Experts have clarified when Australians should consider visiting a chiropractor after fresh accusations of quackery were levelled at the industry.
On Monday, Monash University preventative medicine researcher Dr Ken Harvey criticised the industry regulator, AHPRA’s Chiropractic Board, for not cracking down on chiropractors making claims “likely to harm consumers”, such as the ability to treat asthma and pneumonia and that vaccination causes autism.
Patients need better protection from such “unethical” and “non-evidence-based” claims, Dr Harvey and a co-author argued in the Medical Journal of Australia.
AHPRA’s Chiropractic Board responded on Monday by claiming it had in fact acted on complaints, and that the number of complaints declined in 2014/15.
“AHPRA and the Board urge anyone with concerns about advertising breaches or professional standards to provide it to regulators,” the statement said.
To limit confusion, The New Daily consulted medical professionals, both inside and outside the industry, to determine when chiropractic treatment may be considered safe.
Adult patients with back problems (except pregnant women) were the group for whom chiropractic would be least controversial, the experts agreed.
Patients should also avoid practitioners who make “unreasonable” or “spurious” claims that sound too good to be true, the experts said.
A spokesman for Friends of Science in Medicine, a non-profit advocacy group, advised consumers to seek out “moderate” chiropractors who specialise in back disorders and avoid the “extreme” practitioners with unscientific views.
“There are moderate chiropractors who we do not condemn. They are mostly applying their skills to musculoskeletal medicine, mostly looking after back disorders and they apply essentially physiotherapy-type of care,” Friends of Science in Medicine vice-president Professor Alastair McLennan said.
“The public should watch out for any practitioner saying they can treat an infection [or] an organ that’s not the back.”
The Doctors’ Reform Society, which has also called for better industry regulation, echoed the caution against chiropractors with extreme views. But its spokesman said he was happy for his patients to seek chiropractic treatment for back pain.
“I have no problem with that at all,” Doctors’ Reform Society president Dr Peter Davoren said.
“But if I have a patient with type one diabetes and they have to be on insulin and they say they’re going to see a chiropractor who says they can cure diabetes, that’s a different matter.
“If it sounds too good to be true, it probably is.”
A spokesman for Chiropractic Australia, the industry body most respected by the medical profession, agreed that chiropractors should complement not replace doctors, and that back problems were the “bulk” of their work.
“There is more evidence for using spinal manipulation to treat back problems than there is for most other medical procedures,” Chiropractic Australia president Professor Rod Bonello claimed.
Where the experts disagreed was whether children and pregnant women should be treated. The mainstream experts said no, whereas an industry spokesman said yes.
The two sides also disagreed on whether chiropractic should be restricted to the back. The industry spokesman claimed the neck and other limbs could benefit, whereas a medical expert warned that manipulating the neck risks partial paralysis.
It was also contentious whether a GP should be consulted before a chiropractor.
A mainstream expert warned that serious medical conditions could be missed if patients saw chiropractors first, whereas the industry spokesman said chiropractors could be seen without an initial medical check-up.
The potential benefits were also debated. Mainstream experts said chiropractic treatments probably acted as a placebo, whereas the industry spokesman claimed that manipulation can cure back pain, referred pain and some neurological problems allegedly caused by spinal misalignment.
The New Daily approached the Chiropractors’ Association of Australia for comment, which has been described as having a higher proportion of members who believe in scientifically inaccurate theories. No comment was received.
A spokesperson for medical regulator AHPRA referred The New Daily to the Australian medical practice guidelines, which directs doctors to refer a patient to another medical professional (such as a chiropractor) only if they are satisfied that person has the qualifications, experience, knowledge and skills to provide the care required.
The Australian Medical Association was unavailable for comment.