I do have a life and when I came home there were so many comments to respond from my posting “Savaged by a dead sheep” . It was easier to deal with the comments in a new posting , and differentiate between the comments with colour. I have edited the comments focusing on the Sceptics views which are in red rather than the chiropractors responses and I have answered some comments which were addressed to other chiropractors because I have a massive ego to satisfy. I am in Ireland at the moment so I can be a chiropractor for 48 hours.
And Lewis was on to my dastardly plan straight away and spots my efforts at slight of hand to swindle him out of his $100 ( and I apologise for all the interruptions in to his sentences): “Yes. Your test idea is obvious. Can chiropractors reliably diagnose the same subluxations?”
At this point I am taking the debate seriously and I am wondering if he thinks MDs can reliably diagnose swine flu, or a strain/sprain of the sacra iliac joint?? Unlikely when you consider twenty years ago chiropractors were the only ones saying the SI joint moved. Andy now starts his retreat from the $100 quackometer challenge; “It is not quite the same as homeopaths”.
Even though Andy, has said many times they were the same and he should think before making all his generalisations about CAM practitioners.
Andy has sussed how easy it would be for me to win the challenge because; “Spine wizards could be taught to classify common features as ‘subluxations’ even if they do not represent any pathology. Is’nt that what cervicle screening and mammograms are supposed to do. Dentists are thought to recognise problems before decay sets in. Why do people go to the gym? Lack of joint movement leads to degeneration and pathology in the joint. Maintaining movement prevents it. Lots and lots of research on this.
Andy is on a roll; “One would have thought a mature and responsible profession would have settled this question in its first few years of existence. So a quick literature search shows such tests have been tried – and failed.
One might start with the literature review of Hestbaek and Leboeuf-Yde, (2001) whose objectives were: "To systematically review the peer-reviewed literature about the reliability and validity of chiropractic tests used to determine the need for spinal manipulative therapy of the lumbo-pelvic spine, taking into account the quality of the studies."
"The detection of the manipulative lesion in the lumbo-pelvic spine depends on valid and reliable tests. Because such tests have not been established, the presence of the manipulative lesion remains hypothetical. Great effort is needed to develop, establish, and enforce valid and reliable test procedures."
Just whose head is up whose arse?”
Andy put up a challenge for homeopaths, I offered to demonstrate what I could do. I have always been good at anything I have put my hand to, I will play you at tennis if you prefer. Dont compare my skill to researchers who by nature would be part of your sceptical community. The discussion I am having with you I have been having with them since I was a student at AECC. Many chiropractic tutors were not particularly successful in practice and believed the answer to their problems was to medicalise chiropractic. Hence the GCCs decision to appoint a physiotherapist as chair of its education committee. This whole BCA thing with Simon Sing is laughable because the very chiropractors being attacked are the very ones who bent over backwards to have a love in with the medical community.
The chiropractoirs you are comparing me to are researchers not clinicians its like saying why aren’t the administrators at the LTA able to play tennis like Andy Murray. So bad are many of these people at using their hands to detect and correct subluxations that they want chiropractors prescribing, using ultrasound and interferential. It does not surprise me they are not able to reproduce palpateory skills of experienced chiropractors. Hence my comment (No medipractors in the challenge)
David Colquhoun comment:
Much though I enjoy your tilts at the GCC, the fact remains that; ‘subluxation’ is a preposterous made-up term for an imaginary lesion. How else could one account for the fact that nobody but chiropractors has ever imagined that they could see a ‘subluxation’.
Preposterous made up medicine is not a good idea for patients
Hi David, I agree with your second point, its like MDs telling people smoking was good for them in the 50s, telling mothers Thalidamide helped morning sickness or recommending people with heart disease to take Vioxx for their arthritis. Not to forget immobilise the knee joint after surgery.
I am sure we discussed this before. Subluxation is the name many chiropractors give to describe spinal joint dysfunction and its effect on mechano receptors. The medically minded in the profession call this joint dysfunction a “fixation” Meridle Gatterman described 150 names chiropractors have given to this lesion. We could call it a “Woosion” if Andy prefers.
Surely the point is, can spinal joints loose their range of motion and can I palpate the loss of movement (I can feel the loss of movement in a joint, you could only really “see” this loss in a cadaver. You could “see” differences in grosser range of motion by comparing turning head to right and left) and can I restore loss of spinal joint movement with a spinal adjustment and would the stimulation of those mechano receptors affect the baroreceptors in the carotid artery and increase cerebral blood flow.
My question to sceptics is, are you saying spinal joints do not loose ROM and if you accept the joints move, how would one get the movement back when adhesions form in the joint capsule?
“The blinding on this protocol would be terrible. I cant argue with the point you make. It would especially be interesting if the diagnosis was derived automatically using a machine”. I use mostly my hands to feel the “woosions”. Put your fingers back gently into the hollows on the side of your neck bend neck from side to side and you should feel the spinal joints moving.
“As a (very) preliminary test, this would be an interesting start. I’d be more than happy to take part in a trial. I have a long-term problem relating to my spine which I’d be happy to record ahead of the trial, and then see if a consistant diagnosis can be reached.” If I picked the chiropractors I think it would be pretty consistent.
“How do we go about arranging this? I am happy to be observed, questioned publicly, do Andys challenge, whatever, there are lots of chiropractors who feel the same others who may not be so confident of there skills and are awaiting their prescribing pads in the post.
Can you show any review of chiropractic that looks at studies of practitioner reliability and shows that there are consistent identification of subluxations?
If not, why not? Could it be that chiropractic is a castle built on sand?”
Andy, this is like kids arguing about who can piss the furthest, palpatory reliability ( is it the 4th or 5th thoracic vertebra) is not as important as does an adjustment effect nerves and can a cervical adjustment affect cerebral blood flow and will you pay up if it does?
Andy is now debating on other fronts and offers some help to us the “benign fools”; “Let me help you all out with another review. This time from Gemmell and Miller (2205) of the Anglo-European College of Chiropractic.
They wanted "To determine the interexaminer reliability of multidimensional approaches to detection of the spinal manipulable lesion through a systematic review."
They concluded "There are few studies of adequate quality and these fail to identify any multidimensional testing regimens that have adequate reliability. Further research is required in this area."
You are indistinguishable from homeopaths – unable to evidence the basic assertions of your beliefs. Instead, you like to make up ad hoc meaningless challenges to critics. And you have the cheek to call me ‘ill informed’”.
This is where I stop taking Andy seriously, he seem to be completely unaware of stuff he said only recently. First the challenge is not my idea Andy put it on his website and I followed the criteria he set out for homeopaths to win the $100.
Andy gets excited about a study which says the chiropractors studied were not very good at palpation, notice they use the term “spinal manipulable lesion” What I find interesting about this example of you being so “well informed”, only a few days ago you were accusing these same chiropractic tutors at AECC of brainwashing chiropractic students. You present this study as evidence that chiropractic is crap then when the same researchers do a study stating cervical manipulation is safe the sceptics say they are biased and that study is crap. As I said before you guys do not understand how to apply evidence to clinical practice.
Only a few days ago you were commenting about chiropractic education and stated:
“It does not change the fact that they are being drawn into a pseudomedical cult with absurd beliefs, a worrying business model and not a jot of evidence to support that vast majority of what they believe they can do.
The time to be respectful to chiropractors is when they clean themselves up – practice within their evidence base and abandon their pre-scientific mystical beliefs in non-existent subluxations”.
I clarified a bit about the background of the tutors for you and asked if you accept that the science tutors at AECC, provide chiropractic students with understanding of the scientific process at undergraduate level."
I would of course change my mind if I saw some evidence .To date, attempts to obtain evidence on such matters has been blocked by the colleges.
You knew all along that these tutors were capable of producing objective findings, and the way you have “Cherry picked” the study demonstrates just how prejudiced and narrow minded you really are. You do exactly what you accuse CAM researchers of doing, disregarding evidence that does not suit the point you are trying to make, isn’t that what BCA president Richard Brown did with his plethora of evidence. Birds of a feather Andy.
Andy later challenges Nico:
Nico – can you demonstrate that I have cherry picked?
We rest our case Andy. Then Andy offers this as his cowardly retreat from the “quack” challenge
And as for the little proposed study – then in what way would it offer better evidence than the review studies I have cited?
Fuck the evidence Andy, I just want your $100, can I take it from this you are not going to make me the offer you have made the homeopaths.
Andy finds it staggering that we “have the gall to keep going when you have a busted flush in your hands. To claim that after a hundred years of pretending to be a medical discipline you have no evidence for your central thesis is just staggering”.
Heres a guy who has spent hours reading about chiropractic and he still can not figure out who the medipractors are. Andy is the type of guy who knows the price of everything and the value of nothing. Yes Andy there are chiropractors who want to be medipractors and if you have not figured it out by now who they are, you are wasting your life away reading chiropractic websites.
Shall we ask the question again?
"Can you show any review of chiropractic that looks at studies of practitioner reliability and shows that there are consistent identification of subluxations? Do you have review studies that come to better conclusions?"
You have accused me of cherry picking. I think you ought to substantiate that or retract your accusation.
Andy mate, I have not a clue if there any studies to say the Le Buef girl is as good as me at palpation, and if there are, it is pretty obvious that it will not make the slightest bit of difference to your views of chiropractic. Can we agree to disagree and will you put on your website that you refused to offer me the $100 challenge. Common sense is often way more powerful than scientific journals unfortunately no one told the BCA believers or Andy.