The Ethical Spectacle

Media's Manipulative Subluxation

by Howard Fienberg
January 2001

When does ‘alternative’ medicine become an accepted part of the ‘mainstream?’ A recent Chicago Tribune story (“First line of defense,” Nov. 26) declared that chiropractors, formerly underdog care givers “dogged by a shady reputation” who “resisted attempts to squelch their profession” are now “becoming mainstream.” But this story lacked an important journalistic ingredient needed to differentiate it from a mere infomercial: balance.

The Tribune described the origins of chiropractic care and interviewed patients who swear by it. However, the report did little to explain the basis for the practice or to consider why the American Medical Association (AMA), which has called chiropractors an “unscientific cult,” no longer does so. The AMA indeed “fought to exclude them [chiropractors] from insurance programs and for decades forbade its members from referring patients to them.” But this story made it appear as if the AMA had somehow changed its mind. In fact, the ruling in an anti-trust lawsuit brought by a group of chiropractors against the AMA legally forbade the organization from speaking out against chiropractic.

As the Tribune explained, “the mainstay of chiropractic treatment is the correction of subluxations through the use of spinal manipulation.” These subluxations supposedly interfere with nerve function, thus causing disease. But the Tribune did not define subluxation. According to Dr. William T. Jarvis, professor of public health at Loma Linda University, no “chiropractor has ever been able to reliably demonstrate the existence of ‘subluxations,’ much less validate their importance to health and disease.” Dr. Jarvis does admit that “there is sufficient evidence that manipulation can at least temporarily improve the range of motion of impaired joints and relieve pain ... to make it a worthwhile, although limited medical procedure.” But the most likely reason for chiropractic’s popularity lies in the “laying on of hands, which reportedly has the effect of relaxing the patient.”

No mention was made of the numerous tests of chiropractors’ consistency in diagnosing subluxations. Dr. Jarvis alludes to reporter Ralph Lee Smith’s 1969 book, At Your Own Risk, in which he discusses his trips to two different chiropractors, from whom he received completely different subluxation diagnoses. Dr. Jarvis also cites similar trials have been run since then, including one by consumer advocate Dr. Stephen Barrett, who sent a healthy four-year-old girl to five chiropractors for a simple check-up. Each found something entirely differently wrong with her, ranging from a “twisted” pelvis, to an “elevated” hip, to a “shorter left leg.”

James Winterstein, president of the former National College of Chiropractic, told the Tribune “there’s an awful lot of empirical evidence, but not an awful lot of double blind studies.” That is the extent of the investigation. Lack of supporting scientific evidence was dismissed in the face of anecdotes. The Tribune concluded that “a chiropractor can be helpful for a variety of health problems,” following with a guide to choosing your chiropractor.

Dr. Jarvis’ conclusion? “This article reads like a paid public relations piece for the American Chiropractic Association.”


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