Wednesday 12 October 2011

Quack, Quack

Growing up I remember my older brother referring to the local chiropractor as the "Town Quack".  The term quack can be defined as someone who fraudulently pretends to have a medical skill.  This has often been used to describe chiropractors.  Chiropractors did not pretend to be medical doctors or possess the same skills as a medical doctor, rather we have developed our own particular skill set.  Chiropractors were seen as being unscientific and the chiropractic approach was labelled unorthodox.  Even though countless people were helped with chiropractic care, chiropractic was ridiculed and chiropractors labelled as quacks.

There has been a significant shift in attitudes in the past two decades as science has caught up to what chiropractors have observed clinically for a long time.  Independent researchers and policy makers are acknowledging the benefits of the unique chiropractic approach.  For the great majority of patients with both acute and chronic low back pain, neck pain, and cervicogenic headaches spinal manipulation (chiropractic adjustments) is recommended by authoritative groups who establish treatment guidelines in both Europe and North America.  These include the UK Evidence Report (2010), Joint Clinical Practice Guidelines from the American College of Physicians and the American Pain Society (2007), European Back Pain Guidelines (2004), Bone and Joint Decade Neck Pain Task Force (2006), and Evidence-Based Practice Center at Duke University (2001).  As recently as May of this year the British Medical Journal was arguing that primary care for patients with back pain and musculoskeletal problems should be transferred from general practitioners to chiropractors, osteopaths, and physiotherapists.

The reason for the wide acceptance of the chiropractic approach is that there is now a great abundance of research showing that chiropractic adjustments are amongst the most effective treatments available for neck pain, back pain, cervicogenic headaches, and other musculoskeletal conditions.  More of what we do as chiropractors is validated every year.   More of what we do still needs to proven.  But just because something is not scientifically validated doesn't mean it should be discontinued.

Even as chiropractic struggles to prove itself, much of what we consider to be scientifically accepted medical procedures actually remain unproven.  The Office of Technology Assessment, a branch of the United States Congress, with the help of an advisory board of eminent university faculty, has published a report with the conclusion that, " . . . only 10 to 20 percent of all procedures currently used in medical practice have been shown to be efficacious by controlled trial."  The British Medical Journal puts give the figure 15%. Therefore, 80% to 90% of medical procedures routinely performed are unproven.  Should all these procedures be discontinued until they are scientifically validated?  Probably not and neither should chiropractic procedures.  The very nature of scientific analysis and the vagaries of the human body may mean some very effective procedures may never be scientifically validated.

Only rabid sensationalist continue to call chiropractors quacks.  The term still doesn't apply because we are not medical doctors and we don't pretend to do medical procedures.  We practice chiropractic; a scientifically validated branch of the healing arts.

9 comments:

Chiropractor Adelaide said...

Maintaining optimal health is accomplished through regular minor adjustments of the spine, joints, and soft tissue by either a symptom relief (traditional) or specialized chiropractor.

Chiropractor Adelaide

Unknown said...

Thanks for the comment. The focus on health rather than disease is what separates us and has separated us from medicine.

Anonymous said...

There is a difference between "have been shown to be efficacious by controlled trial," and being unproven and unscientific. You have manipulated the wording to suit your purpose. Effective Chiropractic procedures could just as easily be done by physical therapists, who could do much more and better. Chiropracty is a science in reverse. First it allegedly cured blindness... then it was just altered and pushed long enough as to be kind of useful in very limited ways.

Unknown said...

I certainly agree that just because a procedure does not have the backing of controlled trial does not mean it is not effective. It may simply imply that it has not yet been validated. That certainly was the case for a long time with chiropractic procedures and remains the case with many medical procedures. Validation is an ongoing process in all professions.

A number of professions, notably osteopathy, medicine, and physiotherapy, recognize and utilize manipulative therapies. As noted a study comparing chiropractic and medical/physiotherapy management of low back pain by Tom Meade, M.D. published in the British Medical Journal in 1990, chiropractic was significantly more effective for patients with chronic and severe pain throughout the two year period of assessment.

tahera said...

Ciropractors in NJ help to solve health issues which are difficult to cure by tradtional medicine.

nj chiropractors said...

Delighted that I found your site, fantastic info. I will bookmark and try to visit more frequently.

Unknown said...

Thanks for leaving a comment. I hope this post and my others will stimulate thoughts about becoming healthier.

Anonymous said...

You don't link to your sources, and most of them sound impressive but I have no idea what they are. I used to see a chiropractor and stopped going when I realized he was crazy - he actually stated that chiropractic adjustments could cure gassy babies. This was due to a sample size of one, in an article from the "scientific" journal: The Journal of Pediatric, Maternal, and Family Health. Which is made by chiropractors.

Granted, most chiropractors probably aren't as insane as this man, but this doesn't mean they know what they're talking about. There's almost no independent research that states chiropractors can do anything useful other than slightly dull back pain and give common sense advice like eat right and exercise.

Show me valid scientific evidence in unbiased periodicals that state chiropractic can accomplish anything, I may change my stance. You'll reply "absence of proof isn't proof of absence". I'll give you that, but it also isn't proof of...proof. Until I see anything like that, and I doubt I will, I'll continue to believe that chiropractors are frauds.

Unknown said...

Thanks for your latest comment. I have added some links to the reports I quoted. As for scientific evidence, there are now over a thousand papers published in peer reviewed journals. I would point you to Spine, JMPT, British Medical Journal, Journal of the American Medical Association, Annals of Internal Medicine, and the Australia New Zealand Medical Journal among others.