When my sister visited a chiropractor in Singapore during her pregnancy, I thought I'd do some research into what chiropractic involves so I could better advise patients. In particular, I was focused on the scientific evidence behind chiropractic, which allows a doctor to confidently justify that an offered treatment can result in a beneficial result.
1. What is chiropractic?
Chiropractic was invented by D. D. Palmer in 1895 when he adjusted the spine of a deaf man and supposedly restored his hearing. Based on this case, Palmer proposed that all disease was due to spine misalignment, resulting in nerve interference.
Chiropractors claim to manipulate their patients' spines to cure nerve interference and restore health.
2. Chiropractors are not medical doctors
As pointed out by the Straits Times article, chiropractors are not registered medical practitioners, and receive no formal medical training in a hospital environment.
Essentially, they are addressed as "doctors" because "'Doctor of Chiropractic" is the name of the degree that is conferred on them after 4 years of study. In Singapore, the chiropractic industry is unregulated and classified as alternative medicine.
3. What's the controversy with chiropractic?
Primarily because some practitioners claim spinal manipulation can treat a range of medical conditions, including asthma, allergies, migraines and diabetes (most of which have little or no evidence).
There are also concerns about the safety of using spinal manipulation to treat neck and back pain.
4. So what can chiropractors actually help with, based on evidence?
Research on spinal manipulation is inherently difficult, because double blind studies are impossible and a placebo response is hard to rule out. In simpler terms - a lot of the derived benefits from chiropractic may be psychological, as it's difficult to perform proper studies where spinal manipulation is concerned.
So far, there is no supportive evidence that chiropractic can maintain health or prevent disease.
There is however good evidence that spinal manipulation is effective for some patients with lower back pain, although the same study concluded that it is no better than other existing treatments, such as physical therapy and exercise.
5. Chiropractic can have harmful side effects, which include stroke and death.
Several hundred cases have been documented of patients seriously harmed after spinal manipulations. The most recent news was that of a 32-year-old woman from Jakarta who died after being treated by an American chiropractor.
Up to 50% of patients report short-term increased pain after spinal manipulation. A much more serious complication which has both been reported and studied is that spinal manipulation in the neck can injure your vertebrobasilar arteries, causing stroke, paralysis, and death.
For the full list of references and summarised studies quoted, you can hop over to this link here. This article by a former chiropractor, providing an inside perspective of certain practises within the industry also makes for excellent reading here.