In the last few weeks, a grounp of prominent Australian doctors and scientists with links to groups run by Aus Skeptics CEO Ms Matton have attacked the Chiropractic profession and Central Queensland University after it announced the decision to offer a chiropractic degree from 2012. The group claims the chiropractic is not based on evidence, therefore shouldn't be taught in an Australian university.
As with these discussions, there is always a bias. However, let's just consider the evidence that is out there in the public arena.
Chiropractic treatment is multi-modal, encompassing soft tissue therapies, exercise, advice, electrophysical therapies, sports therapy, taping, spinal manipulative therapy along with a range of low fore non manipulative techniques. Essentially, chiropractors are health care professions that specialise in spinal health and it's impact on the nervous system.
Adjustments, which can involve spinal manipulative therapy, for the bulk of most chiropractors' day to day work. It is a therapeutic intervention performed on the spinal joints to alleviate symptoms. This involves the Chiropractor applying tension to the patient's ligaments and then delivering a short thrust to increase the movement of the vertebra. The therapy works by increasing mobility and improving blood flow to help reduce inflammation. It also changes nerve function which can result in many other effects.
Now the question of evidence and Chiropractic's efficacy. A recent Cochrane Review found that spinal manipulative therapy shows at an absolute minimum, that it's as effective as standard medical care or physiotherapy with an extremely low risk of side effects causing adverse reactions.
In 2007, the American College of Physicians and the American Pain Society recommended guidelines for this Chiropractic treatment modality to be used for those suffering from chronic or sub acute low back pain.
To date, 70 randomised control trials and 10 systematic reviews have been published to support this treatment in low back pain.
Chiropractic Evidence and Education
For the last 20 years, the three current Chiropractic education institutions (Macquarie, Murdoch and RMIT) have been at the forefront of international research to provide evidence based therapies.
It is sometimes understated, that Macquarie University teaches an evidence based program which includes subjects in orthopaedics, neurology, differential diagnosis, research metholody and critical thinking. By the end of the course, students leave with more than 5000 hours of education and a Master's degree. This is equivalent to the time of a medical student. Although, because Chiropractic in itself is a neuromusculoskeletal speciality, a 2001 a study by Tuchin and Bonello found that by the end of the Chiropractic Masters degree, students performed better than Orthopedic Residents in Orthopedic exams.