Beware The Spinal Trap

Simon Singh wrote an article on Chiropractic therapy for the Guardian a couple of months back, with the result that the British Chiropractic Association sued for libel in the British courts. In response, the Sense About Science organisation has started a campaign to keep libel laws out of the subject of science. As part of that campaign, Sense About Science has asked for bloggers around the world to repost the article. So here’s where I do my bit. By the way, do also check out my comment at the end of the reposted article.
You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that ‘99% of all diseases are caused by displaced vertebrae’. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.
In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.
I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.
In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.
More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.
Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.
Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: ‘Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.’
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

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

Now, you will note the words: "edited version" in the sentence above. Head on over to Jack of Kent’s blog to read the two sentences that have been excised from the article above, and which are the ones that all the fuss is about…

About Geoff Coupe

I'm a British citizen, although I have lived and worked in the Netherlands since 1983. I came here on a three year assignment, but fell in love with the country, and one Dutchman in particular, and so have stayed here ever since. On the 13th December 2006 I also became a Dutch citizen.
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3 Responses to Beware The Spinal Trap

  1. Bal says:

    If I didn’t receive chiropractic treatment which release trapped nerves in my neck causing severe dizzziness and misalignments in my lower back sending off sciatic nerve sensations down my right leg (which was numb below the knee!) I would probably be paralysed by now and lord knows a total invalid!!!! My chiropractor Graham uses a McTimoney Method which involved gentle flicks in appropriate places to momentarily suspend the bone, thus releasing any entrapment and realigning the area along with other techniques which he has practiced and studied over an 8 year training period. I can only speak very highly of this man and no physiotherapist, x-ray or scan could help me or alleviate the pain I endured for 6 months trying tirelessly to get my GP to take me seriously about my ailments. I was told "you have had an enormous trauma to your body and it will take time to sort itself out" and yet when I went to Graham, he saw me on 7 occasions and put me back to normal having stated that it would take 5-7 sessions to achieve a result. I still go to him now when I have a fall off my horse and in fact I have chosen annual Mot to ensure my skeletal system is aligned. Interestingly, before I saw Graham for many years I had to change the toilet seat every 6 months or so because it would eventually break. Unknown to me my hips were misaligned and I was jigging my buttocks on these toilet seats and causing them to break. Since my treatment 5 years ago I have not needed to replace a toilet seat once! So you tell me, eh? This guy obviously has an amazing techynique which I totally trust that assists me without any undue pain that you normally experience with a physio as they push your boundaries!!!! Anyway, I wanted to share that with anyone that feels interested about this wonderful treatment. Oh, finally I have referred several people to Graham, all of whom have made wonderful recovery and the most recent person was my son’s girlfriend that was in excruciating pain from a trapped sciatic nerve – her GP gave her diplofenics and signed her off work for a week – following a visit to Graham in two days she stopped needing the painkillers and gained total mobility!!! Now, if she accepted the course of treatment recommended i.e. take pain killers and lay in bed all week, this whole episode would repeat itself over several months and indiscriminently, until her sciatic nerve was sufficiently weakened and Sarah would face a major op to remove this nerve costing the NHS thousands of pounds and possibly her job as a nursery nurse. So you tell me????????

  2. Geoff says:

    Bal Maiden, I don’t doubt that your experience has been good. Singh’s article acknowledges that chiropractic technique can cure some physical problems. But the crux of the article is two-fold: first, the assertions by some chiropractors that the technique will cure illnesses has "not a jot of evidence", and secondly, that some of the chiropractic techniques carry dangers in themselves.

  3. Bal says:

    Ahhhh lightbulb moment! Well, yes I do agree that there is no concrete evidence to suggest that any chiropractic techniques will cure illnesses (imagine???? we’d all go to them with swine flu instead of taking tamiflu this winter if that were the case lol!). As for your second point, I’m afraid that all techniques including physiotherapy, anesthetic, lumbar punchtures, open heart surgery and most procedures of medicine carry dangers with no guarantee, just a guided percentage of success – including medication – so it all comes down to individual belief and choice at the end of the day based on what advice is given and what one decides to do for the best. The overall therory of chiropractic treatment makes total sense to me and I am shocked that the NHS do not adopt some forms of chiropractic treatment, as a patient is at just as much risk with them as they are with other proceedures – afterall we all sign disclaimers prior to treatment at the pre-op stage and that is something you do not do when visiting a chriopractor! Thanks for explaining things to me Geoff xxx

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