time.com

Back Off, Chiropractors!
Recent research suggests some chiropractic techniques may be 
dangerous for patients 

Wednesday, Feb. 27, 2002

Chiropractors have been taking their lumps lately. And not all of the 
criticism has come from their usual critics in the medical 
profession. Indeed, some chiropractors themselves are cautiously 
calling for reforms. 
The most recent and most disturbing news (at least as far as 
chiropractors are concerned) was announced at a recent meeting of 
the American Stroke Association in Texas. There, neurologists from 
Toronto University reported analyzing 156 cases of stroke and 
finding that nearly 40 percent of them had apparently resulted from 
chiropractic neck manipulation. This hands-on treatment had caused 
tearing in the inside walls of the neck arteries, resulting in clots 
that blocked blood flow to the brain, bringing on the strokes. The 
neurologists called for a ban on the procedure. 
Chiropractors immediately challenged these findings, claiming that 
earlier studies had verified the safety of neck manipulation. Yet 
even the doctors who concede that spinal manipulation can be 
beneficial for lower back pain and stiffness generally exclude neck 
manipulation from their endorsement. 
Doctors find many of the other claims and practices of chiropractic 
questionable, if not downright objectionable. Most chiropractors, for 
example, believe that "subluxations," or minor dislocations of the 
spine, put pressure on spinal nerves, resulting in a wide variety of 
disorders. Spinal manipulation, they claim, can effectively treat 
these disorders and, some even suggest, strengthen the body's 
defenses against infectious diseases. 
Chiropractors differ widely in their methods of treatment, some 
attempting to adjust only one specific vertebra at the top of the 
spine, others concentrating on a lower vertebra and still others 
focusing on the entire spine. All this despite the fact that no 
uniform criteria exist for even identifying a subluxation, let alone 
what it causes. 
Chiropractors also employ a bewildering variety of weird practices 
to diagnose their patients. Some use applied kinesiology, a muscle 
test that supposedly can diagnose allergies and diseased organs. Hair 
analysis and iris readings are commonplace in the profession. Even 
sillier are many of the treatments that chiropractors use and 
recommend: homeopathic potions, colon irrigation, magnetic therapy, 
enzyme pills, colored-light therapy, and something called "balancing 
body energy," among other mystical procedures with undocumented 
effects. 
Even more troublesome, all too many chiropractors urge their 
patients to eschew such widely-accepted health measures as 
immunization and fluoridation and to be suspicious of anything 
medical. Are these guys for real? 
Confronted about these therapies and theories, chiropractors like to 
claim that they do not represent the mainstream of chiropractic 
medicine. But Jaroslaw Grod, a faculty member at the Canadian 
Memorial Chiropractic College in Toronto, has undercut that 
argument. "We're trying to get the profession to look at itself 
critically," he says. With two associates, Grod collected and 
evaluated informational brochures from nine leading chiropractic 
organizations in Canada and the U.S. (In other words, the 
"mainstream.") Their conclusion, published in the Journal of 
Manipulative and Physiological Therapies, was damning. All of the 
brochures, they wrote, made claims "that are not currently justified 
by available scientific evidence or that are intrinsically un-
testable." 
None of the more bizarre advice and treatment that chiropractors 
often give their patients was repeated or described in these 
brochures, most probably to fend off any government censure. Yet 
Grod's group found repeated and dubious references to subluxations 
as the cause of many problems, and discovered scores of assertions 
unproven by scientific testing. 
Some examples: 
"80 percent of all headache sufferers obtain substantial relief from 
chiropractors." 
"A chiropractor could prevent...arthritis from developing in the first 
place by reducing their subluxations." 
"A spinal malfunction can interrupt this internal communications 
system and cause pain, muscle and organ dysfunctions and other 
imbalances." 
Pulling no punches, Grod's group concluded that "the distribution of 
patient brochures involving unsubstantiated claims for the healing 
art meets several of the formal criteria for quackery." 
Strong words. But they are highly appropriate and badly needed for a 
profession that has lost its way. Chiropractic, heal thyself.