Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

When the two approaches are compared against each other, spinal manipulation versus conventional medicine, the result is that each is just about as effective (or ineffective) as the other. Indeed, this was one of the main conclusions of Ernst and Canter’s review of reviews: spinal manipulation might help those who suffer with back pain, but conventional approaches offer similarly marginal levels of benefit.

In a situation where two or more rival treatments match each other in terms of their effectiveness, there are several other deciding factors that determine which one is best. The simplest determining factor is often cost, which mitigates strongly against chiropractors, who generally charge a great deal for their services based on the misguided claim that their treatment is superior to conventional treatments. Compare ten sessions with a chiropractor at £50 each with regular exercise or ibuprofen, which are both relatively cheap, and the price difference becomes obvious.

Furthermore, there are more important factors which also favour conventional treatment over chiropractic spinal manipulation. In fact, there are serious problems with chiropractic philosophy and practice, both of which should raise major concerns for prospective patients. These issues are closely linked to the early development of this form of treatment, so in order to appreciate them properly we will take a historical detour and explore the origins of chiropractic therapy.

The bone-setting panacea

The first documented account of manipulating the spine for therapeutic reasons dates back to Hippocrates in around 400 BC. In order to deal with back problems, he asked patients to lie face down on a board and his assistants applied traction by pulling on the head and feet. At the same time, Hippocrates pressed on the painful part of the spine, or sat on it, or bounced up and down, or walked along it. We do not, by the way, recommend you try this at home!

As the centuries passed, it became the responsibility of specialists known as bone-setters to treat bones that were broken, misaligned or dislocated. In Norway the local bone-setter was often a first-born child, whereas in Ireland the bone-setter was typically the seventh-born, but birth order did not matter in Scotland as long as the person had been born feet first. Because bone-setters were not usually formally educated and were not therefore part of the medical establishment, they often drew criticism from physicians. For example, Sarah Mapp, who was one of the most famous bone-setters in London in the 1730s, was nicknamed ‘Crazy Sally’ by many physicians. Percival Pott, an eminent English surgeon who was the first to demonstrate that soot could cause cancer in chimneysweeps, went further and called her an ‘ignorant, illiberal, drunken, female savage’. On the other hand, Sir Hans Sloane, who was President of the Royal College of Physicians, had sufficient respect for ‘Crazy Sally’ to ask her to treat his niece’s back injury.

Chiropractic therapy, which emerged out of the bone-setting tradition, was founded by Daniel David Palmer, who was born near Toronto, Canada, in 1845 and who moved to Iowa at the age of twenty. Palmer gradually developed an interest in medicine, which included spiritual and magnetic healing, but his interest in the potential of spinal manipulation can be traced to a specific event that took place on 18 September 1895. Here is how Palmer later recorded the event:

Harvey Lillard, a janitor in the Ryan Block, where I had my office, had been so deaf for 17 years that he could not hear the racket of a wagon on the street or the ticking of a watch. I made enquiry as to the cause of his deafness and was informed that when he was exerting himself in a cramped, stooping position, he felt something give in his back and immediately became deaf. An examination showed a vertebra racked from its normal position. I reasoned that if the vertebra was replaced, the man's hearing should be restored. With this object in view, a half hour talk persuaded Mr Lillard to allow me to replace it. I racked it into position by using the spinous process as a lever and soon the man could hear as before.

On its own, this incident would not have started a revolution, but Palmer treated a second patient in a similar manner:

Shortly after this relief from deafness, I had a case of heart trouble which was not improving. I examined the spine and found a displaced vertebra pressing against the nerves which innervate the heart. I adjusted the vertebra and gave immediate relief…Then I began to reason if two diseases, so dissimilar as deafness and heart trouble, came from impingement, a pressure on nerves, were not other diseases due to a similar cause? Thus the science (knowledge) and art (adjusting) of Chiropractic were formed at that time. I then began a systematic investigation for the cause of all diseases and have been amply rewarded.