A chiropractic “adjustment” in New Jersey

Here’s a rather interesting wrinkle in the regulation of chiropractors. This time, it’s New Jersey:

A recent state court decision has hundreds of chiropractors across the state bent out of shape because it sharply limits what they can legally do.

And while the decision is being appealed to the state Supreme Court and state legislators have proposed amending state law to return the field to where it was, changes are not expected for months.
In the meantime, the decision “definitely wiped out a source of income, because we were able to bill for the extremity adjustment before and now we can’t,” Ventnor chiropractor Michael T. Sherman said. “We can’t do it. It’s ridiculous. It’s ridiculous is what it is.”

The U.S. government calls chiropractors medical professionals who treat patients with health problems associated with the body’s muscular, nervous and skeletal systems, especially the spine.
Chiropractors frequently treat problems by physically adjusting the spine or working a joint through a range of motion. The field takes a generally holistic view toward overall health.

You know, I’ve always had a bit of a problem with that characterization of chiropractors, at least the ones who claim to be able to do more than just treat the musculoskeletal system, such as treating allergies and other diseases with chiropractic adjustment. Such chiropractors are in essence physical therapists with delusions of grandeur who don’t know their limitations, which is one reason why I like physical therapists much more than I like chiropractors. Physical therapists generally don’t claim to be able to do any more than what they can do, and most of them do it well; indeed, a good physical therapist is probably more valuable than a horde of chiropractors. Better, physical therapists. don’t invoke “adjustments” of nonexistent “subluxations” as a means of curing disease or claim that their treatment can cause people to come off their antianxiety medications, as one of the chiropractors in this article did. From my perspective, I find it rather risible that a profession many of whose members tie all manner of unrelated diseases and health issues to a single structure (the spine) to be “holistic” in anything.

But I digress. After a little mention of those nasty “skeptical doctors” who “question the science” behind chiropractic, the article explains how this came to pass:

Chiropractors’ current problems started with a malpractice case.

A patient named Carol Bedford claimed her longtime chiropractors Anthony L. Riello and Peter E. Lowenstein from Brick’s Coastal Chiropractic tore cartilage in her left knee when they adjusted it in 1999.
The initial trial court found for Riello, Lowenstein and Coastal Chiropractic. But Bedford appealed, asking whether they should even been allowed to manipulate any part of the body other than the “spine and related structures.”

Taking a broad view, chiropractors have for years treated joints and limbs because they said they were related to the spine. A sprained ankle, for instance, could change the way a person walks thereby misaligning their spine and leading to discomfort.

On April 18, the state appellate court ruled in Bedford’s favor, narrowly interpreting a 1953 state law that limited chiropractors to problems related to the spine. “We conclude that the scope of chiropractic in New Jersey is limited to adjustments of the spinal column and does not include the adjustment of other joints,” the opinion read. It allowed a new trial.

Like much of state regulation of alternative medicine, I’m of two minds on this. While it is probably better that such practitioners be regulated rather than unregulated, their regulation by the state gives them more of a sense of respectability than they deserve, as if there were actual science to support what they do. Another drawback is that controversies like this break out periodically over the scope of each “discipline’s” practice. The problem is, there’s no science to support either position