This is a follow up to an earlier blog post on the subject of the GCC’s view of the evidence supporting subluxations. The first part can be found here: Part 1
Before I go any further, it is worth having a quick reminder of the GCC’s initial response when asked for their views:
Thank you for your enquiry. The General Council has never considered the research evidence for the chiropractic vertebral subluxation complex.
That was it, their reply in full. Not happy with that response, the GCC were then asked to provide clear, unambiguous answers to four straightforward questions relating to subluxations, evidence and claims.
Copies of my letter and the GCC’s replies can be found at the bottom of the page.
My letter was distributed to members of the GCC’s Education Committee and discussed at their last meeting on 13 April, the various chiropractic training providers were also asked to provide information on how they teach subluxations and what research they draw from. A subsequent meeting was held on 12 May where the advice from the Education committee and training providers was considered.
These are the questions asked and the GCC’s response :
1. (my original email question) Can you tell me at what level the GCC currently view the evidence for chiropractic vertebral subluxation complex (High, Moderate, Inconclusive, positive or negative etc) with regards to causation of disease or health concerns ? Also if the evidence is considered to be of a positive nature, could you please provide details of the reports used to reach this conclusion.
1. There is no clinical research base to support claims that the chiropractic vertebral subluxation complex is the cause of disease or health concerns.
2. Does the GCC intend to review the research evidence or seek any advice on these claims (ASA/CAP etc), including expected timescale?
2. The GCC does not intend to seek any further advice on the claims made.
3. Provide a statement on how these claims currently relate to the GCC’s Code of Practice?
3a. If considered to breach the COP: What advice would it give to its members?
3b. If not considered to breach the COP; On what justification?
3. Within the next week or so the GCC intends to issue guidance to the profession on claims made for the chiropractic vertebral subluxation complex, a copy of which will be sent to you.
4. What is a subluxation and can it do me harm? ( This is the question removed from the GCC’s FAQ)
4. On your fourth question, the word ‘subluxation’ is a synonym for terms such as joint misalignment, joint dysfunction, facet syndrome and articular derangement.
My apologies to those of you who were hoping to dissect the quality of the GCC’s evidence . They don’t have any …….. dare I say ‘not a jot’!
The answers are very clear, unambiguous and I suspect they will have implications that may be unpopular with some chiropractors.
(answer 1) There is NO research evidence to support any claims that a subluxation (as used by chiropractors) is in any way responsible for causing disease OR other health concerns.
(answer 3) Once the GCC have issued their guidance to their members, their websites and advertising will need to change. To continue to make claims that subluxations are the root cause of health care concerns would breach the GCC’s COP.
Importantly, the GCC acknowledge (answer 4) that terms such as joint misalignment or dysfunction have the same meaning as subluxation. Simply using different terminology is not a get out clause!
The GCC also supplied a copy of another document ‘Advice On The Research Base For The Chiropractic Vertebral Subluxation Complex’
The response at 2.4 from the McTimoney College of Chiropractors where they claims subluxations are only mentioned in the context of the history of chiropractic, seem a little odd. When I sent my letter to the GCC on 28 March, the McTimoney website stated:
The basic principle of chiropractic is that disturbances of the nervous system, resulting from subluxation of the bones of the spine and other parts of the body, are a primary or contributory factor in the pathological process of many common human and animal ailments.
This statement vanished around the time of the 13 April meeting.
This McTimoney prospectus from 2008/2009 also shows that Subluxations were not looked upon simply as a part of the history of chiropractic.
Subluxation isn’t actually mentioned in the ‘History’ section, however the wording used on their website is repeated in the ‘What is Chiropractic’ and also mentioned in the ‘How Chiropractic Works’ section.
What the wider implications of this are will become apparent over the next few weeks/months.
What is clear is that without any evidence to support the various subluxations claims, if the chiropractic profession want to be taken seriously over important issues like evidence based practice – they must consign the subluxation to the history books along with all the other outdated forms of medical quackery!
“The General Council has never considered the research evidence for the chiropractic vertebral subluxation complex” ….. Look what happens when you do!
Related (and very amusing) blog post by Zeno Obituary: The death of the subluxation
Copies of my original letter and the GCC’s replies:
My Original Letter 8 Mar LTR_GCC-SubluxationEv2
GCC letter dated: 14 May SubluxGCC
Advice On The Research Base For The Chiropractic Vertebral Subluxation Complex GCCSubluxAdvice