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The General Chiropractic Council clarifies its position on subluxation

Professor Edzard Ernst looks at the council's latest guidance - and its implications for complementary and alternative medicine as a whole.

The General Chiropractic Council has just published new 'Guidance on claims made for the chiropractic vertebral subluxation complex'.

'The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.

Chiropractors are reminded that:

• they must make sure their own beliefs and values do not prejudice the patients' care (GCC Code of Practice section A3)

• they must provide evidence based care, which is clinical practice that incorporates the best available evidence from research, the preferences of the patient and the expertise of practitioners, including the individual chiropractor her/himself (GCC Standard of Proficiency section A2.3 and the glossary)

• any advertised claims for chiropractic care must be based only on best research of the highest standard (GCC Guidance on Advertising issued March 2010)'

This is a remarkable repositioning not just on subluxation but of the UK chiropractic profession as a whole. It seems to be a clear break with the traditional philosophy of chiropractic assuming that most human conditions are caused by subluxations of the spine and are thus treatable with spinal adjustments.

The existence of spinal subluxations has never been established. Thus chiropractic was built on sand.

The new position seems to more or less admit that and is an attempt to render chiropractic evidence-based. It has to be seen, I think, as the direct consequence of the British Chiropractic Association losing their libel suit against Simon Singh. The case prompted several sceptics to pursue UK chiropractors for making what they considered unsubstantiated claims. Thus the GCC have around 600 complaints to deal with - which are predicted to be very costly.

As I have stressed before, all of this has huge relevance for the future of CAM in the UK and probably elsewhere as well: the times where any CAM practitioner could make any bogus claim and hope to get away with it seem to be over!

Professor Edzard Ernst Professor Edzard Ernst