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

Functional Neurology (FN) is an approach used by some chiropractors. One website proudly proclaims that Functional Neurology, sometimes referred to as Chiropractic Neurology, is a term used to describe a variety of evidence-based treatments relating to neurological disorders. And another one informs us that Functional neurology, aka chiropractic neurology, is a healthcare discipline that utilizes neuroplasticity and contemporary clinical neuroscience to both evaluate and rehabilitate patients that suffer from a complex neurological condition or simply want to optimize their performance. A comprehensive neurological examination is performed in order to determine which area of the nervous system is not functioning appropriately. A customized therapy program is then tailored to address each person’s individualized neurological dysfunction.

The specific therapeutic claims that are being made for FN by chiropractors are impressive. The following list is a non-exhaustive attempt to document some of the conditions which functional neurologists claim to be able to treat: ADD/ADHD, Alzheimer’s, Anxiety disorders, Asperger’s Syndrome, Autism, Balance disorders, Blackouts, Blindness, Brain Aging issues, Canal stenosis, Cerebellar disorders,Chronic pain disorders, Cervical myelopathy, Coma, Complex regional pain syndromes, Concentration issues, Depression, Diplopia, Dizziness, Double vision, Dyslexia, Dystonia, Epilepsy, Fainting, Headaches, Heart arrhythmias, Irritable bowel syndrome, Learning difficulties, Memory issues, Mental Health, Migraines, Motion sickness, Movement disorders, Multiple sclerosis, Neglect syndromes, Numbness, Parkinson’s disease, Peripheral neuropathies, Radicular/nerve root conditions, Reflex sympathetic dystrophy, Sexual dysfunction, Sleep apnea, Sleep problems, Snoring, Speech problems, Spinal cord compression, Squints/skew deviations of the eyes, Strokes, Syncope, Tinnitus, Tics, Tourette’s, Tremors, Vertigo and Visual disturbances.

Is any of this backed up by evidence?

A review of FN included 9 articles. The included studies were conducted on adults or children, symptomatic or not, and investigated various interventions consisting of single or multiple stimuli, of varied nature, all primarily said to be provided to stimulate brain areas. Conditions included attention deficit disorders, attention deficit and hyperactivity disorders, autism-spectrum disorders, cortical visual impairment, traumatic brain injury, and migraine. Balance and the “blind spot” were investigated in healthy subjects. Major design and methodological issues were identified in all 9 studies; only 4 were considered as (potentially) appropriate for further scrutiny.

The authors concluded that no robust evidence could be found in relation to the effect or benefit of the tested FN interventions.

In a nutshell: FN is yet another addition to chiro-quackery.

38 Responses to Functional neurology – more chiro-quackery?

  • [FN] is a healthcare discipline that utilizes neuroplasticity and contemporary clinical neuroscience to both evaluate and rehabilitate patients that suffer from a complex neurological condition or simply want to optimize their performance. A comprehensive neurological examination is performed in order to determine which area of the nervous system is not functioning appropriately. A customized therapy program is then tailored to address each person’s individualized neurological dysfunction.

    How arrogant! FN “utilizes neuroplasticity and contemporary clinical neuroscience”? Chiropractors don’t even understand the most basic scientific principles. How the H-E-double-hockey-sticks are they ever going to understand neuroscience?

    Their feeble attempts and treatments can serve only to mess people up even more. I’ll say it again: How arrogant! Not to mention hurtful.

    Also, if you think seeing a chiropractor for your “complex neurological condition” so they can reorganize your synaptic connections is a worthwhile endeavour, I think your neurological condition is more complex than you think.

    As with most things chiropractors do, this is nothing less than criminal.

  • Sigh.
    Yet another buzz word has been appropriated by quacks and absorbed into their lexicon: “evidence based”.

    The philosophical origins of EBM were kicked off by Avicenna, advanced by Francis Bacon’s Novum Organon in 1620, focussed in mid -19th century Paris, termed as “evidence-based” by David Eddy in 1987, and further formularised as EBM by Gordon Guyatt and David Sackett in 1990.

    But, bear in mind what Sackett said EMB is: “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (David Sackett et al, BMJ 1996; 312:71.)

    The fact is that ‘EBM’ implies that plausible, robust evidence is available (REBM) – not simply a useful marketing tool and glib phrase to trap the unwary into dealing with quacks. And anybody who claims their practice is “evidence-based” when manifestly, it is not – is a quack. By definition.

    Caveat emptor .

  • It has been suggested that politics is like a septic system, the really big chunks float to the top…and so in healthcare fraud there is always a king feces leading the pack, in this case “Dr” Carrick. Of course he’s a (D)octor of (C)oincidenses (perhaps like @DC he too is gifted in “external validity” and sees fit to explain things to we lessers) as well as having a doctorate in education (probably a minor in finance). He’s been giving elaborate seminars for certification in neurology for decades with predominantly ideas usurped from more reputable sources then stylized to fit the Chiroquackery paradigm (that being: get as much repeat business as practical from each sucker).
    The interaction and obsequious testimonial given to him and his methods by talk show right-wing whack job Glenn Beck should be enough to curb most rational adults enthusiasm towards this farce.

  • Where was this review published?
    By who?
    Was there any reply?

    If this is for real discussion than please give all the info, if this is another manipulation of facts to smear chiropractic you can keep up the good work.

    • click on the link and you have the answer

      • Written by Charlotte Leboeuf_Yde in the “obscure” chiropractic journal CMT.
        The researcher who you “highly regard”.
        The researcher who does research on key areas like the cervical spine and adverse events.
        The researcher whose research you have clicked on and read then ignore until you could find an issue with two lines in a blog the you wrote this blog:
        https://edzardernst.com/2017/04/we-have-an-ethical-legal-and-moral-duty-to-discourage-chiropractic-neck-manipulations/
        Most critics by looking exclusively for the BS just find the BS as it confirms their bias.
        You on the other hand you read the research on topics you harp on endlessly then willfully ignore the research and the researchers.

        • do you have a real argument?

        • the journal got Medline listed later and thus obtained some credibility and foremost accessibility.
          GOT IT?

          • For a long time I gave you the benefit of the doubt and thought you would assess the evidence on its merits as it presents itself until your blog on Charlotte Leboeuf-Yde here:
            https://www.mq.edu.au/about/campus-services-and-facilities/hospital-and-clinics/chiropractic-clinics/locations-and-hours#MUcampus
            Then I realized that you were well aware of the researchers and research who were providing the evidence your demand:
            “I have always thought highly of Charlotte’s work, however, her conclusion made me doubt whether my high opinion of her reasoning was justified.” – Edzard Ernst
            “Charlotte certainly knows a thing or two about adverse effects of spinal manipulation, and I have always found her work interesting.” – Edzard Ernst
            and yet you remained silent until you could take issue with two lines then wrote your blog.
            The critics look for the BS in chiropractic and only the BS and they find it as it confirms their bias.
            I’m well aware of this and take it into account when communicating with the critics.
            You on the other hand are aware of the research and researchers providing the evidence you demand then willfully ignore it.

          • too daft to merit a reply!

  • @ pseudo-doctor-Guy: you forgot the word noble….i.e. “keep up the good and noble work”….as it is a noble pursuit to smear quackery wherever it is found. As history has proven a chiroquacker office is a very lucrative spot.
    I recently learned that D(octors) of C(hicanery) billed out 1 billion in services to CMS (Medicare) in 2018 accounting for $600,000 in reimbursements. Funny that Medicare ONLY allows payments of “subluxation-reduction” by DCs…yet the bloggers here consistently tell us the subluxation is dead, DCs don’t believe in it. At $30 per “subluxation-reduction” I’ll have to assume a hell of a lot of them still do. And IF they only bill it to get paid then they are guilty of felony fraud.

  • The answer is that this review was written by chiropractors in a chiropractic journal… Not supporting your political agenda… I of course congratulate the authors for their work and ethical clearity.

  • glad you learned how to quote Chiropractic scholars… next time just try and give them proper credit.

  • [sigh] If only Bill Clinton had had this available to treat his anxiety back in the day we could have avoided a White House scandal and an impeachment.

    I wonder if it is also good for tongue-in-cheek syndrome?

  • I would normally engage in discourse on things chiropractic, but this forum is not designed for that. But, as dedicated as the detractors here are, maybe consider these questions: In response to your diligent efforts here to rid the world of quackery (in this case, chiropractic) do you have any statistics regarding the number of chiropractic colleges that have shut down as a direct or indirect result of your efforts here? How about the number of practices that have been shuttered due to the enlightenment spread here? Perhaps there is a number of states that now no longer license chiropractors as primary contact providers? Any work comp boards that have ceased to cover chiropractic? How about Medicare? Any of the thousands of sports teams, both amateur and professional, fired their chiros, never to employ one again? Has the White House fired their chiro? (Did you know they had one?) Surely you’ve steered hundreds of thousands of documented patients (or would be patients) away from the doors of chiropractic offices, thereby improving their quality of life and preserved their pocket books? Who and where are they?
    The large numbers you will or won’t be able to credibly report will be a direct measurement of the effectiveness of your work here. Or, the lack of it, in which case, it will have been a galactic waste of your time. And “It’s the noble thing to do,” doesn’t wash. If you were paid to do this job, you’d have been fired by now for non-performance.
    I am not interested in any more ascerbic comments–just the data pertaining to my questions above. We will see by your responses if you are capable of actually following instructions and answering my questions as asked, or can’t resist the urge to diverge into more ranting.

    And, finally, after you’ve at least pondered these questions, riddle me this: Who is having the greatest influence on the public–the chiropractic profession, or this group of sycophants?

    • @Bruce Weary

      Hi, Bruce.

      Would I, a skeptic who is not fooled by such quackery because I’ve looked at the evidence, like to point to a “large numbers of victories”? Of course. Admittedly, the nonsense that is chiropractic is a rather large monster to slay and I am far too busy to organize a lobby or keep such statistics. It is all I can do to stick my voice into a conversation being led by those who have a financial interest in keeping the fib alive and hope those listening takes a sober second look before diving into what amounts to a very shallow pool.

      If people take the time to look, it doesn’t take a lot of effort to see how little good Palmer’s magic can and has accomplished. I mean the idea came to DD from “the other world” in the form of the voice of a long-dead doctor. Whack job? Uh, yeah.

      People aren’t stupid, but they are busy—and often desperate. Does snapping your back and moving the gasses around in your spinal joints feel good? Sure, just like cracking your knuckles. Does it actually do any good? Be serious, please.

      We, as skeptics, are fighting an uphill battle. When people are desperate for pain relief and they can get no satisfaction or the results they want from conventional medicine, they will look elsewhere and they will try just about anything, no matter how bizarre a “treatment” might seem.

      And sometimes they get relief—not from the treatment but maybe time naturally healed the issue or, perhaps, the placebo effect was present (as it is a high percentage of the time). In any event, it seems to work. Unfortunately—and stop me if you’ve heard this before—correlation does not equal cause. Just because two things happen one after the other, doesn’t mean one caused the other. (I sneezed just before the the space shuttle Challenger went down. I, in no way, caused that accident, I’m pretty sure.)

      But all of that wouldn’t matter if people simply took the time to look at the evidence—or lack thereof. Chiropractic is silliness. Straight and simple. It’s pretend. Play time. Expensive and useless. Nonsense. And, sometimes, going over all this again and again leaves me weary. Just like your name. And your comments.

      • Bruce Weary wrote: “riddle me this: Who is having the greatest influence on the public–the chiropractic profession, or this group of sycophants?”

        @ Bruce Weary

        IMO, it’s the chiropractic marketing machine. See: https://edzardernst.com/2019/08/the-chiropractic-workforce-a-global-review/#comment-115615

        More about chiropractic industry’s (covert) financial concerns here: https://edzardernst.com/2020/02/so-what-is-chiropractic/#comment-120465

        A good summation here:

        Quote
        “If a chiropractor limited his practice to musculoskeletal conditions such as simple backaches, if he were able to determine which patients are appropriate for him to treat, if he consulted and referred to medical doctors when he couldn’t handle a problem, if he were not overly vigorous in his manipulations, if he minimized the use of x-rays, and if he encouraged the use of proven public health measures, his patients would be relatively safe. But he might not be able to earn a living.”

        Ref: Spine Salesmen’ chapter of the book, ‘The Health Robbers: A Close Look At Quackery In America’
        http://www.chirobase.org/12Hx/hr76.html

      • Well, Ron, you were reasonably civil, so I will respond. First, it’s fruitless for you to attack what D.D. Palmer did or said 125 years ago. Most old ideas look a little ridiculous in the light of the modern day. Just take a look at what they were doing in medicine in the late 1800’s. Not much science there, either. The science of manual medicine has evolved light years since then. You’re showing your empty hand if you truly think that manipulation of spinal joints is the same, and therefore as substanceless, as popping a knuckle. A brief literature search will explain to you what happens with regard to proprioceptive afferents, and effects on local muscle tone, blood flow, and mitigating of pain by stimulating mechanoreceptors, which then, in turn, inhibit nociceptor activity. Athough, it’s actually quite a bit more complex than that. But, you knew that. A far cry from the “dead horse” bone out of place pinched nerve theory which you so like to stomp on and declare, once again, dead. It was, long before you bothered to think so. Look at the work of Wyke and Suh, for starters.
        Another point that often comes up is the assertion that back pain tends to have a natural pattern of improving and/or remitting if the patient simply waits long enough. How can that be true if back pain is one of the leading causes of disabiity? Again, a review of the literature shows that millions of people suffer from back pain for decades, if not life long. Time isn’t helping them, nor is placebo, apparently, as those folks try hundreds of forms of treatment in search of relief. As far as wondering what treatments work or don’t work for back pain, what if instead we asked, “What’s good for abdominal pain?” or “How is chest pain best treated?” Our first thoughts would be drawn to all the organs and conditions that could be responsible for pain in either of those regions. We wouldn’t design studies to find out how to alleviate pain in the abdomen or the thorax without first knowing the cause or the offending tissue/s. Well, the same is true of the spine. Would any of the experts here care to take a guess as to how many different tissues in the spine and back can cause pain, as well as by how many different mechanisms and or disease processes? Just that thought alone should get one thinking that a study of what treats “back pain” is fraught with so many variables as to be almost unmanageable. Thus, it’s not hard to find a study here or there that showed manipulation didn’t seem to have the effect we might expect. In many of the studies done, highly skilled manipulators aren’t even used. Imagine doing a surgical study and letting a first year med student do the cutting?
        As far as the placebo effect, yes, sometimes it’s a factor. But it is for every physician. And it’s not so often at work as you like to think. If it’s so omnipresent, why doesn’t it kick in during the three or four or five or more methods of treatment patients have tried before turning to chiropractic? Patients would bristle at how gullible you suggest they are-lining up, visit after visit, throwing good money after bad, unwittingly subjecting themselves to, at worst, the dangers of manipulation, or, at best, a lightening of their wallets. For 100,000 DCs worldwide to be as interwoven into the health care machine as we are, yet strictly being a cultish group of shysters who are injuring and killing patients by the score, all the while bilking every third party payor system there is, would necessitate a conspiracy the size and likes of which the world has never seen before.
        The comments and detractors here are so biased, that there is no amount of evidence that would convince you. I haven’t been here that long, but I’ve yet to see Dr. Ernst confer even a morsel of credibility upon any of the literature offered here in support of manipulation. He has, himself, however been accused of presenting altered data regarding studies on manipulation. What’s good for the goose……..
        In short, chiropractic is here to stay. I don’t defend much of what some chiros do, but there is plenty of clinical success to be had, supported by good diagnostic and manual skills, as well as appropriate use of imaging and specialty referral. I invite any of the detractors to come and observe in my clinic. You will find intelligent, discerning patients being honestly treated with great success that far exceed placebo, supported by accurate diagnosis, and done with a galactic level of safety. I have neither been sued nor harmed a patient in 38 years of practice. Fellas, there is far more to the science of manual medicine that you can sweep away with biased comment. Especially when it is by no stretch of the imagination a field of expertise for any of you.

        • Bruce Weary wrote: “For 100,000 DCs worldwide to be as interwoven into the health care machine as we are, yet strictly being a cultish group of shysters who are injuring and killing patients by the score, all the while bilking every third party payor system there is, would necessitate a conspiracy the size and likes of which the world has never seen before.”

          @ Bruce Weary

          Or could it be that the very strong chiropractic lobbying group (that has existed for some time) has managed to continually dupe legislators who generally aren’t well-versed in science?

          For example:
          https://www.acatoday.org/Education-Events/ACA-Engage-2020

          Worse, in the UK, in addition to chiroquacks and ignorant legislators, we have unelected aristocracy as a influential force:
          https://www.ebm-first.com/a-close-look-at-alternative-medicine/prince-charles-cam-news-items/2194-the-pursuit-for-chiropractic-legislation.html

          Essentially, the chiropractic ‘bait and switch’ appears to be relied upon heavily by the chiropractic industry to bamboozle:
          https://sciencebasedmedicine.org/the-bait-and-switch-of-unscientific-medicine/

          Finally, re harms caused by chiropractic ‘care’, it’s worth remembering that there are no reliable, global, adverse event monitoring systems and until there are, chiropractic cannot be deemed ‘safe’.

        • @ Bruce Weary

          First, it’s fruitless for you to attack what D.D. Palmer did or said 125 years ago. Most old ideas look a little ridiculous in the light of the modern day. Just take a look at what they were doing in medicine in the late 1800’s. Not much science there, either.

          And there in lies the difference between chiropractic and modern science.

          Today, chiropractors are selling the same nonsense Palmer was selling 125 year ago. Modern science, on the other hand—and, as it is wont to do—has tried, tested, tried again, retested and continually learned from it’s mistakes. Could that learning have happened more quickly? Perhaps. But the fact remains, it has moved forward based on reality, a concept foreign to the so-called profession of chiropractic.

          Another point that often comes up is the assertion that back pain tends to have a natural pattern of improving and/or remitting if the patient simply waits long enough.

          Not sure why you are arguing that with me but I will address it, anyway. No. SOMETIMES, that happens, just like SOMETIMES the pain goes away because of the placebo effect. Not sure anyone has ever argued that it will go away—no questions asked—if you wait long enough.

          The comments and detractors here are so biased, that there is no amount of evidence that would convince you.

          That’s rich. Skeptics—including me—change their minds all the time as new SCIENCE-BASED EVIDENCE comes online. Those who believe in witchcraft, voodoo, unicorns and chiropractic would never do such a thing.

          I invite any of the detractors to come and observe in my clinic.

          The truth comes out! Of course you defend the practice. It’s paying your mortgage!

          Fellas. . .

          Careful, your close-mindedness is showing.

          • @Ron Jette

            You said this:
            Not sure why you are arguing that with me but I will address it, anyway. No. SOMETIMES, that happens, just like SOMETIMES the pain goes away because of the placebo effect. Not sure anyone has ever argued that it will go away—no questions asked—if you wait long enough.

            Why is it always pointed out that homeopathy or CAM therapy conclusions might be as a result of placebo effect, or that the problem resolved itself with time.

            However, the question is never asked of conventional medicine.

          • @ Bruce Weary

            Why is it always pointed out that homeopathy or CAM therapy conclusions might be as a result of placebo effect, or that the problem resolved itself with time.

            Well, one reason—and I’m going out on a limb here—is because it’s true. Test your SCAM in a science-y type way and if it proves itself over time and several good studies, it likely won’t be criticized anymore or called “the placebo effect.” It’s amazing how that works.

            However, the question is never asked of conventional medicine.

            I want you to grab a drink, sit back in a nice comfy chair and contemplate the silliness of that question.

          • ” the question is never asked of conventional medicine”
            WHAT DO YOU THINK THE ~ 700 000 Medline-listed clinical trials are about?

          • Which is EXACTLY why I wanted him to sit back and think about the silliness of that question.

          • I know, but the poor sod does not know about the 700 000 clinical trials, it seems to me

          • Ron Jette

            So it’s a silly question, because you say a drug or therapy that has been subject to clinical trials will perform or be effective on every patient ? It doesn’t work that way.

            Sure, sometimes. perhaps even many times the approved therapy that has been subject to trials is effective. But clinical trials don’t even come close to 100% efficacy…. ever (ok, perhaps on a very small sample test group).
            Many times therapies pass with little more than 50% efficacy. In a few cases, the therapy only needs to prove better than the placebo.
            So narrative that some specific therapy passed clinical trials doesn’t explain enough to excuse the fact that it might fail much of the time also. Furthermore, a positive outcome could be a result of placebo effect, as we know. Beyond that, recovery via time, as we also know.

            Don’t ya think ? And we’re only talking about the positive outcomes currently.

            Why is it that MD’s never seem to acknowledge positive outcomes via the later possibilities. We know the science is not 100% effective…. don’t we ?

          • @ Listener

            Who said anything about them being effective on every patient? “It doesn’t work that way,” you said. One is tempted to say, “No sh!t, Sherlock.” Instead, I will simply say I realize that.

            BTW, your anonymity and your use of absolutes (every, never) both eat away at your cred. Step out of the shadows and stand behind your opinion!

            Also, good science is 100% effective. It’s just not always 100% complete. (Think about that before you jump to any conclusions about what you THINK I meant.)

            One more thing. I’m not an MD.

          • @listener

            We know the science is not 100% effective…. don’t we ?

            How many times does it have to be spelled out… Science is only a tool we can use to avoid fooling ourselves.

            As Terry Pratchett put it: “Science is not about building a body of known ‘facts’. It is a method for asking awkward questions and subjecting them to a reality-check, thus avoiding the tendency to believe whatever makes us feel good.” Or from Carl Sagan: “Thinking of tests you can pose to substantiate or deflate hypotheses, you will find yourself doing science.”

            Science is not a religion, nor a database of well-proven theories. It is not about certainty; which is why you’re wrong even to suggest that MDs never appear (to you) to acknowledge positive outcomes in clinical trials may result from something other than the therapy under test. “Watch and wait” (just Google it) is a well recognized approach to patient management that is used by clinicians to take account of this situation. A good physician who properly applies this approach to an individual patient is demonstrating the effectiveness of science, not the opposite.

  • @ Edzard,

    You have never spoken to Samuel Homola?

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