Back crackers sacked!

Sorry for the pun. I am truly ashamed. It's the only humorous bit of this piece though.

I love blogging and bloggers because it allows the power of millions of bloody-minded nerds to be harnessed for troublemaking purposes.

Here's an example. As this article summarises, Simon Singh is a serious science writer who quite rightly described chiropractic as 'bogus' - i.e. pointing out that chiropractors' claims that their art can cure all sorts of ailments is untrue, a point supported by the Advertising Standards people, lots of proper scientists and so on.

The chiropractors' trade body quietly told all their members to remove any health claims from their websites to avoid prosecution. Then, instead of providing evidence for their assertions or conducting trials, they sued Singh, who has no money, for a six-figure sum, essentially using Britain's incredibly biased libel laws to silence a critic.

It didn't quite work. Thousands of informed bloggers reprinted the article as did Cosmos, an Antipodean popular science magazine), ripped apart the claims of the chiropractors and generally blew the story up. I'm proud to join in.

Shamefully, the Guardian withdrew the original article, though now it seems to have grown a little backbone in printing the account of proceedings. Almost there, Guardian! Although it's easier for annoyances like me to post stuff like this because I'm not worth suing.

So here it is, courtesy of 'gimpy', who added the comments in [].

Beware the spinal trap

This is Chiropractic Awareness Week. So let’s be aware. How about some awareness that may prevent harm and help you make truly informed choices? First, you might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that, “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

[This claim comes from D.D. Palmer The Science, Art and Philosophy of Chiropractic. Portland, Oregon: Portland Printing House Company, 1910.]

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

[This claim comes from D.D. Palmer The Science, Art and Philosophy of Chiropractic. Portland, Oregon: Portland Printing House Company, 1910.]

You might think that modern chiropractors restrict themselves to treating back problems, but in fact they still possess some quite wacky ideas. The fundamentalists argue that they can cure anything. And even the more moderate chiropractors have ideas above their station. The British Chiropractic Association claims that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying, even though there is not a jot of evidence. This organisation is the respectable face of the chiropractic profession and yet it happily promotes bogus treatments.

[These claims are found in the following documents from the BCA website, Happy Families and A Real Pain in the Back.]

I can confidently label these treatments as bogus because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

[All details on Ernst's research on chiropractic can be found on PubMed here. Simon Singh has indeed co-authored a book with Professor Ernst.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

[This appears to be personal opinion based on research conducted by Ernst & others and is not libellous.]

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

[This paper can be found here]

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

[This is a personal opinion based on evidence]

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

[Some reports here.]

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.

[Details of this case and some conclusions here.]

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Professor Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

[Details in this paper.]

Bearing all of this in mind, I will leave you with one message for Chiropractic Awareness Week – if spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Beware of Singh's Sense About Science supporters though. They do some good work in opposing nutters, and have a convincing set of representatives, but they're a front group for some extremist weirdos who gather around Living Marxism, the Insitute of Ideas and Spiked, organisations formed of ex-Trotskyists who now exist solely to push the ultra-libertarian ideals of doing whatever large corporations want and never questioning the behaviour or motives of global capitalism. Interestingly, they all use pseudonyms and don't seem to like dialogue. We're down the rabbithole here, children - they're a fascinating example of what happens to vanguardist leftists who lose sight of reality and become ultrarightwing - as happened to many of Bush's henchmen. Lobbywatch summarises their network here, here and more shockingly here.