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349 thoughts on “Chiropractors as Family Doctors? No Way!

  1. nwtk2007 says:

    This directly from the paper Harriet – “Generally speaking, the conclusions drawn from these systematic reviews were disappointing. The meta-analysis by Assendelft et al.9 suggested that SM was superior to sham therapy or to ineffective/harmful interventions for low back pain. The meta-analysis by Gross et al.12 implied that combining SM with other treatments, particularly exercise, is effective in reducing neck pain but demonstrated that SM is not effective as a singular treatment. Bronfort10 concluded that SM and/or mobilization are viable options for treating low back and neck pain. Bronfort13 concluded that SM has a better effect than massage and a comparable effect to prophylactic drugs for headache. Reid21 found only limited evidence from methodologically poor trials for effectiveness in cervicogenic dizziness. All other conclusions agreed that the effectiveness of SM is not supported by the results from rigorous clinical trials.”

    What jhawk cited was from one of the reviewers (Assendelft). Brontford 13 mentions HA. I cited an article last year here on SBM regarding SM for HA versus Elavil.

    1. Harriet Hall says:

      @nwtk2007,

      Your reply at 8:07 confuses me. You simply copied what I had just copied from the article. What was your point? You do understand, don’t you, that the Ernst/Canter study was a systematic review of systematic reviews of studies on chiropractic for a given time period?

  2. nwtk2007 says:

    @Harriet – Pressed for time, but jhawk needs to remember that this is a review of reviews from the known literature in 2006.

    As there has been a great deal of looking at this subject here on this blog, I am wondering if there is a similar study in the interim since 2006. Despite his agitation, I might imagine skeptic would have such a list. At the risk of acquiescing to his rhetoric against chiropractic, I would find it enlightening as would many of my colleagues.

    Most of us are not adverse to the latest research. Back to NUCCA, based upon what I know about it I can see no clear mechanism of hypothesis as to how it might be able to accomplish what the NUCCA docs claim to be able to accomplish.

    1. Harriet Hall says:

      @nwtk2007,

      “I am wondering if there is a similar study in the interim since 2006″

      Yes, and it was cited by SkepticalHealth on May 7 at 12:41 am. I’ll make it easy for you by providing a link http://journal.nzma.org.nz/journal/abstract.php?id=4815 It was a review of 45 systematic reviews published between 2006 and 2011. From its conclusion: “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.”

  3. nwtk2007 says:

    Thank you for the link. I appreciate it greatly.

  4. jhawk says:

    @HH

    This conversation began with this comment from SH:

    “Just to refresh:Posadzki P, Ernst E. “Spinal manipulation: an update of a systematic review of systematic reviews.” N Z Med J. 2011 Aug 12;124(1340):55-71.
    “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.”

    This is the study in question and is bad science.

  5. Harriet Hall says:

    @jhawk,

    Just to refresh: the rebuttal letter you cited was to the 2006 Ernst/Canter study.
    I have not seen any credible evidence that either the 2006 study or the 2011 study was bad science.

  6. nwtk2007 says:

    I see the “any condition” as possibly a mis-understood way of saying that it is not good for conditions such as asthma, diabetes, etc. The authors would have to be questioned about that. But then again, there is little evidence of its effectiveness in spinal disorders as well, but there is, at least some, at this point. It needs to be remembered that little evidence doesn’t mean no evidence nor does it mean implicitly that the treatment is not effective. Research might be inadequate at this point.

  7. Harriet Hall says:

    @nwtk2007,

    Did you read the full study? It’s available here: http://journal.nzma.org.nz/journal/124-1340/4815/content.pdf
    The conclusion is “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.”

    The key word is “collectively.” Of course there is “some” evidence of its effectiveness, and that evidence is detailed in the report, but the positive studies are factored in with the negative studies to reach an overall conclusion. That’s what systematic reviews are all about. Your comments give the impression that you don’t understand the concept of a systematic review.

    Ernst did not say there was no evidence. He did not say SMT is not effective. He simply said existing data do not demonstrate convincingly that it is effective. He is correct to say that. The discussion section discusses possible sources of bias (on both sides) and methodological inadequacies.

  8. Scott says:

    It needs to be remembered that little evidence doesn’t mean no evidence nor does it mean implicitly that the treatment is not effective. Research might be inadequate at this point.

    It does mean that it’s highly ethically dubious to offer it. And it certainly means that it’s grossly inappropriate to construct an entire profession around it.

    Horses, carts, etc.

  9. nybgrus says:

    It does mean that it’s highly ethically dubious to offer it. And it certainly means that it’s grossly inappropriate to construct an entire profession around it.
    Horses, carts, etc.

    Bingo!

  10. I’m sure the chiropractors are now going to start saying how they offer more than just spinal manipulation, and that we’re all idiots for not knowing this. The truth is that manipulation and adjusting are the primary treatments that chiropractic offers, and it turns out that there’s really no convincing evidence for any of it. Sure, they pretend to be a PT, but their education and training is indisputably poorer due to their learning about quackery, x-ray taking/”reading”, marketing, etc. It’s just hilarious.

    Chiropractic is a garbage profession. Completely useless.

  11. Harriet Hall says:

    I wouldn’t say that chiropractors are “completely useless.” Some of them do help patients. But they are not useful due to the fact that they are chiropractors, but rather in spite of that fact. Their usefulness increases as they distance themselves from chiropractic’s original philosophy.

  12. I see with and agree with what you’re saying. Perhaps a better wording would have been “chiropractic is utterly useless”, but chiropractors themselves may have many uses. I’m sure some are good cooks, talented musicians, and, in a pinch, could act as good sandbags in case Louisiana floods again.

    (Kidding)

  13. nwtk2007 says:

    Listening to you skeptical, one has to wonder how you would be so attuned to the arguments from chiro’s. Of course you troll their sites and blogs. I wonder how many different names you would be known by. A bit pathetic really but I’m sure fun for you. You might want to get a life.

    Be brave and reveal your work as you alluded to before. Still no reason for calling me Rudy? Funny but I do know of a guy by that name. I think its Rhudy. A very smart guy with a million dollar vocabulary. But its all probably fiction, you I mean.

    But the complete antichiro works of yours could be very helpful. If you don’t wish to share, then why bring it up? Oh yes, fiction.

    I think anyone would be thankful to be compared to good cooks and talented musicians but sandbags? Really? How ’bout sand worms. We protects the spice. Please stop our Jedi minds trick boy. They don’t work on me.

  14. I think someone’s manipulated your cervical spine one too many times.

  15. jhawk says:

    @HH

    “Just to refresh: the rebuttal letter you cited was to the 2006 Ernst/Canter study. I have not seen any credible evidence that either the 2006 study or the 2011 study was bad science.”

    SH posted Ernst’s 2011 study in a response to my response of his “evidence” and I posted this in response to the 2011 study: Let’s take a look at this study instead of taking ernst’s word for it. Many of his conclusions do not match with the actual results of the studies. He cites six studies on LBP (3 positive and 3 negative). The first negative states that SMT is not superior to other treatments so SMT is as good as any other treatment option. This cahnges the score to 4 positive and 2 negative. The second negative study is from Ernst and I can not get to the article and can not take his conclusion seriously due to previous bias in his articles (I am willing to change my mind if anyone has a link to this article but it will still just bring us back to 4 to 2). So, we have 4 positive and one negative. Look’s like SMT is effective for LBP.

    And once again his conclusion says this: “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.”

    SH then had no constructive response, only an argument from authority. So I showed him authority figures that disagree with Ernst’s 2006 review which makes some of the same mistakes as the 2011. I think this is when you started to post.

    1. Harriet Hall says:

      @jhawk,

      So you used the rebuttal letter to the 2006 review to cast doubt on the 2011 review? You never even bothered to respond to my rebuttal of the rebuttal letter. Their criticisms were not justified. Now you want to question Ernst’s assessment of the Assendelft review and change it from negative to positive; yet that review found “For patients with acute low-back pain, spinal manipulative therapy was superior only to sham therapy or therapies judged to be ineffective or even harmful.” And it found that manipulation was not superior to back school. I wouldn’t call that very positive. You are trying to impose your own interpretations on Ernst to over-ride his judgments based on pre-defined criteria. You have not convinced me that Ernst’s methods or abstract conclusions are defective.

  16. @jhawk, I think it’s rather telling of your own opinion of your scummy profession if you think a review that finds spinal manipulation to be better than doing something that harms the patient or does absolutely nothing to the patient, but is no better than teaching the patient a few points, is positive. In that regard, your entire profession is outperformed by a $0.01 photocopy. Yikes.

  17. jhawk says:

    @HH

    “So you used the rebuttal letter to the 2006 review to cast doubt on the 2011 review?”

    No, I stated before I posted it that it was a rebuttal to the 2006 study. Just there to show SH that there is disagreement with Ernst.

    “You never even bothered to respond to my rebuttal of the rebuttal letter.”

    Sorry I missed it but you did say you were done wasting time on the rebuttal letter.

    ” Now you want to question Ernst’s assessment of the Assendelft review and change it from negative to positive; yet that review found “For patients with acute low-back pain, spinal manipulative therapy was superior only to sham therapy or therapies judged to be ineffective or even harmful.” And it found that manipulation was not superior to back school. I wouldn’t call that very positive. You are trying to impose your own interpretations on Ernst to over-ride his judgments based on pre-defined criteria. You have not convinced me that Ernst’s methods or abstract conclusions are defective.”

    The rest of conclusion (Assendelft) says this: “Spinal manipulative therapy had no statistically or clinically significant advantage over general practitioner care, analgesics, physical therapy, exercises, or back school. Results for patients with chronic low back pain were similar.”

    I would not call this very positive either but SMT is still as effective as any other treatment per this study. SMT should not have to outperform every other therapy to be considered effective. It is not a glowing reccommendation for any LBP treatment but if all are equally effective then they all should be a treatment option.

  18. Harriet Hall says:

    @jhawk,

    “No, I stated before I posted it that it was a rebuttal to the 2006 study.”
    Yes, but you specifically posted it in order to cast doubt on the 2011 study. You presented it as evidence that Ernst’s work was unreliable.

    I explained why the rebuttal was not valid criticism. You say “Sorry I missed it,” but in fact you didn’t. You commented on it, but you only said you “disagreed” without responding to my arguments that
    1. the rebuttal said he had deviated from proper systematic review methodology but did not specify how; and in fact his methodology was proper
    2. it criticized him for using a cutoff date and not including earlier studies, which in fact is standard procedure and above reproach.
    3. they listed 3 studies they said were eligible that Ernst should have included but did not: I showed that those studies did not meet the clearly stated criteria for eligibility.

    The rebuttal letter to the 2006 study and the similar criticisms of the 2011 study did nothing to create any doubt in my mind about Ernst’s methodology or conclusions. They only confirmed my opinion that Ernst’s critics were grasping at unreasonable straws to try to discredit findings they were unhappy about.

    I personally agree that manipulation is a valid treatment option for certain types of low back pain, that although it is not superior to other treatments it is a reasonable option as long as patients choose it with informed knowledge of the state of the evidence. And as long as they don’t get treated by chiropractors who discourage immunization, use nonsense like applied kinesiology, use manipulation for non-spinal conditions like asthma, or inveigle patients into useless “maintenance” adjustments. I assume you would want MDs to tell patients about manipulation as an option along with the other options of analgesics, PT, exercises or back school. I wonder how many chiropractors present any non-manipulative options to their patients before manipulating them.

    When Ernst says “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.” he is taking into account the quality of the positive studies and other factors, and I think it is a true statement. You yourself agree that the evidence “isn’t very positive.”

    Why should a whole edifice of chiropractic be built around something with “not very positive” evidence for LBP and essentially negative evidence for most other indications? Why should manipulation be the basis of a separate establishment rather than simply one more modality offered within mainstream medicine?

  19. nybgrus says:

    …and can not take [Ernst's] conclusion seriously due to previous bias in his articles…

    You are aware that he was a proponent and purveryor of CAM modalities until he was forced to actually look at the data in detail and discovered the emperor had no clothes, right? If anything his bias should favor chiropractic and other sCAMs

  20. jhawk says:

    @HH

    “I explained why the rebuttal was not valid criticism. You say “Sorry I missed it,” but in fact you didn’t. You commented on it, but you only said you “disagreed” without responding to my arguments that”

    My apologies. There are a lot of comments on this thread and I was/am short on time.

    “1. the rebuttal said he had deviated from proper systematic review methodology but did not specify how; and in fact his methodology was proper
    2. it criticized him for using a cutoff date and not including earlier studies, which in fact is standard procedure and above reproach.
    3. they listed 3 studies they said were eligible that Ernst should have included but did not: I showed that those studies did not meet the clearly stated criteria for eligibility.”

    In short, I pretty much agree with your rebuttal to the rebuttal letter but these 3 points were not the only things being rebutted. The main point, IMO, is that Ernst rated studies as negative just because SMT was not superior to other treatments thus giving the illusion that the totality of evidence was a wash.

    “I personally agree that manipulation is a valid treatment option for certain types of low back pain, that although it is not superior to other treatments it is a reasonable option as long as patients choose it with informed knowledge of the state of the evidence. And as long as they don’t get treated by chiropractors who discourage immunization, use nonsense like applied kinesiology, use manipulation for non-spinal conditions like asthma, or inveigle patients into useless “maintenance” adjustments.”

    Agreed.

    “I assume you would want MDs to tell patients about manipulation as an option along with the other options of analgesics, PT, exercises or back school.”

    yep.

    “I wonder how many chiropractors present any non-manipulative options to their patients before manipulating them.”

    In school the PARQ conference was drilled into our head and had to be documented on every patient.

    “When Ernst says “Collectively these data fail to demonstrate convincingly that spinal manipulation is an effective intervention for any condition.”
    “he is taking into account the quality of the positive studies”

    the key word here is positive. before he takes the quality of the study into account to draw his conclusion he rates studies as negative that show SMT to be as effective as other treatments and are therefore left out of this positive study quality review.

    @nybgrus
    “You are aware that he was a proponent and purveryor of CAM modalities until he was forced to actually look at the data in detail and discovered the emperor had no clothes, right?”

    I am aware of this due to other comments on this site.

  21. Scott says:

    When a treatment is not superior to other alternatives that carry less risk and/or have other advantages (e.g. cost), that IS effectively negative in that it cannot be said to support the use of the treatment.

  22. Harriet Hall says:

    @jhawk,

    “In school the PARQ conference was drilled into our head and had to be documented on every patient.”

    How many chiropractors actually do this in routine practice? I would guess only a tiny minority. Do you have any evidence otherwise?

    “before he takes the quality of the study into account to draw his conclusion he rates studies as negative that show SMT to be as effective as other treatments and are therefore left out of this positive study quality review.”

    That’s not the way I read what he did. I think you are misinterpreting. Your objection to the 2011 study boils down to the way he categorized a single study, the 2004 Assendelft review. I have e-mailed Dr. Ernst to ask him why he categorized it as negative. I’ll let you know when he replies.

  23. jhawk says:

    @HH

    “How many chiropractors actually do this in routine practice? I would guess only a tiny minority. Do you have any evidence otherwise?”

    I do not know and would have to make a guess myself.

    “Your objection to the 2011 study boils down to the way he categorized a single study, the 2004 Assendelft review.”

    Sort of, for the LBP portion anyway. The assendelft study is the highest quality study ranked. Also, I can not find the other LB study done by Ernst that was rated as negative; Ernst E, Canter PH. Chiropractic spinal manipulation treatment for back pain? A systematic review of randomised clinical trials. Phys Ther Rev 2003;8: 85-91.

    “I have e-mailed Dr. Ernst to ask him why he categorized it as negative. I’ll let you know when he replies.”

    Thanks, I am interested to hear his reply.

    @scott

    “When a treatment is not superior to other alternatives that carry less risk and/or have other advantages (e.g. cost), that IS effectively negative in that it cannot be said to support the use of the treatment.”

    The objective of this study is the evidence for or against the effectiveness of SMT. Harm and cost were not studied.

  24. Scott says:

    My point is that even if we were to accept that Dr. Ernst was in error, that does not then provide any support for chiropractic. Hence the point is ultimately moot.

  25. Harriet Hall says:

    @jhawk,

    Edzard Ernst replied, saying “the quote in our table says it all. We did not classify it as outright negative but as (-).”

    There is a subtle distinction that I think I understand, but I can see why you don’t. (-) expresses the general direction of the findings, not an absolute conclusion, and the statement about Assendelft’s results in Table 1 is a necessarily brief description that does not reflect the entirety of his findings. Ernst felt that overall, the study did not really support the efficacy of manipulation.

    I can’t really fault Ernst, although he might have provided better clarification in the text. But think about this: if that one study were re-classified as positive, you would have 4 positive, 2 negative, and one equivocal. It would still be reasonable to conclude that the evidence for manipulation was not convincing. Especially considering that there are no really good placebo-controlled trials because there is no good way to provide sham manipulation.

  26. jhawk says:

    @HH

    Edzard Ernst replied, saying “the quote in our table says it all. We did not classify it as outright negative but as (-).”

    “There is a subtle distinction that I think I understand, but I can see why you don’t. (-) expresses the general direction of the findings, not an absolute conclusion, and the statement about Assendelft’s results in Table 1 is a necessarily brief description that does not reflect the entirety of his findings.”

    ok, that makes more sense to me.

    “Ernst felt that overall, the study did not really support the efficacy of manipulation.”

    I still don’t think I agree with Ernst here though.

    “I can’t really fault Ernst, although he might have provided better clarification in the text.”

    agreed.

    “But think about this: if that one study were re-classified as positive, you would have 4 positive, 2 negative, and one equivocal. It would still be reasonable to conclude that the evidence for manipulation was not convincing.”

    Yes 4 to 2 but lets not forget that one of the 4′s is of the highest quality ranked in the study. Also, I am not sure the equivocal study fits into the same category as the other 6 (ULBP) as it was for pregnant women only. Again, I can not come to a conclusion with this study (Ernst 2011) until I can find the second negative (leaning!) study that was done and cited by Ernst:

    Ernst E, Canter PH. Chiropractic spinal manipulation treatment for back pain? A systematic review of randomised clinical trials. Phys Ther Rev 2003;8: 85-91.

    Do you have this? I can not find it anywhere.

    “Especially considering that there are no really good placebo-controlled trials because there is no good way to provide sham manipulation.”

    This is actually why I have a problem with the final study that was rated in the general direction of negative.
    Ferreira (2002), from the conclusion:
    “Spinal manipulative therapy is not substantially more effective than sham treatment in reducing pain, nor is it
    more effective than NSAIDs in improving disability of patients with chronic low back pain. It is not clear whetherspinal manipulative therapy is more effective than NSAIDs in reducing pain in chronic low back pain patients.”

    The first sentence is moot since, as you say, there is no good sham. The second sentence says SMT is as effective as NSAIDS and the third sentence is equivocal. Is this negative, positive or equivocal? Personally, I think this one actually rates more in the equivocal categroy.

    @scott

    “My point is that even if we were to accept that Dr. Ernst was in error, that does not then provide any support for chiropractic. Hence the point is ultimately moot.”

    I never said it did. It would provide support for SMT though.

  27. nwtk2007 says:

    @Harriet – Your statement is very true that there are no good placebo-controlled trials for SMT. I’ve said that more than a a few times on this blog.

  28. Chiropractic – the profession with zero solid science backing it up.

    Chiropractic – we’ve built an entire (fraudulent) doctorate program around nothing.

    Chiropractic – over 100 years, and still no proof of anything that we claim.

    Chiropractic – proud practitioners of health care fraud.

  29. Tylenol – $8

    Chiropractic education – $100,000

    lol

  30. nwtk2007 says:

    Liver damage – Priceless! @other NSAIDS – gastric ulcer, also priceless. Death from bleeding gastric ulcer, even more priceless. Sad thing about tylenol is that it just doesn’t cut it for musculoskeletal pain either. Thus the uninformed take even more and get even more liver damage. Couple that with the attempt at analgesia with alcohol and you’ve got a GREAT combination.

    Get over your self skeptical. Getting bored with you.

  31. Haha, but your offering may or may not be as good as a Tylenol pill, but certainly not better and likely worse, and costs orders of magnitude more, runs the risk of paralysis, stroke, and death.

    Your entire profession is truly pathetic. I equate you to bank robbers and other scum that belongs in prison.

  32. nwtk2007 says:

    I love the way many members of your medical profession will lash out at the miniscule risk of SMT when juxtaposed to the risks of just OTC medications, not to mention prescription meds. And oh those mistakes.

    Given your gift for gab, coupled with your extreme anger/vendetta issues, I can only assume that you were sexually abused by your parents.

  33. Interesting deductive reasoning, chiropractor. Really showing off your training there.

    (All that’s left is for someone to refer to someone else as Hitler and we’ll be done. I don’t blame you though, it’s gotta be brutal knowing that your day-to-day job has little if any evidence for efficacy and that you’re essentially robbing and defrauding people, daily, to put food on your table. You failed in life to secure respectable income and have to steal to survive, like street trash. Feel free to lash out at me all you want if it helps you cope.)

  34. nwtk2007 says:

    skeptical – “Interesting deductive reasoning, chiropractor. Really showing off your training there.”

    Hey, really buddy, it doesn’t take a rocket scientist to see how troubled you are. Get some help. I know a good chiropractor who could remove that psychological subluxation. Not.

  35. rwk says:

    @nwtk2007
    do you know skepticalhealth recently “tweeted” to Richard Lanigan DC (who actually has colon cancer )
    that he( SH)was hoping cancer would metastasis to Lannigan’s brain and that he would die a painful death with his children watching.

    Still want to waste your time going back and forth with this ass?

    @ SH
    It’s a good thing for you that you’re anonymous

  36. nwtk2007 says:

    The boy has a serious problem.

    He is “wisdom” on other blogs. A former chiro flunky with some good arguments but a serious case of “get even for me being so stupid”. At least thats how his little brain would put it.

    He ain’t no doc and he ain’t no chiro expert. He’s a sham. The dude is all over the place.

    I’m just wait’in to see how long they let him play here.

    His little internet world is soon to collapse.

  37. Wow. :) Again, I don’t blame you for the strange insults, it’s gotta be brutal knowing that your day-to-day job has little (zero) evidence for efficacy and that you’re essentially robbing and defrauding people, daily, to put food on your table. You failed in life to secure respectable income and have to steal to survive, so you’re basically like street trash. Feel free to lash out at me all you want if it helps you cope. I honestly don’t mind. If it helps you feel better or rationalize your scummy existence, then by all means, go ahead.

    But… We can’t forget that despite whatever weird things you say about me, it doesn’t change the fact that there is almost no convincing evidence that chiropractic does *anything* good for patients. Further, we find that given the substantial adverse events associated with chiropractic, there is absolutely, indisputably, no reason that that any person should ever visit a chiropractor. There is just no evidence that chiropractic care does enough good to justify the bad. Zero.

    I hope you think about these last two paragraphs every time you write a check towards your student loans, paying off a completely fraudulent and scam “doctorate” while you deny that you, in fact, failed at life. If only you had tried harder in college you could have earned a better GPA and perhaps pursued legitimate schooling to get a real career in health care.

  38. nwtk2007 says:

    @rwk – I feel like its one of those “topics” blogs. Its the same boy abviously. Amd no, I can’t justify bandying back and forth with it.

    I pity it/him/her.

  39. nobs says:

    rwk posts:
    “do you know skepticalhealth recently “tweeted” to Richard Lanigan DC (who actually has colon cancer )that he( SH)was hoping cancer would metastasis to Lannigan’s brain and that he would die a painful death with his children watching.”

    Yes this is indeed true. I saw it.

    I too, am flumoxed as to why his vitriol has been allowed to continue here for so long.

  40. Harriet Hall says:

    We try very hard not to ban commenters and to let everyone have his say. I am distressed by the vitriol and name-calling on both sides of this debate and I ask for it to stop. Please, let’s stick to talking about issues, not about individuals. And please note that the original subject was whether chiropractors should be family doctors, and every commenter has agreed that they should not. We are all in agreement about that, and my post only served as an opportunity for commenters to hijack the discussion, get on their respective soap boxes, and talk about only loosely related subjects. You have had your say, and the comments have become repetitive as well as offensive. Please stop!

  41. I apologize for any personal insults directly or implied. I too would like to stick to the facts. Following is a overview of major systematic reviews from the last ~20 years investigating the efficacy of chiropractic treatment for different conditions (including both musculoskeletal and not), which further solidifies the point that we all seem to be in agreement with: that chiropractors have no business pretending to be a “family doctor” as their treatments are completely ineffective for practically every application.

    -

    In 1991, a systematic review assessed the efficacy of spinal manipulation for patients with back or neck pain. The review found that although some results are promising, the efficacy of manipulation had not been convincingly shown.269

    In 1992, a systematic review investigated the efficacy of spinal manipulation as a treatment for low back pain. The authors found that spinal manipulation may provide short-term benefit for patients with uncomplicated acute low back pain. The authors found no evidence of the effectiveness of chiropractic manipulation for chronic low back pain. The authors identified several complications of lumbar spine manipulation, including paraplegia and death.270

    In 1996, a systematic review assessed the efficacy of spinal manipulation for patients with low back pain. The review found that efficacy of spinal manipulation for patients with acute or chronic low back pain has not been demonstrated with sound randomized clinical trials.271

    In 1998, a study investigated how well chiropractors followed U.S. guideline recommendations for spinal manipulation in patients with lower back pain. The authors were hoping to find that if chiropractors adhered to guidelines, they may see more referrals from medical doctors. The study found that less than half (46%) of chiropractors treated patients in an appropriate manner. The standard of care was uncertain in 25% of cases and was inappropriate in 29% of cases. The authors concluded that the number of inappropriate decisions to use chiropractic spinal manipulation should be decreased.272

    In 2003, a systematic review evaluated the evidence supporting the use of chiropractic care for any type of non-spinal pain. Studies related to fibromyalgia, carpal tunnel syndrome, infantile colic, otitis media, dysmenorrhoea and chronic pelvic pain were found and examined. The review found the studies did not demonstrate that chiropractic manipulation is an effective therapy for any of these conditions.273

    In 2003, an article examined the trends and issues of the chiropractic profession in the United States. The authors noted that although chiropractic has been established for over 100 years, the profession’s efforts to validate the effectiveness of spinal manipulative therapy, its principal modality, have yielded only modest and often contrary results. The article also noted that the declining reimbursements from insurance companies for chiropractic care is essentially requiring chiropractors to broaden its activities in alternative medicine. Perhaps this explains why many chiropractors incorporate forms of quackery such as iridology and energy healing into their practice.274

    In 2003, a meta-analysis examined the effectiveness of spinal manipulative therapy for low back pain compared to other therapies. For patients with acute low back pain, spinal manipulative therapy was superior only to sham therapy or therapies judged to be ineffective or even harmful. Spinal manipulative therapy had no statistically or clinically significant advantage over general practitioner care, analgesics, physical therapy, or exercise. Essentially, spinal manipulative therapy was found to only be better than doing nothing.275

    In 2003, a systematic review examined the effectiveness of non-surgical treatments (other than steroid injection) for carpal tunnel syndrome. While the review found several non-surgical treatments for carpal tunnel that were effective (for example, wrist braces), the review found that chiropractic care did not demonstrate symptom benefit when compared to placebo or control.276

    In 2004, a systematic review examined the efficacy of spinal manipulation for neck pain. The review found a lack of evidence that spinal manipulation therapy is effective for any type of neck pain.277

    In 2005, a systematic review aimed to determine the extent of current evidence supporting the use of chiropractic manipulation for the treatment of acute neck pain. They found no evidence supporting the use of chiropractic manipulation to treat acute neck pain.278

    In 2005, a systematic review examined the use of different types of physical treatments (physical therapy, massage therapy, and chiropractic) for headache. The review found no convincing evidence that chiropractic manipulation is effective in the treatment of either tension-type headache or migraine headache.279

    In 2005, a systematic review investigated noninvasive interventions for whiplash-associated disorders. The review found no high-quality evidence that chiropractic manipulation was effective for the treatment of whiplash.280

    In 2006, a systematic review evaluated the evidence from recent systematic reviews of clinical trials of spinal manipulation. The review found that recent reviews found no evidence for the use of spinal manipulation for the treatment of any medical condition, with the possible exception of back pain where spinal manipulation was considered superior to sham manipulation but not better than conventional treatments. The review concluded:

    “Collectively these data do not demonstrate that spinal manipulation is an effective intervention for any condition. Given the possibility of adverse effects, this review does not suggest that spinal manipulation is a recommendable treatment.281″

    In 2006, a systematic review assessed the efficacy of manual therapies in reducing pain from tension-type headache. The authors found no rigorous evidence that manual therapies have a positive effect in the evolution of tension-type headache.282

    In 2006, a systematic review examined alternative medical therapies for efficacy in the treatment of fibromyalgia. The review found that chiropractic care has neither well-designed studies nor positive results and concluded that chiropractic care is not recommended for fibromyalgia treatment.283

    In 2007, a study evaluated the perceptions of research, frequency of use of research findings in practice, and the level of research skills of chiropractors. Surveyed chiropractors acknowledged the importance of research to validate their practice, but had little confidence in their research skills and the overall application of research in practice was limited. The study concluded that chiropractors do not consistently apply research in practice, which may result from a lack of research education and research skills.284

    In 2007, a systematic review evaluated the use of nonsurgical treatments such as chiropractic for scoliosis. The review found no evidence that chiropractic care is an effective treatment for patients with scoliosis.285

    In 2008, a systematic review investigated the scope, type, and quality of chiropractic research conducted on the management of upper limb peripheral conditions (problems involving the shoulder, elbow, wrist, hand, forearm, and arm.) The review found that most of the existing research was of low quality and found no high-quality research that suggested chiropractic treatment had any positive effect for upper limb conditions.286

    In 2008, a critical evaluation of chiropractic care found that with the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Despite this lack of evidence, the article found that many chiropractors attempt to treat conditions beyond back pain. It was further noted that manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. The evaluation concluded:

    “The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt.287″

    In 2009, a systematic review examined the effectiveness of chiropractic care in patients with fibromyalgia. The review found no evidence that chiropractic spinal manipulation is an effective treatment for fibromyalgia.288

    In 2009, a systematic review examined the use of chiropractic treatment for fibromyalgia. The review found that existing studies were of poor methodological quality and generated no evidence to suggest that chiropractic care is effective for fibromyalgia.289

    In 2009, a systematic review examined the effectiveness of spinal manipulation for patients with dysmenorrhea (painful menstrual cramps.) Results from trials found that spinal manipulation was no more effective than placebo for the treatment of dysmenorrhea. The authors concluded:

    “Overall there is no evidence to suggest that spinal manipulation is effective in the treatment of primary and secondary dysmenorrhea.290″

    In 2010, a systematic review examined studies using chiropractic spinal manipulation for the treatment of asthma. The review found that chiropractic care was not significantly better than placebo, and that spinal manipulation is not an effective treatment for asthma.291

    In 2010, a systematic review examined the effectiveness of spinal manipulation for neck pain. The review did not find any high-quality evidence that manipulation was effective in decreasing either acute or chronic neck pain, or its associated headaches and pain radiating down the arms.292

    In 2010, a systematic review examined the evidence for the use of manipulation technique for the treatment of shoulder pain. The review found no evidence to support the use of chiropractic manipulation for shoulder pain.293

    In 2010, a systematic review of combined chiropractic interventions (that is, a combination of therapies, other than spinal manipulation alone) for low-back pain was performed. The review found that combined chiropractic interventions slightly improved pain and disability in the short-term and pain in the medium-term for acute and subacute low-back pain. However, there was no evidence that these interventions provide a clinically meaningful difference for pain or disability in people with low-back pain when compared to other interventions.294

    In 2011, a systematic review assessed the effectiveness of spinal manipulation for treating migraine headaches. The review found no evidence to support the use of spinal manipulations for the treatment of migraine headaches.295

    In 2011, a systematic review assessed the effects of spinal manipulation therapy for chronic low-back pain. Studies including sciatica were excluded. The review found that there is high quality evidence that spinal manipulation therapy has a small, but not clinically relevant, short-term effect on pain relief and functional status.296

    In 2011, a systematic review examined the up-to-date literature as it relates to the efficacy and effectiveness of spinal manipulation in the management of cervical, thoracic, and lumbar-related extremity pain. The review found no high quality evidence that spinal manipulation is effective for the treatment of any type of cervical, thoracic, or lumbar-related extremity pain.297

    In 2011, a study investigated whether spinal manipulation would be a useful adjunct therapy to home exercise for patients with chronic neck pain. The authors found that the addition of spinal manipulation did not improve the outcome in patients with chronic neck pain who were already performing regular home exercises.298

    In 2011, a systematic review critically evaluated the effectiveness of chiropractic treatments for gastrointestinal disorders. The review found that existing studies had serious methodological flaws. The author concluded that there is no supportive evidence that chiropractic is an effective treatment for any gastrointestinal disorder.299

    In 2011, an update to the 2006 systematic review of systematic reviews found that spinal manipulation is not an effective intervention for any condition.300

    Part of the “family component” is pediatric care:

    Chiropractors claim many childhood problems are caused by these misalignments, including ear infections, bedwetting, asthma, problems with breastfeeding, attention problems, colic, and even learning disorders such as autism.

    Examples of claims from chiropractic websites:

    “Chiropractic…is a great way to help restore children’s health in a natural way… Chiropractic care…is effective in treating: nose and throat infections, childhood reflux, colic, breastfeeding difficulties, failure to thrive, recurrent infections, tummy upsets and many other childhood conditions.”

    and

    “Problems can develop within your child’s spine during birth or at other times during childhood… [they] can lead to symptoms such as: colic, otitis media, bedwetting, sleeping and feeding problems, poor coordination, adolescent scoliosis, torticolis, hip pain, knee pain, headaches, back pain, asthma, chest infections, behavioral problems, Scheuermann’s disease… Early assessment of your child’s spine may help to prevent some of the above symptoms.”

    and

    “Common childhood disorders can also sometimes indicate a spinal problem. Persistent earaches, sore throats, colic, headaches, bedwetting, and growing pains are but some of the more common problems for which parents bring their children to the chiropractor… Because the scientific literature identifying the benefits of spinal manipulation for children’s problems is not extensive, it is understandable that medical doctors may not be up-to-date in this specialized area.”

    Chiropractic advertisements of pediatric conditions may threaten that if these nonexistent subluxations go unnoticed, they can begin to develop into frequent sore throats, neck and back pain, and even scoliosis.

    All of these claims are completely false and are not backed up by scientific evidence. Sore throats, for example, are caused by viral or bacterial infections. Claiming that a prescientific explanation such as vertebral subluxation causes them completely eschews the germ theory of disease.

    Ethical issues arise in the case of pediatric chiropractic manipulation for several reasons. First, chiropractic manipulation has been shown by the best-quality evidence to be ineffective for the treatment of every pediatric medical condition. Next, it is unlikely that the chiropractor has informed the child and the mother of the dangers of spinal manipulation, especially of the neck. Last, the child does not likely understand the treatment they are receiving and are unable to consent to something that has such a negative risk-benefit analysis.

    Scientific investigations reveal that chiropractic spinal manipulation is not effective for the treatment of any pediatric condition.

    In 1995, a study aimed to evaluate the efficacy of chiropractic treatment in the management of chronic asthma when combined with pharmaceutical maintenance therapy. The study found no clinically important or statistically significant differences between the active and sham chiropractic interventions on any of the main or secondary outcome measures. The results do not support the hypothesis that chiropractic spinal manipulative therapy is superior to sham spinal manipulation in the management of pharmaceutically controlled chronic asthma in adults when administered twice weekly for 4 weeks.231

    In 2001, a study investigated the efficacy of chiropractic spinal manipulation in the management of infantile colic. The study found that chiropractic spinal manipulation is no more effective than placebo in the treatment of infantile colic.232

    In 2004, a systematic review examined the state of evidence for chiropractic care relating to the management of asthma. No subjective measures, such as quality of life, were improved greater than placebo. No studies showed a significant increase in lung function after receiving chiropractic care. The authors found no evidence to support the use of chiropractic spinal manipulation therapy as a treatment for asthma or allergy.233

    In 2005, a systematic review assessed the effects of chiropractic spinal manipulation for nocturnal enuresis (bedwetting) in children. The review found that all existing evidence was of very poor quality, and found no high-quality studies or strong evidence that spinal manipulation has any effect on nocturnal enuresis.234

    In 2005, a systematic review evaluated the evidence for the effects of manual therapies for treatment of patients with bronchial asthma. The review found that chiropractic manipulation was completely ineffective for the treatment of bronchial asthma.235

    In 2005, a systematic review examined the effectiveness of chiropractic treatment of the KISS-syndrome (kinetic imbalance due to sub-occipital strain) in infants with positional preference, plagiocephaly (flattening of one side of the skull), and colic. The review found no evidence that chiropractic spinal manipulation would be of any benefit to infants with KISS-syndrome, especially due to its potential risks.236

    In 2008, a systematic review investigated the evidence related to chiropractic manipulation for any type of pediatric health condition. The review found no high quality evidence to support health claims made by chiropractors with respect to the application of spinal manipulation as a health care intervention for any pediatric health condition. The review further noted that despite any evidence of its usefulness, chiropractors continue to treat a wide variety of pediatric health conditions.237

    In 2008, a systematic review was performed to examine the usefulness of manual therapy (chiropractic, massage therapy, osteopathy, mobilization) for the treatment of adolescent scoliosis. The review found no positive data on the efficacy of manual therapy as treatment for adolescent scoliosis.238

    In 2009, the British Chiropractic Association (BCA) claimed that there was substantial evidence to support the use of chiropractic manipulation for various childhood conditions. Their report cited 19 references. All 19 papers were found to not support the BCA’s conclusions because they either were found to not cite any data related to their claims, were found to not refer to controlled clinical trials, or did not contain statistically significant findings. The BCA’s claims were completely unsubstantiated. No high quality data was found supporting the use of chiropractic care for any childhood disorder.239

    In 2009, a systematic review examined the use of spinal manipulation for the treatment of infant colic. The review found that the evidence failed to demonstrate the effectiveness of this treatment. The review concluded that spinal manipulation is not an effective treatment for infant colic.240

    In 2009, a systematic review critically evaluated the evidence for spinal manipulation as an effective treatment for asthma. All reviewed studies had excellent methodological quality and all studies found that spinal manipulation had no different effect than placebo for the treatment of asthma. The review concluded that according to the evidence of the most rigorous study available to date, spinal manipulation is not an effective treatment for asthma.241

    In 2010, a systematic review investigated whether chiropractic care can reduce symptoms of inattention, impulsivity, and hyperactivity for pediatric and adolescent ADHD (attention deficit hyperactivity disorder.) The review found no evidence that chiropractic care is efficacious for pediatric and adolescent ADHD.242

    And part of pediatrics is vaccinations, which have saved the lives of hundreds of millions of people:

    In 1995, a survey found that approximately one-third of chiropractors believed there was no scientific proof that immunization prevents disease.265

    In 2000, an article criticized the chiropractic profession for maintaining a strong anti-vaccination bias. The article noted the reasons for this bias to lie in early chiropractic philosophy, which considered disease to be the result of spinal nerve dysfunction caused by subluxated vertebrae. Despite that vertebral subluxation is a disproven concept that is rejected by medical science, many chiropractors still maintain this as a cause of disease and therefore refuse to embrace the concept of vaccination.266

    In 2004, a study surveyed chiropractors about their beliefs regarding vaccinations and how they handle such topics in their practice. The study found that only 25% of chiropractors advised their patients in favor of vaccinations for themselves or their children. The study believed that this unscientific behavior is due to chiropractic beliefs about the efficacy/safety of vaccination, chiropractic philosophy and individual rights.267

    Refs:

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    232 E Olafsdottira, S Forsheib, G Flugea, T Markestad. “Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation” Arch Dis Child 2001;84:138-141.

    233 Balon JW, Mior SA. “Chiropractic care in asthma and allergy.” Ann Allergy Asthma Immunol. 2004 Aug;93(2 Suppl 1):S55-60.

    234 Glazener CM, Evans JH, Cheuk DK. “Complementary and miscellaneous interventions for nocturnal enuresis in children.” Cochrane Database Syst Rev. 2005 Apr 18;(2):CD005230.

    235 Hondras MA, Linde K, Jones AP. “Manual therapy for asthma.” Cochrane Database Syst Rev. 2005 Apr 18;(2):CD001002.

    236 Brand PL, Engelbert RH, Helders PJ, Offringa M. “Systematic review of the effects of therapy in infants with the KISS-syndrome (kinetic imbalance due to sub-occipital strain).” Ned Tijdschr Geneeskd. 2005 Mar 26;149(13):703-7.

    237 Gotlib A, Rupert R. “Chiropractic manipulation in pediatric health conditions–an updated systematic review.” Chiropr Osteopat. 2008 Sep 12;16:11.

    238 Romano M, Negrini S. “Manual therapy as a conservative treatment for adolescent idiopathic scoliosis: a systematic review.” Scoliosis. 2008 Jan 22;3:2.

    239 Ernst E. “Chiropractic for paediatric conditions: substantial evidence?” BMJ. 2009 Jul 9;339:b2766.

    240 Ernst E. “Chiropractic spinal manipulation for infant colic: a systematic review of randomised clinical trials.” Int J Clin Pract. 2009 Sep;63(9):1351-3.

    241 Ernst E. “Spinal manipulation for asthma: a systematic review of randomised clinical trials.” Respir Med. 2009 Dec;103(12):1791-5. Epub 2009 Jul 30.

    242 Karpouzis et al. “Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review.” Chiropractic & Osteopathy 2010, 18:13.

    265 Campbell JB, Busse JW, Injeyan HS (2000). “Chiropractors and vaccination: a historical perspective”. Pediatrics 105 (4): e43.

    266 Campbell JB, Busse JW, Injeyan HS. “Chiropractors and vaccination: A historical perspective.” Pediatrics. 2000 Apr;105(4):E43.

    267 Russell ML, Injeyan HS, Verhoef MJ, Eliasziw M. “Beliefs and behaviours: understanding chiropractors and immunization.” Vaccine. 2004 Dec 2;23(3):372-9.

    268 Busse JW, Morgan L, Campbell JB. “Chiropractic antivaccination arguments.” J Manipulative Physiol Ther. 2005 Jun;28(5):367-73.

    269 Koes BW, Assendelft WJ, van der Heijden GJ, Bouter LM, Knipschild PG. “Spinal manipulation and mobilisation for back and neck pain: a blinded review.” BMJ. 1991 Nov 23;303(6813):1298-303.

    270 Shekelle PG, Adams AH, Chassin MR, Hurwitz EL, Brook RH. “Spinal manipulation for low-back pain.” Ann Intern Med. 1992 Oct 1;117(7):590-8.

    271 Koes BW, Assendelft WJ, van der Heijden GJ, Bouter LM. “Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials.” Spine (Phila Pa 1976). 1996 Dec 15;21(24):2860-71; discussion 2872-3.

    272 Shekelle PG, Coulter I, Hurwitz EL, Genovese B, Adams AH, Mior SA, Brook RH. “Congruence between decisions to initiate chiropractic spinal manipulation for low back pain and appropriateness criteria in North America.” Ann Intern Med. 1998 Jul 1;129(1):9-17.

    273 Ernst E. “Chiropractic manipulation for non-spinal pain–a systematic review.” N Z Med J. 2003 Aug 8;116(1179):U539.

    274 Cooper RA, McKee HJ. “Chiropractic in the United States: trends and issues.” Milbank Q. 2003;81(1):107-38, table of contents.

    275 Assendelft WJ, Morton SC, Yu EI, Suttorp MJ, Shekelle PG. “Spinal manipulative therapy for low back pain. A meta-analysis of effectiveness relative to other therapies.” Ann Intern Med. 2003 Jun 3;138(11):871-81.

    276 O’Connor D, Marshall S, Massy-Westropp N. “Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome.” Cochrane Database Syst Rev. 2003;(1):CD003219.

    277 Bronfort G, Haas M, Evans RL, Bouter LM. “Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.” Spine J. 2004 May-Jun;4(3):335-56.

    278 Haneline MT. “Chiropractic manipulation and acute neck pain: a review of the evidence.” J Manipulative Physiol Ther. 2005 Sep;28(7):520-5.

    279 Biondi DM. “Physical treatments for headache: a structured review.” Headache. 2005 Jun;45(6):738-46.

    280 Conlin A, Bhogal S, Sequeira K, Teasell R. “Treatment of whiplash-associated disorders–part I: Non-invasive interventions.” Pain Res Manag. 2005 Spring;10(1):21-32.

    281 Ernst E, Canter PH. “A systematic review of systematic reviews of spinal manipulation.” J R Soc Med. 2006 Apr;99(4):192-6.

    282 Fernández-de-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA. “Are manual therapies effective in reducing pain from tension-type headache?: a systematic review.” Clin J Pain. 2006 Mar-Apr;22(3):278-85.

    283 Sarac AJ, Gur A. “Complementary and alternative medical therapies in fibromyalgia.” Curr Pharm Des. 2006;12(1):47-57.

    284 Suter E, Vanderheyden LC, Trojan LS, Verhoef MJ, Armitage GD. “How important is research-based practice to chiropractors and massage therapists?” J Manipulative Physiol Ther. 2007 Feb;30(2):109-15.

    285 Everett CR, Patel RK. “A systematic literature review of nonsurgical treatment in adult scoliosis.” Spine (Phila Pa 1976). 2007 Sep 1;32(19 Suppl):S130-4.

    286 McHardy A, Hoskins W, Pollard H, Onley R, Windsham R. “Chiropractic treatment of upper extremity conditions: a systematic review.” J Manipulative Physiol Ther. 2008 Feb;31(2):146-59.

    287 Ernst E. “Chiropractic: a critical evaluation.” J Pain Symptom Manage. 2008 May;35(5):544-62. Epub 2008 Feb 14.

    288 Schneider M, Vernon H, Ko G, Lawson G, Perera J. “Chiropractic management of fibromyalgia syndrome: a systematic review of the literature.” J Manipulative Physiol Ther. 2009 Jan;32(1):25-40.

    289 Ernst E. “Chiropractic treatment for fibromyalgia: a systematic review.” Clin Rheumatol. 2009 Oct;28(10):1175-8. Epub 2009 Jun 21.

    290 Proctor ML, Hing W, Johnson TC, Murphy PA. “Spinal manipulation for primary and secondary dysmenorrhoea.” Cochrane Database Syst Rev. 2006 Jul 19;3:CD002119.

    291 Kaminskyj A, Frazier M, Johnstone K, Gleberzon BJ. “Chiropractic care for patients with asthma: A systematic review of the literature.” J Can Chiropr Assoc. 2010 Mar;54(1):24-32.

    292 Gross A, Miller J, D’Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Brønfort G, Hoving JL; COG. “Manipulation or mobilisation for neck pain: a Cochrane Review.” Man Ther. 2010 Aug;15(4):315-33. Epub 2010 May 26.

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  42. mattyp says:

    Wow. 345 comments. I stopped following at 150.
    For what it’s worth, I do not feel as though we (chiropractors) should be family doctors. However, here in Australia we are primary contact, in that, a patient does not need a referral to be able to see us. What we do need, however, is a solid base of training and education in how to recognise dangerous conditions that may masquerade as simple chiropractic problems, and refer them to their medical practitioner (or emergency room as indicated. eg. CES). It would do our patients a disservice to pretend to be general practitioners or family doctors unless chiropractic became a sub-specialty within medicine such as general practice, orthopaedics or perhaps even physical therapy – which would nullify the need for the profession named “chiropractic”. Undoubtedly, some of you here would see this as a good thing. But the point I am taking a long time at getting to is that while long attention is paid to diagnosis with relation to pain (and at my institution we are quite good at it) and even being able to throw up certain medical conditions as differential diagnoses, we are currently unable to order the required tests are not sufficiently trained in pharmacology to prescribe the adequate treatment these medical conditions require.
    Given the wide range of conditions that present with pain, or neurological signs, or general unease, chiropractors should be trained for all of the possibilities that it could be. But just because we might spot a probable case of MS from a patient’s history, or deduce that the shoulder pain that our patient is experiencing is actually from a MI, we really need to realise that we have a limit to the scope of our practice and simply refer on to the appropriate medical practitioner.

    I’m not suggesting throwing the baby out with the bathwater in regards to chiropractic care, but it seems as though many within chiropractic want for chiropractic to be experts at every aspects of medicine and the human body – that is impossible. The more you try to broaden your scope the more you dilute your effectiveness at what you do (very homeopathic eh?).

    Stick with what we’re good at – musculoskeletal diagnosis and treatment. Best leave family practice to those who are trained at it – the general practitioners.

    Forgive the rant.
    Matt

  43. DavidRLogan says:

    I thought I’d dredge this one up with anecdote: just found out my partner’s daughter (19 yo) had her ribs broken this week by a chiropractic adjustment. She’d lost alot of weight over the past year, after pregnancy, and’d been very malnourished and had weak bones. As far as I can tell, the chiropracter involved did zero as far as a medical history.

    Very sad and annoying. I was instantly reminded of this thread and am annoyed I hadn’t heard she was going to a chiro.

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