I just stumbled over a paper we published way back in 1997. It reports a questionnaire survey of all primary care physicians working in the health service in Devon and Cornwall. Here is an excerpt:
Replies were received from 461 GPs, a response rate of 47%. A total of 314 GPs (68%, range 32-85%) had been involved in complementary medicine in some way during the previous week. One or other form of complementary medicine was practised by 74 of the respondents (16%), the two most common being homoeopathy (5.9%) and acupuncture (4.3%). In addition, 115 of the respondents (25%) had referred at least one patient to a complementary therapist in the previous week, and 253 (55%) had endorsed or recommended treatment with complementary medicine. Chiropractic, acupuncture and osteopathy were rated as the three most effective therapies, and the majority of respondents believed that these three therapies should be funded by the health service. A total of 176 (38%) respondents reported adverse effects, most commonly after manipulation.
What I found particularly interesting (and had totally forgotten about) were the details of these adverse effects: Serious adverse effects of spinal manipulation included the following:
- spinal cord transection,
- fractured vertebra,
- unspecified bone fractures,
- fractured neck of femur,
- severe pain for years after manipulation.
Adverse effects not related to manipulation included:
- death after a coffee enema,
- liver toxicity,
- 17 cases of delay of adequate medical attention,
- 11 cases of adverse psychological effects,
- 14 cases of feeling to have wasted money.
If I remember correctly, none of the adverse effects had been reported anywhere which would make the incidence of underreporting 100% (exactly the same as in a survey we published in 2001 of adverse effects after spinal manipulations).