Chiropractic Scepticism

It would seem that Edzard Ernst is not a fan.

While treating Katie, the chiropractor twisted her neck and severed an artery in her upper spine that supplies blood from the heart to the brain.

Katie suffered a stroke and was admitted to hospital several hours later where she eventually died.

Okay, obviously this is tragic, but any medical intervention carries risk. The question is whether chiropractic carries more risk and is it effective? It’s worth mentioning at this point that Ernst is a serial complainer on the subject, cropping up every few years with an article that regurgitates the same scare stories.

However, as I discovered when I embarked on my 30-years of investigating the evidence behind the practice of chiropractic, what is most shocking is that serious complications like those Katie May suffered are far more common than anyone realises – but all too often go unreported.

Okay, so it should be a thorough analysis.

It was when researching the evidence behind chiropractic that I received the biggest surprise. While many of these techniques are used regularly, there was next to no evidence that spinal manipulations are effective at reducing pain or curing any other condition.

Even worse, it appeared that many patients were suffering injuries at the hands of chiropractors.

Some specifics would be useful here. Bearing in mind, I have some personal experience of my own to offer later.

Our research showed that around half of all patients who see a chiropractor and undergo spinal manipulation suffer from side effects – typically pain and stiffness.

Yes. If you see a chiropractor, they will warn you about this.

These symptoms are usually not severe and normally disappear after a few days.

Yup, this is what you will be told by the practitioner.

However, I also began to catalogue a long list of patients who suffered serious complications after chiropractic manipulations, including strokes, bone fractures, paralysis and death.

Chiropractors have long argued that these events are rare. But the truth is that nobody really knows because there is no system in the UK – or in any other country – which monitors such events.

Okay, so how long is this list, how does it compare to the overall numbers and how does it compare to injuries caused by the conventional medical profession?

In 2001, my team and I at Exeter asked all members of the Association of British Neurologists to keep track of the number of patients they saw suffering complications within 24 hours of seeing a chiropractor.

Over just one year, our monitoring unearthed a total of 35 cases where patients had suffered chiropractor-related injuries.

These included several strokes, subdural haematomas – a life-threatening bleed between the skull and the brain – and serious spinal cord injuries.

Okay, some specifics. However, 35 is a small number. How does this compare to conventional medicine using the same base numbers? Also, how many of the 35 suffered severe injuries? How many had an underlying condition that made them susceptible?

This raised a terrifying question: just how many British patients had been severely injured by a chiropractor?

Good question, but given the relative silence on the matter, it is likely to be a very small number. If there was a pandemic of chiropractic injuries, I’m sure we will have heard something about it and the jails will be full of chiropractors prosecuted for manslaughter.

What I find particularly unnerving is the way that almost all chiropractors disregard medical ethics on a daily basis.

In medicine, there is an important concept known as informed consent. This means that patients need to be fully informed of the nature and risks of any treatment they undertake as well as the chances of it being effective.

Really? I’ve not had this experience.

Having said all of this, I do not judge patients for seeking out chiropractors.

Around a third of Britons live with chronic pain. Half of these sufferers have back pain – which is notoriously difficult to treat.

It’s no surprise that, with so many living in agony, people are drawn to alleged quick-fix solutions like chiropractic.

It isn’t a quick fix solution.

Yet, the truth is that preventing or combatting pain can involve a lot of hard work on the part of the patient.

Regular exercise, losing weight, changing to a firmer mattress, and avoiding lifting heavy things may all be ways of preventing back pain, for example.

Many patients will also benefit from sessions with a physiotherapist who usually teach exercises designed to reduce pain and improve mobility in the affected area.

Okay, now for my anecdote. I suffered from extreme pain recently due to sciatica. The local chiropractic practice is also a physiotherapist specialising in sports injuries and has supported the England Rugby team. I had a series of sessions manipulating the lower back area to ease pressure on the nerves. I’ve not suffered any pain since that point. That was back in November and December. It is now mid April. I exercise and I am not overweight. In the past, I used a chiropractor to get me out of trouble with a trapped nerve in my lower back. The late Mrs L had to hold me up to get me in there. I walked out unaided. So, my experience is that this is one example of alternative medicine that works – unlike acupuncture or homeopathy that is just woo. The linked article is strong on scary, but weak on actual, hard data. There is a risk with neck manipulation for obvious reasons, but spinal manipulation can and does – in my experience – alleviate trapped nerves and chronic pain. All medical intervention carries risk, so choose or not as you feel inclined. That sciatica has gone and I have no pain.

An interesting footnote to is that Simon Singh, Ernst’s co-conspirator in all of this was unwisely sued by the chiropractic association. Singh eventually won the the right to defend his case as fair comment at appeal – albeit a reasonable man might have read his comments as statements of fact – and the case was withdrawn. Ultimately, the case was more about freedom of the press than it was about the efficacy of chiropractic.