Consumer Reports Readers Recommend Chiropractic Treatment, but CR really doesn't - my perspective

The September 2011 is of Consumer Reports has an article regarding Alternative Therapies. There are listings of common health complaints and respondents were asked how well the therapies worked. Of particular note are “back pain”, “osteoarthritis”, ”headache and migraine”, “”cold and flu”, “neck pain”, and “allergy”. Since my primary focus is musculoskeletal, I was interested in the neck and back pain polls. Sixty-four and sixty-five percent respectively of respondents said that chiropractic treatment “helped them a lot”. This is an enviable outcome compared to only 49% and 53% respectively for prescription medications.
I’d like to think that we can completely trust Consumer Reports to give an unbiased and fair view of products and services. I am, of course, pleased that such favorable results are reported for my life’s work. I do not understand that Consumer reports found it necessary to summarize the results by also saying that “..chiropractic .. are possibly effective for low back pain”. Possibly???? Chiropractic treatment scored the highest of ALL listed forms of treatment. Chiropractor treatment scored higher than prescription and OTC medications. Higher than any other form of treatment listed. The same is true for neck pain. Chiropractic scored dramatically higher than medication. However, Consumer reports apparently felt the need to say that Chiropractic manipulation has been linked to “severe side effects including stroke, which appears to be very rare”. Yes, so rare that it isn’t even worth mentioning. In fact, the Connecticut Board of Chiropractic Examiners looked into the issue and determined that based on all available research, there is no direct correlation between cervical spinal manipulation and stroke. http://www.chirobase.org/08Legal/stroke_memo.pdf . Further, a study published in the medical journal “Spine” concluded: “VBA stroke is a very rare event in the population. …..We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.” http://journals.lww.com/spinejournal/Abstract/2008/02151/Risk_of_Vertebr... .
Conversely, I looked up the side effects of Prednisone (a commonly used corticosteroid used as an anti-inflammatory.
The following adverse reactions have been reported with Prednisone or other corticosteroids:
Cardiovascular System
bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, ECG changes caused by potassium deficiency, edema, fat embolism, hypertension or aggravation of hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, necrotizing angiitis, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.
Dermatologic
acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymoses and petechiae (bruising), erythema, facial edema, hirsutism, impaired wound healing, increased sweating, Karposi’s sarcoma, lupus erythematosus-like lesions, perineal irritation, purpura, rash, striae, subcutaneous fat atrophy, suppression of reactions to skin tests, striae, telangiectasis, thin fragile skin, thinning scalp hair, urticaria.
Endocrine
Adrenal insufficiency-greatest potential caused by high potency glucocorticoids with long duration of action (associated symptoms include; arthralgias, buffalo hump, dizziness, life-threatening hypotension, nausea, severe tiredness or weakness), amenorrhea, postmenopausal bleeding or other menstrual irregularities, decreased carbohydrate and glucose tolerance, development of cushingoid state, diabetes mellitus (new onset or manifestations of latent), glycosuria, hyperglycemia, hypertrichosis, hyperthyroidism, hypothyroidism, increased requirements for insulin or oral hypoglycemic agents in diabetics, lipids abnormal, moon face, negative nitrogen balance caused by protein catabolism, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery or illness), suppression of growth in pediatric patients.
Fluid and Electrolyte Disturbances
congestive heart failure in susceptible patients, fluid retention, hypokalemia, hypokalemic alkalosis, metabolic alkalosis, hypotension or shock-like reaction, potassium loss, sodium retention with resulting edema.
Gastrointestinal
abdominal distention, abdominal pain,anorexia which may result in weight loss, constipation, diarrhea, elevation in serum liver enzyme levels (usually reversible upon discontinuation), gastric irritation, hepatomegaly, increased appetite and weight gain, nausea, oropharyngeal candidiasis, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis, vomiting.
Hematologic
anemia, neutropenia (including febrile neutropenia).
Metabolic
negative nitrogen balance due to protein catabolism.
Musculoskeletal
arthralgias, aseptic necrosis of femoral and humeral heads, increase risk of fracture, loss of muscle mass, muscle weakness, myalgias, osteopenia, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture (particularly of the Achilles tendon), vertebral compression fractures.
Neurological/Psychiatric
amnesia, anxiety, benign intracranial hypertension, convulsions, delirium, dementia (characterized by deficits in memory retention, attention, concentration, mental speed and efficiency, and occupational performance), depression, dizziness, EEG abnormalities, emotional instability and irritability, euphoria, hallucinations, headache, impaired cognition, incidence of severe psychiatric symptoms, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, increased motor activity, insomnia, ischemic neuropathy, long-term memory loss, mania, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychiatric disorders including steroid psychoses or aggravation of pre-existing psychiatric conditions, restlessness, schizophrenia, verbal memory loss, vertigo, withdrawn behavior.
Ophthalmic
blurred vision, cataracts (including posterior subcapsular cataracts), central serous chorioretinopathy, establishment of secondary bacterial, fungal and viral infections, exophthalmos, glaucoma, increased intraocular pressure, optic nerve damage, papilledema.
Other
abnormal fat deposits, aggravation/masking of infections, decreased resistance to infection, hiccups, immunosuppresion, increased or decreased motility and number of spermatozoa, malaise, insomnia, moon face, pyrexia.
Oh yes and even death. http://www.druglib.com/adverse-reactions_side-effects/prednisone/serious...
I found it interesting that the Consumer Reports “medical experts” warn that “Chiropractic care may be risky”. However there are no cautionary statements in regards to prescription medications. And while I admit that corticosteroid may or may not be representative of types of medical intervention, risks or prescriptions are certainly appropriate in this discussion. However, Consumer Reports medical experts make no warning or mention of drugs risks.
They say there isn’t a high wall between Chiropractic doctors and Medical doctors. I agree. Frankly, I didn’t realize a wall existed anymore. We routinely refer and accept referrals from MD’s. We treat MD’s in our office. It is unfortunate that the Consumer Reports readers could be dissuaded from seeking appropriate care by an otherwise glowing recommendation for chiropractic treatment.