Articles by JCS

More Witches Down Under

                                                                                                   

Word count: 3793

More Witches Down Under

The witch hunt against pediatric chiropractic care Down Under has resurfaced on a television program, Studio 10. The TV hostess introduced her interview with Dr. Ian Rossborough and immediately showed her bias with the inflammatory prelude, “The crack heard around the country and has gone viral around the world.”

First clue this was going to be another witch hunt by an uninformed news person. You can view this interview here: Baby cracking chiropractor flounders, published on May 3, 2016, Studio 10, with Anne Blake:

“Interview with Melbourne chiropractor Ian Rossborough about the promotional video in which he claimed to treat a four day old baby for "colic" by administering a painful crack to the lower back. The loud crack and the baby's screams have caused widespread outrage and led to calls for the banning of chiropractic ‘therapy.’"

As you can see, even the introduction to this video clearly shows bias – “administering a painful crack…baby’s screams have cause widespread outrage and led to calls for the banning of chiropractic "therapy".

Of course, the only “calls for the banning of chiropractic therapy” stem from the medical curmudgeons and their allies in the media. However, no parent of any colicky child has called for any ban, but presenting a “fair and balanced” argument was not the intent of this TV program’s witch hunt.

It was obvious from the start Dr. Rossborough had already been convicted in the minds of this TV panel. Aside from one woman who spoke about chiropractic helping her migraines, the other panelists teamed up to cast aspersions with inflammatory remarks at Dr. Rossborough. Certainly their tone was very skeptical and I doubt nothing he said would have convinced them otherwise.

Another newspaper article has also recently appeared Down Under in the Daily Mail casting the same aspersions against the notion of pediatric chiropractic featuring a chiropractor who is also a television personality, “Bachelor star Tim Robards works at health clinic which promotes controversial chiropractic techniques to treat newborns,” by Jenny Awford for Daily Mail Australia on May 3, 2016.

Undoubtedly this television bachelor and sexy hunk must have created mixed emotions among the female panelists – on one hand physically attracted to this good looking professional, but now taught to be afraid of his profession. Oh, the pain of unrequited love!

This article once again quoted the same curmudgeon: “President of the College of GPs, Dr. Frank Jones, told Daily Mail Australia that manipulating a child's spine is a 'cruel' process. ‘I think that this is an unnecessary and seemingly almost cruel process that there is actually no evidence to support,’ Dr. Jones said. ‘It should not be advertised, it should not be practiced.’”

Certainly manipulating a child’s spine is not safe practiced by an untrained MD, but for chiropractors trained in pediatric spinal care, it is an effective treatment as the research shows and as Drs. Rossborough and Robards will attest.

Once again Dr. Jones’ statement is without merit considering there are scientific studies supporting pediatric chiropractic care. Just like the news reporters, Dr. Jones simply did not do his homework on this issue, typical of a witch hunt to ignore the facts and act solely on emotion and vested interest.

A simple search on PubMed would have found the studies I previously cited in support of chiropractic care for colicky babies, such as:

·                     The Chiropractic Care Of Infants With Colic: A Systematic Review Of The Literature.[i]

RESULTS: Our findings reveal that chiropractic care is a viable alternative to the care of infantile colic and congruent with evidence-based practice, particularly when one considers that medical care options are no better than placebo or have associated adverse events.

·                     Efficacy of Chiropractic Manual Therapy on Infant Colic: A Pragmatic Single-Blind, Randomized Controlled Trial.[ii]

CONCLUSIONS: In this study, chiropractic manual therapy improved crying behavior in infants with colic.

·                     Manipulative therapies for infantile colic.[iii]

CONCLUSION: The majority of the included trials appeared to indicate that the parents of infants receiving manipulative therapies reported fewer hours crying per day than parents whose infants did not, based on contemporaneous crying diaries, and this difference was statistically significant.

Despite its mantra of “fair and balanced,” FOX News in the US jumped on this bandwagon with its segment, WATCH: Chiropractor Faces Firestorm for Cracking This Newborn Baby's Back. To its credit, unlike the TV segment from Down Under, this FOX report included a few kind words:

One doctor said on Fox and Friends Weekend this morning that the treatment is not as dangerous as it may sound – and “works really well with calming babies.”

“The noise you hear is gas being released from the joint. It’s a fairly normal thing,” said Dr. Tim Bain of Bain Complete Wellness. “You’re not cracking the back, per se.”

But attending physician Dr. Philippa Cheetham says she wouldn’t do it for her kids.

“The problem with this – first of all, we still don’t know what causes colic. We know that it’s a very distressing symptom for baby and for parents,” she told Brian, Tucker and Anna.

Colic is “extremely common,” Dr. Cheetham pointed out. “Children grow out of it. We must remember that this does not have a medical cause.”

“We have to be very careful,” she added. “There’s no evidence that this is effective treatment for colic.”

 

Once again we see another uninformed expert on this issue considering there is plenty of evidence. Afterwards, the ACA sent a response to FOX News on April 28, 2016, noting a 2014 review that found only 12 reported cases of serious adverse events (seven of which involved a chiropractic physician) and three reported deaths (none of which involved a doctor of chiropractic) in over 115 years of literature.  12 cases in 115 years! Can any medical treatment compare as well?

The authors concluded:

“Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are exceedingly rare. There have been no cases of deaths associated with chiropractic care reported in the academic literature to date.”[iv]

Another study found parents who bring their children to a Doctor of Chiropractic are highly satisfied. A 2008 study noted that examined 781 pediatric patients under 3 years of age (73 percent of whom were under 13 weeks) who received 5242 chiropractic treatments over a 3-year period, 85 percent of parents reported improvement in their children’s symptoms.[v] 

Yet will this good evidence be mentioned by Fox & Friends or will an apology from Dr. Philippa Cheetham be forthcoming?

Witch Bitch

Certainly Dr. Rossborough needed more preparation for his interview. For example, many members on the panel of this medical inquisition kept asking, “Where are the research studies?” It would have been helpful if he had done research on this issue beforehand to cite scientific literature.

Instead he replied, “I’m not an expert on research, people can access the evidence what’s out there.” That went over well as if he was dodging the question.

Other comments from the uninformed TV panelists indicated their fears and worries, such as “I can’t watch without wincing…total bunk…taking advantage of parents.”

Another panelist asked, Why did the baby need a spinal manipulation?”

“Because it was crying incessantly,” Dr. Rossborough responded.

“But don’t all babies cry?” Obviously this woman is unaware of the ordeal of colic.

“Most babies cry 2 or 3 hours a day, but not 24 hours day and night.”

Again, she seemed to be minimizing the need for care; after all, she replied, “most babies grow out of it.”

Another panelist asked, “Have you used it on your own children?”

“Of course, yes,” he said.

Obviously these questions were intended to raise the emotional tenor among the audience of this television inquisition. They also kept ignoring the fact the colicky baby is now better, a point Dr. Rossborough made but ignored by the panelists.

If the goal of the TV producers was to strike an emotional chord, I would be curious to know how these panelists might feel if they had watched this instruction video, FORCEPS DELIVERIES - PIPER FORCEPS | Medical Training Film?  What would they say about another YouTube news report with parents saying their baby allegedly died after its head was crushed in a forceps delivery?[vi]

Obviously these women were reacting emotionally after viewing the infant’s adjustment and hearing the baby cry. Apparently the baby crying or as they put it, “screaming,” was enough to throw the baby out with the bathwater! (Pun intended!)

If the criterion of a baby crying is sole evidence of an unacceptable medical treatment, these panelists would freak out seeing the use of forceps delivery or watching children cry from vaccine injections that undoubtedly are more traumatic and controversial than Dr. Rossborough’s gentle adjustment.

If the truth be known, spinal adjustments never look good to someone who has never been adjusted – they just don’t understand how good it can feel. Adding to the “cracking” sound, the crying of an infant certainly pulls at the heart strings of anyone, compounding the sympathy for the baby and anger toward the alleged assailant. Indeed, Dr. Rossborough was damned from the start on his own video by naïve viewers who have taken it completely out of context.

In my office, I discourage patients who want to bring family members or potential new patients into my adjusting room to watch. I have seen on those rare occasions when I have allowed them to watch, undoubtedly they flinch, thinking it is a painful experience. They obviously have seen too many Arnold Schwarzenegger movies showing him wrenching necks!

I must admit Dr. Rossborough’s explanation also was too obtuse for this medically-minded panel to understand. For instance, he was unable to give a good explanation how his manipulation helped colic. He admitted there is no “colic bone to adjust” and explained chiropractors “Take something that is not natural and make it natural.”

While that may be true, it was not a concrete example for this panel or TV audience to understand. Indeed, neurophysiology and spino-visceral physiology is a difficult subject to explain to laymen or to MDs stuck in the germ theory.

At the end of the interview, the TV hostess shot another zinger at Dr. Rossborough when she broached an incident when a baby allegedly died from a spinal fracture after being adjusted. Dr. Rossborough replied that “that didn’t happen, it was a congenital deformity.” He also mentioned “if there were a problem, I would know about it, but I haven’t heard of one.” Considering there have been only 12 cases in 115 years, he is perfectly right to suggest chiropractic care for infants is incredibly safe – again a statistic he should have used to put these panelists on their heels.

Instead, he was forced onto his heels to defend his actions in a victimless non-crime to a group of ignorant and biased TV panelists who obviously had an ax to grind and wanted to be judge and jury in the court of public opinion. It was definitely a no-win situation for Dr. Rossborough.

To pour more salt into his wound, just before the end of the interview the hostess asked him, “Do you support vaccination?” knowing this is also a very controversial topic very similar to abortion in an attempt to portray him as a medical heretic. Dr. Rossborough aptly said, “I support the parents’ choice.” Bravo!

What should have been a story of baby getting well with happy parents instead continues to be a witch hunt to a crowd of bloody reporters wanting their pound of flesh from this alleged baby abuser.

If Dr. Rossborough had done his homework, he could have nipped this medical argument at the bud. Instead, we now see him and the entire profession reeling from behind the wave of unsubstantiated criticism.

If this medical inquisition were “fair and balanced” about medical iatrogenesis in general, a comparison of chiropractic vs. medical care would have been appropriate to put the danger/safety issue into perspective. That would have opened up a whole new can of worms!

For example, a recent article in the British Medical Journal revealed the overall danger of medical care: “Medical error—the third leading cause of death in the U.S.[vii] Yet I doubt this article will be the topic of “Studio 10” or go viral in the media although it is much more important matter to more people than pediatric chiropractic care.

Another irony appeared recently in coincidental article in the Medical Journal of Australia: “Perspectives: Surgical management of low back pain.”[viii] If “patient safety” is an issue Down Under, this article should raised a bigger issue than pediatric chiropractic care. The authors stated “Spinal surgery for chronic low back pain is controversial, and the disproportionate number of fusions in private hospitals is unexplained.” Obviously this is quite a damning indictment from the leading medical journal that will probably go unmentioned Down Under by these Chicken Little journalists.

A related online article published by the MJA InSight newsletter on April 26, 2016, Spinal Fusion Surgeries Questioned,[ix] also was painfully clear the urgent need to stop the tsunami of back surgeries:

“Spinal fusion surgeries for chronic low back pain are on the rise, despite the lack of research to back their efficacy, and experts are now calling for tighter guidelines, including a waiting period.”

Dr. Richard Williams, orthopaedic surgeon and spokesperson for the Royal Australasian College of Surgeons, told MJA InSight that a key regulation should be that patients must wait a period of 12 months before a spinal fusion surgery was performed, noting "Most patients will recover after these 12 months” without any surgery.

Imagine the impact this policy would have on the lives of thousands of Aussies, the money that would be saved by avoiding the high cost of surgery, hospitalization, rehab and the inevitable chronic pain that follows failed back surgery and the risky use of opioid (heroin) painkillers.

But these important issues were virtually ignored in the media in lieu of one DC who adjusted an infant in a victimless non-crime. Suddenly these television personalities pile on acting as if chiropractic care is more dangerous or controversial than back surgery or narcotic pain pills. Again, a typical reaction in a witch hunt to ignore real threats instead harping on imaginary ones.

Worldwide Witch

It’s probably only a matter of time before this witch hunt goes viral in the U.S. and every advanced country of the world, just as the Lana Lewis case went viral after she suffered a fatal stroke on September 12, 1996 in Toronto, Ontario.  The Canadian media, with encouragement from the medical society, jumped on this case to frighten the public and even demanded that chiropractors not be allowed to do cervical adjustments.

This lone incident created the fear that chiropractors may cause strokes or paralysis, and the medically-friendly media was glad to spread this Chicken Little scare, “Chiropractors causing strokes.” The evidence in this case was spurious and unsupported, but the medical propagandists did not let the facts get in their way and used the event to tarnish the professional image of chiropractic as dangerous.

Text Box:
R. Levin, “America’s Biggest Lobby, the A.M.A.,”
Journal of the National Chiropractic Association
19/12 (Dec 1949):  27-28, 64, 66.
Lewis’ chiropractor was eventually found not negligent in this case, but the PR damage was already done in the media.

The Hamilton Spectator’s headline was most sensational, "Getting Back To The Truth; Once Again, The Chiropractic Community Simply Won't Come Clean About Neck Manipulation." The headlines of the majority of newspaper articles were completely false or exaggerated, yet this headline clearly suggested the chiropractic profession was covering-up the truth.

At trial researchers brought to light many interesting facts about spinal manipulative therapy (SMT) and stroke that never made it past the salacious headlines or biased newspaper articles to rebuild chiropractic’s reputation after the initial headlines had already convicted chiropractors in the court of public opinion.

This stroke issue is not exclusively a North American or Australian issue. In 2010 this issue resurfaced with an incendiary report from England, “Deaths after Chiropractic: a Review of Published Cases,” by Edzard Ernst of the Medical School at the University of Exeter. Once again he raised the level of fear over chiropractic care when he noted that “Twenty-six fatalities were published since 1934 in 23 articles.”[x]

Considering 26 deaths over 76 years equates to 0.34 deaths per year (which is one-third of a person!), instead of sounding an alarm to scare people, Ernst should have praised chiropractic care for its obvious safety record since this is an extremely low rate in comparison with equivalent medical methods for the same diagnostic condition

On June 8, 2012, a London newspaper published another article that came unexpectedly and immediately went viral, “Letting Chiropractor 'Crack' Your Neck To Relieve Pain Could Trigger Stroke” with the subtext,Neck 'cracking' could trigger 'catastrophic' health problems such as strokes, experts have warned.”[xi]

Nonetheless, this publication went viral with nine articles appearing within days across the pond. This unfounded attack was not spurred by any event—no one had died and no one was injured—so this attack virtually came out of nowhere.

·                     “Is Spinal Manipulation For Neck Pain Safe?” by Lara Salahi,  ABC World News With Diane Sawyer

·                     “Is Spinal Manipulation For Neck Pain Safe? Experts Disagree” by Kim Painter, USA TODAY

·                     “Should Spinal Manipulation For Neck Pain Be Abandoned?” Science Daily, June 7, 2012

·                     “Spine Manipulation For Neck Pain 'Inadvisable '” BBC News,7 June 2012

·                     "Debate Over Risk From Spinal Manipulation," NHS Choices, 7 June 2012

·                     “Scientists Debate Safety And Value Of Spinal Manipulation For Neck Pain,” Arthritis Research UK, 08 June 2012

·                     Is Spine Manipulation For Neck Pain Safe? A Common Chiropractic Treatment For Neck Pain Is “Inadvisable” Due To A Risk Of Stroke, And Should Be Avoided, Say Experts." By Shawn Radcliffe, Men's Fitness.

·                     “Stroke Risk From Neck Pain Treatment, Spinal Manipulation Used By Chiropractors As A Treatment For Neck Pain Should Be Abandoned Because Of The Risk Of Causing Strokes, Say Experts" by Peter Russell, Web MD

·                     “Spinal Manipulation For Neck Pain Should Be Abandoned," by Ingrid Torjesen, Onmedica News, 8 June 2012

This outcry is not only another paranoid Chicken Little delusion aimed to cause public hysteria about chiropractic care, it’s also an example of “citation laundering”[xii] where writers misquote the facts, embellish each other’s story, and pass on as ‘perceived wisdom’ by supposed experts who quote each other or parrot incendiary comments from other non-experts because they are controversial sound-bytes that “bleed.”

More Bloody Headlines

There is a history to these unwarranted media attacks on chiropractors. Every few years the Chicken Little stroke issue reappears inciting the fear that “chiropractors cause strokes” as we witnessed in 2014 with one unsupported article went viral that I wrote about in “Strokes & AHA.”

Dozens of articles went viral following this AHA/ASA Scientific Statement with more bleeding headlines aimed to frighten the public, such as “Neck Manipulation May Be Associated with Stroke” written by José Biller, MD, lead author, professor, and chair of neurology at the Loyola University Chicago Stritch School of Medicine.[xiii]

While the headline bled profusely indicting chiropractic care, even the introduction admitted to the lack of credibility in his claim:

“Treatments involving neck manipulation may be associated with stroke, though it cannot be said with certainty that neck manipulation causes strokes, according to a new scientific statement published in the American Heart Association’s journal Stroke.”

Ironically, Dr. Biller also admitted there is no link between CMT and stroke in his warning, making one wonder why this writer was crying wolf in the first place:

Although a direct cause-and-effect link has not been established between neck manipulation and the risk of stroke, healthcare providers should inform patients of the association before they undergo neck manipulation.”

This has to be the first time in the history of the AHA and the ASA when they felt compelled to issue a warning to every provider and patient about a procedure that is so rare in occurrence that it cannot be said with confidence that neck manipulation causes strokes. Of the 800,000 strokes that occur each year of all kinds, none can be attributed to spinal manipulation as the sole factor.

To paraphrase this new Chicken Little alarm, “the sky may be falling, but there’s no scientific proof, so still be afraid that it might!”

Now we should be ready to defend ourselves with another unwarranted Chicken Little attack, “chiropractors cracking babies’ backs.” If the chiropractic profession doesn’t prepare itself on the issues in this controversy, don’t be surprised if we suffer the same fate in the media.

Indeed, are the national and state associations prepared with knowledgeable spokespeople armed with the research or will we suffer the same embarrassment as we see Down Under with well-meaning chiropractors unprepared to face a hostile media?

Rather than a reactive strategy after the attack, I suggest the World Federation of Chiropractic and every national chiropractic association worldwide develop a game plan with the supportive research and history of these issues to show this is just another battle in the medical war against chiropractors.

It’s time to show the public that the media propaganda remains a big part of this war starting in 1930 when Morris Fishbein, the Medical Mussolini, declared to “destroy chiropractic.” After his reign of terror, the Committee on Quackery, Ann Landers, Ralph Lee Smith, and many other paid media shills continued the PR attack.

Indeed, if we don’t understand the history of this media war against chiropractors, we are bound to repeat the same fate as our hapless forefathers.

It’s time to gone on the offensive.

First of all, disseminate the research vindicating pediatric chiropractic care.

Secondly, start a campaign about the dangers of opioid painkillers for back pain that are a poor substitute for chiropractic care that has led to this Pharmageddon.

Thirdly, jump up and down about the research Down Under calling for a 12-month waiting period before back surgery.Let's put the medical curmudgeons on their heels with their own research and recommendations!

The research now shows for most back pain, chiropractic care is a proven treatment. Plus, being both nondrug and nonsurgical as well as incredibly inexpensive, every health organization and insurance company should be using DCs as the portal of entry as the Optum research has suggested a few years ago:

"An internal analysis of 1.4 million non-surgical back pain episodes by Optum Health determined the best track to take for cost efficiency begins with a patient consulting a chiropractor first.[xiv] When a chiropractor was the first provider, treatments were “well-aligned with clinical evidence; the least fragmentation of care; low rates of imaging, injections, and prescription medications; and low total episode cost when manipulation is introduced within the first 10-days of the episode.”

This is the information we must take to the media.

It’s past time to stop taking a Spoon to this Knife Fight.



[iv] Todd AJ, Carroll MT, et al. Adverse events due to chiropractic and other manual therapies of infants and children: a review of the literature.  J Manipulative Physiol Ther 2015; 38(9):699-712. 

[v] Miller JE, Benfield K. Adverse effects of spinal manipulation therapy in children younger than 3 years: a retrospective study in a chiropractic teaching clinic. Jour Manip Physiol Ther 2008;31(6):419-422.

[vii] BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2139 (Published 03 May 2016) Cite this as: BMJ 2016;353:i2139

 

[ix] Charlotte Mitchell, Spinal fusion surgeries questioned, MJA InSight, 26 April, 2016

[x] E Ernst “Deaths After Chiropractic: A Review Of Published Cases,” Int J Clin Pract, 64/8 (July 2010):1162–1165

[xi] ANI, London, 08 Jun 2012

[xii]On the Media”, NPR, March 18, 2012, http://www.onthemedia.org/2012/mar/16/calculating-body-counts

[xiv] Thomas M. Kosloff, DC, David Elton, DC, Stephanie A. Shulman, DVM, MPH, Janice L. Clarke, RN, Alexis Skoufalos, EdD, and Amanda Solis, MS, Conservative Spine Care: Opportunities to Improve the Quality and Value of Care, Popul Health Manag. Dec 1, 2013; 16(6): 390–396.


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