BY MICHAEL VAGG
This weekend saw another exchange of views between chiropractors, the AMA and the Friends of Science in Medicine. It was set off by a number of stories by Amy Corderoy, the Health Editor at the Sydney Morning Herald, here and here and here.
In a nutshell, the issue was that government funding of chiropractic care for children under 14 was reported to have risen by 185% in four years. This prompted the AMA and others to question the advisability of this spending given the poor scientific evidence base for such care, as well as the potential for harm to children given that no clear benefit has been established. A particularly worrying point was the apparent tacit support of the Chiropractic Board of Australia for professional development courses run by opponents of mass immunisation.
The response from the Chiropractors’ Association of Australia (CAA) can be found here. Predictably enough, the CAA has chosen to cast chiropractors as the hapless victims of a league of overpaid bullies representing unnamed but powerful medical interests.
What concerns me? The back story…
What particularly concerns me is the near-complete avoidance of any plausible effort to address the concerns raised by the AMA and FSM. The CAA release simply dismisses them as “purported concerns” and claims there is no evidence presented to back them up. According to one of the SMH articles:
National director of the Chiropractors Association of Australia Tony Croke said in the past 40 years no serious adverse health consequences of chiropractic had been recorded in a child.
Well, I have some news for CAA. It took me about a minute to find it on PubMed.
Here is one case. And here is another. Here is a whole systematic review of serious adverse events in children receiving chiropractic care, including some fatalities.
Top Comments
I have had both good & bad experiences with a chiropractor. My philosophy is that if you've found something that works for you - great!
However my bad experience with a chiro has put me off them for life. I was told by my chiro that her practice was all about treating the patient individually for their needs. However, it was a same treatment fits all practice. Must come in weekly for maintenance. I had originally gone in for chronic neck problems. These continued even after 2 years if treatment. Since stopping - no issues.
I was told to go off wheat & dairy (as we're all patients). She even recently wrote a blog suggesting no children should eat wheat & dairy. She also advocates against vaccination & medical intervention (scans, X-ray etc) during pregnancy.
At the time I was having issues getting pregnant. I decided to see an acupuncturist. She disagreed with this course of treatment saying it was unnecessary to see anyone but her for health care. She knew my body best.
The last appointment I had I was 12 weeks pregnant. she said my hormones were fantastic and the baby was thriving. That afternoon I had a scan - I'd lost the baby a week earlier.
I'd had a vomiting reaction to some antibiotics from my GP at one point. She told me it was my body rejecting western medicine & that I should disregard anything they say to me. When I had a vomiting reaction to a chiro adjustment, she said it was a perfectly fine reaction to my body ridding itself of bad energy.
I now have a great GP (who treats with honey & lemon drinks, dietary changes etc rather than antibiotics for everything) an acupuncturist and myotherapist who look after all my health needs. No neck pain, 2 successful pregnancies and great general health. And all practitioners are happy to work together to achieve optimum health for me.
Quitting chiro was the best thing I've ever done for my health.
read your article with dismay at the many errors contained within.
First your link to manipulation and your assumption that all manipulations are performed by Chiropractors and all that Chiropractors do is perform spinal manipulation. Chiropractors use a variety of techniques that may include soft tissue treatment, exercises, stretching, nutritional, postural rehabilitation....Yes our mainstay is spinal adjusting (manipulation ).
In May of 1995,Dr. Allan Territt drew international attention when JMPT published his article that contended that a number of published studies linking chiropractors with complications arising from cervical spinal manipulation were misrepresentations. The article concluded: "The words chiropractic and chiropractor have been incorrectly used in numerous publications dealing with SMT [spinal manipulative therapy] injury, by medical authors, respected medical journals, and medical organizations. In many cases this is not accidental, as the authors had access to original reports, which identified the practitioner involved as other than a chiropractor."
The large majority of the injuries due to manipulations in this article were performed by non chiropractors despite chiropractors delivering the majority of spinal manipulations world wide. The injuries were due to people such as barbers, karate instructors, spouses who have seen the procedure, self manipulations and one was linked to a GP. These were all referred to as Chiropractic manipulations despite not being performed by a chiropractor.
I know of a nurse at a hospital who challenged the reporting of a neck injury, which was going to classified as a 'chiropractic injury' because she knew the person who performed the service was not a chiropractor. The injury was then listed simply as a 'neck injury'.
The first link in your article was to a SIDS death in a baby that was found to have clavicular fractures. The baby who had manipulations by an un-licensed therapist 3 or 4 weeks prior to it's death, and this was referred to as "chiropractic manipulation". Could it have it have been performed by masseuse, a homeopath or a deregistered GP? When I was in Tasmania, in the 1990's, there was a former Hobart GP who had lost his license and called himself a 'back specialist' who performed spinal manipulation. At that time neither the Medical Board or Chiropractic Registration Board would prosecute him for practicing without a license.
The second link Is to a rib fracture linked to manipulation in an infant
In the third link you state "Here is a whole systematic review of serious adverse events in children receiving chiropractic care, including some fatalities." This is a review regarding manipulation that included 2 studies and 11 observational reports. Manipulation is performed by chiropractors, osteopaths, physical therapists (some bill them selves as manipulative physical therapists), Medical Physicals (some after taking a weekend or online course) and bone setters in countries like Japan. There are also medical physicians who perform manipulation under anesthesia- I have seen a video of a child undergoing this and it was much more severe than anything I was ever taught. I have met several massage therapists who have said they they perform ' chiropractic manipulations' ( with no training that I am aware of) and I have had patients who have reported that they had their neck manipulated by their Naturopaths.
You state regarding this 3rd link that "... including some fatalities." When I reviewed the links there is no mention of fatalities. The only fatality listed was in first article in which the death is attributed to SIDS and there is no inference that the manipulation, by the unregistered health practitioner, was causal. The conclusion of this review study includes ".., neither causation nor incidence rates can be determined from observational data..."
I can present both published and unpublished cases (observational data) were the medical system failed miserably with children and who then went on to achieve results with Chiropractic care.
There is a risk with any procedure. I, like most of my colleagues try to be thorough and treat any of my patients, regardless of their age with due diligence and care. We review consent with all of our patients as required with our legislation.
I have been referred children through the Medicare Enhanced Primary Care Program and I am proud of my contribution to their health.
I think your article is erroneous, inflammatory, prejudicial and misleading.
Michael Landry D.C.