March 2006

Controversial British study causes uproar among DCs

An article to be published in the April issue of the Journal of the Royal Society of Medicine on the efficacy of spinal manipulation has caused an uproar among both British and American chiropractors.

In the study entitled “A systematic review of systematic reviews of spinal manipulation,” the authors reviewed 16 research papers published between 2000 and 2005 on back pain, neck pain, primary and secondary dysmenorrhoea, infantile colic, asthma, allergy, and cervicogenic dizziness.

Authors of the article, professors Edzard Ernst and Peter Canter of Peninsula Medical School at Exeter, wrote that they found no convincing data to support claims that spinal manipulation is effective. They said that with the possible exception of back pain relief — when spinal manipulation is as good, but not better than conventional treatments — the technique is worthless.

The British Chiropractic Association (BCA) considered the article biased. A statement from the BCA said:

“Ernst and Canter have carefully selected negative articles in support of their conclusion that manipulation cannot be recommended as a treatment when national clinical practice guidelines, based on much more and better research than the studies this article has selected, has come to exactly the opposite conclusion.”

The BCA also went on to say, “Professor Ernst has a track record of disparaging not only the chiropractic profession but also other similarly regulated healthcare professions.”

The American Chiropractic Association (ACA) said the review “is biased and misleading, and needlessly alarms the public about a safe and effective form of treatment.”

In a March 23, 2006, letter from ACA president, Richard G. Brassard, DC, Brassard responds, in part, by stating, “The truth be told, the authors have limited the evidence to suit their own arguments, and in fact they have included so much of their own opinionated research — approximately one-fifth of the papers cited — that their study is closer to personal opinion than an unbiased review.”

Sources: Journal of the Royal Society of Medicine,www.jrsm.org; Times Online, www.timesonline.co.uk; British Chiropractic Association, www.chiropractic-uk.co.uk; American Chiropractic Association, www.acatoday.org

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