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Chiropractic is an alternative medicine practice that is based on the theory that spinal misalignments, termed “subluxations”, interfere with the traveling of nerve signals to and from the brain. It is suggested that these subluxations are at the root of a variety of health problems, including many non-spinal syndromes.
According to traditional chiropractic theory, spinal adjustments (which are forceful thrusts applied to the spine by a chiropractor) can effectively “unblock” these nerve signals restoring the body’s “innate intelligence” and enabling the body to heal itself.
Chiropractic is based on a philosophy of “vitalism” (the idea that health is determined by the flow of an innate energy) a doctrine that sharply contrasts with the tenets of modern science and medicine. Notably, no scientific evidence exists to validate the existence of spinal subluxations, as there is no way to detect, harness or measure so-called innate intelligence in any scientifically verifiable way. As chiropractic is based on unscientific premises, its doctrines are not amenable to empirical research or testing.
Chiropractic in the Treatment of Spinal Conditions:
The Canadian Chiropractic Association claims that there have been countless scientific clinical studies evaluating spinal manipulation as an appropriate and effective medical treatment. However, it is important to note that systematic reviews of the available research indicate that the majority of support for chiropractic comes from case studies focusing on unreliable testimonial evidence. Furthermore, few randomized controlled trials (RCTs), the gold-standard for efficacy research, have been conducted to date.
Scientific reviews of the evidence for chiropractic in the treatment of musculoskeletal conditions have been conflicting. A recent review of RCTs presented in the Chiropractic & Osteopathy “UK Evidence Report” indicates that when compared to sham treatment, spinal manipulation/mobilization can be effective in adults for the treatment of musculoskeletal conditions such as low back pain, migraine and cervicogenic headache, cervicogenic dizziness, several extremity joint conditions, and acute/subacute neck pain.
Notably, however, evidence from a previous systematic review of RCTs published in the New England Journal of Medicine concludes that “research shows that spinal manipulations ease back pain no better than specialised physiotherapy and only slightly better than doing nothing at all”.
Chiropractic in the Treatment of Non-spinal Conditions:
There has been a lack of empirically valid research conducted on the efficiency of chiropractic for non-spinal conditions. Research published in the New Zealand Medical Journal on the effectiveness of chiropractic for conditions including painful menstrual periods, carpal tunnel syndrome, fibromyalgia, ear infections, infantile colic, and gynaecological pelvic pain, concludes that the evidence for the effectiveness of chiropractic manipulation in the treatment of non-spinal syndromes are not based on data from well-designed clinical trials.
The researchers furthermore state that the notion for the treatment of chiropractic manipulation in such conditions is “scientifically implausible”. In addition, the “UK Evidence Report” has found moderate negative evidence (and not merely lack of evidence) for chiropractic in the treatment of asthma, hypertension, dysmenhorrea, ankle fracture and infantile cholic.
Despite the widespread acceptance of chiropractic as a medical treatment, chiropractic is based on theories that have not been validated by modern science. Though some evidence exists to suggest that chiropractic may be effective in the treatment of musculoskeletal complaints such as low back pain, other research indicates that chiropractic may be no more effective than doing nothing.
While chiropractors commonly promote and practice manual therapy in the treatment of non-spinal ailments, it is important to note that the risks of chiropractic manipulation may be considerable, and currently no scientifically reliable study exist to show efficacy of such treatment in non-spinal conditions.
“The effectiveness of Chiropractic for Treatment of Low Back Pain: An Update and Attempt at Statistical Pooling” Assendelft, W.J., Koes, B.W., van der Heijen, G.J., & Bouter, L.M., 1996.
“Effectiveness of Manual Therapies: The UK Evidence Report” Bronfort, G., Haas, M., Evans, R., Leininger, B., & Triano, J., 2010.
“A Comparison of Physical Therapy, Chiropractic Manipulation, and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain” Cherkin, D.C., Deyo, R.A., Battie, M., Street, J., & Barlow, W., 1998.
“Deaths After Chiropractic: A Review of Published Cases” Ernst, E., 2010.
“Safety of Chiropractic Interventions: A Systematic Review” Gouveia, L.O., Castanho, P., & Ferreira, J.J., 2009.
“The Use of Expertise-Based Randomized Controlled Trials to Assess Spinal Manipulation and Acupuncture for Low Back Pain: A Systematic Review” Johnston, B.C., da Costa, B.R., Devereaux, P.J., Akl, E.A., & Busse, J.W., 2008.
“Evidence-based medicine and its implications for the profession of chiropractic. Social Science & Medicine” Villanueva-Russell, Y., 2005.