Letter to WebMD

May 06, 2008

Robert Davis, PhD
WebMD Public Editor
1175 Peachtree Street, N.E.
Atlanta, GA 30361-6207

Dr. Davis:

As president of the American Chiropractic Association (ACA), I was pleased to see information about chiropractic included in your online health library at www.webmd.com.  However, I would like to correct some inaccuracies that appear on the site. To assist you in locating my areas of concern, I’ve referenced below specific pages from the WebMD site.

Contrary to the information provided by your organization, a considerable amount of evidence shows that chiropractic can be more effective than treatment using traditional medical care for problems such as acute and chronic lower-back pain, neck pain, headaches and other neuromusculoskeletal conditions.1 A sampling of research includes:

  • A seven-year, international study published in the Feb. 15, 2008, issue of the journal Spine, that found that some alternative therapies, including neck manipulation, are better choices for managing the most common neck pain than many traditional treatments.
  • A 2005 study in the Journal of Manipulative and Physiological Therapeutics concluded that chiropractic and medical care have comparable costs for treating low-back pain, with chiropractic producing better outcomes for chronic pain.
  • A 2003 study published in the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than does a variety of medications.
  • A 2001 study by Duke University found chiropractic manipulation appropriate for both tension-type headaches and cervicogenic headaches.

Enclosed is a copy of the ACA’s brochure, “Chiropractic: What Research Shows,” which highlights additional studies from the literature that show the positive benefits of chiropractic.

A few of the articles on WebMD seem to suggest that patients should first consult with their medical physician before seeking the professional services of a doctor of chiropractic; however, this recommendation is unwarranted.1 Chiropractors are trained and licensed in every state as primary care providers. They are aware of the types of conditions that will respond to their care, and they can also recognize those that require referral to other healthcare providers/specialists.

Chiropractic physicians are committed to offering patients a multi-dimensional approach to pain management and to work closely with other members of the patients’ health care team.1 In addition to spinal manipulation, doctors of chiropractic offer patients therapeutic and rehabilitative exercises, and provide nutritional, dietary and lifestyle counseling—all of which are important components in chronic pain management.

When it comes to musculoskeletal conditions, in particular, chiropractors are by far the experts and receive the most formal education in this subject.2 The typical applicant at a chiropractic college has already acquired nearly four years of pre-professional undergraduate college education, including courses in biology, inorganic and organic chemistry, physics, psychology and related lab work. Once accepted into a chiropractic college, chiropractic students complete at least four to five academic years of professional study.

In total, the chiropractic curriculum includes a minimum of 4,200 hours of classroom, laboratory and clinical experience. Following graduation, doctors of chiropractic must pass national board examinations and become state-licensed. Additionally, a large number of doctors continue their education and specialize in areas such as internal disorders, neurology, nutrition, occupational health, orthopedics, radiology, and sports injuries.

Lastly, when it comes to the risk of adverse events following cervical chiropractic manipulation, you may be interested in reviewing the latest research, which is not mentioned on your Web site.3, 4 According to a February 2008 study published in Spine, the risk of vertebrobasilar artery (VBA) stroke associated with a visit to a chiropractor’s office appears to be no different than the risk of VBA stroke following a visit to the office of a primary care physician.
The study goes on to say that any observed association between a VBA stroke and chiropractic manipulation, as well as its apparent association with primary care visits, is likely due to patients with an undiagnosed vertebral artery dissection seeking care for neck pain and headache prior to their stroke.  To read the full study, visit www.acatoday.org/pdf/Stroke_Risk_Spine.pdf. This most recent study offers important information that healthcare consumers need when making an informed decision about the safety of chiropractic manipulation.

In closing, I appreciate the breadth of information WebMD offers its patrons about chiropractic. I hope you will consider refining your articles based on the above-mentioned facts and research. If you need additional information, please contact the American Chiropractic Association. The association’s staff would be happy to provide your writers with material and spokespeople for future stories.

Glenn D. Manceaux, DC
President, American Chiropractic Association
WebMD Reference Pages

  1. “Key Points”
  2. “What kind of training do chiropractors receive?”
  3. “Have side effects or problems been reported from using chiropractic to treat back pain?”
  4. What Are the Benefits and Risks?