Last month, a few fellow skeptics and I visited the Mind, Body and Spirit festival in Cork City Hall. It was quite an experience. There were shamans, psychics, angel healers, Scientologists, magic crystal sellers and prayer cults to mention a few. All flavours of the weird and wooful, along with plenty of people ready to part with large portions of their earnings to hear their dubious wisdom. It’s a bit like a visit to an expensive version of Harry Potter’s Diagon Alley, without the magic. Enough subject matter to keep us going for a year, without a doubt. I daresay we might talk about this further in future posts.
Nested in the middle of the exhibition were a number of chiropractic booths. They were professionally laid out and populated by friendly people who were eager to help any people who came along. Chiropractic is described as “a primary health-care profession that specialises in the diagnosis, treatment and overall management of conditions that are due to problems with the joints, ligaments, tendons and nerves, especially related to the spine”. That sounds medical. So, what was it doing in the midst of shamans, faith healers and angel channellers?
Chiropractic operates somewhat on the fringes of medicine. Some of its claims are pseudoscientific, such as the assertion by its founder that subluxations, or displacements in the vertebra, are responsible for 95% of all diseases. This is easy enough to refute, given that this statement seems to contradict all known studies into pathology, and to be fair, it may not accurately represent the philosophy of all modern chiropractic practitioners. Nevertheless many chiropractors have made health claims that extend outside their field of study (e.g. infant colic), and this has resulted in unwanted media focus and significant damage to the profession’s reputation. In a famous case in 2008, the British Chiropractic Association sued the writer Simon Singh for declaring such treatments “bogus” in a newspaper (they withdrew the claim in 2010 when Singh won right of appeal). In addition, the evidence produced by the BCA to support their main claims was shown to be scientifically questionable. There remains a significant burden of proof on chiropractors to demonstrate that many of their treatments work above what might be expected from normal healing processes.
Nevertheless, back pain is real. It’s a grinding, soul destroying problem afflicting a large percentage of people in the community at any time. It can often take a long time to resolve, even with the best medical treatment. There is certainly a case to be made for qualified caregivers to assist people through recovery using a variety of techniques such as advice, counseling, exercise, relaxation and massage, in addition to the normal medical pain management solutions. A visit to someone who will take the time to listen and give sensible suggestions on lifestyle changes to accelerate the healing process is unlikely to be detrimental.
It is probably the case that most chiropractors take the problems of their patients very seriously. It is also probably the case that an earnest chiropractor will look beyond the nonsense of subluxations and into the realm of hard medical facts when seeing ways to provide pain management solutions to clients. If chiropractors are seeking a “total solution” to patient wellbeing, then it would seem remiss not to include medical treatment in their toolkit of methods used to help patients. Many patients report improvements after visits to chiropractors, whether this be real or perceived. Indeed, many people who go to chiropractors defend them quite vigorously. The bottom line is that there appears to be a strong need in the community for such care, even if it is debatable how effective this care may be.
If professional caregivers are available to help people get through a period of back pain, if the patient is properly informed and if science is central to the treatment process, I’m not sure if this is something I would have much of a disagreement with. The issues I would have is with supposed remedies that are not backed up by any form of objective study, where treatments are being used that have little or no plausibility or evidence of efficacy, where the healthcare is spilling over into fields that have nothing to do with back-pain, where some practices involved are needlessly harmful, or where practitioners are trying their best to blacken scientific and medical knowledge in order to make patients more dependent on their own treatments or other alternative treatments. These issues are at the centre of many objections by skeptics.
This brings me back to my opening question. Where do chiropractors want to see themselves? If they truly see themselves as important primary care givers, then why maintain the attachment to pseudoscience? Why attend conferences with psychics, angel channelers and faith healers? Is it a marketing or a branding thing? Are such associations beneficial? Do chiropractors prefer to remain in the medical twilight zone, or do they wish to be seen as proper adjunct health-care professionals meeting what is certainly a need in the community?
Your comments are most welcome.