his post is the first for over a month, during which time I’ve been on the move in the UK, USA and Canada, teaching, seeing patients, and trying hard to remain focused, as the prospect of 3.5 months in Corfu (which I reached last week) loomed – just ahead – like a mirage of a cool oasis pool, to a thirsty desert traveller.
During this period a drama has been unfolding in the UK, as a major chiropractic organisation sued a journalist for libel. The BCA alleged that Simon Singh (writing in the Guardian newspaper) had alleged that chiropractic claims to successfully treat such conditions as ear infection and infant colic, were ‘bogus’.
The original article is no longer available on the Guardian site (doubtless for legal reasons), but numerous pro and con commentaries exist that contain extracts.
An example of an anti-chiropractic view can be found on the Quackometer website.
A more balanced view can be found on The Times Higher Education website.
An initial court ruling found in favour of the BCA, awarding damages, and Singh has now announced that he intends to appeal this judgement.
The whole furore has hinged on the interpretation by the judge of the word ‘bogus’, rather than on any attempt to analyse whether the claims by chiropractors have any foundation.
Prominent personalities (Stephen Fry, for example) have rallied to Singh’s defence, in the name of freedom of speech, while supporters of alternative, complementary and integrated health have been saddened by the failure of the process to allow intelligent analysis of the actual essence of the issue – can chiropractic care help conditions such as ear infection and infantile colic?

Do I have an opinion?
Well it seems to me that health enhancement involves a variety of possible influences – including biomechanical.
A brief search of available, easy to access, data, on research into chiropractic and health enhancement (outside of the obvious biomechanical, musculoskeletal arena) brought me the following articles that might be pertinent, and some of which might well have been part of the BCA defence of their position. Indeed as Singh is appealing the case, there might eventually actually be consideration of the real, underlying, in fact critical, question – can chiropractic enhance general health, and thereby encourage resolution of apparently unrelated health problems?

A brief literature search, limited to the last 3 years, using key words ‘chiropractic’ and ‘colic’ and ‘ear conditions’ yielded a selection of studies and reports, including the following:

  • Browning M Miller J 2008 Comparison of the short-term effects of chiropractic spinal manipulation and occipito-sacral decompression in the treatment of infant colic: A single-blinded, randomised, comparison trial Clinical Chiropractic 11(3:122-129.
  • Di Duro J 2006 Improvement in hearing after chiropractic care: A case series Chiropractic and Osteopathy 14:2
  • Hawk C Khorsan R Lisi A 2007 Chiropractic care for nonmusculoskeletal conditions: A systematic review with implications for whole systems research Journal of Alternative and Complementary Medicine 13(5):491-512
  • Hipperson A 2004 Chiropractic management of infantile colic Clinical Chiropractic, 7(4):180-186
  • Jamison J Davies N 2006 Chiropractic Management of Cow’s Milk Protein Intolerance in Infants With Sleep Dysfunction Syndrome: A Therapeutic Trial Journal of Manipulative and Physiological Therapeutics 29(6):469-474
  • Kingston H 2007 Effectiveness of chiropractic treatment for infantile colic. Paediatric nursing 19(8):26

The excellence or otherwise of these is not my focus, only the fact that they exist, which is enough to at least call into question Singh’s blanket use of the word ‘bogus’, with its’ connotations of fraud and deception.

The Hawk review paper (2007) contained a number of conclusions, amongst which were:
(1) The few reports of adverse effects of spinal manipulation for all ages and conditions were rare, transient, and not severe.
(2) Evidence from controlled studies and usual practice supports chiropractic care (the entire clinical encounter)
as providing benefit to patients with asthma, cervicogenic vertigo, and infantile colic. Evidence was promising for potential benefit of manual procedures for children with otitis media and elderly patients with pneumonia.

The Jamison and Davies paper (2006) was also insightful, since it makes clear that the ‘chiropractic treatment’ offered dealt with the issue of cow’s milk intolerance, with no mention of manipulation – only of a careful evaluation of possible dietary/invironmental influences that – if modified – might assist in health enhancement.
Singh seems to have failed to recognise that chiropractic is a health care profession, and that seeing a chiropractor does not necessarily mean that the patient will inevitably be manipulated.
This reminded me of a lecture I was asked to give on the subject of amino-acid nutritional supplementation, sometime in the mid-1980s, at Los Angeles College of Chiropractic, where I was a periodic visiting lecturer/tutor on soft tissue manipulation topics. Nutrition, lifestyle and general health maintenance was a major part of chiropractic training back then, and is today.

Since the judgement for the BCA has been appealed, it is to be hoped that at some stage the real issues will be evaluated in court.
Meanwhile the opportunity can be seen to exist for clarity to emerge as to just what chiropractic can offer in health terms, apart from its value in musculoskeletal care.

Conflict of interest note:
I am not a chiropractor, but have taught at some of the best chiropractic training colleges – and am happy to say that some of my best friends are DCs!

I once again apologise to blog readers for the lengthy gap in posts….caused by a tiring trip to the US and UK.
I am now back in blissful Corfu, where I am currently reviving!