Beware the Spinal Trap
The substance of the following article by Simon Singh was printed in the Guardian last year. The British Chiropractic Association decided to sue him for his trouble. The offending paragraphs can be found at Jack of Kent’s Blog
Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.
You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.
In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.
You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.
I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.
But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.
In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.
More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.
Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.
Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared:”Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”
This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.
If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.
No commentsMy Hottest 100 Top Ten
Because everybody just has to know and there aren’t enough top ten lists on the internet. No order except for #1
- 1. Nick Cave & The Bad Seeds – Mercy Seat
- John Lennon – Imagine
- 10cc – I’m not in love
- U2 – Sunday Bloody Sunday
- David Bowie – Ziggy Stardust
- Peter Gabriel – Games Without Frontiers
- Bob Marley – Redemption Song
- Rufus Wainwright – Hallelujah
- Muse – Knights of Cydonia
- XTC – Dear God
- (last song reluctantly culled) The Pixies – Monkey Gone To Heaven
I’m sure they’ll all be different in a week. I just want the tickets to Reading. Some happy but fuzzy memories of Reading 2003 with the Darkness, Blur and Metallica, all of whom just missed out on being in the list above. I’m sure they’ll be gutted.
No commentsOff up/down the Nile
It depends on whether you’re considering compass direction or fow. But I’m off on the overnight train to Aswan in a couple of hours. From there I will be doing/seeing:
- Abu Simbel/Lake Nasser
- A 3 dy, 2 night Felucca trip north from Aswan towards Luxor
- Seeing the Valley of the Kings and Valley of the Queens on the West bank at Luxor
- Seeing Karnak on the East Bank at Luxor
and then I’ll be getting another train up her to Cairo where I’ll be off to see some of the things I missed this week and to go back to the Museum. I don’t know what sort of internet access I’ll have while I’m away but I should be twittering away happily.
No commentsPyramids Sound and Light Show
So after I came down from the roof it was time to head over to the sound and light show. I was pretty tired by now, but I’d had my expectations suitable lowered by my guide book and other travellers. But low enough for guys in Egyptian headdresses playing bagpipes badly? Tough call. But it happened, and it happened for nearly half an hour while they waited for it to get dark enough to begin the show. I’m afraid I was too overwhelmed by WTF to get any photos of that dismal performance.
The light show however when it started was a little more impressive.
Pyramid Light Show Crowd
Memphis: Elvis is not here
You know how I told you about the dodgy tour and driver. Well Memphis was one of the places he raved about. Turns out it was because he wanted to drag me to a dodgy kebab joint where I paid 60 quid for a bad kebab and 20 quid each for beers.
Before that ripoff, we went to Memphis, once the capital of the Egyptian Empire, now a tatty museum where all the pieces not good enough to be in the British or Egyptian Museum are. Except for a huge reclining statue of Ramses II. That was ok.
Ramses II Statue from the feet
North Saqqara: World’s first pyramid
South of Giza, just outside of Memphis is the vast necropolis of Saqqara, with many pyramids and mastabas and other ancient bits of rock. My driver was intent on just showing me the step pyramid but I was onto him by now and decided to have a good look around.
Having stayed outside at Giza, I was keen to crawl around inside the odd pyramid, and Saqqara offered a great chance to do this. I started off being accosted by an “Egyptologist” who wanted to show me around inside a couple of tombs. I took him up on his offer as he seemed quite knowledgable, unlike my horse guide at Giza who told me that the Great Pyramid was 500 metres tall.
So we wandered off and round a corner to this locked mastaba. A very desert looking guy shuffled up, produced a key and let us in. Turns out this was the tomb of twin noblemen, who’s high status was ensured because they were the King’s manicurists, as well as scribes and some other stuff, but the drawings and hieroglyphics on the wall were dominated by hands with neatly trimmed fingernails.
They must have gotten on ok as they were buried next to each other. You’re not meant to take photos but I grabbed a couple anyway since I knew I’d be paying for it in tips anyway.
Egyptian Nobles Tomb Painting
Sphinx: Horus of the Horizon
There, easy to get impressive post titles after 5 minutes in Wikipedia. Sphinx is the Greek name, Hor-em-akhet (Horus of the Horizon) is a later Egyptian name, no-one knows the real name. I tried saying “Here kitty kitty” but got no response. So that’s another mystery I haven’t solved.
Awesome Bloke in front of Sphinx
This post occurs directly after the last pyramid shot but that post was getting long and I was getting sloppy since I’d had 5 cans of Heineken from the off-license I found just down the road. Yesterday’s exploration was good and I have much better bearings for where I am.
No comments“I was full of dreams”
said Napoleon, “I saw myself founding a new Religion, Marching into Asia, Riding an Elephant, a Turban on my head and in my hand, the new Qu’ran.”
I want what he’s having! Egypt hasn’t quite grabbed me like that yet, though I’ve only been here a few days so maybe it creeps up on you. Anyway boys and girls, I’ve finally made it to the pyramid post.
Against my better judgement, and it seems the advice of the Rough Guide, I booked a tour through the Mayfair Hotel. As the Rough Guide says (paraphrased): Great place to stay, don’t book a tour there. In my defence, I’d just landed and had just been driven through Cairo traffic for nearly two hours.
And anyway, it wasn’t quite as dire as I was dreading so no harm done really. Up early to head off at about 8am, I arrived in the foyer to find my driver asleep, a state he was in for most of the remainder of the day.
He woke up long enough to rive me down to Giza. We hadn’t gone far when I got my first glimpse of pyramids in the distance. When we got a bit closer I stopped the driver so I could take this shot:
Giza Pyramids from road
Then the driver took me to some stables near the pyrmiofds here the hard sell was put on for a camel or horse trip. I started with a camel…
No commentsPlanes over the Sheraton Deira
So I’m not really a planespotter. Well not a good one anyway. But the Sheraton was on the flight path. And it was near the airport. And there was a swimming pool on the roof. And the pool had a bar. And the bar served vodka tonics. And the stereo only had one cd. And the CD was Bob Marley’s Greatest. So to cut a long story short, I took a lot of photos of planes.
Most of them were terrible, a few were ok./ They need better framing which I can’t be bothered doing. Here they are:
UPS Jumbo
Walking to Burj Dubai from Deira
This was a monumentally stupid idea. You can see from the photo in the last entry the two of the reasons why I should never have tried this. It’s a long way away and the air is full of sand and smog. The final reason is hinted at by the picture below. Duba is the domain of the car. I think I spent as much time trying to cross roads and work out which of 5 exits from an intersection was the one I wanted.
Burj Dubai from highway overpass - what was I thinkng!