Beware the Spinal Trap

I’m reposting this article in support of CSICOP….

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Beware the Spinal Trap (link to article on csicop.org)

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

Simon Singh

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On 29th July a number of magazines and websites are going to be publishing Simon Singh’s Guardian article on chiropractic from April 2008, with the part the BCA sued him for removed.

They are reprinting it, following the lead of Wilson da Silva at COSMOS magazine, because they think the public should have access to the evidence and the arguments in it that were lost when the Guardian withdrew the article after the British Chiropractic Association sued for libel.

We want as many people as possible around the world to print it or put it live on the internet at the same time to make an interesting story and prove that threatening libel or bringing a libel case against a science writer won’t necessarily shut down the debate.

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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.

Ghost Hunters? Or Story Tellers?

Let me just say that I certainly approach this subject skeptically. I understand that these shows are made for TV. So right out the gate, in the back of my mind, is that this could all be fabricated and I’m just being handed some entertainment to keep my mind wondering about things that really have no basis in reality whatsoever.

I’m fairly proud of the progress that I’ve made in the previous months at enhancing and growing the critical thinking portion of my mind. I’m trying to become more and more scientific about how I approach all topics, because, in the end, I believe that science will be the method where we find the truths about all topics (if those truths can even be found).

That being said, I’m a huge fan of the Ghost Hunters shows on TV. The ones that I truly enjoy are ‘Ghost Hunters’ and ‘Ghost Hunters International’ on SciFi…(lol SyFy…because they just changed their name to that…pretty weird…but I digress). The ‘Most Haunted’ show with the folks from the UK is, in my opinion, the biggest bunch of crap on TV…but that doesn’t entirely stop me from watching – and often laughing at – the ridiculousness.

The trouble I am having lately is that I’ve become a huge fan of CFI (Council for Inquiry) and it’s Podcast/Radio show ‘Point of Inquiry’. It’s really helped me understand what things constitute real evidence versus pseudoscience. And a couple of the articles/shows have discussed the paranormal and these ‘ghost hunter’ shows. Basically, saying outright that they are pseudoscience at best. Some of the discussions even said that these guys have slowed down recordings to make their ‘evps’ more ominous or to even make some random sounds seem more like a voice. Now, I understand that this is a TV show and that’s a very real possibility. But with the original Ghost Hunters in particular, I have a hard time believing that these guys would do something like that. They seem to have a genuine interest in getting to the real truth. And sometimes they come up with recordings (audio/video) that just make me give pause.

It seems that the perspective of CFI, etc is, that because these guys aren’t real scientists and the ‘evidence’ isn’t gathered according to scientific standards, that they are fabricating things. I find it hard to believe that these guys are being blatantly dishonest. Again, I can certainly see how that could happen (being glorified for TV and all), but it also seems like such a stretch. And it seems almost close-minded to just disregard it and turn the other way. I would think that someone who is in a search for ‘truth’ would accept even SOME of this stuff, and maybe mark it into the ‘that’s interesting’ column rather than just outright rejecting it.

I’m hoping that I’m just misinterpreting what they are saying and that because they discuss these topics, obviously they must find something intriguing about them, and therefore count them as valuable. Even if it’s obviously not ‘scientific evidence’ that is being presented.

I continue to have questions about these ‘supernatural’ topics. But more and more I’m finding myself trying to apply rationality and logic to them, and coming up with answers that say ‘There’s just no real evidence’

 

-eoe-