shutterstock_9267889There are many that make the claim chiropractic is unscientific or based on pseudo-science.  Is that true?  Is chiropractic quackery?

Well, according to the scientific literature and to every judicial and formal government inquiry ever conducted, no other profession is as qualified, well trained, evidence based or as safe when it comes to restoring spinal health.

 Here are some quotes:

“By the end of the Inquiry we found ourselves irresistibly and with complete unanimity, drawn to the conclusion that modern chiropractic is a soundly-based and valuable branch of health care in a specialised area neglected by the medical profession (Chiropractic in New Zealand.  (1979) Report of New Zealand Government Commission on Chiropractic.)

 

“On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain.” “Many medical therapies are of questionable validity or clearly inadequate.  Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain.” “There is also some evidence in the literature to suggest that spinal manipulations are less safe and less effective when performed by non-chiropractic professionals.” (Professor Pran Manga Ph.D. University of Ottawa. The Manga Report. (1993) An Independent Report Commissioned by the Ontario Provincial Government in Canada.

 

In addition, people who were mostly treated by chiropractors had, on average, less expensive medical services and shorter initial periods of disability than cases treated by physiotherapists and medical physicians.  This clear trend deserves some attention considering that chiropractors are the only group of providers who explicitly state that they have an effective treatment approach to maintain health.” (Cifuentes et al. (2011) Health Maintenance Care in Work-Related Low Back Pain and its Association With Disability Recurrance. Journal of Occupational and Environmental Medicine pp 190-198)

Many who claim that chiropractic is pseudo-science wouldn’t think twice about popping a NSAID (pain pill) or muscle relaxant for their low back pain.  Maybe they missed this double blind randomised controlled trial…

In a subgroup of patients with nonspecific low back pain, spinal manipulation was significantly better than non steroidal anti-inflammatory drug diclofenac (Voltaren) and clinically superior to placebo.”  Von he-man, W. et al. (2013) Spinal High Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain; A Double-Blinded Randomised Controlled Trial in Comparison With Diclofenac (Voltaren) and Placebo.  Spine 38 (7) 540-548

And perhaps they forgot this…

Studies do not provide evidence for long-term use of muscle relaxants in chronic low back pain.” “Muscle relaxants demonstrated more CNS side effects compared with placebo in nearly all trials.  Sudden discontinued chronic use of benzodiazepines (muscle relaxants) is associated with delirium tremens, whereas abruptly discontinuing baclofen may result in seizures.” “The blockade of COX enzymes, neutrophil function, and phospholipase activity by NSAIDS (Voltaren) account for related renal, GI, and potential cardiovascular side effects.  The risk of GI, renal, and hepatic complications in patients taking NSAIDS is well known.”  “The costs of side effects associated with these drugs should also be considered.  A Canadian study using the Quebec provincial public health-care database base found that for each dollar spent on NSAIDs an extra $0.66 was used on their side effects.”  Malanga & Wolff.  Evidence-informed management of chronic low back pain with non steroidal anti-inflammatory drugs, muscle-relaxants, and simple analgesics.  The Spine Journal 8 173-184

Finally in the first reported randomized controlled trail comparing clinical-guidelines based treatment (including spinal manipulative therapy administered by chiropractors) to family physician-led usual care of acute low back pain the results were:

Compared to family physician-led usual care, full clinical guidelines-based treatment including chiropractic spinal manipulative therapy is associated with significantly greater improvement in condition specific functioning.” (Bishop et al. (2010) The Chiropractic Hospital-based interventions Research Outcomes (CHIRO) Study; a randomised controlled trail on the effectiveness of clinical practice guidelines in the medical and chiropractic management of patients with acute mechanical low back pain.  The Spine Journal 10; 1055-64

There are new studies involving chiropractic appearing all the time.  You can find one here done by the Australian Spinal Research Foundation on chiropractic and pelvic floor function in pregnant women.

Perhaps some of these attacks on chiropractic in Australia have their roots in the American Medical Association’s well documented organised attack on chiropractic, culminating in the formation of the “Committee on Quackery” in 1963.  This isn’t a shadowy conspiracy theory.  These attacks are admitted and written about by the American Medical Association itself here.

Hopefully, we will soon move past these false accusations and GP’s, physios, osteos, and chiros can all work together to give those who need our help the best possible health care.