The Simon Singh/BCA libel case is having the unintended consequence of the media being full of reports of the strange beliefs of chiropractors. They are a cult like body of people and are demonstrating that they are unwilling to discuss matters of evidence but very happy to call their lawyers to get at their critics. In this way they show behaviour more readily expected from scientologists than a responsible health profession.
Another unintended consequence of the BCA decision to sue Simon Singh is that an army of bloggers, scientists and sceptics have been scouring leaflets, advertising and web sites of chiropractors resulting in hundreds of complaints being made to the Advertising Standards Authority, Trading Standards and directly to the General Chiropractic Council. What was once considered a strength of Chiropractic – Statutory Regulation – is now being turned back on them as the GCC is obliged by law to investigate every complaint made to them. They are now sitting on a huge pile of letters. The ASA has recently ruled on one claim by a Dr Carl Irwin that he should not call himself ‘Dr’ or claim he can treat things like babies colic. Hundreds of chiropractors make similar claims. The GCC will be busy.
This sort of mass complaint would be powerless against homeopaths. It is now well established that the homeopath’s regulatory bodies, such as the Society of Homeopaths, do not upkeep their own code of conduct and ethics. They are under no obligation to do so by law. But Chiropractors now have to suffer from their own status.
Statutory Regulation of chiropractic makes a number of demands on the trade. Importantly, their education must be from one of three approved schools that provide a degree level education. One school stands out here: the McTimoney College based in Abingdon, Oxfordshire, where the degrees are underwritten by the University of Wales. McTimoney Chiropractic is a sect within the bigger cult. It has its own ideas about how hard you should hit the body when it is ill. According to the McTimoney Chiropractic Association, the School was set up in Oxfordshire by John McTimoney who believed that “health depends on healthy nerve messages, subluxations of the vertebrae or other joints interfere with these, and that such subluxations can affect not only joints and muscles, but every cell and organ in the body.” McTimoney Chiropractors do not rely on X-rays to ‘diagnose’ problems, but use their hands to ‘feel’ for things to ‘correct’. Their Latin motto, In Manu Vis Medendi, means ‘in the hands is the power of healing’.
These sort of beliefs would appear to be the root of the sort of claims that Simon Singh was disputing. Whilst there is some plausibility that a chiropractic back massage may help back pain, there is no good evidence that chiropractic subluxations exist and that correcting them allows general health conditions to be treated.
The McTimoney Association is quite explicit in its beliefs. Singh was questioning the role of chiropractic in children. McTimoney’s believe that the act of birth harms children and that chiropractic can correct birth problems:
Birth is probably one of the toughest events we undergo as humans. A baby’s head has to squeeze through a small birth canal to be born. In doing so the baby’s head in particular will absorb much of the shock, and the soft bones will yield slightly allowing it to travel down the birth canal. This is called ‘moulding’. After birth the baby’s head will gradually revert to a more normal shape. However, if this ‘unmoulding’ doesn’t take place completely, the baby can be left in some discomfort which they are unable to communicate.
Most babies cope extremely well with the process and emerge contented, happy, able to feed, sleep, and grow normally. However, for some, the recovery can take longer, especially those who had a particularly difficult entry into the world and these babies may show some, all, or a combination of the following signs:
- Irritability, fractiousness
- Feeding problems
- Continuous crying
- Sleeps little, difficult to settle
- Colic, sickness and wind
All of these could indicate that there is a misalignment in the baby’s skeletal system and that the baby is uncomfortable as a result.
Evidence for this is of course lacking. It’s nonsense.
Of course birth is not the only problem, but growing children also suffer “simple bumps and tumbles associated with growing up can often cause misalignments of the skeleton”. Naturally, only chiropractors appear to be able to detect these problems. There appears to be few childhood conditions that a good bone rub can’t help:
There is also a range of problems which cannot necessarily be associated with a bump or fall, but which may nonetheless be due to bony misalignment and the subsequent interference with nerves. There are many recorded incidences where treatment has been beneficial for the following symptoms:
- Some childhood asthma
- Learning difficulties and behavioural problems including:
- Poor concentration and inattentiveness
- Fidgeting and difficulty sitting still
- Hyperactivity
- Vunerability [sic] to infections including:
- Ear infections
- Repetitive colds
- Sinus and dental problems
- Clumsiness or poor co-ordination
It would appear that a huge source of bogus* chiropractic claims come straight from the (undoubtedly sincerely held) beliefs of the McTimoney’s.
Amazingly, the McTimoney School offers a MSc in Chiropractic Paediatrics. This postgraduate degree is underwritten by the University of Wales. You can also gain a similar MSc in crunching the bones of animals as well as babies. The University validates these degrees and presumably passes them as meeting acceptable standards. What these standards are though must surely exclude having a sound scientific basis. It is the GCC that assesses the content of the courses. We may not expect the GCC to be too harsh in assessment – its own survival depends on the survival of the college. It may also be worth noting that the McTimoney College Principal, Christina Cunliffe, is on the Education Committee and General Council of the GCC.
Without the degree awarding body of the University of Wales endorsement of these courses, students could not join the GCC and subsequently practice as Chiropractors. By underwriting the claims that chiropractic can treat colic, the University has allowed this whole affair to happen.
Recently, Universities have been attacked for offering bogus* science degrees in pseudoscientific subjects, such as homeopathy. Many courses have closed as a result. This does not harm homeopaths too much; most learn their trade from private unaccredited schools.
Somehow, the Chiropractic degrees have escaped this scrutiny. I do not think that will last. And if similar decisions are made in places like the University of Wales as has happened elsewhere, the very future of chiropractic in the UK will be severely threatened.
Chiropractic statutory regulation has given this form of quackery* great strength. But that strength may well be turned against itself and be the undoing in the long run.
* Deliberate deception not implied.
I am in my late 60s and go to a massage therapist on an occasional basis when I have severely taxed my muscles. Her take on chiropractic is the muscles which may have caused misalignment of vertebrae (which may not be true) are left untreated by chiropractic manipulation. By relaxing the overused muscles, my back and leg pains are diminished. After that I am given quite a set of stretches and exercises to maintain muscle tone and flexibility. I don't even think chiropractors are qualified as decent massage therapists.
The massage solves the problems for the extant case, but I must return infrequently for further help. Part time farming, although physically and psychically rewarding, is not without its exertions.
This is by my own doing and choice. The treatment provided includes education on what was injured (I know why). I have never perceived chiropractic as a profession that educates its customers.
You make an excellent point that these degree courses exclude scientific method. They must also dismiss teaching of Evidence Based Medicine. Of course if the practitioners of chiropractic had to learn these topics they could legitimately be accused of fraud in addition to offering bogus* treatments.
*As defined by any reasonable dictionary and not by Eades.
Maybe we should all support Simon Singh by agreeing with him:
Short version:
The BCA happily promotes bogus treatments.
Long version:
In their ignorance, the BCA promotes treatments for which there is neither evidence for any effect, nor a mechanism by which it could work.
Simple fact. Repeat it often. They can't sue us all.
See you in court :D,
BillyJoe
Here's the programme specification from the University of Wales for the McTimoney MSc in Chiropractic Paediatrics:
http://www.wales.ac.uk/resources/documents/PDF/MSCCHIROPRACTIC(PAEDIATRICS).PDF
Apparently by the end of the programme students will have the necessary skills to "ensure the precise identification and correction of the chiropractic subluxation".
Could we find a name of someone high up in the University of Wales to complain to ?
I've got a local chiropracter 'Dr' in my sights. Australian graduate.
The Chiropractic Council website shows quite energic disciplinary procedures. The really believe it,
Unfortunately, no… it seems that the chancellor of the university is the Quacktitioner Royal.
http://en.wikipedia.org/wiki/University_of_Wales
Well if it is anything like the validation of Nutritional Therapy by the University of Wales ('Another worthless validation . . . ;), this could be interesting. I'll send off the Freedom of Info requests tomorrow. Now that the Information commissioner ruled in my favour, they will find it hard to refuse.
What about the Anglo European College of Chiropractic in Bournmouth? http://www.aecc.ac.uk/ The BCa recruit most of their members from this college.
Degrees are awarded by Bournmouth University and include a paediatrics Msc.
But there is also a free lance 'short'{4 weekends!] paediatrics course run by a 'Dr' Steve Williams. http://www.stjameschiropracticclinic.co.uk/pages/SeminarSouthampton.php
If a chiro can 'learn' paediatric chiro skills in four weekends why would any of them bother to take a Masters? What kind of double standard is this?
Dizzyblonde
I should first point out that I am a practising chiropractor. It is highly unusual for me to get involved in internet blogs or forums as, no offence intended, I have much better things to be doing. However, occasionally I come across one that leads me to post a comment, in an attempt to try to balance the argument. Of course, such sites are not renowned for their objective thinking (neither incidentally are many chiropractors that I have the misfortune to call my colleagues). The first comment by the anonymous author has shown a gross misunderstanding of what the manipulation of joints as carried out by chiopractors, osteopaths and some physios actually achieves (evidently the massage therapist to whom he/she refers is equally ignorant). There is ample research to justify the use of manipulation of the spine, both in the lower back and the neck, for certain conditions and for certain populations of patients. As we learn more about how to classify these patients and conditions more accurately, we are able to provide a more balanced package of care to those patients. Does this mean that we "crack" every patient that comes through the door? No, not in any reasonable clinic. Does this mean that when we manipulate patients we do nothing else? No. The fact that the recent NICE guidelines recommend spinal manipulation for certain types of patient (as do the RCGP guidelines) should tell you something about the rigour of the available evidence.
This may be a point of some digression, as the bulk of this page appears to be concerned with the chiropractic management of paediatric patients. I don't personally treat children (other than older children for musculoskeltal problems, injuries etc) but I am forced to concede that the evidence for chiropractic management of colic, as an example, is lacking. There are studies that have shown a positive effect, but most of these have failed to include a control group (for comparison of natural history) and a placebo group. This makes it very difficult to draw any conclusions of any meaning. There is a study published in 1999 which showed a positive benefit of chiropractic in the treatment of infant colic versus a placebo group (I forget the "p" value but it was statistically significant); unfortunately this article appears to have been published in abstract form only (god knows why) which means that I cannot grade it for methodological quality. Thus, this article, although it may have been a high quality study, cannot enter into the current debate. What has become clear from the evidence is that taking a colicky infant to a chiropractor has a very high chance of resulting in an improvement of the symptoms. Whether this effect is placebo or not still remains to be clarified, but I feel that, from a humanitarian rather than staunchly scientific view, it would be a shame to remove this option for parents who are struggling to bond with their child as a result of continuous crying. We are in danger of turning this situation into a witch hunt. Saying that, it falls to the chiropractic community to carry out the necessary research to either confirm or refute their belief(s) (I shudder to use the word "belief" as I feel it has no place in healthcare, but couldn't think of a better one at the time)… cont below
… cont.
Another of my concerns regarding some of the posts is the implication that a chiropractic qualification is equivalent to a "bought off the internet" degree which fails to provide students with the critical thinking skills and clincial knowledge required to enable them to stand alongside other health professionals in scientific debate. This stance is nothing but total fallacy (although I can't speak for the McTimoney College, as they have battled with accreditation by the GCC for a long time). The course at the AECC (Anglo-European College) is closely formed around an evidence-based attitude, where students are taught and encouraged to engage in critical evaluation of available evidence. They are also taught about research methods, statistical analysis and literature searching in order to enable them to achieve this. Further to that, and this may be a critical point, they are taught how to carry out assessments of patients with a view to correct diagnosis of their condition. This separates the chiropractic graduate from some other forms of complementary healthcare. Chiropractors are also required, in order to maintain accreditation, to carry out CPD by attending seminars etc. Unfortunately, there are practitioners out there who seem happy to ignore all this high quality training in favour of a cult-science type approach. However, these are by far the minority and should not be implied to be the rule.
I apologise for the length of this comment and I hope it is taken in the spirit which it is intended. I would like to conclude by saying that, although I feel that Simon Singh could have chosen more appropriate words in his article in the Guardian (which forms the catalyst for the situation in which we now find ourselves), I agree with the general sentiment that libel laws should not, within reason, be used as a weapon in matters of science. It is unfortunate that we are now in a situation where this issue has become a somewhat personal battle between Simon Singh and his supporters, and the chiropractic profession. I hope we don't throw the baby out with the bathwater (no pun intended).
Thank you for your constructive comments.
I have no doubt that chiropractic can help somewhat with lower back pain. Whether it is an appropriate treatment though is a very different matter.
This post is about something quite specific:
– the lack of good evidence base for treating children
– the pseudoscientific nature of McTimoney teaching on chiropractic
– the fact that an MSc in paediatric chiropractic is being offered
– the fact that this MSc is underwritten by a University
And so the question: should a University be underwriting a MSc in a subject that is based on pseudoscientific principles and where there is no good evidence that the methods taught are effective and where there may be risks to a children?
Those are the quesitons that need addressing.
Regarding your final point, to what risks are you referring?
I am not aware of any risks that chiropractic causes to children. I have seen firsthand problems resulting from drug side effects though. When looking at what a parent's options are, I would go with the least invasive, most natural treatments first, and then try the medical route if those don't work. Besides, other mother's have reported some pretty amazing results from chiropractic care for their children. Just because I don't understand how it works doesn't mean I'm going to discount it. Plus, I live in America and the chiropractic curriculum here looks as good as med school, just a different focus:
http://positivemotionchiropractic.com/downloads/How-Well-Educated-Is-Your-Chiropractor.pdf
The MSC is a three year course with a dissertation at the end. Steve Williams course is a seminar teaching a technique. Steve is on the Board of the GCC and obviously believes as I do that having spinal joints that move symmetrically mean receptors are been activated symmetrically and this enhances health.
My evidence I started off reading the evidence and tried things; Now I have four children who never had any medicine. That is not to say if they got run over by a car or contracted meningitis I would not seek medical treatment. I just dont rate the biomedical model so highly at promoting health which after all is hardly an exact science anyway, look at chiropractors as personal trainers who enhance the function of the spinal joints, nerves muscles etc and who knows what else.
Chiropractors should not claim to treat anything, but they do because many have been trained to think medially and focus on symptom resolution. Chiropractors love preaching to the converted, these discussions will help the profession to look at how they present themselves.
I have no doubt the AECC is the best chiropractic college in the world (I have visited 12)and I suspect the chiropractor posting above is a tutor from there its rather depressing they don’t use their names for fear of saying the wrong thing and not doing what the BCA lawyers want.
I would say to any of you check out the AECC, if I have a criticism of the course its that they have tried too hard to make it like a medical degree.
I've just started study at the McTimoney college in Abingdon and am 6 months into my first year of the 5 year program. As you can imagine i meet this recent development with mixed views. On one hand i'm glad the profession and my college along with is members are pushed into a corner to consider how we can conduct ourselves from now on to help the profession and ratify what we all believe as students and regular patients of Chiropractic; It has a place in modern healthcare and helps give many individuals relief from disscomfort. The scientific basis to the course, which has recently been altered to fullfill the GCC requirements, is a great comfort to me and contradicts the earlier post of 'pseudoscientific' training. The college has worked very hard to evict the sandal wearing, tie-dye image of Mctimoney but unfortunately like with most things it takes time. Persecution always comes from lack of understanding and i intend to make it my responsability to, where possible, not tell tales on the bullies but face them head on and try to answer whatever questions they want to ask. For now i don't have the answers and i may never have them, but what i do know is that 15 years ago as a teenager i first walked into a chiropractor's practice with low back pain that left me almost fainting with pain and after my visit i didn't. You may argue that any therapy may have helped but many didn't including pysiotherapy. If it works for the patient and the practitioner is carrying out the treatment in a safe manner under safety guidlines and in good faith that what they are doing is going to be of benefit to the patient, all i can see that needs to be addressed is a poorly advised p.r campaign. As for court action as opposed to evidence submission to feed the appetite of the hungry villagers on their witch hunt… sometimes the monkeys need to grind the organ and tell the organ grinders – 'rather than concentrating on observing the practice of their members so closely perhaps they need to regulate their own actions for the sake of everyone'… please…
Blogger you are a moron, and Richard Lanigan is correct.
As for your name, you discredit it, so I don't really care what it is, and I'm not sure why you are so filled with venom and hate for something you know nothing about – obviously your atlas is up your arse.
As a consumer of the chiropractor profession, I have had very good experiences and so so ones. My best experience was when my daughter (ten months at the time? I think?) was being watched by a specialist because she wasn’t reaching the milestone of the sitting position in the time that she should have. I heard about a GP that did manipulations on babies and I thought I’d see if that could help. The Doctor did some manipulations and by the next day she was sitting. Also I had a very bad pregnancy with my son and went to a chiropractor when I was in hospital before he was born. I couldn’t stand the pain in my back. None of the hospital staff seemed interested in my back pain, therefore I went to see if he could help. The chiropator wasn’t keen to do anything but he did do a small amount. The small amount was enough to take away most of the pain. It helped a lot! My reason for saying all this is I agree that there needs to be evidence to support a practice so people are not doing something blind, but to be honest all people in the health profession are “known” in a community as good or not. As was the case with the people I’ve used. So if their work works, people go to them and it soon gets around. Word of mouth and reputation I believe is a powerful aspect to any profession regardless of letters or what type of letters at the end of a name (no disrespect to those who have worked hard to get those letters just saying it as it is).
Ear infections are typically caused by fluid build up in the middle ear. The Eustachian tube is constricted not allowing fluid to drain out of the ear and into the back of the throat. The Eustachian tube is a muscle and can become constricted if the nerves innervating it are compressed in anyway. To get to the root cause of the problem, you should address the cervical plexus (C1-C4) for subluxations.