Significant issues and developments related to chiropractic.
This page was last updated on 6th January 2013.
The Texas Supreme Court has reinstated a $740,000 judgment against a chiropractor whose patient suffered a stroke due to an "undetectable" physical condition. Lawyers Weekly USA (10th December 2012)
A New Jersey judge ordered Daniel H. Dahan, D.C., Practice Perfect, and Robert H. Borsody, Esq. to pay Allstate Insurance Company nearly $4 million for violating New Jersey's Insurance Fraud Protection Act. The judge also ordered Dahan and Medical Neurological Diagnostics, Inc. (MNDI) to pay an additional $10,125. Dahan is president of Practice Perfect Management & Consulting Services, of Long Beach, California, which specialises in helping chiropractors set up clinics that "integrate" chiropractic, medical, and physical therapy services. Borsody, who practices law in New York City, devised the legal strategy and forms used to provide the "integration." Practice Perfect seminars taught chiropractors how to set up medical corporations that appeared to comply with state regulations as to ownership and control, but would actually be under the chiropractor's control through devices such as undated documents, penalty clauses, and one-sided agreements. Chirobase (21st November 2012)
15th November 2012: Colorado State Chiropractic Board has decided that chiropractor, Brandon Cradeur, only needs to keep better paperwork and has apparently dismissed concerns about his "functional endocrinology" practices. However, concerns about Credeur's practices are ongoing. The state's Board of Medical Examiners has now opened an investigation "regarding allegations of the unlicensed practice of medicine," an official confirmed.
Canada's top court will not hear an appeal by an Alberta chiropractor who was ordered to pay more than $1.3 million in damages to a patient who he severely injured....Alberta Court of Queen's Bench Judge Donna Shelley ruled in 2010 that the chiropractor was negligent and caused an uncommon disorder known as cauda equina syndrome, where the nerve roots below the lower end of the spinal cord become compressed. CBC Health News (1st November 2012)
Chiropractic neck procedures cause strokes, say survivors - Manitoba group wants high neck manipulation banned
“Members of Winnipeg Chiropractic Stroke Survivors will meet with Health Minister Theresa Oswald this morning to make their case for a ban on high neck chiropractic manipulation…The group claims that repeated chiropractic neck manipulation causes arterial damage and stroke….The group not only wants neck manipulation to be banned, but it also wants the province to de-insure chiropractic services and hold a public inquiry on the effects of high neck manipulation on patients. The Manitoba Chiropractors Association declined to comment." Reported by CBC News (4th October 2012)
UPDATE: More than a half-dozen members of the group, including three who say they suffered strokes after having their necks manipulated by a chiropractor, met for an hour with Health Minister Theresa Oswald on 5th October 2012. "I thought it was a very favourable meeting, a very positive meeting," said Pat Chevrier, whose son Tim had a stroke in 2006, which he blames on chiropractic neck manipulations…. Manitoba is the only province that provides universal chiropractic coverage. Anyone with a Manitoba Health card gets $11.20 of the cost of a visit paid for by the government. Adjustments to the spinal column, pelvis and extremities are covered. The group also complained to Oswald that many chiropractors say they can treat colic and bedwetting through manipulating the spine of children.
More questions over chiropractic care in Manitoba can be read here.
The Texas Board of Chiropractic Examiners’ proposal to recognise a specialty it calls 'chiropractic neurology' could deceive and harm patients, the Texas Medical Association (TMA) warns in a letter to the Board
"TMA is very concerned that not only will patients be deceived and misled, but many could also suffer injury and harm, for example by delayed diagnosis," TMA President Michael E. Speer, MD, said in a formal letter to Yvette Yarbrough, executive director of the Texas Board of Chiropractic Examiners. "A patient suffering headaches, syncope, or seizures could have a serious neurological disease, but that patient could easily find himself or herself in a 'chiropractic neurologist's' office. The patient could easily be deceived into believing that this chiropractor could diagnose or treat his or her medical condition, including a brain tumour, aneurism, or stroke. This proposed rule is not in harmony with the Texas Chiropractic Act, the Healing Art Identification Act, or the Health Professions Council Statute." He noted that some chiropractors are "already pushing the envelope" in their advertisements by burying the designations required under Texas law, thus confusing patients about whether the chiropractor is a physician. Dr. Speer added that the state Chiropractic Act "makes no reference to neurology. Neurology does not involve the biomechanics of the spine and musculoskeletal system. Neurology is clearly beyond the scope of chiropractic in Texas, and this proposed rule is a brazen effort by the board to circumvent Texas statutory law to expand chiropractors' scope." Texas Medical Association (1st August 2012) [Includes full text of letter]
Round up of the heated dispute among various chiropractic factions and the Council for Chiropractic Education (CCE) over new accreditation standards for chiropractic colleges
Jann Bellamy, Science Based Medicine (28th June 2012)
UPDATE (5th December 2012): ACA, ICA, COCSA, FCLB and Select College Presidents Meet with CCE: "...it was predicted that victory in the accreditation war would be declared by the conservative, traditional faction as soon as language regarding vertebral subluxation was put back in a more prominent role along with "without drugs and surgery."
Click HERE for more background.
“…the Government says they have no plans to re-evaluate chiropractic coverage. The program they fund right now shows 90 percent of the clients aren’t using their allotted 12 treatments anyways.” Global Regina (7th June 2012)
“A report by Dr. Steven Welsh of the Georgia Chiropractic Council indicates that the Council on Chiropractic Education has seemingly ignored the overwhelming input from the profession at large. In September 2010, the CCE Task Force on Accreditation Standards released a second draft to the public for comments. At the latest meeting Jan. 14, the CCE met and adopted new educational standards that will become effective in January of next year. Welsh, who attended the public proceedings, reports that the CCE President announced that the Council had received two complaints. No details were provided. Council members were reminded of the need for complete confidentiality. In October 2010, it was reported by Welsh that the CCE had received approximately 3,000 submissions from the profession. During their annual business meeting last Friday, the CCE reviewed and approved the 3rd draft submitted by the Task Force, which included multiple amendments by individual council members. One proposed amendment was not approved by the council. Based on feedback from the chiropractic profession, Dr. Guy Riekeman suggested that the new standards include a reference to the foundational concepts upon which our profession is based…After a discussion of the fact that the CCE doesn't support any specific philosophy and a comment from one council member that subluxation is not evidence informed, the council overwhelmingly defeated the motion.” Chiropractic Economics (25th January 2011)
UPDATE 1 - March 2011: Hundreds of chiropractors sign a petition aimed at stopping the CCE from redefining chiropractic.
UPDATE 2 - March 2011: US Council on Chiropractic Education (CCE) makes only "minor" revisions to draft standards. (Changes in force from 2012.)
UPDATE 4 - Summary of the CCE's one-year recognition renewal granted in December 2011: "The Council on Chiropractic Education (CCE), the sole agency recognized to specifically accredit chiropractic colleges in the United States, was given a one-year renewal of its status with the Department of Education (DOE) after being presented with a list of 42 “issues or problems” it must address within the coming year. The National Advisory Committee on Institutional Quality and Integrity [NACIQI] spent more than four hours on Dec. 14, 2011, hearing from CCE supporters and detractors before making its decision on the agency, which has come under fire for making major changes in its Accreditation Standards last year. The CCE’s changes eliminated all reference to subluxation, removed the term "without drugs or surgery" from the description of chiropractic and asserted its authority to accredit any program it deems to be "equivalent" to the current DC program…The Committee did make it clear that it “is not the Department’s responsibility to take sides in this ongoing philosophical discussion,” and that many of the charges leveled against the CCE were not related to the Secretary’s Criteria for Recognition, which is the sole standard by which an accrediting agency may be evaluated. It did, however, note that the CCE “did not provide evidence of its consideration of all comments it received during the course of its standards review process. It should be noted that an agency is required to consider all comments, but is not required to implement all of the comments or suggestions it receives.” Twenty individuals appeared as commenters during the meeting…Speaking in opposition to the CCE’s new standards were the International Chiropractors Association, the International Federation of Chiropractors and Organizations (IFCO), the Movement for Chiropractic Quality and Integrity, the Georgia Council of Chiropractic, and the Foundation for Vertebral Subluxation, among others."
UPDATE 5 - Anti-subluxationist elected as the Chair of the CCE: Craig Little DC, DABCO, a member of the affirmed anti-subluxation West Hartford Group, ran unopposed for the position of Council Chairman on 13th January 2012.
UPDATE 6 - May 2012: The Truth About CCE: What really happened with NACIQI and USDOE Fact: The term “subluxation” was not removed from the 2012 CCE Standards; Removal of “without drugs or surgery” from the 2012 CCE Standards…Primarily, the language was removed because it is inaccurate and misrepresents reality. Drugs and surgery are a part of the chiropractic profession and have been for at least 108 years. As difficult as it may be for some to accept this fact, it is nevertheless, true. At least one chiropractic college teaches minor surgery in its core curriculum and has done so continuously for decades. Some other chiropractic colleges either offer minor surgery as an elective or as a continuing education program. At least one state licensing board requires 36 hours of instruction in minor surgery as an eligibility requirement for licensure in that jurisdiction. As for “drugs,” this is a much more difficult and complex issue to address because the term “drug” needs further refinement and definition…Vitamins, minerals, supplements, medicinal herbs, nutraceuticals, etc., any or all of which are taught at some chiropractic colleges and used specifically to influence human physiology, certainly qualify under the broader definition of drug. Compounding this issue is the use of over-the-counter, non-prescription aids, many of which were at one time controlled, prescription items…Therefore, it is accurate to state that chiropractic practice does include at least some degree of both the practice of minor surgery and the use of drugs; Disregard of input from the chiropractic profession during the CCE Standards review process: Fact: During its evaluation of the CCE, USDOE staff reviewed: memos, emails and meeting agendas of the Standards Review Task Force (SRTF); minutes of CCE Council meetings regarding SRTF actions and activities; a timeline of the review process; announcements for public comment, actual comments submitted and CCE staff reviews of public comments; and memos demonstrating the process of how all comments received were reviewed for consideration. Additionally, USDOE staff was provided factual details regarding the letter writing campaign for which opposition has given so much importance; Other facts: Contrary to widely held belief among the CCE opposition, it is not the responsibility of the CCE to represent the profession – this is the function of professional trade organizations (ACA, ICA, etc.). Further, the authority to define the profession and to establish the scope of practice remains with the jurisdictional licensing authorities and legislatures of each state. The CCE is responsible for ensuring that doctor of chiropractic degree programs provide an educational program that is characterized by quality and continuous improvement. Of the 54 US jurisdictions (including District of Columbia and three territories), 45 boards directly reference the Council on Chiropractic Education in their laws (statutes and/or regulations) while the other eight Boards indirectly reference CCE (most often as “a chiropractic accrediting agency recognized by the USDE.”) In the end, the staff of the United States Department of Education saw through the misrepresentations and faulty claims made by those in opposition to CCE. [American Academy of Chiropractic Physicians website]
82% of practicing chiropractors struggle to pay their bills, or don't pay them, and out of all chiropractic graduates, 50% fail, and nearly 20% don’t use their diploma which many spend anywhere from $150,000 to $200,000 acquiring. American Chiropractor (April 2012) [p.36]
The Chronicle of Higher Education has reported that many of the United State's 16 chiropractic programs are struggling to stay in business. According to the journal's analysis, during the past 10 years, enrolment at chiropractic colleges fell by 8% to about 12,000 students, and four lost close to half of their students. This is a serious problem because about 85% of chiropractic college income comes from tuition. One cause of financial stress is the high compensation packages of their presidents, which consume 2% of their colleges' budgets (five times as much as the typical president at a private college with a budget over $50 million). Some earn nearly as much as leaders of research universities that are 10 times or more their size. (Scroll to end the of the link for graphs) [Source: Fuller A. Chiropractic colleges seek legitimacy amid financial woes. The Chronicle of Higher Education, April 1, 2012]
US chiropractor, Benjamin Altadonna, created a fraudulent national marketing campaign for the DRX 9000, a device that aims to treat back problems using spinal decompression. Mercury News (26th March 2012)
“The Colorado State Board of Chiropractic Examiners has filed a complaint charging Denver-based Brandon Credeur, D.C., with (a) false, misleading, and unethical advertising, (b) abandoning a patient, (c) ordering and performing unnecessary tests, and (d) practicing outside the scope of his license in connection with his dealings with five patients. Credeur, who does business as the Functional Endocrinology Institute of Colorado, represents himself as "uniquely skilled and experienced at treating the root physiological, biochemical and hormonal imbalances associated with Type II Diabetes and Hypothyroidism." A typical course of treatment, which includes a diet and dietary supplements, costs several thousand dollars. In April, Denver's ABC News, aired a critical broadcast that triggered more than 100 calls and complaints. In subsequent broadcasts, the station's CALL7 news team reported that more than a dozen patients are suing Credeur and that the state Attorney General is investigating whether Credeur should be charged with practicing medicine without a license. The TV reports also describe how Credeur has been marketing his program to chiropractors with glowing reports about its profitability.” Consumer Health Digest Newsletter (15th December 2011)
A group of [Australia’s] top medical experts has condemned the planned launch of a new university course to train chiropractors, denouncing it as "non-science" that could encourage the provision of dangerous treatments to children. The group of 35 experts, including the cervical cancer vaccine inventor Ian Frazer, public hospital physician John Dwyer and Australian Medical Association president Steve Hambleton, have signed an open letter urging Central Queensland University to reconsider its plans to launch the course, due to accept its first intake of about 30 HECS-funded undergraduates in March. The letter to the university's Pro-Vice-Chancellor, Graham Pegg, and Dean of Medical and Applied Sciences, Grant Stanley, expresses "concern about the increasing numbers of universities that are allowing non-evidence-based 'pseudo' disciplines to be offered to their students". Adam Cresswell, Health Editor, The Australian (3rd December 2011)
The Royal Melbourne Institute of Technology (RMIT) has won the Bent Spoon Award for being “the perpetrator of the most preposterous piece of paranormal or pseudo-scientific piffle”, for the alleged content of its chiropractic degrees. Awarded by the Australian Skeptics, the dishonour was given to the Melbourne-based university for its chiropractic teachings and for treating children and infants at its on-campus paediatric chiropractic clinics. The clinics were subject to a series of complaints earlier this year by leading figures in medicine, amid concern there was no evidence that chiropractic treatments on children were safe or effective. The university refused to comment on its award. Australian news report (25th November 2011) [PDF]
“A type of chiropractic device mired by lawsuits and controversy is again under fire in Florida. This time, the FDA’s focus is Spinetronics, owned by Coral Springs chiropractor David Bass. FDA says Bass over-stated the treatment capabilities of a spine-stretching device he invented, the Antalgic-Trak. Sarasota-based Axiom Worldwide and Melbourne-based Vax-D have also run into trouble in recent years for misrepresenting similar “spinal decompression” devices. Although each company made something a little different, all the devices required patients to recline on a table as a computer-controlled machine stretched the body in different ways. Some chiropractors say the treatment is valid, but sales have led to lawsuits and accusations of fraud.” Health News Florida (3rd November 2011)
The Archives of Internal Medicine and American Family Physician reject ad promoting chiropractic's role in medical home model. Dynamic Chiropractic (November 2011)
“After an examination, [my chiropractor] told me I had a lot of tightness in my neck and shoulder,” Sorbo says. “Then he cracked my neck, which he had never done before, saying he felt the manipulation would help alleviate some of the tension.” Driving home, Sorbo began to experience blurry vision, dizziness, and buzzing in his head. He decided to sleep it off. But the next morning, his speech was slurred and he could barely walk…MRI tests show that Sorbo had suffered three distinct strokes, accounting for his dizziness and vision loss. One of his other doctors suggested that Sorbo's clots may have travelled in reverse, toward his brain…“I was told clots don't typically travel ‘upstream’—in reverse to the brain—so my doctors were unsure whether [my shoulder] aneurysm was related to the strokes,” Sorbo says. “I began to wonder whether having my neck cracked had somehow exacerbated my condition.” Sorbo didn't have any of the risk factors for stroke, which include high blood pressure, high cholesterol, smoking, diabetes, obesity, a family history of stroke, drug use, or cardiovascular disease. Since his symptoms first appeared immediately after having his neck cracked, many of his doctors believed that the chiropractic adjustment, combined with his existing aneurysm, could have triggered his strokes. Neurology Now (October/November 2011, Vol 7 Issue 5 pp 26–28, 30–31)
"In a massive and historic outpouring by practicing chiropractors, students and patients, the chiropractic profession is demanding that the United States Department of Education consider a series of complaints being lodged by the profession regarding the governance of the non-profit group that controls accreditation of chiropractic schools - the Council on Chiropractic Education (CCE)…With their virtually complete control of the education and licensing of the entire chiropractic profession, the CCE has recently changed its Standards by which chiropractic educational programs are accredited. Those changes include the characterization of chiropractors as primary care physicians while removing the designation of chiropractic as occurring without drugs and surgery. Most significant is the complete removal of the chiropractic profession’s reason to be – the vertebral subluxation….This has set up a perfect storm for a battle between those within the profession who wish to give up their traditional, conservative practice to take advantage of a broader scope through a merging with medicine and those who wish the profession to remain separate and distinct from organized medicine and keep its focus on the analysis and correction of vertebral subluxation.” Press release (12th September 2011)
Update: 22nd November 2011 - The Council on Chiropractic Education (CCE) publishes an open letter to the chiropractic profession. [PDF]
Update: 30th December 2011 - When the Council on Chiropractic Education (CCE) published its proposed 2012 Accreditation Standards for chiropractic colleges, reference to the word “subluxation” was omitted. The American Chiropractic Association (ACA) responded, in part, arguing that “The elimination of any reference to this term in the proposed standards will be viewed by many within the profession as a counter productive action that will, in the long-term, likely weaken the profession’s collaborative strength and historical identity.“ The CCE compromised by using the nebulous phrase “subluxation/neuro-biomechanical dysfunction” in the final 2012 Standards in order to satisfy advocates of the vertebral subluxation theory. (An open letter to the profession from CCE, Nov 22-11 – see above) Obviously, the factory of the chiropractic profession has not discarded subluxation theory. Chiropractic associations continue to reflect the views of the majority, even if such views are based on a belief system.
With the recent adoption of new informed consent requirements for California chiropractors, the California Board of Chiropractic Examiners has joined the ranks of only a few chiropractic regulatory agencies in the [U.S.] to require its licensees to inform patients of potential risks of their treatment. The new law, which goes into effect on Oct. 7, 2011, requires chiropractors to obtain patient consent prior to providing any treatment that could pose a risk of harm to the patient. Specifically, this regulation will do the following:
- Require all licensees to inform each patient, verbally and in writing, of the material risks of proposed care (defining "material" as a procedure inherently involving known risk of serious bodily harm)
- Require the licensee to obtain the patient's written informed consent prior to initiating clinical care
- Provide that the signed written consent shall become part of the patient's record
- Specify that a violation of the above requirements constitutes unprofessional conduct and may subject the licensee to disciplinary action
Dynamic Chiropractic (12th September 2011)
Preview chapter of Darryl Cunningham’s upcoming Science Tales book, which will be published by Myriad Editions in 2012. (19th August 2011)
“In a closed door meeting, the licensing panel of the Colorado Medical Board found ‘evidence’ chiropractor Brandon Credeur performed the ‘unlicensed practice of medicine’ and referred the case to the Attorney General for legal review.” Denver news report (19th August 2011)
“Currently, there is no way to determine whether one may be at risk, making chiropractic neck manipulation akin to playing Russian roulette. One of the greatest myths ever is that stroke and death due to chiropractic neck manipulation is a rare and unfortunate side effect of a ‘valuable treatment’. In fact, 99.9 per cent of all chiropractic neck manipulations have nothing to do with treating neck pain, or any other musculoskeletal pain but by the unproven, non-scientific belief system that chiropractic upper neck manipulation is a cure for every disease…Even going to a chiropractor for musculoskeletal pain can cause stroke, therefore, it is recommended that you never let a chiropractor touch you above the shoulders.” Sharon Mathiason, The StarPhoenix (18th August 2011)
Australia’s health regulator is facing calls to investigate a prominent chiropractor who said vaccines contain "toxic poison"
“In a public talk, the Sydney chiropractor linked vaccines to asbestos, thalidomide and cigarettes, and said they contained bits of aborted fetus. The chiropractor backed the debunked research of deregistered British doctor Andrew Wakefield - which suggested the measles, mumps and rubella vaccine might cause autism - as ‘scientifically good’. The parents and pregnant women who attended the talk in March were told ‘homeopathic vaccines’ - which are regarded as scientific nonsense by most experts - were safer than conventional vaccines. The comments by Nimrod Weiner, who is vice-president of the Chiropractors Association of Australia (NSW), were recorded by Australian Doctor. They were condemned as ‘outrageous’ yesterday by the Australian Medical Association…Mr Weiner declined to comment, referring questions from The Australian to a PR company, which said the Chiropractors Association of Australia (NSW) had no position on vaccination and "any comments that Nimrod Weiner may have made would be his private opinions, not those of the association".” Australian press report (17th August 2011)
“Doctors have accused some chiropractors of undermining public health policy by supporting a discredited anti-vaccination group and directing patients to the site for information. Chiropractors are the biggest professional supporters of the anti-vaccination group the Australian Vaccination Network (AVN). Last year, the Health Care Complaints Commission issued a public warning about the AVN after it found the group was spreading misinformation about childhood vaccination. The AVN refused to comply with the HCCC's recommendation that they place "a statement in a prominent position on its website" outlining their anti-vaccination stance and was subsequently stripped of its charitable status. Of the network’s 198 professional members, 128 are registered chiropractors. Many are members of the professional body the Chiropractor’s Association of Australia, or CAA…Dr Brian Morton from the Australian Medical Association said it was “reprehensible (some) chiropractors support the anti-vaccination lobby” and they should not have access to Medicare rebates and taxpayer subsidies from private health insurers…The Chiropractors Association of Australia refused to take an official position on vaccination and told news.com.au that the Chiropractors’ Association of Australia (NSW) did not have an official position on vaccination…Rachael Dunlop, a biologist, attended a vaccination information seminar held by Newtown chiropractor and CAA NSW vice-president Nimrod Weiner six months ago. “Over two hours we were told that vaccinations caused autism and brain damage and as we were leaving we were given a pamphlet that said ‘18 reasons not to vaccinate',” the 40-year-old from Petersham said…The AMA called on Federal Health Minister to review Medicare payments to chiropractors who supported the anti-vaccination lobby.” Australian press report (27th July 2011)
“Members of the Korean Chiropractic Association [KCA] in South Korea are in uproar at the scrutiny of their profession, after an investigation of formal Chiropractic clinics by local health authorities has led to more legal proceedings…Under the law, It is illegal for independent Chiropractors to practise. If you were a Medical Doctor who took some seminar classes in Chiropractic or similar manipulative therapies, you could legally practice those techniques, however, someone who just went to a Chiropractic college in America, the UK, or Australia could not legally practice in Korea…Appeals from the Members of the KCA claim that the law is unconstitutional, however, while this defence erroneously characterizes the law as being "anti-Chiropractic", South Korean law doesn't state that Chiropractic is illegal. Rather, the law states Chiropractors can't practice their techniques unless they're qualified Medical Doctors.” Bayani Mills, Birmingham Skeptics (18th July 2011)
Canadian rocker, Alannah Myles, explained to her audience how she had overdone chiropractic treatments, having some 500 treatments over three years, and had suffered some severe spinal damage. Canadian press report (1st July 2011)
Police want to know what happened to 30-year-old Jeremy Youngblood. His father told police he died after getting a neck adjustment. His family claims that during the appointment…Youngblood began vomiting and sweating profusely. The medical examiner said he later died from a stroke caused by manipulation of the neck. His family hired an attorney. “Once I conclude the investigation and the facts are as I think they are, we will be vigorously and aggressively prosecuting a death claim on behalf of Jeremy Youngblood,” said Leo Austin, Youngblood’s attorney. Oklahoma press report (22nd June 2011) Jeremy Youngblood's Death Certificate and Autopsy Report can be viewed here [pdf].
Owners of McTimoney College of Chiropractic under investigation by US Government for deceiving students
The Guardian (16th April 2011)
“Details of the settlement aren’t being released, said Amani Oakley, the lawyer for Joe Labonte of Guelph whose wife, Dora, died of a stroke in July, 2002, several weeks after a chiropractic treatment.” Canadian press report (28th March 2011)
Document submitted to the Australian Federal Health Minister requesting closure of the Royal Melbourne Institute of Technology’s Chiropractic Paediatric Clinic
The request has been made on the basis that the Royal Melbourne Institute of Technology (RMIT) Chiropractic Paediatric Clinic is “teaching inappropriate and potentially dangerous techniques that target pregnant women, babies, infants and children”. The 20-page document submitted by Loretta Marron, a long standing campaigner against pseudosciences in health, includes expert opinion from high profile and well-regarded Professors of Medicine relating to supposed efficacy of chiropractic; identifies the claims made by lecturers and graduates from RMIT and other chiropractic teaching institutions; identifies the relevant codes of conduct that are breached by graduates; identifies research relating to spinal manipulation on a wide range of health conditions; refers to the General Chiropractic Council (UK) on comments on ‘subluxations’ and evidence-based practices; refers to the HCCC anti-vaccination campaign, which is supported by over 120 chiropractors; refers to a recent US-based court case which limits chiropractic diagnoses to biomechanical conditions of the spine and musculoskeletal system; and recommends that the competency and education standards for chiropractors be reviewed. (16th March 2011) [PDF]
Three members of the Connecticut Board of Chiropractic Examiners are caught breaking the law and the state Department of Public Health orders compliance. Their response? Lobby the legislature for a bill to change the law. Newhaven Independent (8th March 2011)
The decision was made due to “challenging economic conditions and a continuing downward enrolment trend”. Cleveland Chiropractic College press release (3rd March 2011) [pdf]
Jury orders chiropractor to pay injured patient $800,000 for apparently concealing treatment via fraudulent record-keeping
US press report. (3rd March 2011)
Kaiser Permanente, which provides health care plans for more than 8 million Americans, operates through regional divisions. In July, in a move with serious implications for the chiropractic profession, Kaiser Permanente Mid-Atlantic States and Mid-Atlantic Permanente Medical Group decided to exclude cervical chiropractic manipulative treatment (CMT) from coverage. The American Chiropractic Association responded swiftly and…Kaiser Mid-Atlantic has suspended its decision and reinstated coverage.” p.16, Quarterly World Report, World Federation of Chiropractic (31st December 2010) [PDF]
Spain: The Spanish Chiropractors´ Association (AEQ) has started a project with the objective of seeking legislation. Sweden: The Swedish Agency for Higher Education has presented a report for the Government proposing that chiropractors should first become physiotherapists, then add an extra two years to become chiropractors. Norway: The Ministry of Education has been given the task by its government to make a report on how to establish a chiropractic university program in Norway, and how to establish research within the chiropractic field in Norway. After the development in Sweden, there is some concern about the content of this report. Germany: An initiative is being made towards establishing a chiropractic education at a university in Germany. Luxembourg: The chiropractic association of Luxembourg has scheduled a meeting with the European Chiropractors Union (ECU) President for the 2nd weekend of January 2011. Focus will be on organization, legislative initiatives and development of chiropractic in Luxembourg. France: The French Chiropractic Association has taken some major steps towards recognition and regulation. If everything goes according to plan, chiropractic will have a new law in France in 2011. Great Britain: Early professional conduct cases arising from mass complaints made by UK skeptics have resulted in not guilty verdicts. In particular, the Professional Conduct Committee accepted the argument that chiropractic care extends beyond the narrow focus of manipulation, massage and mobilisation that was the subject of the Bronfort Report. It has also accepted that an indication on a website that chiropractors treat named conditions is not potentially misleading, nor does it exploit the public's lack of knowledge about chiropractic. Many more cases will follow in 2011. The Netherlands: The Dutch Chiropractic Association has decided to make the position of president a paid position which will further the professionalisation of the Dutch Chiropractic Association. Croatia: The President of the Croatian Chiropractic Association will apply for ECU membership next year. Hungary: The Hungarian Chiropractic Association is in the middle of a process of getting the association officially registered in the country. ECU membership will be applied for as soon as the registration process is completed in Hungary. (December 2010)
“This an important achievement for the school and equally important for the chiropractic profession because the principal goal of the profession is to assure the quality of chiropractic undergraduate education and training against a set of educational standards. The Barcelona College of Chiropractic [BCC] is a public university affiliated college of chiropractic and registered with the Catalan Government's Justice Department via a non-profit foundation.” Øystein Ogre, European Chiropractors’ Union President (18th November 2010)
UPDATE - 1st June 2011: It is important to note that the Barcelona College of Chiropractic is not recognised as a University by the Spanish Ministry. The complete list of recognised Universities can be checked here or via the Spanish Ministry directly. The BCC course, and title awarded -"Título Superior en Quiropráctica del Barcelona College of Chiropractic – Escuela Superior Internacional"- is not recognised as an official title by the Spanish Ministry. This can be checked here (note that the BCC or "quiropráctica" are not even mentioned there). Although the BCC has signed collaborative agreements with Universidad Pompeu Fabra (UPF) and Universidad de Girona¨(UG), neither UPF nor UG assume, recognise, or endorse the title. This can be checked on their respective sites here and here. The agreements seem to be aimed only at allowing the BCC to use some facilities of the Universities (see here). Although all foundations must be "government registered" under Spanish Law, this does not mean any sort of official endorsement of their activities. In fact, the BCC carefully avoids to present itself explicitly as a "university". The claim is made by third parties, such as the Spanish Chiropractic Association, that the BCC presents as "Institutional Support". The association claims that: "Pese a que aún queda mucho camino por recorrer, estudiar quiropráctica en España ya es posible desde 2007 gracias a la creación de dos titulaciones universitarias de grado superior: la primera, en el Real Centro Universitario Escorial-María Cristina (San Lorenzo de El Escorial, Madrid), y el Barcelona College of Chiropractic, que echó a andar el pasado año. En ambos centros universitarios, se necesitan cinco años de estudios, además de un último curso de prácticas para poder ejercer la profesión". [TRANSLATION: "Although there is still a long way to go, to study chiropractic in Spain is now possible since 2007 with the creation of two **university degrees** in higher education: the first in the Real Centro Universitario Escorial-Maria Cristina (San Lorenzo de El Escorial, Madrid), and the Barcelona College of Chiropractic, which took off last year. In both **universities**, it takes five years of study, and a final year to practice the profession.]
NOTE: Adrian Wenban, B.Sc.(Anatomy), B.App.Sc.(Chiropractic), M.Med.Sc.(Clinical Epidemiology), MACC, Principal, Barcelona College of Chiropractic, claimed in private correspondence on 1st June 2011 that the BCC "is a private college with strong public university affiliations. In addition the BCC is the property of a non-profit government registered foundation, called the Fundacio Privada Quiropractica (FPQ). The FPQ is registered with, and recognised by, the Catalan regional government's Justice department. The BCC is not, and never has been 'under investigation' for inappropriately using the title 'University'."
UPDATE summary - 27th June 2011: The Spanish government does not recognise chiropractic as a health profession or as an official degree. The government accepts some foreign titles, but not to practice as a chiropractor, only as a physiotherapist. Although some chiropractors claim that there are two chiropractic college degrees in Spain, none of them is official. The Barcelona College of Chiropractic (BCC) is a private institution, not recognised as a university by either the Catalan regional government or by the Spanish government, and its title has no official status. The Real Centro Universitario Escorial-Maria Cristina (RCU) has been licensed only to give a Degree in Law, backed by the Universidad Complutense de Madrid, but its other degrees are not official. Currently, the RCU is being investigated by the Madrid regional government for offering its degree in chiropractic as a "University Degree". In fact its website now makes it clear that the degree is of private character and unofficial. With regard to the AEQ, it is a private association that does not have any official status.
UPDATE - 4th August 2011: Chiropractors to be recognised and regulated under the Spanish Health System. The Minister for for Health, Leire Pajin, announced in the Senate that in September the final list of natural therapies recognised and regulated by the National Health System will be released. Among theme is chiropractic… “The AEQ (Asociacion España de Quiropractica) has been working hard over the past 20 years to promote the highest standards of chiropractic care and to protect the name of chiropractic. The recognition of chiropractors in Spain is a big move towards full legislation, exactly as in the UK, where it is illegal to use the title ‘Chiropractor’ without having a full Master’s degree…Chiropractic, born in the United States in 1895, is recognised in the legislation of all European countries except Greece, Luxembourg and Spain, and in Spain there are currently circa 200 professional practitioners.”
“Last Tuesday the Swedish Agency for Higher Education released a report regarding the education for chiropractors and naprapaths. Their conclusion is deeply concerning and unacceptable to Swedish chiropractors. If the recommendations in the report goes through, the chiropractic education and profession as we know it today will be removed with a stroke of the pen. In short, the group which made the recommendations propose that the Swedish government should make chiropractic a specialty of physiotherapy.” Øystein Ogre, European Chiropractors’ Union President (13th November 2010)
The American Chiropractic Association has managed to persuade Kaiser Permanente Mid-Atlantic States and Mid-Atlantic Permanente Medical Group (Kaiser) to *suspend* its recent decision to exclude cervical Chiropractic Manipulative Treatment (CMT) from coverage, having claimed in a letter to Kaiser that there is a “large body of clinical research supporting the effectiveness and safety of cervical manipulation”. The ACA President, Rick McMichael, DC, has also claimed in a public statement that, if allowed to stand, the restriction would be “harmful to chiropractic patients and doctors”. Dynamic Chiropractic (11th November 2010)
Medical researchers Professor Shaun Holt and Andrew Gilbey have issued a strong warning against parents taking their children to see a chiropractor for any reason. Many chiropractic practices and organisations, in New Zealand and overseas, advocate routine spinal manipulation in infants and children, for conditions ranging from ear infections, colic and asthma to ADHD and even cancer…Holt and Gilbey's advice echoes similar warnings issued by paediatricians overseas. The Australian Medical Association has stated that chiropractic care for children is a waste of money and inappropriate. They advise parents who are worried about any aspect of their children's health to consult a medical doctor. Infonews New Zealand (14th October 2010)
A look at the possible consequences of the North American Spine Society [NASS] having now joined the American Medical Association's Scope of Practice Partnership. Dynamic Chiropractic (October 2010 issue)
Legal clearance has been received for a class action lawsuit against the Life University College of Chiropractic in Marietta Georgia. The suit will be open to individuals who attended approximately between 1992-2001. If you attended Life University within or near this time period and notice the same deficit contact Allen Botnick DC at the given in the email below. An important cause of action will be breach of contract for failing to teach differential diagnosis in the core curriculum, a problem which has been verified by the CCE in an official US Department of Education investigation. Individuals will have to pay a reasonable retainer to participate. If you are a Life graduate from this time period or know someone who might be please contact Allen Botnick DC at aljbotnick @ yahoo dot com as soon as possible. Chirotalk (30th September 2010)
Judge rules that chiropractors can diagnose patients within limits, but can't perform two procedures medical doctors sued them over. The Statesman (9th September 2010)
The vigorous spinal manipulations used by many chiropractors are an unnecessarily dangerous way to treat neck pain, an Australian researcher says. Dr Andrew Leaver, from the University of Sydney, said the practice should be reviewed after a study showed how a much milder therapy was just as effective at alleviating neck pain…"It makes us question why patients, or practitioners, would favour a treatment which possibly carries (the) risk of catastrophic outcome."… The frequently quoted estimate of serious injury following neck manipulation was one in a million, he said, though this was conservative and it could be as much as one in 15,000. "Whilst this appears to be a rare occurrence ... patients have a right to make an informed choice," Dr Leaver said. "We should also consider the severity of the risk and remember that the condition which people are initially seeking treatment for is a non life-threatening and mostly self-limiting condition." The research was carried out in collaboration with the University of Queensland, and the results are published in the journal Archives of Physical Medicine and Rehabilitation. Australian press report (8th September 2010)
“A major HMO has taken a decisive action in support of science-based medicine. Kaiser Permanente Mid Atlantic States and Mid-Atlantic Permanente Group recently announced the elimination of neck manipulation from their chiropractic coverage. The revised policy states,
Given the paucity of data related to beneficial effects of chiropractic manipulation of the cervical spine and the real potential for catastrophic adverse events, it was decided to exclude chiropractic manipulation of the cervical spine from coverage.
Their decision was applauded by some but was predictably attacked by chiropractors.” Harriet Hall, MD, Science Based Medicine (31st August 2010)
Washington DC lawyer applauds medical group’s decision to exclude cervical chiropractic manipulative treatment from coverage
“We now have a reputable medical organization, Kaiser, which has acknowledged that there is a real potential for a catastrophic event caused by an upper neck manipulation, and that the risk outweighs the benefit,” says attorney Michael A. Abelson, a long-time advocate for victims of stroke. PRWEB (25th August 2010)
[Michael A. Abelson of the Abelson Law Firm was named Lawyer of the Year by the Trial Lawyers Association of Washington, DC and has been listed in “The Cream of the Legal Establishment” by Washingtonian magazine. Mr. Abelson has more than 35 years of legal experience. He is a member of the American Board of Trial Advocates and a sustaining member of the American Association for Justice.]
The Texas Medical Association hails a state judge's announced intention to impose limits on chiropractors' rights to diagnose medical conditions
A Texas district court judge has ruled that chiropractors must limit their diagnoses to biomechanical conditions of the spine and musculoskeletal system. The judge's reasoning is spelled out in the decision letter issued in August. The final order ended a four-year lower-court battle that pitted the Texas Medical Association (TMA) and Texas Medical Board against the Texas Board of Chiropractic Examiners (TBC) and Texas Chiropractic Association (TCA). The TMA initiated the suit in 2006 to block TBC rules that would permit chiropractors to perform clinical needle electromyography (EMG) and spinal manipulation under anesthesia (MUA), which the TMA charged were beyond the chiropractors' lawful scope of practice. The TMA also challenged whether chiropractors should have the right to "diagnose" medical conditions. MUA has some respectable use for treating frozen shoulder or knee problems, but spinal MUA has none. Aetna's Clinical Policy Guide provides a detailed discussion of MUA. In November 2009, the judge ruled that Texas law prevents chiropractors from performing EMG or MUA. The chiropractors have notified the court that they will file an appeal. The TCA Web site, which is seeking donations to help pay for the appeal, claims that the adverse ruling has the potential to wipe out the entire chiropractic profession. Health Leaders Media (24th August 2010)
An Auckland chiropractor has been found guilty of malpractice after telling a woman she had a degenerative spinal problem that needed expensive treatment when she visited him with a sore elbow. The chiropractor rang her at home after she decided against the treatment, warning her that she would be in a wheelchair within a year. New Zealand press report (24th June 2010)
*Osteopathic* neck manipulation injury in the US: Physical Therapist and husband receive $5.6 million verdict in Montgomery County jury trial
“A Montgomery County jury reached a $5.6 million verdict after a nine day medical malpractice case against an osteopath for causing nerve and spinal injuries during a high velocity cervical manipulation performed upon his patient…In February 2005, Ms. Marquez presented to Dr. Rassael's office for purposes of receiving a very light, non-twisting osteopathic manipulation to her hip joint know as "muscle energy technique." Since her days as a Division One swimmer on the Michigan State swim team, and her participation in numerous trialthalons, many of which she won, she suffered from periodic hip pain which was resolved through use of the muscle energy technique. She presented to Defendant Rassael's office after specifically asking whether he was familiar with that technique and was told he was. After arriving at the office, however, the doctor laid Ms. Marquez on an exam table and proceeded to examine her back. When his hands got to the back of her head, he suddenly and without warning twisted her neck in both directions in a forceful manner, causing injury to the nerves in her neck and a rupture of one of her vertebral disks at C5-6. Ms. Marquez, now age 33, has never recovered from her injuries…Of significance, during the trial, the defendants intended to call a neuoradiologist, Charles Citrin, M.D., as an expert. Believing Dr. Citrin was a "professional witness" whose opinions were suspect, the plaintiffs sought discovery of Dr. Citrin's financial records to prove he was a "hired gun" expert. After three attempts to obtain this information to no avail, the presiding judge, The Honorable Marielsa Bernard, ordered Dr. Citrin to appear before her. After considering his testimony as to the whereabout of his financial records as "disingenuous" and his honestly questionable, she refused to allow Dr. Citrin to testify. This is one of the first reported cases of an expert being stricken for failing to produce financial information as to his/her income as an expert witness.”
Maryland Malpractice Lawyer (19th June 2010)
A patient advocacy group is suing sue two Connecticut chiropractic trade groups, accusing the chiropractors of violating patients' right to know about the health risks of neck manipulations and committing hundreds of violations. Victims of Chiropractic Abuse Inc. is suing the Connecticut Chiropractic Council and the Connecticut Chiropractic Association, two trade organizations that represent most of the chiropractors in the state…The complaint, filed in Hartford Superior Court and in the process of being served, claims members of the two organizations are leading patients to believe the procedure of neck manipulation is safe by failing or refusing to inform them about the risk of stroke from neck manipulations….If the chiropractic associations try to claim they don't represent individual chiropractors to avoid the lawsuit, the advocacy group has identified 453 chiropractors it believes have violated state laws…The group is seeking financial damages, an injunction forbidding what it considers "deceptive tactics" and other relief, such as an order requiring some chiropractors to pay fines. The lawsuit comes three months after the Connecticut Board of Chiropractic Examiners voted 4-1 to reject a proposed declaratory ruling that would have required chiropractors to warn their patients about the risks of neck manipulations. Associated Press (10th June 2010)
“…rumors are that the state regulatory bodies in the US are working on defining chiropractic in a whole new light." Matthew McCoy DC, Journal of Pediatric, Maternal and Family Health – Chiropractic (19th May 2010)
For at least the next three years, Victims of Irresponsible Chiropractic Education & Standards (V.O.I.C.E.S.) will be alerting patients of chiropractic across the United States to the dangers of neck manipulation. It is now blanketing large markets throughout the United States with outdoor advertisements. "Healthy young people, mostly between 25-45 years of age, are having strokes just because a chiropractor refused to inform them of the risks so that they could make informed health care choices," said Susan Hoffman the Founder of V.O.I.C.E.S. "After more than 60 years of irrefutable evidence, it is time for Chiropractors to begin acting like responsible healthcare providers and tell patients, 'we know there is a possibility spinal adjustment can cause a stroke, but now you should know it too'." PR Web (12th May 2010)
“Chiropractors are making baseless claims about treating conditions such as asthma, ear infections and colic, new research reveals. The research, which appears in the latest New Zealand Medical Journal, reviewed the websites of 200 chiropractors and nine chiropractic associations in New Zealand, Australia, Canada, Britain and the United States. Ninety-five per cent of websites made unsubstantiated claims of being able to treat at least one condition including asthma, migraine, infant colic, ear infections and whiplash.” New Zealand Press (10th April 2010)
“It is time for the [Connecticut] state legislature and scientific-minded chiropractors to act. Informed consent about the possibility of a stroke from neck manipulation is in everyone’s interest.” By Preston Long, forensic examiner, and J. William Kinsinger, M.D., New Haven Register (6th April 2010)
“Health Minister Don McMorris said discontinuing the subsidy was a tough decision. [The government covered $12.25 per chiropractic visit and the patient $17] "The question is, 'Is it a service that the taxpayers of Saskatchewan should subsidize?' "We looked at the service and we looked at what other provinces do and we also realized that it's a very tight budget and we have to put things in that context and we moved on it," McMorris said. "There are nine provinces and territories that don't cover it at all."” Leader-Post (25th March 2010)
“California physicians have raised concerns about new regulations affirming chiropractors' ability to perform manipulation under anesthesia [MUA]…state medical board officials and physician organizations, including the California Medical Assn. and the California Society of Anesthesiologists, testified at public hearings that MUA falls outside chiropractors' scope of practice and puts patients at risk. Physicians said the procedure is akin to surgery and involves the use of drugs -- which pose dangers that only physicians are qualified to treat and are prohibited in chiropractic practice. The regulations are set to take effect April 16.” American Medical News (22nd March 2010)
“HARTFORD — Advocates have failed to convince a licensing board to order chiropractors to warn patients about the possible risk of stroke from neck manipulation, but they are not giving up. The Connecticut Board of Chiropractic Examiners voted 4-1 this week against issuing the declaratory ruling. The board heard four days of testimony last year from patients who said they were harmed by neck manipulation, while chiropractors said the risk was low and their profession was being singled out. Janet Levy, president of Victims of Chiropractic Abuse, said she was disappointed, but not surprised. “From the start of this declaratory ruling process, it was evident that the chiropractors on the board had no intention of protecting patients’ rights,” Levy alleged. Norm Pattis, attorney for the Chiropratic Stroke Awareness Group, said he has been led to believe the legislature will mandate patients be warned. If that is not the case, he plans to appeal the issue to Superior Court once a final written ruling is issued within three months. The four members who voted against the ruling are chiropractors. The dissenting vote was from Jean Rexford, executive director of the Connecticut Center for Patient Safety. Levy said the board is missing two of the three public members required by law.” Newhaven Register, Connecticut (19th March 2010)
“With very limited ability to move or speak, Scott Tatro has published a book called, "Locked In: Chiropractic Adjustment Gone Wrong." Ten years ago, Scott Tatro was the proud owner of an excavating business. Today, he can hardly talk, and can only move his hand, neck, and face. A trip to the chiropractor in 2000 changed his life as he knew it. "He had gone to the chiropractor and he had is neck adjusted on Thursday and he came home and said it hurt so bad he had to quit," says Ann Tatro, Scott's wife. His wife Ann, recalls her husband having headaches and feeling dizzy. She says, "The next Sunday he went back for another adjustment and they called and said he had some kind of seizure." Scott had had a brain stem stroke, resulting in Locked In Syndrome. Ann says, "It was happening right when your neck was twisted the second time."” Wisconsin news report (24th February 2010)
A chiropractor disciplined for luring patients in with discounted initial consultations then selling them expensive long-term plans is now advertising an even cheaper deal. A 2008 Chiropractic and Osteopathy Board of South Australia inquiry into Dr Robert Marin was sparked by 10 "disturbingly similar" patient complaints. "The common thread seems to have been that patients felt Dr Marin provided them with an exaggerated diagnosis of the severity of their condition, with a view to persuading them to enter into a long-term treatment plan (of questionable benefit) at some expense." The inquiry found Dr Marin, who advertised an initial consultation for $27 or $37, then pressured patients to commit to a long-term plan that cost thousands, used testimonials purporting to be from his own patients - which were not….Australian Medical Association state president Dr Andrew Lavender said the practice of "loss leading" - where customers are drawn in by advertisements for unrealistically cheap deals - was concerning when it came to health. "The whole purpose is to sign people up for long and expensive courses of treatment with no scientific proven value," he said. "When someone promotes this to the general public, you know that they're doing it without any scientific basis and they're going to try to pander to the greatest fears of people. "There's very little evidence anywhere about any benefit of chiropractic treatment." Adelaide Now (22nd January 2010)
“A new court ruling has again called into question a widely used but controversial chiropractic treatment, concluding that a Newfoundland practitioner made a patient deaf in one ear and caused other debilitating injuries by performing a neck manipulation on him. The judge in the civil suit found the chiropractor negligent and will decide later what compensation to award Abe Gallant, who says he had to leave his $80,000-a-year job because of the damage. The decision follows a series of public inquiries and inquests that have blamed cervical manipulation for strokes, some of them fatal, and the filing of a $500-million class action suit in Alberta that targeted the allegedly dangerous chiropractic therapy. "This is not something new ... they've been maiming people all over the country," Mr. Gallant said in an interview yesterday, suggesting the procedure be banned. "I'm lucky that I can talk about what happened. Most of them are dead or on respirators."” National Post (21st January 2010)
Online recordings of the January 2010 Connecticut State Board of Chiropractic Examiners Public Hearing on Informed Consent for Chiropractic Procedures
DAY 1 (5th January 2010)
Morning Session: Following a lengthy review of the exhibit list and attorney arguments on several motions to recuse a board member and exclude evidence, testimony begins with William Lauretti, Doctor of Chiropractic
(Length: 2 hr 51 min)
Afternoon Session: The cross examination of the Connecticut Chiropractic Association's witness William Lauretti, Doctor of Chiropractic, continues. He is followed by Doctors of Chiropractic James Lehman and Clay McDonald. (Length: 2 hr 58 min)
DAY 2 (6th January 2010)
Morning Session: After legal arguments on a motion to exclude proposed testimony on subluxation, intervenor Jann Bellamy of the Florida-based Campaign for Science-Based Health Care testifies for the remainder of the session (Length: 2 hr 44 min)
Afternoon Session: Gerald Clum, DC testifies for the CT Chiropractic Assoc. followed by intervenor Sharon Mathiason, a Canadian woman who testifies about the death of her 20-year-old daughter. Concludes with Gina Carucci, DC & President of the CT Chiropractic Assoc. (Length: 3 hr 13 min)
DAY 3 (19th January 2010)
Morning Session: Features the testimony of Dr. Douglas Fellows, representing the CT Medical Examining Board on its position on providing informed consent for patients and George Curry, Doctor of Chiropractic , representing the CT Chiropractic Council. (Length: 3 hr 14 min)
Afternoon Session: Includes the testimony of intervenor State Sen. Len Fasano and of stroke victims Janet Levy, Britt Harwe and Christa Heck. Susan Hoffman and Michael McCormick testify about their spouses' deaths following strokes. (Length: 2 hr 7 min)
DAY 4 (22nd January 2010)
“A Winnipeg woman is suing her chiropractor, whose treatment she claims caused her to have a stroke only hours after visiting his office. Debbie Henderson, 43, filed a lawsuit Dec. 23 claiming unspecified damages and medical costs in relation to a stroke she suffered last May, which caused her to be hospitalized for 17 days and has left her with lingering disabilities.” The Winnipeg Sun (1st January 2010)
A radical attempt by chiropractors to treat patients in hospital emergency departments in Australia faces fierce opposition from doctors. Australian Medical Association president, Andrew Pesce, said: ''There is still very little evidence on which to make any claims about chiropractic treatment.Chiropractors do seem to help some people with back pain, but a lot of it is probably just helping the patient feel better while their back gets better anyway…There is no evidence [that chiropractors can help treat medical conditions] … and that's not turf protection, that's common sense and patient safety". The (Australian) Sun Herald (8th November 2009)
"If Ierano or other chiropractors want to provide good quality evidence for chiropractic that has not already been dealt with and thoroughly debunked by the likes of Professor Edzard Ernst, we are confident the scientific world would be interested. Until they do, they should refrain from making claims unsupported by evidence or complaining when the risks and lack of evidence for efficacy are highlighted." Australian Skeptics (25th October 2009)
Jack of Kent blogspot (14th October 2009)
"He [Australian chiropractor, Joseph Ierano] chose to complain, revealing to all that he is not interested in a discussion but rather silencing of an organization that did no more than report on an already widely publicized article." Article by Jeff Wagg, James Randi Educational Foundation (11th October 2009)
Eran Segev, President, Australian Skeptics [pdf]
End of an Era: Foundation for Chiropractic Education and Research [FCER] decides on self-liquidation and files for bankruptcy
"Over the foundation's history, volunteers contributed more than 33,000 articles and helped fund over 152 randomized, controlled trials concerning chiropractic manipulation, as well as supported over 100 research fellowships leading to MS and/or PhD degrees…the loss of FCER will have a devastating effect on the chiropractic profession." Dynamic Chiropractic (October 2009)
"A $500,000 donation from Standard Process highlighted the record financial support received by the Foundation for Chiropractic Progress (FCP) at the Florida Chiropractic Association 2009 national convention and expo in Orlando. All told, the foundation received approximately $650,000 in pledges…The mission of the Foundation for Chiropractic Progress is 'To increase the public awareness of the benefits of chiropractic'." The Chiropractic Resource Organisation (29th September 2009)
"Chiropractors are getting very touchy indeed, all over the world. And no wonder, because their claims are being exposed as baseless as never before…" Critique of the latest attempt by chiropractors (this time in New Zealand) to stifle criticism. By David Colquhoun, DC Science (23rd September 2009)
Informed consent has been brought up before in the Connecticut state Legislature but the bill has never gone anywhere. Now supporters are bringing their issues before a state board to create awareness to certain chiropractic procedures that could hurt you. Connecticut News (10th September 2009)
"I can confirm today that I have applied for a hearing to ask the Court of Appeal to reconsider its recent denial of permission…..The new application will be oral, as opposed to the previous one, which was on paper." Simon Singh's full statement available via this link to Sense About Science. (11th August 2009)
"The Dutch sceptics group, Vereniging tegen de Kwakzalverij (VtdK — The Society against Quackery) have managed to overturn an important court ruling that was preventing them calling quacks *quacks*. In a remarkable case, that in many ways closely parallels the BCA vs. Simon Singh case in the UK, a judge has decided that using a narrow definition of the word 'Quack' that a previous ruling was forcing the group to defend in a libel case, was incompatible with Article 10 of the European Convention of Human Rights." The Quackometer (3rd August 2009)
"In an article in the Guardian last year, [Simon] Singh made claims regarding the evidence base alleged to support the promotion of chiropractic treatments in certain non-skeletal conditions in children. As Singh explains on the website www.senseaboutscience.org.uk, the Guardian offered the BCA an opportunity to lay out their evidence rather than to sue him for libel. The BCA opted to sue…..the vice president of the BCA, Richard Brown, has now presented the evidence. He writes, "There is in fact substantial evidence for the BCA to have made claims that chiropractic can help various childhood conditions" and lists 18 references. Readers can decide for themselves whether or not they are convinced. Edzard Ernst is not. His demolition of the 18 references is, to my mind, complete. Weak science sheltered from criticism by officious laws means bad medicine. Singh is determined to fight the lawsuit rather than apologise for an article he believes to be sound. He and his supporters have in their sights not only the defence of this case but the reform of England's libel laws." Fiona Godlee, Editor, British Medical Journal (9th July 2009)
Science journalist Simon Singh joins ABC's Lateline to discuss the defamation case brought against him. Dr Singh is being sued by the British Chiropractic Association after he criticised some chiropractors in the UK for claiming they could treat some childhood conditions like colic. ABC News — Australia (6th July 2009) [11mins 49secs]
"The BCA [British Chiropractic Association] has shot itself in the foot by taking the heavy-handed approach it did with respect to Simon Singh's article. By doing so, it has brought the lack of good evidence for many of chiropractors' claims right out into the bright light of day." Article by Professor Chris French, Guardian Science News (20th June 2009)
"Please rally around him. Don't just post your comments here, go to the The Times website and register your support for Simon there, too. Also, British readers please write to your MP, to newspapers etc. And please sign your support for the campaign to reform English libel law, and end England's ignominious status as the Libel Tourism Capital of the World." Richard Dawkins, RichardDawkins.net (13th June 2009)
"Beginning May 28th a series of trucks started travelling through various cities and towns in Connecticut with the message "Are you aware there is a risk of stroke with a chiropractic adjustment?" These trucks will be on the road from 9am to 5pm five days a week." PRWEB Press Release (29th May 2009)
Under its new budget, the province of Alberta, Canada, will no longer pay for chiropractic services. It is calculated that it will save $53 million. Edmonton Journal (8th April 2009) [NOTE: Chiropractic services have also been delisted by the governments of the Canadian provinces of British Columbia and Ontario.]
"Donald Harte, a Corte Madera chiropractor, has been ordered to pay two of his former patients a total of more than $7,000 after they took him to small claims court alleging he used false advertising and scare tactics. Commissioner Harvey Goldfine, who presided over the small claims proceeding in Marin County Superior court on Jan. 30, took several weeks to weigh the evidence before issuing his decision on Feb. 19. "I think he was very clear," Gertrude West, one of the patients, said of Goldfine's decision. West, 76, of Larkspur said Harte lured her into his practice with false advertising, used scare tactics to get her to sign a long-term contract and refused to refund her money when her condition failed to improve. The other former patient, Victoria Pollock-Grasso of Tiburon, objected to Harte charging her a $559 administrative fee when she decided to stop receiving adjustments from him. Grasso said she stopped seeing Harte because an orthopedist she went to for a second opinion informed her she had degenerative disc disease in her cervical spine and that Harte's manipulation of her neck could cause her to have a stroke." Contra Costa Times (28th February 2009)
A team of research-oriented chiropractors have bared their profession's shortcomings in an article that calls for "dramatic changes." The article states:
(1) Chiropractic's market share is dwindling.
(2) Despite its longevity, the profession has not succeeded in establishing respect within mainstream society.
(3) A Gallup Poll found that it rated dead last among healthcare professions with regard to ethics and honesty.
(4) Many chiropractors aggressively (and dogmatically, without evidence) have opposed public health measures such as vaccination and fluoridation.
(5) The profession must become more involved in teaching patients how to stay healthy without frequent, endless visits to chiropractic offices.
(6) Many chiropractic colleges embrace the concept of spinal subluxation as the cause of a variety of internal diseases and the metaphysical pseudo-religious idea of "innate intelligence" flowing through spinal nerves with spinal subluxations impeding this flow. These concepts lack a scientific foundation and should not be taught at chiropractic institutions as part of the standard curriculum. Faculty members who hold to and teach these belief systems should be replaced.
(7) There is a tremendous void in how chiropractic graduates develop any meaningful hands-on clinical experience with real patients in real life situations.
(8) The chiropractic profession has an obligation to actively divorce itself from metaphysical explanations of health and disease as well as to actively regulate itself in refusing to tolerate fraud abuse and quackery which are more rampant in chiropractic than in other healthcare professions.
Murphy DR and others. How can chiropractic become a respected mainstream profession? The example of podiatry. Chiropractic & Osteopathy 16(10) 2008. Full article re-published in this link to Chirobase (24th February 2009)
Wethersfield, CT, USA (PRWEB) February 18, 2009 -- The Chiropractic Stroke Awareness Group (CSAG) is flooding the State of Connecticut [USA] with outdoor advertisements. The goal is to ensure that survivors of chiropractic stroke know there is a place to turn for support, as well as to alert the general public to the potentially life altering risks of chiropractic treatment. "Otherwise healthy people are having strokes just because no one told them of the risks so that they could make informed health care choices," said Britt Harwe the Founder of CSAG. "Chiropractors need to step up, be responsible and just say to their patients, 'we know that that there is a possibility a spinal adjustment can cause a stroke, but now you should know it too'". It is the objective of CSAG supporters, who have committed resources for advertisements for at least the next four years, to ensure that by the time they are through every citizen in Connecticut will be aware of the risks of chiropractic adjustment.
Comprehensive inventory of blog and media articles covering the case. (Compiled by Chris Kavanagh)
Wethersfield, CT, USA, Nov 18, 2008) -- The Chiropractic Stroke Awareness Group (CSAG) is dramatically expanding its nationwide advertising campaign with the placement of billboards in some of the largest metropolitan areas in the country….."The American public needs to know that chiropractic adjustments can cause severe injuries, permanent disabilities and even death," said Britt Harwe, Founder of CSAG. "Our promise to CSAG members is that the awareness campaign will continue to grow in intensity until the chiropractic industry begins the process of meaningful reform."
An update from Professor David Colquhoun on the legal threats being made by the New Zealand Chiropractors' Association: "Although the chiropractors seem to be rather upset by the criticisms that have been levelled against them, the most interesting war is not between chiropractors and people who think that medicine should not be based on metaphysics. It's the war *within* chiropractic itself." DC Science (5th September 2008)
A link to the full unedited version, as published by The Guardian, of Simon Singh's article 'Beware The Spinal Trap' that was critical of chiropractors and is subject to legal threats by the British Chiropractic Association (BCA). Gimpy's Blog (17th August 2008)
A lawyer for the New Zealand Chiropractors' Association has sent a threatening letter to the New Zealand Medical Journal alleging libel in two articles. In response, the Journal's editor, Professor Frank A. Frizelle, said "The Journal has a responsibility to deal with all issues and not to steer clear of those issues that are difficult or contentious or carry legal threats….. I encourage, as we have done previously, the chiropractors and others to join in [the debate], let's hear your evidence not your legal muscle". DC Science (8th August 2008)
Sharon Mathiason, mother of Laurie Jean Mathiason who died in 1998 a few days after having her neck adjusted by a Saskatoon chiropractor, has decided to resume her battle to have neck manipulation banned. "We don't want to see any more deaths. This is just a belief system. There is no science to it," Sharon Mathiason said as she compiled packages of information in her living room to be sent to various politicians this week. Saskatoon Star Phoenix news report (18th June 2008)
Consumer advocates and victims of chiropractic have asked to meet with Canadian legislators and the Minister of Health to propose the following guidelines:
1. INFANTS AND CHILDREN: Highest neck manipulation should never be done in infants and children for claims to treat such conditions as ear infections, tonsillitis, infantile colic, asthma and gastro-intestinal disorders nor as an alternative to scientific immunization against diseases such as polio, tetanus, measles, mumps, German measles or chicken pox. The Chiefs of Paediatrics of our Canadian Hospitals have all condemned such claims by chiropractors.
2. PHILOSOPHICAL CLAIMS: Highest neck manipulation should never be done for the claim that it is effective to awaken the "innate intelligence of the spinal cord" and thereby provide "wellness or health" of the entire body. The idea that the spinal cord has some magical "innate intelligence" is a fundamental chiropractic belief. It is false.
3. REPETITIVE HIGHEST NECK MANIPULATIONS: Highest neck manipulation should not be done on a repetitive basis with claims that this will keep the neck vertebrae in proper alignment. It is false to claim that highest neck manipulation is necessary for the "maintenance" of the alignment of the highest neck vertebrae. The vertebrae are attached to each other by a complex structure of bone, ligaments and muscles. Manipulating the highest neck time and time again on people who have no complaints in that area should not be done.
4. INFECTIONS: Highest neck manipulation should not be done for any claims that it alters in any manner, the immune system, to prevent or to treat infections such as Acquired Immune Deficiency Syndrome and other bacterial, viral or fungal infections.
5. BODY ORGANS: Highest neck manipulation should not be done for claims that it can have a health benefit upon a body organ such as the heart, lungs, kidneys and liver or as a means of preventing the onset of genetic disorders or cancer.
6. VERTEBRAL SUBLUXATIONS: Highest neck manipulation should never be done for the claim that it can remove so called "vertebral subluxations" in the highest neck area. It is false to claim that these top vertebrae are out of alignment, even in new born babies, and that manipulating the highest neck area one can improve the function of the brain stem as well as treat conditions such as sinusitis and even multiple sclerosis. There is no neurological or scientific basis for such claims'. [Ends] These guidelines make sense, and rational chiropractors should have no objections to them. They would not interfere with spinal manipulation therapy for musculoskeletal conditions, and they would eliminate much of the quackery in chiropractic.
Harriet Hall, MD, Science Based Medicine (1st July 2008)
CTV News video clip of Sandra Nette's landmark lawsuit. [3 mins 12 secs]
Complete Statement of Claim for the above class action suit. [81 pages — pdf]
An Alberta woman, paralyzed after her neck was manipulated by a chiropractor, has launched the biggest-ever class action suit against chiropractic in Canada. The suit, filed yesterday in Edmonton, is asking for more than a half billion dollars in damages not only for the victim, Sandy Nette and her husband, David, but for an entire class — anyone in Alberta treated or harmed by chiropractors who deliver "inappropriate and non-beneficial adjustments." News report by Paul Benedetti and Wayne MacPhail (13th June 2008)
The Chiropractic Stroke Awareness Group (CSAG) is continuing the expansion of its chiropractic-stroke awareness campaign to western states of the USA, including Colorado, Arizona and California. This is the latest phase of a coast-to-coast public relations offensive intended to make the public aware there are possible severe risks to chiropractic treatment. Leaders in the chiropractic industry have publicly expressed concerns that warning the public about risks of certain chiropractic manipulations may scare away potential patients. Press Release from The Chiropractic Stroke Awareness Group (27th April 2008)
"Does it work? There is no evidence to suggest that spinal manipulation is effective for anything but back pain and even then conventional approaches (such as regular exercise and ibuprofen) are just as likely to be effective and are cheaper…Neck manipulation has been linked to neurological complications such as strokes — in 1998, a 20-year-old Canadian woman died after neck manipulation caused a blood clot which led to stroke. We would strongly recommend physiotherapy exercises and osteopathy ahead of chiropractic therapy because they are at least effective and much safer…If you do decide to visit a chiropractor despite our concerns and warnings, we very strongly recommend you confirm your chiropractor won't manipulate your neck. The dangers of chiropractic therapy to children are particularly worrying because a chiropractor would be manipulating an immature spine." Article by Simon Singh and Professor Edzard Ernst, Daily Mail (8th April 2008)
Increased membership of the Chiropractic Stroke Awareness Group (CSAG) has delivered increased resources. "Our members worldwide are determined to share with the public an accurate, ethical and responsible message about the health risks of chiropractic," said Britt Harwe, Founder of CSAG. "Our informational message stands in sharp contrast to the deliberate deception fuelled by a chiropractic industry more interested in profits than patients." Wethersfield, CT — PRWEB (12th December 2007)
"Spinal manipulation (and/or use of diclofenac) does not speed up recovery from back pain reported five newspapers (9 November 2007). The newspaper reports of a well-conducted trial of people with acute back pain were generally accurate. The study's results appear reliable, and are applicable to people with acute lower back pain." NHS National Library for Health (12th November 2007) Links to newspaper reports included.
"The Chiropractic Stroke Awareness Group (CSAG) is expanding its television awareness campaign, this time asking the question, "Have you been injured by a chiropractor?" on the ABC affiliate in Connecticut. The commercial then provides contact information for victims to seek information and support. The ad is part of an ongoing public awareness effort (including print and outdoor advertising) designed to raise the public consciousness about the risks of chiropractic treatment. Last month CSAG launched the television component on WTIC-TV the Fox affiliate in Connecticut. "The response has been overwhelming," said Amanda Thompson of CSAG. "Many people are coming forward to share their horror stories and to seek help." The organization represents hundreds of people across the country who have been injured by chiropractic treatment. Potential risks can include stroke, permanent disability and even death. CSAG is dismayed at the chiropractic community's response of preferring not to inform patients apparently out of fear some people might decide against chiropractic treatment if they were informed. "Sadly, the chiropractic industry remains more concerned about protecting profits than protecting their patients," Ms. Thompson said." Wethersfield, CT — PRWEB (4th November 2007)
Victims of Chiropractic Abuse (VOCA) has released a stamp honouring the life and legacy of Linda Solsbury, the courageous activist who started the push for chiropractic reform by working diligently to warn the public that chiropractic is not without risks. In 1985 Ms Solsbury became mute and paralysed as the result of chiropractic manipulation. She died in 2006 during an operation to relieve some of the effects of her injuries. PRWeb Press Release (29th August 2007)
"Manipulating the upper spine during back treatments could result in serious injury, experts have warned. A review of studies published in the Journal of the Royal Society of Medicine (JRSM) concluded that spinal manipulation should not routinely be done on patients. When performed on the upper spine, it may result in serious and possibly fatal complications, such as stroke, the experts said." The Scotsman (1st July 2007)
Four-page article revealing how chiropractors' moves can trigger strokes in healthy patients. MSNBC News (17th June 2007)
"The scientific standard developed by families and by medical specialists, and by chiropractors who have given up highest neck manipulation, is very simple. In essence it states that highest neck manipulation should not be performed on infants and children or on people who have no neck pain, or as part of a philosophy that falsely believes it can be used to prevent or treat organic illness. This standard cannot be argued against rationally and scientifically." Article in the National Post (18th May 2007) [pdf]
Professor Edzard Ernst is reportedly against regulation of alternative medicine until there is evidence. In an article in the British Medical Journal on 5th May 2007 he argued that regulation would be interpreted by the public as having sufficient evidence to recommend it. He said: "The evidence for the efficacy of chiropractic, for example, is very slim indeed. And since it has been regulated, research for establishing that it works has diminished. People are saying: 'We are fully regulated so don't ask us questions about whether this works or not.'" Science and Progress (7th May 2007)
"A Quebec coroner has recommended a full review of chiropractic neck treatments, saying a cervical adjustment contributed to the death of a woman in 2006. Coroner Paul G. Dionne released his recommendations Thursday, more than a year after Pierrette Parisien died following chiropractic care for severe neck pain." CBC News (12th April 2007)
The story of a UK chiropractic patient who, in 2003, suffered an arterial dissection which caused a brain stem stroke. Her chiropractor admitted liability for her injuries. NOTE: The UK General Chiropractic Council claims that there is no evidence that neck manipulation causes stroke. Currently there appears to be no official system in place in the UK to monitor adverse reactions/injuries caused by chiropractic treatment. Action for Victims of Chiropractic (May 2006)
BBC News report on a new study published by the Journal of the Royal Society of Medicine. (22nd March 2006) [Click on the link below to read the paper]
American Speciality Health, Inc. (ASH) has issued clinical practice guidelines for 81 "complementary" techniques and procedures, most of which are used mainly by chiropractors. The documents (all of which are contained in this link) indicate that 68 of the methods would not be covered under the plan because they are considered unsubstantiated, unsafe, or both; 67 of the methods are classified as experimental or investigational because credible scientific evidence is inadequate to support their claimed applications; 48 of the methods are scientifically implausible because they require the existence of forces, mechanisms, or biological processes that are not known to exist with the existing framework of scientific knowledge; 11 of the methods are considered unsafe, either directly or indirectly; and 53 of the methods would render the practitioner ineligible to participate in the network. The methods include: Acutonics/Sonotonics, Addictionology, Advanced Biostructural Correction (ABC), Applied Kinesiology, Ashiatsu Oriental Bar Therapy, Axial Decompression Therapy, Bach Flower Remedies, Bio Energetic Synchronization Technique (BEST), Bio-Cranial Therapy, Bioenergetic Sensitivity and Enzyme Therapy (BioSet), Bio-Geometric Integration (BGI), Biological Terrain Assessment (BTA), BioMeridian (MSA Machine), Clinical Kinesiology (CK), Cold Laser-Low Laser Light Therapy (LLLT), Colonic Irrigation, Colorpuncture, Concept Therapy, Contact Reflex Analysis (CRA), Craniosacral Therapy (CST), Current Perception Threshold (CPT) — Sensory Nerve Conduction Threshold (sNCT), Diagnostic Ultrasound — Spinal/Paraspinal, Directional Non-Force Technique (DNFT), ElectroAcupuncture by Voll (EAV), Electrodermal Screening Test (EDST), Force/Functional Recording and Analysis System (FRAS), Functional Leg Length Inequality, Gemstone and Crystal Therapy, Holistic Kinesiology, Homeopathy, Infratonic/Infrasonic or Qui Gong Machine (QGM), Intradermal Needles (Needle Implants/Ear Tacks), Iridology, Jaffe-Mellor Technique, Live Blood Cell Analysis, Logan Basic Technique, Magnets — Static, Manipulation Under Anesthesia (MUA) — Spinal, Manual Muscle Testing — Psychological Disorders, Moxibustion — Direct, Nambudripad's Allergy Elimination technique (NAET), Nasium Vertex X-Ray Views, Network Spinal Analysis, Neuro Emotional Technique (NOT), Neurolinguistic Programming (NLP), Neurolink, Neurovascular Dynamics (NVD), New-Stim Bio-Kinetics, Organ/Visceral Manipulation, Ortho-Bionomy, Radionics, Reflexology — Diagnostic, Reiki, Rolfing, Ryodoraku and Electro Meridian Imaging (EMI), Sacro Occipital Technique (SOT) — Diagnostic, Surface Electromyography (SEMG), Surrogate Testing, Thermography, Toftness, Total Body Modification, Upper Cervical Adjusting Techniques, Vector Point Cranial Therapy, Vegatesting, Videonystagmography (VNG) and the Webster Technique. [Most of the guidelines were implemented during February 2006] Information source: Chirobase
Latest news. Includes correspondence with the UK General Chiropractic Council (GCC) regarding the risks of chiropractic and the validity of a number of chiropractic practices. The GCC appears to avoid directly answering many of the questions put to it, most notably on the issue of the safety of neck manipulation where the risk/benefit ratio for the procedure is in question due to the availability of safer options. [NOTE: In its August 2005 reply, the GCC stated that it understood that the British Chiropractic Association (BCA) was in the process of establishing a national database to which UK chiropractic patients could report complications following their treatment. However, in a letter to Nature on 22nd September 2005 (in response to an article which questioned what complementary and alternative medicine [CAM] organisations were doing to monitor adverse reactions) Barry Lewis of the BCA stated that the association had, in conjunction with the Anglo-European Chiropractic College, "set up a chiropractic reporting and learning system; more than 1,200 practitioners who are members of the BCA have recently received an information pack to enable them to participate in the scheme. Resulting data will be analysed at the Anglo-European Chiropractic College and outcomes will be relayed to the profession, through our newsletter, journal and website, so practitioners may learn from the experience of others. The intention is that the scheme will, if successful, be offered to other chiropractic associations within Europe in 2006". No mention was made of a database to which the patients of all (approx 2,300) UK chiropractors could report complications following their treatment.]
Dangers of chiropractic therapy (including Risks Related to Manipulation of the Cervical Spine: Consequences for Evidence Based Practice)
This news update contains three films worth seeing, chiropractic references and articles, the Florida State Univesrity School of Pseudoscience Scandal and, with regard to manipulation of the cervical spine, the following suggested PRECAUTIONARY GUIDELINES:
[1.] Manipulation, especially with rotation (the most commonly used method by chiropractors), should be considered a contraindicated technique.
[2.] Manipulation of C1-C2 should be considered absolutely contraindicated. (This is also the area of the neck most commonly manipulated by many chiropractors.)
[3.] In principle these guidelines and cautions apply to all involved professions, since it is primarily the technique that is the problem, even though chiropractors are by far responsible for the greatest number of injuries, strokes, and deaths. This is a logical consequence of their exaggerated and unwarranted self-confidence and erroneous education, combined with their historically and educationally conditioned overrating of the value of spinal manipulation as a whole.
[4.] All healthcare professions, including Emergency Room staff, must be alert to the possibility of injuries caused by spinal manipulative therapy (SMT). The patient's medical history should include questions about possible spinal manipulation within the last 30 days, at the very least. Symptoms and injuries can include: headache, dizziness, vertigo, nausea, pain, strains, sprains, whiplash type injuries, Horner's syndrome, Wallenberg's syndrome, permanent or transient paralysis, blackouts, fainting, blood clots to the brain, and death. Few of these consequences, especially deaths, are ever identified as results of previous SMT, since autopsies are rarely performed in these cases. Since strokes can occur up to a month — and even later — after manipulation of the cervical spine, a suspicion of any connection is rarely awakened.
[5.] When dealing with stroke cases, all MDs — be they general practitioners, specialists, pathologists, or coroners — should routinely examine the patient's (or deceased's) medical history (including interviews with relatives) for any cases of SMT within the previous 2-3 months, including number of times, since each repetition increases the risk. If this isn't done, the real extent of SMT induced strokes and deaths will not be exposed, and it will be impossible to institute preventive measures in harmony with quality control principles.
[6.] Physical Therapists should encourage patients with such injuries to report them to their own doctors. (I can't be the only PT who has encountered patients with fractured spines, spinal stenosis, herniated discs, paralysis, stable fractures made unstable, severe sprains and strains, torn muscles, and unremitting headaches for years, all as a direct result of a specific chiropractic "adjustment". I have seen all of these injuries, but those who have died haven't come to me or their chiro, for obvious reasons.)
[7.] Whiplash patients should never receive cervical manipulation, especially in the acute phase. Hairline fractures are easily overseen on x-rays at this point in time. This may create a false sense of security, resulting in treatment which can destabilize otherwise stable fractures. Such fractures become visible after a short time, often within a few weeks *if* the x-ray is taken from precisely the right angle, which isn't necessarily one of the standard angles.
NO MORE UNDERREPORTING: The massive underreporting (nearly 100%) that is currently occurring must stop. Neurologists and Physical Therapists encounter these cases regularly, but may not be recognizing them. Awareness of the problem will help to bring far more cases to light. They should then be reported to centrally established centers in all lands. In Canada the Canadian Stroke Consortium is attempting to uncover the real frequency of these injuries and deaths, since they are much more common than are indicated by chiropractic sources, where there is a vested interest to deny, ignore, and even cover-up, the problem.
NO EXCUSE FOR MANIPULATION OF THE CERVICAL SPINE (MCS): There is no excuse (with rare exception) for the manipulation of the cervical spine (MCS), especially in light of several facts:
[1.] The majority of such manipulations are not indicated, especially when the problem is located elsewhere in the body. MCS in such cases constitutes gross malpractice and reckless endangerment.
[2.] The real problems in the neck, head, and upper extremities, for which treatment of the neck is properly indicated, can be treated (a) without the use of MCS, (b) using other methods, (c) with longer lasting results, and (d) with much less risk than is involved with MCS.
I hope that these precautionary guidelines will become widely disseminated and formally adopted (and adapted) by all medical professions which deal with the locomotor system."
Guidelines compiled by Paul Lee, PT, quackfiles.blogspot.com (2005)