FSU's proposed chiropractic program was a major featured in this morning's St. Petersburg Times. Here is a summary:
Placing the cart before the horse: This story discusses the history of the Florida legislature's adoption of a program that FSU did not request (at least formally); the legislature adopted the program with no testimony or debate at all as to the merits, based almost entirely on a questionable report. [For criticism of the report, see Rhosgobel.] FSU did not request this program. Now that the money has been appropriated and that it has spent some of it, the FSU administration wants the program.
Voodoo or science?: This story addresses some of the tension between chiropractors and physicians, focusing on the scope of FSU's proposed program. The chiropractic lobby attempts to portray this as a dollars issue, but there are serious questions about the scope of the scientific benefits of chiropractic. The story contains an excellent summary of the evidence:
Scientific studies say chiropractic treatment helps low-back pain, although just how much is debatable. One New England Journal of Medicine study of 321 peopl e found chiropractic treatment to be more effective than giving patients a booklet on managing their back pain, but only "marginally better." An agency within the prestigious National Institutes of Health called the scientific evidence on chiropractors "weak and less than convincing" in a 2003 report summarizing the research.
A 2003 scientific review of low-back pain studies called the evidence "at best uncertain" and said that newer studies "have not tended to be encouraging." An analysis of such studies found spinal manipulation more effective than sham therapy, and about as effective as other treatments, such as medication.
Chiropractors point to other studies, such as one last year in the journal Spine. That study by two Australians who hold doctorates, one of whom also is a chiropractor, divided 115 patients with chronic back pain into three groups and found that the patients treated with chiropractic manipulation were much more likely to recover quickly than patients treated with drugs or acupuncture.
Other aspects of chiropractic care remain more controversial. Manipulating the neck may cause tears in an artery that could cause a stroke. Chiropractors say the risk is tiny, but doctors opposed to the practice say it is significant.
Also debated: whether chiropractic care has any effect on ailments unrelated to spinal pain, such as ear infections, asthma or digestive problems. Studies in two of the nation's most prestigious journals, the New England Journal of Medicine and the Journal of the American Medical Association, have found chiropractic treatment manipulation didn't help childhood asthma or tension headaches.
Towards a changing definition of chiropractic? And an opinion piece by Martin Dyckman, a Time Columnist, points out that, if FSU were to adopt this questionable proposal, Florida may need to change it statutory definition of what chiropractic practice entails -- Florida's chiropractic practices act still implicitly allows spinal manipulation as a therapy for any disease, including diabetes and cancer.
Also, an op/ed in this morning's Lakeland Ledger joins the chorus of op/eds opposed to FSU's proposed chiropractic program. 5 newspapers have come down in the last week in opposition to FSU's adopting this program without serious debate by the faculty, FSU Board of Trustees and approval based on need by the Board of Governors: Orlando Sentinel, St. Petersburg Times, Palm Beach Post, Tampa Tribune, and Lakeland Ledger. Most, and arguably all, of these newspapers call for rejection of the FSU chiropractic proposal.
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