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Chiropractic 'can be deadly'

GPs should not refer patients for chiropractic treatment as there is evidence it is dangerous and potentially deadly, a leading expert in alternative medicine has warned

Professor Edzard Ernst, professor of complementary medicine at Peninsula Medical School in Essex, found 200 patients who had been seriously harmed by spinal manipulation, the main chiropractic treatment, since 2001. Additionally, up to 61% of patients who used the treatment experienced milder adverse effects.

Professor Ernst suggested that the figures could be even more damning as underreporting of adverse events was close to 100% among chiropractors. 'In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation. It carries an inherent risk,' he said. 'GPs should assess the evidence for effectiveness and safety of spinal manipulation critically. In my view, it does not justify referrals to therapists who use spinal manipulation.'

Professor Ernst conducted a systematic review of all of the papers published since 2001 on spinal manipulation. A significant number of the studies showed a 'certain' causation by spinal manipulation of serious adverse events, such as ischaemia of the spinal cord or arterial dissection. A number of these events led to serious long-term conditions, such as severe neurological deficit, stroke or paraplegia.

Dr Barry Lewis, president of the British Chiropractic Association, said the causative link was unproven. He said: 'Professor Ernst has taken low-level research and made a big, sensationalised deal of it. It's the same as saying we should stop giving vaccines because people have a sore arm afterwards.'

He added: 'NSAIDs are 2,500 times more risky than spinal manipulation. I would urge GPs and patients to look at the evidence to see that chiropractic treatment is safe and effective.'

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