Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Saturday, August 27, 2005

Christopher Cain: Spinal claims have no backbone

The Advertiser

Christopher Cain: Spinal claims have no backbone

THERE are a lot of myths and misconceptions about what makes good treatment for backs, as there is about many other ailments. Sorting the facts from the fiction is not easy for the public.

The medical profession does not have all the answers, but what we do know, and what the community rightly expects, is that there is evidence to support particular forms of treatment before they are embraced for general use. Doctors are trained to practise good medicine and good medicine needs an evidence base.

This brings me to the claims of some chiropractic groups around town. The Australian Medical Association of South Australia has been concerned about some of the claims that are made that spinal manipulation has a role to play in the treatment of conditions like asthma and ear infections ñ claims that are not supported by scientific evidence.

Our clear advice is to consult your family doctor rather than your chiropractor about these medical conditions. On the topic of things chiropractic, you may have heard the term "subluxation" used fairly widely in the media and in our community.

While not the true medical meaning of the term, in this context it is used to refer to joints that are apparently "out of place" and which can be "clicked back" by manipulation.

This clicking noise is created by the separation of the joint surfaces and the creation of a vacuum effect, just like when a suction cup is removed from a smooth surface.

I am sure most of you will have "cracked" your knuckles or heard a "crack" in your knee or back when you bend or twist in certain directions. This is caused by the rapid separation of the joint surface and not true "subluxation", which implies a significant injury to the ligaments and soft tissue around the joint.

Your fingers, knee or back were probably working fine before you heard the "crack", and will have continued to do so afterwards. Chiropractic is a well-accepted therapeutic treatment used in the community, and it certainly has a role to play in the management of a range of musculoskeletal complaints.

A deep-seated massage will no doubt make you feel better for a while, but be aware there is no evidence to support other therapeutic benefits of this treatment, despite a considerable amount of research done over a long period of time to try to validate this.

Any treatment, chiropractic, physiotherapy or medical, should provide a benefit within a relatively short period of time (two or three weeks) if it is going to be effective in the longer term. If this is not the case, or if the treatment actually aggravates your symptoms, there is no point persisting.

Dr Christopher Cain is state president of the Australian Medical Association.

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