Singh’s chiropractic article

Sense About Science is coordinating a mass posting of Simon Singh’s deleted Guardian article about chiropractic, which was the subject of bogus libel action by the egregious British Chiropractic Association.

Most of the reprints, including this one, have excised the two sentences which the BCA complained about:

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.

Here is the article, without the allegedly libelous material:

Beware the spinal trap
Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.
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.
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.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.
I can confidently label these assertions as utter nonsense 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.
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.
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.
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.
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.
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.’
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard 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. 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.
Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

2 Responses to “Singh’s chiropractic article”

  1. Joel Saeks says:

    Just a quick comment on the dangers of chiropractic . The incidence of VBAI is 1 in 3 million you have as much chance of a problem having your hair washed at a Salon or having sex. If it was such a problem then why are there no cases of an incidence in Chiropractic schools? In Chiropractic schools, students practice on each other. Everyday add all of the students getting their necks adjusted by untrained students without any problems other than some soreness. Don’t people who have surgery have post op soreness? I saw no mention of the number of deaths due to prescription drugs or people undergoing surgery . Or how about the percentage of patents receiving back surgery who have a lifetime of back pain the procedure around 40%.
    there are many things done in Medicine that has no randomized controlled blind studies and many Meds. have no known mechanism of action yet it is used with a host of side effects more dangerous than chiropractic. The variables in the human population is vast and it is possible that there is no real way to do a randomized controlled blind study. Show me some randomized controlled studies on back surgery. Lets face it studies can be skewed by the people who do them. And before I am attacked over statistics I took a class and in it statistically speaking there is no supposed connection to any problems with second hand smoke. Look into the increased incidence in earaches in homes of smokers. Millions of people get relief from chiropractic. I will say there are some unscrupulous chiropractors out there but there are also many great ones who help their patients with no drugs, little side effects, and for a lot cheaper. It is time for all this attacking of a great profession that has been shown Scientifically to be more effective than surgery for certain types of back problems. And if you want to bring up dangers of something need I remind you of Heath Ledger who died to to prescription meds. Hew was famous so we heard about it. How many people do you think die due to these meds. let alone something considered harmless like aspirin

  2. Bobbob says:

    Could you reference the studies or statistics that back up the facts you have stated.

    I disagree that properly conducted and documented scientific studies can be skewed by those conducting them. One of the main requirements is that an independent third party can recreate the study and should get a similar result.