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

spinal manipulation

1 2 3 25

In so-called alternative medicine (SCAM) we have an amazing number of ‘discoveries’ which – IF TRUE – should have changed the world. Here I list of 10 of my favorites:

  1. Diluting and shaking a substance makes it not weaker but stronger.

Homeopaths call this process ‘potentisation’. They use it to produce highly ‘potent’ remedies that contain not a single molecule of the original substance. The assumption is that potentisation transfers energy or information. Therefore, they claim, molecules are no longer required for achieving a clinical effect.

2. A substance that causes a certain symptom in a healthy person can be used to cure that symptom when it occurs in a patient.

The ‘like cures like’ principle of homeopathy is based on the notion that the similimum provokes an artificial disease which in turn defeats the condition the patient is suffering from.

3. Subluxations of the spine are the cause of most diseases that affect us humans.

DD Palmer, the inventor of chiropractic, insisted that almost all diseases are due to subluxations. These misplaced vertebrae, he claimed, are the root cause of any disease by inhibiting the flow of the ‘innate’ which in turn caused ill health.

4. Adjusting such subluxations is the best way to restore health.

Palmer, therefore, was sure that only adjustments of these subluxations were able to restore health. All other medical interventions were useless or even dangerous, in his view. Thus Palmer opposed medicines or vaccinations.

5. An imbalance of two life forces is the cause of all illnesses.

Practitioners of TCM believe that all illnesses originate from an energetic imbalance. Harmony between the two life forces ‘yin and yang’ means health.

6. Balance can be restored by puncturing the skin at specific points.

Acupuncturists are convinced that their needling is nothing less than attacking the root cause of his or her problem. Therefore, they are convinced that acupuncture is a cure-all.

7. Our organs are represented in specific areas on the sole of our feet.

Reflexologists have maps of the sole of a foot where specific organs of the body are located. They palpate the foot and when they feel a gritty area, they conclude that the corresponding organ is in trouble.

8. Massaging these areas will positively influence the function of specific organs.

Once the diseased or endangered organ is identified, the area in question needs to be massaged until the grittiness disappears. This intervention, in turn, will have a positive influence on the organ in question.

9. Healing energy can be sent into our body where it stimulates the self-healing process and restores health.

Various types of energy healers are convinced that they can transmit energy that comes from a divine or other source into a patient’s body. The energy enables the body to heal itself. Thus, energy healing is a panacea and does not even require a proper diagnosis to be effective.

10. Toxins accumulate in our bodies and must be eliminated through a wide range of SCAMs.

The toxins in question can originate from within the body and/or from the outside. They accumulate and make us sick. Therefore, we need to eliminate them, and the best way to achieve this is to use this or that SCAM

 

I could, of course, list many more such ‘discoveries’ – SCAM is full of them. They are all quite diverse but have one important thing in common: they are false (i.e. there is no good evidence for them and they fly in the face of science).

If they were true, they would have changed the world by revolutionizing science, physics, physiology, anatomy, pathology, therapeutics, etc.

ALL THESE UGLY FACTS DESTROYING SUCH BEAUTIFUL THEORIES!

WHAT A SHAME!!!

Compelling evidence has long shown that diagnostic imaging for low back pain does not improve care in the absence of suspicion of serious pathology. However, the effect of imaging use on clinical outcomes has not been investigated in patients presenting to chiropractors. The aim of this study was to determine if diagnostic imaging affects clinical outcomes in patients with low back pain presenting for chiropractic care.

A matched observational study using prospective longitudinal observational data with a one-year follow-up was performed in primary care chiropractic clinics in Denmark. Data were collected from November 2016 to December 2019. Participants included low back pain patients presenting for chiropractic care, who were either referred or not referred for diagnostic imaging at their initial visit. Patients were excluded if they were younger than 18 years, had a diagnosis of underlying pathology, or had previously had imaging relevant to their current clinical presentation. Coarsened exact matching was used to match participants referred for diagnostic imaging with participants not referred for diagnostic imaging on baseline variables including participant demographics, pain characteristics, and clinical history. Mixed linear and logistic regression models were used to assess the effect of imaging on back pain intensity and disability at two weeks, three months, and one year, and on global perceived effect and satisfaction with care at two weeks.

A total of 2162 patients were included, and 24.1% of them were referred for imaging. Near perfect balance between matched groups was achieved for baseline variables except for age and leg pain. Participants referred for imaging had slightly higher back pain intensity at two weeks (0.4, 95%CI: 0.1, 0.8) and one year (0.4, 95%CI: 0.0, 0.7), and disability at two weeks (5.7, 95%CI: 1.4, 10.0), but these differences are unlikely to be clinically meaningful. No difference between groups was found for the other outcome measures. Similar results were found when a sensitivity analysis, adjusted for age and leg pain intensity, was performed.

The authors concluded that diagnostic imaging did not result in better clinical outcomes in patients with low back pain presenting for chiropractic care. These results support that current guideline recommendations against routine imaging apply equally to chiropractic practice.

This study confirms what most experts suspected all along and what many chiropractors vehemently denied for years. One could still argue that the outcomes do not differ much and therefore imaging does not cause any harm. This argument would, however, be wrong. The harm it causes does not affect the immediate clinical outcomes.  Needless imaging is costly and increases the cancer risk.

Neck pain affects a vast number of people and leads to reduced quality of life and high costs. Clinically, it is a difficult condition to manage, and the effect sizes of the currently available treatments are moderate at best. Activity and manual therapy are first-line treatment options in several guidelines. But how effective are they really?

This study investigated the combination of home stretching exercises and spinal manipulative therapy in a multicentre randomized controlled clinical trial, carried out in a multidiscipline range of primary care clinics.

The treatment modalities utilized were spinal manipulative therapy combined with home stretching exercises compared to home stretching exercises alone. Both groups received 4 treatments for 2 weeks. The primary outcome was pain, where the subjective pain experience was investigated by assessing pain intensity (NRS – 11) and the quality of pain (McGill Pain Questionnaire). Neck disability and health status were secondary outcomes, measured using the Neck Disability Indexthe EQ-5D, respectively.

One hundred thirty-one adult subjects were randomized to one of the two treatment groups. All subjects had experienced persistent or recurrent neck pain the previous 6 months and were blinded to the other group intervention. The clinicians provided treatment for subjects in both groups and could not be blinded. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. An intention-to-treat analysis was used.

Sixty-six subjects were randomized to the intervention group, and 65 to the control group. For NRS – 11, a B-coefficient of – 0,01 was seen, indication a 0,01 improvement for the intervention group in relation to the control group at each time point with a p-value of 0,305. There were no statistically significant differences between groups for any of the outcome measures.

Four intense adverse events were reported in the study, three in the intervention group, and one in the control group. More adverse incidents were reported in the intervention group, with a mean pain intensity (NRS-11) of 2,75 compared to 1,22 in the control group. There were no statistically significant differences between the two groups.

The authors concluded that there is no additional treatment effect from adding spinal manipulative therapy to neck stretching exercises over 2 weeks for patients with persistent or recurrent neck pain.

This is a rigorous and well-reported study. It suggests that adjuvant manipulations are not just ineffective for neck pain, but also cause some adverse effects. This seems to confirm many previously discussed investigations concluding that chiropractors do not generate more good than harm for patients suffering from neck pain.

The effectiveness of manipulation versus mobilization for the management of spinal conditions, including cervicogenic headache, is conflicting, and a pragmatic approach comparing manipulation to mobilization has not been examined in a patient population with cervicogenic headache.

This study evaluated the effectiveness of manipulation compared to mobilization applied in a pragmatic fashion for patients with cervicogenic headache.

Forty-five (26 females) patients with cervicogenic headache were randomly assigned to receive either pragmatically selected manipulation or mobilization. Outcomes were measured at baseline, the second visit, discharge, and 1-month follow-up. The endpoints of the study included the Neck Disability Index (NDI), Numeric Pain Rating Scale (NPRS), the Headache Impact Test (HIT-6), the Global Rating of Change (GRC), the Patient Acceptable Symptoms Scale (PASS). The primary outcome measures were the effects of treatment on disability and pain. They were examined with a mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization) as the between-subjects variable and time (baseline, 48 hours, discharge, and follow-up) as the within-subjects variable.

The interaction for the mixed model ANOVA was not statistically significant for NDI (p = 0.91), NPRS (p = 0.81), or HIT (p = 0.89). There was no significant difference between groups for the GRC or PASS.

The authors concluded that manipulation has similar effects on disability, pain, GRC, and cervical range of motion as mobilization when applied in a pragmatic fashion for patients with cervicogenic headaches.

Essentially, this study is an equivalence trial comparing one treatment to another. As such it would need a much larger sample size than the 45 patients enrolled by the investigators. If, however, we ignored this major flaw and assumed the results are valid, they would be consistent with both manipulation and mobilization being pure placebos.

I can imagine that many chiropractors find this conclusion unacceptable. Therefore, let me offer an alternative: both approaches were equally effective. Therefore, mobilization, which is associated with far fewer risks, is preferable. This means that patients suffering from cervicogenic headache should see an osteopath who is less likely to use manipulation than a chiropractor.

And again, I can imagine that many chiropractors find this conclusion unacceptable.

As we have discussed ad nauseam on this blog, spinal manipulation therapy (SMT) can cause serious adverse events, including spinal epidural hematoma (SEH), an emergency that can cause severe neurological dysfunction. Chinese surgeons have reported three cases of SEH after SMT.

  • The first case was a 30-year-old woman who experienced neck pain and numbness in both upper limbs immediately after SMT. Her symptoms persisted after 3 d of conservative treatment, and she was admitted to our hospital. Magnetic resonance imaging (MRI) demonstrated an SEH, extending from C6 to C7.
  • The second case was a 55-year-old man with sudden back pain 1 d after SMT, numbness in both lower limbs, an inability to stand or walk, and difficulty urinating. MRI revealed an SEH, extending from T1 to T3.
  • The third case was a 28-year-old man who suddenly developed symptoms of numbness in both lower limbs 4 h after SMT. He was unable to stand or walk and experienced mild back pain. MRI revealed an SEH, extending from T1 to T2.

All three patients underwent surgery after failed conservative treatment. Blood clots were found during the operation in case 1 and case 2, and the postoperative pathology confirmed a hematoma. In case three, a vein ruptured during the operation, causing massive bleeding. The three patients recovered to ASIA grade E on day 5, 1 wk, and day 10 after surgery, respectively. All patients returned to normal after 3 mo of follow-up.

Imaging examinations of case 1. A: T1-weighted preoperative magnetic resonance imaging (MRI) image shows high signal intensity (orange arrow); B and C: Preoperative T2-weighted image shows low signal intensity, and an axial T2-weighted image demonstrates that the hematoma occurred in the posterior region (white arrow); D: Preoperative enhanced MRI suggests an enhanced hematoma signal (orange arrow); E: Intraoperative photograph shows that spinal cord compression has recovered; F: Postoperative pathology suggested a hematoma; G and H: X-ray at the 3-mo follow-up indicated intact internal fixation.

The authors concluded that before proceeding with SMT, each patient should be evaluated in detail and checked for risk factors. In cases where the physical condition changes rapidly, physicians should be alert to the danger and send the patient to the emergency department for a complete MRI examination. We recommend surgery if neurological symptoms appear.

In their paper, the authors also review 15 further cases of SEH that have been previously published. They stress several times in their article that this complication is rare. In my view, this begs the question: how do they know? As there is no post-marketing surveillance of chiropractors or other clinicians doing SMT, I would insist that nobody can be sure about the true incidence of SEH or any other complication after SMT.

The ‘International Chiropractors Association’ (ICA) has just issued a statement entitled “International Chiropractors Association Affirms Policy on Health Freedom“. On the background of the fact that US President Biden, issued a series of Executive Orders related to mandating federal employees and federal contractors to receive the COVID-19 vaccine, the ICA try to explain their position regarding vaccinations. Here are a few passages from this statement:

…In a world of public health that promotes evidence-based decision making, we see the importance of natural immunity being ignored and replaced with a totalitarian approach of compulsory vaccination.  At a time when the Surgeon General says misinformation has become an urgent threat to public health, misinformation is now being used in an attempt to discredit the chiropractic profession, the International Chiropractors Association, and all chiropractic patients who desire to focus on improving health naturally. After enduring 18 months of shutdowns, lockdowns, flattening the curve, masking, limitations of speech on social media; and a cancel culture environment that threatens the basic freedoms our country was founded upon in 1776, ICA will not compromise on the importance of protecting health freedom…

The ICA Policy on Immunization and Vaccination has remained unchanged for almost 50 years and clearly states:

“The International Chiropractors Association recognizes that the use of vaccines is not without risk and questions the wisdom of mass vaccination programs.  Chiropractic principles favor the enhancement of natural immunity over artificial immunization.

The ICA supports each individual’s right to select his or her own health care and to be made aware of the possible adverse effects of vaccines upon a human body.  In accordance with such principles and based upon the individual’s right to freedom of choice, the ICA is opposed to compulsory programs which infringe upon such rights.

The International Chiropractors Association is supportive of a conscience clause or waiver in compulsory vaccination laws, providing an elective course of action for all regarding immunization, thereby allowing patients freedom of choice in matters affecting their bodies and health.”

The International Chiropractors Association maintains that all healthcare interventions, including the chiropractic adjustment, are associated with some level of risk and that every individual is entitled to be informed of those risks, no matter how insignificant. All individuals must retain the freedom to accept or reject any healthcare product, procedure, or medication including vaccinations.  The International Chiropractors Association therefore strongly opposes the use of medical mandates that violate personal sovereignty, violate the principles of informed consent, and constrain the rights of patients to make their own health care choices…

The ICA encourages the recognition that natural efforts to enhance the innate immune system ability to adapt to novel viruses are grounded in science and rejects the notion that the patients’ freedom to rely on naturally acquired immunity is not based upon unscientific beliefs.

The ICA rejects the premise that the chiropractic profession’s long history of promoting health freedom and supporting conscientious exemptions is based upon unscientific or non-mainstream beliefs…

I find this statement clear as mud and have the following questions:

  • Do the ICA recommend vaccinations?
  • In particular, do they encourage their members to get vaccinated with the COVID-19 vaccines?
  • Do they advise to recommend COVID-19 vaccinations to their patients?
  • Or do they think that natural immunity is preferable and advise their members and patients accordingly?
  • Do they believe that spinal manipulation enhances natural immunity?
  • Do they think that spinal manipulations are an effective alternative to COVID-19 vaccinations?
  • Do they believe that scientific evidence trumps dogma or vice versa?
  • Which of the two should, according to their conviction, must influence the decision-making processes in healthcare?
  • If the ICA object to misinformation about COVID, why do they not stop their members from promoting it?
  • What makes them think that information about the possible adverse effects of vaccines upon a human body is unavailable?
  • If the ICA recognizes the risks of spinal manipulation, why do they not inform the public about them regularly and objectively?
  • If the ICA knows about the importance of informed consent, why do not all of their members adhere to it?
  • And finally, why do the ICA insist on the term ‘international’ in the name of their organization, if they purely deal with the US situation?

I do not expect the ICA to give me the answers to these questions. But perhaps their Wiki page goes some way towards answering some of them: “… The ICA supports the efforts of the National Vaccine Information Center (NVIC).[13] The NVIC is known for promoting false and misleading information about vaccines, in particular the discredited claim that vaccines cause autism.

The ICA’s annual conferences have featured anti-vaccination propaganda. In 2018 Guest Speaker Beau Pierce (Pierce co-produced a series entitled Vaccines Revealed) hosted a session entitled Vaccines Revealed.,[14] and Jeff Hays, known for producing the anti-Vaccine propaganda Vaccines Revealed, was invited to host a session the 2017 ICA Council on Chiropractic Pediatrics Annual Conference. In 2016 the widely discredited anti-vaccination propaganda film VAXXED was shown at a conference sponsored by the ICA’s Council on Chiropractic Pediatrics …”

SAY NO MORE!

This article from AP News caught my attention. Here it is (I haven’t changed a word):

The flashy postcard, covered with images of syringes, beckoned people to attend Vax-Con ’21 to learn “the uncensored truth” about COVID-19 vaccines.

Participants traveled from around the country to a Wisconsin Dells resort for a sold-out convention that was, in fact, a sea of misinformation and conspiracy theories about vaccines and the pandemic. The featured speaker was the anti-vaccine activist who appeared in the 2020 movie “Plandemic,” which pushed false COVID-19 stories into the mainstream. One session after another discussed bogus claims about the health dangers of mask wearing and vaccines.

The convention was organized by members of a profession that has become a major purveyor of vaccine misinformation during the pandemic: chiropractors.

At a time when the surgeon general says misinformation has become an urgent threat to public health, an investigation by The Associated Press found a vocal and influential group of chiropractors has been capitalizing on the pandemic by sowing fear and mistrust of vaccines.

They have touted their supplements as alternatives to vaccines, written doctor’s notes to allow patients to get out of mask and immunization mandates, donated large sums of money to anti-vaccine organizations and sold anti-vaccine ads on Facebook and Instagram, the AP discovered. One chiropractor gave thousands of dollars to a Super PAC that hosted an anti-vaccine, pro-Donald Trump rally near the U.S. Capitol on Jan. 6.

They have also been the leading force behind anti-vaccine events like the one in Wisconsin, where hundreds of chiropractors from across the U.S. shelled out $299 or more to attend. The AP found chiropractors were allowed to earn continuing education credits to maintain their licenses in at least 10 states.

On this blog, I have often discussed that chiropractors tend to be anti-vax. It all goes back to their founding father, DD Palmer, who famously wrote:

  • Vaccination and inoculation are pathological; chiropractic is physiological,
  • and who in 1894, published his views on smallpox vaccination: ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …’
  • and who stated in 1896 that keeping tissue healthy is therefore the best prevention against infections; and this is best achieved by magnetic healing.

But that’s long ago! We are not like that anymore! … say the chiros of today.

Do you believe them?

If so, you might want to read this article by Jann Bellamy. Or alternatively, just look at some of my finds from the Internet:

 

 

 

The purpose of this survey was to quantify and describe the clinical practice beliefs and behaviors associated with US chiropractors. A 10% random sample of US chiropractors (n = 8975) was selected from all 50 state regulatory board lists and invited to participate in a survey. The survey consisted of a 7-item questionnaire; 6 items were associated with chiropractic ideological and practice characteristics and 1 item was related to the self-identified role of chiropractic in the healthcare system which was utilized as the dependent variable to identify chiropractic subgroups. Multinomial logistic regression with predictive margins was used to analyze which responses to the 6 ideology and practice characteristic items were predictive of chiropractic subgroups.

The survey instrument used in this study was developed by the authors and modeled after similar chiropractic identity analyses. The survey instrument included a total of 7 items intended to elicit divergent ideologies and practice behaviors. The figure below is a copy of the survey instrument.

A total of 3538 responses were collected (39.4% response rate). Respondents self-identified into three distinct subgroups based on the perceived role of the chiropractic profession in the greater healthcare system:

  1. 57% were spine/neuromusculoskeletal focused;
  2. 22% were primary care focused;
  3. 21% were vertebral subluxation focused.

Patterns of responses to the 6 ideologies and practice characteristic items were substantially different across the three professional subgroups.

The authors concluded that respondents self-identified into one of three distinct intra-professional subgroups. These subgroups can be differentiated along themes related to clinical practice beliefs and behaviors.

Here are the results in more detail as sated by the authors:

Regarding scope of examination (survey question 1), respondents reporting the scope of their clinical examination to only include spinal analysis for the assessment of vertebral subluxation had a 70% probability of belonging to the subluxation focused subgroup, a 20% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. Conversely, respondents who reported the scope of their clinical examination only includes a differential diagnosis had a 0% probability of belonging to the vertebral subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup.

Concerning conditions treated (survey question 2), respondents who reported predominantly treating vertebral subluxation as an encumbrance to health had an 80% probability of belonging to the vertebral subluxation focused subgroup, a 10% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. In contrast, respondents reporting predominantly treating neuromusculoskeletal conditions had a 0% probability of belonging to the vertebral subluxation focused subgroup, a 90% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.

Regarding the role of spinal manipulation for those with cancer (survey question 4), respondents reporting the role of spinal manipulation for those with cancer is to remove interference to innate intelligence had a 70% probability of belonging to the vertebral subluxation focused subgroup, a 20% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup. Respondents reporting there is no role of spinal manipulation in those with cancer also had a 10% probability of belonging to the subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.

Regarding vaccination (survey question 5), respondents who strongly disagreed that vaccinations have had a positive effect on global public health had a 50% probability of belonging to the vertebral subluxation focused subgroup, an approximately 25% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and an approximately 25% probability of belonging to the primary care focused subgroup. In contrast, respondents who strongly agreed that vaccinations have had a positive effect on global public health had a 0% probability of belonging to the vertebral subluxation focused subgroup, a 90% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 10% probability of belonging to the primary care focused subgroup.

Concerning the detection of vertebral subluxation on x-ray (survey question 6), respondents who strongly agreed that x-ray is helpful in detecting vertebral subluxations had a 40% probability of belonging to the vertebral subluxation focused subgroup, a 40% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup. Respondents who strongly disagreed that x-ray is helpful in detecting vertebral subluxations had a near 0% probability of belonging to the vertebral subluxation focused subgroup, an 80% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and slightly below a 20% probability of belonging to the primary care focused subgroup.

Regarding use of x-rays for new patients (survey question 7), respondents who reported prescribing x-rays for 0–20% of new patients had a 20% probability of belonging to the vertebral subluxation focused subgroup, a 60% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup. Respondents reporting prescribing x-rays for 81–100% of new patients had a 40% probability of belonging to the vertebral subluxation focused subgroup, a 40% probability of belonging to the spine and neuromusculoskeletal focused subgroup, and a 20% probability of belonging to the primary care focused subgroup.

END OF QUOTE

While I am not sure that the division into the 3 subgroups is valid and suspect that there must be a substantial overlap between them, I must admit that the paper is rich in fascinating information. Generally speaking, I find all subgroups somewhat mysterious and would ask them the following questions:

Subgroup 1: why did you not study medicine or physiotherapy?

Subgroup 2: does it not bother you that your education and training are woefully insufficient for primary care?

Subgroup 3: is it not time to abandon the obsolete nonsense of your guru, the old charlatan DD Palmer?

 

 

Static or motion manual palpation tests of the spine are commonly used by chiropractors and osteopaths to assess pain location and reproduction in low back pain (LBP) patients. But how reliable are they?

The purpose of this review was to evaluate the reliability and validity of manual palpation used for the assessment of LBP in adults. The authors systematically searched five databases from 2000 to 2019 and critically appraised the internal validity of studies using QAREL and QUADAS-2 instruments.

A total of 2023 eligible articles were identified, of which 14 were at low risk of bias. Evidence suggests that reliability of soft tissue structures palpation is inconsistent, and reliability of bony structures and joint mobility palpation is poor. Preliminary evidence was found to suggest that gluteal muscle palpation for tenderness may be valid in differentiating LBP patients with and without radiculopathy.

The authors concluded that the reliability of manual palpation tests in the assessment of LBP patients varies greatly. This is problematic because these tests are commonly used by manual therapists and clinicians. Little is known about the validity of these tests; therefore, their clinical utility is uncertain. High quality validity studies are needed to inform the clinical use of manual palpation tests.

I have repeatedly drawn attention to the fact that the diagnostic methods used by chiropractors and osteopaths are of uncertain or disproven validity (see for instance here, or here). Why is that important?

Imagine you consult a chiropractor or osteopath. Simply put, this is what is likely to happen:

  • They listen to your complaint.
  • They do a few tests which are of dubious validity.
  • They give you a diagnosis that is meaningless.
  • They treat you with manual therapies that are neither effective nor safe.
  • You pay.
  • They persuade you that you need many more sessions.
  • You pay regularly.
  • When eventually your pain has gone away, they persuade you to have useless maintenance treatment.
  • You pay regularly.

In a nutshell, they have very little to offer … which explains why they attack everyone who dares to disclose this.

Prior research has generated inconsistent results regarding vaccination rates among patients using so-called alternative medicine (SCAM). Given that SCAM includes a wide range of therapies – about 400 different treatments have been counted – variable vaccination patterns may occur within consultations with different types of SCAM practitioners.

A recent analysis aimed to evaluate differences between categories of SCAM regarding vaccination behavior among US adults.

Data from the 2017 National Health Interview Survey (NHIS; n = 26,742; response rate 80.7%) were used. Prevalences of flu vaccination, consultations with SCAM practitioners in the past 12 months, and their potential interactions were examined. 42.7% of participants had received the flu vaccination in the past 12 months, 32.4% had seen one or more SCAM practitioners. Users of any type of SCAM were as likely as non-users to have received a flu vaccination (44.8% users versus 41.7% non-users; p = 0,862; adjusted odds ratio [AOR] = 1.01, 95% confidence interval [CI] = 0.95–1.07).

Regarding specific SCAM types,

  • individuals consulting with naturopaths (p < 0.001; AOR = 0.67, 95 %CI = 0.54–0.82),
  • homeopaths (p < 0.001; AOR = 0.55; 95 %CI = 0.44–0.69)
  • chiropractors (p = 0.016; AOR = 0.9, 95 %CI = 0.83–0.98)

were less likely to be vaccinated. Other SCAMs showed no significant association with flu vaccination behavior. Independent predictors for a flu shot were prior diabetes, cancer, current asthma, kidney disease, overweight and current pregnancy. As well, higher educational level, age, ethnicity, health insurance coverage, and having seen a general physician or medical specialist in the past 12 months were also associated with a higher vaccination rate.

The authors concluded that SCAM users were equally likely to receive an influenza vaccination compared with non-users. Different SCAM therapies showed varied associations with vaccination behavior. Further analyses may be needed to distinguish influencing factors among patients’ vaccination behavior.

This survey confirms what we have discussed repeatedly on this blog (see, for instance here, here, here, here, and here). The reason why consumers who consult naturopaths, homeopaths, or chiropractors get vaccinated less regularly is presumably that these practitioners tend to advise against vaccinations. And why do they do that?

  • Naturopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Homeopaths claim that vaccines are toxic and their therapeutic options protect against infections.
  • Chiropractors claim that vaccines are toxic and their therapeutic options protect against infections.

Do these ‘therapeutic options’ – detox, nosodes, spinal manipulation – have anything in common?

Yes, they are bogus!

Conclusion:

Many naturopaths, homeopaths, and chiropractors seem to be a risk to public health.

1 2 3 25
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories