Chiropractors: How some are creating an unconscionable con

I just recently popped in to buy a single item at the local Woolworths. As I entered I was given a free raffle ticket. A $25 gift voucher was the prize. My Skepdar scanned for the expected catch but returned a green light rating. I acquiesced and wandered off thinking I’d be long gone before raffle time.

As it turned out an announcement shortly came over that the draw was five minutes away. I checked my ticket – number 1099. As I scanned shelves the draw was announced with the winning ticket “Ten Ninety Six… 1096”. Immediately I felt a brief intuitive Doh! as if I’d come close to winning because my ticket number was a mere three numbers off. Because I’d “come so close”, I actually felt rather good and more interested in this raffle business – as though I’d done well in the great cosmic fate of ticket draws. Part of my brain was ready to believe a confidence and satisfaction just out of reach.

Of course, this all took place in a second or two, and at much the same time I marvelled at how our brains can be so easily fooled by intuition born of utterly irrelevant information. I’d come no closer to winning than any other ticket holder in the draw. For all I knew ticket 1096 could be stuffed in the pocket of the guy on the microphone. How many shoppers lingered that extra five minutes, selecting products they may not otherwise have? But what if the irrelevant information was much more complex than reasoning odds – or if I lacked the ability to analyse the true outcome? What if I was prone to go with intuition over analysis and had an emotional investment at stake? What if there was someone nearby interested in my experience, empathetic, concerned and generously explaining that all this information didn’t present a brief belief but proof I was right in feeling better, more confident and satisfied?

I’d come for one tiny item, only been there six minutes and already found myself in a privileged few – and feeling better! What then would I make of advice to persist with faith in my intuition? How far could I be led if the information was well beyond my ability to understand or critically analyse and presented as evidence that “raffles” had significant merit for my general well being? Perhaps my friends and neighbour’s were already “raffle” devotees offering glowing testimonies. In the absence of a proper grounding in or ability to analyse the credibility of information presented to me, the more likely I would be to believe testimonies, promises and trust my intuition backed by an empathic consultant.

In fact, in a confronting article in The Weekend Australian on the high risk practice of paediatric chiropractic, we can see exactly these questions being answered. And the overall message suggests I’d be a sitting duck ruthlessly exploited and ripped off in my blissful ignorance. What’s worse I’d be likely to sing the praises of those who are misguided carers at best or unconscionable charlatans at worst. Professor Jenny Couper, head of paediatrics at Adelaide University points to evidence that shows people who consult empathic practitioners are 70% more likely to report improvement, when treated with placebo. That’s a nice way of saying 7 out of 10 people would endorse a scam if conned properly. We’ve long known about white coat syndrome and blue sugar pills being more effective than red, yellow more effective than white and “scientician” jargon. This has been great for the multitude of pseudoscientific gigs rorting gullible Aussies and by extension Australian taxpayers. But what if there was a one stop shop where everything can be maintained, improved, treated, cured or prevented?

Enter the New Age Chiropractor armed with fundamentalist mumbo jumbo a Wellness “Clinic” and the title of “Doctor”, able to tackle anything from allergies to addiction. I first encountered the bizarre, grandiose, combative and frankly offensive anti-science and anti-medicine views of these chiropractor’s when debating the merits of vaccination. More and more chiropractors were refuting vaccine efficacy, inserting themselves into debate, distributing material from their practice, offering lethal witness testimony or running evening seminars wherein they imparted the very worst of anti-vaccination propaganda. They could provide a spinal adjustment which would defy the rules of neuro-physiology, virology, immunology and optimise your immune system such that vaccination was unnecessary. In peddling such misinformation chiropractors essentially profit financially from contributing to the resurgence of vaccine preventable disease with consequent infant and child fatalities along with untold disabilities.

The Weekend Australian focuses on primary offender Warren Sipser. He distributes anti-vaccination propaganda based on debunked and dangerous far out fringe notions. If he can successfully con grateful parents to abuse their children in this way, no doubt they’ll be back for “immune optimisation” and treatment when they catch vaccine preventable disease. What’s certain is that his sleight of hand will help no-one in the sample of children who suffer terribly, endure weeks of hospitalisation, are maimed for life and who die from catching diseases he’s helping to spread. He says of his qualifications in this regard;

“It isn’t outside our role because our role is to provide information on healthcare. If there is a potential for something to harm someone, whatever that may be, I am well within my scope of practice to warn them.”

Sipser is also known in vaccine defence circles as the “expert witness” who argued in the family court against vaccination of a five year old girl. Dad had remarried and wanted the child vaccinated for her health and that of his new family. Mum was arguing the risk of vaccine preventable disease was small. Here’s where the sheer threat from people like Sipser is highlighted. Rather than explain that the risk of disease far outweighs any risk from any vaccine, he failed this mother, accepted a large fee and gave public voice to sheer quackery. This intellectual repugnance won him Fishslapper of the week – an award given by a real doctor on the Skepticbros site. Fishslapper is named after the comical health insurance advertisement, offering premiums for real treatments that featured an alternative practitioner chanting and slapping his “patient” with dead fish.

The court decision finally handed down was an order for the mother to have her child vaccinated. Many of you will remember Meryl Dorey, on and off president of the disgraced Australian Vaccination Network reacting with “Court orders rape of child… we’re talking rape with full penetration”, even disgusting her own members in an attempt to further cultivate her prison planet vaccine conspiracy. At the time various reports noted of Sipser;

The decision shocked paediatric chiropractor and author Dr Warren Sipser. “It’s a sad situation,” Dr Sipser said outside court.

“I think it’s dangerous to impose [immunisations] on anyone when there are two opposing viewpoints and when there is credible evidence they may do more harm than good,” he said.

But there is no evidence. Far less than one in one million will suffer serious reactions from MMR vaccination. As many as one in 200 will suffer the same from measles alone, resulting in meningitis and encephalitis. Death and the brain damaging Subacute Sclerosing Panencephalitis – SSPE – are not associated with MMR. From measles cases the rate may be as many as one in 8,000 and one in 2,500 respectively. Blindness (rubella, mumps) and deafness from mumps is all too common to even contemplate gambling with an innocent childs health and life potential. Presently the rise of vaccine preventable disease focuses on “educated parents” making the decision not to vaccinate. Yet only the conspiracy minded can be sucked in by the vitriolic ramblings that dominate anti-vaccination sites. We need another variable – and that variable is people like Warren Sipser taking advantage of the many intuitive failings in human reasoning. The same failings I experienced with my Woolworths raffle ticket.

This new chiropractic belief system is almost endless. Seeing an opportunity to cash in on Australia’s growing alternative practice market many if not most chiropractors have long since abandoned their ethical standard. As long as 20 years ago, I had many professional experiences with unethical chiropractors promising the impossible to road trauma patients usually within a set number of appointments. As many patients had severe brain injuries resulting in compromised cognition it was a heartbreaking and deeply disturbing lesson in callousness and greed. Many of these cases however, were exaggerations of the concept of manipulation for lower back pain. A type of othopaedic magic. Bed wetting has been a staple “chiro’ cure” for at least 50 years and impossible claims about peripheral symptoms managed by spinal adjustments have grown steadily, culminating in today’s pseudoscientific everything.

Sipser rattles off  “colds, ear infections, colic, bed-wetting, hyperactivity, asthma” and reflux in a six week old. Think about that. Reflux in a six week old. It’s chilling to think he “manipulates” soft vertebra after massaging a mother’s irrational anxiety. As he told one mother he can “fix everything”. As such he represents a clear and present danger, not just to his “patients” but to public health in Australia. He argues, “… taking a proactive approach means you can see kids on an ongoing basis for body balance and even DNA repair.” The DNA myth is based on a single much debunked Journal of Vertebral Subluxation article. Professor Steven Salzberg, director of the Centre for Bioinformatics and Computational Biology at the University of Maryland notes a statistical error rendering it meaningless.

In 2006 chiropractors resurrected training in their 19th century founders’ teachings – this action alone representing an all too common theme for 21st century devotees of debunked dogma. Daniel David Palmer, a USA born magnetic healer believed that spinal adjustments unlock the body’s God-given energy flows. Known today as vertebral subluxation complex [VSC] this hanky panky sounds like homeopathy’s “water memory” or TCM’s “energy meridians” and “chakras”. It’s listed as one of chiropractic’s “core beliefs”. We’re told with a straight face VSC is the theory of tiny misalignments of the spine upsetting the “expression of innate intelligence”, and from there flows disease. From The Weekend Australian:

The fundamentalists argue that each vertebra in the spine influences corresponding internal organs, and that chiropractors can heal the body by correcting minor spinal lesions known as “subluxations” which affect nerve-flows. This theory has been repudiated by many leading chiropractors in the 120 years since Palmer proposed it; last year, Britain’s General Chiropractic Council reiterated that it is a purely theoretical concept “not supported by any clinical research evidence”.

Noting that this discipline attracts intelligent students it strains at credibility to accept they are about anything less than scamming vulnerable patients to line their own pockets. However, I’ve no doubt there are some New Age Chiropractor’s who care for their patients, want to do the right thing but are befuzzled by confirmation bias and struggling with cognitive dissonance. To this we must add the genuinely honest chiropractors such as John Reggars, past president of the Chiropractors Registration Board of Victoria and present vice president of the Chiropractic and Osteopathic College of Australasia.

On May 11th Paul Smith writing for Australian Doctor, published an article that referenced a paper Reggars had written targetting the irresponsibility of RMIT University in Melbourne who offer a Bachelor of Health Science in chiropractic. RMIT run their own children’s clinic using techniques medical experts have likened to child abuse. This welcome condemnation reported in the BMJ came in support of a submission to federal health minister Nicola Roxon urging her to shut the clinic down. It was authored by former Australian Skeptic of the year, successful activist against useless and risky treatments, and vocal chiropractic critic, Loretta Marron.

The submission cited the no-nonsense opinion of David Colquhoun, professor of pharmacology at University College in London. He notes the “principles of chiropractics are no better than witchcraft” insisting that the “idea that just about any disease originates from some problem in the spine is pure rubbish”. Ian Frazer and John Dwyer were among eleven scientists who put their name to Loretta’s submission. Marron has also noted the bizarre claim by some that they can treat ADHD. Later I list articles in which astonishing claims about addiction, compulsive disorders and hyperactivity all stemming from a single successfully treatable chiropractic phenomenon are made.

Reggars was scathing toward RMIT’s teaching of pseudoscience to chiropractic students. Reggars was also highly critical of the Chiropractors’ Association of Australia – the CAA. Correctly pointing out how the CAA had abandoned science for fundamentalist ideologies, he wrote that the “all-encompassing alternative system of healthcare is both misguided and irrational”.

Quoting the article, Paul Smith wrote;

“Chiropractic trade publications and so-called educational seminar promotion material often abound with advertisements of how practitioners can effectively sell the vertebral subluxation complex to an ignorant public,” Mr Reggars said.

“Phrases such as ‘double your income’, ‘attract new patients’ and ‘keep your patients longer in care’, are common enticements for chiropractors to attend technique and practice management seminars.” Mr Reggars, who stressed his support for the “mainstream majority”in the profession, also condemned the use of care contracts, where patients signed up to a fixed number of treatment sessions.

“Selling such concepts as lifetime chiropractic care, the use of contracts of care, the misuse of diagnostic equipment such as thermography and surface electromyography and the X-raying of every new patient, all contribute to our poor reputation, public distrust and official complaints.”

“For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.”

An example of the preemptive fear mongering and pseudoscientific “scientician” jargon can be found in this Australian Family article, Building Brain Power, by marketing and advertising guru Barbara Grace. Note the seamless transition from a reasonable thesis to implausibility, all the time leading to the conclusion chiropractic “treatment” alone can help. Let’s remember visual, auditory, taste and olfactory (smell) are senses with no connections to the spinal cord. If these senses were “carried by the nervous system to the spinal cord” quadriplegics would be blind, deaf and bereft of smell and taste. [Bold mine].

During a child’s early years, some children don’t progress according to developmental milestones, with delays in learning, socialisation and motor co-ordination limiting their potential…. Neuroplasticity research shows that a child’s environment shapes brain development, with all sensory perception carried via the nervous system to the spinal cord, where it is integrated into the brain’s cortical map. Helping a child achieve full potential begins early with positive environmental experiences.

‘We are sensory organisms and we develop through our sensory experiences,’ says Dr Genevieve Keating, a Melbourne pediatric chiropractor whose research into ‘how we are who we are’ underpins her work with young children. ‘The richness of our environment wires the brain and affects motor and cognitive development,’ she says.  A baby’s brain, the most immature organ at birth, continues developing as higher brain centres integrate primitive (startle, suckle) reflexes and establish postural reflexes (for movement, balance, co-ordination) as a child grows.  ‘We know that failure to integrate primitive reflexes in the normal developmental windows is a reliable predictor for further interruption to development,’ says Dr Keating.

‘Sometimes babies won’t crawl, but move along on their bottom, an action commonly known as ‘butt scooting’ or ‘bottom shuffling’. This behaviour can indicate a developmental delay. When a child puts his or her hand on the floor to assist butt-scooting, then the child is developing asymmetry in their nervous system,’ says Keating. Strong sensory and motor pathways enhance clarity of thinking, smoothness of thought and social skills. If a child has poor social development, Keating believes that often it indicates the child hasn’t yet developed maturity in their neural pathways.

‘Children with poor social development often are unable to read other people well, they’re too ‘in your face’, or they’ll be uncoordinated and bump into other children and display inappropriate reactions.’

The article then broaches plagiocephaly, the asymmetrical distortion of any skull bones. It may result from intrauterine conditions or from sleeping on the back, particularly due to SIDS awareness. It’s true that the SIDS sleeping campaign has increased the incidence of plagiocephaly. It is more than adequately treated with physiotherapy and occupational therapy (the arch nemesi of credibility poor chiropractors), sometimes requiring a customised orthopaedic band. Nonetheless, the above article misleads by selectively referring to a “recent” paper by Miller and Claren. “… published in the prestigious journal Pediatrics, showed that 39.7 per cent of babies with this condition later required an individual education plan involving speech education, physical therapy, occupational therapy or special education services.”

When you read about an unreferenced “recent paper” in such publications you may arguably be assured it isn’t. Miller and Claren were published in February 2000 – Long-Term Developmental Outcomes in Patients With Deformational Plagiocephaly. [Pediatrics, Vol 105 No. 2, Feb. 2000 doi: 10.1542/peds.105.2.e26 ]. Miller and Claren are also cited frequently in physiotherapy journals, and I stress again the important clinical role of physiotherapists in managing plagiocephaly. A General Practitioner or paediatrician may assist with a referral to a physiotherapist skilled in this area. The most important point is do not ever subject your children to the pseudoscience of chiropractic. Dangerous advice given by chiropractors, specific to plagiocephaly, is to sleep babies prone. This is in direct contravention to the SIDS safe sleeping campaign. A far safer approach is to increase “tummy time” when babies are awake and can be monitored.

The harvesting of research and the cherry picking of data by chiropractors is designed to convey a fear of brain dysfunction, as if the brain has been adversely effected by skull shape. In fact the paper is describing routine occupational, speech or physical therapy. As the bones begin to reshape, babies are beginning to vocalise. With cheek and jaw bones moving into place it’s vital that the bad habits or coping techniques previously learned are not carried into the phase of speech development. But why not forget that, take a swipe at conventional medicine and praise the magic of the paediatric chiropractor instead?

Many medical practitioners, including GPs and pediatricians, assume a ‘watch and wait’ procedure when parents express concern over their child’s development, which without intervention can delay a child’s development by up to a year and seriously impact on ability to learn.

Dr Sharon Pedersen-Jones, a chiropractor on the Bellarine Peninsula agrees. ‘Once we assess a child and begin adjustments, parents often report an improvement to their child’s literacy skills and attention span as pressure is released from nerves in the neck. This release allows for optimal brain communication, which can improve a child’s concentration and overall energy levels.‘

Or as Professor Jenny Couper said above, 70% of people will report favourably with no evidence of any change. There’s ample nonsense here, but I found the appalling distortion of the development of proprioceptive attenuation almost hilarious. As children grow it takes time for the growing body to be properly represented in the sensory motor cortex. The constant feedback on joint and limb position is accurate but the fact it represents a changing limb part is a catch up duty for the brain. Tripping over feet or miscalculating leg length is simply a part of growing up. In Building Brain Power, we read;

Petersen also comments that while stumbles and falls are a natural part of childhood, ‘the body’s pain receptors don’t fully mature until 16 years of age, meaning the body will adapt if there’s been a shift in a bone’s position.

‘This is why spinal problems often go unnoticed in children. Pain often presents when a child is older, hosting problems developed much earlier in their lives.’

It seems a pattern for these arguably unconscionable con artists is to turn routine everyday normality into pseudo-pathology, whilst misinforming the public and undermining conventional medicine. A visit to the one stop chiro’ shop however will work like magic.

Not much is beyond them. Addiction treatment has been redefined years ago as “Reward Deficiency Syndrome”. A truly spectacular abuse of the neuropharmaco-kinetics and dynamics of the nucleus accumbens aka the “drug pleasure reward system”. The Chiropractic Journal once reported a Discovery Channel documentary on the topic.

The Brain Reward Cascade and RDS explain how persons can manifest a deficiency in their state of well-being, which interferes in their potential and quality of life. This work was eventually published in the Journal of Psychoactive Drugs….. Although RDS is estimated to be as high as 30% of the general population, persons suffering from addiction best represent RDS, as RDS is responsible for most addictions and compulsive disorders. The five addictions include work, eating disorders, sex, gambling and drugs. Compulsive disorders include Attention Deficit Disorder, ADHD and Tourette’s Syndrome.

Eh Gads! Almost a one in three chance of having RDS which is best represented by “persons suffering from addiction”. You could already have it! And what type of parent would take those risks? Drugs, sex, gambling, food and work. Or porn as we see below. Probably Gonzo Porn. Could you imagine what would happen if Gail Dines found out about this!? Hooley Dooley, a 30% chance of being addicted to the horrors of entwined flesh, bottom spanking, appalling music and lack luster plot lines.

Only 11 months ago Fighting Addiction With Chiropractic Care was published in Australia. In Beating Addiction – Chiropractic we read the fallacy;

In a randomized clinical trial with 98 addicts designed by Robert Duncan, Ph.D., biostatistician at the University of Miami School of Medicine, Dr. Holder found that daily chiropractic adjustments five times a week over a 30-day period increased the retention rate to 100%. “This is unheard of; it’s never happened before in addiction treatment,” Dr. Holder says. At a national average of only $40 per chiropractic adjustment, this rate of success costs only about $800 per month. Add to this $50 for a one-month’s supply of amino acids and $240-$400 a month for four addiction counseling sessions, and you have a total program cost of $1,100 to $1,250.

“This is unheard of; it’s never happened before in addiction treatment.” No kidding? And in Super Healthy, we read about “Super Recovery”. This guy kinda goes off the rails somehow, even squeezing in autism as a compulsive or addictive “behaviour”;

It could be a minister of religion gripped by an addiction to online pornography; it could be a housewife who covers her emotional and physical pain with prescription and over-the counter pain and anti-depressant pills….

Could Reward Deficiency Syndrome (RDS) be the common psychological thread that links a myriad of compulsive and addictive behaviors? What single trait is shared by… addiction to drugs (be they alcohol, cocaine, heroin, marijuana, or cigarettes); sugar and carbohydrate bingeing; pathological gambling; sex-related addictions; ADHD; Tourette’s Syndrome; Autism; Anorexia and Bulimia; Being a Workaholic; Risk-taking behaviors; and even many of the compulsive disorders?

In 2008 lacking evidence to support the claim of ability to treat colic – something science writer Simon Singh referred to as “bogus”, the British Chiropractic Association filed against him for libel. This rightly prompted England’s most senior judge to comment, “The opportunities to put this right have not been taken… I’m just baffled. If there is reliable evidence, why hasn’t someone published it?” He was also critical of the BCA’s inability to provide evidence of their ability to treat “childhood asthma and other ailments”.

These are exactly the claims being made by Warren Sipsis and his ilk, and I can assure readers there remains not a jot of evidence to support the notion of this lucrative one stop shop. What followed in the UK was that a full 25% of chiropractors fell under investigation for making unsubstantiated claims following the backlash from Singh supporters, the launch of Keep Libel Laws out of Science by Sense About Science and eventual dropping of the libel case against Simon Singh.

A major problem in Australia remains our toothless Therapeutic Goods Administration. Rubbish treatments and phoney diagnostic aids are approved on a risk basis – not an efficacy basis. This sees tricks like “crystal therapy” rated in the highest class for heart valve failure, electrical field treatment second and evidence based surgical replacement rated three categories on in the lowest. Therein lies another issue with sham treatments – the exploitation of practitioner and “patient” gullibility. Sipser has paid a small fortune no doubt, effectively for a “Machine that goes ‘Bing'” – used to fool the medical administrator in Monty Pythons The Meaning of Life. Fortunately The Weekend Australian captures the “sciencey” calming of intuition perfectly;

[Sipsers’ wellness practice has an] Insight Subluxation Station, which Sipser uses to diagnose patients. It employs surface electromyography (EMG) to detect electrical impulses in muscles, along with information on heart-rate and temperature which is fed through a computer to produce a chiropractic diagnosis. “It measures how much activity is in the muscles, and the thermal reading measures activity in the autonomic nervous system,” explains Sipser. “It shows how the nervous system is communicating with the organs.”

Reggars believes this is absolute nonsense. “Surface electromyography as typically used by chiropractors is just a gimmick and sales tool to encourage people to have chiropractic care,” he says. There is absolutely no evidence that surface EMG yields any information about internal organs, says Reggars, an opinion shared by Sydney University’s co-ordinator of musculoskeletal physiotherapy, Andrew Leaver. “I don’t know of any research that has even looked at the link between EMG results and organ pathology,” says Leaver.

For a parent concerned about her child’s health, however, watching the computer-screen’s horizontal graph-lines turn from dangerous black to benign white is reassuringly scientific. “I do like it because it’s something black and white, you can see the changes in the body,” says Liz van der Slot, whose children receive an EMG every six months.

Warren Sipser’s arrogance however, shows through in his dismissal of Reggars evidence based stance and focus on musculoskeletal problems. “That’s a very small part of the profession and they sometimes get publicity because controversy sells newspapers and television shows,” he says. “In truth, their numbers are so small that we can’t gauge what effect they are having”, he says. It’s a pity the same cannot be said about pseudoscientists like paediatric chiropractors. I’ve little doubt there are many like Sipser, and if the ranting of my anti-vaccination interlocutors is any sign as to how they cling to their demonstrably false beliefs there’s a genuine malignancy in Australian public health.

Ultimately there must be concerted efforts to complain about and deconstruct the false claims and grand promises of this fundamentalist new age money spinning hanky panky. It appeals directly to the “worried well” and insults collective intelligence by attacking conventional medicine. There’s no nice way to put it, but a great many chiropractors are perhaps liars and charlatans who make it up as they go. Others are sincerely misled with a high risk tendency to draw conclusions where there can be none. From a health care standing they are all to medicine what theologians are to astrophysics.

Finally the ball as ever is in our regulators court. The TGA must enforce much stricter standards on fake diagnostic tools and supplements that adorn chiropractor reception areas. The federal health portfolio must seek to take away as much rubbish, as it does add and reinforce genuine services.

Perhaps however, the greatest impact will come from science advocates, skeptics and mainstream medical activists using social media and large scale networking to call this scam to account.