I’m aware that I’ve blogged rather a lot about homeopathy being crap because I just love the lunacy of it so much but today I thought I’d redress the balance a bit by writing an equally objective and unbiased post about why chiropractic is also crap. I didn’t have to look far for inspiration. Take a look at this:

What I like to do is live a life of health and vitality by eating well, exercising every day, making sure I receive Chiropractic every week, take no medications, not getting vaccinated, drinking pure water, taking wholefood supplements/fish oil/probiotics, no smoking or alcohol and making sure I treat my body with respect.

When a chronically ill skeptic tells me that my lifestyle is quackery, I only feel sorry for them being trapped in a belief system that suppresses their quality of life. It’s not my job to change that belief system.

I like the fact that it is a free world and I get to choose what I do with my body.

This very sad comment, by someone called Jeremy, appeared on my blog months ago but I ignored it and forgot about it. I was reminded of it only after seeing the same kind of nonsense posted on different websites recently. It’s not all nonsense, of course. Eating “well” (we assume he means a balanced, nutritious diet) and taking regular exercise together with not smoking or drinking heavily are indeed a good idea for anyone who wants to stay as well as possible and the NHS has a huge website which includes a wealth of information about healthy eating and exercise and much else besides.

The nonsense part is in the middle and starts with weekly chiropractic sessions and ends with probiotics. I can’t be bothered to deal with most of it at the moment. Obviously the guy’s living a great lifestyle and, as long as he manages to keep out of the way of any serious infectious diseases and any organic banana skins when he’s out exercising with his blinkers on, I’m sure he’ll be fine. In any event, the people who are most likely to die in epidemics are not healthy adults like him and if he wants to reject evidence-based medicine and spend his own money on unnecessary food supplements and probiotic yogurts or whatever, I’m sure nobody cares enough to try to stop him.

No, what I’d like to challenge here is the weekly chiropractic he “makes sure” he gets. Why, for fuck’s sake?  Time and time again I see this notion that we have to do something more than just eat, exercise and not smoke. To keep really, really well, it seems we have to regularly fork out extra money for some quack therapy or wonder foodstuff. Too often, the normal ups and downs of everyday life: tiredness, aches and pains, the odd tension headache, occasional insomnia or bowel problems, etc, are viewed as problems we need to not only treat as if they were potentially life-threatening medical conditions but that we should spend money on trying to prevent them happening at all.

Hmm…that maybe wouldn’t be such a bad thing if these therapies were effective but here’s the thing about chiropractic: having it regularly doesn’t make an iota of difference to your physical health and you may as well spend the money on talking about yourself to a counsellor or just having a nice evening out. Decide which leisure activity you can afford that is most likely to lift your spirits and go for it — but preferably choose one that doesn’t carry a risk of a vertebrobasilar artillery stroke.

Thanks to the British Chiropractic Association’s unutterably stupid decision to sue Simon Singh, which has forced the spine wizards into the spotlight, many of us know a lot more about chiropractic now than we did before. Indeed, there are many who didn’t realise that chiropractic isn’t part of mainstream medicine. But they realise it now, in spite of the best efforts of some quacks to continue to misrepresent the BCA v Singh case. (If you missed the storm kicked up by an idiotic homeopath called Lionel Milgrom wrongly stating that the BCA had won the libel case and been awarded substantial damages when it hasn’t even gone to trial yet, read about it here, here and here.)

And for those that have been on another planet for the last few months, the backlash against Mr Justice Eady’s decision at the preliminary hearing took the form of hundreds of complaints being made to the GCC and Trading Standards about the implausible claims made by hundreds of UK chiropractors. The message is clear: if there is a jot of scientific evidence for these claims, bring it forth or withdraw the claims. Don’t resort to legal muscle to shut us up.

Inevitably, a few pissed-off spine wizards dipped their toes into the shark-infested waters of internet forums where skeptics gather or left their droppings beneath the blog posts of the complainants. It was a “witch-hunt” said one. The complaints are “vexatious”, said another, who goes by the name of David and more of him in a moment .

I’ve always thought the term ‘witch-hunt’ quite an appropriate one to use about people who promote and practise pre-science therapies. As for ‘vexatious’, isn’t this adjective usually reserved for complaints that are intended to cause inconvenience but have no real grounds? The complaints against chiros do have good grounds: there are chiros making unsupported claims that they can treat things like asthma, which have nothing to do with the spine, chiros misrepresenting themselves as doctors and chiros claiming that having regular sessions will help maintain good health. That the complaints should cause inconvenience or annoyance is just an added bonus. Yes, it may be annoying and inconvenient for them to have to change their websites and leaflets but they shouldn’t have been making those claims in the first place. Those who call these complaints ‘vexatious’ presumably believe that chiropractic really can treat everything from asthma to bedwetting to sports injuries to colic. I wonder if they also believe it can cure deafness?

Because that’s how it all started that day in September 1895 when, so the story goes, a grocer called D.D. Palmer prodded and poked at a deaf man’s spine after which the man said he could hear again. There’s an excellent article by the SkepDoc, Harriet Hall, in the current issue of Skeptic magazine, which reminds us that a science develops over many decades but a pseudoscience can pretty much be thought up over breakfast. A pseudoscience like chiropractic is, in my opinion, more like a New Religion — otherwise known as a cult — than like science. D.D.Palmer and L.Ron Hubbard, founder of Scientology, seem to have a have been cut from the same cloth. Indeed, Harriet Hall tells us that Palmer “spoke of a God-given calling and seriously considered making chiropractic a religion”.

It’s reasonable to describe what Palmer invented as a pre-science therapy because he based it on an idea that we know now to be wrong: that all bodily functions are controlled by the nerves. He thought he could feel bones out of place in the spine and decided for no good reason that these “subluxations”, as he called them, were the cause of most cases of disease. Funnily enough, these chiropractic subluxations, didn’t show up in x-rays, an inconvenience chiropractors addressed by changing the definition of subluxation from the partial dislocation that Palmer imagined to

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.

The World Health Organisation quoted by Wiki.

It may seem hard to believe that anyone still subscribes to the idea that disease prevention depends on keeping one’s spine ‘aligned’ but evidently many people do. Harriet Hall’s article includes a list of chiropractic insanity in her local community (somewhere in the US, I presume) and it includes this:

A chiropractor informed me that if germs caused disease we’d all be dead and insisted that you can’t become ill if your spine is properly aligned.

Presumably my commenter, Jeremy, who makes sure he gets his weekly preventative dose of chiroquackery believes the same thing, as does the chiro who helpfully commented beneath another of my previous posts thus:

Do you get regular check ups at the dentist to avoid tooth decay? Do you get your car serviced regularly to prevent major engine problems? Our bodies are constantly put under stresses of everyday living, therefore, some patients like to have problem areas worked on at regular intervals (every one-six months perhaps) to help prevent their problem returning…I do this by using spinal manipulation, massage, postural advice, exercises programs, dry needling (like accupuncture) etc.

I’m sure he gives a great massage and gives very good advice on how to sit up straight and what exercise to take. These, however, are not chiropractic. You can get equally good advice from a physio and you can get a massage in, um, other places.

It’s disagreement over what chiropractic actually is that seems to be vexing David  over on Zeno’s blog. He is one of those chiropractors who eschews the use of the term “subluxation” and argues that the practice of most British chiropractors is properly described by the Anglo-European College of Chiropractic and the Welsh Institute of Chiropractic i.e. they focus on what the latter calls the “diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system and the effects of these disorders on the functions of the nervous system and general health”.

Well, it’s true that description doesn’t use the word ‘subluxation’. It does, however, allude to the effects of “mechanical disorders” of the musculoskeletal system on the nervous system and general health. It stops short of giving examples of these effects but it sound suspiciously like the idea that a back problem can be connected in some way to ailments that having nothing to do with the back, which is at the heart of why chiropractic is dismissed as quackery by so many. It’s also the reason why there are currently hundreds of complaints being investigated about chiros claiming on their websites that they can treat a variety of different complaints that have absolutely nothing to do with the back.

David asserts that “spinal manipulation does not equal chiropractic”, which we all knew anyway. “It’s the complete package that counts,” he tells us. “We have the whole range of techniques available to us”. What he does not tell us is this: If chiropractic is no longer the theory that mythical subluxations of the spine are the cause of most ailments, then what is it? I mean what is the theory behind chiropractic nowadays? What distinguishes these modern chiropractors who are focussing on “mechanical disorders” from other practitioners who use manual therapies?  David does not tell us and neither does the Anglo-European College or the Welsh Institute. Nor, in spite of David insisting that chiropractic treatment is scientifically supported, do any of these sources tell us where to find the scientific evidence that supports it.

Another claim he makes is that,

Interestingly, physiotherapists only really took to manipulation when they realised that chiropractors were getting so much better results in the treatment of back pain.

Actually, that’s not very interesting. At least, not as interesting as this systematic review, which reveals that spinal manipulation is no better than other therapies for treating lower back pain. And there is no evidence that it is effective in treating — or preventing — anything else. What’s more there is a “very small but very real risk”, as Hall puts it, of stroke with neck manipulation. In a previous post I gave the example of a young woman called Kristi Bedenbaugh who saw her chiropractor for sinus headaches. During a neck manipulation she suffered a brain stem stroke and she died three days later. Harriet Hall mentions 20-year-old Laurie Jean Matthiason,  who saw her chiropractor for lower back pain and had 186 neck manipulations over a six month period. The last one killed her.

The gullible fool who goes for a weekly chiro session in the belief that it maintains his good health, might be interested in the case of Sandy Nette, who used to believe the same thing until she suffered a severe stroke. Click on her name to see her website if you dare. It’s mostly still under construction but here’s a taster:

Due to Chiropractic Highest Neck Manipulation
I Am Now Trapped Inside An Immobile Body

I don’t mean to scaremonger…well, not very much anyway. I will happily concede that vertebrobasilar artillery stroke resulting from chiropractors performing their manipulations is extremely rare. In a nine year population-based study [Cassidy et al] conducted in Ontario, “only” 818 patients were hospitalised for VBA strokes after chiropractic manipulation. The best article I’m aware of on the dangers of chiropractic manipulation and which refers to the Ontario study is right here.

As the man, Jeremy, says, it’s a free world and we can choose what to do with our bodies, including subjecting them to costly, needless and potentially dangerous physical therapies. Just don’t make claims for those therapies unless you can point to evidence that your claims are true. That’s all.

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