The article begins harmlessly enough with this fact: "If you haven't yet experienced low-back pain, the odds are nearly four to one that you will someday." But before long, the article departs from customary journalistic fairness. The author mentions that two out of every three office visits for back pain "take place in a chiropractor's office, not a physician's." (Why the emphasis on chiropractors as non-physicians?).
In the next paragraph, chiropractors are relegated to the bottom of a list of practitioners who perform manipulation: "Practitioners who manipulate the spine -- osteopaths, physical therapists and even some MDs, as well as chiropractors ..." The next few sentences lump chiropractors into one group which believes that subluxations are responsible for "everything from eye trouble to heart disease." As if this weren't enough, the article then denies that the subluxation theory has any validity, "But when shown x-rays of those alleged subluxations, orthopedists, radiologists, and conservative chiropractors see no abnormality."
The anonymous author(s) does pause long enough to describe the British Medical Journal (BMJ) study and the RAND study. The article admits that the study of 740 patients found chiropractic more effective at relieving low-back pain than physical therapy. There is this grudging acceptance of the BMJ study: "While a number of weaknesses in the study's design ultimately made that finding difficult to interpret, the study did draw serious scientific attention to the possible merits of chiropractic manipulation." The article is somewhat more positive about the RAND study: "RAND researchers reviewed the evidence on spinal manipulation and concluded that manipulation may help people whose low-back pain developed within the previous three weeks, so long as the spinal nerves to the legs are not involved." But the author qualifies this with, "However, the RAND group did not find enough evidence to recommend manipulation for longer-lasting pain."
To conclude the article, the Consumers Union makes several unbelievable recommendations to its readers: to contact the "National Association for Chiropractic Medicine," a miniscule (probably less than 100 members) chiropractic splinter organization headquartered in Middleton, Wisconsin, for a member referral; to avoid any chiropractor who claims to treat problems other than musculoskeletal pain; and to stop receiving manipulative therapy after "a couple of weeks" if pain is not significantly reduced. The author also writes, "Chiropractors perform most of the spinal manipulation in this country, but not all of it. Osteopathic physicians (D.O.'s or doctors of osteopathy) have a broad medical education in addition to training in spinal manipulation. Some physical therapists practice manipulation as well."
Even if the publication did not list its two MD medical advisors, the bias of the article would still be clear. The final line sums up the general tone and overall slant of the article: "There's no convincing evidence of any benefit from the prolonged program of 'maintenance' manipulations -- sometimes continuing for years after the pain has disappeared -- that many chiropractors prescribe."
This piece obviously lacks the necessary research and impartiality which are crucial to solid, unbiased reporting. Unlike some past articles on chiropractic, such as the September 23, 1991 Time magazine story (please see December 6, 1991 issue of "DC") or the July 3, 1991 New York Times story (See August 2, 1991 issue of "DC"), the author of the Consumer Reports on Health article never bothered to interview any chiropractors nor did the author contact any viable national chiropractic organizations such as the American Chiropractic Association or the International Chiropractors Association.
With some time and research, the author might have written an accurate assessment of chiropractic. Instead the focus of the article betrays the anti-chiropractic bias of Consumer Reports on Health. Sadly, the publication has lessened its credibility and misinformed its readers with this type of unprofessional reporting.
Barbara Migliaccio,
Second Assistant Editor