Chiropractic vs. Science Based Medicine (2/2)

In Part 1, I talked about the case of Simon Singh vs. the British Chiropractors Association.
Why did he say the things he said?
Because chiropractic is a pseudoscience. It's not capable of providing consistent relief
in colicky babies, people with sleep disorders, asthma, digestive disorders, bedwetting, hyperactivity,
all of which are claims that the BCA makes. Chiropractic is not based on a scientific
understanding of the body. The basis of it is in vitalism and supernaturalism. The professional
groups are a crazy mixture of acupuncturists, homeopaths, and some actually smart people
who are aware of the limitations of their profession. Most chiropractic is just back
cracking plus placebo effect.
Now, there is some demonstrated benefit for lower back pain sufferers that is superior
to a simple placebo treatment. It may not be more effective than a nice massage, but
it does at least have a demonstrable effect in that instance.
I'm going to do my best to give you a factual account of what chiropractic is. Let's start
with history. DD Palmer was at times a school teacher, beekeeper, grocery store owner, and,
most importantly, a "magnetic healer". His beliefs on healing were influenced very heavily
by the turn of the century beliefs about spiritualism and vitalism, the idea that invisible energies
flowed through us and made us different than non-living things.
Palmer often read medical and scientific journals on physiology and anatomy. In September of
1895, in Davenport, Iowa, working as a magnetic healer, he met Harvey Lillard, a janitor who
was deaf. After an examination, Palmer discovered a lump on the man's back, near the neck. Through
force and massage at the site of the lump, Palmer was able to restore the man's hearing.
Another man, this time with unspecified heart disease, was also miraculously cured by a
spinal manipulation. Thus goes the lore surrounding the events.
Palmer opened the first school of chiropractic two years later, taking on students and starting
the practice of chiropractic. The philosophy behind the healing relies on a belief in the
existence of "the Innate", a force that allows for self-healing. A misalignment of the spine
blocks the flow of this vital force. Palmer called these misalignments "subluxations".
He is quoted as saying, "A subluxated vertebra is the cause of 95 percent of all diseases...
the other five percent is caused by displaced joints other than those of the vertebral column.
It's also important to note some of Palmer's other beliefs. He was a regular at seances,
at which he received knowledge and philosophy from Dr. Jim Atkinson, the spirit of a great
healer of the past. He often referred to chiropractic as the beginnings of a great religion, and
compared himself to Jesus, Mohammed, and Martin Luther. He believed that chiropractic, besides
curing all disease by correcting subluxations, could also cure psychological problems, or
abnormalities of the intellect.
If we took doctors of the same period, we could find that they had equally ridiculous
ideas. The big difference is that modern doctors actively seek to replace those outmoded ideas
by the practice of empirical science to determine what is effective, and what is not. Chiropractic,
on the other hand, is based on outmoded, supernatural beliefs, and so is not grounded in material
science.
The modern field of chiropractic has many subgroups within it, in fact, I'm going to
have to greatly oversimplify because there are so many subcategories. There are the straights,
that hold very closely to the original mystical beliefs of DD Palmer, and believe they can
cure nosebleeds and diarrhea with spinal manipulation. This group tends to reject vaccination, fluoridation,
and all forms of modern medicine. Of course they do, they believe that all disease is
due to blockage of the Innate, even dental cavities. Then there are the objective straights,
who focus more strictly on the disorders of the spine, making fewer claims to treat non-structural
problems. This is the only slightly deluded group, and it seems to be a large percentage
of all chiropractors. They still refer to the nonexistent subluxations as the cause
of some disorders, like tension headache, and they take it all very seriously, but they
have dropped the claims of treating all diseases and some even work in partnership with physicians.
The last group are called mixers, or reformists. They mix different modalities, and the range
here is incredible. Some use homeopathy and herbal and nutritional supplements, and some
are one step removed from being specialist physicians of the spine. The problem is that
you don't know what craziness lies in store for you before you interview the chiropractor.
I want to share with you my experience with chiropractic. In 2009, I developed a disc
herniation, probably as the result of my sedentary lifestyle and a history of disc problems in
my family. I was desperate enough, and in enough pain, to interview a series of chiropractors
at the advice of friends with similar problems. It was a very negative experience for me,
like going to buy a used car. I was pressured to strip to my underwear and get a full body
X-ray, to buy herbal products. One chiropractor essentially discussed with me how to defraud
my insurance to get free treatments. I later learned that some chiropractors spend their
weekends in seminars, learning how to increase profits by effective marketing. One thing
that really bothered me was that all three of the interviewed chiropractors attempted
to sell me herbal rubs, creams or pills. And this was before they had done any examination.
Instead, I chose regular physical therapy, exercises, daily walking, I lost some weight,
and I use heat and cold appropriately. I also take daily pain medication. I have the back
pain pretty much under control, although I still get the ocasional flare-up. Now maybe
chiropractic could have helped, I don't know. But as a scientist, I want to use therapies
that not only have been demonstrated to work, but that actually have a known scientific
basis for working. I don't want someone popping my back that thinks that a mystical force
is being disrupted by the alignment of my spinal joints.
A couple of details about chiropractors I should probably throw in. Most have some university
education, and then two to four years at a school of chiropractic, where the emphasis
is mostly in classroom lectures. Some countries and states have licensing boards that require
practicioners of chiropractic pass exams and complete certain minimal educational requirements.
There are an estimated 53,000 chiropractors in the U.S., 7,000 in Canada, 2,500 in Australia,
and 2,000 in the UK. A study of California disciplinary statistics during 1997–2000
reported 4.5 disciplinary actions per 1000 chiropractors per year, compared to 2.27 for
MDs; the incident rate for fraud was 9 times greater among chiropractors than among physicians.
The percent of people who use chiropractic is usually between 6-12% in the US and Canada.
There is also a real risk to chiropractic. 33 to 61% of patients report a temporary worsening
of their symptoms that usually resolves with 24 to 48 hours. Much less common are complications
that can lead to stroke, paralysis or death. How common this is very hard to determine,
because these events are probably heavily underreported. The other risk is the full-body
X-ray procedure used by a very high percentage of chiropractors. It remains to be seen if
the benefits outweight these risks. I personally don't think so.
Okay, so what's the bottom line? Chiropractic is based on a pseudoscientific belief in vitalism,
but within the field, there are many diverse groups, ranging from completely ineffective
modalities to a competent integrative medicine approach. There is some evidence that chiropractic
can give some subjective relief to back pain sufferers, but the effect is pretty modest,
and comparable to exercise, massage and heat therapy.
Here's what I hope to accomplish from this video. I want the chiropractors of the world
to get over their multiple personality disorder and decide if they want to be scientifically
based, materialistic integrative medicine, or if they want to be a religion that worships
the Innate. One way or the other, they need to start policing themselves, because they
will be judged by the most extreme of their members, and that group is making outrageous,
unsupportable claims.
I also want to see them drop their action against Simon Singh, whose criticims are valid,
and his intent, like mine, is to prevent people from getting hurt by the bogus claims happily
promoted by the British Chiropractic Association.
So, what's the challenge for this video? I'm going to call it the BCA Libel challenge.
In support of Simon Singh, post a video containing your thoughts on chiropractic, but make sure
you include the phrase "happily promoting bogus treatments" or some variation thereof,
specifically in reference to the British Chiropractic Association and any other group you want to
include. You can post your video as a response to this one.
This is a way to stand up to the legal bullying of an organization that supports pseudoscience.
Don't let them use libel laws to gag a science journalist critical of their beliefs.
Thanks for your help, and thanks for watching.