The process of chiropractic adjustment is a safe, efficient procedure which is performed nearly one million times every working
day in the United States.
There is a singular lack of actuarial data that would justify concluding that chiropractic
care is in any way harmful or dangerous. Chiropractic care is non-invasive, therefore, the body's response to chiropractic care
is far more predictable than its reactions to drug treatments or surgical procedures. Of the nearly one million adjustments given
every day in this country, complications are exceedingly rare. Perhaps the best summary statement on the subject of safety was
published in 1979 by the Government of New Zealand which established a special commission to study chiropractic. They found:
"The conspicuous lack of evidence that chiropractors cause harm or allow harm to occur through neglect of medical
referral can be taken to mean only one thing: that chiropractors have on the whole an impressive safety record."
I
could also add this: Hands-on experience - Chiropractic
is both safe and effective, says Peter Dixon
A
man suffering with chronic back pain was persuaded by his partner earlier this year to consult a chiropractor about his
condition. His visit to a local chiropractic clinic coincided with an article in a national newspaper about the risks of
chiropractic treatment (The Independent, 2 June). He arrived at the clinic brandishing the article and refusing treatment. The
article echoed much that Edzard Ernst, professor of complementary medicine at the University of Exeter, had written two months
earlier in this magazine (Forum, 18 April, p 49).
Chiropractors diagnose and treat conditions caused by the mechanical
dysfunction of joints and the effects these have on the nervous system. The tendency of the media to warn that danger surrounds
the specialised manipulative techniques chiropractors use does not instill confidence. Nor does the confusing variation in
chiropractic's legal status. In Britain, for example, chiropractors can practise legally because no law stops them doing so. In
Spain, Belgium and France a licence is needed to practise any form of medicine. To get such a licence, a conventional medical
qualification is needed.
To confuse things further, people in Britain can call themselves chiropractors whether they are
qualified or not. But following the Chiropractors Act of 1994, the General Chiropractic Council will soon open its
"statutory register". Thereafter only registered practitioners will legally be able to call themselves chiropractors in
Britain. Similar regulations already exist in Australia, Denmark, Sweden and the US.
Like other forms of healthcare that
do not involve drugs, chiropractic does not attract the sort of funding that pharmaceuticals companies allocate to research. But
scientific evidence for the effectiveness and safety of chiropractic is growing, and practitioners are demonstrating this through
peer-reviewed research.
In 1990, a detailed study on low back pain was published in the British Medical Journal (vol
300, p 1431). It compared chiropractic with hospital outpatient treatment for managing low back pain. It demonstrated that
chiropractic was the more effective of the two. A follow-up study in 1995 confirmed this conclusion, reporting a 29 per cent
improvement level for chiropractic over hospital treatment (BMJ, vol 311, p 349).
In 1997, at the World Chiropractic
Congress in Tokyo, Danish researchers presented results showing that chiropractic reduced the duration of headaches by 69 per
cent (compared with 37 per cent for massage) and their intensity by 36 per cent (compared with 17 per cent for massage). It also
reduced the number of painkillers needed by 36 per cent. And a Dutch study shows that for shoulder pain arising from disorders of
the spine or upper ribs, chiropractic manipulation has very positive effects (BMJ, vol 314, p 1320). But despite such evidence,
the case for the profession is confounded by inaccurate use of the term chiropractic. In 1995, Alan Terrett, an Australian
professor of health science, reviewed the published research on the complications of chiropractic neck manipulation. On
contacting the original authors and patients, he found that many reported incidents were not severe at all and that many of the
"chiropractic manipulations" were not performed by chiropractors.
The risks of chiropractic should be
put in perspective. The Independent's article said that "chiropractic treatment can result in vascular damage in an unknown
number of cases" - so it's not surprising it caused some alarm. Based on published cases and insurance reports,
complications from genuine chiropractic manipulation to the neck are, at worst, a problem for 1 in 500,000 patients so treated.
That's just 0.0002 per cent. In contrast, a 1995 risk assessment study (Journal of Manipulative and Physiological Therapeutics,
vol 18, p 530) reported that nonsteroidal anti inflammatory drugs can carry a 0.4 per cent risk per year of severe stomach
ulceration, possibly leading to perforation and death. Would the reluctant patient have chosen painkillers rather than
chiropractic had he known?
