Chiropractic Activator Device by Michael Dorausch
There was a great article in The Weekend Australian magazine this weekend about chiropractors treating children for conditions other than mechanical spine issues (note that it does say that only some chiropractors do this). It grabbed my attention because the article stated that some parents take their children to chiropractors to treat autism and ADHD – conditions that I see in clinical practice.
I have never been to a chiropractor but know many people who swear by them, and I have absolutely nothing against alternative health practitioners. But there are two issues that worry me. First, when practitioners say they can treat conditions with no evidence to back it up, and second, when there is a risk of harm from the treatment – either directly or indirectly.
Lack of evidence
I will point out that the chiropractor in the article above says that he never claimed to be able to cure autism, but rather, a parent was convinced that the chiropractor cured her son’s condition.The practitioner quoted in the article does imply that chiropracty – through realigning the spine – can help with colds, ear infections, bed wetting, ADHD, and can even ‘repair’ DNA.
In clinical medicine, we are taught to look for evidence that the treatments we use work. Some treatments are straightforward: we can see in the lab that a particular antibiotic will kill certain bacteria. I know that in my own speciality, psychiatry, some of the evidence for treatments (particularly psychotherapy) is less strong because of difficulties in measuring what we do. However, the vast majority of treatments – physical and behavioural – have good scientific evidence to back them up. In the case where the evidence is lacking, but we have reason to try a particular treatment, we explain the risks and benefits to patients and come to an informed decision together.
I am not aware of any scientific evidence (randomised placebo controlled trials with statistically significant results) that chiropracty can cure asthma, allergies, reflux or autism.
Risk of harm
Many of my patients ask my opinion about unproven remedies for various disorders and I always encourage them to try anything they want to – as long as it’s in conjunction with proven treatments, and that it does no harm. And in the vast majority of cases, alternative medicine doesn’t do any harm, and may help. I don’t know of any direct risks from chiropracty.
I have seen ‘harm’ caused by other alternative medicines: I have once seen a woman who became pregnant after using St John’s Wort to treat mild depressive symptoms, because she wan’t aware that it interacted with her contraceptive pill and made it less effective. She had the idea that because St John’s Wort was ‘natural’ it didn’t have any side effects or interactions.
In the article above, parents say that they see their chiropractor before their GP, and one mother lists her chiropractor on forms as her family doctor. In my mind, this is risky. A chiropractor is not medically trained and cannot diagnose medical illnesses, and there is a risk that children will be wrongly diagnosed, or that illnesses will be missed. Children may therefore miss out on proven treatments, and in the case of disorders such as asthma, allergies or autism, this can have grave consequences. Some believe that chiropractors can replace immunisation in children – again, this has potentially serious consequences.
What to do?
Overall, my advice to parents and patients won’t change: by all means try alternative medicine if you want to. But make sure that you have a medical diagnosis and treatment plan, and that your medical doctor knows what other treatments you are having. Ideally, medically trained and alternative health practitioners can work in tandem to treat each individual patient.
Reputable health practitioners – medically qualified or not – will always explain risks and benefits of their treatments.
One sad fact is that the parents quoted in the article feel that they get much more holistic and empathic treatment from their chiropractor compared with their GP. It’s an important point: our medical system is busy and understaffed, and perhaps sometimes the patient as a person gets lost in amongst the science. That is one thing that medical professionals need to take note of.
I would love to hear from anyone with any experience or comments…
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