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Pushback on Chiropractic

Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

Daniel David Palmer, creator of the nebulous subluxation and father of chiropractic.

From time to time we respond directly to reader comments or e-mails in an article, when it seems that doing so would be a useful teachable moment. One of the strengths of social media is that it is interactive, which can be didactic.

I feel it is very important to respond to what people actual believe and say, because otherwise we may tend to get lost in our own narrative, as legitimate as it might be. That is the essence of ivory tower syndrome, academics talking to themselves without a reasonable sense of what is happening in society. Part of our mission is to interact with society, not just our colleagues, and to engage in a serious conversation about the nature of science and medicine.

To that end, I recently received an e-mail responding to an interview I had done previously about chiropractic. The e-mail is full of pro-chiropractic propaganda and misconceptions, and so it provides an opportunity to address some of these claims. (more…)

Posted in: Chiropractic

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Chiropractic and the Newborn Baby

birth subluxation

I had the pleasure of speaking on the topic of chiropractic and the newborn baby earlier this week at a meeting of the Boston Skeptics. There is a video of the talk online for anyone interested in learning more. And if you haven’t yet, please read yesterday’s post on chiropractic and babies by Sam Homola.

My introduction to pediatric chiropractic

Although I was aware of the existence of chiropractic well before beginning my medical training, I was blissfully ignorant of the full scope of what many chiropractors actually do on a daily basis. My belief that they practiced solely as “doctors of the back” was shattered early in my pediatric training at Vanderbilt while on a pulmonary medicine rotation when I was asked to consult on the child of a well-known musician who lived in the area. The patient, perhaps only hours from respiratory failure, had been brought to our emergency department only after chiropractic treatments had failed to manage a severe asthma exacerbation.

That encounter, as well as another around the same time involving a child with a throat abscess being treated with acupuncture, inspired me to dig deeper into the general concept of alternative medicine. I even went so far as to approach a local chiropractor who had set up a table at a Nashville YMCA to promote chiropractic prevention and treatment of the flu. Dr. Fakename happily allowed me to spend a day in his office, and even brought in his own child to demonstrate his approach pediatric care.

Needless to say, Dr. Fakename failed to convince me of the benefits or need for chiropractic involvement in pediatric healthcare. When the discussion turned to routine childhood vaccines, I heard the party line on the subject for the first of many times. Dr. Fakename was not against vaccines, he was in favor of giving families all of the facts. He gave me some reading material, and a book suggestion or two, which provided nothing but potential and unproven risks with no mention of the well-established benefits and proven safety of immunizations. I’ll never forget what his wife, who had brought their child in for the demonstration, whispered to me during a moment of distraction: “Don’t worry, we vaccinate our kids. I make sure.”

By the end of my residency I was a full blown skeptic of a variety of alternative medical modalities in addition to chiropractic, and had built a reputation as someone interested in and knowledgeable on the subject of quackery. I even gave a grand rounds on pediatric CAM with a focus on chiropractic which I’m proud to say drew a standing room only crowd that included folks from the community interested in alternative medicine as well as from the brand new integrative medicine center at Vanderbilt. I had even been asked to serve as a resident representative, however that invitation was quickly rescinded after my skeptical talk. (more…)

Posted in: Chiropractic, Science and Medicine

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NCCAM manipulates spinal manipulation

chiropractice-baby
“Complementary and alternative medicine,” as pediatrician and fellow blogger John Snyder aptly stated in a recent journal article on CAM and children,

is a term used to describe a disparate, poorly defined set of practices and treatment modalities presumed to be distinct from so-called ‘conventional medicine’.

As we have discussed here at Science-Based Medicine, this amorphous concept facilitates a convenient fluidity in delineating the parameters of CAM. Without a clear definition, CAM (and integrative medicine) proponents are able to rebrand plausible and evidence-based practices such as diet, exercise and relaxation as CAM, a tactic we at SBM call “bait and switch.” This results in inflation in the figures of CAM use (important because CAM is all about popularity) and claims that CAM “works.”
(more…)

Posted in: Chiropractic, Politics and Regulation

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An Appraisal of Courses in Veterinary Chiropractic

Today’s guest article, by By Ragnvi E. Kjellin, DVM, and Olle Kjellin, MD, PhD, was submitted to a series of veterinary journals, but none of them wanted to publish it. ScienceBasedMedicine.org is pleased to do so.

 

chiropractor-adjusting-basset-hound
Animal chiropractic is a relatively new phenomenon that many veterinarians may know too little about. In Sweden, chiropractic was licensed for humans in 1989, but not for animals. Chiropractors claim that their field is scientific, while others consider it to be a form of ”alternative medicine” with an implausible and unsubstantiated theoretical foundation and little evidence of efficacy. Chiropractic is not taught in medical or veterinary schools.

Courses in “veterinary chiropractic” are offered by two companies in Germany. In their classes, veterinarians and human chiropractors are purposely mixed. A recent malpractice case in Sweden involved one of their students, a veterinarian who was accused of injuring a horse with chiropractic neck manipulation. That case led us to inquire into the underlying theory, clinical practices, and training of “veterinary chiropractors”.

Human chiropractic was founded in 1895 when D.D. Palmer, a grocer and magnetic healer with no medical training, decided that 95% of all diseases were due to vertebral subluxations that blocked the flow through the spinal nerves to all muscles and organs of the body, including the brain, eyes and ears. Adjusting subluxations supposedly allows the body to heal itself by “innate intelligence.” Over a century later, there is still no evidence that such subluxations or “intelligence” exists.

Mainstream medicine has always been skeptical of chiropractic1. Even some chiropractors have criticized the practices of their colleagues2,3. Several recent meta-analyses of chiropractic for various ailments4,5,6 have concluded that musculoskeletal back and possibly neck pain may benefit from spinal manipulation therapy; but the results are not superior to other treatments, and there is no evidence of benefit for other ailments.

Considerable controversy surrounds the chiropractic field. It is therefore essential that veterinarians understand the facts about chiropractic before they consider practicing it, recommending it, or even condoning it for the animals they treat. (more…)

Posted in: Chiropractic, Veterinary medicine

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Science-based Chiropractic: An Oxymoron?

ChiroAdj
I spent 43 years in private practice as a “science-based” chiropractor and a critic of the chiropractic vertebral subluxation theory. I am often asked how I justified practicing as a chiropractor while renouncing the basic tenets of chiropractic. My answer has always been: I was able to offer manipulation in combination with physical therapy modalities as a treatment for mechanical-type back pain—a service that was not readily available in physiotherapy or in any other sub-specialty of medicine.

If I had it to do over again, however, I would study physical therapy rather than chiropractic. Considering the controversy that continues to surround the practice of chiropractic, I would not recommend that anyone spend the time, effort, and money required to earn a degree in chiropractic. Physical therapy, which is now beginning to include spinal manipulation in its treatment armamentarium, may offer better opportunity for those interested in manual therapy. Properly-limited, science-based chiropractors are now essentially competing with physical therapists who use manual therapy. Unfortunately, only a few chiropractors have renounced the vertebral subluxation theory, making it difficult to find a “good chiropractor.” I consider physical therapy to be more progressive and more evidence based. For this reason, I generally recommend the manipulative services of a physical therapist rather than a chiropractor.

There are some science-based chiropractors who use manipulation appropriately, but until the chiropractic profession abandons the implausible vertebral subluxation theory and is defined according to standards dictated by anatomy, physiology, and neurology, I would not describe it as a science-based profession.
(more…)

Posted in: Chiropractic

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