Trick or Treatment-forfatter Edzard Ernst har helt nylig også publisert en kritisk gjennomgang av kiropraktikk i tidsskriftet Journal of Pain and Symptom Management (fulltekst her for dem med abonnement).
Artikkelen tar for seg tema som historikk (bl.a. hva slags syn som ligger til grunn for behandling), risiki, kostnader, effekt og etikk. Abstractet sier det vi etterhvert er vant til å lese:
Chiropractic was defined by D.D. Palmer as «a science of healing without drugs.» About 60,000 chiropractors currently practice in North America, and, worldwide, billions are spent each year for their services. This article attempts to critically evaluate chiropractic. The specific topics include the history of chiropractic; the internal conflicts within the profession; the concepts of chiropractic, particularly those of subluxation and spinal manipulation; chiropractic practice and research; and the efficacy, safety, and cost of chiropractic. A narrative review of selected articles from the published chiropractic literature was performed. For the assessment of efficacy, safety, and cost, the evaluation relied on previously published systematic reviews. Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today. Currently, there are two types of chiropractors: those religiously adhering to the gospel of its founding fathers and those open to change. The core concepts of chiropractic, subluxation and spinal manipulation, are not based on sound science. Back and neck pain are the domains of chiropractic but many chiropractors treat conditions other than musculoskeletal problems. With the possible exception of back pain, chiropractic spinal manipulation has not been shown to be effective for any medical condition. Manipulation is associated with frequent mild adverse effects and with serious complications of unknown incidence. Its cost-effectiveness has not been demonstrated beyond reasonable doubt. The concepts of chiropractic are not based on solid science and its therapeutic value has not been demonstrated beyond reasonable doubt.
Det er litt strengere enn i Trick or Treatment som er mer tilbøyelig til å akseptere virkning for behandling av smerter i nedre del av ryggen (men ender opp med å anbefale alternativer som fysioterapi og advare pga potensielle skader ved kiropraktisk behandling).
Jeg for min del falt for historiebiten (som høres interessant nok ut i seg selv), og ikke minst biten under «religion»:
Most early and many of today’s chiropractors agree: «Men do not cure. It is that inherent power (derived from the creator) that causes wounds to heal, or a part to be repaired. The Creator…uses the chiropractor as a tool…chiropractic philosophy is truly the missing link between Religion or Power of the various religions.»41
Nå om dagen virker slike synspunkt å være utdatert i mange land, deriblant Norge, mens USA og visstnok også Tyskland sin del av de mer «tradisjonelle».
Interessant artikkel med mange gode referanser å gå videre på.