How can Edzart Ernst be considered an expert on clinical Chiropractic?

Professor Edzart Ernst is proclaimed as the first professor of complementary medicine and the “expert” usually quoted in negative articles about chiropractic. It took me five years to train as a a chiropractor and another five years in practise before I felt anything like an expert. So how can Professor Ernst present himself as an expert in Chiropractic. You do not need an expert to tell you that there is a lack of evidence to support chiropractic as an intervention beyond neck and back pain. However you would need to be an expert or be a patient to state, absence of evidence is not evidence of absence of  benefits from chiropractic care. Ernst does not have the experience to make that statement. I do and others like me who are rarely interviewed.

I make clinical judgements based on 14 year of practice. I have seen possibly 5,000 patients in that time. If I find spinal dysfunction( vertebral subluxation complex) in a patients neck I correct it regardless of where the symptoms are. I hope I help people, the worst thing imaginable would be to hurt someone.

If chiropractic is as dangerous as Ernst suggests someone should have had an adverse reaction in my clinic by now. Not one that I am aware of, not even one, anyone who is interested can visit my practise any time they like. www.parkclinic.info . Every patient I see with back or neck pain is told to stop taking their  pain medication so we know for sure that spinal care is helping them. Its fair to say I have taken thousands of people off pain medication and the vast majority have returned to normal activity within two weeks of care starting Adverse events from anti inflammatory medication is estimated at 1% , risk of death one in five thousand.

With all the adverse publicity Professor Ernst has generated about the risk from chiropractic one would expect him to have a little more evidence to support his theory rather than relying on his same old anecdotal evidence at the bottom of his pyramid of evidence. Yet the sceptics attach much importance to these anecdotes. Hardly the gold standard of clinical evidence is it? In fact its the same sort of evidence Professor Ernst uses to disparage chiropractors for using.  Patients recommend people because I have helped them and can help their family and friends without using drugs.

The vast majority of patients who come into my clinic come with back pain. We take a medical history and very often patients have other conditions like asthma and irritable bowel, pain during menstruation. Three of my children were diagnosed with whooping cough in 2006, www.vaccination.co.uk  Eloise was two weeks old. There is no medical treatment for whooping cough so according to the medical advice, you might as well pray. Fortunately I do not believe in God, but know a bit about neurophysiology and conceived a chiropractic care plan that worked really well for my three children. No one would report how healthy my children are, they want death and irresponsible parents for their headline. The Health Protection Agency warned me the worse might happen, yet showed no interest in finding out how my children had managed to “survive” without any medical attention.

On the Park Clinic website we list all the different conditions patients have when they present at  the clinic. We also state; "There is no suggestion that spinal care can cure any of these conditions however for a variety of reasons we find improving spinal joint function does improve the quality of life of the vast majority of our clients. If you click the links there is plausible "ANECDOTAL EVIDENCE" of people being helped". It is reasonable to describe my approach as making a “conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” who do not want to take pharmaceuticals if they can avoid it. As David Sackett requires for evidence based practise. Not great evidence but evidence for a clinician to base a care plan on.

This is where  Professor Ernst’s credibility really starts to crumble, when he states “There is no logical, rational or scientific reason why manipulating a patients spine should effect colic,  Irritable bowel or asthma”. This sounds more the Eddie Ezard (who I find entertaining if not clinically relevant), than a professor of complementary medicine

Trouble is contrary to what Professor Ernst stated in his first ever newspaper interview in the Independent ten years ago, he courts media attention and far too many journalists are impressed by his title rather than question his lack of expertise regarding chiropractic. To be fair to professor Ernst it may be a reflection on the calliper of chiropractor he has been meeting with, academics and politicians as opposed to clinicians who have given him this poor impression, these are the comical Ali’s of the chiropractic profession. 

 

The theory is that sensory signals that drive autonomic activity originate from the (a) the Viscera (b) the surface of the body (Touch, Spinal Manipulation) and (c)

the external environment

 

If we were talking about respiratory dysfunction as say in asthma, I would bear in mind that, autonomic centres in the brain stem drive somatic motor neurons that control the diaphragm and intercostal muscles in coordination with postganglionic sympathetic motor neurons that control the calibre of the bronchi and pulmonary blood vessels. If you look at the diagram you can see the spine and spinal cord and sympathetic chain (these nerves are too easily excited with asthma)

 

Convergence of visceral (organs,blood vessels) and somatic (muscles) sensory signals onto common spinothalamic neurons in laminae I and V of the dorsal horn

There are 24 vertebra 48 spinal joints ( no 9 in diagram) The adjustment activates receptors in the joint, which may not be functioning properly due to lack of movement in the spinal joint ( The vertebral subluxation complex) Many senior people in the chiropractic profession were trained in the dark ages of chiropractic education and  may not be able to articulate the theory of the Vertebral Subluxation Complex and are of the view that subluxation theory is bogus and chiropractors shood stick to clicking backs to help pain syndromes. May I recommend  Foundations of Chiropractic – Subluxation by Meridel Gatterman 2005 Mosby for people with an open mind wishing to understand the Eddie Izzard view of chiropractic.