Subluxations: Still no evidence ..

Posted on October 17, 2010

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This post is an update on my earlier discussions with the General Chiropractic Council on the subject of the evidence to support various claims surrounding the Chiropractic Vertebral Subluxation Complex (VSC).

The background to this post can be found here:

Subluxations: We’ve never considered the research Pt1

Subluxations: We’ve never considered the research Pt2

This resulted in the GCC issuing some guidance to its members. To say this new guidance was unpopular with chiropractors would be something of an understatement.  Chiropractors in the UK (and abroad) became very vocal in demanding this guidance be changed.

An organisation calling itself the Alliance of UK Chiropractors (AUKC) was formed and they proceeded to put pressure on the GCC to reinstate their beloved subluxation. Afterall, chiropractic without subluxations is little more than a vigorous back rub!

Eventually the GCC gave way and issued an amendment to their guidance.  More on this can be found here: GCC under pressure over subluxations

The GCC’s original statement was that there was no evidence to support subluxation claims, yet after this meeting they changed the guidance.  If they are going to allow subluxations to be linked to health concerns, then surely they must now have some evidence.  The AUKC had submitted a ‘120 page dossier’ they describe as:

“A lengthy and detailed presentation was made by the Alliance about the VSC and a substantial 120 page dossier entitled The Vertebral Subluxation Complex – The History, Science, Evolution and Current Quantum Thinking on a Chiropractic Tenet was also presented to Council members”.

Maybe that contains the evidence!

So on 27 Aug  I wrote to the GCC asking if they could explain the reasoning behind changing the guidance and asked if they now had any evidence.  My personal view was that these changes had more to do with chiropractic politics than actual evidence.

My letter can be found here:   GCC_SubluxRevisionX

The GCC’s response is here:     GCCSubluxReply

I also asked for a copy of the 120 page dossier. At present I don’t have a copy of the dossier and this is ongoing as part of an FOIA request to the GCC.   There will be more on this in a later blog post.

However it is clear that whilst the AUKC may consider this dossier important, the GCC very clearly do not.  They have stated that

“the changes to the GCC’s guidance on the chiropractic vertebral subluxation complex (VSC) were not based on the contents of the dossier”

And ….

”the Council has not discussed the dossier, either during or after the meeting with the professional associations, and has no view on it”

At first glance it seems odd that although this dossier was presented to the GCC during discussions on the VSC  the GCC seem keen to distance themselves from it and are reluctant to make any public comment on its contents.

That alone speaks volumes for the quality of the information contained in the dossier.  If it contained any credible evidence to support claims surrounding the VSC then I think we could be sure it would have played a part in the decision making.

What we do know is that the dossier contains input from Christopher Kent D.C (a confirmed anti-Vax campaigner ) and Bruce Lipton (a chiropractic supporter with some ‘fringe’ ideas on genetics ), I’m sure it will make an interesting read, even though the AUKC seem reluctant to release it.

Reading the GCC’s response you’ll see there is no mention of new evidence linking the VSC and ‘health concerns’.   They do mentions the NHS Clinical Knowledge Summary on low back pain (without radiculopathy), linking lower back pain to ‘disturbance of function’.

What they fail to mention is that this report doesn’t actually cover the VSC and the only condition it mentions is ‘lower back pain’.  Current NICE guidelines only consider that chiropractic can be considered as a treatment option for ONE condition – Lower Back Pain.

Even if we were to accept this as suitable evidence for the VSC, then perhaps the GCC’s guidance should limit itself to ‘lower back pain’ rather than allowing more general ‘health concerns’.

Chiropractors & the GCC would do well to look at NHS information that specifically relates to chiropractic!

NHS Patient Information: Common uses for Chiropractic

NHS Patient Information: Chiropractic Evidence

What should not be overlooked in the GCC’s letter is their comment that:

“Council considered whether to replace the words ‘and health concerns’ with ‘and specific conditions’ but this was considered unnecessary as ‘disease’ would include specific conditions”

So if ‘disease’ is to be taken to mean any ‘specific condition’ then it is clear that chiropractors should not be making any specific claims linked to the presence of the VSC.  If the VSC is not actually responsible for any specific condition, then chiropractors have no reason to conduct X-rays based on the supposed presence of a VSC!

I’ll finnish this post by repeating a comment from a study called ‘An epidemiological examination of the subluxation construct using Hill’s criteria of causation’), this  research concludes that:

“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention”

Again it is important to remember that any evidence should not only establish a  link  between a  ‘disturbance of function’ and  a particular condition, but MUST also show that chiropractic manipulation is justified as a treatment!

I’m sure the AUKC will look favourably on my request for a copy of the dossier!

 

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