Alternative therapy for backache 'can kill or disable'

One of the most common 'alternative' treatments for backache is dangerous and can kill, says Britain's leading expert on complementary medicine, Professor Edzard Ernst.

Spinal manipulation, used by chiropractors to treat hundreds of thousands of patients a year, poses serious risks, he warns in a paper published in the Journal of the Royal Society of Medicine

'[It] is associated with frequent, mild and transient adverse effects as well as with serious complications which can lead to permanent disability or death.'

Spinal manipulation involves sharp thrusts against a patient's spine to push individual vertebrae beyond normal levels of stress. But Ernst says that such violent therapy can seriously damage the arteries running near the spine, triggering thrombosis or a stroke.

The claim has incensed chiropractors. In letters to be published in the journal's October issue, they accuse Ernst of distortion, errors and misinterpreting data.

'The major body of published evidence points to manipulation being a safe and effective tool,' says Barry Lewis, president of the British Chiropractic Association. He accuses Ernst of 'puffing up his evidence out of all proportion'.

One case involves Frances Denoon, who was in her 20s when she pulled a nerve in her neck while exercising. She visited a registered chiropractor and recalled feeling a 'crack' when he began his treatment. 'I couldn't focus and realised I wasn't saying words clearly,' she says on the Action for Victims of Chiropractic's website. Denoon suffered a brain-stem stroke and now has poor balance and cannot write with her right hand. A court cleared her chiropractor of negligence.

Such stories are just the tip of an iceberg, says Ernst, director of complementary medicine at the Peninsula Medical School, run by Exeter and Plymouth universities. He has collected details of about 700 cases.

'I am not calling for a ban on chiropractors carrying out spinal manipulation but I think we have to think about regulating the practice far more carefully than we do at present,' he said.

A spokeswoman for the General Chiropractic Council (GCC) said 2,300 chiropractors were registered with it and that since 2001 only one had been disciplined for breaching guidelines.
Peter Dixon, the council's chairman, said the report was 'yet another research scare' story.

'This does not serve the interests of the public or those of researchers who are dedicated to improving the public's health,' he said.