Chiropractic controversy and criticism

Throughout its history, chiropractic has been the subject of internal and external controversy and criticism.[1][2] According to magnetic healer Daniel D. Palmer, the founder of chiropractic, "vertebral subluxation" was the sole cause of all diseases and manipulation was the cure for all disease.[3][4] Internal divisions between "straights," who adhere strictly to Palmer’s original philosophy, and "mixers," who incorporate broader medical practices, have further complicated the profession’s identity.[4] A 2003 profession-wide survey found "most chiropractors (whether 'straights' or 'mixers') still hold views of Innate Intelligence and of the cause and cure of disease (not just back pain) consistent with those of the Palmers".[5] A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today."[3] Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license.[3] D.D. Palmer considered establishing chiropractic as a religion to resolve this problem.[6] For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as vertebral subluxation.[7]

Chiropractic researchers have documented that fraud, abuse and quackery are more prevalent in chiropractic than in other health care professions.[8] Unsubstantiated claims about the efficacy of chiropractic have continued to be made by individual chiropractors and chiropractic associations.[3] The core concept of traditional chiropractic, vertebral subluxation, is not based on sound science.[3] Collectively, systematic reviews have not demonstrated that spinal manipulation, the main treatment method employed by chiropractors, was effective for any medical condition, with the possible exception of treatment for back pain.[3] Spinal manipulation, particularly of the upper spine, can cause complications in adults and children that can cause permanent disability or death.[9][10][11] Scientific studies have generally found limited evidence for chiropractic efficacy beyond back pain, and concerns about patient safety, particularly with neck manipulations, have been raised.[12][13][14]

Legal battles, including the landmark Wilk v. AMA case and Simon Singh’s libel suit, highlight tensions between chiropractors and mainstream medicine.[15][16][17] Ethical issues, such as misleading advertising and opposition to vaccination, continue to draw criticism. Despite efforts to modernize, chiropractic remains controversial within both the medical community and the public sphere. In 2008, Simon Singh was sued for libel by the British Chiropractic Association (BCA) for criticizing their activities in a column in The Guardian.[18] A preliminary hearing took place at the Royal Courts of Justice in front of judge David Eady. The judge held that merely using the phrase "happily promotes bogus treatments" meant that he was stating, as a matter of fact, that the British Chiropractic Association was being consciously dishonest in promoting chiropractic for treating the children's ailments in question.[19] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[20] The libel case ended with the BCA withdrawing its suit in 2010.[21][22]

Chiropractors historically were strongly opposed to vaccination based on their belief that all diseases were traceable to causes in the spine, and therefore could not be affected by vaccines.[23] Some chiropractors continue to be opposed to vaccination.[24] Early opposition to water fluoridation included chiropractors in the U.S. Some chiropractors opposed water fluoridation as being incompatible with chiropractic philosophy and an infringement of personal freedom. More recently, other chiropractors have actively promoted fluoridation, and several chiropractic organizations have endorsed scientific principles of public health.[25]

  1. ^ Kaptchuk, TJ; Eisenberg, DM (November 1998). "Chiropractic: origins, controversies, and contributions". Archives of Internal Medicine. 158 (20): 2215–24. doi:10.1001/archinte.158.20.2215. ISSN 0003-9926. PMID 9818801.
  2. ^ Jaroff, Leon (February 27, 2002). "Back Off, Chiropractors!". Time. Retrieved June 7, 2009.
  3. ^ a b c d e f Ernst, E (May 2008). "Chiropractic: a critical evaluation". Journal of Pain and Symptom Management. 35 (5): 544–62. doi:10.1016/j.jpainsymman.2007.07.004. ISSN 0885-3924. PMID 18280103.
  4. ^ a b Kaptchuk, Ted J.; Eisenberg, David M. (November 9, 1998). "Chiropractic: Origins, Controversies, and Contributions". Archives of Internal Medicine. 158 (20): 2215–2224. doi:10.1001/archinte.158.20.2215. ISSN 0003-9926. PMID 9818801.
  5. ^ Gunther Brown, Candy (July 7, 2014). "Chiropractic: Is it Nature, Medicine or Religion?". HuffPost.
  6. ^ Palmer, Daniel (May 4, 1911), D. D. Palmer's Religion of Chiropractic (PDF), The Chiropractic Resource Organization, retrieved February 22, 2015
  7. ^ Keating JC Jr; Cleveland CS III; Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Retrieved June 16, 2008. A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine. Chiropractors' tendency to assert the meaningfulness of various theories and methods as a counterpoint to allopathic charges of quackery has created a defensiveness which can make critical examination of chiropractic concepts difficult (Keating and Mootz 1989). One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994).
  8. ^ Murphy, DR; Schneider, MJ; Seaman, DR; Perle, SM; Nelson, CF (August 2008). "How can chiropractic become a respected mainstream profession? The example of podiatry". Chiropractic & Osteopathy. 16: 10. doi:10.1186/1746-1340-16-10. PMC 2538524. PMID 18759966.
  9. ^ Cite error: The named reference WHO-guidelines was invoked but never defined (see the help page).
  10. ^ Ernst, E (July 2007). "Adverse effects of spinal manipulation: a systematic review". Journal of the Royal Society of Medicine. 100 (7): 330–38. doi:10.1177/014107680710000716. ISSN 0141-0768. PMC 1905885. PMID 17606755.
  11. ^ Vohra, S; Johnston, BC; Cramer, K; Humphreys, K (January 2007). "Adverse events associated with pediatric spinal manipulation: a systematic review". Pediatrics. 119 (1): e275–83. doi:10.1542/peds.2006-1392. ISSN 0031-4005. PMID 17178922. S2CID 43683198.
  12. ^ Kaminskyj, Adrienne; Frazier, Michelle; Johnstone, Kyle; Gleberzon, Brian J. (March 2010). "Chiropractic care for patients with asthma: A systematic review of the literature". The Journal of the Canadian Chiropractic Association. 54 (1): 24–32. ISSN 1715-6181. PMC 2829683. PMID 20195423.
  13. ^ Chen, W.-L.; Chern, C.-H.; Wu, Y.-L.; Lee, C.-H. (January 2006). "Vertebral artery dissection and cerebellar infarction following chiropractic manipulation". Emergency Medicine Journal: EMJ. 23 (1): e1. doi:10.1136/emj.2004.015636. ISSN 1472-0213. PMC 2564146. PMID 16373786.
  14. ^ Jones, Jeremy; Jones, Catherine; Nugent, Kenneth (January 2015). "Vertebral artery dissection after a chiropractor neck manipulation". Proceedings (Baylor University. Medical Center). 28 (1): 88–90. doi:10.1080/08998280.2015.11929202. ISSN 0899-8280. PMC 4264725. PMID 25552813.
  15. ^ Johnson, Claire D.; Green, Bart N. (September 1, 2021). "Looking back at the lawsuit that transformed the chiropractic profession part 1: Origins of the conflict". Journal of Chiropractic Education. 35 (S1): 9–24. doi:10.7899/JCE-21-22. ISSN 2374-250X. PMC 8493520. PMID 34544156.
  16. ^ Dyer, C. (April 1, 2010). "Appeal court judges say scientific controversies must be settled by science not law". BMJ. 340 (apr01 2): c1895. doi:10.1136/bmj.c1895. ISSN 0959-8138.
  17. ^ Dyer, C. (April 15, 2010). "Chiropractors drop their libel action against science writer Simon Singh". BMJ. 340 (apr15 3): c2086. doi:10.1136/bmj.c2086. ISSN 0959-8138.
  18. ^ Eden, R (August 16, 2008). "Doctors take Simon Singh to court". The Daily Telegraph. London. Retrieved August 16, 2008.
  19. ^ Boseley, Sarah (May 14, 2009). "Science writer accused of libel may take fight to European court". London: The Guardian (UK). Retrieved May 19, 2009.
  20. ^ "Unjust burdens of proof". Nature. 459 (7248): 751. June 2009. Bibcode:2009Natur.459Q.751.. doi:10.1038/459751a. PMID 19516290.
  21. ^ Pallab Ghosh (April 15, 2010). "Case dropped against Simon Singh". BBC News.
  22. ^ Mark Henderson (April 16, 2010). "Science writer Simon Singh wins bitter libel battle". Times Online. London. Archived from the original on June 11, 2011.
  23. ^ Busse, JW; Morgan, L; Campbell, JB (June 2005). "Chiropractic antivaccination arguments". Journal of Manipulative and Physiological Therapeutics. 28 (5): 367–73. doi:10.1016/j.jmpt.2005.04.011. ISSN 0161-4754. PMID 15965414.
  24. ^ F. Nelson, Craig (April 1, 1999). "Spinal Manipulation and Chiropractic: Views of a Reformist Chiropractor". American Council on Science and Health. Archived from the original on April 9, 2009. Retrieved June 7, 2009.
  25. ^ Jones, RB; Mormann, DN; Durtsche, TB (October 1989). "Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success". American Journal of Public Health. 79 (10): 1405–08. doi:10.2105/AJPH.79.10.1405. ISSN 0090-0036. PMC 1350185. PMID 2782512.

Chiropractic controversy and criticism

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