Chiropractor Guillaume Goncalves, Professor Christine Le Scanff and Professor Charlotte Leboeuf-Yde have searched the literature for evidence that manipulation of the spine or chiropractic treatment can be used to prevent non-MSK diseases in primary or early secondary prevention.
They found no evidence for this claim and they come down hard on the vitalistic approach to chiropractic.
‘The chiropractic vitalistic approach to the concept of ‘subluxation’ as a cause of disease lacks both biological plausibility and possibly proof of validity. Nonetheless, some chiropractors purport to prevent disease in general through the use of chiropractic care. Evidence of its effect is needed to be allowed to continue this practice’ the three researchers write in their paper.
In the light of the lack of evidence, the question is why some chiropractors continue to practice according to the vitalistic model? According to the three researchers it is because the chiropractors in question find evidence for their interpretation in the scientific literature. This is a misconception based on the quality of the available literature, the researchers explain; they emphasise their argument by going through the criteria for good scientific literature and explaining why the available literature regarding prevention of general diseases via chiropractic treatment does not live up to these criteria, hence not containing useful evidence.
Because of the lack of evidence for the effect of chiropractic treatment as prevention of non-MSK diseases, ‘chiropractors have to assume their role as evidence-based clinicians and the leaders of the profession must accept that it is harmful to the profession to imply a public health importance in relation to the prevention of such diseases through manipulative therapy/chiropractic treatment’.
The three researchers wonder why some chiropractors want to extend their scope outside the MSK field: ‘It is unclear why some chiropractors feel the need to extend their scope of practice into implausible areas, when there is so much to do in the musculoskeletal field’ they conclude their paper.
As part of their systematic review, Guillaume Goncalves, Christine Le Scanff and Charlotte Leboeuf-Yde screened more than 13 000 papers in English from three databases, PubMed, Embase and Index to Chiropractic Literature in their search for evidence, using the search words ’chiropractic’, ’subluxation’, ’wellness’, ’prevention’, ’spinal manipulation’ and ’mortality’. The screening yielded 13 papers dealing with various disorders of public health importance, e.g. diastolic blood pressure, blood test immunological markers and mortality. Two of the 13 papers could be used for data synthesis and none showed any effect of spinal manipulation or chiropractic treatment on non-MSK diseases.
Effect of chiropractic treatment on primary or early secondary prevention: a systematic review with a pedagogic approach. Guillaume Goncalves G, Le Scanff C, Leboeuf-Yde C. Chiropractic & Manual Therapies 2018. https://doi.org/10.1186/s12998-018-0179-x