Anything that does you good without doing you harm is good medicine. That’s a saying I’ve always stood by.
However, no treatment that’s effective can escape some side effects.
Professor Edzard Ernst, emeritus professor of complementary medicine at Exeter University, says what really counts is a balance between risk (side effects) and benefit.
It was exactly this balance that came to mind when one of my relatives, who had been suffering back pain for months, asked me if I could recommend a chiropractor. Whoa there! Chiropractic is something I’ve learned to be sceptical about.
For one, the benefits of manual spinal manipulations are not clear. Plus it’s claimed they are effective for a large number of conditions that I can’t tie together such as asthma and IBS.
However, having read Professor Ernst’s book on the subject, I know there’s precious little published evidence to support the claims. Because of this I wouldn’t be prepared to tolerate the risks or side effects. And there are many – more than half of all patients suffer mild to moderate side effects after seeing a chiropractor, lasting up to three days.
But that’s not all. There are several hundred well-documented cases where patients were seriously injured. Last year, a 32-year-old woman from Jakarta, Indonesia, died after being treated by an American chiropractor. What probably happened is that while manipulating the upper spine, an artery supplying the brain was over-stretched and tore.
Chiropractors claim such incidents are extremely rare events unconnected to their manipulations. However, an effective system to monitor adverse effects of alternative therapies doesn’t exist, so no one knows how many there may have been.
About 30 deaths after chiropractic work have been recorded but Professor Ernst believes under reporting is close to 100% in the UK, so at least twice that.
Now, mainstream medics must get informed consent from patients before starting a treatment. If that was applied to chiropractors, they would have to tell patients there’s hardly any hard evidence that spinal manipulations are effective.
They should also admit chiropractic care may cause serious harm. But three out of four chiropractors treat patients without discussing serious risk.
In 2014, the Professional Standards Authority audited The General Chiropractic Council and reported: “The extent of the deficiencies we found raises concern about the extent to which the public can have confidence in the GCC.”
To come back to my first point, doctors use, whenever possible, only treatments where the benefits outweigh the risks.
Sadly I don’t think this is always the case with chiropractic.