Sunday, February 5, 2012

Weekender: Sidney Crosby and Quackopractic

As long-time readers of this space know, there is only one "system" of medicine, the one based on scientific research via double-blind studies conducted by bona fide peer-reviewed scientists at multiple locations.  One body of knowledge that supports the medical professions we ultimately depend on: physicians, dentists, nurses, dental hygienists, emergency medical personnel, lab technicians, and physiotherapists, etc.  In Alberta chiropractic was de-insured in 2009 by the Alberta Government.  As for Sidney Crosby specifically, one of my favourite hockey players, Dr. Steven Novella writes: "... so-called “straight” chiropractors who adhere to the original philosophy of D.D. Palmer - that a vital force they call innate intelligence is responsible for health, and blockages in the flow of this magical force through the nerves are what cause illness. Such chiropractors believe they can influence non-neuromuscular conditions by restoring the flow of innate intelligence blocked by mysterious “subluxations” in the spine. From chiropractors.org we have this definition of “straight" chiropractors: 'Because straight chiropractors believe that nearly all diseases are caused by issues with the spine, they don’t believe they need any diagnostic tools. Traditional testing done by medical doctors and hospitals is not even considered by a straight chiropractor as being necessary. Diagnosis is done by finding the subluxations in the spine so that those can be corrected.' This particular version of chiropractic (by some estimates about a third of chiropractors follow this philosophy) is pure pseudoscience. It is, as indicated by the quote above, hostile to science-based medicine. After a century of such belief there isn’t a bit of evidence to support the notion of innate intelligence, chiropractic subluxations, or health benefits from this approach. Some straight chiropractors even “specialize” - one specialty, chiropractic neurology, has been getting some press because hockey star Sidney Crosby has been going to a chiropractic neurologist, Ted Carrick, to treat his concussion. The main idea behind chiropractic neurology is the same as for straight chiropractic in general, just applied to neurological disorders. Carrick claims that he can treat a variety of brain disorders with targeted manipulation and elaborate exercises and routines. In a PBS interview he said: "Well, we’re finding every day that more and more things that we didn’t think were associated with chiropractic treatment can be affected very nicely. There are testimonials from people who have had their eyesight and hearing back, and people waking up from comas." Waking a patient from a coma is perhaps the ultimate rehabilitative claim in neurology. You will notice, of course, that Carrick refers to only “testimonials”. The reason for that is because there are no published articles establishing such bold claims. Chiropractic neurology does not appear to be based on any body of research, or any accumulated scientific knowledge. I am not aware of any research that establishes their core claims. A search on PubMed for “Carrick T” yielded nothing, and searching on “chiropractic neurology” yielded mostly studies about neurological complications from chiropractic treatment. There was one letter from the President of the International Academy of Chiropractic Neurology. I followed that link to the IACN website, but found no references or links to any published studies establishing the scientific basis of chiropractic neurology. There was no science at all. I also noted that the IACN mission statement does not make any mention of promoting scientific research or science-based standards. Chiropractic neurology appears to me to be the very definition of pseudoscience – it has all the trappings of a legitimate profession, with a complex set of beliefs and practices, but there is no underlying scientific basis for any of it."