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Holy crap, I’m slipping a subluxation and need a readjustment: The 117th Meeting of the Skeptics’ Circle

Yikes! How did I forget to plug the Skeptics’ Circle? This time around, it’s the Skeptics Circle #117: The Chiropractic Edition and it’s here to readjust your subluxated skepticism. Or something. Either way, it’s a hoot.

I do fear one thing though. Mike Meadon referred to the Skeptics’ Circle as “venerable.” Back when a blogger named St. Nate started this whole thing and then a few months later handed it off to me, way back in 2005, I never would have ever thought that one day the Circle would be referred to as “venerable.”

God, I’m so old. Or my blog is. Or something.

In any case, next up on August 27 is The Evolving Mind. Be sure to get your skeptical brains working to produce the fodder for yet another in the venerable line of skeptical explorations that the Circle has become.

Finally, I was perusing the schedule for upcoming Skeptics’ Circles, and I noticed that there are openings to host on October 22 and November 5, which shockingly, are not that far away. After that, other than December 17, there are no openings until late January. So, if you’re interested, now’s the time to volunteer, before those three openings are snagged by eager skeptical rogues.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

7 replies on “Holy crap, I’m slipping a subluxation and need a readjustment: The 117th Meeting of the Skeptics’ Circle”

It’s interesting that those tattoos do a better job of realistically representing the cephalopod eye (the one that’s visible in each, anyway!) than most cartoons do. There are probably cartoony versions of cephalopods on tattoos too though.

You all seem to be ignoring some important facts here. The libel suit against Singh is for the most part silly. The BCA should have known better than to print brochures that made claims not fully supported by the evidence. True.

However, Singh himself has printed many things about the chiropractic profession that also are not supported by the evidence. Most natably he has grossly overstated the risks involved when he wrote that hundreds of thousands of patients have been seriously injured and killed by chiropractic manipulation. The evidence is very clear in the exact opposite direction. The risk of injury is beyond remote, about 1:4,000,000 encounters, yet Mr Singh felt it was ok to slander the profession in that sense.

Basically, this idiot is going to be harrased from this point forward every time he speaks negatively about chiropractic in the same way he himself harrasses chiropractors. He shamelessly scares patients away from something very safe and effective and toward things that are much more dangerous and not as effective. Where is the balance in your judgement or do you see things one way and then cherry pick the evidence to support it? Are you the monsters you detest?

The risk of injury is beyond remote, about 1:4,000,000 encounters, yet Mr Singh felt it was ok to slander the profession in that sense.

Citation?

I’ve seen much higher figures. In one month on neurology I saw 2 young otherwise healthy people with vertebral artery dissection within 6 hours of chiropractic appointments, with onset of symptoms during the manipulation. The patients were at the chiropractor for maintenence adjustments, NOT for neck pain, so the argument that patients who are having clinically relevant dissections are more likely to be going to the chiropractor are not relevant to this anecdote. According to our neurologists, we see this sort of case 1-3 times a month on average.

I don’t go to med school at a major metropolitan area, there isn’t a population of “millions” to be having millions of encounters.

A brief review of the literature finds a much higher figure, a risk of JUST veretebral dissection of 1:10000 per encounter. That’s 400 times what you’re calling a remote risk.

Emerg Med J. 2006 January; 23(1): e1.
doi: 10.1136/emj.2004.015636.

Liliana Olim Goueveia et al “Safety of Chiropractic Interventions” Spine (2009) 34:11 E405-413. “There is no robust data” with the worst estimates being 5 strokes in 10,000 manipulations.

Problems studying the issue include the fact that neurologists only recently learned to ask victims about chiro. Also, if a person goes home and never regains consciousness, it may not be possible to determine if a chiro did it. However, sometimes it is obvious- bilateral artery dissection is chiro’s gift to humanity.

Also, we know that chiros dominate the field: Richard P Di Fabio “Manipulation of the Cervical Spine: Risks and Benefits” PHYS THER Vol. 79, No. 1, January 1999, pp. 50-65. http://www.ptjournal.org/cgi/content/full/79/1/50 If you look at the tables, you will see that chiros are oing the damage, and PTs outnumber chiros 10:1! This is explained by John Kinsinger (MD) as showing that PTs are more selective and skilled.

Chiros do a lot of neck snapping, including on people who have no apparent need (as observed by WTC). Moreover, they have no evidence that it is more effective than safer procedures. No, MrWonderful, Dr. Singh is correct.

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