Tuesday, February 17, 2009

Pediatric Chiropractic


The Wellness section of the paper, section C of Feb. 16 edition, had an article on chiropractic and children. That it can improve infant sleep. They talk about the nerves leaving the base of the brain and adjusting them helps babies sleep better. Really? Then there was some anecdotal claims by happy parents and some article published in the chiropractic literature. In the chiropractic own literature on pediatric manipulation a review article called “Chiropractic Manipulation in Pediatric Health Conditions – an updated Review” authored by Allan Gotlib and Ron Rupert published 12, of September of 2008 of Chiropractic and Osteopathy states; “The health claims made by chiropractors with respect to the application of manipulation as a health care intervention for pediatric conditions continue to be supported by only low levels of scientific evidence. Chiropractors continue to treat a wide variety of pediatric health conditions. The evidence rests primarily with clinical experience, descriptive case studies and very few observational and experimental studies. The health interests of pediatric patients would be advanced if more rigorous scientific inquiry was undertaken to examine the value of manipulative therapy in the treatment of pediatric conditions.”
In a book published last year by Simon Singh and Edzard Ernst, MD (who holds the chair and first professor of complementary medicine at the University of Exter in the UK) states in a review in 2006 of the worlds literature Published in the Journal of the Royal Society of Medicine in a paper entitled “A Systematic Reviews of Spinal Manipulation” large range of conditions, pediatric and adult, concluded that spinal manipulation was ineffective. One review of chiropractic manipulation could be effective when used in combination with standard treatments. However, the combination effect is hard to disentangle and say anything significant from this. They also showed that chiropractors tend to generate more optimistic conclusions than scientists, maybe because they have an emotional investment in the result. All in all the evidence was insubstantial in the author’s words.
The history of chiropractic is long and interesting. There were mistakes made by the medical profession in dealing with it early. But as for misaligned spines causing other medical ailments then we should expect to see people with back problems to suffer with other ailments. In 1995 Donald Nansel and Mark Szlarzk at the Palmer College of Chiropractic found no sign of this in the large body of published medical literature. They said in their work; “There is not the slightest suggestion that patients suffering from severe primary mechanical low back pain, are more prone to develop higher incidences of prostate or testicular carcinoma, colititis, ovarian cysts, endometriosis, pancreatitis, appendicititis, diabetes, melitis, or any other category of regionally or segmentally related organ disease. In a follow up study two years later they failed to find any evidence that theses disease were more likely in patients with broken necks or backs. And this comes from the Harvard of Chiropractic schools.
So I would take the article, published with good intentions by our local paper, with a very large grain of salt.

The Skeptical DoDo


Brad Borkhuis said...

In rebuttal to the Op-Ed Piece submitted by Dr. Stripe I must first address two issues, first I am a primary critical thinker and second, the article was written about my wife so I must admit a logical bias to her but will submit logic to contradict your statements.

Dr. Stripe cites the statement regarding the benefit to pediatric that “The evidence rests primarily with clinical experience…” and my response to that would be, of course it does! What better way for someone to evaluate care than with results. The primary employment for a chiropractor is to help patients in a practice, not to do research or hold chairs. Thus the opportunity for focused research writing is limited but then again would we not want them helping people get results as opposed to gaining standing in academia?

In regards to the statements made by Dr. Stripe in regards to the Chiropractic article he is attempting to throw mud and confusion on a field that has continued to show results. If you want proof, look at the highly skeptical insurance industry. They currently recognize a Dr. of Chiropractic as a primary care physician, the same as an MD. Your position is not wrong in stating the fact that there is limited published research, it just ignores the fact that the “anecdotal claims by happy parents” are because of results and that is what my wife and yourself are paid hard earned money to produce.

Your ignorance of the science and procedures behind chiropractic lead you to make inferences that since there are not large scale studies that there are no results. Remember as a former market research analyst I know statistics and studies can be manipulated to show nearly any result. I recommend that all of those satisfied patients of the great chiropractors call you at your office and let you know loud and clear if they are more skeptical of chiropractic or the medical “establishment”.

Remember, skepticism and critical thinking are good, ignorant skepticism with a defensive posture is not so productive.

To my wife and other great chiropractors and medical doctors, continue to focus on listening to the patient and providing them your minds and hearts on the way to a healthy lifestyle.

Anonymous said...

In response to the comment. I appreciate you statements. Couple points however, The Minot Skeptical Society purpose to look critically at ideas not people. So if you think this was attacking your wife, I apologize, it wasn't. Next the insurace industry like government is subject to political critique, not the hard cold critique of scientific investigation. Next ancedotal evidence is not scientific evidence,it is a poll and it is a demonstrated fact, scientifically, that ancedotal evidence is poor at best. So satisfied customs just means they are satisfied, not that it works. For example there are satisfied people that voodoo works, but only to the point of placebo. Placebo is a valid scientific concept and it has an effect of up to 30%. That is why when medical studies are done they have to show more effect than what can be accounted for by placebo. Now there is some evidence that chiropractic has effect for back pain. I didn't mention anything about that, I believe that chiropractors do a better job than we MDs with back pain. We do listen to patients, but we have to provide evidence based medicine not wishful thinking. Again I thank you for your comments.
Skeptical DoDo