FAACT - Families Against Abusive Chiropractic Treatments

Chiropractic based on flawed science

Provided by: Calgary Herald

Written by: Marvin Levant M.D., FRCP(C)

I have taken the liberty to highlight and set up headlines in the text to make it easier to read.
I have also inserted hyperlinks.

Magic or medicine?
From the earliest times, treatment of illness was the domain of priests and magicians. Witch doctors still dominate the healing arts in primitive cultures. In our modern culture, herbs, therapeutic touch, potions, magnetism, manipulation and amulets persist.
The public in their adoption of "alternative" or "complementary" medicine abandons logic, for the therapies are neither "alternative" or "complementary" At best, they are innocuous. At worst, they exploit the individual financially and may be dangerous.

The push by patients for personal health autonomy has provoked a consumerism, a "health care on demand", a "cafeteria care", with over 400 therapies from which to choose, from applied kinesiology to therapeutic touch, from magnetism to mysticism.

Legal implications
The November/December 1999 issue of the Canadian Lawyer features "Suing the Alternative-Health-Care Provider" and discusses the "millions of dollars in potential damages in a new and as yet undeveloped area of civil liability"
The article's major focus is on chiropractic stroke and on a recent high profile coroner's inquest on death from chiropractic neck manipulation. Another focus is on the liability of a physician referring a patient to alternative therapists, particularly chiropractic.

"(I)t doesn't matter whether the paraprofessional delivered flawless care or bungled it completely; the doctor is responsible," the article said.

This includes midwifery, homeopathy, naturopathy and a host of other therapies.

"The courts may decide physicians are negligent if they refer patients to particular therapies that have been proven to offer no practical benefit."

For most people, a chiropractor appears to be a professional trained in the care of musculo-skeletal problems. The person calls himself or herself a "doctor" and people assume there must be some degree of advanced education, approved by a university, science or medical faculty. Such is not the case.

A mother named Sharon Mathiason stated, at the coroner's inquest into her daughter's death, that she felt deceived to learn that chiropractors are not really medically trained.

She wrote, "I do not see how real medical doctors who value their degree can refer a patient to a chiropractor who also claims to be a "doctor".

I must agree with her. I do value my degree. No medical faculty recognizes chiropractic schooling. During my four years of radiology residency, comprising about 12,000 hours of hospital attendance, emergency call and lectures, I never saw a chiropractor. Their training is inadequate to attend hospital patients.

With the exception of infants and children brought by their parents, many people initially visit a chiropractor for back pain. The examination appears to be complete, the diagnosis may make sense and the treatment proposed seems to be supported by the personal testimony of others. A good impression may result because most backaches disappear no matter what you do.

The Emperor has no clothes
In the Hans Christian Anderson fairy tale, the Emperor who had no clothes also made an initial good impression. It took a child, and in this case the Chiefs of Pediatrics of our Children's Hospitals (1994) as well as the Canadian Pediatric Society (1998) to call out, this is all "useless" and especially in regard to chiropractic x-rays of children, these can lead, without any benefit, "to the risk of cancer and genetic damage".
With chiropractic, the spinal column is the entryway into a philosophical belief system that the spinal cord is somehow the master of the human body. Keep the bones in a perfect alignment and all disease will be prevented.

Every first year medical student knows what every fourth year chiropractic student and indeed "doctors of chiropractic" appear not to know. The notion that the spinal column through the autonomic nervous system, somehow controls all our body functions, is an anatomical impossibility. It has never been true and can never be true.

Why do the abdominal organs such as the liver, spleen , kidneys, gallbladder, continue to function in a paraplegic? Yet chiropractic needs this belief system because without it, as one chiropractor stated, "we are just glorified physiotherapists."

Chiropractors attack medicine by saying that not everything in science is proven. With more modern technology, more and more of which physicians do, can, in fact, be proven and understood. The real issue, however, is that what is known to be unproven and false is abandoned, with remarkable speed and clarity, by scientific medicine. Chiropractic does the opposite.

So what happens when you go to many chiropractors? Sometimes a person is given simple physiotherapy advice that makes sense. However, chiropractors are not fully trained physiotherapists. Just as tooth repair is what dentists do, the only function unique to chiropractors is their own version of spinal manipulation. The cracking one hears when the spine is manipulated is the same sound as cracking your knuckles and of no significance.

Valid concerns - pediatric chiropractic
There are however many valid concerns about chiropractic ideas and practices of spinal manipulation. These include the notion that the spinal nerves control body functions and hence you will see infants and children in a chiropractors office being "treated" for everything from colic to ear infections.
If you ask about immunization, you may often be discouraged to allow this, or told this is a question of freedom of choice.

Rather, chiropractic philosophy maintains, the removal of phantom spinal subluxations is the "natural" way to prevent polio, tetanus, diphtheria, measles, etc. etc. The chiefs of pediatrics stated that "chiropractic spinal adjustment is not an alternative for pediatric immunizations".

Yet believe it or not, Alberta Health care pays for a chiropractor to give a parent such advice. No wonder our immunization rates are dropping (Calgary Herald front page headline, January 3, 2000), with the resulting threat to public health.

Unscientific claims and the "silent killer"
Adults attend chiropractic for conditions that have nothing to do with low back pain. While scientific medicine searches out treatments for diseases that are diagnosed; chiropractic is a treatment in search of a disease. The disease is "spinal subluxations" and everyone, right from birth on, has them.
A popular chiropractic pamphlet warns:

"Are you and your family carrying the silent killer, the vertebral subluxation complex in your spines? Only a chiropractic spinal check- up can tell."
Unscientific claims are being made that spinal manipulation can help everything from diarrhea to high blood pressure, sinusitis, to acne and migraine headaches.

Lana Dale Lewis, whose family is suing the Canadian Memorial Chiropractic College, the Ontario Chiropractic Association and a chiropractor for $12 million, died after a chiropractic neck manipulation.

She sought help for migraine. Migraines start in the brain, not the spinal column. Chiropractic philosophy appears to leave out the existence of a brain.

Claims are being made that manipulating your neck can help your lower back. Laurie Jean Mathiason who also died following chiropractic neck manipulation, sought help for low back pain, not neck pain.

Wendy Venegas left three young children behind when she died because a chiropractor believed manipulating her neck could help sinusitis. A young Saskatchewan woman was stroked last month when her neck was manipulated for low back pain.

In fact, reports of the dangers of neck manipulation go back over 50 years. I attended the inquest into the death of 20 year old Laurie Jean Mathiason. The jury felt very concerned that the public was not aware of the dangers. Chiropractic has to come to terms with the fact that upper neck manipulation is both a dangerous and an unnecessary procedure whose risk benefit is not justified.

The inquest jury concluded that neither the benefits nor the risks of neck manipulation were really known and they recommended there be a warning about "the risk of stroke and other inherent risks associated with chiropractic treatment be visible and available in the reception area of every chiropractic facility."

Have you ever seen such a warning?

Chiropractic authorities have claimed that the risk is only one stroke for every one million patients. However, the scientific research has found that the risk may be very many times higher, probably closer to one in 5,000. The highly respected Canadian Stroke Consortium at Sunnybrook Hospital, Toronto, has found that chiropractic neck manipulation is the single leading cause of damage to the neck arteries leading to stroke in people less than 45 years of age. Reports from respected neuro-radiologists and pathologists indicate that a person may have damage to their arteries at the time of manipulation, with symptoms of stroke being delayed as long as three months.

Chiropractors attack the messenger
Chiropractors counter attack by making false comparisons, saying the risk of neck manipulation is much smaller than things such as neck surgery or the taking or anti-inflammatory medications.

Every treatment must stand on its own merit. Attacking science does not defend chiropractic claims and procedures.

Neck surgery is done for many reasons, cancers, blood vessel blockages, slipped neck disks, etc. For all cases requiring neck surgery, forceful manipulation would be the last thing you would want to do. A short-term course of medications for neck pain is not going to kill you nor cause a stroke.

As for low back pain, the October 8, 1998 New England Journal of Medicine showed that chiropractic manipulation is really no better than reading a pamphlet on back pain and waiting for the pain to go away.

In medicine, the first principle is: "Do no harm"; the benefit of a therapy must outweigh the risk. Why do patients accept neck manipulation for sinusitis, ear ache, acne, colic and a host of other symptoms and diseases with the inherent risk of stroke or even death?

Why take the risk? Why risk it in a child?

Provinces are being taken to the cleaners
The real problem is the deception played by provincial health departments. In December of 1998, Alberta pediatricians made representation to the government to stop public funding of all pediatric chiropractic, including x-rays. The pediatricians were ignored. Why?
The Chiefs of Pediatric Hospitals of Canada clearly stated in 1994 that government health payments give parents "the false impression that society endorses such treatments".

They are ignored. Why?

The Alberta government allows chiropractors to call themselves "doctors", giving them a political rather than a medical degree? Why?

Alberta Health is paying $32 million a year for non-existent subluxations, $3 million for children. No radiologist has ever seen these elusive subluxations. This is not a turf war. In September, 1998, the Alberta Society of Radiologists voted unanimously to return hundreds of thousands of dollars of x-ray referrals back to chiropractic because of concerns for patient health and radiation exposure.

The answer lies in the mistaken belief that personal testimonial and public votes are more important than scientific responsibility. Governments seem to like the slogans such as "wellness" and "holistic". The government should stop this deception and act in a scientific and a responsible manner. As advocated by Alberta pediatricians in December, 1998, the government should stop public funding of pediatric chiropractic.

Inform yourself by reading Consumer Reports, June 1994. (If you want to see how one chiropractor answered that attack, just click here)

Or, by accessing:

www.canoe.ca/ChiroYork
www.chirowatch.com
E-mail: stroke@neck911.com - For those for whom it is too late and have experienced a chiropractic mishap:
As a parent, do you really believe that there are little bones out of place in your newborn baby's neck causing all types of life long health problems if not fixed? Next time a chiropractor does a so-called "adjustment" look closely to see if anything was really done. If you do believe, why don't you videotape it and show it to your pediatrician? Better still, send it to Alberta Health.

--------------------------------------------------------------------------------
Dr. Levant practices radiology in Calgary
--------------------------------------------------------------------------------

Responses to Levant's article
Pro
CCA is a ship without a captain - Feb 28, 2000 - Dr. Terry Polevoy
When the CCA and the regulators clean house, and when the rats have left the ship, maybe then we could have another commission, or another study that will show that indeed chiropractic is headed on a straighter path to shore. Until then, chiropractic is without a captain, it without a helmsman, but it has plenty of ballast it has failed to off-load.
Laurie Forbes - Feb 21
There are too many alternative medicine practitioners, and patients who, even in the absence of scientific evidence, simply "know" that a treatment works. Chiropractic is but one such example. One could also include naturopathy, homeopathy, iridology, therapeutic touch, herbology, etc. I would hope that the Herald would see fit in future to expand on this theme -- there is here a great potential for an enterprising reporter or guest experts to serve the public good by exposure of ineffectual, and sometimes harmful, medical treatments.
Murray Katz - Feb 21
Murray Katz's letter. I like this one best.
" The chiropractor tells the concerned parent that their newborn has a neurological spinal problem called subluxations that may require years of prevention and care. If an obstetrician billed Alberta Health for the delivery of a baby from a male patient, the claim would be returned. Yet, the invisible subluxation claim in a newborn is paid for with our tax dollars."

Con
Last word on chiropractic? Feb 28, 2000 - G. Roland Bryans - president of the CCA
No other health discipline in modern times has been as thoroughly investigated as chiropractic!
Chiros can do it better, faster, and they do it with only one leg, I guess
Here's a response from someone who says that chiropractors are in some sort of "race" with physiotherapists and medical doctors. What she didn't say is that the latter are working with four legs, and the chiropractors are working with about one leg. The way I see it, they don't have any legs to stand on.
Manipulation is defensible - Dr. Levant's personal prejudice and misconstrued facts have twisted an invalid statement into an exaggerated warning regarding chiropractic care. Dr. Levant's blatant misrepresentation of fact is not in the best interest of the public. His wild and outrageous claims presented with his own emotion and conviction suggests to me a vision of Jerry Springer.

Interesting links to Alberta chiropractors
Alberta's vets are out of joint over animal chiropractic - A turf war has broken out between the Alberta Veterinary Medical Association (AVMA) and the province's chiropractors over animal chiropractic, a booming billion-dollar industry in the United States now taking hold in Canada.