MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The question whether chiropractic spinal manipulations are an effective treatment of infantile colic has been raging ever since the BCA sued Simon Singh over it (and lost). On this blog, I have discussed the evidence several times (see here, here, here and here). Now a new paper has emerged with the title ‘MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. As it was published on a journal not listed in Medline (J Contemporary Chiropr 2019;2:60-75), I will quote more extensively from it than I do normally. Here is the abstract in its original form:

Objective: Strong evidence is found for European medical management of ‘infantile colic’ by spinal manipulation. This paper identifies and describes this body of evidence. We apply the social research method of document analysis to the European medical literature and report the medical practices regarding the management of infantile colic by manual means including manipulation.
Data Sources: Primary data sources were Medline, accessed via PubMed, and the Index to Chiropractic Literature (ICL). Secondary material was sourced from the private collections of the authors. Acceptability criterion included a report of the medical management of infantile colic.
Data Synthesis: A range of languages were accepted and either translated or interpreted by clinicians known to the authors. Each retrieved paper was then hand-searched to identify additional citations which were also collected. A total of 69 papers met the acceptance criteria. The statements accepted for appraisal were those of methods descriptive of the clinical assessment and management of patients classified by the practitioner as a child with infantile colic.
Results: The medical management of infantile colic by spinal manipulation is well reported in the European medical literature. Triangulation also identified reports of medical management of a range of pediatric nonneuromusculoskeletal conditions. European medical papers report a number of positive outcomes for infantile colic with care broadly considered to be manipulative care. These outcomes parallel those known to be widely reported in the chiropractic literature.
Conclusion: We report strong evidence from the European medical literature related to the management by manipulation of infants with infantile colic and other conditions.

In the article proper, the authors conclusions are more detailed and very much longer:

It is difficult to reconcile the positive evidence for manipulative management of infantile colic recorded in
the European medical literature and the known safety of chiropractic management with the need for the 2019 Safer Care Victoria inquiry into Chiropractic manipulation of infants. We consider there is no reasonable evidential basis for this inquiry.
The evidence is that “Infantile colic is an easily identified childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.” (163)
Infantile colic remains a medical enigma with no evidence of safety for medical management, in fact the determination of terminology for reporting such adverse events is relatively new. (164) On the other hand the remarkable safety of chiropractic management is known and the finding that European medical literature strongly indicates manipulative management of infantile colic as a safe and effective practice, places conventional chiropractic as a safe evidence-based choice to meet parental demand.
Alcantara et al (165) show support for this position by stating “chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.”
In the absence of consistently effective management options, accepting the evidence of the European medical literature shows the benefit of manipulative care for infantile colicky patients and the wider collateral beneficial effect on parents. (166,167)
We consider it important to report the uncertainty of medical management of infantile colic and to recognize manual therapy as a legitimate management option as actively utilized by mostly European medical doctors. Multiple case reports document the efficacy of manual therapy of infants. There is a distinct absence of original evidence contradicting the efficacy of spinal manipulative management of infantile colic and an absence of evidential contraindications for its implementation.
This paper reports considerable material in the European medical literature on the manipulative management of infants, particularly infantile colic. Although supportive in safety (150,158) and efficacy (145), the chiropractic literature on these topics was not the primary focus at this time. However in relation to safety, Funabashi and colleagues noted providers of spinal manipulation have similar or better dimension scores compared to the 2016 medical data base of the Agency for Healthcare Research and Quality. (158)

On balance we can state with confidence that the published, indexed evidence places conventional chiropractic management of infantile colic as safe and effective in the manner clearly documented as clinical methods in the European Medical literature.

I find it hard to decide where to begin. The problem is that there is almost nothing right with this review.

Let’s start with the title, MEDICAL MANAGEMENT OF INFANTILE COLIC AND OTHER CONDITIONS WITH SPINAL MANIPULATION: A NARRATIVE REVIEW OF THE EUROPEAN MEDICAL LITERATURE’. What do they mean with ‘other conditions’? As the review does, in fact, include plenty of non-European papers, this title is simply nonsensical.

Next is the objective: it states that there is good evidence for spinal manipulation as a treatment of infantile colic. The authors thus managed to disclose their bias in the very first sentence of their paper.

The rest of the abstract is similarly incompetent. Crucially, we do not learn what inclusion/exclusion criteria the authors applied and how they evaluated the methodological quality of the included studies. Remarkably, this information is also not provided anywhere else in the paper. Thus, this article lacks all the essential elements of a scientific review and turns out to be little more than a highly biased opinion piece. In fact, it is worse; the introduction, for instance, begins with what I can only call a rant: Within Australia there is a government-manufactured controversy regarding the management of infants by chiropractors…

The results section is equally remarkable. Here are a few direct quotes to give you a flavour:

Forty-five papers were accepted as valid clinical reports of the management of infantile colic by medical manipulation (Table 1). There are over 60 papers relating to infantile colic on ICL; we do not report these. The Chiropractic Resource Organisation (CRO) website essentially carries the same papers as ICL. Many of these listings are case reports and outcome-based studies. (33, 34) Reference lists were also obtained from indexed papers as well a range of medical and chiropractic textbooks. (35 – 37)

The truth is that the 45 papers are not ‘valid clinical reports’ but a mixture of comments, case reports, opinion pieces, observational studies and a few clinical trials. The latter are identical with those discussed in proper systematic reviews of the subject. There is thus no reason for arriving at different conclusions than these reviews. But, of course, the authors do exactly that, and they do not explain why. They claim that European doctors use spinal manipulation routinely for colicky babies; this is not true (I am a European doctor and have never seen this happening). They claim that unearthing the European literature revealed more positive evidence; this is also not true: this literature was not hidden but it simply does not measure up to the standard required for evidence and was thus not included in previous reviews.

The authors could not identify any original research study report that rejected spinal manipulation of infants for colic on the grounds of being unsafe or with negative clinical outcomes.

As the authors did cite a few (by no means all) review papers that clearly showed the risks of spinal manipulation, one must ask what this statement was intended for. Was it to give the false impression that chiropractic spinal manipulations are safe?

The criticism of commentators seems to be that chiropractic care for infantile colic is no better than a placebo (147), the same finding for a common colic medication. (148) In other words, chiropractic care is equal to or just as effective as placebo and medication and therefore becomes the preferred clinical option on
the basis of safety and the absence of potential adverse effects. (63,149-151)

I fail to understand the logic behind this argument. The authors seem to admit that chiropractic care is a placebo therapy. To any reasonable person, this means that any benign and cost-free intervention (such as a gentle massage or cuddle by a parent) is preferable to an expensive and potentially harmful chiropractic treatment.

Chiropractic has been examined with rigour and found safe. Our interpretation of this evidence is that there is virtually no danger to infants from carefully applied manual methods by qualified providers and perhaps the best of both worlds is concomitant care among chiropractors and medical practitioners.

This conclusion is not supported by the evidence presented, and the authors do not explain how they arrived at it.

In addition to such irrational passages, we find plenty of nonsensical or factually incorrect statements in the authors’ pseudo-review. Here are a few examples that I found amusing:

Spinal manipulation as it is known today was brought to European medical doctors by chiropractors and osteopaths, (105) and since then it has become an entrenched medical practice in most European countries, particularly Germany. In Europe, the use of spinal manipulation within the medical profession for the management of infantile colic has been a well-recognised procedure for some decades. (38,43,63,106)

The chiropractic vertebral subluxation is recognised in the medical literature (107) contrary to unsupported claims that it cannot be identified. It is this type of mechanical spinal lesion that has been identified to address as a vertebrogenic factor under this model.

However, my favourite bit is this direct quote:

The evidence is that “Infantile colic is an easily identified childhood entity that has no clear treatment guidelines. The management of infantile colic varies among physicians, and families are often frustrated by the medical community’s inability to prescribe a cure for colic.”

The authors quote here from my own review, and remarkably it is the only quote from it. The authors otherwise ignore it completely and, crucially, they do also not list it as one of the 45 included papers. Why? To answer this question, we need to see what my review says. Here is its very short abstract:

Some chiropractors claim that spinal manipulation is an effective treatment for infant colic. This systematic review was aimed at evaluating the evidence for this claim. Four databases were searched and three randomised clinical trials met all the inclusion criteria. The totality of this evidence fails to demonstrate the effectiveness of this treatment. It is concluded that the above claim is not based on convincing data from rigorous clinical trials.

Call me biased, but I do believe that this is much closer to the truth than the lengthy pseudo-review above.

Let me finish this post by revealing who its authors are.

  • Peter Rome, Chiropractor, retired
  • John Waterhouse, Private practice of chiropractic
  • Glenn Maginness, Private practice of chiropractic
  • Phillip Ebrall, Tokyo College of Chiropractic

No funding was received for this study.

No author declared a conflict of interest (at least, this is what they claim).

No further contact details were provided.

My conclusion of all this:

We have to search long and far before we find a SCAM article that is more misleading and less competent than this one.

50 Responses to More chiropractic delusions about infantile colic

  • For readers not familiar with the background of a couple of the paper’s authors:

    Peter Rome was a co-author of the dossier, ‘THE VERTEBRAL SUBLUXATION COMPLEX: The History, Science, Evolution and Current Quantum Thinking on a Chiropractic Tenet’ http://archive.is/QC5pE#selection-153.0-165.40

    He also produced a few hundred ‘Subluxation Synonyms and Metaphors’ https://tinyurl.com/y62a4pec

    Phillip Ebrall is on record with this:

    “Inspired by a visit to Disneyland this paper explores the challenges associated with the need to teach something that may not exist…perhaps the entire profession of chiropractic is a ‘bizarre fiction’ with no substantive grounding. If so, what is the basis for anyone being a chiropractic academic? In writing this paper the content preceding the point was shared with an academic colleague of the writer. The colleague is a learned man with qualifications in chiropractic and philosophy and suggested the writer should stop wasting time and simply accept that the subluxation exists…as long as we lack a technological means to generate quantitative evidence of the subluxation and its effects on human function, there is little option other than to rely on an intelligent use of language within a true context of philosophy to encapsulate the discipline’s beliefs…it matters not whether the subluxation is a tangible clinical entity with physical dimensions or a mental creation; what does matter is that the statements used to describe it are in themselves true.”
    https://www.ebm-first.com/chiropractic-questionable/2037-towards-better-teaching-about-the-subluxation-complex.html

    If you go to page 13 here https://www.wfc.org/website/images/wfc/qwr/2018/QWR_2018APR.pdf you can view Richard Brown, DC, Secretary-General of the World Federation of Chiropractic (and ex-British Chiropractic Association president) posing with Phil Ebrall in an academic photo.

    How can anyone take this ‘profession’ seriously?

  • I do hope better work will come out of Tokyo Chiropractic College… this is embarrassing to say the least

  • Chasing the chimera of “spinal intervertebral misalignment/dysfunction” to improve infantile colic really doesn’t seem all that different than suggesting it can improve back, neck or head pain by “getting to the REAL source of the problem” (if NOT that then why are there colleges devoted to that proposition? These 4 year, $200,000 institutions don’t advertise that they can only teach “transient reduction of back pain”. There MUST be a foundational principal that drives non-scientific, magic-based healthcare). The REAL chiroquackers tell us that the “cause” of ill health is subluxation….the reformers refuse to tell us what theirs is. Chiroquackery requires a deep deference to a religious proposition and figurehead. Irrespective of whether “back pain” (vs organic disease amelioration) requires a little less dogma and has more adherents.

  • I shared this paper a few days ago with some of my EB peers. They didn’t care for it either.

    But its a narrative review published in a low level journal.

  • Anyone who believes in subluxation might as well believe in midichlorians, cos using chiropractors to cure anything is about as useful as using The force (though now I think about it, The Force sounds a lot like Reiki)

    • Okay, I get how chiro, acupuncture, homeo, naturo, parlour-room magic and God (your choice) are all fake. The evidence simply does not exist. I can wrap my head around that. But PLEASE do not tell me that The Force is fake.

      I am just recovering from brain surgery—it took doctors 23 hours to put my brain back together. It exploded after I read Edzard’s post that started: “The authors of the paper in question evaluated antinociceptive efficacy of Rhus Tox in the neuropathic pain and delineated its underlying mechanism. Initially, in-vitro assay using LPS-mediated ROS-induced U-87 glioblastoma cells was performed to study the effect of Rhus Tox on reactive oxygen species (ROS), anti-oxidant status and cytokine profile.”

      If I find out The Force is fake, I may have a relapse explosion.

      Thanks, in advance.

  • We criticized Phillip Ebrall on social media for the rubbish he publishes. He does not take kindly to criticism.
    He wrote a journal editorial in response and called us “fringe and bottom dwellers” and “the scum ring around the bathtub of life”.
    He used to be one of the subluxationists who held key positions in Australia to protect their “sacred truth/trust”.
    They have been sidelined.

    • @ Critical_Chiro

      Doesn’t look to me like he’s been sidelined…

      QUOTE
      “WFC Secretary-General Richard Brown gave a commencement address at the graduation ceremony of the Tokyo College of Chiropractic (TCC), the first time in the WFC has attended such a ceremony in TCC’s history. President of TCC, Professor Phillip Ebrall, also addressed the graduates during the ceremony, which was held at the Red Cross Headquarters in central Tokyo.”

      See p.13 here https://www.wfc.org/website/images/wfc/qwr/2018/QWR_2018APR.pdf

    • Finally, after digesting both the “reformer-DCs” and others comments over these last few years I think I can now accurately define “Chiropractic”:
      “very expensive, transient-alterations in subjective musculoskeletal symptoms (sometimes better and sometimes worse) generated by independent business owners who may or may not refer to themselves as “doctor”, and who may or may not consider their education substantially similar to standard university-education, utilizing over 100 diverse, disparate and typically poorly-researched “techniques” and devices…virtually all intertwined with pre-scientific, unscientific and religious assertions, or not, meant to entice and captivate gullible and less-educated sufferers of musculoskeletal and possibly organic disease…or not, and whose professional-organizations do not necessarily speak for the individual-practitioner nor can accurately define for the majority what chiropractic is or is attempting to become….since 1895”. Voila’.

      • Well, that’s not a definition but rather a description.

        • Bingo….”it” can’t be defined, only described. And even if it could i.e. a prescientific religious proposition regarding human health, innate intelligence and it’s connection to spinal-column thrusting to replace misaligned vertebra”….none of you are EVER willing or able to add your own definition…..only criticize those who attempt to describe its typical practice (scams and quackery for financial gain) as it’s essence. Which is only logical given it’s practitioners cannot agree on any standard to which science and logic can adjudicate.
          Clearly to describe it is to denigrate it, and this isn’t lost on you “reformers”. Only a smattering of its acts can be suggested to be meritorious vs meretricious. Exercise instruction and ergonomic education to name two. Though reason might contend they (exercise and ergonomics) are much better being dolled out by PTs, exercise physiologists or ATCs, and do not constitute a majority of DC practice descriptions as seen in adverts.

        • Troll comment.

  • Ebrall used to head the department at RMIT in Melbourne. The subbies thought they controlled a university program.
    He left and was replaced by evidence based chiro’s. The subbies were pissed to put it mildly.
    He then went to Central Queensland University (CQU) and help set up the chiropractic program. He wanted the faculty to represent the broad church and appointed many subbies. He left after negative publicity following his social media outbursts. The new department head was like minded and the subbies breathed a sigh of relief.
    CQU now has evidence based chiro’s in the key positions. The next head of department left and I have heard that they are going to the proposed Subbie college in South Australia (SA). The move to set up a private college in SA followed the subbies losing control of CQU which again pissed of the subbies.
    This private college is already under fire and will find it difficult to survive in competition with four university based courses, two of which have recently secured level E academic positions.
    Ebrall then shifted to Japan which had connections to RMIT in the past.
    Their research department is headed by two combined MD, PhD, DC’s who are publishing some good research though I am not sure who controls their board of trustees so the subluxation BS may be slipped through the back door while publicly ticking all the right boxes to get accredited by CCEA.
    Japan is still the wild west when it comes to chiropractic though the current head of the Japanese Chiropractic Association is moving in the right direction.

    • Eball has published very little and NOTHING of value; he certainly understands nothing about the principles underpinning systematic reviews.
      [I like the way you pretend there is such a thing as an evidence-based chiropractor!]

    • @C_C

      You wrote

      Their [I presume CQU] research department is headed by two combined MD, PhD, DC’s who are publishing some good research

      Darned if I can find any examples with a pubmed search based on ‘chiropractic’ AND ‘queensland’ [affiliation]. Please help us out here by providing references to what you call ‘good research’.

      Simply googling “central queensland university chiropractic research” produces mainly hits about the chiro courses at CQU. One hit that does mention research is this piece, headed “CHIROPRACTIC SCIENCE UNDERPINNED BY SAFETY, EVIDENCE AND RESEARCH”. in which ‘discipline leader’ Sharyn Eaton says “We are also keen to draw on a research perspective and we have a post-doctoral researcher on staff here in Sydney.” Maybe all the ‘good research’ you mention is coming from other branches of CQU?

      I guess you’ll disagree with the 2011 open letter described in the BMJ under the headline “Doctors urge Australian university to rethink plans for chiropractic course.”

      Please feel free to describe this comment as ‘carpet-bombing’ — you usually do — and to ignore the specific points it’s making and the questions it asks.

      • FO….This is the HOD, maybe you can start there…

        https://spectre.cqu.edu.au/profiles/view/2070

      • @FO
        Read carefully. You presumed wrong.

        @EE
        I agree with you R.E. Phillip Ebrall.
        [I like the way you pretend there is no such thing as an evidence based chiropractor!]

        • @C_C

          I’ve re-read your rather convoluted comment carefully, three times. If the line I quoted was not referring to CQU, then to what institution does it allude? From your English syntax, “their research department” should be referring to “Japan which had connections to RMIT in the past”. But that can’t be right as ‘Japan’ is a country not an institution. Is RMIT the place you judge as “publishing some good research”?

          Searching PubMed for papers containing ‘chiropractic’ AND with affiliation ‘RMIT AND melbourne’ produced 23 hits. I looked at the first seven of these and they’re all of the dismally low standard of chiropractic research that’s often been the subject of posts on this blog. The very first paper is the only comparative trial among the seven. Its abstract contains the magic words “Sample sizes of n = 150 or n = 222 for dizziness or neck pain disability as the primary outcome measure, respectively, would be needed for a fully powered trial.” The sample sizes tested were 12 and 10.

          Among the 23 RMIT papers there’s three with “leg length discrepancy” in the title. Come on, C_C, where’s the ‘critical’ part of your title. Leg length discrepancy is one of the more laughable con tricks in the chiropractic bag. Good research my foot!

          • @Frank Odds
            The Tokyo College had past connections to RMIT but is now independent.
            We have ignored Ebrall since he left Australia and went to Japan.
            Happy to see him go.

          • @C_C

            Why are you persistently avoiding answering my fundamental question? Which institution do you consider has a group “publishing some good research”? You made the claim in your original comment, please support it with evidence, so we can all see what you consider to be good research.

    • Evidence-based chiros?

      So, if they treated based on the evidence, what did they do, just pass along the telephone numbers of real doctors?

      • Ron, love your work.

      • RJ…Evidence-based chiros? So, if they treated based on the evidence, what did they do, just pass along the telephone numbers of real doctors?

        Depends. The “real doctors” may just send them back.

        Eleven guidelines provided recommendations for spinal manipula- tion, and nine guidelines recommended its use. Most guide- lines (6 out of 9; 66%) recommend spinal manipulation for acute LBP, but there are some discrepancies on the indi- cations. The guidelines recommend spinal manipulation in addition to usual care [30], if there is no improvement after other treatments [7, 31], or in any circumstance [10, 28]. Three guidelines [15, 24, 32] (33%) recommend spi- nal manipulation as a component of a multimodal or active treatment program for patients with any symptom duration. Three guidelines (33%) recommend spinal manipulation as a component of a multimodal treatment program [10] or in any circumstance for chronic LBP [28]. In contrast, two guidelines recommend against spinal manipulation for acute LBP [9] or chronic LBP [31].

        Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview
        European Spine Journal · July 2018

      • @RJ
        Would you like some telephone numbers of some PhD’s?
        Physio? Chiro? MD? Collaborating?
        Happy to oblige.

        • Chiro’s not a doctor, physio’s not a doctor. Frankly, a PhD might have a better, more evidence-based treatment!

          So ya, give me a PhD (in Bakery Science, Theme Park Engineering, Egyptology or even Puppet Arts) over a chiro any day. At least they would likely care enough to look at the real science.

          • @Ron Jette
            You could start with the Lancet Low Back Pain Series.
            Top chiro, physio and MD researchers shaking up the status quo.
            But wait there are chiro’s involved so it must be flawed.

          • Yes, I suspect it will be.

            Do you have flat feet from jumping on and off the bandwagon? If so, perhaps you should give reflexology a go. It’s about as effective as chiropractic. Perhaps more so if they just wave their hands above you Reiki-style and don’t actually touch your feet.

          • EE…. In my version of the Lancet table.

          • @Ron Jette
            Critics love making assumptions.
            I never jumped on the subluxation band wagon to begin with. I have been following the research and best evidence for close to 30 years. The way I practice is constantly evolving as best evidence and best practice presents itself. I actively seek change.
            I am not stuck in 1895 like the subbies and the critics here who both ironically use the same arguments.

            Here is a question for all the critics here:
            “How would you define an evidence based critic?”
            Is there such a creature?
            Are the critics here prepared to change as new research is published?

            @EdzardErnst
            In your blog cited above.
            “The thing is that I am broadly in agreement with the evidence presented in Lancet-paper! But I also know that things are a bit more complex.”.
            I agree with you.
            The Lancet LBP series is a “Call To Action”” for all professions treating LBP that business as usual is not good enough. It shook up the status quo and will have an impact for years to come.

            The Lancet LBP series key messages:
            •Use the notion of positive health—the ability to adapt and to self-manage in the face of social, physical and emotional challenges—for the treatment of non-specific low back pain.
            •Avoid harmful and useless treatments by adopting a framework similar to that used in drug regulation—ie, only include treatments in public reimbursement packages if evidence shows that they are safe, effective, and cost-effective.
            •Address widespread misconceptions in the population and among healthprofessionals about the causes, prognosis, and effectiveness of different treatments for low back pain, and deal fragmented and outdated models of care.
            •Policy, public health, health-care practice, social services, and workplaces must jointly tackle the low back pain paradox in low-income and middle-income countries, where improving social and economic conditions could prevent or reduce low back pain incidence, but at the same time create expectations and demands for medical investigations and low-value health care that increase the risk of long-term back-related disability.

          • Critical_Chiro, if you’d been following the evidence for 30 years, you would have packed in the chiro business 29 years ago.

            Now, to your questions. . .

            Q: “How would you define an evidence based critic?”
            A: That’s a silly notion. I don’t have to prove I’m a critic. I LOOK for evidence. (Spoiler: There is none.)

            Q: Is there such a creature?
            A: Answered.

            Q: “Are the critics here prepared to change as new research is published?”
            A: Another silly question because the answer is so obvious. Of course they are!

            Let me give you my perspective on the real difference between the two sides on this issue.

            On the one side, we have you (representing the average chiro). If real evidence walked up to you and whacked you in the face (every day for 30 years), you would deny it, dig your heels in and call everyone who doesn’t believe you a “critic” instead of what they really are: a skeptic. We are called that for a reason.

            Now, on my side of the fence, the skeptics. I think I speak for almost every skeptic when I say that if I saw solid evidence (and all that implies), I would be a believer. Just like when I was a young boy and I thought it was okay to touch the hot stove. The evidence showed itself and I’ve been a believer ever since.

            Evidence. It’s a thing.

          • @C_C

            “Are the critics here prepared to change as new research is published?” I most certainly am, but the research needs to be of good quality. I’ve asked you repeatedly to point us to the institute you described in your comment of last Saturday so we can judge what you regard as good research, but answer comes there none. Hmm.

  • Lol, collaboration. Are the PhDs’ French romantic poetry doctors? Yes I can hear it now: “hello faux-doctor Johnson, this is real-orthopedic MD Dr. Smith, I have a patient with a stubborn ASRA atlas misalignment and I can’t get it with my toggle-recoil adjusting. I had the DPT try but he accidentally adjusted AIRA and the patient developed a tumor”. “We’ll need you stat”.
    Or perhaps the MS and PhD exercise physiologists are sending patients to you highly-trained and highly arrogant chiroquackers for exercise instruction and ergonomic counseling? Everyone knows that exercise is less effective when subluxation is lurking about scuttling ol’ innate. And how many delusional PTs are there who think a subluxation is at root in their recalcitrant patients…and are incapable of fixing it themselves? Would none sound about right? Let’s ask Bogduk and McGill how often they “collaborate” with DCs besides the incredible tiny minority who may be their personal friends and have virtually nothing in common with 99% of practicing DCs?
    Chiropractic: “stringing people along with false hope, nonsensical treatments and religious propositions since 1895….and passing out phone numbers and farcical testimonials since 1950”.
    Oh dear I think I hear the whistle of carpet bombs.

    • McGill will be the keynote speaker at a chiro conference in a few months.

      Much of the modern chiropractic model deals with proprioception. So yes, having proper proprioception may be important.

      Example…

      These findings suggest that functional brain changes during proprioceptive processing in patients with NSLBP may contribute to their postural control impairments.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545448/?fbclid=IwAR1HQCF8zadpXKlkTYgz9mZ5QSEj_q_VvO7PVwzPoYYyg5ocLC6Pi_pmILg

      But if you want to be stuck in 1895 sobeit.

      • I actually attended McGills seminar at the chiroquacker Vegas event…..I was anxiously waiting for him to discuss and/or endorse/validate: AS/PI pelvis, atlas-misalignment, motion palpation, leg length discrepancy, 3x a-week-wellness-manipulation sessions, laser therapy, decompression, Arthro-stim “proprioception” adjusting, Activator, homeopathic muscle relaxants, energy-balancing techniques and thermography. Needless to say I was disappointed. I did recognize him, cliche as it may be, trying to herd cats. You and your 15,000 friends can’t really be making a viable living AS chiroquackers playing in the land of evidence, since there isn’t any. McGill pointed out his initial examination often requires 3 hours…and unlike MOST DCs that doesn’t include 2 hours and 45 minutes of “patient education” regarding false health-claims, spinal biomalarky and how as-the-twig-is-bent so grows the tree, farce. He is after all a genuine PhD. If you even spent 15 minutes walking around the hall you should be amply ashamed of your profession.

        • MK….You and your 15,000 friends can’t really be making a viable living AS chiroquackers playing in the land of evidence, since there isn’t any.

          No evidence for what? The things you pick and choose that have no evidence, uh, yah, OK.

          Regarding McGill, his team has been working with CMCC since the 1990s. He has been involved with some research on spinal manipulation…found some preliminary evidence of responders vs non-responders. (Ex. https://www.clinbiomech.com/article/S0268-0033(00)00085-1/abstract). The evidence based group acknowledges this and researchers are digging deeper into this area (work by Kawchuk, et al)

          As far as his view on the medical field, I think he may be a little more disappointed…

          “Well I’ve already mentioned that most family doctors, if we were to take them as a clinical category, they could virtually nil training on what to do with patients who come in with so-called back pain, and when you speak with them, they will freely admit that they don’t know what to do with patients, so they end up giving what they know which is an analgesic pill, a pain pill,…” #67: Dr. Stuart McGill Podcast Interview – World Leader of Spine Biomechanics
          by admin | Feb 5, 2018

          • DC did your mom never let you play connect the dots? Let’s see…125 years and “modern chiroquackery” is still (based on a simple perusal of internet ads) replete with dogma invoking the “big idea”, wellness and systemic health via “spinal adjustments”. 14% of the populous visit one. Most are selling all manner of other-than-EB SMT. The more years elapse the more decompression, adjusting guns, laser, taping, vaping and energy balancing begin to define chiroquackery. MANY DCs with decades in practice switch to Activator and other “guns” and drop-tables and give up SMT altogether. So some of those most deeply entrenched in SMT question its veracity?
            He (McGill) has been working with CMCC since the 1990s and maybe there is some preliminary suggestion that SMT Might have a role somehow in someone? Profound indeed (but which “technique” and arcane “tests” will he endorse?….and is even his research vast enough to choose between competing theories)? Perhaps McGill also has pecuniary aspirations and chiropractic is a lucrative landscape? If it is so important then why isn’t he a DC? Can a PhD perform manipulation legally in Canada? Why wouldn’t he want to be part of that action?
            Out of curiosity IF, as the odds ration may predict, he uncovers little value for it past placebo or a Tylenol…will you persist in selling it to your clients? At what point is 125 years of conniving the gullible with false hope and gypsy tricks enough?
            I’m guessing you and your 15,000 friends have not one “drop-table”, flexion-distraction table or Activator among you….being evidence based and all…?

          • McGill has about 8 papers he has co-authored on spinal manipulation. I don’t know his views on the various approaches.

    • MK write: “Lol, collaboration. Are the PhDs’ French romantic poetry doctors? Yes I can hear it now: “hello faux-doctor Johnson, this is real-orthopedic MD Dr. Smith, I have a patient with a stubborn ASRA atlas misalignment and I can’t get it with my toggle-recoil adjusting. I had the DPT try but he accidentally adjusted AIRA and the patient developed a tumor”. “We’ll need you stat”.

      I laughed out loud. For the record, though, as a French romantic poetry doc, he would actually be “faux-docteur Johnson.”

      Thanks. I needed that!

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