General Chiropractic Council unable to cope with complaints

According to a letter shown to this blog, the General Chiropractic Council has written to complainants and chiropractors saying that it can not cope with the number of complaints it has received (590 last month compared with 40 per year).

The GCC have stated that

it will be necessary to increase our regulatory staff capacity before we issue formal notification of any complaints relating to chiropractic websites.

The lack of staff will delay the commencement of the formal process until September 2009. The increase in complaints was due to the British Chiropractic Association's attempt to silence criticism about claims for chiropractic being an evidence-free zone.

If the BCA had been a bit less foolish, it could have avoided this whole debacle, but it appears that it was spoiling for a fight, and is looking pretty groggy.

BPSDB

Chiropractors admit "Chiropractic has never cured anyone of anything"

Recently, I blogged about Glasgow Chiropractic changing their website to remove references to colic.

Previous posts on this site have demonstrated that evidence-free claims about the ability of chiropractors to cure/treat period pains, carpal tunnel syndrome and asthma are routinely appearing on chiropractor's websites - in the blogposts above, I linked to Glasgow Chiropractic as an example.

A specific complaint about the contents of their website had been sent to the GCC and so, using www.changedetection.com, I was able to see how Glasgow Chiropractic would react.

As a pleasant surprise, the chiropractors seem they have come over all hand-wringy and repentant and have updated their website accordingly.

The change detection page for menstrual pain is here and the one for shoulder pain and carpal tunnel syndrome is here. You can see the changes made by clicking on " View changes: 2009-07-08 13:57" about half way down on the left hand side.

The new page on shoulder pain is here and contains the bold title

Chiropractic has never cured anyone of anything.

Wow.

Quite an admission, although one that is completely backed up by research data.

The new addition to the website goes on to say:

If we go looking for the named condition that Chiropractic can be applied to and produce change in we will find ourselves in a merry-go-round of symptoms, loosing [sic] sight of the whole because of an obsession with the parts.

So the question of What can Chiropractic Cure should be changed to "How" can Chiropractic Assist? The answer is simple. A well functioning mind and body has a greater opportunity to heal, repair and function than a poorly functioning one. A well functioning mind and body depends to a significant degree on a well functioning spine and nerve system. This is Chiropractic's contribution.

People find that chiropractic's ability to produce better spine and nerve system function changes their life expression. There are thousands of symptoms and conditions that chiropractic has been associated with helping, however don't ask "Can Chiropractic Cure this or that condition" - instead ask "If my mind and body was functioning better through Chiropractic would I be better placed to handle this condition?"

Have you got that? Don't ask "can chiropractic cure". Just don't. Ask a different question if you must, but don't ask if it can cure.

The page on menstrual pain contains an almost identical admission along with postmodern flakery but has some interesting text manipulations further down (new text in bold, previous text in brackets/italics)

Chiropractic management of dysmenorrhoea

When helping (treating) women who suffer from dysmenorrhea, the majority of chiropractors address only problems located in the areas directly involved in causing the symptoms. In a study conducted to establish which styles of Chiropractic care (treatments) are most frequently used by chiropractors for dysmenorrhea, manipulation was used in 100% of the cases.

Read that last sentence again in its old and new forms - the meaning has been changed to the point of silliness. Although perhaps they are now referring to a different study? Who knows.

A chiropractor’s role is to normalise the functions of the body by correcting spinal problems. The rationale behind the chiropractic management (treatment) of women suffering from dysmenorrhea is to deal with (treat) its spinal and skeletal aspect.

Chiropractic provides the mechanisms through which dysmenorrheic women can be relieved of their pain in a drug-free environment and even go on to live a life free of period pain.

How (What) can Chiropractic assist with (a Chiropractor do for) menstrual pain?

Your chiropractor will perform a complete consult and examination and may take radiographs (x rays) if clinically required.). After review of the examination findings your chiropractor will recommend an appropriate and individual care program. Chiropractic care (Treatment) consists of specific manual adjustments, to the individual joints of the body and spine, which restore damaged neurologic function. As Grey’s Anatomy text states every single organ in the body is controlled by the nervous system. This includes the uterus and reproductive systems. Through the specific adjustment your chiropractor provides neurological input (imput) that allows your nervous system, and so your organs, to adapt to environmental stresses.

So by changing the word 'treat' to 'help' or similar, that makes it all ok. It's good to see that the X-rays are now only done 'if clinically required'.

Will that ever be the case if chiropractic has never cured anyone of anything?

BPSDB

MHRA publish public assessment of homeopathic arnica, admit it does nothing, but license it anyway

Just off so no time to blog this properly, but back in May I blogged about the Medicines and Healthcare Products Regulatory Agency giving their blessing to Nelson's selling homeopathic arnica with therapeutic indications.

The full report is now published and can be found here.

A few choice quotes for your discussion:

The homeopathic medicinal product consists of white to off-white spherical pillules
for oral administration, containing 30c (GHP) Arnica montana. It is used for the
symptomatic relief of sprains, muscular aches and bruising and swelling after
contusions. Two pillules should be taken every 2 hours for the first six doses, then
four times daily until symptoms improve for up to a maximum of 7 days.

The excipients used to manufacture the homeopathic medicinal product are lactose,
sucrose and purified water.

Oh, no arnica then?
This bit is utterly laughable:

Published scientific literature review
The applicant has provided a bibliographic reference documenting a summary of
clinical trials using arnica in homeopathic dilutions. The summary refers to studies
where Arnica had been administered in a number of clinical conditions.
The applicant has also provided further details of eleven published clinical studies
investigating the clinical effects of arnica. The studies were performed under
randomised, double blind conditions and were carried out to investigate the post
operative clinical actions of arnica, such as pain relief and bruising.
The results of the clinical trials and studies provided were not conclusive in
establishing the clinical effects of arnica but indicated that there may be a trend
towards demonstrating some beneficial effects of arnica in some situations.

I'll be contacting the MHRA as they seem to have omitted an important safety concern - how do I know that what is in the pack is what is on the label? Both you, I, MHRA and Nelson's know it is impossible to tell.

Say goodbye to colic the easy way!

.... by deleting it from your website, indeed.

Previous posts on this site have demonstrated that evidence-free claims about the ability of chiropractors to cure/treat period pains, carpal tunnel syndrome and asthma are routinely appearing on chiropractor's websites - in the blogposts above, I linked to Glasgow Chiropractic as an example.

[Many other bloggers are carrying out similar investigations into chiropractic claims, in light of the British Chiropractic Association's spectacularly bad decision to sue Simon Singh for stating there was no evidence for many of Chiropractic's claims of efficacy.

As a result, a number of complaints have been put to the General Chiropractic Council, and McTimoney Chiropractic, a professional body for a branch of chiropractic, sent out an edict to its members to shut down their websites, for fear of investigation.]

One of the complaints to GCC was about Glasgow Chiropractic's claims on their website and so, using the power of the intertubes, and changedetection.com, a page monitor for two of Glasgow Chiropractic's pages was set up.

This week, the first notice of change appeared. This provides a comparison of the old site with the changed one - click on 'View Changes' about half way down the page on the left hnd side.

Notice on the left hand side in the yellow box, the word 'Colic' with a line through it. (You'll see the new page has the word 'Colic' removed). They've decided that chiropractic is no longer useful for treating colic. No need to tell anyone though, just say goodbye by deleting it from your website in a wonderfully Orwellian way.

The internets never forget though.

[In a similar fashion, the Complementary and Natural Healthcare Council got caught playing a seemingly dishonest game, by editing old press releases to remove undesirable targets they had set themselves.]

BPSDB

"Before every action ask yourself - Will this bring more monkeys on my back?" - Chiropractors react to legal decision

So said Alfred A Montapert. The full quote is:

Before every action ask yourself - will this bring more monkeys on my back? Will the result of my action be a blessing or a heavy burden?

His words seem extremely relevant in light of the recent chiropractic debacle. In short, the British Chiropractic Association is suing science writer Simon Singh for remarks made about the lack of evidence for chiropractic. This has led to the searchlight of skepticism being shone in every corner of the chiro world. Their actions have lead to many more monkeys on their back and the result is a heavy burden for the chiropractic community.

In some astonishing developments brought to light by The Quackometer, Gimpyblog and The Lay Scientist via chiropracticlive.com, McTimoney Chiropractic Association (a chiro representation body) has issued an email telling all McTimoney Chiropractors to remove their websites, remove any claims of cure/help for which there is not evidence (i.e. practically of it), along with the following chiller:

IF YOU DO NOT FOLLOW THIS ADVICE, YOU MAY BE AT RISK FROM PROSECUTION. IF YOU DO NOT FOLLOW THIS ADVICE, THE MCA MAY NOT BE ABLE TO ASSIST YOU WITH ANY PROCEEDINGS.

The McTimoney website itself now only has a basic holding page.

A McTimoney Chiropractor, Jo Hanstead, used to have this page on her website (note the reference to period pains, debunked in this blogpost), the others have a similar lack of evidence:

It now reads like this.

Emails shown to this blog from Jo Hanstead regarding chiropractic help with arthritis included the following information:

I usually find that treatment can relieve some/all symptoms, depending of course exactly what is going on. Most people with hip problems have a pelvis that is way out of balance. Balancing the pelvis changes the dynamics at the hip joint, and improves the nerve supply.

I read this to be a strong endorsement of chiropractic for arthritis, for which there is no evidence. When questioned about the evidence, this was extremely telling response:

Trouble is, complementary medicine does not have the money pharmaceutical companies have, nor are theralpes [sic] amenable to double blind trials, hence going at it by research publiched [sic] may not get you a realistic viewpoint.

So the claim is that chiropractic can relieve the symptoms of arthritis, but evidence is not available because of lack of funds alog with special pleading that double blind trials are not suitable. Utter nonsense. There are many, many double-blind, sham-treatment controlled, research papers into chiropractic and other manipulation therapies. This reply is just a smokescreen to try and disguise the fact that the evidence is weak to non-existant.

The various chiropractic associations are now wishing they had thought more carefully about the fall-out of the BCA's decision to sue Simon Singh. The number of monkeys is increasing every day.

EDIT: Zeno has also covered the story here, DC is covering the story here, JDC's coverage is here and Frank @ SciencePunk has posted his post here.

BPSDB

Chiropractors take money for trying to relieve asthma, despite a lack of evidence. What a wheeze!

Previous blogposts on this site have demonstrated how a collation of published research, gathered by the independent body, The Cochrane Collaboration, has shown that there is no evidence that chiropractic can relieve menstrual pains or is any better than placebo or control at relieving carpal tunnel syndrome.

Another common claim by chiropractors is that chiropractic can relieve asthma. Asthma is a complex chronic clinical condition - airway inflammation contributes to airway hyperresponsiveness, airflow limitation,
respiratory symptoms, and disease chronicity. (National Heart, Lung and Blood Institute .pdf here)

There is no cure for asthma, but there are a number of treatments that can normally manage the condition. Treatment is based on two important goals:

* Relief of symptoms.
* Preventing future symptoms from developing.

Successful prevention can be achieved through a combination of medicines, lifestyle advice and identifying and then avoiding potential asthma triggers.

Taken from the NHS website. As with carpal tunnel syndrome and menstrual pain, asthma is a condition which can be difficult to treat, can cause pain and inconvenience and is reasonably common - the NHS website suggests about 5 million people suffer from it in the UK. These is a classic situation for complementary and alternative medicine to step in and offer relief. The barrier to success is laid so low, as the patient is ready to try anything (regardless of evidence or how 'creative' the therapy is) just to get some respite from the condition.

As with carpal tunnel syndrome and menstrual pain, the Cochrane Collaboration has published a review on the evidence available for asthma relief by chiropractic and can be found here. (The abstract and conclusions can be found here).

The Cochrane research published in 2005 came to the following conclusion:

There is insufficient evidence to support the use of manual therapies for patients with asthma. There is a need to conduct adequately-sized RCTs that examine the effects of manual therapies on clinically relevant outcomes. Future trials should maintain observer blinding for outcome assessments, and report on the costs of care and adverse events. Currently, there is insufficient evidence to support or refute the use of manual therapy for patients with asthma

The hesitance in the last line is due to poorly-run trial using massage therapy that indicated some benefit, however that is outwith of chiropractic. The author notes that the best run trial between chiropractic and sham treatment found no significant difference.

Any chiropractor who keeps up to date with the research (as is required by General Chiropractic Council’s Code of Practice and Standard of Proficiency - .pdf here) would surely not advertise that chiropractic can help with asthma, or if they had been advertising it, would remove such a claim from their site. A quick search of Google shows that plenty of Chiropractors are seemingly happy to advertise asthma relief despite lack of evidence to back up the claims and therefore contravening their Code of Practice. (I mean, no-one would advertise asthma relief *knowing* that there was no evidence, right?)

As with the previous two ailments, Glasgow Chiropractic is forthright in its misguided belief of asthma help:

The chiropractor will make a detailed examination of the spine, which may include x-ray. He will then decide which misalignment of the spine requires manipulation in order to correct the problem. Correcting the misalignment can halt the chain of events which lead to closing of the airways and asthma attacks, resulting in symptomatic relief and a reduction in frequency of attacks

Fulham Wellness Chiropractic Clinic has decided that:

Chiropractic care can help improve the patient's neurological status and respiratory function through stress management, lifestyle and dietary advise together with specific joint adjustments and exercises.

I wonder how much is down to the chiropractic - the evidence suggests not a jot.
Chiropractors Brighton think:

Chiropractic care can help children with asthma

Chiropractic Health Centres, based in London reckon:

Most common symptoms helped by Chiropractic are asthma, colic and repetitive ear infections.

Many other chiropractic practices like Emerson's Green Chiropractic near Bristol also claim asthma as a treatable condition.

How can the GCC claim to be regulating chiropractic when the treatments offered for specific ailments are not backed up by any worthwhile evidence?

As discussed prevously, the Cochrane Collaboration has reviewed the available research on menstrual research and carpal tunnel syndrome and found the evidence lacking compared with placebo or control. In many cases, Chiropractic practices are claiming to be able to treat these conditions despite a complete lack of evidence. This post has demonstrated that asthma can be added to that list.

Three strikes and you're out.

BPSDB

The Law Has No Place in Scientific Disputes

Simon Singh has decided to appeal the illiberal ruling of Justice Eady, in the nonsensical libel case brought by the British Chiropractic Association, over his use of the word 'bogus'.

David Colquhoun's blog DC Science and Andy Lewis' Quackometer are leading the charge, along with science charity Sense About Science, who have launched the "Keep Libel Laws Out of Science" campaign. Click here to get the SaS button for your website.

Simon's Facebook page is here and Simon writes in his own words here. Jack of Kent has been following this story in full here.

Anyone in the midlands area free on Mon 8th June 2009, should make their way to the The Chequers Inn in Oxford, where Simon is the guest speaker at Skeptics in the Pub (Oxford)

I'll see you there!

BPSDB