Crticism of Chiropractic

JJM

Graduate Poster
J
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There is an old thread in another subforum on this topic http://www.internationalskeptics.com/forums/showthread.php?t=85436

I started this one because I think it is more appropriate in this subforum, and to provide a place to post on chiropractic, in general, outside of the thread on BCA vs. Singh. Also, I recently acquired an article featuring chiropractors critical of their business.

Jaroslaw P. Grod, DC, David Sikorski, DC, and Joseph C. Keating, Jr, PhD "Unsubstantiated Claims in Patient Brochures From the Largest State, Provincial, and National Chiropractic Associations and Research Agencies" Journal of Manipulative and Physiological Therapeutics Volume 24 • Number 8 • October 2001 pp. 514-19
Conclusion: The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior.
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That is straightforward. Since the publication is not readily available, I will quote some of the objections to claims:
A prophylactic or health-maintaining effect of manipulation has not been experimentally demonstrated to date.

The value of “regular check-ups” by chiropractors is also unknown.

The effects, if any, of spinal subluxations upon athletic performance have not been scientifically validated.

The disease-producing and pathology-producing effects of subluxation-complex, if any, have not been demonstrated experimentally.

Adjusting has not been experimentally demonstrated to alter vertebral alignment or “nerve pressure”; such effects, if possible, have not been shown to influence neuritis.

Currently available experimental data do not justify any claims for the value of chiropractic care in populations of children.

The “causes of chronic pain” that may respond to manipulation have not been established.
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That article fits nicely with: "Improper Claims on Chiropractic College Web Sites" http://www.chirobase.org/03Edu/webclaims.html

When a chiro claims to have a chiropractic-subluxation free practice, one must ask why they spent so much time "studying" that fairy tale: Association of Chiro Colleges statement http://www.chirocolleges.org/paradigm_scope_practice.html http://www.chirocolleges.org/paradigm_scopet.html
Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.
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"The page cannot be found
The page you are looking for might have been removed, had its name changed, or is temporarily unavailable."
 
Gord_in_Toronto said:
The article is available online:
www.journalchiroed.com/2003/JCEFall2003Sikorski.pdf. ... :D
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The link does not work. perhaps the period (full stop) at the end is the problem because I pasted the whole thing and it worked. Thanks, that was a different, and useful, article. ETA: fls fixed it.

Jeff Corey said:
"The page cannot be found ..."
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Thanks, I noted that and will look for its replacement.

ETA current link is now in my original post.
 
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End of an Era: FCER Decides on Self-Liquidation
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http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54144

FCER is the Foundation for Chiropractic Education and Research. Founded in 1943,
Over the foundation's history, volunteers contributed more than 33,000 articles and helped fund over 152 randomized, controlled trials concerning chiropractic manipulation ...
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So, why are chiros arguing, today, that they have no research that definitively supports their claims because of a lack of money? Even the claims to treat acute, low back pain are a bit shaky (according to the latest Cochrane review, which requires a subscription in most of the USA).
 
It's interesting to note that as the FCER is closing down, the Foundation for Chiropractic Progress (FCP) has received approximately $650,000 in pledges to help with its mission “To increase the public awareness of the benefits of chiropractic”.
http://www.chiro.org/wordpress/?p=1151

The words 'very few' seem to have been omitted from its mission statement.
 
There are tons of chiropractors around here, and our local paper has a weekly Ask the Experts column that includes one. There was an ad yesterday in which the chiropractor was offering to treat mental disorders (anxiety and depression, specifically.) I am always amazed that this stuff is legal.
 
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For those who may have missed it, at the end of last month Jeff Wagg wrote an interesting article looking at CAM practitioners and vaccination. It's accompanied by a short video of a questionable chiropractic presentation:

No Vaccine Against Greed
http://www.randi.org/site/index.php/swift-blog/724-no-vaccine-against-greed.html

Here's snippet from the article:
One of the things that's always puzzled me about the anti-vax movement is why people are motivated to rail against something with so much supportive evidence. Sure, there are legions of misinformed parents who think they're helping society by decrying the vaccination conspiracy, and there are certainly those that have experienced personal loss due to the very, very, rare negative side effects of vaccination. But Chiropractor Dr. Chad Rohlfsen [the chiropractor who features in the video] illustrates in abundance what I think might be the primary motive for anti-vaccine rhetoric, and that is pure, simple, banal greed.
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Seems those assumptions may not be too far off the mark.
 
There is news on chiropractic. Four of them went looking and could not find any evidence for the existence of the "subluxation" that is the centerpice of their work! This is news, despite the fact that we have known it for decades, because it is an admission from the chiros. http://www.sciencebasedmedicine.org/?p=3022

According to the Association of Chiropractic Colleges
Chiropractic is Concerned with the preservation and restoration of health, and focuses particular attention on the subluxation.
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http://www.chirocolleges.org/paradigm_scope_practice.html
 
JJM said:
There is news on chiropractic. Four of them went looking and could not find any evidence for the existence of the "subluxation" that is the centerpice of their work! This is news, despite the fact that we have known it for decades, because it is an admission from the chiros. http://www.sciencebasedmedicine.org/?p=3022

According to the Association of Chiropractic Colleges http://www.chirocolleges.org/paradigm_scope_practice.html
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Don't be surprised if chiropractors claim in their defence that the authors only went looking for one type of subluxation...
Subluxation Synonyms and Metaphors
By P. L. Rome

The following 329 terms either relate to, are synonyms for, or have been used or cited in connection with describing a subluxation or aspects of a VSC. The use has been in chiropractic, medical and osteopathic papers. There are in fact 371 terms, including the 42 on the sacroiliac list.

Aberrant motion
(Ab)normal articular sensory input
Abnormal dysfunction
Abnormal fixation
Abnormal instantaneous axis of rotation
Abnormal mechanics
Abnormal motion or position
Abnormal muscle function
Abnormal nervous system function
Abnormal spinal function
Altered intervertebral mechanics
Altered joint structure and function
Altered nociceptive and proprioceptive input
Altered regional mechanics
Arthropathic
Abnormal function
(Ab)normal joint mechanics
Abnormal joint motion
Abnormal motion or position
Abnormal muscle function
Abnormalities of range of motion or coupling
Abnormal nervous system function
(Ab)normal regional sympathetic tone
Abnormal restrictive barrier in or around joints
Abnormal spinal function
(Ab)normal structural relationship
Acute joint locking
Acute locking
Adverse mechanical tension of the nervous system
Altered alignment
Altered joint motion
Altered nervous system movement
Altered physiological function
Apophyseal subluxation
Arthron (extremity joint subluxation -- see also "vertebron")
Articular derangement
Articular dyskinesia
Articular juxtaposition
Biomechanical distortion
Biomechanical impropriety
Biomechanical insult
Biomechanical stress
Blockage
Blocking
Bony displacement
Bony maladjustment
Bony lesion
Cervical joint dysfunction
Changes of the dynamic segment
"Changes of thoracic segments"
Chiropractic lesion
Compensatory structural subluxations
Comprehensive lesion
" ... compromise proper function"
Deconditioned syndromes
Deviation of the bodies
Errors of static or motor mechanics
Facet joint syndrome
Facet synovial impingement
Facilitated spinal system
Facilitated subluxation*
Functional pathology
Functional subluxation*
Chiropractic subluxation
Chiropractic subluxation complex
Comprehensive lesion
" ... compromise proper function."
Delayed instability
Deformation behaviour
Degenerative dynamic segment
Derangement
Derangement of the opposing joint surfaces
Discoradicular conflict
Disorder of the disc
Disrelationship of the facets
Displacement
Disturbance in the mechanico-dynamics
"(vertebrae) ... don't move enough, or they move too much."
Dynamic forceps
Dynamic segment
Dysarthric lesion
Dysarthrosis
Dysfunctional joint
Dysponesis
Dystopia
Dysfunctional segments
Engagement of the spinal segment in a pathologic reflex chain
Erratic movement of spinal articulations
Excursion (Conley) = ("Wandering from the usual path." -- Taber's)
Facet imbrication
Facet joint dysfunction
Facet syndrome
Facilitated segment
Facilitative lesion
Fanning of interspinous space
Fixation
Fixed vertebra
Focal tenderness
" ... force other joints to move too much."
Functional block
"(subluxations) ... force other joints to move too much."
Functional compromise
Functional deficit
Functional defects
Functional derangement
Functional and structural changes in the three joint complex
Functional disturbance
Functional impairments of motion
Functional spinal lesion
Functional subluxation*
Gravitational (im)balance of joints (with) reduced chronic, asymmetrical forces
Harmful dysfunction of the neuromusculoskeletal system
Hyperaemic subluxation
Hyperanteflexion sprain
Hypermobility
Hypopmobility
Hypokinetic aberration*
Impairment
(Im)properly direct(ed) coordinated, (in)harmonious motor programming
Inability of the segment to articulate about its new axis
Incomplete luxation
Incomprehensible pattern of symptoms and clinical findings when compared to with examination of mechanical lesions in the extremities
Instability of the posterior ligament complex
Interdiscal block
Internal joint derangement
Internal vertebral syndrome
Intersegmental instability
Intersegmental subluxation
Intervertebral blocking
Intervertebral disrelationship
Intervertebral dysfunction of the mobile segment
Intervertebral joint subluxation
Intervertebral obturations
Intervertebral subluxation
Joint bind
Joint disturbances
Joint dysfunction
Joint immobilization
Joint "instability"
Joint movement restriction
"Just short of a dislocation"
Kinesiopathology
Kinetic intersegmental subluxation
Kinetic subluxation
Lesion
Less than a locked dislocation
Ligatights
Localised/referred pain
Locked
Locking
Locked subluxation
Locks up and restricts motion
Lose their normal motion or position
Loss of elasticity
Loss of joint movement
Loss of juxtaposition
Loss of segmental mobility
Low back dysfunction
Malalignment
Maladjustment (of a vertebra)
Malposed vertebra
Mechanical interferences
Mechanical malfunctioning
Mechanically infringe
Manipulatable joint lesion
Manipulatable lesion (adjustable subluxation!)
Mechanical derangement
Mechanical disorder
Mechanical dysfunction
Mechanical instability
Mechanical irritation of the sympathetic ganglionic chain
Mechanical musculoskeletal dysfunction
Mechanico-neural interaction
Metameric dysfunction
Mild pubic diastasis
Minor derangement
Misalignment
Misalignment of the fibrocartilaginous joint
Motor unit derangement complex
Motion restriction
Movement restriction
Multisegmental spinal distortion
Musculoskeletal dysfunction
Myopathology
Nervous system impairment by the spine
Neuro-articular dysfunction*
Neuro-articular subluxation*
Neuro-articular syndrome*
Neurobiomechanical
Neuro-dysarthric
Neuro-dysarthrodynic
Neurological dysfunction
Neurodystrophy
Neurofunctional subluxation*
Neuro-mechanical lesion*
Neuromuscular unit
Neuromuscular dysfacilitation
Neuromuscular dysfunction
Neuropathology
Neuropathophysiology
Neurospinal condition
Neurospinal distortions
Neurostasis (Wilson)
Occult subluxation
Offset
Orthokinetics
Ortho-spondylo-dysarthrics
Osteological lesion
Osteopathic lesion
Osteopathic spinal lesion
Osteopathic spinal joint lesion
Pain and debility without recognisable pathology
Painful intervertebral dysfunction ("PID")
Painful minor intervertebral dysfunction ("PMID")
Palpable changes
Paravertebral subluxation
Partial dislocation
Partial or incomplete separation
Partial fixation
Partial luxation
Pathogenic interaction of spine and nervous system
Pathophysiological mechanics
Pathologically altered bradytrophic tissue
Pathologically altered dynamic segment
Pathomechanics
Pathophysiology
Perverted function
Physiologic displacement
Physiologic lock the motion segment
Positional dyskineria
Posterior facet dysfunction
Posterior joint dysfunction ("PJD" -- see "three-joint complex"!)
Posterior joint syndrome
Post-traumatic dysautonomic
Prespondylosis
Primary dysfunction
Primary fibromyalgic syndrome
Pseudosubluxation
Putative segmental instantaneous axis of rotation
Reflex dysfunction
Reduced mobility
Regional dysfunction
"Relative as absolute lack of space within the intervertebral foramen"
Residual displacement
Restricted motion
Restriction
Restriction of unisegmental mobility
Reversible with adjustment/manipulation
Sagittal translation (Conley)
Sectional subluxation
Segmental dysfunction
Segmental instability
Segmental movement restriction
Segmental vertebral hypomobility
Semiluxation
Simple joint and muscle dysfunction without tissue damage
Shear strain distribution
Slight luxation
Slightly luxated
Slightly misaligned vertebra
Soft tissue ankylosis
Somatic dysfunction
Spinal dysfunction
Spinal fixation
Spinal hypomobilities
Spinal irritation
Spinal joint blocking
Spinal joint complex
Spinal joint dysfunction
Spinal joint malfunction
Spinal kinesiology
Spinal lesion
Spinal mechanical dysfunction
Spinal pathophysiology
Spinal segmental facilitation
Spinal segmental instability
Spinal subluxation
Spine restriction
Spino-neural conflict
Spinostasis (Wilson)
Spondylodysarthric lesions
Sprain
Stable cervical injury of the spine (see also "instability" above)
Static intersegmental subluxation
Static subluxation
Strain
Strain distribution
Structural abnormalities
Structural derangement
Structural disrelationship
Structural intersegmental distortion
Structural lesions
"Stuck"
Subtle instability
Sub-luxation
Subluxation
Subluxation complex
Subluxation complex myopathy
Subluxation syndrome
Subluxes
Three joint complex
Tilting of the vertebral body
Tightened, deep, joint related structures
Total fixation
Translation
Unresolved mechanical tension or torsion
Unstable lumbar spine
Unstable subluxation
Vertebragenous syndromes
Vertebral derangement
Vertebral displacement
Vertebral dysfunction
Vertebral dyskinesia
Vertebral factor
Vertebral genesis
Vertebral induction
Vertebral lesion*
Vertebral pathology
Vertebral subluxation
Vertebral subluxation complex
Vertebral subluxation syndrome
Vertebrally diseased
Vertebroligamentous sprain strain
Vertebron (see also "arthron")
Wedged disc
Zygopophyseal pathophysiology

42 Terms for a Sacroiliac Subluxation

Abnormal pelvis biomechanics
Altered sacroiliac mechanics
Changed motor pattern (in muscles)
Change in relation
Displacement
Disturbed normal relationship
Distorting the normal mechanics
Downslips (see also "upslips")
Dysarthria
Dysarthric syndrome
" ... effect on body mechanics"
Instability of the pelvic joints
" ... irritation of the nerves is possible ... "
Joint binding
Joint dysfunction
Joint lesion
Joint motion restriction
Joint slip
Joint syndrome
Limitation of motion
Malposition
Malrotation
Mechanical dysfunction
Misplaced
Misplacement
Motions are restricted
Partial luxation
Primary dysfunction
Restrictions
Rotatory slips
Shear dysfunction
Shear mechanism
Slight luxation
Slip
Slipping sacroiliac joints
" ... stick at the limit of normal motion ..."
Strain
Strain and laxity
Tilts (anterior, posterior)
Upslips (see also "downslips")
Vertical slipping of the innominate on the sacrum


Synonyms
59 Synonyms or Metaphors for the "Spinal Adjustment"
Arthral alignment
Atlas therapy
Biokinetic remediation
Bone setting
Chiropractic manipulation
Chiropractic manipulative therapy
Corrective spinal care
Disengage
Diversified-type force application to release the segment at its articulation
Facet adjusting
Fix
Flexion distraction manipulation
Functional restoration
Gentle adjusting
Gently relieve the locked subluxation
High velocity facet adjusting
Human readjustments
Joint manipulation
Low force/amplitude manipulation
Manipulation
Manipulative surgery
Manipulative therapy
Manipulatory
Manual adjustment
Manual cavitation
Manual medicine
Manual reflex neurotherapy
Manual therapy
Manual treatment
Mechanical treatment of the nerve centres.
Mobilisation
Neuro-mechanical spinal chiropractic management
Neuromechanical correction*
Neurotherapeutic
Neurotherapy
Orthokinetics
Orthopedic orthokinetics
Osteopathic manipulative therapy
Osteopathic osteological adjustment
Physiatry
Physical medicine
Readjustment
Reconstructive measure
Reduced
Reduction
Reduction of dislocation
Release of intraarticular pressure
Replacement
Repositioning
Restoration of mobility
Slipped into place
Specific mobilization
Spinal adjustment
Spinal manipulative therapy
Spinal manual therapy
Spondylotherapy
"Springing the spine"
Vertebral adjustment*
Vertebral medicine

* Unreferenced

Reference

Rome PL. Usage of chiropractic terminology in the literature -- 296 ways to say "subluxation." Chiropractic Technique 1996;8:1-12.
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Indeed, the UK chiropractic regulatory body, the General Chiropractic Council claims that there is scientific evidence for "the many interpretations" of 'subluxation':
http://209.85.229.132/search?q=cach...action+victims+chiro&cd=1&hl=en&ct=clnk&gl=uk

:boggled:
 
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@Blue Wode, that is a distressing list. However, it does not disentangle the cases where (for example) "spinal dysfunction" is offered as an alternative to "subluxation" which would have been found in the search. In other words, I think the terms would often have been linked ("the spinal dysfunction also known as the subluxation"). Also, we are talking about the "official" term of the ACC, if we deviate from that we deviate from their "paradigm."
'
But, yours is a good catch- we will have to be ready if it comes up.
 
I am sure that even chiropractic schools cannot agree on how to accurately diagnose is a subluxation.
 
I used to work in a chiropractor's office. When there was no one around I used to read the various publications that the chiro subscribed to. There was (and is) an enormous amount of bickering and infighting among the leading lights of chiropractic about how to define a subluxation, how much "philosophy" to include in their training and public presentations, and on and on. It seemed disingenuous, to say the least, to be claiming to treat subluxations on the one hand while on the other bickering about how to define the term. If you don't have an objective definition of a subluxation, how can you possibly claim chiropractic is effective in treating it?
 
Could chiropractic be doomed in the UK?

That chiropractic can improve the spine and nervous system — whether or not they shun the dreaded ’subluxation’ word — is a universally held belief amongst chiropractors and central to their practice. Although there is no good independent evidence for the existence of subluxations — and some evidence that they don’t exist and do not have any effect on nerve function — there can be little doubt that, without such beliefs, chiropractic does not have a leg to stand on.

It is difficult to imagine how you could describe chiropractic without claiming it improves spine and nerve function.

So what would happen if these claims were undermined by, say, the ASA [Advertising Standards Authority] declaring that such claims have not been substantiated?

That is exactly what the ASA have said.

In my complaint, I doubted that the advertiser could justify the claims that chiropractic could improve the function of the spine and nervous system. The ASA have told me that they expect the advertiser to remove all the claims about conditions, serious or otherwise, not on their approved list and that:

This also applies to the claim that chiropractic is able to improve the function of the spine and nervous system, so we would expect the advertisers to also remove this claim.​

A claim about improving the function of the spine or nervous system is treated just like a claim about colic or asthma: they are not on the list, therefore they are not allowed.

However, this is not something new or a new interpretation of their guidance:

…this has been the CAP/ASA position for some time. It is based on substantiation we have seen from the Chiropractic community, independent expert advice and previous adjudications.​

A chiropractor making such a claim would be contrary to ASA guidance — and this has been the case for some time. And since ASA guidance forms an integral part of the GCC’s Code of Practice, it would seem that chiropractors are in a bit of a pickle.

http://www.zenosblog.com/2010/01/discover-chiropractic/
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