 | Chiropractic: Encyclopedia II - Chiropractic - Criticism of chiropractic
Chiropractic - Criticism of chiropractic
Critics, including many mainstream medical doctors and scientists, often reject the claims of some chiropractic associations and schools as pseudoscience, quackery, or fraud.
Advocates believe at least some of this criticism was encouraged by the American Medical Association during the 1970s and early 1980s in what they have labeled "anti-chiropractic prejudice". In a carefully worded statement, the judge in a trial against the AMA recognized that this skepticism was also the inspiration for the AMA's actions in instituting an illegal boycott of chiropractic:
In 1987, federal court judge Susan Getzendanner concluded that during the 1960s "there was a lot of material available to the AMA Committee on Quackery that supported its belief that all chiropractic was unscientific and deleterious." The judge also noted that chiropractors still took too many x-rays. However, she ruled that the AMA had engaged in an illegal boycott. She concluded that the dominant reason for the AMA's antichiropractic campaign was the belief that chiropractic was not in the best interest of patients. But she ruled that this did not justify attempting to contain and eliminate an entire licensed profession without first demonstrating that a less restrictive campaign could not succeed in protecting the public. Although chiropractors trumpet the antitrust ruling as an endorsement of their effectiveness, the case was decided on narrow legal grounds (restraint of trade) and was not an evaluation of chiropractic methods. [22]
It is, however, factual that this policy of containment was also dispersed within the Australian Medical Association as late as 2001. Nowadays medical physicians and chiropractors look back at their animosity toward each other as a historical process. More and more, the public is demanding that professions work together for the patient's benefit. Many GPs work with chiropractors.
In 1985, The National Council Against Health Fraud (NCAHF), a non-profit healthcare watch-dog group, issued a Position Paper critical of chiropractic. A newer Fact Sheet has since been issued in 2001.
Chiropractic - Safety concerns
Critics cite major medical risks associated with spinal manipulation in their opposition to the practice of chiropractic. These risks include vertebrobasilar accidents, disc herniations, vertebral fracture, and cauda equina syndrome, according to Harrison's. Most serious complications occur after cervical (neck) manipulation. The practice of greatest concern is the rotary neck movement, sometimes called "Master cervical" or "rotary break", which has led to trauma, paralysis, strokes, and death among patients.
Many chiropractors report that these serious complications due to manipulation of the cervical spine remain rare, having been documented at 1 in 3 or 4 million manipulations or fewer [23]. Such estimates are believed to be highly unreliable based on the possibility of vast (up to 100%) underreporting of problems. While still rare, the true incidence could be higher, and further research may shed more light on this situation.
Highly specific spinal adjusting procedures have been developed to address vertebral subluxation of the high neck region (upper cervical) using x-ray imaging. A controlled, linear, low force adjustment is slowly applied to the top vertebra (Atlas), removing the need for more forceful, rapid adjustive procedures. Development of this upper cervical technique technology by the National Upper Cervical Chiropractic Association in the U.S.A. first started in the 1960's in Monroe, Michigan by Dr. Ralph Gregory DC. This work is being carried further today, with the establishment of Atlas Orthogonal Technique (AOT) in 1981, by Dr Roy Sweat of Atlanta, USA. Both AOT and NUCCA have advanced Gregory's work to develop programs endorsed by some chiropractors, dentists, and medical doctors in psychiatry, orthopaedics and neurology, who consider it to be a safe and effective way of dealing with kinematic disorders of the upper cervical joint complex. All upper cervical work is a legacy of the dedication and nurturing by Dr. B.J. Palmer of Davenport, Iowa, USA, in the early 1900s. He advocated the HIO (Hole In One) concept, where he claimed that it was only necessary to adjust the top vertebrae in the spine, making it unnecessary to adjust any of the other vertebrae. He later modified this position.
Some doctors who have submitted research backing up the medical benefits of limited forms of spinal manipulation have found their claims incorrectly applied to the entire field of chiropractic manipulation. Perhaps the best-known case of this occurred in response to The RAND report on The Appropriateness of Spinal Manipulation for Lower-Back Pain. This study was a meta-analysis of 22 controlled experiments; the conclusion was that certain forms of spinal manipulation were successful in treating certain types of lower back pain. Many chiropractors seized upon these results as proof that chiropractic hypotheses was sound and that chiropractic had reliable results; in fact, the authors of the report said no such thing. Misuse of this report reached such an extent that the RAND report authors were forced to issue a public statement. In 1993 Dr. Paul Shekelle rebuked the chiropractic industry for making false claims about RAND's research:
...we have become aware of numerous instances where our results have been seriously misrepresented by chiropractors writing for their local paper or writing letters to the editor....RAND's studies were about spinal manipulation, not chiropractic, and dealt with appropriateness, which is a measure of net benefit and harms. Comparative efficacy of chiropractic and other treatments was not explicitly dealt with.
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 Adapted from the Wikipedia article "Criticism of chiropractic", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki |
