A new study by Edzard Ernst and Andrew Gilbey recently appeared in the New Zealand Medical Journal surveying Internet advertising claims made by individual chiropractors and major chiropractic organizations from Canada, the U.S., New Zealand, and The U.K.
They divided the claims into those for which there is reasonable evidence of some benefit (lower back pain) and those for which no good evidence of efficacy exists (headaches, migraines, colic, asthma, ear infections, neck pain, and whiplash). What is not surprising is that chiropractors, and the professional organizations that represent the profession generally, routinely suggest or outright state that their manipulations can treat conditions which they cannot. 95% of individual chiropractic websites made at least one such claim, and all of the professional associations did as well. 38% of the chiropractors made treatment claims concerning all of the conditions in the survey which chiropractic has not been shown to actually treat.
What is a bit more surprising is that many of the sites and organizations did not promote chiropractic for lower back pain, the one condition for which the evidence of some benefit is decent. Only 28% of the individual sites and 4 out of 9 association web sites specifically mentioned lower back pain. One would think they would be most aggressively advertising their treatments for the diseases for which the best evidence exists that they actually help. But remember, chiropractic is, for the most part, really a faith-based practice founded on the non-existent subluxation and the vitalist “innate intelligence,” not an evidence-based medical specialty. It is true some individual chiropractors are exceptions to this rule and limit themselves to treating musculoskeletal pain. And there are some signs that the profession may be moving to downplay the subluxation mythology. But in general, the practice of chiropractic is still dominated by 19th century spiritualist notions and isn’t much interested in the verdict of science on its efforts.
So how do we explain the apparent de-emphasizing of the most reasonable claims chiropractic could make? I suspect that there is a deliberate effort on the part of the chiropractic profession to avoid getting limited in the public’s mind to treatment of musculoskeletal pain. Chiropractors want to be seen as an alternative choice to conventional medical providers, and they want to be involved in much more than just the treatment of musculoskeletal pain. So despite the lip service they may pay to the concept of evidence-based medicine, in reality they are convinced their treatments work for all sorts of problems regardless of the lack of evidence, and they want to protect and nurture the false impression the public may have that chiropractic is good for more than just back pain.