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Educators Blast Mainstream
Chiropractic Brochures
Stephen Barrett, M.D.
Chiropractic is based on the belief
that spinal problems ("subluxations") are the cause or underlying cause
of health problems and that spinal manipulations ("adjustments")
can restore and maintain health. These ideas clash with what
is known about health, disease, and the human body, but the vast
majority of chiropractors still subscribe to them in one way
or another [1].
During the past 25 years, I have never
seen a major chiropractic organization acknowledge that there
is anything fundamentally wrong with chiropractic beliefs or
practices. When misleading chiropractic claims are criticized
by an outsider, they say that the critic is biased. When embarrassed
by quotes from within their own profession, they claim that whatever
is said does not represent the chiropractic "mainstream."
[2]
A few months ago, the leading chiropractic
journal published criticisms that could not be defended with
these tactics. After examining various patient-education materials,
three chiropractic college professors reported:
The largest professional associations
in the United States and Canada distribute patient brochures
that make claims for the clinical art of chiropractic that are
not currently justified by available scientific evidence or that
are intrinsically untestable. These assertions are self-defeating
because they reinforce an image of the chiropractic profession
as functioning outside the boundaries of scientific behavior
[3].
In addition, the trio wrote, "the
distribution of patient brochures involving unsubstantiated claims
. . . meets several of the formal criteria for quackery."
The critics were Jaroslaw
P. Grod, DC, a professor at Canadian
Memorial Chiropractic College, in Toronto, and two other professors
at Los Angeles College of Chiropractic. Together they objected
to 26 claims in 20 brochures distributed by the American
Chiropractic Association, the Canadian Chiropractic Association, the Foundation
for Chiropractic Education and Research,
the British
Columbia Chiropractic Association,
the Ontario Chiropractic
Association, the California
Chiropractic Association , the New York State Chiropractic Association, or the Texas
Chiropractic Association.
In considering the brochures, the professors
considered three types of statements to be improper:
- Claims that spinal manipulation could
treat diseases unrelated to musculoskeletal problems were considered
unsubstantiated.
- Vague statements that "chiropractic
care" is beneficial were considered untestable and therefore
misleading.
- Assertions that chiropractors treat
"subluxations" were considered unsubstantiated because
no such entity has been experimentally established.
Here are examples of their analyses:
| Unjustified
Claim |
Objection |
| "The doctor of
Chiropractic adheres to the philosophy that the body is capable
of maintaining and restoring health with a balanced diet, rest,
and a properly functioning nervous system. Manipulation of the
spine and other areas is the key to recovery." (Canadian
Chiropractic Association) |
"This panacea assertion suggests
that manipulation produces a nonspecific and beneficial effect
on the nervous system; no experimental data are available to
substantiate this assertion." |
| Chiropractic differs
from traditional medicine because "chiropractic treats the
patient, not just the symptoms . . . the doctor of chiropractic
not only addresses the problem, but the cause as well."
(American Chiropractic Association) |
Chiropractors have yet to demonstrate
any unique cause for any condition. |
| "When compared
to other therapies, chiropractic is safer and more effective
. . . chiropractic care is safe and effective with less risk
than many medications or medical interventions." (Canadian
Chiropractic Association) |
"Claims for . . . relative
safety and effectiveness . . . should be judged with respect
to the particular health problem for which care is provided.
There are very few trials that compare chiropractic (manipulative)
and medical (pharmacological) intervention methods." |
| "The spine . .
. should get the same regular checkups as your teeth, not just
when you've got pain. (Canadian Chiropractic Association) |
The preventive value, if any, of
chiropractic care is unproven and largely unstudied. The value
of "regular check-ups" by chiropractors is unknown. |
| "A chiropractor
could prevent many of these problems [arthritis] from developing
in the first place by reducing their subluxations and other spinal
problems." (Ontario Chiropractic Association) |
"Chiropractic care" and
"subluxation correction" have no proven value |
| "Chiropractic care
is one of the safest types of treatments available today, and
is an effective alternative to drugs and surgery for many conditions."
(American Chiropractic Association) |
"The claim for effectiveness
of unspecified chiropractic methods is untestable because the
"many conditions" are not defined. Experimental comparisons
of medical, surgical, and chiropractic interventions are extremely
rare." |
It will be interesting to see whether
the organizations mentioned in this report will stop making any
of the claims that were criticized. My guess is that they will
not. In fact, the only reaction I have seen from a chiropractic
leader came from Matthew McCoy, D.C., editor of the Journal
of Vertebral Subluxation Research, who said (in part):
Want to know what really makes me mad
as hell? We have probably less than 100 full time researchers
in the chiropractic profession and we can't even afford to pay
them a livable wage. The least we should be able to do is rely
on our research journals, foundations and institutions to make
sure idiots like this do not work in our profession. Their obvious
skewing of data, mining of the literature and political agendas
are obvious to anyone with a head just a tad sharper than a bowling
ball. . . .
Will YOU call your alma mater and ask
why these people are still on the payroll? Will YOU write to
the Editor of these journals and ask how these people get past
peer review? [4]
In 2003, the professors who did the
above study have reported that in July 2001, the majority of
chiropractic college Web sites contained similarly unsubstaniated
claims [5].
References
- Chiropractic's elusive
"subluxation." Chirobase,
updated Dec 25, 2001.
- Barrett S. The
spine salesmen. In Barrett S. Knight
G. The Health Robbers: How to Protect Your Money and Your Life.
Philadelphia: George F. Stickley Co., 1976
- Grod JP, Sikorski D, Keating J. Unsubstantiated
claims in patient brochures from the largest state, provincial,
and national chiropractic associations and research agencies. JMPT 24:514-519, 2001.
- McCoy M. Stroke,
chiropractic and subluxation: Sorting fact from fiction. JVSR Research Update, March 4, 2002.
- Barrett S. Improper
claims on chiropractic college Web sites.
Chirobase, March 6, 2004.
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This page was posted on March 6, 2004.
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