A Carnival of Bogus* Chiropractic

One of the side effects of the BCA vs Chiropractic libel case is that there are a growing number of people who now realise that Chiropractic is bogus*. Even though Simon Singh may well have suffered a set back from a judge who according to the law can define words as he sees fit, we are now seeing increasing exposure to the bogus* practices of the chiropractic trade.

One way to show the ridiculousness of the legal decision and of chiropractic would be to have a little blog carnival on the bogus* nature of chiropractic claims and practices, and so I suggest that sceptical bloggers and writers help out by doing the following…

1. Find a chiropractic claim from an association or practitioner and examine the evidence for it critically. Look at Cochrane reviews (if they exist), papers and the basic science behind the claims. Write to the claimant involved and ask them for their evidence for their claims.

2. If the evidence for effectiveness is lacking, call it a bogus* treatment.

3. Let me know what you have written and I will do a round up in a few weeks. Email me or twitter me @lecanardnoir.

4. Spread the word. Twitter like crazy.

I am on hols at the mo, so can I suggest all entries are emailed to me (see my ‘about’ pages) so that the carnival will appear y June 5th.

I think with not much effort we could turn the chiropractic google space into  a web of critical articles. That would be a small step in the right direction.


* deliberate deception not implied.

62 Comments on A Carnival of Bogus* Chiropractic

  1. I came across a local chiro who was using the title 'Dr' on his website. This is definitely a bogus claim, so I checked with the General Chiropractic Council (GCC, http://www.gcc-uk.org) who confirmed they should not be doing this. I have written about this in more detail, including exactly what the GCC said on Think Humanism at http://www.thinkhumanism.com/phpBB3/viewtopic.php?f=14&p=54535#p54535. I will also complain to the BCA and my local Trading Standards.

    I'm sure this won't be the only one and will be looking through other chiro websites for any sort of bogus claims.

  2. I looked up a few of my local practitioners, and on the first one I found the claim: “Chiropractic treatment has been proven to be effective in managing the following conditions: * Back pain and sciatica * Neck pain or whiplash * Arthritis and Joint Pains” blah blah blah (a long list of conditions, including some of children).

    The others I looked at use more cautious language, such as “Conditions commonly treated by chiropractors include…” or use the word “may”.

    What would be interesting to hear from others (maybe some have experience of this kind of thing) is, what sort of approach to a chiropractor might be more useful in eliciting information about their views on the evidence base for their trade? I guess that some kinds of question might provoke a negative reaction. Perhaps one should pose as a potential client?

  3. “BCA vs Chiropractic libel case” – is that a Freudian slip? They certainly are not helping their cause…


  4. I think it’s worth pointing out that Health Food Manufacturer’s Association routinely complain about advertisers of health foods for making unreasonable claims about their products. I’ve never seen the BCA do this. I think it could be worthwhile taking the BCA to task as disciplinarians of their own field.

  5. Jack of Kent: LOL! I thought your blog post of the McLibel case was very apt in terms of the damage the BCA are doing for themselves.

    Eveningperson: They use weasel words all the time. If they had evidence for what they do they would use the ‘cure’ word. Instead, they try to con the public by saying ‘it has been used to treat’ and other such nonsense. Many people will simply read that as the same as being ‘effective’.

    Getting a complete list of BCA members is easy as is extracting the ones who have a website. If anyone is interested in a complete list (of those with websites), it can be downloaded from Think Humanism at http://www.thinkhumanism.com/files/BCA%20websites.txt. If anyone wants a complete list of all BCA or GCC members, let me know.

    Are you on Bad Science Forum?

    (Alan Henness)

  6. Ok. Here is one from my nearest backcracker/neckwrencher.

    “”””” With a healthy spinal column, a child’s body can better deal with sore throats, ear infections, stomach-aches, fevers, and the hundred-and-one other problems that often make up young life. Without Chiropractic care some children will live in continued sickness, condemned to a life of taking medicines and perhaps even surgery.

    Chiropractic care has been beneficial in a wide range of child-hood ailments, including:

    – ADHD
    – Asthma
    – Bedwetting
    – Colic
    – Poor posture
    – Allergies “””

    I love the weasel words, the scare tactics and the complete lack of any evidence for the claims.

    Although I suppose “has been beneficial” is not weaselly and could be picked up on. Simply show us the evidence.

    The front page gives the game away with:

    “””””See a Chiropractor and make Chiropractic care part of your healthy lifestyle”””

    Which translates as “give us your fooking money for life and we will do nothing in return”.

    I always wonder which part of this “safe and gentle” treatment ruptures your arteries.

    I am torn between complaining to Woking TS or firebombing the place.

  7. @John H

    “I am torn between complaining to Woking TS or firebombing the place.”

    By all means state your opinion, however there is no need for that. You do not gain respect by writing things like that.

  8. Anonymous (if that’s your real name) – I reckon he might have been joking.

    Anyway, LCN – might be worth also getting people to backup the urls of the places they contact, CAMs have a habit of playing about with websites and denying the previous evidence. Using something like backupurl.com might be helpful.


  9. I’ve recently looked at BCA members Bassett Chiropractic and found that the evidence didn’t seem to support their claims that their chiropractors help people with (among other things) whiplash injuries and headaches. I’ve emailed them now and asked what evidence they’re basing their claims on.

  10. Anonymouse

    I was rather thinking along the lines of the Smith and Jones Das Kapital reading group sketch (although it could have been NTNON).

    As you have converted me to the path of righteousness I will refrain from torching the quacks.

  11. It would appear that OfCrack chucking you out of the fraternity of BackQuacks carries about as much clout as the Dennis The Menace fan club chucking me out for cruelty to Gnasher. (DING DONG)

  12. John H,

    “I am torn between complaining to Woking TS or firebombing the place.”


    I take it all back.
    You indeed have a keen sense of humour.


  13. Hey

    Just been looking at the website for my local back quack


    Here’s the list of treatments for children
    Prolonged crying
    Sleep and feeding problems
    Breathing difficulties
    Difficulty passing stools
    Frequent infections, especially in the ears

    Bedwetting seriously, surely this would be physiological or a bladder problem, going to ask them how they treat that with spinal manipulation.

    Apparently they are all doctors as well.


  14. having taken a look at the Basset Chiropractic website I noticed that they can’t even spell carpal properly which speaks volumes about their anatomical knowledge outside of the spinal column . . .

  15. It is very difficult to know what kind of situation will be faced with a doctor, so it is preferable to conduct a comprehensive and thorough checkup from time to time and thus avoid these cases.

  16. Norco

    Sorry but I find your post incomprehensible.

    Is your point that you should go to a back quack periodically (as they suggest, and incur costs accordingly) so that you do not need to go to the doctors.

    And you should avoid going to the doctor because you do not know what situation you will be faced with when you get there ? (What sort of doctor do you have ?).

    If so then you have lost me.

    Why not ignore the back crack quack entirely and go to the doctor when you are ill. Oddly enough this plan seems to work for most sane people.

  17. What I would like to know and this is a completely innocent question from someone who is on the fence, is something like back surgery “quackery” too? Is there double-blind, placebo controlled studies such as those that are required from the chiropractics? It confuses me as common sense indicates that it would be impossible. Any help clarifying this matter would be good.

  18. Wrysmile

    That was an interesting list of childhood ailments you published. My nearest arterial rupturer has pretty much the same on their website.

    – Colic
    – Asthma
    – Prolonged crying
    – Sleep and feeding problems
    – Breathing difficulties
    – Hyperactivity
    – Bedwetting
    – Difficulty passing stools
    – Frequent infections, especially in the ears

    It seems to me that most of these ailments are self limiting and will clear up over a given time period. The dictionary definition of colic is actually “”a form of pain in the abdomen which starts and stops abruptly“. Asthma, bedwetting and constipation will all go away. Ear infections come and go – Calpol usually makes them go. Most parents will have had some combination of these minor ailments with their children and get over them without recourse to an expensive and non-scientific massage parlour.

    Although some of them could be symptomatic of serious illness (prolonged crying maybe in response to pain) and some of them ought to warrant a trip to hospital (breathing difficulties – but no more specific than this).

    The back crack quack hacks are onto a winner here and you have effectively pointed out the reason for their commercial (if not exactly scientific) success. As all these ailments are self-limiting any course of treatment over a period of time is bound to “cure” them. Rather like the woman on DC’s site who took HY sugar pills for 4 or 5 years and eventually they “cured” her asthma.

    And as backcrackeryquackery is as much about sales as anything else the message is to get people coming back time after time after time (I think Rose Shapiro talks about the sales training and marketing techniques they can buy into to continue fleecing the gullible. It is always worth remembering that backcrackery was founded by a shyster out for a quick buck who had tried various forms of quackery before he settled on his “own brand”, which he had just made up).

    And of course if the child dies (maybe from the brain tumour the prolonged crying was a response to) then it’s not our fault – we weren’t treating them for that and how could we have known.

  19. “What I would like to know and this is a completely innocent question from someone who is on the fence”

    “is something like back surgery “quackery” too?”
    What type of back surgery specifically?

    “Is there double-blind, placebo controlled studies”
    Are. Good luck with double blinding an operation.

    “such as those that are required from the chiropractics?”
    By whom is this required?

    “It confuses me as common sense indicates that it would be impossible.”
    Right on.

    “Any help clarifying this matter would be good.”


  20. Anonymouse at 21 May, 2009 09:46

    You make a valid point. Insane possibly but valid nonetheless.

    It is possible that there have been no double blind trials done on heart, lung, liver transplants etc as the subjects were naturally cautious of a blind surgeon operating on their vital organs (although admittedly the donor couldn’t give a shit).

    The extent to which medicine operates in the absence of properly controlled trials is worse than your simple allusion to back pain.

    I have been unable to find a single properly controlled trial for the use of water and other fluids in the treatment of serious dehydration yet so called allopathic doctors still use this alleged “cure”.

    Even worse, the (also) so called World Health Authority not only advocates the “WHO rehydration therapy” without any evidence of efficacy from clinical trials but adds salt and sugar to the water. Everyone knows that salt and sugar are bad additives incorporated into foodstuffs by BigFoodCo. Clearly WHO is in the pay of Tate and Lyle, SAXA and all the other robber barons.

    It shouldn’t be allowed.

  21. And also what about prosthetic discs. There is no long term data for treatments such as these. Surely that would also be quackery no?

  22. And off the top of my head I guess there are no placebo controlled studies done so how do we know that part of back surgery success is not placebo effect?

  23. OK OK OK

    You saw your leg off with a chainsaw. Go to the hospital. Doctor says we can glue it back on and you will be break dancing in six months.

    You say oh no, there have been no clinical trials. I would rather trust back crackery and the placebo effect.

    Sometimes a cigar is just an effing cigar.

  24. I’m not talking about sawing a leg off. I’m talking about surgery for something as simple as back pain, not a life threatening emergency. Im asking a valid question, seems I’m not getting a valid answer.

  25. I am not sure if you are a troll. You are certainly starting to sound like one.

    There is a gulf of difference between something like back cracking which was invented by a crook and modern surgery which is the result of significant advances in surgical techniques, anaesthesia, immunosupression, medication, technology and so forth.

    You would only have surgery for back pain if the cause of that pain warranted surgery. Doctors don’t cut your back open because you have a little twinge from doing the gardening.

    On the other hand a back crack quack would sign you up for an expensive course of quackery for the slightest twinge. They spend more time learning sales and marketing than they do any accepted form of medicine.

    I am not aware that any doctors/surgeons have ever recommended back surgery for asthma or bedwetting. Maybe for bone cancer but certainly not for constipation.

    It may well be that a different standard of evidence is required for quack treatments and rightly so. If you are making a fairly outrageous claim that defies most medical knowledge then you need to produce some fairly spectacular evidence to support it.

    Back crack quacks have signally failed to do this.

  26. As soon as I ask a serious valid question, and get some really sarcastic and cynical comments back and continue to ask that question, I am now a troll. Ha.

    I’m all for evidence-based medicine, but it can’t be one rule for one, and another rule for the other. Funnily enough, the question still hasn’t been answered though.

  27. Whether back surgery is quackery is an interesting question. Current back surgery does not perform well in RCT’s in non-specific low back pain (an umbrella term which comprises the majority of back pain presentations.

    What separates it from quackery is prior plausbility, an absence of science-defying theories and the fact that it is not touted as a cure for non-back related symtpoms like colic or ADHD etc etc etc. Where trials show it to be ineffective it simply becomes another failed treatment(one of a long line in back pain management).

    Perhaps if you continue to advocate surgical techniques in the face of the evidence you cross the line into quackdom. But there are instances (e.g profound nerve root compromise) where back surgery is both indicated and appropriate.

  28. What trials of back surgery use involve is testing the effectiveness of surgery vs non invasive treatment such as physiotherapy. Obviously you cannot blind such a regime and so the studies are depowered but that does not mean they cannot answer the question asked.

    It is possible to single blind surgery, it involves anaesthetising and making an incision in some patients but then sewing them up again without doing anything more. Good luck getting that one past a modern ethics committee though they were done in the past. Science uses them as controls in experiments with animals that involve survival surgery. You can double blind those by coding the animals and not revealing the codes to those collecting and analysing the data.

  29. Anonymous said:
    “I’m talking about surgery for something as simple as back pain…Im asking a valid question, seems I’m not getting a valid answer.”

    It’s not a valid question as I tried to point out in my response. I tried to get you to clarify your question because it’s impossible to asnwer unless you do so. But you haven’t even attempted to do this. Instead you simply re-asked your invalid question. So don’t blame me if you’re not getting it answered.

    I’ll try again: What type of back surgery? In other words tell me what condition you have in mind, what the usual indications for surgery are for this condition, and what type of surgery is usually performed when these conditions are satisfied.

    Then I’ll see if I can answer your question about whether that type of surgery, with those indications satisfied, in that type of back condition is quackery or not.

    If you can’t do that, thanks for playing and goodbye.


  30. My obseration may be superficial – but here goes. Looking briefly at the educational content within ‘colleges’ alleging to educate chiro-practitioners – it may be that some factual theory within their syllabus (eg staight forward anatomy and physiology) may be legitimate but it is the use to which and by which it is applied that gives these practioners the delusion of therapeutic efficiency and efficacy. Afterall, medical and nursing students learn the same subjects of A/P, admittedly at differing levels of intensity, but the use to which and by which they apply this knowledge and understanding is light years down the evidence based pathways of legitimate research and applied specialist wisdom compared to chiropactitioners. It is not just the smoke and mirrors of chiropractic customer cracking but the smoke and mirrors of their ‘college’ curriculum that fools the equally gullible student.

  31. Absolutely Clarinda. At my local Chiro college, studends are under the impression that they are studying ‘postgraduate’ level material and that they are thoroughly studying anatomy etc. They are undoubtedly being systematically misled into believing they are receiving a more competent training than they really are. In a conversation with one student, after saying how ‘postgraduate’ it all was began to tell me how subluxations caused all sorts of illnesses and problems throughout the body. One can only concluded how pseudoscientific and substandard the training is – and all underwritten by a UK university. Shameful. And yes, the principle of the college spends all their time teaching ‘business skills’.

  32. Having had a look at a local Chiropractic site in Edinburgh, I see they claim (in woefully poor grammar) to be “highly trained” (???) in radiology to take AND diagnose x-rays!!!!! Good grief – what ignorant self-delusional state are they in?
    A Consultant Radiologist will take a minimum of five years undergrad. and around ten years post grad. just to start their consultant career! It is three/four years minimum for Radiographer training without a specialist elective. Therefore, will someone tell me how a chiro can condense twenty years radiological medical AND technician training and experience into a half-baked module and who are their radiology qualified teachers?
    This particular paddling of quacks in Edinburgh do, however, reassure the quackophile customer that they take x-ray “safeties” (sic) seriously at “family affordable prices” – so that’s alright then. As I forced myself to read through their eye-watering blurb on “pregnant ladies” having trouble with their “low back” (sic)- I am genuinely shocked that this bilge is allowed to be in the public domain and I commend your efforts to rid us of this fraud, incompetence and deception.
    Is there a published meta-analysis in the radiological medical journals re- direct injury caused by chiropraxis – e.g. I have been reliably informed that chiropractic induced neck injury is known to have very serious sequelae.
    We must not be lulled into an indifference to allow these quacks to profit from their quackophile punters. There are serious factors of guilt by association etc. by knowingly ignoring criminal deception. The law does not recognise ignorance in the face of freely available evidence as a robust defence.

  33. Chiro on the NHS following the Singh case in their favour! How do they do it? Chiros probably are having a carnival even if a few of them are now in some haste removing Dr from their headed paper and name plates and reviewing their websites.

  34. Wow. Why do you people have such a beef against Chiropractors?
    Surely if someone uses one and they get benefit then that is a good thing? Ok some may not be very good and so they aren't going to prosper are they? I have had many successful visits to various Chiros and most have worked very well. If they were so bad, how come they exist, just because they make alleged bogus claims?

    To pursue a vendetta against a very small profession and the tiny organisation that not all Chiropractors are actually members of is at best childish. This action is portrayed as the big guys silencing the little guy yet this hero of yours Mr Singh has a huge following. Perhaps a moment to think about the impact this campaign is having on the real, good chiropractors and the organisation they belong to would be good?

  35. Anonymous:

    1) Why do we have a beef? The libel case is a big clue.
    2) "Surely if someone uses one and they get benefit then that is a good thing?" Show me who benefits, for what conditions and with what risks. Chiropractors do not like this sort of question. Evidence for their trade is not good.
    3) "how come they exist?" Good question. I would expect it is mainly due to a misinterpretation of the course of complaints such as back pain.
    4) Pursuing a vendetta? It is not us suing for libel using unjust laws with potentially crippling financial results.
    5) Big guys? Who are you talking about. The BCA is a wealthy organisation. We are bloggers.
    6) We have thought of the impact if our 'campaign' and we hope it will help clean up this rather shabby cult like trade.

  36. Well I should be grateful that you have responded and posted my comment. Several level headed responses to other sites have been censored. Thankyou.

    1) I see the libel case as a profession defending itself against Simon's constant unfounded criticism. I can see why they felt they had to do this. If you had spent 4 years at college specialising in the Spine and aren't one of the minority of Chiro quacks I accept exist, wouldn't you? I know they are a fairly strange bunch and from the outside this looks like they are after Simon but he kicked this off with his pursuit and refusal to withdraw his comments. I accept that the evidence has not been shown to substantiate the claims shown on Facebook regarding Colic and I don't really understand why this is the case but I don't think they would have got so far with the case if it didn't exist. I'm just sorry that the good chiropractors aren't out there defending themselves from some of the rubbish I have been reading on the web. Hopefully as a patient of several different practitioners over the years, I can help get the point across.

    2) I have used one and so have thousands of others. I have injured my back through bad posture or sports injuries and they provided the benefit of a speedy and controlled relief of pain. They have not caused any problems at all. Where is your evidence that shows this significant percentage of patients who visit Chiropractors have had problems? My evidence is based on my limited circulation of friends and colleagues. The problems most people speak about at the sort of statistical level we are speaking about are insignificant.
    What I will admit is that a lot of the problems I have had would probably have solved themselves over time but I have no objection to paying to speed things up. I really don't think you live in the real world when you speak about the risks.

    3) They exist because they work as in my previous point. As with all medical profesionals, quacks and all, some of them are idiots who pull the group into disrepute, I think you are focusing on these people but they are the minority. There are a lot of good chiropractors out there.

    I guess we will have to disagree on the last points as this post is getting a bit long now. It will be interesting to see how the next months go. I hope you guys find something more worthwhile to direct your obviously plentiful spare time towards. World hunger, climate change, loan sharks not the poor group of small businesses in the UK practising Chiropractic medicine 🙂


  37. P

    1) If the criticism of chiropractic is unfounded then the way to deal with this is by the discussion of evidence, not through the courts. Science and Medicine depend on robust and thorough criticism. Public health is more important than public reputations. If you are wrong about something, then so be it. Chiropractors cannot and should not be able to shield themselves from strong critical appraisal. They may not like this, but that it the same for everyone who makes scientific or medical claims. Robust criticism is how we spot drugs and treatments do or do not work, or have bad side effects. Writers, scientists and doctors should be free to be as tough as they like on claims without fear that nuanced words will see them on the wrong side of a mortgage sized bill.

    Chiropractors mau well have studied hard – but what they have studies may be thoroughly wrong. Personal feelings and pride may be hurt but chiropractors should not be shielded from criticism. This is not about a few 'quacks'. The whole of chiropractic appears to be based on bogus principles an the evidence for effectiveness looks non existent to nearly all conditions bar lower back pain – and even then, it is no better than other treatments that might be cheaper.

    2) I suffer from back pain. Ten years ago it was very bad with months of pain. Over the years it has flaired up only to go down again days later. Now I rarely get problems. I have not had treatment – I Have merely kept mobile. How does my experience of back pain differ from someone who has had years of 'adjustments'. Chiropractic may well be just playing on the cyclical and self-limiting nature of most back pain. People may swear by their chiro, but they are being fooled by their own bodies healing. Chiropractors need to show this is not the case. They cannot and do not – instead they reach for their lawyers.

    Shockingly, there has only been one controlled trial of the possible harm and side effects of chiropractic. This is damning in itself. The trial showed 30% of patients suffered some form of adverse effects.


    3) You say chiropractic works. Well all you need is to show me the evidence. Where is that evidence that chiropractic can cure colic? Where is it?

    And then you spoil yourself by saying that I should be picking on other targets such as 'loan sharks'. This blog is about quacks. That is what I choose to write about. I am not going away and nor are many other people.

  38. 1) I completely accept every point you make here, except for the last. These critics need to provide their proof as well. These were not nuanced words, they were deliberately written to provide harm to the Chiropractic profession, that is what the case seems to be about. Simon has turned it into something more than it really is. I just hope that the Chiropractors can provide the evidence for their claims, maybe this is something that will happen and close some of this down.

    2) Maybe if you had treatment earlier, you would have less suffering. I made this point to you and you have just emphasized it by showing you don't seem to have ever visited a Chiro? That doesn't sound like you have the qualifications to spout about this sort of thing. I have not had years of adjustments, I use a Chiro when I need one as a sort of speedy tune up or correction and I speak from experience, do you?

    I understand the point you make from this trial but I have had these sort of adverse affects getting up out of a chair. It's rubbish. If you have your spine manipulated to fix a problem, this is going to happen. The serious issues are statistically insignificant and that's what the first paragraph says. People aren't going to a Chiro and coming out crippled, they come out feeling like someone has done something to them and then after a few days this settles down and the latent problem goes away.

    3) Chiropractic works for me and many others. I can't present any evidence as I'm not involved in this, the case seems to have prevented them from showing any evidence as their probably scared it will impact the outcome. I'm confident it exists or they wouldn't have pursued the case, I hope it does or their whole argument disappears.

    My last paragraph was merely intended to show that I don't see the Chiropractor as my local villain as you guys are portraying them. Surely someone who is actually harming people is more of an issue. I don't respect the tactics used in this campaign and I hope that the good Chiropractors can present the evidence to show Simon Singh is wrong is his criticism.

  39. 1) Simon did provide evidence to back up his claims. If you read the alleged defamatory document, Simon makes it quite clear what he means by 'bogus' and why he came to that conclusion. You can read that evidence too in his book Trick or Treatment.

    And yes, maybe the words were designed 'to bring harm' to the chiropractic trade by pointing out treatments that have no evidence and plausibility. That is the point of criticism – either the BCA could show evidence that Singh was wrong, or ask their members to stop advertising these treatments. Funnily enough, the ASA has since adjudicated that chiropractors should not make similar claims. Why do the BCA not do the same? Where is their evidence? I understand the Guardian has offered to give them space to publish it. They have not taken up the offer. Why?

    2) Maybe my back would be better. Maybe not. Where is the evidence that chiropractic offers long term relief rather than temporary relief? Nowhere. My experience with back pain is indistinguishable from most – except I am not forking out money to various forms of quackery while I ache.

    And yes, some people do getseriously hurt – or even killed. Rarely, thankfully. But as the chiropractic trade has not seen fit to properly monitor adverse affects, caution would be wise.

    3) Classis. "It works for me" and "I have no evidence". In a nutshell, you have stated why people fall for quackery.

    Chiropractors may not be villains, but they have fallen into a rather strange cult-like pseudo-medical group and may not have the insight to realise this has happened to them – just like any other cult. Its mostly delusion – not malice. But will all cults, it usually takes people from the outside to rescue the cult victims from their own prisons.

  40. I joined the Carnival of bogus*, but not with Chiropractic; with Homeopet, a homeopathic pet products company that I have been dealing with for several months. They like to cite studies showing that their products were no more effective than a placebo as evidence that their products work.

  41. re clinical trials and surgery, a question raised above (and not answered?) – not directly related to back surgery, but still bone stuff.

    See, it is a false to assume that what 'real' medicine does, also at great cost to people or the public purse, is not immune to advocating apparently worthless treatments. When subjected to clinical studies.

    Surgery seems one of the most significant really important means of preventing mortality in modern society. However, it ranges from the life saving to the purely cosmetic, but all has risks.
    Hygiene and better living standards are probably far more significant in truth though.

    Clinical trials in surgery are definitely possible, but not often performed. Everyone in the medical/healthcare has a vested interest in other people's disease. It's the nature of the human beast.
    Seeing as surgery, even brain surgery, was performed within the context of ancient cultures in many places, using herbs and other techniques in anesthesia, bleeding etc. It could even qualify as a traditional technique itself… I guess trying to physically cut out the problem is a very ancient meme in the human psyche.

    Aside from ongoing open debate, no-one is going to control what everyone else thinks about the basis of human life. Which in turns determines what we see as the cause of dis-ease in the human.


    No benefit from knee arthroscopy

    by Dr Norman Swan

    A Canadian study shows no benefit from arthroscopy – keyhole surgery to wash and polish the knee joint – in people with knee osteoarthritis.
    06 10 2008

    There's good news and bad news for people with knee osteoarthritis. The good news is that you can be saved from unnecessary surgery. The bad news is that you've got a bit of work to do to limp on longer before you need a knee replacement.

    The results of a recently published trial have consigned a popular form of knee surgery to the dustbin of medical history. The procedure is arthroscopy – keyhole surgery – to wash and polish the joint.

    A few years ago, a study which randomised people with knee arthritis to arthroscopy or placebo surgery showed no benefit. Knee surgeons though, weren't convinced and picked holes in the research. So a Canadian group did another trial addressing the orthopods' criticisms. This time the comparison was surgery against intensive physio and rehabilitation.

    And again – unfortunately – there was no benefit from the surgical clean-out. It means that people with knee arthritis have to focus on losing weight, exercising and strengthening their quadriceps.

    Taking these two trials together, this is now an opportunity for the government to show that it's truly committed to evidence-based care and remove Medicare benefits for this procedure, so taxpayers' money can be better spent on things that work.

  42. Didn't NICE recently recommend chiropractic and osteopathy (spinal manipulation) for back pain – based on evidence. Does anyone know if there is any evidence physiotherapy helps low back pain or are we all paying taxes for unproven treatments via the NHS.
    What is the evidence base for a lot of what goes on in the NHS such as physiotherapy, art therapy, homoepathy (do we still fund homoepathic hospitals?) occupational therapy, psychotherapy, IVF, ECT and etc. Much of this being pre NICE fell under the NICE radar. . NICE needs to extend its scope.
    As for titles – I have come across dentists using Dr and osteopaths as well as chiropractors.
    Can similar criticisms be also made of osteopathy. A brief look at the BOA (British osteopathic asociation)website front page tells us : ''A baby has to cope with the stresses of birth, and a toddler may have frequent ear and/or chest infections. The school child carries heavy school bags, whilst the student spends long hours hunched over the laptop peering at low level screens. Driving to work and long hours at a desk increase the pains begun as a student. Sports people push their bodies to the limit and over-stretch their ligaments and tendons. In old age our joints stiffen and our circulation slows. These are the types of activities that lead to long or short term discomfort and pain which an osteopath can alleviate.'' Ear and chest infections – can they prove it?
    A glance at a Felixstowe osteopaths website would lead the unsuspecting to belive they treat; glue ear, teeth grinding, insomnia, asthma, colic, sinus pain, heartburn , constipation, morning sickness, developmental delay, and IBS.
    I would not doubt they can help with back pain – as NICE suggest, but the other stuff?
    Are they any different to chiroprators?

  43. I would like to know why people always have their digs at chiropractors and not osteopaths or physiotherapists who both will manipulate the spine. The NICE guidelines now reccomend a course of spinal manipulation for chronic low back pain…please explain why this would be if chiropractic treatment was bogus, did not work and unsafe!? It is because it works!! I would rather see a professional with 4-5 years training in manipulation rather that a weekend course, which is what other healthcare professionals are now doing!! and why are they doing this if it doesn't work and is unsafe? Professional chiropractors should never claim to cure these other conditions, only help in possibly relieving some of the symptoms for which evidence does exist.
    Maybe some people would rather head straight for back surgery rather than conservative care.. well that up to you, but maybe you should look up the statistics on failed back surgey!!

  44. Having read many of the concerned comments above i would just like to say that I have been helped by a chiropractor for my crippling headaches. Yes, I alos know that they are caused by stress, but who is not stressed these days. I had an xray any have early degeneration at age 35, from an old moto cross injury. I consider my chiropractic care to have been straightforward, commonsense, practical and informed. The NHS suggested oromorph (morphine) dihydrocodeine, amitryptaline and pain clinic counselling. I compete in international triathlon. Tell me I am wrong visiting the chiropractor for help !

  45. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance for healthcare within the U.K
    Modern healthcare relies on this independant research organisation for guidance into the most cost effective form of healthcare interventions.
    The NICE guidelines appear to back chiropractic for low back pain, and according to research, now advise against other forms of care that have been 'modern healthcare' and NHS funded for a number of years.
    If chiropractic manipulation has proved its effectiveness for certain conditions, then this should be used to help the general public.
    Petty scaremongering gossip will not help anyone.

  46. Anonymous – if chiropractic can help lower back pain then so be it. The evidence is not as strong as you might think and NICE have been heavily criticised for making this recommendation. eg. here.

    What the argument here is about though is chiropractic for childhood, non-spinal ailments – for which there is no reason to believe they are effective.

    This is not 'Petty scaremongering gossip' but a valid concern about the overpromotion of an alternative medicine that has not been proven.

  47. The evidence is far stronger than for spinal surgery or medication, so I will go along with the NICE recommendations, who are as evidence based and as you can get.

  48. I am not sure that is true about the evidence base for chiro and back pain. It would be good if you could reference such assertions.

    My understanding is that back pain is a chronic condition where there is no one good intervention that can described as effective. Pain killers help, a little chiro may help too – but not much.

    Assuming you are not a chiro advertising here, you may like to also consider this review of the NICE guidelines:


  49. So is my chiro the only one not claiming funny things then? Until today, I wasn't even aware that some of them claim to be able to heal whatever. I just go there for issues with my spine, hip and shoulder and it works well for that.

  50. I for one have suffered from constant migraines and neck aches since I was a child. The only method of relief the doctor provided was through painkillers which eventually started causing problems of their own.

    I started seeing a Chiropractor a few years back and even after my first adjustment I noticed instant relief. I now go only a couple of times every few months, my neck is fine, my posture is 300% better, I no longer suffer from migraines, my jaw no longer aches and gurns constantly.

    I have also referred my brother after a freak “crack” of his spine whilst doing some mundane taske left him in crippling pain and unable to stand properly, one adjustment and he was right as rain again. I was also referred originally by someone else who also swore by them (a member of my family) and had been recieving care on and off for a number of years, when need be.

    Mine certainly doesn’t claim to perform miracles and I am glad I went, I both trust my Chiropractor and highly recommend him to anyone else with spinal issues.

    Just for reference I am a professional software engineer with a strong grasp of logic and reasoning, therefore I also know that somethings are best experienced first hand than via proxy.

  51. I have had a couple of appointments at the Ideal Spine Centre in Canterbury and am rather sceptical about their methods in that I have had a couple of appointments (x rays) etc., but no actual examination which I find bizarre and asking me to check the posture of the rest of the family. Am I being paranoid or do you think like me that this is all about the money???

    • It is illegal for anyone to give you an x-ray without a specific medical justification.

      Chiropractors have been under a lot of criticism for using X-rays as a sales tool, rather than a diagnostic tool. Since the core belief of chiropractic is about the detection of subluxations (which do not exist) chiropractic x-raying is a very dubious activity.

      Chiropractors have also been heavily criticised for heavy sales techniques that often involve roping in other family members for ‘wellness’ programmes. Chiropractors are unable to show any evidence of benefit for such programmes.

      If you feel that your chiropractor has not been acting solely in your best interest, you should write to the General Chiropractic Council with your concerns.


  52. http://www.sciencebasedmedicine.org/index.php/dummy-medicines-dummy-doctors-dummy-degree-part-1/comment-page-1/#comment-71272

    where I said,

    “the darwinianly successful SCAMster is the one who keeps he patient coming back frequently to have their “treatment” tuned up. What must not be allowed to happen is for the patient to be left alone with their problem. If the therapist is really successful he or she can control the message so tightly that he/she can engineer the death of the patient (Cf Penelope Dingle)”

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