Beware the spinal trap
[Note: This post is not the work of the usual author of this blog. Simon Singh was recently successfully sued for libel in England by the British Chiropractic Association for publishing the following article about the dangers of chiropractic treatment. In order to ensure a wider dissemination of the information that the lawsuit seeks to suppress, many bloggers have chosen to post an edited version of Singh's article on their blogs. The original article, which contains the supposedly libelous material, can be found here.]
Beware the spinal trap
Some practitioners claim it is a cure-all but research suggests chiropractic therapy can be lethal
Simon Singh
The Guardian, Original version published Saturday April 19 2008
Edited version published July 29, 2009
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.
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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.
I question some of the statements above. I did ethnographic research in college focusing on the profession of Chiropractic. I learned then that their science is sound on how the human body communicates and how a healther nervous system can aid in keeping away the common cold, ear and headaches, back pain, and the list continues. Unfortunately, the Chiropractic profession comes under fire as they seem to have to treat often. Manipulation is often hindered by the muscles and tendons that attach. These at times can hold the body in the wrong position. When someone is antalgic, the term means leaning away from pain. I have experienced low back pain. I understand that once symptoms are in place, the cause came long before. So if most people would use chiropractic correctly, meaning regular “maintenence” checkups to use them as preventative care as oppossed to “ouch, I have pain, I need a chiropractor, then the profession would get a better light. I would be interested in knowing the affiliation either authors have with companies that represent medical, pharma, or biotech companies. AMA in US is supported heavily has over 80 of visits result in the prescription of medication by the Dr. I visited doctors and chiropractors. Funny thing is a decade ago, doctors wanted to do surgery and prescribe pain meds and anti inflamatories. I decided to go the way of Chiropractic therapy. I recently learned that I have 2 hernated discs in my lower back. Doctors say that surgery is not required as many people live with this condition, pills or shots recommended. Chiropractor recommended exercies to stregnthen my core. Again, one covers up symptoms and doesn’t always diagnose cause, while the other is always working to keep the cause from occuring so symptoms don’t have to exist. A difference in thinking. The human body is a wonderful mechanism, designed to be able to fight off diseases, build immunities, repair itself. It is this belif that guides that Chiropractic community. they are trying to learn more about how to make our bodies work better for us and not against us. I honestly don’t see an issue with this. So a few people got hurt, how many people die in the hospital annually from complications of minor surgeries? I rest the case on that one. These articles are published to mislead people. Beware!