Apologies for the length of this post, but I’m hoping it informs new readers.
From the CSAG campaign press release:
Chiropractors need to step up, be responsible and just say to their patients, 'we know that that there is a possibility a spinal adjustment can cause a stroke, but now you should know it too'.
That’s the same message that Simon Singh and Professor Edzard are trying to get across. On p.285 of their book,
Trick or Treatment? Alternative Medicine on Trial, they propose that all chiropractors be compelled by law to disclose the following to their patients:
“WARNING: This treatment carries the risk of stroke or death if spinal manipulation is applied to the neck. Elsewhere on the spine, chiropractic therapy is relatively safe. It has shown some evidence of benefit in the treatment of back pain, but conventional treatments are usually equally effective and much cheaper. In the treatment of all other conditions, chiropractic therapy is ineffective except that it might act as a placebo.”
And, interestingly, paragraph 155 of Sandra Nette’s Complete Statement of Claim (in her ongoing class action lawsuit against the chiropractic profession in Alberta, Canada), which looks at informed consent, says:
It should be disclosed that with the possible exception of back pain, chiropractic spinal manipulation (A) Has not been shown to be effective for any medical condition. (B) The risk associated with chiropractic adjustment of the neck is unknown. (C) Alternative treatments are available. (D) In many cases, neck symptoms will go away without treatment. (E) Certain types of neck manipulation carry a higher risk than others. (F) Claims that chiropractic spinal manipulation and adjustment can remedy systematic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rational.
Note, also, that page 42 of the Claim carries a ‘confidential’ Malpractice Alert from 1981 for members of the International Chiropractic Association. It begins:
Evidence has now accumulated to the point that the chiropractic profession can no longer ignore the increasing incidents of strokes occurring concomitant with cervical manipulation.
Read on…
http://www.casewatch.org/mal/nette/claim.pdf
It's a crime that such a dangerous and potentially life-threatening procedure is allowed for non-life-saving "treatments" of dubious value.
Just my thoughts, Miss Kitt
My thoughts too.
I'd like to see reporting of such events mandatory in every state.
We could do with that here in the UK as well. Interestingly, in August 2005, the UK chiropractic regulatory body, the General Chiropractic Council (GCC), informed the UK-based group, Action for Victims of Chiropractic (AVC), that it understood that the British Chiropractic Association (BCA) was in the process of establishing a database to which patients could report any adverse events they might experience following treatment. See the letter that the GCC sent to AVC in the August 2005 news item in this link:
http://www.chirovictims.org.uk/victims/news.html
Then, the following month, in response to a news story 'Survey questions safety of alternative medicine' (Nature 346,898; 200510.1038/436898b) which quoted Edzard Ernst as saying that complementary and alternative medicine organisations were not doing enough to monitor adverse reactions, a representative of the BCA, Barry Lewis, responded by saying that, in conjunction with the Anglo European Chiropractic College, the BCA had set up a "chiropractic reporting and learning system" and went on to say that:
More than 1,200 practitioners who are members of the BCA have recently received an information pack to enable them to participate in the scheme. Resulting data will be analysed at the Anglo-European Chiropractic College and outcomes will be relayed to the profession, through our newsletter, journal and website, so practitioners may learn from the experience of others. The intention is that the scheme will, if successful, be offered to other chiropractic associations within Europe in 2006.
http://www.nature.com/nature/journal/v437/n7058/full/437476d.html
However, one can only assume that the scheme was unsuccessful since no chiropractic professional body in the UK seems to have made any further mention of it despite the fact that Item 7 of the Minutes of the GCC’s 2nd March 2006 meeting stated very clearly that:
If chiropractors are to provide a safe clinical experience for patients then a reporting procedure needs to be put in place, within the clinics and within the profession as a whole, which allows for adverse events and near misses to be shared on an anonymised basis so that we can all learn from them.
http://www.gcc-uk.org/files/link_file/C-020306-Open1.pdf
It all seems to confirm Dr Harriet Hall’s views in her recent blog post entitled “Chiropractic’s Pathetic Response to Stroke Concerns”:
http://www.sciencebasedmedicine.org/?p=362
I think the purpose of this campaign is to make people aware of a complication which is not always discussed with patients by the chiropracter.
Apparently true:
Consent: Its Practices and Implications in United Kingdom and United States Chiropractic Practice
Results from this survey suggest a patient's autonomy and right to self-determination may be compromised when seeking chiropractic care. Difficulties and omissions in the implementation of valid consent processes appear common, particularly in relation to risk.
Langworthy JM, and Cambron J, Institute for Musculoskeletal Research and Clinical Implementation, [AECC], Bournemouth, UK, July-August 2007
http://www.ncbi.nlm.nih.gov/sites/e...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
It’s also worth noting that in a recent investigation (“Consent or submission? The practice of consent within UK chiropractic”), which focused on approaches to consent of a small sample of practicing UK chiropractors, only 23% reported that they always discussed serious risk with their patients, and over one third did not advise patients of alternative available treatments despite their being legally obliged to obtain informed consent from their patients to ensure that patients understand the principal benefits, risks and alternatives regarding their proposed treatment. See here:
J. M. Langworthy and C. le Fleming, Institute of Musculoskeletal Research and Clinical Implementation, AECC, UK
Journal of Manipulative and Physiological Therapeutics, January 2005
http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=15726031
Okay, how does messing with one's spine lead to stroke? I can see spinal injuries but not stroke.
In addition to JJM’s link to Chirobase above, also see Dr Harriet Hall’s analysis of chiropractic and stroke here:
http://www.sciencebasedmedicine.org/?p=94
Where chiropractors claim a potential benefit that simply does not exist - and I think we would agree that this happens in many cases- they are being criminally negligent if they apply a potentially dangerous technique knowing it is useless.
All of which makes you wonder how the UK regulators manage to evade accountability for being less than robust in their primary duties to protect patients and set standards - especially when you consider that some of the following treatments are likely to include unnecessary neck manipulations…
Overall, mechanical conditions of the musculoskeletal system were felt to be treated effectively by chiropractic intervention and there was 100% agreement that it was beneficial in treating mechanical dysfunctions of the spine. Non-musculoskeletal conditions in adults, including asthma (64%), gastro-intestinal complaints (61%) and pre-menstrual syndrome (PMS) (70%), were considered conditions that can benefit from chiropractic management. Opinions on the treatment of osteoporosis (43%), obesity (26%), hypertension (42%) and infertility (30%) were less conclusive. Childhood musculoskeletal and muscular conditions, infantile colic, otitis media and asthma were perceived to benefit from chiropractic intervention by more than 50% of the respondents.
-snip-
Traditional chiropractic beliefs (chiropractic philosophy) were deemed important by 76% of the respondents and 63% considered subluxation to be central to chiropractic intervention.
Aranka Pollentier and Jennifer M. Langworthy,
The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic, Volume 10, Issue 3, September 2007, pp147-155.
http://www.cam-research-group.co.uk...linical Chiropractic 2007 10 3 pg 147-155.pdf
In view of the above, the following, IMO, is what needs to be made widely known to the general public (in addition to the proposals made by Singh and Ernst):
Chiropractic is perhaps the most common and egregious example of the bait and switch in medicine…
..someone may go to see a chiropractor and think they will be seeing a medical professional who will treat their musculoskeletal symptoms, but in reality they will see the practitioner of a cult philosophy of energy healing…
The bait - claims that chiropractors are medical practitioners with expertise in the musculoskeletal system. The switch - practitioners of discredited pseudosciences that have nothing to do with the musculoskeletal system…
A more subtle form of the bait and switch among chiropractors is the treatment of musculoskeletal symptoms with standard physical therapy or sports medicine practices under the name of chiropractic manipulation. Ironically, the more honest and scientific practitioners among chiropractors are most likely to commit this subtle deception. The problem comes not from the treatment itself but the claim that such treatments are ‘chiropractic’…
But by doing so and calling it ‘chiropractic’ it legitimizes the pseudoscientific practices that are very common within the profession - like treating non-existent ‘subluxations’ in order to free up the flow of innate intelligence.
The Bait and Switch of Unscientific Medicine (Steven Novella)
http://www.sciencebasedmedicine.org/?p=156
