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