On 18 Aug 2010 the GCC held a meeting where they discussed a revision to their chiropractic vertebral subluxation (VSC) guidance issued earlier in May this year.
Following the meeting the GCC have decided to change the wording of their subluxation guidance and as the initial statement was made in response to questions I raised, they were kind enough to send me a courtesy copy of the new guidance.
At first glance the changes seem minor and no doubt that is how the GCC hope it is viewed. However the wording of this revised guidance and the GCC’s rationale behind issuing it are worth a closer look.
In the covering letter the GCC say that the members of the council reflected on the following points:
- The term ‘subluxation’, as used by chiropractors, refers to functional derangements of the spine
- Functional derangements of the spine are the basis for health concerns
The outcome of the meeting was that they would drop the term ‘health concerns’ from their initial statement;
The chiropractic vertebral subluxation complex is an historical concept but remains a theoretical model., It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.
Surely the GCC must have good, evidence based reasons for making this change, or is there pressure being applied from elsewhere!
On the first point the council members considered, the GCC have previously stated that:
“the word ‘subluxation’ is a synonym for terms such as joint misalignment, joint dysfunction, facet syndrome and articular derangement”.
So unless an articular derangement is drastically different from a functional derangement, little would seem to have changed. If they insist that a functional derangement is somehow different where has it come from and why was it never mentioned before.
On the second point, the GCC have previously stated that there is insufficient evidence to support the VSC as a cause for health concerns, in May this year all of the chiropractic degree training establishments stated that they do not teach the VSC as a causal factor in health concerns.
Furthermore this 2009 review (‘An epidemiological examination of the subluxation construct using Hill’s criteria of causation’) of the latest 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”
At this point it is worth highlighting the last two words of this statement ‘requiring intervention’! Even if there is any evidence that a VSC may be a contributing factor in any health issue, there absolutely must be evidence to show that any health issue requires chiropractic intervention and that chiropractic is actually an effective treatment.
So what we have is a definition of what a subluxation is (functional derangement) combined with research reviews & GCC statements that there is no evidence to support such claims. We also have confirmation from the training establishments that they do not support or teach links between the subluxation and health concerns.
Clearly something has prompted the GCC to issue a revised guidance. Are the GCC in possession of updated research confirming a link, if so then this is truly a breakthrough and should be published ……. Or is there another reason for the U-Turn?
Many will be aware that since issuing their original guidance, the GCC has been widely criticised by chiropractors, both home and abroad and has been under pressure to withdraw or change that guidance.
As we can see here, this pressure would certainly seem to have played a major part in the GCC’s decision
On 17 Aug 2010 representatives of the Alliance of UK Chiropractors (AUKC) comprised of members of the MCA, SCA and UCA met with the GCC, the main subject of this meeting seems to have been the subluxation. At the meeting the AUKC presented what they describe as ‘a substantial 120 page dossier entitled The Vertebral Subluxation Complex – The History, Science, Evolution and Current Quantum Thinking on a Chiropractic Tenet’. (this document does not appear to be publically available via the internet)
This dossier was commissioned by the AUKC and includes contributions from Christopher Kent D.C a confirmed anti-Vax campaigner and Bruce Lipton a supporter of chiropractic with some ‘fringe’ ideas on genetics . So I have sent a letter to the GCC and asked them for a copy of the 120 page dossier and their view as to the quality of dossier as a basis for evidence.
I have also asked for details of exactly why they felt compelled to issue updated guidance. If this is based on the availability of new evidence then I have asked them to supply copies. They state that the VSC is the basis for health concerns and I have asked them to list these health conditions (along with supporting evidence).
I have also asked them for assurances that the changes are ‘evidence based’ and not simply due to outside pressure!