MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The chiropractic profession have been reminded time and times again that their claim to be able to effectively treat paediatric conditions is bogus. Many experts have asked them to produce some compelling evidence or stop this dangerous nonsense. Yet most of them seem to remain in denial, famously documented by the British Chiropractic Association suing Simon Singh for libel after he disclosed that they happily promote bogus treatments.

Some chiropractors now say that things have changed and that chiropractors are finally getting their act together. If that is true, progress must be painfully slow – so slow, in fact, that it is hard to see it at all. There are still far too many chiropractors who carry on just as before. There are hundreds, if not thousands of articles promoting chiropractic for childhood conditions; a very basic Google search for ‘chiropractic for children’ returns more than 7 million hits many of which advertise this sort of approach. Take this website, for instance; it makes its bogus claims entirely unabashed:

Even as an infant your child may have spinal nerve stress, known as subluxations. Although subluxations may not be painful, they can pose serious threats to your child’s development. If your baby was in a difficult position in the womb, or experienced a traumatic birth they may have developed subluxations. A common condition attributed to subluxations in children is known as Blocked Atlantal Nerve Syndrome. This condition may be the primary cause of ear and upper respiratory infections, and chronic tonsillitis.

Even regular childhood activities such as tumbles taken while learning to walk and run, bike riding, and participation in sports can also cause stress on your child’s body. Emotional stress and trauma may also be a cause of subluxations. Unless they are corrected they can affect future nerve function and the development of your child’s nervous system. They can also cause problems as your child grows and develops into adulthood.

With regular chiropractic care your child may be at less risk for common childhood disease such as colds and fevers. Some children show a marked improvement in asthma symptoms with regular chiropractic care and nutritional counselling. While chiropractors do no treat disease or sickness, they can identify and remove subluxations which interfere with your child’s natural ability to heal. By removing this stress from your child’s spinal system their immune system may function more efficiently and your child may have a better defense to disease. Their overall health may improve as their natural healing power is released. Children who receive regular chiropractic care may also be able to handle emotional and physical stress better and this care may contribute to their natural development.

Your child is never too young to start chiropractic care. Well-child care starts are early as the first month of life. Doctors use a very gentle pressure to treat children (no more pressure than picking up a tomato in the grocery store) and their treatments are very soothing to your child. After their first visit it is recommended that they receive treatments every three months up to age three, and then every six to 12 month after that. You may also want to visit your chiropractor after major milestones in your child’s life such as learning to sit up, crawl, and walk. They should also be seen if they experience any falls or trauma, and if you notice any balance issues they may be experiencing. These may include head tilting and limping.

Pediatric chiropractic care has many benefits. Children as young as infants may see an improvement in their development and overall health with regular care. Doctors of chiropractic take a proactive approach to health by striving to return and maintain your body’s natural balance. If you are looking for an alternative or supplement to traditional medical care, look into chiropractic care for your entire family.

Just a few rotten apples!… the apologists would probably say. But this is clearly not true. I find it even hard to locate the non-rotten apples in this decomposing and disgusting mess. More importantly, if it were true that things were now changing, one would expect that the progressive sections of the chiropractic profession protest regularly, sharply and effectively to shame the many charlatans amongst their midst. Crucially, one would expect the chiropractic professional organisations  to oust their bogus members systematically and swiftly.

The sad truth, however, is that none of this is really happening – certainly not in the US or the UK. On the contrary, organisations like THE INTERNATIONAL PEDIATRIC ASSOCIATION, books entitled CHIROPRACTIC PEDIATRICS, and periodicals like the JOURNAL OF PEDIATRIC, MATERNAL AND FAMILY CHIROPRACTIC remain popular and respected within the chiropractic profession. A few lip-services here and there, yes. But truly effective action? No!

The tolerance of quackery, I would argue, must be one of the most important hallmarks of a quack profession.

92 Responses to The tolerance of quackery renders chiropractic a profession of quacks

  • Subluxations and claims for treatment of disease may be the more lunatic parts of chiropractic but take that away and what are they left with? An expensive but dangerous massage?

  • The author (and Acleron) both seem horribly misguided/misinformed about the risks associated with chiropractic care. And sadly their rhetoric would be better served were it turned inward for some meaningful self reflection. Having worked in the chiropractic profession and in the consulting business, all practitioners, most notably the medical profession, is reluctant to change even in the face of compelling evidence ie. in spite of an extremely well done article demonstrating that acetaminophen is no better than placebo for acute LBP, they are not advocating that it be removed from guideline recommendations. And acetaminophen is the leading cause of liver failure in the US. I strongly recommend that Ernst spend a bit more time working on his own profession if health care change is really what he is after.

    • “an extremely well done article demonstrating that acetaminophen is no better than placebo for acute LBP”…it might help to quote the article.

    • you are here promoting a common fallacy, I think; just because many people die on the street, it is not fine that the trains are unsafe too.

      • Actually, you are simply trying to avoid the initial argument that change is slow and difficult even in the face of evidence contrary to entrenched protocol by deflecting to another “train” of thought. Nowhere in his response did he suggest that chiropractic was a better treatment modality than Tylenol. That was an assumption made on your part and is an entirely different topic for discussion.

    • A Red Herring.
      This thread is not about conventional medicine and its issues.
      Stick to the discussion about chiropractic.
      Thank you.

    • This paracetamol paper has chiropractors all over the world jumping as if a miracle had happened – but what did the study actually show? The end-point was recovery from the overall episode of back pain. They didn;t even measure whether each dose of paracetamol relieved pain at the time.

      Ernst is right – it;s all to easy to find the ”subbies” and the false claims – there are thousands of chiros in the US, UK, AUstralia and Europe claiming that spinal manipulation is required to adjust a spine that is out of place, pressing on nerves and affecting neurological transmission between the brain and organs, and/or that chiro works for neonatal colic, childhood asthma, and many other false and exaggerated claims.

      Certainly there are rational chiros that help people with back pain or sports injuries, but the magicians are not a small minority by any means.

    • have you even read the Lancet paper?
      it does not show what you claim it does.

    • Some information about John Ventura.
      Apart from having a superior air and a propensity for logical fallacies (such as the Red Herring),
      “He currently teaches an online course in evidence based practice for D’Youville College of Chiropractic (DCC)”

      Some information about DCC.
      History of chiropractic on website
      Chiropractic developed as a defined profession in the late 1800’s in the United States. It has since spread throughout the world and is recognized and regulated by law in approximately 40 countries.
      The profession has evolved to be a cost-effective, efficient healthcare profession that deals primarily with neuromusculoskeletal issues. There is evidence that shows that chiropractic is extremely effective for managing low back and neck pain through conservative non-surgical methods.
      Numerous articles have been published in international, peer-reviewed journals, demonstrating the efficacy and cost effectiveness of chiropractic care for a variety of conditions.”
      According to DCC, the evidence on chiropractic is already in and it is all positive.

      Research being conducted – http://www.chiro.org/ChiroZine/ABSTRACTS/Chiropractic_Profession_at_Crossroads.shtml
      “The Origins and History of Chiropractic
      Chiropractors have designated 18 September 1895, when Daniel David Palmer reportedly gave his first spinal adjustment, as the origin of the chiropractic profession; however, spinal manipulation is one of the oldest and most widely practiced healing methods. References to spinal manipulation, and even the term subluxation, can be traced back as far as Hippocrates and Galen [ 16 ], and manual and manipulative procedures have been depicted in the art and writings of most ancient cultures. Although manipulation has been part of orthopedic medical practice for centuries, most nonmedical practitioners of spinal manipulation in the 19th century were “bonesetters” who had learned their skills primarily by apprenticeship and observation [ 17 ].”
      It seems as though DCC still accepts the concept of the “subluxation” though it also appears as though none of their research has found it.
      Also;
      “The early and middle years of chiropractic were dominated by charismatic and authoritarian figures who often disagreed with one another. Many of the early schisms around the theory and scope of practice from this period still exist in some form [ 9, 17 ]. Daniel David Palmer, who originally practiced as a lay magnetic healer, is credited with professionalizing the practice of spinal manipulation. He integrated popular natural health and scientific models of the day to present a unique theory of chiropractic. He did this by incorporating the concept of an inherent healing ability of the body, which he named “innate intelligence,” into concepts drawn from contemporary knowledge about anatomy and physiology. He eschewed the use of drugs and surgery as unnatural invasions to the body and focused on what he perceived as normalizing the function of the nervous system as the key to health [ 17 ].”
      They seem to have left out the less savoury bit about DD’s criminal history, but have included the defunct notion of “innate intelligence”. It is quite flattering of DD, don’t you think?
      The Chiro lab at DCC also says “Chiropractic students work with patients one-on-one in the clinic, which contains a large variety of chiropractic equipment including state of the art modalities like US, EMS, Cold Laser, and phototherapy.”

      It would appear as though John’s strategy of attack is the best form of defense is to avoid scrutiny which reveals some severe chinks in the armour of “reason”.

  • It is very difficult to escape the cultish chiropractors when they are vocal and the rest of the medical profession does NOTHING to assist the advanced thinkers. We don’t want these people to represent us in our endeavors, but when you are pressed from both sides, progress is very slow. My suggestion, when you see a group pushing for scope change and advancing their education, get behind them and help them leave the others in their cult. Eventually, they will fade away!

  • References for Dr. Ventura’s statement regarding acetaminophen

    1: Williams CM, Maher CG, Latimer J, McLachlan AJ, Hancock MJ, Day RO, Lin CW.
    Efficacy of paracetamol for acute low-back pain: a double-blind, randomised
    controlled trial. Lancet. 2014 Jul 23. pii: S0140-6736(14)60805-9. doi:
    10.1016/S0140-6736(14)60805-9. [Epub ahead of print] PubMed PMID: 25064594.

    2: Williams CM, Latimer J, Maher CG, McLachlan AJ, Cooper CW, Hancock MJ, Day RO,
    McAuley JH, Lin CW. PACE–the first placebo controlled trial of paracetamol for
    acute low back pain: design of a randomised controlled trial. BMC Musculoskelet
    Disord. 2010 Jul 23;11:169. doi: 10.1186/1471-2474-11-169. PubMed PMID: 20650012;
    PubMed Central PMCID: PMC2918542.

    3: Williams CM, Maher CG, Latimer J, McLachlan AJ, Hancock MJ, Day RO, Billot L,
    Lin CW. PACE–the first placebo controlled trial of paracetamol for acute low
    back pain: statistical analysis plan. Trials. 2013 Aug 9;14:248. doi:
    10.1186/1745-6215-14-248. PubMed PMID: 23937999; PubMed Central PMCID:
    PMC3750911.

    What evidence is there for the popularity of the organizations, books, websites and periodical? If they have buzz maybe it’s just that the minority in the profession are more vocal? And we do know it is a minority about 18% and while I agree that’s too many it’s not as Dr Ernst would make it appear.

    1. BMC Complement Altern Med. 2014 Feb 10;14:51. doi: 10.1186/1472-6882-14-51.

    Differentiating intraprofessional attitudes toward paradigms in health care
    delivery among chiropractic factions: results from a randomly sampled survey.

    McGregor M(1), Puhl AA, Reinhart C, Injeyan HS, Soave D.

    Author information:
    (1)Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H
    3 J1, Canada. mmcgregor@cmcc.ca.

    BACKGROUND: As health care has increased in complexity and health care teams have
    been offered as a solution, so too is there an increased need for stronger
    interprofessional collaboration. However the intraprofessional factions that
    exist within every profession challenge interprofessional communication through
    contrary paradigms. As a contender in the conservative spinal health care market,
    factions within chiropractic that result in unorthodox practice behaviours may
    compromise interprofessional relations and that profession’s progress toward
    institutionalization. The purpose of this investigation was to quantify the
    professional stratification among Canadian chiropractic practitioners and
    evaluate the practice perceptions of those factions.
    METHODS: A stratified random sample of 740 Canadian chiropractors was surveyed to
    determine faction membership and how professional stratification could be related
    to views that could be considered unorthodox to current evidence-based care and
    guidelines. Stratification in practice behaviours is a stated concern of
    mainstream medicine when considering interprofessional referrals.
    RESULTS: Of 740 deliverable questionnaires, 503 were returned for a response rate
    of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined
    unorthodox perspective of the conditions they treat. Prediction models suggest
    that unorthodox perceptions of health practice related to treatment choices,
    x-ray use and vaccinations were strongly associated with unorthodox group
    membership (X(2) =13.4, p = 0.0002).
    CONCLUSION: Chiropractors holding unorthodox views may be identified based on
    response to specific beliefs that appear to align with unorthodox health
    practices. Despite continued concerns by mainstream medicine, only a minority of
    the profession has retained a perspective in contrast to current scientific
    paradigms. Understanding the profession’s factions is important to the
    anticipation of care delivery when considering interprofessional referral.

    PMCID: PMC3922917
    PMID: 24512507 [PubMed – in process]

    http://www.ncbi.nlm.nih.gov/pubmed/24512507

    • Stephen Perle wrote: “…maybe it’s just that the minority in the profession are more vocal? And we do know it is a minority about 18% and while I agree that’s too many it’s not as Dr Ernst would make it appear.”

      Fortunately, Professor Ernst has a much more thorough understanding of the problems with chiropractic.

      As has been pointed out previously to Professor Perle, the McGregor et al study (which Professor Stephen Perle has asserted is “one of the most rigorous studies of the profession” – see his replies in the comments here http://www.sciencebasedmedicine.org/a-cure-for-chiropractic-2/ ), the 18% is not what it appears to be.

      For example, the study stated: “As with any investigation, this study has limitations. First, although the response rate was good at 68%, it remains unclear what practice perspectives and behaviours are associated with non-participants. Also, although the sample was randomly selected and stratified according to the number of licensed practitioners in each province, the sample represented only approximately 12 percent of practitioners from each province. As always, there is the possibility that despite the randomization scheme, a unique sample was selected, and generalizability is a possible concern.”

      Certainly, the results do seem somewhat inconsistent with the other available data:
      http://tinyurl.com/pts2ns5

      Most significantly, McGregor’s 1st, 3rd, 4th, 5th, and 6th subgroup descriptions don’t seem to exclude the unethical chiropractor element. IOW, 5 of the 6 subgroups could easily indulge in chiroquackery – (1) “Wellness”, (3) “general probs”, (4) “organic-visceral”, and (5/6) “subluxations”.

      Also, according to Science Based Medicine author, Jann Bellamy: “The survey was of Canadian chiropractors, most of whom graduated from Canadian Memorial Chiropractic College, which appears to have a more orthodox orientation than, for example, Life or Palmer…the groups not included in the unorthodox category doesn’t mean the others are necessarily free of unorthodox views. While the survey is interesting, I thought it disingenuous for the authors to compare the stratification in chiropractic to that of medicine. That we are talking about vastly different phenomena is illustrated by the two examples they offer from medicine: the original rejection of Jenner’s paper on smallpox, which occurred in 1797, and Duesberg’s claim that HIV is not a cause of AIDS, which has been widely and publicly decried by scientists, and not just in their own journals.”

  • Edzard it appears that the site you have linked to has been written by a freelance medical writer in the US and not by a chiropractor.

    • I did not claim that it was written by a chiro, did I?

      • That is true but I would suggest that most readers would assume, given the tone of your article, that the example that you use comes from the chiropractic profession when it in fact does not. I am certain that you could have found many examples from the US chiropractors and some from those in the UK that promote similar issues but in the UK there is a strong and growing trend towards evidence informed practice with chiropractors working within the musculoskeletal field. Your articles never give any credit to chiropractors working in this way and therefore do not provide a balanced view of UK chiropractic.

        • why don’t you show us some UK initiatives then of chiros protesting against the many overt charlatans in UK chiropractic?

          • A public debate between the extremes of chiro? Is that it?

          • @Alan Hennes

            First i read all of these attacks on chiropractors and how they are unwilling to stand up against those people who are at the fringes of the profession and when asked for initiatives and i provide one, you just shrug your shoulders and dismiss it as being a debate between the extremes? I’m sure if you’re willing to add yourself to the debate the chiropractors involved would not take issue with it. I believe, at least on this occasion you would be on the same side, “bien étonné de se retrouver ensemble!” The chiropractor pleading to treat ebola with chiropractic (dear me) is American so it’s not a initiative directed towards UK chiropractors but at the very least you could applaud the effort. It’s what you have been screaming for as far as i can tell. Is it not? There’s just no pleasing some people.

          • @Koen

            Do you not think that it needs something more than just a debate? If that was the start of a big push amongst chiropractors to clean up their act, to get the regulators to do their job of protecting the public, the start of a campaign to educate the public into recognising bogus claims made by chiros, a plan to wrest control of chiro training schools so that they fully embrace evidence, then OK, but there is no sign of that. Just a public debate. Is there more or is that it?

          • @Alan

            I most certainly hope it is the start of all that you described. And, just as yourself , i am rather skeptical of this being ‘the great leap forward’ too. The start of denouncing bogus claims of chiropractors BY chiropractors. I think it would help the profession tremendously towards earning recognition in the field if we did start to see more of these campaigns. That being said i still feel this ‘debate’ (if ever there will actually be one) feels like a breath of fresh air coming from the chiropractic profession, at least to every ‘scientific chiropractor’ out there. I know you will probably feel that’s an oxymoron. Even if it is only to tell some twisted mind that he’s not doing anybody a favor by claiming we need to get adjusted to prevent ebola. Anybody with any common sense will immediately see this claim for what it really is. I would very much appreciate it if similar campaigns were to be launched regarding rheumatoid arthritis, lupus , Südeck’s atrophy and many MANY more falls claims. All of these diseases i have seen in my office and all of these have been referred out to get proper medical attention that i feel was warranted at the time. Now i know you feel like all forms of chiropractic are bogus but i guess we’ll have to disagree on something in the end then. 🙂

      • With respect Dr. E, I have to say that I thought you had linked to a chiropractic practice website. The writer you did link to no doubt supports chiropractic practices, but it seems a bit disingenuous to draw conclusions from such an obvious puff piece that really only represents her own views. I think you could have found adequate examples of actual chiropractic websites.

  • In response to Ernst’s comment: “because many people die on the street, it is not fine that the trains are unsafe too”

    My point is, given your profession is ‘the streets’, you would be better off spending your time making ‘the streets’ safer and not worrying so much about ‘the trains’.

  • This author is NOT a chiropractor but a US freelance reporter. However, I have reported her to the publication she has written in as misrepresenting the evidence, if any of any import, on the association of subluxations with immune function amongst other unsubstantiated claims in this article…given I am only one individual I cannot police the world, but be assured there are many of us that are determined to make the moderate, evidenced based professional chiropractic voice be heard as loudly as those that peddle less than evidenced approaches…….I suspect it may be too much to ask that you might support us in that effort..but thank you for your efforts in pointing this out.

  • Edzard, your article did start with this:
    “The chiropractic profession have been reminded time and times again that their claim to be able to effectively treat paediatric conditions is bogus.” Positioning statement of “Their claim”???

    The subluxation chiropractors are being pushed to the margins. Their desperate bid to set up their own private colleges in the face of university based education is quite apparent. Just look at McTimmony there, Barcelona which has just opened, New Zealand college and in the USA, Life College!
    One of the frustrations of pushing reform is being sandwiched between the vocal zealots within the profession who refuse to critically examine and evaluate what they do and the critics who share our passion for critical thinking and reform, yet tar us with the same subluxation brush. As I have repeatedly said, any critique should be a two part process:
    1. Point out whats wrong and a load of BS.
    2. Support the reformers within the profession who are doing whats right!
    I share your frustrations in regards to the pace of reform, yesterday is preferable to me. But, is an article like this helping the reform process?

  • Im a DC who works side by side with medical pain management. In my 10 years of practice no one has died on my table, had a stroke, or suffered any kind of neuromuscular lesion. However, in the past two years my medical colleagues have killed one patient during a simple pain injection procedure, caused 3 strokes due to combination of anesthesia and meds, sent another patient to the ER due to lung aspiration and punctured the upper right lung of a patient during a simple trigger point injection. You are a hypocritical uneducated idiot Dr. Ernst. Your profession is ill supported by scientific proof, rather you are supported by AMA and pharma lobbyists that ensure positive propaganda for you and negative for my profession. what a joke! your profession kills over 600,000 people per year! are you kidding me with the “chiro is unsafe” bullshit?

    • ever heard of such a thing as ‘risk/benefit’ assessment?
      calling me ‘idiot’ does not reflect well on your manners nor your education.

    • @”Dr”‘ Wendy
      “In my 10 years of practice no one has died on my table, had a stroke, or suffered any kind of neuromuscular lesion.”
      On the other hand, what have you actually done, apart from offer a placebo and lightened people of their burden (aka money)?
      “my medical colleagues have killed one patient during a simple pain injection procedure, caused 3 strokes due to combination of anesthesia and meds, sent another patient to the ER due to lung aspiration and punctured the upper right lung of a patient during a simple trigger point injection.”
      Yep, quite possibly all true; all procedures you are not qualified nor capable of performing and in circumstances in which you wouldn’t survive. Those people are real doctors dealing with real problems, which involve puncturing and cutting the skin, blood, injections, anaesthetics, surgery, and life and death.
      When you get cancer, “Dr” Wendy, to whom are you going to turn, your chiropractic colleagues or a “hypocritical uneducated idiot” like Dr Ernst? No guesses were I would turn. By the way, learn to write properly. (Yep, snide, but people who claim to be educated but are incapable of even writing correct prose reflect their underlying intelligence.)

  • Since the title of your article was obviously written more for sensationalism than accuracy and you managed to catch all DC’s underneath that big wet blanket, I propose the following.
    http://archinte.jamanetwork.com/article.aspx?articleid=210591 I believe these numbers have gone up since this study was done, admittedly it’s a bit old but let’s assume it’s correct today as is or even slightly less.
    I survive on referrals from physicians, as a matter of fact, I have a waiting list of a few months and every single solitary patient I see is a referral from my colleagues and your brethren, physicians.
    So I wonder whom you’d make out to be the bigger quack? The supposed charlatan who sets up shop and sells “quackery” or the fools who send them their patients…and do so with confidence? I’d say neither, but you see when you sensationalize with the intent to then proselytize…what a tangled web you might weave? But you wouldn’t try to deceive….would you?
    I hope you get the point here.

    • I think i get the point. It goes something like this:

      Son- ” but mammy it wasn’t just me that beat up that kid. It was Billy that told me to”.
      Mother ” Oh why didn’t you say before!, that’s ok then son”

      The moral of the story is that its ok to think our behavior is acceptable if others are doing the same.

      • And is it ok to beat up the small guy when the big guys are doing more damage blatantly? In some circles it might be called ‘bullying’. The truth is medical profession is unable to do anything about back ache, etc. Chiros may not be perfect but they are the best we have got at this moment in time.

  • Let us remember that 150 years ago, medical doctors were bloodletting. Let us also note that medical professionals fail time and again to “cure” their patients, leaving them to “live with the pain”. It is frequently this result that leads people to a chiropractor’s office in the first place.

    Frankly, the medical belief – put forward by this doctor’s rejection of the chiropractic philosophy of joint movement – that proper spinal joint motion has NO effect on a patient’s health is a belief that defies logic. It is a fact that the body begins to degenerate joints that have no motion or improper motion. Further, if you sever the nerve supply to a joint, you will see that joint wither, die, and degenerate over time at a much faster rate than a joint that has a proper nerve supply. Doesn’t it make sense to take care of both the proper motion and proper nerve supply to all the joints of the body – therefore reducing the likelihood of degeneration? Or would that cut in to pharmaceutical profits on arthritis drugs, perhaps? What do the original Doctors of Osteopathy (D.O.) have to say about this inherent claim that proper joint motion and proper joint nerve supply mean nothing?

    This article smacks of anger over the tremendous number of people who see chiropractors regularly and have better results (and happier results) without drugs than medical doctors can deliver with millions of dollars of drug advertising and millions/billions of dollars spent on drugs by the populace. You can find these happy patients in almost every chiropractic office. Yet it is a fact that at most, only 8% of the US population is seeing a chiropractor regularly at any given time (compared to over 95% seeing a medical doctor at any given time).

    I am not arguing that chiropractic should entirely replace medical… medical has its uses, and there are times when it is crucial. And it is true that chiropractic – JUST like the medical profession – has its share of bad apples. However this incredible amount of vitriol – with no provocation – has me jumping for joy at the opportunity to reveal the facts above that fly in the face of any amount of hate thrown in the direction of chiropractic as a profession.

    On a side note, a question for Mr. Edzard… what chiropractor did something to you that caused you to loose this venom?

    • alerting consumers to the facts about chiropractic is not ‘venom’; if might look like venom, if you have been brain-washed in chiro-school to believe all the nonsense they taught you.

    • @Presten Wetherspoon
      “Let us remember that 150 years ago, medical doctors were bloodletting.”
      Yes, until a doctor decided to research this practise during the American Civil War. It was found that blood-letting was dangerous and poor medical practise, so the profession discontinued it. It needs to be said that reference to blood-letting is silly nonsense and reflects a failure to understand and appreciate medical history. You believed it served a purpose; unfortunately, the only purpose it has served is to illustrate the pointlessness of your argument.

      “Frankly, the medical belief – put forward by this doctor’s rejection of the chiropractic philosophy of joint movement – that proper spinal joint motion has NO effect on a patient’s health is a belief that defies logic.”
      Whose logic, yours or that which is revealed by properly conducted research? If it is so self-evident, where are all the papers in Cochrane attesting to its worthiness?

      “It is a fact that the body begins to degenerate joints that have no motion or improper motion.”
      Yes, this is accepted but your following reasoning is unsound.

      “Further, if you sever the nerve supply to a joint, you will see that joint wither, die, and degenerate over time at a much faster rate than a joint that has a proper nerve supply.”
      Here you are conflating separate issues. It is not the severance of a nerve supply to joint that is the problem, or indeed whether joints have their own “nerve supply”, which they don’t. The matter of joint, muscle and limb degeneration is caused by lack of use of the limb. It is the non-use of the muscles in the limb, and the consequentially inability to load the limb and joints through use, that causes muscle waste and joint deterioration.

      “Doesn’t it make sense to take care of both the proper motion and proper nerve supply to all the joints of the body – therefore reducing the likelihood of degeneration?”
      What is a “proper nerve supply”? You use the term as if people understand it? Would you please define it and provide some links where everyone can see what you are talking about? By papers, I mean proper research. It certainly sounds like you are talking about the discredited notion of vitality, but I may be wrong.

      “Or would that cut in to pharmaceutical profits on arthritis drugs, perhaps?”
      Ah yes, big pharma; the evil empire that rapaciously flogs medicines solely for the purpose of profit, controlled by the equivalent of Darth Vader and enforced by the mindless storm-troopers. Is that the image you want to convey? The pharmaceutical companies staffed by people who do not have any relatives; children, wives, brothers, sisters, parents, uncles, aunties, or friends who get sick and would use these drugs?

      I was going to critique the rest of your post but there are so many fallacies and non sequiturs that it would take too long. The comments above are enough to clearly show that you engage in faulty thinking, apparently most of the time.
      My question though is; have you had any medical training?

      • @ Frank Collins – “If it is so self-evident, where are all the papers in Cochrane attesting to its worthiness?”

        The fact that proper spinal joint motion (or any other joint) would affect health shouldn’t, and doesn’t, need Cochrane papers. It is quite self-evident.

        • but the assumption that a therapeutic intervention does more good than harm – any therapeutic intervention – DOES NEED PROOF. otherwise it remains an assumption and nothing more.

          • The fact that proper spinal joint motion (or any other joint) affects health, isn’t a therapeutic intervention. I thought that was also self-evident.

          • Oh dear? I think your personal bias is affecting how you’re reading Presten Witherspoon’s comment.
            “Frankly, the medical belief – put forward by this doctor’s rejection of the chiropractic philosophy of joint movement – that proper spinal joint motion has NO effect on a patient’s health is a belief that defies logic.”

            In that sentence, there is no mention of therapeutic intervention. Not even an assumption of therapeutic intervention. Just a very polite expression of bewilderment as to how one could possibly think that joint movement has no effect on health.

            @Presten Witherspoon – please correct me if I’m reading that wrong.

          • falling down a staircase would also impact on health in several ways – but it is not an effective therapy.

          • In the sentence I’m quoting, there is no mention of therapeutic intervention whatsoever.
            Thanks for the non sequitor staircase tip, though.

        • Sorry jm,
          There does seem to be some difficulty in your understanding of text, so I’ll make this clear;
          – Proper joint movement isn’t a problem, unless there is some pain/discomfort.
          – The issue you raised is the “chiropractic philosophy of joint movement”, so comments about joint movement are/were in this context.
          – Accepting, as you must, that chiropractic is an intervention intended to remedy a problem, real or imagined, which involves artificial movement of joints, that intervention must be subject to scrutiny.
          – Any intervention by another person into a person’s health must be shown, objectively, to be efficacious and beneficial.
          – The only way to determine the benefit, if any, of an intervention is by a properly configured study.
          – If there are no RCTs into an intervention to show that it is beneficial, or the RCTs don’t show any benefit above that of a placebo, the question then is; why should they continue?
          – Such is the nature of chiropractic.

          • “Proper joint movement isn’t a problem”
            Well said, Frank. Words to live by.

          • hi Frank,

            Can you point me towards the evidence or even show me examples of the evidence for manipulation as a treatment for thoracic spine pain. Just asking as you never showed me any examples on another thread and i thought you forgot about it.

            Thanks

          • @An Other,
            I really don’t understand you. You ask questions but don’t answer those asked of you, so is it any wonder why people don’t want to bother with you. All your questions tend to become circular too.
            Anyway, I did Google “evidence for thoracic spine manipulation” and received 329,000 results in 0.36 seconds.

          • @ Frank

            I looked at that evidence and as far as i can see none of it is for thoracic spine pain, which was the question I was asking of you.

            So, i will repeat again where is the evidence for spinal manipulation to treat thoracic spine pain?

            This is not the same as what you searched for which was evidence for thoracic spine manipulation

        • In the sentence I’m quoting, there is no mention of therapeutic intervention whatsoever.
          Thanks for the non sequitor staircase tip, though.

          • Does the word “context” not exist in your universe? Please, if you are going to say something, make it sensible, or at least intelligible?

        • jm,
          I finally found it; you practice Gua Sha.

          I haven’t had a really good belly laugh in a few days, so thanks.

    • Presten Witherspoon revealed;

      http://www.fixthecause.com/aboutus.htm
      “A word from Dr. Witherspoon:

      “I am so grateful to be blessed with the ability to share what I have learned with the people who live where I grew up!

      “God granted me four years (2007-2011) of working with veteran Chiropractors to expand my knowledge and abilities. Now, I am blessed to be able to extend that knowledge and those abilities to you. Through prayer and brainstorming, God guided Maggie and I (sic) to name my practice Fix The Cause Chiropractic, because that is really what we do! After all, common sense tells us if you don’t fix the cause of a problem, it will come back!

      I look forward every day to helping my community reach a new dynamic and exciting level of health! Our community will grow healthier one person at a time, one family at a time. I pray you will grant me the opportunity to help you achieve great health; then you can help us spread great health to your circle of family and friends. Our business grows primarily through referrals, and your positive experiences and results will help us grow to the point that our corner of the world experiences something that most communities never do… an explosion of great health!

      May God bless you!

      Best regards,

      Presten Witherspoon, DC
      Chiropractor”

      The conditions treated by the “doctor”;
      “At Fix The Cause Chiropractic, Dr. Presten Witherspoon has been able to help patients with

      Headaches and Migraines
      Neck Pain
      Lower Back Pain
      Pain Between the Shoulders
      Numbness and Tingling
      Chronic Muscular Pain
      Knee Pain
      Carpal Tunnel Syndrome
      Car Accident Recovery
      Food Allergies and Nutrient Deficiencies
      Weight Loss
      and many more issues.”

      This page also says these conditions can be treated;
      Indigestion,
      Asthma,
      Migraine,
      Bed-wetting,
      Numbness, and Tingling.

      There doesn’t seem to be much that “Dr’ Witherspoon can’t cure. Oh yes, he doesn’t exactly say he will cure these conditions, however, he does say he does “fix the cause”, implying that they will be “cured”.

      God helps him too, so it seems. Bjorn, does god look aver your shoulder when operating?

  • In reply to Wendy:
    Cite the research, don’t snipe the critic. Personal attacks achieve nothing except portray our profession in a poor light and do not add to the dialogue or further reform. The chiropractic profession needs to engage the critics. Contrary to how you feel right now, we must be the ones to apply the blowtorch of critical thinking to everything that we do, not blindly defend it or try to justify it with strawman arguments.
    In my reply to a previous blog I cited 74 journal articles and the critics went silent. Interesting don’t you think!
    http://edzardernst.com/2014/10/the-chiropractic-attempt-to-have-the-cake-and-eat-it-has-failed/#comment-62043
    Not one article is about subluxation. They are all looking into the neurology of SMT by chiro’s, physio’s, osteo’s, MD’s and PhD’s. The one thing that has me quietly chuckling is that the lead author of the study that Prof Ernst is critical of is a medical doctor who teaches differential diagnosis at Macquarie University chiropractic faculty. She is a tough teacher and doesn’t put up with any subbie BS! Ideal differential diagnosis teacher! Treating is easy, knowing when not to and refer is far more important!
    Some posts exchanging articles for you enjoyment:
    http://edzardernst.com/2014/07/spinal-manipulation-for-herniated-discs-chiropractors-should-start-doing-meaningful-research/#comment-60270
    http://edzardernst.com/2014/05/spinal-manupulation-little-more-than-a-theatrical-placebo/#comment-59317
    I rather like what I cited here, wishful thinking, you bet 😉
    http://edzardernst.com/2014/07/chiropractic-care-for-reducing-body-weight-or-just-for-reducing-cash-in-the-patients-pocket/#comment-60184

  • I once had severe pain from an automobile accident, e.g. whiplash and shoulder pain, that NO medical doctor or osteo or ortho could seem to touch. It was excruciating! But in the hands of a very seasoned chiropractor (one at the instructor level, and so fully booked he was difficult to get in with) the excruciating pain was gone in ONE session. As a health care researcher, what works, works – no placebo effect for me – where the strongest of meds (and not the best for kidney health) couldn’t even begin to dull the pain. Marketing aside, CHIROPRACTIC care is VALUABLE and I see most of the fear mongering against it as being from people protecting their own territories (financial interests). FIRM believer that GREAT chiropractors can do more for pain than many physicians and other allied health.

    • @Connie Ball,
      “As a health care researcher, what works, works – no placebo effect for me – where the strongest of meds (and not the best for kidney health) couldn’t even begin to dull the pain.”
      Well, in that case, everyone can now stop doing RCTs because there is no point, according to you. Do you want to shut down Cochrane too? All that pointless research wasting resources, space and time.

      What’s more, because you are superhuman, placebos do not affect you at all. (Say hello to Kal-El for me, please?)

      Really, if you are a “health care researcher”, do you think your post paints a picture of reason, logic, science, and lack of bias? If you answer “no”, I think you should find another occupation and let real scientists do the work.

      • @ Frank

        Are you going to answer my question? It would be good of you if you did 😉

        • An Other (or is it An other),
          You seem to be very good at asking questions but not answering when questions are asked of you. I did respond; maybe you weren’t paying attention.

          Notwithstanding, you are a contrarian and a pointless one at that.

          • @ Frank

            What questions have i not answered?

            You never replied to the question that was being asked of you. The question asked was is there any evidence for spinal manipulation for thoracic spine pain? You answered this question with – there is evidence for thoracic spine manipulation, which doesn’t answer the question i asked of you.

            Also, you may have missed my reply to the contrarian point – i will re-post it here:

            A contrarian in a scientific debate is someone who is arguing against a general scientific consensus. Considering i am arguing for evidence based medicine can you explain how i am i am going against this general scientific consensus? Therefore either you do not know what the meaning of contrarian or you are using this term to avoid answering a question. Also scientific contrarianism is frequently referred to, favorably, as skepticism – does this mean you think i am being skeptical? Looking forward to your reply to all the questions i have stated

          • No interest.

          • @ Frank

            So, you have no interest in evidence based medicine! No interest in whether a treatment that you had, has evidence for the complaint that it was used to help with!

            That is interesting 😉

          • Now you’re just being silly.

          • @ Alan

            What is silly?

          • Your bizarre conclusion that Frank isn’t interested in EBM.

          • @ Alan

            How would you explain Frank having non-evidence based treatment?

          • What on earth has that got to do with anything?

          • Alan,
            I wouldn’t bother with An Other. He/she/it is too clever by half.

            Speaking of which, I use my name, as do you and many others; some can’t operate without anonymity.

          • @ Frank

            With regards anonymity I will quote from a regular contributor on this blog and others – Blue Wode.

            This person said “Anonymity is irrelevant, it’s the science that counts. Please stop using diversionary tactics as a defence”

          • @ Alan

            Frank has said the following on this post:

            – Any intervention by another person into a person’s health must be shown, objectively, to be efficacious and beneficial.
            – The only way to determine the benefit, if any, of an intervention is by a properly configured study.
            – If there are no RCTs into an intervention to show that it is beneficial, or the RCTs don’t show any benefit above that of a placebo, the question then is; why should they continue?

            But Frank has gone to a practitioner, who has then treated him with spinal manipulation for his thoracic spine pain. There is no evidence for using spinal manipulation to treat thoracic spine pain. So it seems Frank is contradicting his own advice that he is giving other people on this blog. Also, EBM is based on the application of appropriate evidence to a particular complaint. Therefore in this context Frank has a poor understanding of EBM and hence no interest in learning about EBM.

            Dos this explain why Franks use of non evidence based treatment is relevant to my conclusion that he has no interest in EBM?

          • Frank Collins said:

            I wouldn’t bother with An Other.

            Having just read his last comment, I’m inclined to agree.

          • @ Alan

            What is wrong with my last comment?

          • @Pointless One (or other)
            “With regards anonymity I will quote from a regular contributor on this blog and others – Blue Wode.

            This person said “Anonymity is irrelevant, it’s the science that counts. Please stop using diversionary tactics as a defence””

            Context seems to be a problem for you. From what I’ve seen, BW is far from anonymous, but please carry on as if I’ve said nothing.

          • @ Frank

            So if Blue Wode is not anonymous what is his/her name?

            Also, you have generally said nothing because you still have not answered my question regarding evidence for spinal manipulation when treating thoracic spine pain.

          • About Blue Wode:
            http://www.ebm-first.com/
            https://twitter.com/blue_wode?lang=en
            https://uk.linkedin.com/pub/blue-wode/32/542/78b

            If you want to contact Blue directly, here is your opportunity. Hardly as anonymous as “An Other” and not difficult to find.

            And in relation to you, here it is again;

            “No interest.”

            This should interest you too; http://edzardernst.com/rules/
            The likelihood is low though so keep it up.

            P.S.
            I did stumble on what type of alt-med jm practices; Gua sha. I had gua sha a couple of times; once when my social studies teacher dispensed a yard long rule across my buttocks for failing to complete some homework, and a few times when I fell off my motorbike. I had scraping and bruising aplenty and, sadly, it only made me feel sad at the pain I was in. lol

          • @ Frank

            The definition of anonymous is “(of a person) not identified by name; of unknown name”. I would say that Blue Wode is not a name in the traditional sense of the word. If you think it is then AN Other is a name too. Also the website, twitter, and linkedin accounts don’t reveal anything about Blue Wode other than comments on EBM.

            If you show on interest in learning then that is up to you. But remember there is a difference between spinal manipulation for thoracic spine pain and thoracic spine manipulation. Also, look at the definition of contrarian again you got that wrong too.

  • To all those stating that joint dysfunction leads to pain and disability have not looked at MRI/X-ray studies. Multiple studies have shown that painfree, fully functioning adults have all sorts of degenerative changes in the spine with, as stated, no symptoms. Just as there are people out there with terrible scolioses or deformities, yet are walking around and are fully functioning members of society with no need for any type of intervention.

    • @ Avashem,
      Very good point, one which escapes the strange logic of chiropractors. If there are no symptoms and no impediment to a normal life, the person may not need any treatment (I say this because there are exceptions).

      This is contrary to the chiropractic notion that restrictions to the “flow of nerve energy” is the cause of most of human ills.

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