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Educators Blast Mainstream Chiropractic Brochures

Stephen Barrett, M.D.

Chiropractic is based on the belief that spinal problems ("subluxations") are the cause ­ or underlying cause ­ of health problems and that spinal manipulations ("adjustments") can restore and maintain health. These ideas clash with what is known about health, disease, and the human body, but the vast majority of chiropractors still subscribe to them in one way or another [1].

During the past 25 years, I have never seen a major chiropractic organization acknowledge that there is anything fundamentally wrong with chiropractic beliefs or practices. When misleading chiropractic claims are criticized by an outsider, they say that the critic is biased. When embarrassed by quotes from within their own profession, they claim that whatever is said does not represent the chiropractic "mainstream." [2]

A few months ago, the leading chiropractic journal published criticisms that could not be defended with these tactics. After examining various patient-education materials, three chiropractic college professors reported:

The largest professional associations in the United States and Canada distribute patient brochures that make claims for the clinical art of chiropractic that are not currently justified by available scientific evidence or that are intrinsically untestable. These assertions are self-defeating because they reinforce an image of the chiropractic profession as functioning outside the boundaries of scientific behavior [3].

In addition, the trio wrote, "the distribution of patient brochures involving unsubstantiated claims . . . meets several of the formal criteria for quackery."

The critics were Jaroslaw P. Grod, DC, a professor at Canadian Memorial Chiropractic College, in Toronto, and two other professors at Los Angeles College of Chiropractic. Together they objected to 26 claims in 20 brochures distributed by the American Chiropractic Association, the Canadian Chiropractic Association, the Foundation for Chiropractic Education and Research, the British Columbia Chiropractic Association, the Ontario Chiropractic Association, the California Chiropractic Association , the New York State Chiropractic Association, or the Texas Chiropractic Association.

In considering the brochures, the professors considered three types of statements to be improper:

  1. Claims that spinal manipulation could treat diseases unrelated to musculoskeletal problems were considered unsubstantiated.
  2. Vague statements that "chiropractic care" is beneficial were considered untestable and therefore misleading.
  3. Assertions that chiropractors treat "subluxations" were considered unsubstantiated because no such entity has been experimentally established.

Here are examples of their analyses:

Unjustified Claim  Objection
"The doctor of Chiropractic adheres to the philosophy that the body is capable of maintaining and restoring health with a balanced diet, rest, and a properly functioning nervous system. Manipulation of the spine and other areas is the key to recovery." (Canadian Chiropractic Association) "This panacea assertion suggests that manipulation produces a nonspecific and beneficial effect on the nervous system; no experimental data are available to substantiate this assertion."
Chiropractic differs from traditional medicine because "chiropractic treats the patient, not just the symptoms . . . the doctor of chiropractic not only addresses the problem, but the cause as well." (American Chiropractic Association) Chiropractors have yet to demonstrate any unique cause for any condition.
"When compared to other therapies, chiropractic is safer and more effective . . . chiropractic care is safe and effective with less risk than many medications or medical interventions." (Canadian Chiropractic Association) "Claims for . . . relative safety and effectiveness . . . should be judged with respect to the particular health problem for which care is provided. There are very few trials that compare chiropractic (manipulative) and medical (pharmacological) intervention methods."
"The spine . . . should get the same regular checkups as your teeth, not just when you've got pain. (Canadian Chiropractic Association) The preventive value, if any, of chiropractic care is unproven and largely unstudied. The value of "regular check-ups" by chiropractors is unknown.
"A chiropractor could prevent many of these problems [arthritis] from developing in the first place by reducing their subluxations and other spinal problems." (Ontario Chiropractic Association) "Chiropractic care" and "subluxation correction" have no proven value
"Chiropractic care is one of the safest types of treatments available today, and is an effective alternative to drugs and surgery for many conditions." (American Chiropractic Association) "The claim for effectiveness of unspecified chiropractic methods is untestable because the "many conditions" are not defined. Experimental comparisons of medical, surgical, and chiropractic interventions are extremely rare."

It will be interesting to see whether the organizations mentioned in this report will stop making any of the claims that were criticized. My guess is that they will not. In fact, the only reaction I have seen from a chiropractic leader came from Matthew McCoy, D.C., editor of the Journal of Vertebral Subluxation Research, who said (in part):

Want to know what really makes me mad as hell? We have probably less than 100 full time researchers in the chiropractic profession and we can't even afford to pay them a livable wage. The least we should be able to do is rely on our research journals, foundations and institutions to make sure idiots like this do not work in our profession. Their obvious skewing of data, mining of the literature and political agendas are obvious to anyone with a head just a tad sharper than a bowling ball. . . .

Will YOU call your alma mater and ask why these people are still on the payroll? Will YOU write to the Editor of these journals and ask how these people get past peer review? [4]

In 2003, the professors who did the above study have reported that in July 2001, the majority of chiropractic college Web sites contained similarly unsubstaniated claims [5].

References

  1. Chiropractic's elusive "subluxation." Chirobase, updated Dec 25, 2001.
  2. Barrett S. The spine salesmen. In Barrett S. Knight G. The Health Robbers: How to Protect Your Money and Your Life. Philadelphia: George F. Stickley Co., 1976
  3. Grod JP, Sikorski D, Keating J. Unsubstantiated claims in patient brochures from the largest state, provincial, and national chiropractic associations and research agencies. JMPT 24:514-519, 2001.
  4. McCoy M. Stroke, chiropractic and subluxation: Sorting fact from fiction. JVSR Research Update, March 4, 2002.
  5. Barrett S. Improper claims on chiropractic college Web sites. Chirobase, March 6, 2004.

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This page was posted on March 6, 2004.