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Chiropractic in a pickle

Edzard Ernst considers the latest analysis of the evidence for chiropractic and finds little succor for practitioners who claim it can treat asthma and otitis media.

About one and half years ago, when the British Chiropractic Association (BCA) decided to sue my friend Simon Singh, many claims made by UK chiropractors were called into question, e.g. those related to asthma, otitis media, enuresis and infant colic.

Several people complained to the General Chiropractic Council (GCC) about hundreds of its members making unsubstantiated claims on their websites. Thus the GCC decided to commission a mega-review of the ‘effectiveness of manual therapies' [1]. This, they hoped would answer the question whether or not these claims were, in fact, ‘bogus'.

The report was recently published. It turns out to be an assessment of the RCT evidence not of chiropractic specifically but of 1) manipulation, 2) mobilization and 3) massage therapy for any human condition.

Here are verbatim extracts on what the report says about the conditions disputed in the BCA libel case:

• ‘Spinal manipulation is not effective for asthma'

• ‘In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation'

The authors also write ‘anyone in medicine today who does not believe in evidence-based healthcare is in the wrong business.'

All of this puts UK chiropractors in a bit of a pickle, I think. Not only is that report (written by North American chiropractors) not at all helpful for the BCA's libel action, it might also mean that the GCC has to somehow reprimand hundreds of its members who made these claims. Worst of all, the GCC might have to reprimand itself for having posted some of these unsubstantiated claims on their own websites.

Not a jot of evidence? I wonder.

Edzard Ernst