Friday, May 1, 2009

Swine Flu & Chiropractic

I recently saw a blog that suggests that the second best of the "Sure-fire Strategies to help you and your family respond to the threat of the flu." is chiropractic. Now don't get me wrong, I'd love to be able to say with a straight face and the research to back it up that going to see a chiropractor would help you prevent or even get better from the swine flu, er I mean Influenza A(H1N1) (surely we don't want to insult swines). But honestly I think it is intellectually dishonest and a public disservice to imply that a chiropractor has unique therapeutic tools that will help prevent or treat the flu.

Let's look at the argument in favor of chiropractic as part of how ones family should "respond to the threat of the flu."

Supposedly Ronald W. Pero, Ph.D. performed one of the most important studies that showed the positive effect chiropractic care has on immune function and general health. First the link in the blog leads to an article about the 1917-8 flu epidemic. I'd like to see the original data rather than the owner of that web sites excerpts. Nevertheless it might be true that chiropractic care was better than medical care for the flu in 1917-8. There is a world of difference in the field of medicine between then and now. I hate to say it but I do not think there has been an equally large increase in the effectiveness of an adjustment. In fact I think most traditionalists in my profession would suggest it was as good as it was going to get way back when and we've only screwed stuff up since then.

I searched the National Library of Medicine's online database search system, PubMed to find any published paper by Dr. Pero on chiropractic. I can't find it. Here is that search. Here is another search of just what R Pero published. I read the title of all 183 papers and none appear to be about chiropractic. If anyone can find me the paper, rather than an article in a chiropractic newspaper talking about the research I really would be grateful to find the paper and read it.

Next the blogger discusses a study done at the National College of Chiropractic (now National Health Sciences University) by their then research director, Patricia Brennan. Brennan’s study, if anyone actually reads it, is not really about immune function. It was an attempt to find a physiological marker of active manipulation. The intent was to see if they could differentiate between a sham and real manipulation.

Lots of folks want to use this study to show how chiropractic improves immune function. What is stated: “phagocytic respiratory burst of polymorphonuclear neutrophils (PMN) and monocytes were enhanced in adults that had been adjusted by chiropractors.” is true. So to the true believer in the unlimited wonders of the adjustment this is “proof” that an adjustment improves immune function. Unfortunately, one cannot conclude this from that study. First of all the subjects were healthy normal individuals. We do not know if the response will happen to those who are ill. Maybe when one is ill the response is blunted or eliminated because the PMN’s are already “enhanced” by the need to fight an infection. Conversely, it is possible that the response is enhanced even to a greater degree in the person fighting an infection. We just do not know. Also the response was transient; it was found at 15 minutes but dissipated by 30 minutes after the manipulation. The true believer’s response would be, "so adjust the patient every 15 minutes." That seems logical, except we don’t know if the response is repeatable or if it fatigues. And again it could be more profound as it is repeated, we don’t know. Also we do not know if the increased phagocytic respiratory burst will actually work in any appreciable way to make one better able to defend against an infection or to help the individual get better faster or have reduced effects of the infection that one might have.

The blogger mentions a study done at Life Chiropractic University. There is no such educational institution in the US. The name of the institution is Life University which was Life Chiropractic College. For some reason there are a lot of people who make this mistake. If one googles "life chiropractic university" one finds many chiropractors web pages say they graduated from there. I suggest they take a look at their diplomas.

Regarding this study, I can not comment about any specifics, I haven't read the paper. My only comment is that good research requires replication and if the best we can do is a paper in a defunct journal that is more than 10 years old...

The blog goes on to say that chiropractic improves "And chiropractic care improves the function of the nerve [sic] system through improving the movement of the spinal bones that encase and protect the spinal cord." This is an interesting theory that has been espoused by some in my profession for years. I am aware of no valid research that supports this statement. There is a growing body of good scientific evidence that spinal manipulation can be an effective treatment method for neck pain, headaches and low back pain. Overstating what we know only serves to decrease our credibility.

For information on prevention and treatment of influenza A(H1N1) (swine flu) see the CDC or CDC's flu pandemic web site or MedLine Plus (great consumer oriented health information). Hopefully your chiropractor will recommend these sources of information rather then suggesting that a sure-fire strategy is getting a chiropractic adjustment.


1 comment:

  1. Thanks for the posting. I was curious about the historical validity of what I had been reading regarding chiropractic and flu. So much so that I did a search of our History Archive at The search came up mostly empty. BTW, anyone can search Keating's files with our search tool.