple of back rubs isn’t what I understand to be educating. I thought you lot use the term doctor in the sense that you ‘treat’ rather than teach.

    • November 17, 2010 at 9:08 am

      I proclaim no expertise, just opinion. I think I make this quite clear in my posts, so there really is no need to try and score brownie points on character assassination (the ad hominem does not lie in the expertise in chiropractic-I hasten to add, lol, but in the assertion that I “self-proclaim”-only small-dicked egos self-proclaim their expertise)
      A simple example of CSC at work would be a unilateral pes planus, forcing internal rotation of the tibia, torsion at the knee and resultant passive torsion at the femoral head causing anteflexion of the iliac brim on the same side of pes planus. This will cause anomalous rotation at the lumbo-sacral junction and cause hyperplastic development of the Erector spinae and gluteal musculature on that side. Evetually this person will develop recurring sacro-iliac sprains, low back pain with myofascial syndromes and possible myofascial referred pain patterns.
      That’s just an example

      • Badly Shaved Monkey
        November 17, 2010 at 11:45 am

        What does the term CSC add to that speculative chain of connections?

        I’m not saying they’re biologically unfeasible but what has the label CSC added to your description? What common feature does it represent when another chiro invokes it in explaining the pathogenesis of eczema?

  171. Badly Shaved Monkey
    November 17, 2010 at 12:54 am

    Here’s another, even better, challenge for Stefaan.

    Describe some feature of a medical case that is true if, and only if, the “chiropractic subluxation concept” is valid.

  172. Badly Shaved Monkey
    November 17, 2010 at 1:03 am

    Bruce, while we’re watching Stefaan flounder, you could answer this question;

    Do homeopathic remedies work (beyond placebo)?

  173. November 17, 2010 at 3:03 pm

    I wonder how the Alliance of UK Chiropractors (AUKC)/British Chiropractic Association (BCA) meeting with the General Chiroproactic Council (GCC) is going today?

    Quote:
    The BCA approached the Alliance to work collaboratively which has culminated in a joint letter to the GCC advising them that we no longer have confidence in the ability of the GCC to regulate the profession. The Alliance and the BCA will be meeting with Council on 17th November 2010 to discuss this matter…

    http://forums.randi.org/showpost.php?p=6564649&postcount=5

  174. Badly Shaved Monkey
    November 20, 2010 at 10:38 am

    @Stefaan

    This is only the beginning

    Nope. I think it was the end and we seem to have broken our chiroprators. That’s a shame. I really wanted to see if either of them could tell us what a subluxation was, especially since the AUKC seems determined that chiroprats base their practice on it.

    • November 21, 2010 at 2:55 pm

      Hihi BSM,
      you have a knack at over-estimating yourself, but amuse yourself by all means. What has become clear is that you cannot differentiate between a philosophically driven aspiration and a clinical entity. In consequence there is nothing for us to talk about, unless you can step off your self-proclaimed gilded ivory tower and converse like a grown-up.
      Let me know when you actually understand what you’re talking about, because at the moment it is blatantly clear that you have no interest in understanding this discussion and are filling in the gaps with assumption, not knowledge, opinion, not fact and a whole lot of arrogance, not the humility one who seeks understanding ought to have.
      Good luck anyway as I am very much still going,…
      This is after all only the beginning!
      Stefaan

  175. Badly Shaved Monkey
    November 20, 2010 at 10:40 am

    Oops, sorry. Couple of typos there.

    Where I typed “chiroprat” I obviously meant ‘chiropillock’.

    I hope that’s cleared things up.

  176. David
    November 21, 2010 at 1:45 am

    @BSM

    If you were seeking clarification, I think you’ve managed to show yourself up perfectly. Well done.

  177. Badly Shaved Monkey
    November 21, 2010 at 8:40 am

    Ah, David. Would you care to explain in clear and meaningful terms want a subluxation is? Stefaan seems to have given up, which is a shame at a time when the AUKC is determined to remind us of its centrality to chiropractic?

  178. Badly Shaved Monkey
    November 21, 2010 at 8:05 pm

    @Stefaan

    “What has become clear is that you cannot differentiate between a philosophically driven aspiration and a clinical entity.”

    Blah, blah, blah, blah, blah, Stefaan

    Still waiting for you to provide a clear definition of a subluxation that would allow you to show us some clear predictions using it. So far all we have is your silly rhetorical bullshit and tedious prolixity.

    An interesting side effect of this is that I had never paid much attention to chiros before and now I have. It seems you are not the only chiro suffering from this incapability.

    Well, it’s been sort of interesting. I’ve got used to homeopaths’ collective refusal to engage adequately with reality. Its been facsinating to see the same traits in the chiros.

    Unless you can contribute something coherent to this conversation, such as some falsifiable predictions involving subluxations, then I think you are done here.

    • November 21, 2010 at 9:22 pm

      Ah, bless you bsm. I am afraid that not playing by the rules you set out is not quite the same as having nothing of value to contribute.
      Regardless, I have given you answers to your questions, provided you with examples and given you ideas on how the predictors would come together and apply. The fact that I cannot give you all the answers you crave for in a manner you require is only reflection of my own limited capacities and in no way shape or form are reflective of “chiropractic”.
      The answers are all there, and I have learned a lot from your questions and from formulating what I thought were logical answers to those questions. I have failed. What has also become clear is that you just haven’t got enough background knowledge and clinical experience to assimilate my answers with you questions and therefore there is nothing much I can do for you as that would really take too long. Sorry for what must feel like me giving up on you, but I just haven’t got the time to teach you the basics. There are some good institutions that can help you with that. One I really liked is the AECC in Bournemouth
      Best of luck big man,
      Stefaan
      This is only the beginning

  179. Badly Shaved Monkey
    November 21, 2010 at 9:43 pm

    Stefaan

    This is not a pissing competition about who is the smartest or who went to the best academic institutions, but, rest assured, if it were I’d be decorating the ceiling and you’d barely manage to raise your stream above the skirting board.

    Meanwhile, you still do not seem to have grasped the concept of a falsiffiable hypothesis, but, to reiterate, unless you can contribute something coherent to this conversation, such as some falsifiable predictions involving subluxations, then I think you are done here.

    If you think you have already given us a falsifiable prediction based on subluxations, then please cite the specific passage in which this was done.

    • November 22, 2010 at 2:07 pm

      Good to see you are as retentive on the urinary front as you are anally.
      Go back and read what’s written. It’s all there.
      Then ask questions. Say thank you when you get an answer and answer the ones you have been asked. Then, maybe, if you have satisfied yourself that the answer to your next question is not entailed within the existing answers, ask another one. With some respect for your interlocutor. Common courtesy and all that.

      Stefaan
      This is only the beginning

  180. Badly Shaved Monkey
    November 22, 2010 at 3:29 pm

    Stefaan, you have not made a single falsifiable statement about “subluxations”. That’s the problem.

    Stefaan Vossen on November 22, 2010 at 2:07 pm
    With some respect for your interlocutor. Common courtesy and all that.

    Stefaan Vossen on November 12, 2010 at 10:21 am
    Tosseratum ad Wankeratio

  181. November 22, 2010 at 6:56 pm

    Yes, many people did think that was funny after you’d pedantically been throwing your lexicon of inductive reasoning out of the pram. Got quite a few e-mails over that in fact.
    It is not my place to decide for the entire chiropractic profession what the falsifiable statements that define chiropractic practice are, but I will give you another example of one that may very well be:
    It is better to address all sources of dysfunctional movement patterns than it is not to.
    Stefaan Vossen
    This is only the beginning

  182. Badly Shaved Monkey
    November 22, 2010 at 7:17 pm

    Ooh, brilliant, Stefaan, I didn’t realise we had an audience and you get fanmail. That’s terrific.

    Can any of them help you to pull out a single falisfiable hypothesis involving the “vertebral subluxation complex”? I keep asking. You keep dodging.

    And no this;

    It is better to address all sources of dysfunctional movement patterns than it is not to.

    Is not even close.

    • November 22, 2010 at 8:10 pm

      Right, so you would like to see a falsifiable hypothesis involving the vertebral subluxation complex:
      “In those cases where spinal dysfunction is a causal (co-)factor of a person’s dysfunctional movement pattern, it is better to manipulate that joint so as to facilitate restoration of movement within that joint than it is not to do so, all other co-factors being treated equally.”

  183. Badly Shaved Monkey
    November 22, 2010 at 8:39 pm

    Tricky one. You will, of course, acknowledge that your suggestion involves the fallacy of assuming the antecedent or begging the question.

    The question is whether you can associate something called a subluxation with a disease stare- shows its presence in disease, show its resolution with chiro, show that resolution to be associated with cessation of the disease. All you need is reliable way to measure “subluxation”.

    But, this is what I have been asking you for weeks. You are not alone in your inability to answer it as we have seen from your representative organisations. The issue is whether your inability leads to any meaningful introspection. None evident so far.

  184. Badly Shaved Monkey
    November 22, 2010 at 8:40 pm

    Typo

    “disease staTe”

  185. November 22, 2010 at 9:10 pm

    I do melud, but the problem is of course that such levels of assumed antecendence are ofcourse called skill and knowledge.
    Secondly: why associate to a disease state? I have been asking you that question for weeks too? It makes no sense to do that at this stage in our courtship as we haven’t even gotten over the primary fdallacies of the theory yet.

  186. Badly Shaved Monkey
    November 22, 2010 at 10:34 pm

    Um, that would be because chiropractic claims to treat diseases. That’s why we’re having this lovely chat.

    If chiropractic’s central idea and unique feature is not associated with disease then you are just a rather brutal masseur.

  187. November 23, 2010 at 10:05 am

    Brutal masseur it is then. Chiropractic theory never claimed anything rgearding the causation of disease. The profession has observed many associations to disease processes and some people within that profession made possibly misguided claims (potentialobserver fallacies), but the theory never did.
    Stefaan

  188. Badly Shaved Monkey
    November 23, 2010 at 1:55 pm

    Let’s just frame this line and let it stand out;

    Chiropractic theory never claimed anything rgearding the causation of disease.

    I accept you may think that to be true.

  189. November 23, 2010 at 2:40 pm

    Show me otherwise by all means.

  190. November 23, 2010 at 6:19 pm

    Awaiting eagerly

  191. Badly Shaved Monkey
    November 23, 2010 at 9:00 pm

    Stop being silly, Stefaan.

    You know full well what a large number of chiros believe about their ability to treat the cause of disease and that “subluxations” are that cause.

  192. November 23, 2010 at 9:12 pm

    That means they are in my opinion tossers (if you were right). You are however largely wrong. There are some who believe that and should be put against the wall of shame and delusion. There are in fact not that many, but they have oft been quoted and even more oft been misquoted. Anyway you are missing the point; you stated that “chiropractic claims to treat disease”. You cannot say that, I don’t think. I in fact thta there is no evidence of that whatsoever. What you have evidence is some people practising it made assumptions and drew far-fetched conclusions from which they made scientifically unsubstantiated claims. These two matters are very different. Do you accept that the two matters are different or do we need to go into the difference between practice and practitioner?
    On a side note:
    If I ask you whether a hug a day to each person is likely to improve the nation’s health what would you say?

  193. Badly Shaved Monkey
    November 23, 2010 at 10:45 pm

    Anyway you are missing the point; you stated that “chiropractic claims to treat disease”. You cannot say that, I don’t think. I in fact thta there is no evidence of that whatsoever.

    Cobblers. You cannot really believe that.  You may not personally be a loony vitalist, but you know that chiropractic is riddled with this tosh. 

    If I ask you whether a hug a day to each person is likely to improve the nation’s health what would you say?

    I’d say that we could adequately define a hug, show where one is happening and even test responses to hugging. You cannot show any of these for “subluxations” despite my repeated requests, but nor have you been willing to draw the necessary inference from your inability to do so. 

  194. November 24, 2010 at 10:54 am

    “Cobblers. You cannot really believe that. You may not personally be a loony vitalist, but you know that chiropractic is riddled with this tosh.”
    Right, let’s just make one thing very clear: “chiropractic” is not the same as “chiropractors”.
    You have not been able to fault chiropractic theory so far, and I do not expect you will really. “Chiropractors” on the other hand can be faulted relatively easily. Maybe not with the frequency you intimate here, and I would suggest that you are far from able to substantiate that claim. I concede that silliness is to be found amongst all professions, including the chiropractic profession. And I concede that in your perception of the chiropractic profession it may be at a frequency that is above tipping point, but I think you will need to concede that such perceptual tipping points are one thing. The reality quite another.
    Sorry mate but you’re making generalisations like a quack.
    Stefaan
    ps do you think that all hugs are the same?

    • Mojo
      November 24, 2010 at 12:14 pm

      “You have not been able to fault chiropractic theory so far, and I do not expect you will really.”

      As long as your “chiropractic theory” doesn’t make any falsifiable claims, you are on pretty safe ground here.

    • Badly Shaved Monkey
      November 24, 2010 at 2:04 pm

      It’s lack of falsifiability is the fault at its core. You really don’t understand this, do you?

      Wow. Never mind. There comes a point where I can’t explain this any more simply or clearly. I give up.

      • November 24, 2010 at 2:18 pm

        And that is exactly the point. You make statements about the theory being cobblers etc, but it’s not the theory it’s what you know to be falsifiable in the theory. You talk about chiropractic making claims but its not chiropractic doing that, it’s certain chiropractors, and until you are prepared to make nuances and define correctly what you are talking about there is no point in talking. It is making you seem arrogant and unrefined not to make what are quite important semantic nuances.
        Finally, it is (against your belief) falsifiable, you just don’t know it yet and it is not me who has been making claims that it is all “insert any derogatory term of your choosing” it’s you lot, and all I have done is ask you to back up your statements and claims. In fact, prove to me that the theory is not falsifiable whilst you’re at it! Whilst in fact it is extremely simple to falsify and test in theory, the practicalities are showing a need for large-scale studies and clear definition of parameters. Is short-term improvement all that is needed? This is long-term functional thinking. Is an increased in ROM all that is needed? This is about safe-guarding the joints and musculature for the future as much as it is about improving matters in the medium-term. Is low-cost all that is needed? Or do we set cost off against savings in joint-replacement surgery and quality of life?
        Now you might start to understand why this is really, only, just the beginning!

  195. Badly Shaved Monkey
    November 24, 2010 at 3:10 pm

    Stefaan, it’s not other chiropractors, it’s you that has the problem. You have chosen to invoke a thing called “chiropractic subluxation concept”, while your authorities invoke something they call the “vertebral subluxation complex”. None of you are capable of making a single meaningful statement about this thing. Unless you can, it must be regarded as empty rhetorical bullshit that just happens to misapply and misuse a perfectly sensible medical word. Look back over the dozens of posts in this discussion and you will see where I have repeatedly asked you to use the term in a way that would be capable of experimental proof or refutation and you have simply not been able to do it. You’ve talked about a lot of things, but you have not done that thing.

    I don’t think you are able to answer those questions. I don’t think you understand why.

    Try this:

    Do you agree with this sentence?

    Chiropractic is a separate distinct healing profession that emphasises the inherent recuperative power of the body to heal itself without the use of drugs or surgery with particular focus on the subluxation.

    But, none of this is a major problem provided you only crack sore backs, though the evidence is against your therapy being any better than anything else and there is some evidence that chiropractors occasionally kill people with neck manipulations. However, there are hundreds of your colleagues who think they can treat asthma, eczema and a variety of other non-spinal diseases and who line up with the anti-vaccine movement presumably in part because chiropractic’s metaphysical origins lead them to deny the role of germs in infectious disease.

  196. Badly Shaved Monkey
    November 24, 2010 at 3:21 pm

    p.s. As an aside I was just reading this page;

    http://www.chiropracticlive.com/?p=1012&cpage=3#comments

    “Dr Bilbo Baggins” and “Bruce” are awfully similar. I wonder if they inhabit the same head.

  197. November 24, 2010 at 4:02 pm

    What you think you know and what actually is the case are sometimes widely varying things.
    The CSC was invoked in order to differentiate and define a working term for the lesions contained in the over-all chiropractic theory/philosophy and distinguish it more clearly from what you seem to equate it to as being about vertebral subluxations only. The concept of the chiropractic vertebral subluxation is not the whole chiropractic concept, only a part of it. The chiropractic vertebral subluxation is one type of subluxation (as you seem to like the word so much) which has qualities that make it similar to the medical subluxation but are understood by chiropractors (wrongly or correctly is irrelevant at this stage) to have wider ramifications.
    I was trying to help you clear up the befuddled understanding you have of it all, but gracious me you’re a rude boy sometimes!
    Define meaningful, define what you need it to be described as before you understand the obviousness of it all. I have given you very simple, testable ramifications but that doesn’t seem to float your boat either. What do you want? A study? some research? a tool that picks it up in a way you understand? As I have told you many times before; they aren’t there, but that in itself doesn’t mean it’s all “rhetorical bullshit”. Lots of things must be rhetorical bullshit in your world if that is how you define it.
    Yes I agree with that sentence. it seems so obvious it hurts.
    Are all hugs the same?

  198. Badly Shaved Monkey
    November 24, 2010 at 5:22 pm

    So, can I take it that you do agree with this sentence?

    Chiropractic is a separate distinct healing profession that emphasises the inherent recuperative power of the body to heal itself without the use of drugs or surgery with particular focus on the subluxation.

    You started out here not seeming to want to accept the idea that chiropractic is based on “subluxations”.

    Can we move forward on the basis that you agree with the statement I have quoted?

  199. Badly Shaved Monkey
    November 24, 2010 at 5:30 pm

    Here’s an example of you wanting to distance yourself from “subluxations”;

    Campbell and Busse start off quite badly in their abstract: “chiropractic philosophy…considered disease the result of spinal nerve dysfunction caused by misplaced (subluxated) vertebrae.” NO reference- and as I will point out later that is poo anyway.
    “Although rejected by medical science, this concept is still accepted by a minority of chiropractors”-NO reference.
    “Opponents include some religious organizations, citizens’ groups, and practitioners and followers of alternative health care systems, including chiropractors” This latter part (ref chiropractors) is referenced to Ernst’s paper (in which, by means of example of his poor understanding of chiropractic and chiropractic theory (the same mistake Campbell and Busse make) he states-without reference- that “Chiropractors believe that misalignment of the vertebra is the
    cause for many diseases.” For your information: they don’t and that is utter codswollop)

    It is really rather pointless discussing anything with you when you can’t decide whether you are the true Scotsman or not, or even whether you’d know a Scotsman if you saw one.

  200. November 24, 2010 at 6:17 pm

    Find me one reference from chiropractic textbooks that states that chiropractic theory states that subluxations cause disease, then it might be worthwhile pursuing your point. Until then you’re just missing the point by arguing that something is true when it blatantly isn’t. Chiropractic subluxations are more than medical subluxations. Hence why I tried to help you and explain the difference. They use the same word, mean different things, hence why I added “chiropractic” for your ease. I personally don’t care what the thing is called, but the meaning of the word as per chiropractic theory doesn’t change. You’re trying desperately to make it mean the same as a “medical subluxation” when it isn’t in the slightest. You seem very confused about this important distinction, no wonder you don’t know your Scot from your Welshman.
    Don’t know what the point was of your quotes, I stand by them. Prof Ernst says things about misaligned vertebrae which in itself has little to do with what chiropractors believe, let alone that they believe that it causes disease. Again, a reference for this please as you boys are just playing circular reference games, only serving to confuse you further.
    ps. are all hugs the same?

    • Badly Shaved Monkey
      November 24, 2010 at 6:58 pm

      I don’t have any chiropractic textbooks (why would I?), but ten seconds on Google with the search terms Chiropractic + “subluxations cause” leads us to this as its second hit;

      http://www.lockerdc.com/subluxation.htm

      Presumably that is the website of someone completely devoid of the blood of the Picts in his veins.

  201. Badly Shaved Monkey
    November 24, 2010 at 6:29 pm

    Do you agree with this sentence?

    Chiropractic is a separate distinct healing profession that emphasises the inherent recuperative power of the body to heal itself without the use of drugs or surgery with particular focus on the subluxation.

    No, hugs are not all the same, but I suspect one could frame a brief definition of a hug and test people’s concordance in judging what is and what is not a hug and there would be a fairly good degree of correlation in their judgements. That is not true of a “subluxation”.

  202. Badly Shaved Monkey
    November 24, 2010 at 6:38 pm

    p.s. I only appear confused because I choose to share in your confusion and reflect it back at you.

    That you do not recognise yourself in the reflection speaks volumes.

    Please do not think that your art is so subtle that it is not actually very simple to criticise it without getting bogged down in all its self-imposed internal complexity. Consider homeopathy. I neither know nor care what homeopaths think are the different uses of Nux Vom versus Arnica. It has no more bearing on the real world than the twelve uses of dragons’ blood apparently codified by Albus Dumbledore. It is not relevant to knowing that homeopathy is also a magical fiction.

    Looks like a duck, quacks like a duck…

  203. November 24, 2010 at 7:05 pm

    Find me one reference in a chiropractic text book that states that subluxations cause disease. Until then you’re just telling stories… derogatory stories, but stories nevertheless.
    If not all hugs are the same, how many parameters do you think you would need to measure in order to recognise patterns of efficacy?

    • November 24, 2010 at 7:52 pm

      Stefaan Vossen wrote: “Find me one reference in a chiropractic text book that states that subluxations cause disease.”

      Here you are:

      Quote
      “I have never felt it beneath my dignity to do anything to
      relieve human suffering. The relief given bunions and corns
      by adjusting is proof positive that subluxated joints do cause
      disease.” [19] P.322

      Ref [19]: Palmer DD. The Chiropractor’s Adjuster (also called The Text-Book of the Science, Art and Philosophy of Chiropractic), Portland Printing House, 1910.

      See page 10 here:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505094/pdf/jcca00005-0041.pdf

      • Badly Shaved Monkey
        November 24, 2010 at 8:09 pm

        I do find it curious that this pattern pops up repeatedly with SCAMsters. Raise silly objections as excuses for not engaging with the core issues. It’s almost like they think people can’t be bothered to call them out on their prevarications.

    • Badly Shaved Monkey
      November 24, 2010 at 8:03 pm

      Wha you keep doing, Stefaan, is muddling the “in Universe” detail of what you thin you do for patients with the discussion of the rules that you think govern that Universe.

      Meanwhile, we return to a simple question you have now evaded several times:

      Do you agree with this sentence?

      Chiropractic is a separate distinct healing profession that emphasises the inherent recuperative power of the body to heal itself without the use of drugs or surgery with particular focus on the subluxation.

      Experience of SCAMsters over the years suggests that repeated avoidance of a simple question usually means we have hit the limits of their willingness to confront their own assumptions. The thing is, if you just want to say you are a masseur, that’s fine, but if you insist that being called a chiropractor has some value then you need to answer rather better for your beliefs.

      By the way, Blue Wode, gave you a quite from your founding guru. Thanks, BW.

  204. November 24, 2010 at 7:25 pm

    sounds like a bull having a poo and smells like bovine excrement

    • Badly Shaved Monkey
      November 24, 2010 at 8:04 pm

      It’s a “chiropractic subluxation concept” stuck to your shoe.

  205. Badly Shaved Monkey
    November 24, 2010 at 8:06 pm

    p.s. Blame the typos on smartphone’s predictive text and small screen!

  206. Badly Shaved Monkey
    November 24, 2010 at 8:12 pm

    Stefaan, reference that quote BW cited.

    Follow this link and ask yourself what is that loud buzzing sound;

    http://forums.randi.org/showthread.php?postid=6586586#post6586586

  207. November 24, 2010 at 9:13 pm

    1) I replied at 4.02pm to your question (so much for being evasive-and your bs rhetoric which was borne from it-shows how much attention you pay to what’s written)and the answer is yes I agree.
    2) since when is a corn/bunion a disease? The primary cause of these is maladapted soft-tissue strain (skin and boney calluses respectively) secondary to poor gait motion patterns.
    3) I think that the above two points should elicit a little more humility and a little less cock-sureness on your behalf, but I ain’t holding’ my breath.
    What buzzing sound? I am not hearing anything other than the sound of cow pats dropping-oh no, it’s a bull!
    So, like I said one reference to disease please until then you’ve got nothing to add as your premise revolves around chiropractors wanting to be involved in directly reducing disease. Maybe one day you’ll start by investigating the basic premises of your complaint and go from there. For now it’s all built on “So-called Skeptic” hot air.
    Stefaan

    • Badly Shaved Monkey
      November 24, 2010 at 9:23 pm

      1. Wow! You’re right. There it is as the last sentence of a post I gave up reading halfway through because it was the usual waffle up to that point. Sorry for that. You do believe in “the subluxation”!

      2. You should ask your founding father DD Palmer.

      OK, so are you now trying to defend a position that says chiros don’t treat disease? Are you really sure you want to go down this line. Remember, we don’t mind you if you just want to be a masseur, so you’d have no objection from us if that’s all you claim. But when it turns out that a large proportion of your profession do think they treat disease then this would rather disqualify you as an interlocutor.

      Stefaan, other than in back pain, in what disease states is it worth treating “the subluxation”?

      • November 24, 2010 at 9:37 pm

        For someone who claims to be intelligent you can’t be that brilliant. I have been saying for ages now that CHIROPRACTIC (not chiropractors-note the difference-the latter is people who practice chiropractic-the former the theory according which they claim to practice) does not claim to treat disease. DD was 100 years ago, shall we go back 100 years in medical history and see how much error and typos there were back then? You’re clutching at straws to validate your assault sailor boy.
        I believe in the concept of it -which seems to evade you because you still don’t actually know what one of them is supposed to be in the chiropractic context.
        Clutch a bit harder

  208. November 24, 2010 at 9:28 pm

    and whilst you’re at it Blue Wode, go and tell Edzard about the difficulty you’re having to found and reference his statement about chiropractic stating that subluxation cause disease.
    I hope you both feel suitably ashamed for the simplicity with which your objections to “chiropractic” are assailed, just shows how much you are used to hearing what you want to hear without great skepticism and the ease with which you infer what you see in some onto the many. Fact is that you can’t approach individual chiropractors because it would leave you open to libel claims, so you have to attack the group. But you have no foundations to attack the group, so much should be clear to you by now. the fact that Ernst says something, does not perse make it true, evaluating that critically is skepticism. What you are doing is not.
    Stefaan
    This is only the beginning

  209. Badly Shaved Monkey
    November 24, 2010 at 9:31 pm

    Just to clarify, Stefaan, are you saying subluxations do not cause disease?

    • November 24, 2010 at 9:43 pm

      No, I do not understand or believe chiropractic subluxations to cause disease. They may contribute, but in order for any cause to be established, a level of predictability needs to be established prior.
      Stefaan

      • Badly Shaved Monkey
        November 24, 2010 at 9:45 pm

        Badly Shaved Monkey on November 24, 2010 at 9:33 pm
        (I feel a bit of silly semantic gaming lies just over the horizon to do with the meaning of the word “cause”, but let’s let Stefaan answer first)

        I win!

      • November 24, 2010 at 9:51 pm

        Congratulations (for finally understanding something I told you weeks ago)

      • Badly Shaved Monkey
        November 24, 2010 at 10:11 pm

        It’s not a problem of understanding. I’ve just been trying to get you to state your fallacious beliefs explicitly without the screeds of pointless waffle that only serve to hide the plain simplicity of your core idea. Now we can play with the wrongness of that idea and show its internal contradictions.

      • November 24, 2010 at 10:19 pm

        and how did you do that? Or let’s correct that for “how do you think you did that?”
        You only claim victory for something that should have been clear to you ages ago.
        But then you state that not believing that subluxations cause disease is fallacious…
        Have you completely lost the plot?

      • Mojo
        November 26, 2010 at 10:11 am

        “They may contribute, but in order for any cause to be established, a level of predictability needs to be established prior.”

        Sounds a bit like “the soil is everything” to me.

  210. Badly Shaved Monkey
    November 24, 2010 at 9:33 pm

    (I feel a bit of silly semantic gaming lies just over the horizon to do with the meaning of the word “cause”, but let’s let Stefaan answer first)

  211. Badly Shaved Monkey
    November 24, 2010 at 9:36 pm

    http://www.ucbelleville.com/index.php?page=faqs#faq04

    How can a Subluxation cause me to have physical problems?

    Your nervous system is responsible for controlling every single function of your body. If it is interfered with due to a subluxation, your body will begin to malfunction. When that happens, your body begins to build itself sick. This can cause muscle or joint pain, organ dysfunction, lowered immune system and countless other conditions that you would not ordinarily relate to a problem originating in your neck.

  212. Badly Shaved Monkey
    November 24, 2010 at 9:39 pm

    http://www.chirodrharte.com/templates20/custom-content/1medicine_chiro

    “we are going to locate the vertebral subluxation cause of her sickness, so we can correctly adjust it.” replied Dr. Palmer.

  213. Badly Shaved Monkey
    November 24, 2010 at 9:43 pm

    Anyway, it’s over to you Stefaan.

    I’m predicting we’ll hear the familiar sound of the weasel.

    • November 24, 2010 at 9:58 pm

      Rude and condescending, well, well we’re getting it all tonight aren’t we? Listen sailor, you’re finally understanding stuff you have been explained ad nauseam for weeks now. You finally started to ask the right questions, and that’s great but tone the condescendence down will you? I think you catch my drift don’t you? Let me know if you can start talking like a grown up.

      • Badly Shaved Monkey
        November 24, 2010 at 10:07 pm

        What do “subluxations” do if they don’t cause disease.

      • November 24, 2010 at 10:13 pm

        here’s a good idea for you: http://www.chiropracticlive.com/?p=1058

      • Badly Shaved Monkey
        November 24, 2010 at 10:21 pm

        Oh, good, a paper in which the blogger scatters the word “subluxation” in the margins but where the word itself does not appear in the article itself. Ah, that elusive subluxation. Even when the chiros talk about it they can’t quite bring themselves to use the word, so keep their meaning obscure.

      • Badly Shaved Monkey
        November 24, 2010 at 10:32 pm

        “In addition, the study concludes that these results are not simply due to altered input from vestibular, muscle or cutaneous afferents as a result of the chiropractor’s touch or due to movement of the patient’s head, because no changes were found after passive neck movement. This finding strengthens the argument that results are likely specific to the delivery of the high-velocity, low-amplitude thrust of a spinal manipulation. In summary, the study notes that episodes of acute pain with injury may induce plastic changes in the sensorimotor system including dysfunctional motor control of spinal joint segments; that is, the manipulable lesion that chiropractors treat. Cervical spinal manipulation appears to improve cortical integration of somatosensory input and helps explain a mechanism for pain relief and restoration of function after spinal manipulation.”

        Breaking news. Cracking back alters pain sensation in cracked back.

        Still no news whether this is better than any other treatment in long-term and keeps focus on uncontroversial field of back pain rather than the wilder realms of chiro belief.

        And now the weather: huge dark clouds still hang over chiropractic profession

  214. Badly Shaved Monkey
    November 24, 2010 at 9:46 pm

    OK, Stefaan, now the weasel has broken cover, please ask him what do “subluxations” do if they don’t cause disease.

  215. Badly Shaved Monkey
    November 24, 2010 at 10:16 pm

    Let’s summarise;

    1. Stefaan believes in the existence of “the subluxation”

    2. According to Stefaan “the subluxation” does not cause disease.

    3. We can easily find other chiros can readily be found who diametrically disagree with Stefann with respect to number 2.

    4. Stefaan has not so far been able to show us a picture, provide us with a measurement or demonstrate the presence of “the subluxation” in any disease state or its amelioration with chiropractic treatment, though he does believe it exists.

  216. November 24, 2010 at 10:46 pm

    Stefaan Vossen wrote: “…and whilst you’re at it Blue Wode, go and tell Edzard about the difficulty you’re having to found and reference his statement about chiropractic stating that subluxation cause disease.”

    It was really quite easy to locate the reference considering it formed part of a response to a systematic review of spinal manipulation which Professor Ernst co-authored in 2006:

    Quote
    “Spinal manipulation was first described in 1895 by the `magnetic healer’ D D Palmer as a treatment of `subluxations’ of the spine and other joints. Early chiropractors believed that `subluxations’ were the cause of all diseases—to quote Palmer: `95% of all diseases are caused by displaced vertebrae, the remainder by luxations of other joints’.[2] Today, 89.8% of (USA) chiropractors feel that spinal manipulation should not be limited to musculoskeletal conditions.[3]

    It is thus not `methodologically unsound’, as D Byfield and P McCarthy assume, but necessary to conduct a health technology assessment of spinal manipulations for the full range of conditions for which adequate data are available. Similarly, global assessments exist also in the chiropractic literature and are acclaimed by chiropractors—as long as they are not truly critical of their practice.[4]

    Of course, Byfield and McCarthy are right, the majority of chiropractic patients suffer from musculoskeletal problems, but are they suggesting one must not ask questions about the rest? And, of course, the `straight’ chiropractors adhering to Palmer’s gospel are in the minority; but, in the UK, the influence of those `vitalists’, who insist spinal manipulation is a panacea, is growing.[5]”

    Refs provided…
    http://jrsm.rsmjournals.com/cgi/content/full/99/6/279

    [NB. Ref 3 also revealed that 76.5% of chiropractors teach that there is a relationship between spinal subluxations and internal health and that subluxation is a significant contributing factor in 62.1% of visceral ailments.]

  217. November 24, 2010 at 10:48 pm

    I would add that my comment above has great relevancy to Zeno’s latest blog post:

    Where the evidence leads
    http://www.zenosblog.com/2010/11/where-the-evidence-leads/

  218. November 25, 2010 at 2:00 am

    I can offer that the linkages between statutory regulators (eg. Health Professions Council), voluntary regulators (eg. CHNC) and educational accreditation quangos like OfQual, Skills Active and Skills for Health is ACTUALLY very tenuous indeed – nothing more than a paper chain.

    Also, the linkages between the “accreditation” bodies and the universities, colleges and private training providers perhaps even more so as most rely on the information that is provided by the prospective applicant without any wider consultation.

    And the final link – between the practitioners themselves and the professional training bodies is VAPOUROUS.

    There appears to be a common thread with all regulation of these types of practices (psychotherapy, chiro, homeopathy et al)and it is this: aggressive political maneuverings are undertaken by a small group of over-ambitious narcissists with a background in law, corporate management or marketing.

    They are bought in to shore up a growing hegemony of trade misdescriptions from collaborators that simply don’t have the time or the resources to look into the issues in any depth; or realise that they are being conned; or that they are being incentivised to blatantly con the public under a guise of regulatory respectability.

    Saying “no” to the application to join some mighty box-ticking organisation is counter-intuitive to a sole trader or small partnership.

    The only way to disrupt this unhealthy status quo is to unsettle the idea that regulation is at all in the interest of “protecting the public”.

    We must encourage what is probably quite a caring and benign demographic to hold themselves in from making such bold and audacious claims that go against advertising and trading standards – as a number of these claims are without sufficient evidence as to efficacy.

    CAM practitioners should be left to do what they do best – which is to make SOME of the people FEEL happier SOME of the time when they are faced with the (SOMETIMES) harsh realities that entail following sound medical advice as provided by GP’s and the NHS.

  219. Badly Shaved Monkey
    November 25, 2010 at 3:14 pm

    Stefaan wants us to read this;

    http://www.chiropracticlive.com/?p=1058

    I suggest reading this as well
    http://www.badscience.net/2010/10/neuro-realism/

    Let’s now take a little diversion into personal anecdote.

    I get a bad back. It’s mainly when I do too much heavy manual work. Sometimes I get to the point where I can’t stand up because of the pain from spasmed muscles in my lower back. I whack those spasmed muscles with a balled fist and that usually breaks the spasm and off I go again.

    If you put me in an fMRI scanner, provided the machine was switched on and I wasn’t actually dead, there might be differences to see between when I am in pain and after I have whacked those painful muscles out of spasm. If the technology is any good, I would indeed hope that it would find a physical correlate in the brain. Does whacking my own back and altering the correlated physical changes in my brain prove that “the subluxation” exists as a meaningful concept? No. Does me whacking my own back make me a chiropractor? No. Or, at least, probably not because who gave DD Palmer the right to call himself a chiropractor in the first place.

    If the article you cite is evidence for “the subluxation” then it is equally valid for for the existence of what we must now call “the whackhole”. I cure my painful back by giving it a whack. Therefore there must have been a whack-shaped hole that needing filling with whack.

    Whackholology is just as valid as chiroractic luxation theory.

    Do I think a whack on the back would cure my asthma, eczema, birth-trauma or bed-wetting? I doubt it because there is not a ‘jot’ of evidence to sustain that claim. If I stop wheezing, itching and lying natally traumatised in a wee-soaked bed after a mere whack on the back then I would regard that as a coincidence.

    So, to reiterate, “the subluxation” invoked by chiropractors is an empty concept. It provides neither predictive nor explanatory power. Chiros can produce no evidence of its physical existence nor any changes in it relating to treatment. It strikes me that “the subluxation” and the Invisible Pink Unicorn may well be the same thing.

    http://en.wikipedia.org/wiki/Invisible_Pink_Unicorn

    Stefaan, prove me wrong.

  220. David Wellington
    November 26, 2010 at 3:05 am

    @-badly shaved monkey
    This is probably the best 3 questions you can ask any “traditional straight” chiropractor.

    1. Please provide a good quality piece of evidence that such a well-characterised subluxation exists in the vertebrae.
    2. Please provide a good quality piece of evidence that your well-characterised subluxation is present in a. back pain b. asthma
    3. Please provide a good quality piece of evidence that correcting your well-characterised subluxation relieves a clinical symptom or sign.

    As a chiro myself, I am well versed in the VSC “vertebral subluxation model”. However, Im not in any way an advocate of the concept. Simply because, VSC cannot be all of the following facet syndrome, spinal stenosis, internal disc disruption, radicular pain, radiculopathy and others. Go to the International Association for the Study of Pain (IASP) they have definitions.

    But your questions made me think, what do I do, why and how. If nothing else you have made a tiny difference. Spinal manipulative therapy (SMT) is as effective as NSAIDs but safer, (Prof Nik Bogduk and hes no advocate of Chiro) Im happy with that. Do I treat asthma, NO because I dont have the ability to diagnose asthma, similar to middle ear infections, etc. As for Cervicogenic Headaches, Neck pain, musculoskeletal pain, radicular pain etc following along the lines of Likelihood and odds ratios, a history you can reasonably predict a spinal entity that is aggravated, therefore you can assume common medical parlance of a spinal lesion.
    How does SMT work, Melzack and Wall Spinal Gate theory, descending modulation via PAG pathways and segmental reflexes, activity dependent synaptic modulation, reflexive stabilisation. Nothing clever there, well acknowledged.
    Why? because I enjoy helping people, the way I practice isnt for everyone, I dont harass people, I dont bullshit them, and if I dont think I can help I tell them, sometimes I get it right, sometimes I dont.
    Am I comfortable with what, how and why for me, yes. Will that evolve, yes it will because knowledge changes as you learn more.

    My thought is though, if you could rid the world of Subluxation based Chiropractic, would it change your “perspective” of Chiropractic if the only remaining practitioners were using well established evidence based models of practice?

    David

  221. Badly Shaved Monkey
    November 26, 2010 at 8:09 am

    My thought is though, if you could rid the world of Subluxation based Chiropractic, would it change your “perspective” of Chiropractic if the only remaining practitioners were using well established evidence based models of practice?

    Yes, I think so, because you would be restricting the scope of your activity to things that make sense.

    Where one would next head is towards looking at the relative risk:benefit ratios of your therapy versus others. But that’s as it should be for any aspect of medicine.

    I would then ask what it is that defines a “chiropractor” that so distinguishes them from other physical therapists that they require and deserve a protected title, separate regulation and privileges such as the right to perform radiography.

  222. Badly Shaved Monkey
    November 26, 2010 at 8:49 am

    Why do I think there is a problem with special regulation and recognition of chiropractors?

    Because they are tied to a very specific kind of physical intervention. This means they have a huge vested interest in protecting the role of that intervention and spreading its application, potentially in defiance of the evidence for it. It seems obvious that this is why they are so protective of their turf. That this is true is shown by moves to make chiros a first port of call for medical care http://www.sciencebasedmedicine.org/?p=8252 and all the stuff about needing regular “adjustments” for the maintenance of health.

    This makes no more sense than creating a certain class of doctors who can only treat disease by giving injections, protecting the title of Injector and creating a unique professional body to regulate them.

  223. Badly Shaved Monkey
    November 26, 2010 at 11:55 am

    Further to the above, and now I’ve got a few mins, I think chiros are particularly prone to these problems because, as with homeopathy, the founding father invented his therapy as a supposedly complete system of medicine. Rational chiros seem to be trying to dig themselves out from under this burden but the aims of the AUKC imply there is a widespread hope for a counter-reformation. 

    This is why I focus so heavily on “the subluxation”. It is the defining belief of chiropractic. Without it there seems to be a gaping void which the “straights” are too afraid to confront. 

    Testing belief in “the subluxation” looks to me like a good way to assess the mindset of an individual chiro. 

    David, how would you define chiropractic devoid of subluxations and why should it be its own profession yet avoid the dangers I outlined that face the one-trick pony therapist. 

  224. Badly Shaved Monkey
    November 26, 2010 at 3:23 pm

    Stefaan Vossen on November 24, 2010 at 10:19 pm
    and how did you do that? Or let’s correct that for “how do you think you did that?”
    You only claim victory for something that should have been clear to you ages ago.
    But then you state that not believing that subluxations cause disease is fallacious…
    Have you completely lost the plot?

    Stefaan, we’ve been through this. Either “the subluxation” exists, in which it does something and you interact with it during treatment and it has provable consequences, or it doesn’t exist in which case it doesn’t and you don’t and it is indistinguishable from the IPU.

    That roaring sound in your ears is the wind rushing past as you are hoist by your own petard.

    • November 29, 2010 at 1:45 pm

      Things can exist in a theoretical construct but may or may not exist in reality. That in itself does not make the theory untrue. It just makes it no more than a theory. A theory that one needs to believe in for it to be true (to the person believing it to be true). But that one needs to believe in a theory for it to be true, does not make it any less true.
      It just make the trueness of it less potent. Truthfulness is only ever an approximation, never an absolute (but that, on the contrary, is an absolute).
      Some theories may have semantic agreements which may not be the best or the clearest, but that in itself doesn’t make the theory untrue. It just makes the people that made those choices responsible for the confusion. But they are all dead now.
      Some theories lack the public (professional) agreement on meaning and interpretation to formulate testable parameters.
      That in itself does not make the theory untrue. It just raises the challenge of establishing an interpretation which is testable, then proceed to test it and see what the outcomes are. That, dear BSM is what I am doing-hence why this really is only the beginning, regardless of what you think.
      Some people have real problems with uncertainty and are of the opinion that unless the truthfulness of a theory is established to be above belief, it must be untrue. Tell Einstein that.
      Zeno and Simon Perry et al did not challenge the truthfulness of theory or even practicality, but of the truthfulness of individual chiropractor’s ability to make certain claims in regards to application of treatment.. That is sensible. What you’re doing on the other hand is just arrogant and deluded. Particularly if you bear in mind I already made clear my position on lack of evidence, lack of structure and lack of professional agreement on parameters. But all those lackings, do, in themselves, not lead to conclusion of falseness. That may indeed make it no less indistinguishable from the Invisble Pink Unicorn. Thing that you have to bear in mind though is that the conceptual idea of the IPU is one of derision and the idea of looking at causes for anomalous movement patterns as a cause for pain and discomfort is in my view not something to be derided readily. If you think otherwise, do so by all means but don’t expect me to think you’re clever for it.
      Stefaan
      This is only just beginning

      ps the way I work I see something, I interact with it and the consequences are predicable. Proof? That’s coming on nicely and I will keep you posted.

  225. Badly Shaved Monkey
    November 29, 2010 at 8:30 am

    @Stefaan
    This is only the beginning

    I think events now show it really isn’t.

    • November 29, 2010 at 1:55 pm

      What is it called again when someone thinks that only those things they see, understand and stand central to, exist and have value? Oh yes, narcissism.

  226. Badly Shaved Monkey
    November 29, 2010 at 4:35 pm

    @Stefaan

    A theory that one needs to believe in for it to be true (to the person believing it to be true). But that one needs to believe in a theory for it to be true, does not make it any less true.

    Oh, sorry, I thought we were talking about science, but you’ve been talking about fairies all along. Well, that explains it.

  227. November 29, 2010 at 5:34 pm

    @BSM
    Finally!
    It took you long enough to realise that.
    Of course C.G.Jung will point out to you that fairies are of course not just fairies….

  228. Badly Shaved Monkey
    December 7, 2010 at 11:35 pm

    OK. We won.

    Now, back to mocking homeopathy.

  229. December 15, 2010 at 1:50 pm

    ehm, no you didn’t.
    You finally, after much pointing out and explaining, finally realised that all your puff and bluster was as meaningless as we told you all along. Not quite a victory is it? Maybe a Pyrrhic one, but that is assuming that you care about how idiotic you look, but you make clear that you don’t in hiding behind pseudonyms and enjoying mocking people. Enough said.
    Stefaan Vossen
    This is only the beginning

  230. Badly Shaved Monkey
    December 15, 2010 at 2:28 pm

    Hey, Stefaan’s back. Here you go;

    Either “the subluxation” exists, in which it does something and you interact with it during treatment and it has provable consequences, or it doesn’t exist in which case it doesn’t and you don’t and it is indistinguishable from the IPU.

    Tell us, O wise one, how do you know you are manipulating a subluxation rather than an Invisible Pink Unicorn. Are they different colours?

    Meanwhile, I see your regulator has difficulty even deciding what the word evidence means.

    http://www.zenosblog.com/2010/12/humpty-dumpty-regulation/

    By the way, I used my real name once upon a time but found being stalked in the real world by alternative medicine loons to be unpleasant. One meets such nice people interacting with the alt.med. fraternity. They tend to be all sweetness and light until you actually challenge the core of their beliefs and ask them to answer some meaningful questions. Then they flounder, as you have done, then simply resort to abuse. It’s their loss. I find it funny rather than being hurt by it.

    • December 15, 2010 at 6:19 pm

      Hey bsm, as I have said to you before: a subluxation exists but is not a clinical entity it’s a philosophical umbrella concept. A subluxation can be many things and you know it’s there because it is anomaly to normal motion and function, resulting in tissue stress, weakness and pain.
      You seem to really struggle with that one and I don’t know why.
      On a side note: Make fewer silly claims, be less pedantic and condescending and maybe the abuse will reduce. Maybe there is something of a lesson in that for you? Anyone who holds it against you for changing your mind and improving yourself is a dick and there are laws to protect good people from bad people, so fear not!
      Regs,
      Stefaan

      • Badly Shaved Monkey
        December 15, 2010 at 6:47 pm

        Oh, you really want to be run around this circuit again do you?

        Fair enough, I can shoot if you want to dance.

        Give a single falsifiable prediction that employs the chiropractic “subluxation” where I can’t just insert Invisible Pink Unicorn and ask you to prove it isn’t pink.

        Remember, your “subluxation” doesn’t show on radiographs so has the distinct disadvantage of being a gross distortion of normal medical language, which is not a great starting point.

  231. Badly Shaved Monkey
    December 15, 2010 at 6:51 pm

    Look, for extra credit, here’s another challenge;

    Explain the difference between the “subluxation” that chiros believe to be present in eczema and the one that is present in bed-wetting

  232. December 15, 2010 at 7:14 pm

    Cowboy AND ill-mannered? No wonder you choose to remain anonymous…
    It’s not a piece of “medical language” it’s a piece of philosophical language. As such it is merely part of a belief system which can be subjected to testing by asking the research question “does removing stressors increase health and well-being?” That of course would be ridiculous, about as ridiculous as your rhetoric. I have already said that it is EXACTLY like the Invisible Pink Unicorn, OTHER than that there is a very feasible way of testing this one because it is really quite visible whether this old Unicorn has been down a certain path, or alternatively for the really dimwitted; whether a person got better or not.

    • Mojo
      December 16, 2010 at 11:36 am

      “As such it is merely part of a belief system which can be subjected to testing by asking the research question “does removing stressors increase health and well-being?””

      This statement would appear to be inconsistent with your earlier claim that chiropractic subluxations do not cause disease.

      And where do you get “cowboy” and “ill-mannered” from? The only place these term appear in this thread are in your own post above.

  233. Badly Shaved Monkey
    December 15, 2010 at 7:58 pm

    So, it’s an Invisible Pink Unicorn that “very feasible” to test. Excellent.

    What is the difference between the subluxation in eczema and the one in bed-wetting?

    Come on, there are chiropractic’s taking money every day for treating both conditions. Explain the basis of that treatment.

  234. December 15, 2010 at 9:10 pm

    well done!
    On bedwetting/eczema topic: I have no idea what you are talking about, I have never heard of a chiropractic treatment for either, unless we of course look at the possibility for relief in either arena when there is a reduction of some form of stress or tension when such tension or stress is related to the occurrence of the condition in a particular patient, other than that I think it is the silliest thing I have heard in some time.
    On the topic of IPU, I would personally choose more something like “it’s like gravity (bleedin’ obvious but invisible), but without the evidence (yet)”

    • Badly Shaved Monkey
      December 16, 2010 at 8:57 am

      @Stefaan;

      “On bedwetting/eczema topic: I have no idea what you are talking about, I have never heard of a chiropractic treatment for either”

      Well, you obviously don’t get out much among your chiropractic peers. Fair enough, you are not competent to comment. Unfortunately, the chiros who do claim to treat eczema or bed-wetting are doing so on the same basis of “subluxations”. Did you skip those classes at back-cracking school?

      “it’s like gravity (bleedin’ obvious but invisible), but without the evidence (yet)”

      Yes, exactly like gravity. I’ve never heard of gravity being measurable and I’ve never heard of any scientific test that would show the operation of gravity. Oh, wait a minute. There was this bloke called Newton…

      Which is it to be, Stefaan? Either the “subluxation” is an invisible, intangible, unmeasurable, unfalsifiable, redundant “philosophical concept” or it is a real physical process about which testable predictions can be made. You alternate between making each of these claims depending on which seems to get you off the most recent hook.

      • December 16, 2010 at 11:00 am

        Yes, like I said, invisble (like gravity) but without the evidence (yet). That, as far as I am aware, means that it is invisble (like gravity is invisble, we only see its effects) with the difference that gravity has been proven to exist (amongst others thanks to Newton, who was after all primarily a natural philosopher) whereas the concept of subluxation has not. Gravity is also very obvious in its existence through the visibility of its effects on all things existant within the universe, like it is obvious that sometimes people will become unwell and sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses. Or would you like to argue that this notion is fallacious?
        In fact for extra marks BSM, how about you argue that this notion, the core tenet to chiropractic philosophy is wrong… or at least has not even a plausibility to it. I warn you that if you can’t you must accept that the core tenet of chiropractic philosophy is plausible at least in theory. After that I will propose to you that the term subluxation is an umbrella term to represent all possible causal agents to physical, chemical and emotional stress. Then I will propose to you that vertebral subluxations are anomalously functionaing vertebral units, which are a sub-set of physical subluxations, together with amongst other TMJ and gait subluxations (and I would personally prefer to use another word but I continue using this one so you could finally come to comprehend their individual meaning). I am by no means implying that this view is exclusive to chiropractic philosophy but it is chiropractic philosophy nevertheless…
        Good luck!
        Stefaan

      • Mojo
        December 16, 2010 at 11:38 am

        We don’t really need Newton to prove that gravity exists. Things used to fall even before he formulated his laws.

      • December 16, 2010 at 11:41 am

        Exactly Mojo, exactly…

      • Mojo
        December 16, 2010 at 12:38 pm

        On the other hand, the chiropractic subluxation diffweres from gravity in that it appears to be unobservable.

      • December 16, 2010 at 12:51 pm

        when did you last see gravity Mojo?

      • Mojo
        December 16, 2010 at 12:58 pm

        Are you sitting comfortably?

  235. December 16, 2010 at 1:11 pm

    Oh Mojo! You are so very clever! Now you are going to refer (ever so cleverly) to the effect of gravity on my physical body! Wonderful!! So clever!!
    As I said to BSM: “…like gravity is invisble, we only see its effects…”
    What were you saying again Mojo? Oh? You were goignt to refer to teh effect of gravity were you? Ah, yes, sorry we crossed that bridge already. Maybe you could start by reading the post, or better still can you maybe argue that chemical/emotional/physical stresses do not have the EFFECT of causing/increasing the probablility of well-being and health? Just because BSM has gone awfully quiet…
    Stefaan

    • Mojo
      December 16, 2010 at 2:08 pm

      But unlike gravity, the chiropractic subluxation is not only invisible, but also, according to you, has no effects (unless you are retracting your earlier position that it doesn’t cause disease).

      • December 16, 2010 at 2:39 pm

        Causing disease and predisposing to disease are two very different things old chap! In my text I quite clearly refer to predisposition: “sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses”.
        Also I would point out that the sentence: “But unlike gravity, the chiropractic subluxation is not only invisible, but…” implies that gravity, unlike a subluxation, IS visible. Are you telling me that gravity is visible? Or did you mean that “like gravity is invisble, but unlike gravity is has no effect (unless I am retracting my earlier statements-which as you now know I don’t, as you misconstrued my earlier statement of predisposition to be equatable to causality, which of course it isn’t.
        But that aside, what do you think of the principal tenet of chiropractic philosophy as proposed above? Plausible/implausible/idiotic?
        Stefaan

      • Mojo
        December 16, 2010 at 2:50 pm

        “Also I would point out that the sentence: “But unlike gravity, the chiropractic subluxation is not only invisible, but…” implies that gravity, unlike a subluxation, IS visible.”

        Only if you ignore the words “not only”, and the fact that the sentence continues after the “but”.

      • Mojo
        December 16, 2010 at 2:54 pm

        “Causing disease and predisposing to disease are two very different things old chap!”

        How are these “predispositions” detectable?

      • December 16, 2010 at 3:00 pm

        Little problem with that, but it might be my being a foreigner, but as far as I understand the English language the words “unlike gravity” would imply that it is so UNLIKE aka not like gravity, but nevermind, at least you know. How about an answer that has some meaning to it?

      • Mojo
        December 16, 2010 at 3:15 pm

        OK, how about an answer to this: how can you tell that predispositions to disease are caused by chiropractic subluxations?

      • December 16, 2010 at 3:19 pm

        How to detect predispositions to weakness, injury, illness? Well, I think we can discuss that at a later stage, as long as we can agree about the rest first? Just so I know I am not wasting my time away here you see…

      • Mojo
        December 16, 2010 at 3:28 pm

        “How to detect predispositions to weakness, injury, illness? Well, I think we can discuss that at a later stage, as long as we can agree about the rest first?”

        Could you give me a single clear statement of what you expect me to agree to, please?

        But never mind how to detect the predispositions: assuming that we can detect them, how can you tell that they are caused by the chiropractic subluxation?

      • December 16, 2010 at 3:48 pm

        “sometimes people will become unwell and sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses”

      • Mojo
        December 16, 2010 at 3:54 pm

        But never mind how to detect the predispositions: assuming that we can detect them, how can you tell that they are caused by the chiropractic subluxation?

      • Mojo
        December 16, 2010 at 3:58 pm

        “sometimes people will become unwell and sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses”

        I’ll agree to that, but it is a fairly trivial statement. OK, people sometimes get ill, and are sometimes predisposed to illness.

        Now, what has this got to do with the chiropractic subluxation?

    • Badly Shaved Monkey
      December 16, 2010 at 4:15 pm

      Um, not gone “awfully quiet”. Been doing the thing called working. Anyway, I’m getting some more popcorn now.

  236. Badly Shaved Monkey
    December 16, 2010 at 4:31 pm

    [puts down popcorn]

    “it is obvious that sometimes people will become unwell and sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses. Or would you like to argue that this notion is fallacious?”

    As Mojo says this is a trivial statement and is in no way a special claim of chiropractic. Correcting “subluxations” is the special claim of chiropractic.

    The distinction between ’cause’ and ‘predisposition’ is not an easy one to make. Whichever is said to be the case, to be a cause or a predisposition the “subluxation” must have an effect. These effects need to be reliably related to some quantifiable aspect of the “subluxation”, but you seem still to be unable to produce any evidence for such a quantifiable process. You seem to have moved back into the territory of claiming “subluxations” have effects. Let’s see how long we stay there before you revert to calling it an unmeasurable “philosophical concept”.

    [/popcorn again]

  237. December 16, 2010 at 4:51 pm

    (Yawn) Hi there bsm, how sweet of you to join.
    Like I said before, you really struggle with the difference between a philosophical discussion and a scientific discussion,… how about a bit more popcorn?
    A subluxation is a philosophical unmbrella term for any agent contributing to a mechanism which causes a chemical/physical/emotional stress. The effect of the “subluxation” is the stress. We could test by changing something and then see whether the stress goes down, right?
    Stefaan

  238. December 16, 2010 at 4:59 pm

    sorry it’s not teh stress that should go up or down (i.e. the variable) but the mechanism causing the stress (strictly speaking)

  239. Badly Shaved Monkey
    December 16, 2010 at 4:59 pm

    I knew it! We’re half way down that road again.

    You’ve reverted to saying that the “subluxation” is some piece of empty rhetorical bullshit that adds nothing to our understanding.

    Fine, if it’s a rhetorical device that has no practical implications that are neither trivial nor better referred to in ordinary biological language then there is no space left for such a thing to have any meaning and you are straight back from saying it’s like gravity with real observable effects to wanting it to be just like my Invisible Pink Unicorn except a different colour.

    Meanwhile you claim to alter this intangible thing by whacking people’s backs and others of your profession do the same to itchy kids and kids who wet the bed.

    It’s a funny old philosophical concept that gets changed by a whack on the back.

    “Ooh, there is geometric beauty in the architecture of the Parthenon.” [back-crack]. “Ooh, now it’s not beautiful at all.”

    • December 16, 2010 at 5:33 pm

      That’s right, it’s like gravity and all I am interested in is devising experiments to find out whether there is any evidence or not. But in order to devise the correct experiment, one must understand the rhetoric…

  240. Badly Shaved Monkey
    December 16, 2010 at 5:02 pm

    But, let us not forget that Mojo had a question for you. I wouldn’t want that to get overlooked by my recent detour.

  241. Mojo
    December 16, 2010 at 5:05 pm

    Assuming that we can detect predispositions to illness and injury, how can you tell that they are caused by chiropractic subluxations?

    • December 16, 2010 at 7:43 pm

      Because a subluxation is that which causes a predisposition to illness and injury… Duh!

      • Mojo
        December 17, 2010 at 12:48 am

        How do you know that subluxations cause a predisposition to illness and injury?

      • December 17, 2010 at 8:12 am

        Because we agreed that stresses can predispose to illnesses and injuries and that by their definition subluxations are causal agents to such stressors, ergo “subluxations” are causal agents to stresses predisposing to injuries.

      • Mojo
        December 17, 2010 at 10:04 am

        No, we didn’t. This is the statement we agreed on (see your post of December 16, 2010 at 3:48 pm):

        “sometimes people will become unwell and sometimes even be (further) predisposed to developing illness due to physical, chemical or emotional stresses”

        It says nothing about subluxations or indeed about any cause of predispositions to injury or illness. It just says that sometimes illnesses and predispositions to illness exist (I told you it was trivial).

        It does, however, state that predispositions lead to injuries and illnesses being caused by subsequent stresses. You are now claiming that it is “stresses” that cause the predispositions and that it is subluxations that cause these stresses.

        But putting this fresh source for potential confusion aside, you haven’t answered the question.

        How do you know that chiropractic subluxations cause predispositions to illness and injury? Assuming that we can detect these predispositions, how can we know whether or not patients exhibiting them actually have chiropractic subluxations, given that the subluxations cannot be detected directly but only inferred as a result of the predispositions you claim they cause? How can you possibly know that the predispositions are caused by subluxations, and not, say, by miasms, obstructed meridians, evil spirits, or other undetectable entities?

  242. Badly Shaved Monkey
    December 16, 2010 at 9:11 pm

    Can I suggest you answer Mojo’s question? It’s several steps further down that path.

    This “subluxation” is something you make money from every day of the week. We really should be past this point. As should all the chiros treatin eczema and bed-wetting.

    • December 16, 2010 at 9:24 pm

      Can I suggest to you that I don’t adjust subluxations every day of the weeek, nor do I treat eczema or bedwetting and nor do any of the chiropractors I know and I know a lot of chiropractors. As such I put it to you me’lud that you don’t know your proverbial ass from your proverbial elbow and that the notions you project as factual are no such thing.
      Stop being silly BSM and Mojo’s question is no further evolved then what I answered it with.

  243. Badly Shaved Monkey
    December 17, 2010 at 8:17 am

    Stefaan, is eczema a disease?

    • December 17, 2010 at 9:33 am

      It’s a chronic form of dermatitis classed by some as an allergic disease. Why?

      • Mojo
        December 17, 2010 at 10:05 am

        Do you class it as a disease, allergic or otherwise?

      • December 17, 2010 at 10:42 am

        Please start reading the replies Mojo; and allergic disease is a disease, is it not?

      • Mojo
        December 17, 2010 at 11:22 am

        I read your reply. It said, that eczema is “classed by some as an allergic disease”. You didn’t say whether you class it as an allergic disease, or indeed as a “disease” of any kind.

        So, Stefaan: do you consider eczema to be a disease?

      • December 17, 2010 at 12:23 pm

        Don’t be moronic,
        I don’t make the classifications.

      • Mojo
        December 17, 2010 at 12:46 pm

        Do you have an opinion on whether or not those who classify eczema as a disease are correct inthis classifictaion?

      • December 17, 2010 at 1:09 pm

        The classification is correct because it is the classification. Dura lex, sed lex. What difference does it make whether it is or isn’t a disease?

  244. Mojo
    December 17, 2010 at 11:27 am

    Anyway Stefaan, could you see your way to addressing the questions I asked above?

  245. Mojo
    December 17, 2010 at 11:30 am

    Just to make it a bit easier for you, here they are again:

    How do you know that chiropractic subluxations cause predispositions to illness and injury? Assuming that we can detect these predispositions, how can we know whether or not patients exhibiting them actually have chiropractic subluxations, given that the subluxations cannot be detected directly but only inferred as a result of the predispositions you claim they cause? How can you possibly know that the predispositions are caused by subluxations, and not, say, by miasms, obstructed meridians, evil spirits, or other undetectable entities?

    • December 17, 2010 at 12:52 pm

      One last time: a subluxation is a philosophical umbrella term that contains a wide number of clinical entities who in turn can be noted through clinical observation, tests and questionnaires.
      On a side-note, I believe that “miasms, obstructed meridians, evil spirits, or other undetectable entities” are similiar theoretical attempts to classify, organise and legitimise those clinical presentations which seem to respond in ways that conventional classification does not predict or legitimise.
      Stefaan

      • Mojo
        December 17, 2010 at 1:13 pm

        You appear to be redefining the chiropractic subluxation as “any unknown cause of predispositions to illness or injury”, and effectively synonymous with miasms, obstructed meridians, and evil spirits. Does it not occur to you that this is not a terribly useful definition, since it can provide no indication as to how these “subluxations” can be treated or rectified? All it amounts to as far as dealing with patients is concerned is “you have something causing a predisposition to illness, but I haven’t the faintest idea what it is”. Is this what you tell your patients if you diagnose them as having a “subluxation”?

      • December 17, 2010 at 1:43 pm

        Yep, pretty much (not quite those words though), other than that, I would also have you note unequivocally that I don’t “treat” illness, as the word treat implies predictable outcomes, which I cannot offer on illnesses. I do on the other hand predictably provide solutions to biomechanical pain. So I guess, one could say that I treat certain cases of back pain, but this is predictably achieved by improving motion patterns (the stressor) by changing the causal agent (the subluxation). This can be done by improving occlusional patterns, gait patterns or spinal motion patterns. If the latter is required in teh treatment and management of teh patient in front of me, then I will offer them my care with the words “I am setting out to improve your movement pattern that you happen to get better in consequence is a predictable by-product. It is the reason you think I am treating you but it is in fact the reason why you think it appropriate to pay me. The reason I personally treat you for is to improve the way you move.” This will then be followed by time-frame, treatment protocol and costs. Recovery rates within two, four, six and eight weeks are given and the money-back guarantee is explained.
        Whether any of this actually redefines chiropractic care, I am not sure, I just think it updates tha language and refines the applications, but the basics were always there… Like I have said before, no-one within the chiropractic profession is actually argueing with my interpretation of the chiropractic theory, but you of course may know more about the theory than the chiropractors I have proposed this interpretation to and in consequence I am quite happy to listen to your argument that my view point is a redefinition rather than an alternative interpretation of the original definitions…? Why do you think it is a redefinition?

      • Mojo
        December 17, 2010 at 2:13 pm

        Because all the definitions of the chiropractic subluxation I’ve seen involve partial dislocations and consequent disruption of nerve function.

        Incidentally, how do you differentiate the sort of “chiropractic” treatment you are describing from physiotherapy?

      • December 17, 2010 at 2:33 pm

        No, partial dislocations are subluxations, not chiropractic subluxations.
        My first education was as a physiotherapist. There are many differentiating factors between what I do as a chiropractor and what I did as a physiotherapist.
        Stefaan

      • Mojo
        December 17, 2010 at 2:56 pm

        Such as?

      • December 17, 2010 at 3:44 pm

        Go and have a look at the respective syllabi.

      • Mojo
        December 17, 2010 at 4:58 pm

        You can’t even describe a single difference?

      • Mojo
        December 18, 2010 at 3:40 pm

        Re the definition/redefining of the chiropractic subluxation – I should have said dysfunction rather than dislocation. I was probably thinking too much of the medical definition of the term. But if the chiropractic subluxation is not actually a subluxation, why use the term?

        Anyway, your very broad definition of the chiropractic subluxation would certainly differ from the rather more specific defintions I’ve previously seen, which seem to involve some sort of joint dysfunction with consequent nerve (and other) dysfunction, see for example the WHO’s definition:

        Subluxation1
        A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity.”

      • December 19, 2010 at 6:59 pm

        I didn’t want to bruise your ego, let’s just leave it to that.

  246. Badly Shaved Monkey
    December 17, 2010 at 2:42 pm

    Stefaan, many of the 523 chiropractors against whom complaints have been made to the GCC make claims to treat non-musculoskeletal diseases.

    http://www.thinkhumanism.com/files/GCC%20Complaint%20for%20web.pdf

    You have invoked “subluxations” as a general process underlying disease. Do you agree that “subluxations” underlie the non-musculoskeletal diseases as claimed by your colleagues? The list includes eczema and bed-wetting, of course.

    You did say on December 15, 2010 at 9:10 pm;

    “On bedwetting/eczema topic: I have no idea what you are talking about, I have never heard of a chiropractic treatment for either”

    Well, it turns out that we and many of your colleagues have heard of it.

    • December 17, 2010 at 3:43 pm

      I assume that you know that I have such a complaint against me? But I assume you don’t know that the complaint was against a site I had no control/authority over. For some of the people amongst that number I would argue (and know for a fact) the same is true. For some others it will have been because they lazily and unthinkingly copied what was the “approved list” as provided by implication of the GCC’s listing of these conditions and for some others still it will be because they are using the words “treat” in an inaccurate and uncritical manner due to lack of critical thought, laziness or apathy, and for very few it may be that they actually believe that a subluxated vertebra can trap a nerve which then directly affects the organ at the end of that nerve. I would argue that the latter group, the relevant group to your point of view, is a very small minority and can easily be dismissed as dangerous under-educated lunatics. This, I would argue will be representing less than 20 people out of that total figure you mention, were I to hazard a guess.
      Your inference that many of my colleagues have heard of a treatment for bedwetting is very largely erroneous and the notion that a large section of the workload we see is non-musculo-skeletal is even more so. Regardless of what presume these numbers and stats infer, they, as is often the case with numbers and stats, are I sincerely believe, not representative of the truth.
      Stefaan Vossen

  247. Badly Shaved Monkey
    December 18, 2010 at 4:25 pm

    Just thought I’d repeat some of Stefaan’s words;

    For some others it will have been because they lazily and unthinkingly copied what was the “approved list” as provided by implication of the GCC’s listing of these conditions

    The implications of that statement run in all sorts of directions.

  248. Badly Shaved Monkey
    December 18, 2010 at 4:31 pm

    Oh, an another thing

    Stefaan Vossen on November 10, 2010 at 7:05 pm
    “Think not of pixies (even if the band was really worthwhile listening to), but rather of the meaning I attempted to extend to the CSC and how it differs from a subluxation, the way we both understand it. ”

    @Stefaan Vossen on November 12, 2010 at 8:45 am
    “In response to the explanation I gave about CSC and how it is a theoretical concept with in itself little clinical legs you replaced both “subluxation” and “CSC” for “evil pixies”, thereby creating a solipsistic and tautological logically fallacy in your argument as it was key to the discussion that I differentiated the two terms to be different and distinct. One being a clear and obvious clinical entity, which you agreed exists, and the other being a theoretical construct underpinned by beliefs.
    How about you let me know what about the theory is bonkers, plus if possible give a reference that these statements you make are actually based in the theory rather than the interpretation by some individuals.”

    Stefaan Vossen on December 17, 2010 at 12:52 pm
    “I believe that “miasms, obstructed meridians, evil spirits, or other undetectable entities” are similiar theoretical attempts to classify, organise and legitimise those clinical presentations which seem to respond in ways that conventional classification does not predict or legitimise.”

    So, after all this, it turns out to have been evil pixies and their kin. Amazing.

  249. Badly Shaved Monkey
    December 18, 2010 at 4:35 pm

    And to give an explicit answer to Stefaan’s question,

    How about you let me know what about the theory is bonkers

    The answer is,

    Because you invoke evil pixies

    </iplus if possible give a reference that these statements you make are actually based in the theory rather than the interpretation by some individuals.

    That would be a chiro called Stefaan Vossen on this blog on December 17, 2010 at 12:52 pm

    Right, now I’m going to watch the snow some more.

    • December 19, 2010 at 6:56 pm

      @bsm
      1. At no point do I invoke evil pixies. You do. And you create a serious logical fallacy in the process.
      2. I ask you for a reference from theory and not individuals. In argument you quote me. An individual.
      On both counts: zero points. And because you still cannot differentiate between a theoretical construct which happens to use confusing terminology on one hand and a clinical entity on the other, you fail to answer the question, but rather deride by implication offering no real argument. A poor attempt at bamboozeling the reader, I am afraid.
      So for your ease, let me ask you the question differently: is it bonkers, according to you, to seek to improve the quality of function in order to reduce stressors? And is it bonkers to believe that in certain cases removing/reducing stressors may improve well-being? Because that is what in my view chiropractic theory was constructed to set out.
      I can only comment from my personal views and opinions, and what you find here is exactly that; my view and opinion.
      Stefaan Vossen
      This is only the beginning

  250. Mojo
    December 20, 2010 at 5:23 am

    “At no point do I invoke evil pixies.”

    Pretty much:

    “Yep, pretty much (not quite those words though)”

    • December 20, 2010 at 8:32 am

      Conceptually speaking, and in the context of theoretical constructs one can call “subluxation” by any one term one wishes, as long as the term is chosen in such a manner that the semantic principle retains its original meaning. “evil pixies” is a set of choice word, like any other and therefore qualifies for the first criterium (i.e. it’s a word) but does not for the latter (i.e. it attempts to attach derogation and ridicule to the meaning and does not respect the original meaning). So indeed, “pretty much (conceptually speaking) but not quite those words”, I do not invoke “evil pixies” at any point and therefore the argument laid out by bsm is false.
      How about an answer to: “So for your ease, let me ask you the question differently: is it bonkers, according to you, to seek to improve the quality of function in order to reduce stressors? And is it bonkers to believe that in certain cases removing/reducing stressors may improve well-being?”
      So, is it, Mojo? Or are you so blinkered by your preconceptions of the profession that you fail to remain objective and sceptical of the chiropractic profession? How many idiotic claims to physios make in the UK Mojo? I was appalled about this when I first came to the UK. In fact, in Belgium we weren’t even allowed to advertise full stop. Maybe something to consider in this country?
      Stefaan Vossen

  251. Badly Shaved Monkey
    December 20, 2010 at 8:21 am

    At no point do I invoke evil pixies. You do. And you create a serious logical fallacy in the process.

    Indeed, you are right. I invoked evil pixies while you said, “I believe that “miasms, obstructed meridians, evil spirits, or other undetectable entities” are similiar theoretical attempts to classify, organise and legitimise those clinical presentations which seem to respond in ways that conventional classification does not predict or legitimise.”

    My mistake. But I am intrigued to know how evil pixies cannot be among those “other undetectable entities”. 

    2. I ask you for a reference from theory and not individuals. In argument you quote me. An individual.

    You have appointed yourself as mouthpiece for chiropractic here.  If you cannot accurately answer for its theory then perhaps you should withdraw. 

    On both counts: zero points. And because you still cannot differentiate between a theoretical construct which happens to use confusing terminology on one hand and a clinical entity on the other,/i>

    No, Stefaan, I am well aware of the distinction you are drawing between a real subluxation demonstrable by physical diagnostic methods and something chiros call a “subluxation”. What we have shown is that your “subluxation” is either empty and redundant rhetoric or is a real physical process that would have real physical effects distinguishable from other physical processes, but neither you nor any other chiro can show this. 

    it bonkers, according to you, to seek to improve the quality of function in order to reduce stressors? And is it bonkers to believe that in certain cases removing/reducing stressors may improve well-being?

    Well, that’s fine as a statement of the bleedin’ obvious but every quack from homeopath to reflexologist would claim to do the same and so would real, effective medicine. 

    Because that is what in my view chiropractic theory was constructed to set out.

    And does so either erroneously or redundantly. 

    I can only comment from my personal views and opinions, and what you find here is exactly that; my view and opinion.

    That’s not a Get Out of Jail, Free card. You make very authoritative-sounding assertions as if you know what chiropractic is supposed to be. If you can’t tell us about chiropractic then this is all a bit pointless. 

  252. December 20, 2010 at 8:46 am

    So you agree with what I understand to be the albeit obvious assertions of chiropractic theory.
    But then you state that it does so either erroneously or reduntantly… which one is it to be? Redundant or erroneous. They are quite different you know.
    Re authority; if you think that I am an authority because I am making authoritative-sounding assertions then I would advise you question your ability to remain sceptical… Anyway your rhetoric is irrelevant as the question was levied against a criticism you make against the theory as you understand it, and I therefore ask you to back that up. My view point is different to your interpretation and I think mine is correct and yours is wrong. Therefore my opinion is irrelevant to the discussion if we are setting out to identify whose interpretation is right and our only point of reference could only be the theory itself. Good luck

  253. Badly Shaved Monkey
    December 20, 2010 at 5:28 pm

    But then you state that it does so either erroneously or reduntantly… which one is it to be? Redundant or erroneous. They are quite different you know.

    Yes, I know. They are the mutually incompatible consequences of your arguments in favour of chiropractic “subluxations”. So it’s your problem, not mine. My saying it represents a QED on the logical consequences of your notions.

    Since, you have missed the point I’ll repeat it. Either the chiropractic “subluxation” is redundant or it is an erroneous construct.

    That’s all. We win.

  254. December 20, 2010 at 5:54 pm

    You seem very taken by the notion of winning,… Interesting childhood was it?
    Nevertheless, can you please explain to me how redundant and erroneous are mutually exclusive? You are all bluster aren’t you? In fact many of your statements are both erroneous AND redundant, so that is another false argument.
    Sorry no win
    Stefaan

  255. Badly Shaved Monkey
    December 20, 2010 at 7:49 pm

    The “subluxation” is either redundant: incapable of being declared right or wrong and is mere word salad.

    Or it is erroneous: capable of being right or wrong, and actually being wrong.

    It can’t be both. Hence they are mutually incompatible.

    Obviously in a wider context, one could come with things that are both redundant in the given circumstances and also erroneous. Then they are not mutually incompatible. But we’ve reached a point with the particular facts and arguments that have been put forward to say that, in these circumstances, they are.

    Why do you have a problem with the notion of winning? In an argument, one side may be correct and show the other to be incorrect. That’s called winning the argument. What was the point of this discussion if not to find out who was right and who was wrong? There are circumstances where all sides can be said to have a valid viewpoint and sharing them is interesting. This is not one of those circumstances.

  256. December 20, 2010 at 8:27 pm

    Sorry bsm, but you’re actually talking shite.
    Erroneous is not “capable of being wrong” it is “based or derived from an error”. The rest you’re writing on that topic, therefore does become “redundant”.
    The subluxation concept as I proposed it to you is “capable” of being proven right or wrong, but so far you insist on not understanding that the notion, at its simplest is perfectly respectable and applicable. All one needs to do is identify the reason why a person moves badly and one will be staring the subluxation in the face.
    I clearly need to be very careful with you as you not only misquote me, attribute statements I did not make to me but now you also come up with fictitious definitions.
    Golly bsm, you sure are a liability in argument

  257. Badly Shaved Monkey
    December 20, 2010 at 10:32 pm

    OK, more TEFL.

    Erroneous is not “capable of being wrong”

    I said;

    “Or it is erroneous: capable of being right or wrong, and actually being wrong.”

    I was obviously being too elliptical.

    What I could have said was;

    Or it is erroneous, in which it would fall into that category of things which is capable of falsification. That is to say, if true, it could be shown to be true, whereas, if false, it could be shown to be false. It has been shown to be false.

    I said what I meant and I meant what I said.

    Clear now?

  258. December 20, 2010 at 11:02 pm

    So it (the theory) could either be false, or it could be true or it could on the other hand be redundant if it can’t be either false or true. i.e. it is either falsifiable or, if it is not falsifiable it is redundant. Oh wonderful, but that is far from what you were stating (eliptical? non-sensical you mean) as falsifiability is in no way mutually exclusive to redundancy (i.e. a theory can falsifiable and redundant at the same time, as well as it can be unfalsifiable but not redundant as falsifiability may have technical limitations).
    Your statement: “Either the chiropractic “subluxation” is redundant or it is an erroneous construct.”
    So, in your “elliptical” rhetoric erroneous may just as well mean correct? So according your little crawling back of semantic pride,… are you basically saying that your revelation to me is that: Either the chiropractic “subluxation” is redundant or it is an erroneous or a correct construct? No shit Sherlock. May I just point out that you still have not indicated or given any reason why it (the theory) “has been shown to be false”. Which is all I have been asking for quite some time now, but you have been unable to answer (although you like to claim a “win”-yet again without substantiation). So, just you don’t get too confused: what, in your opinion shows that the chiropractic theory has been shown to be false? Or is that not what you meant (again)?
    Stefaan Vossen
    This is only the beginning

  259. Badly Shaved Monkey
    December 21, 2010 at 8:16 am

    Oh, good grief!

    It is either redundant. It is incapable of being demonstrated, tested and distinguished from evil pixies or miasms. 

    Or it is not redundant because it makes falsifiable predictions about its special properties; properties that chiropractors uniquely interact with. Chiropractors, nor anyone else, can show us a picture or point to a needle on a meter that proves its existence. To the normal standards of empirical science it is a falsified hypothesis. You will probably reply with something trite like “absence of evidence is not evidence of absence”, except that statement is only strictly true if no evidence has been sought. 

    I’m not retracting anything, I’m just trying to explain something to someone who has insisted on presenting mutually incompatible ideas according to the happenstance need of the moment. In case, you get stuck on this one, I’m talking about a different dichotomy, though related to the other. In this one you have asserted that “subluxations” are a label for something unquantifiable and unmeasurable; a matter of faith and belief like evil spirits. But then, almost in successive words, you have asserted that it has measurable effects like gravity. Now it has, I suppose, to be acknowledged that this last position contains another bifurcation because you could be describing a process special to chiropractic, in which case you get to give it a name, though not something stupid and confusing like “subluxation”, which is simply an abuse of language, or it is a redundant description of something described better by other words, so it’s a redundant concept again. 

    Plainly, that is all deeply confused, but that’s because it is a summary of your ideas and they are deeply confused. 

    My position is quite simple. “Subluxation” is empty rhetorical bullshit. The word was invoked by chiros who really thought misaligned vertebra underlay all medical diseases. When this was shown to be profoundly stupid and no such physical lesion could be shown it retreated to being an unhelpful label, and the need for inverted commas arose, for absolutely everything that disturbs homeostatic equilibrium, but which chiros still think they can fix by whacking your back. Sounds pretty dumb, but it’s not my profession so I get to describe it without having to defend it. 

  260. December 21, 2010 at 9:02 am

    Let’s keep this simple. On the one hand chiropractic theory is, until evidence is sought, rhetorical bullshit. I agree. Whole-heartedly. On the other hand it is a theory, which like any theory remains theory until it has been proven, in which case it become fact or falsitude. It is however disingenuous to call a theory “bullshit” just because it has not yet sought evidence. Was Einstein’s theory of relativity “bullshit” until blackholes were discovered? Your bias is painfully obvious and your condescendence measurable. If on the other hand you feel it was bullshit until blackholes were discovered then, within the boudaries set by your extreme view point, I will agree that it is similar to Einstein’s theory until blackholes were discovered.
    Secondly, you seem to confuse yourself immeasurably due to your mixing up of the theoretical aspect, which one minute you declare as “bonkers” and the next minute as “obvious” and on the other hand the practical aspect of “subluxations” which you say I asserted to be “a label for something unquantifiable and unmeasurable; a matter of faith and belief like evil spirits”. I did not. In the process you yet again misrepresent what I am actually stating and seem to be indeed deeply confused.
    Make it clear in your own mind, for once and for all that it is pointless testing a theory unless it has some plausibility to it. I have come here to propose to you an interpretation of the theory which I believe to be more refined and above all testable. What other chiropractors believe the theory to be interpreted as is their problem, I am only interested in you challenging my view of the theory so I can set out to test it. Hence why I am keen for you to find error in the interpretation I gave the theory. I have made clear in multiple posts that I claim no authority but you allocate to me representational authority regardless.
    I ask you very simple questions to see if you can fault my interpretation of the theory, you so far have not been able to. You called it bonkers, but have been unable to substantiate that statement. You make broad-sweeping statements about chiro’s believing that they can fix absolutely anything that disturbs homeostatic equilibrium by whacking your back. Which is both utter and unsubstatiated non-sense and in direct contravention with what I proposed to you. Let me worry about the practical aspect of the testing and let’s just stick to the thing you are actually criticising aka “the theory”. Just so you don’t get anymore confused then you already are. Theory on one side, practicalities on the other. Separated for now. So: Do you, in theory, agree that removing causal agents to abnormal or inefficient function is likely to in some cases improve health and well-being and reduce the occurence of injury. Yes or no?
    Can’t be that hard.
    Stefaan
    ps please stop misrepresenting my statements, it’s unbecoming

  261. Badly Shaved Monkey
    December 21, 2010 at 3:46 pm

    “So: Do you, in theory, agree that removing causal agents to abnormal or inefficient function is likely to in some cases improve health and well-being and reduce the occurence of injury. Yes or no?”

    Yes. Chiropractic makes no unique statement if that’s all it says. 

    Black holes are a prediction of Newtonian physics, but never mind that. You are correct that there are predictions from Relativity that Newtonian Gravity would not predict. Testing for these distinguishes the theories and shows Relativity to be better. What prediction is made by the “theory” of the chiropractic “subluxation” that would distinguish it from any other theory of disease pathogenesis? I keep asking about its falsifiability, but to no avail. 

    I am not confused about “subluxations”, the silly idea of chiropractors, and subluxations that can be shown practically by real medical tests. If chiros restricted themselves to saying they whack backs to relieve pain and forgot all their other pretensions then they might merely be wrong that their methods are any better than anything else. You’d still have no business using the word subluxation without an ability to demonstrate that one exists consistent with the normal use of language in the rest of medicine, anything that resembles DD Palmer’s claim to have cured deafness is bonkers and the hypothesis behind it is bonkers. 

    (By the way, I’ve just consciously  registered one source of confusion. You are confusing theory and hypothesis, which is not helpful. You also use theoretical when you mean abstract or hypothetical at different times. But I can’t speak Dutch or Flemish.)

    I’m also still going to say that your ideas are trite, where they are true, and bonkers where they are either wrong or incapable of being judged right or wrong.

    Really, it all boils down to one thing. Make one prediction from your “subluxation” hypothesis and how it has been tested or could be tested. 

  262. December 21, 2010 at 4:57 pm

    Dutch and Flemish are the same, but I do speak Italian, French and German too.
    Newtonian physics did not accurately predict black holes, Einstein did. For your information one-way passage through black stars (Laplace and Michell’s black hole precursor) is impossible and as such black stars are not an accurate precursor to black holes.
    Thank you for your time. I am glad you now understand that my interpretation of chiropractic theory may at best be trite and that as you have no knowledge of the predictive capacities associated to my interpretation of the chiropractic theory you will, until proven otherwise have to veer on the side of caution and must include “and at best trite” whenever you write that the theory is “bonkers”.
    This inclusion of nuance will suit you well and I hope you will now see some sense in being less condescending and obtuse.

    Merry Christmas
    Stefaan Vossen
    This is only the beginning

  263. Badly Shaved Monkey
    December 21, 2010 at 5:17 pm

    http://www.chiropracticlive.com/?p=1036

    In which, Stefaan, tells us again that there is no coherent base for chiropractic. He does this with a large dose of Ad Hominem comment, which might be regarded as “unbecoming”.

    Hey, ho. Back to the fun.

    Stefaan, state your hypothesis and your test.

  264. Badly Shaved Monkey
    December 21, 2010 at 6:07 pm

    By the way, we must have cross-posted. Yes, the non-relativistic object is a “black star” I was tryingto remember the term before I posted. I didn’t look it up because it’s a bit tedious reloading this page on a phone.
    Cheers

  265. December 21, 2010 at 8:15 pm

    No worries, was good fun, hope you got the full gist of it though and I wouldn’t have done it if you weren’t an anonymous poster ;).
    Just one last thing: it wouldn’t be an “ad hominem”, as for my argument to be an argumentum ad hominem, my position would have to be such that I imply or state that your argument is fallacious because you are narcissistic puppet. I in fact stated that you had a point despite being a narcisstic puppet. That’s an insult, not an ad hominem. Skepticat makes that mistake regularly so I thought it should be corrected once and for all. Point is: I don’t know if you are or not, it just serves me well to point out to you the mistakes you make. Only to take you down from this self-=indulgent pedestal you seem to inhabit. I would also like to make it clear thta the only reason I do so is not out of malice or malevolence, just because I sincerely hope that one day we can debate like grown ups and come to some constructive discussion rather than this puerile vocabulary show-down.
    Best regards,
    Stefaan Vossen

  266. Badly Shaved Monkey
    December 21, 2010 at 11:49 pm

    Stefaan, state your hypothesis and your test.

  267. April 5, 2011 at 8:04 pm

    Very interesting article. I have gone to chiropractic care after major accidents and now have adopted it as a part of my health maintenance. I would recommend it to anyone suffering from back pain or anyone who is just trying to maintain a healthy lifestyle.

  268. TomB
    June 1, 2011 at 12:00 am

    A very apt article.

    My sister-in-law was suffering from migraines and a friend recommended a Chiropractor. She went, the Chiro “adjusted” her neck, and now she’s paralyzed.

    If someone recommends a Chiro to you, they don’t know what they are talking about.

    • Badly Shaved Monkey
      June 1, 2011 at 8:09 am

      Is this in the UK? Are cases being pursued with the GCC and in the courts?

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