View from the profession

Chiropractic responds to overall safety and efficacy questions

Dr. Stan Gorchynski is Chairman of the Board of the Ontario Chiropractic Association (OCA) and the Secretary/Treasurer of the Canadian Chiropractic Association. He recently spoke by phone to Tandem about the practice of chiropractic, its benefits, scientific validity and risks, and his take on the Paul Benedetti/Wayne MacPhail book Spin Doctors: The Chiropractic Industry Under Examination, a work that raises many issues and cautions about the overall safety and efficacy of chiropractic, as well as contending that the profession is out of control and in need of enforcing stringent guidelines on its practitioners.
Spin Doctors is particularly critical of the so-called "mixed bag" of alternative therapies and remedies which are frequently administered by chiropractors as supplements to the chiropractic adjustment, therapies that often have no scientific proof backing them up. Gorchynski weighs in on this issue. "Let me say to you that of all medical procedures, only 18 percent have scientific validity," he asserts. "Eighty-two, 83 percent of what medicine currently does has no scientific validity. I'm not making this up. The medical research community has put this out; I use their terminology."
"Chiropractors, the main thing they do is the chiropractic adjustment, that has been researched up, down, sideways, back and forth," Gorchynski continues. "That has not only been validated nationally in Canada, it has been validated internationally in the U.S. in Europe and other countries. There has been no study found yet to say it does not work." He points to some studies which he notes have found chiropractic to be more effective for low back pain than other conventional treatments, a point that is hotly debated by chiropractic opponents, each camp having studies to back up their beliefs. Statistics also vary about the rate of incidence of stroke or death associated with neck manipulation. The OCA puts the figure around one in 5.6 million, based on a study it cites from the Canadian Medical Association. Neck adjustment, Gorchynski states, is "very safe."
Gorchynski adds that the chiropractic profession is involved is studies to determine the efficacy of some alternative therapies, and offers that they are doing this without access to the kind of public funding and pharmaceutical monies for research that the medical profession generally is supported by. "The reason that this material just doesn't come flooding forward and cascade over the public is that our profession has to do our own research," he explains. "We are getting to this as we're able to and we'll bring this information forward."
"But chiropractors do use other forms of alternative healthcare as well in order to enhance the well being of the patient," he agrees. "Some of them have very little if any scientific validity but that's not chiropractic. They will through their own choices look to find areas or certain therapies that will assist in what they're doing.
"I'm only speaking specifically to the chiropractic adjustment, and what we do as chiropractors. In my office, all I do is adjust. I don't do anything else," Gorchynski underlines. "It is my job to ensure that the neurological health of the patient is enhanced, and that's what I focus on and there are other chiropractors who do other things."
Gorchynski talks about what he sees as an unbalanced view of chiropractic as presented in Spin Doctors. "I think the book goes out of its way to try to paint a picture of the lack of help, the unscientific basis of the whole profession. It's unfortunate that the book's tone," he continues, "does not focus on the fact that four and a half million Canadians see chiropractors annually, that the patients themselves are very well aware that they get benefit. They do come to chiropractors to continue to get the help that they can't get elsewhere.
"I think the focus of the book misses the fact that as a treatment modality that is safe, very effective, non-invasive(which he notes is key) and drugless is something that not only can save governments tonnes and tonnes of money, but it really enhances the patients' ability to get their health and keep their health, without changing their bodies through surgery, of forcing their bodies to have to use drugs and pharmaceuticals that alter the way the body has to work." He explains that the intake of drugs adds to the body's workload and stress when it is unwell, as the medicine is seen as foreign, and the liver and kidneys keep flushing it out .
Another concern raised by the book is that chiropractors treat "sublaxations" when doing adjustments, something which the book's authors contend have not been proven to exist, and is in fact is a word not found in a conventional dictionary.
"Sublaxations is a profession-specific term referring to an area of the body that is not functioning properly," Gorchynski clarifies. "It can be around a joint, it can be in the spine, it can be in a shoulder or elbow. It can be anywhere that there is an alignment of functional structural problem that is not allowing either muscles, tissues, circulation to work properly. All of this stems from interference with the nervous system being able to properly perceive the way the body is working. So chiropractors call that a sublaxation." He lists other terms that reference similar kinds of problems, such as fixation, hyper tonicity, hypo tonicity and trigger points. "Anything that has to do with proper neurological function that is in an area is what we call a sublaxation."
The word sublaxation does not appear in a chiropractic fact file put out by the OCA. "To the public it's not necessarily a clear term that they would understand," he explains. "So essentially the general description of what chiropractors do in the Fact File talks about structural alignment, removing problems." But the term is used on the Association's website for the public in the Question-and-Answer section. Gorchynski explains that it is to provide a bit of grounding for patients, who can talk to their chiropractor if they want more information.
According to Gorchynski, chiropractors see the spine and nervous system as crucial to determining the overall health of a person, and that a low back pain can be indicative of other problems. He points out that by working on localized pain on the back, patients have been seen to respond in other areas of the body, which he notes is an adaptive compensating structure. The bone structure is held in place by ligaments by small muscles all controlled by the nervous system, he says, and that if the nerves are not allowed to do what they have to do illnesses and diseases are generally the result. On some people, the workload placed on the body by day-to-day living is more onerous than on others.
"Generally those who have the most structural difficulties that the body has to adapt to and compensate to have poorer health," Gorchynski says. "I would say it's almost always a fact but some people's systems continue to perform at a very high level; they're unaware that their systems are struggling as hard as they can." He offers some examples, such as not being able to turn the head as far in one direction as the other, not being able to eat spicy food as before, or no longer being a morning person. He dismisses the idea that this is an inevitable part of the aging process, and that the body should not force a person in middle age to have to make limiting choices to compensate for what it can no longer deliver. He stresses that at 40 the body should still have the full range of motion it did at 20.
As for the treatment of babies with chiropractic, another contentious issue brought up by Spin Doctors, Gorchynski stresses that work done on infants is extremely gentle and not the same as what is practised on an adult. "If you knew what it did for you, and you saw how your doctor worked on you, and if you ever observed a doctor working on a baby, you would see that the techniques are vastly different," he states. "Babies can't tell you 'I've got a backache or a leg pain or a headache', but what you see in babies is colic, you will see upset tummies, constant infections and so on. What these generally tell a chiropractor, as well as parents who can't sleep and are unable to really cope and adapt to the child, is that there's something wrong."
"By removing and helping the body very gently - it's usually done with fingertips - it's not a violent aggressive process at all, it's very gentle, very, very easy," he continues. "In fact babies love to be held, and they don't know the difference between being held and being adjusted by the chiropractor. It's that simple. Generally what you notice is the baby's health starts to respond within hours, if not moments."

Publication Date: 2003-09-14
Story Location: http://tandemnews.com/viewstory.php?storyid=3147