There are few areas of healthcare more heavily debated than the value of chiropractors. Once firmly centred among the “alternative” medicines, some elements of Chiropractic have been recently found to marginally aid lower back pains and some studies have inconclusively shown a potential for aiding with neck pain, and potentially even some forms of migraine.
Armed with this new legitimacy from what is termed “standard medicine” Chiropractic practices are springing up around the country in increasingly larger numbers. Whether they have any value however is difficult to determine and to some researchers, the risks associated with these alternative practitioners are extremely high.
What do chiropractors do?
To understand whether a trip to a Chiropractor would work we must first understand what they do. The basic description centres around spinal manipulation. Chiropractors believe that every part of the body is connected to the nervous system, that the spine is the nervous system’s superhighway, and therefore by manipulating it to correct errors you can alter health in any body part through its nerves.
“There isn’t a cell in the body that isn’t in some way connected to the nervous system,” explains practising South African Chiropractor Susan Goslett. “Nerve interference can result in altered messages being sent to different organs and muscles, which means they no longer function as they were intended to. By restoring normal alignment in the spine we allow nerve messages to flow without interference.”
It is an intriguing proposition, but one even Goslett says is more complex than the simple description.
“Of course, the messages being sent from the nerves are only one aspect of health. One also has to look at diet, lifestyle, and genetic conditions to truly heal any kind of ailment. Caring for your spine and ensuring that the correct messages are reaching your cells is only one part of ensuring you maintain a healthy body,” she says.
To back up Chiropractic theory, there is some medical evidence that spinal adjustments may in fact aid with lower back pain.
A 2018 study published in JAMA Network Open enrolled 750 active-duty military personnel in the United States, who complained of back pain. Half were randomly assigned to receive usual care (including medications, self-care, and physical therapy) while the other half received usual care plus up to 12 chiropractic treatments.
After six weeks of treatment, those assigned to receive chiropractic care, reported less pain intensity, experienced less disability and more improvement in function, reported higher satisfaction with their treatment and needed less pain medicine.
While study subjects knew which kind of treatment they were receiving, and therefore were eligible for the placebo effect, and were mostly young and the study did only last six weeks, the study’s findings are backed up by a 2016 research review in the journal PLoS One, which concluded that “chiropractic care works as well as physical therapy, a staple treatment medical doctors would prescribe for low back pain, with few negative side effects”.
Similar small studies have also pointed to a potential for Chiropractics to aid in neck pain, or even potentially some kinds of migraines, but there is nothing conclusive on this front.
History of chiropractic
Chiropractic (as it is known) was founded on September 18, 1895, when a “magnetic healer” named Daniel David Palmer, met a deaf janitor named Harvey Lillard in Davenport, Iowa. Palmer claimed they had an extensive conversation about how Lillard’s hearing could be repaired by adjusting his spine, which subsequently appeared true when “with a crack of the back”, the janitor suddenly found his hearing cured.
This new medicine was subsequently developed into a healing art by Palmer who held séances to contact a dead physician named Jim Atkinson as detailed on Palmer’s own book The Chiropractor:
“The knowledge and philosophy given me by Dr. Jim Atkinson, an intelligent spiritual being, together with explanations of phenomena, principles resolved from causes, effects, powers, laws and utility, appealed to my reason. The method by which I obtained an explanation of certain physical phenomena, from an intelligence in the spiritual world, is known in biblical language as inspiration. In a great measure, The Chiropractor’s Adjuster was written under such spiritual promptings.”
In a video on her website, Goslett claims to aid, “Babies suffering from colic and reflux, feeding and latching issues and all the developmental things that can happen through your childhood”.
Independent studies conducted by mainstream medical organisations and universities on these sorts of chiropractic claims that they are able to heal illnesses as broad as those of the organs, allergies or learning difficulties repeatedly show that there is zero effect from Chiropractic manipulations on these illnesses and some even find that the practice can actively cause harm.
Goslett is however convinced and is happy to explain how Chiropractic is able to aid children with various behaviour or developmental difficulties and the causes for them.
Despite these claims, there have so far been no scientific studies that prove chiropractic therapy can help kids with ADHD or learning issues. Of the studies conducted on chiropractic therapy for kids with ADHD, the results have been inconclusive.
What is known however is that what chiropractors believe about the cause of learning and attention issues is not consistent with what experts have discovered. For example, experts and scientists know that the bones in the skull don’t move. This is contrary to what chiropractors say about chiropractic adjustment helping develop the brain.
The proven dangers of Chiropractic
Sam Homola, a licensed chiropractor and the author of Bonesetting, Chiropractic, and Cultism, wrote in an article at Science-Based Medicine, “Spinal manipulation has the potential to injure the spine of a child. A systematic review of 13 studies published up to June 2004 uncovered 14 significant manipulation-related injuries in children up to 18 years of age, 9 of which were serious (e.g., subarachnoidal hemorrhage, paraplegia) and 2 of which were fatal (one child died from a brain haemorrhage and another from dislocation of the atlas following neck manipulation).”
But it’s not just children who can potentially be harmed. A particularly damning warning was issued by the American Heart Association in 2014, in which it was stated that getting your neck adjusted by a chiropractor or osteopathic doctor may make a person between three and twelve times more likely to have a stroke.
Arterial dissections occur for a number of reasons, including car accidents or sporting events. Two pairs of blood vessels in the neck, known as the cervical arteries carry blood to the brain. A tear in the lining of one of these vessels called a cervical artery dissection, is rare, occurring in just one to three in 100,000 people per year, but doctors at the AHA have cautioned that these could be more common in people who have undergone the rapid jerks and thrusts of Chiropractic neck adjustments.
To date, more than 30 cases have been reported worldwide of people dying from cervical artery dissections that occurred soon after undergoing chiropractic neck adjustments. For their part, Chiropractic associations have countered that the dissections may have been the very reason patients had been feeling pain and sought out assistance, thereby distancing themselves from the accusations, but not helping the perceived power of a chiropractor to make an accurate diagnosis.
In July 2022, a student in Georgia, USA, Caitlin Jensen was paralysed on the right side of her body and lost the use of her vocal chords after a chiropractor manipulated her neck, and tore four blood vessels resulting in a stroke and cardiac arrest. The case made national news in the states, but few know that more than a year later, Jensen still can not walk or swallow, though she has begun to haltingly speak again.
It is impossible to know how truly common these sorts of events are, as there is no formal tracking system anywhere in the world, and most court cases are settled out of court. Caitlin’s mother Darlene Jensen has been quoted in the media saying that the insurance company for the chiropractor paid the malpractice claim without disputing it. One study of over 50 000 cervical spine manipulations found, however, that 16 out of every 1000 resulted in the signs of minor artery dissections being fainting, dizziness and lightheadedness. For their part, chiropractors often say that arterial dissections are usually the reason people visit them and not the result of that visit. The counter to which is clearly that doctors should be doing a thorough analysis of their patients to diagnose such dangerous conditions as an arterial dissection before further manipulating the neck or spine.
Ultimately, the studies show that receiving any kind of complication occurs in less than 2% of cases. For those who swear by their chiropractic manipulations, perhaps this is a risk that people are still willing to take. The caution, of course, is that in severe cases, such manipulations could alter their abilities and quality of life forever or even, result in death.
