Chiropractic: not all it's cracked up to be

Chiropractic [1]. First, a disclaimer: I work in Deloraine in the Deloraine Chiropractic clinic [2]. My landlord’s Dr Roberto De Souza – a chiropractor and an exceptionally lovely man. My personal view of chiropractic? First, I must explain, there are basically two groups of chiropractors, i.e. those who diagnose and treat musculoskeletal symptoms by physical spinal techniques, and those who use same or similar techniques to treat non-musculoskeletal conditions they believe are spinally caused, e.g. lung, digestive, skin conditions. I tolerate – without embracing – the first group, for though I may disagree with their theories on disease, injury and symptom causation, doctors don’t know everything, and if something works then it works. (And if it doesn’t, it doesn’t. But maybe it’s better to try it than not.) The second group I shun totally. Because their practice’s not remotely scientific. Regarding medicine and chiropractic, as Australian Doctor editor Dr Kerri Parnell wrote last Tuesday: ‘the issue is fraught’ [3]. The tension’s probably due to a sense of being threatened – on a clinical level but also regarding finances and professional rivalry. On 13 June 2009 I wrote of the Simon Singh case [4]. Singh was sued by the British Chiropractic Association following his vehement public criticism of chiropractors who use spinal manipulation to treat childhood conditions including asthma, colic and ear infections. On 15 April 2010 the BCA officially withdrew its lawsuit, ending the case [5]. As a result of Singh’s article and case, 25% of UK chiropractors are under investigation [6]. Ho hum.

farmdoc's blog post number 419

What do Richard Dawkins, Karl Kruszelnicki, George Monbiot, Ricky Gervais and Martin Amis have in common? Ten days ago they and many others issued this statement insisting it’s inappropriate to use the English libel laws to silence critical discussion of medical practice and scientific evidence. On 19 April 2008 noted science writer Simon Singh wrote in the Guardian newspaper criticising claims by chiropractors that spinal manipulation was efficacious treatment for childhood conditions including asthma, colic, and ear infections. He suggested there was ‘not a jot’ of evidence to support such efficacy, and he asserted the British Chiropractic Association ‘happily promotes bogus treatments’. The Association sued Singh for libel. On 7 May 2009 in the UK High Court, Mr Justice Eady issued a preliminary ruling that Singh’s words meant the Association knowingly and therefore dishonestly promoted a treatment it knew to be a sham. Singh’s stated that given this interpretation, it’d be difficult for him to win the case. But he’s appealing Mr Justice Eady’s ruling anyway. In its 3 June 2009 Editorial the BMJ opines that the proper way for the Association to rebut Singh is to quote peer reviewed scientific literature – i.e. evidence – and not to resort to libel which is essentially playing the man and not the ball. Dawkins et alii assert that libel law has no place in scientific disputes about evidence. I agree.