Why I’d never send my patients to a chiropractor
Q I’VE been suffering from sciatica and back pain and a friend has suggested seeing a chiropractor. Does it work – and, as a GP, would you recommend it?
A LOWER back pain and sciatica are very common reasons for people to attend a GP consultation. While both conditions can resolve on their own over time, there are a number of treatment options that can help to provide relief in the interim.
Pain-relief options include medication, physiotherapy and heat treatments. And, of course, a number of alternative treatments are available. One that’s reasonable to try in this case is acupuncture, which may offer relief and relaxation from pain, with very little likelihood of harm.
Indeed, this is the key issue whenever approaching alternative treatments that aren’t scientifically proven to help – they’re only worth trying if there’s no risk of harm.
Chiropractic treatment involves spinal manipulation and stretching – and it may help back pain in some people. However, the chiropractic community is notorious for spurious declarations about what it can cure and has been strongly reprimanded over the years for claiming to treat conditions such as asthma, colic and ear infections.
The founder of chiropractic treatment wrongly believed that all ailments can be alleviated with spinal manipulation, and this false panacea notion persists today among some practitioners.
But more than just false claims, chiropractic treatment, even when limited to back pain, does carry serious risks. The success of it as a treatment for back pain is not thought to be substantial – and a large number of people will suffer shortterm pain, dizziness, headaches and numbness due to nerve damage.
More worryingly, there are also far more damaging effects from the thrusting spinal movements. This is because around the spinal area being manipulated, there are blood vessels that pass by on their way to the brain.
Published medical literature has warned how stretching and damage to these vessels has led to permanent brain damage, stroke and disability. At least 30 deaths have been recorded – with experts believing there are many more unreported cases. Weighing up the small potential benefit to be gained from chiropractic treatment, I would not recommend it, given the potential risks of stroke or spinal injury.
Q EVERY year, I suffer severe night sweats as soon as the weather gets colder. I’ve tried changing my duvet and nightwear, but nothing helps. The only time I don’t suffer is on the rare occasion I have a few drinks. Should I be worried? I’m 37, fit and healthy.
A NIGHT sweats are what GPs call a ‘red flag’ symptom: something that warrants urgent investigation. This is justified, as night sweats can be a sign of serious infections such as TB, and cancers, specifically Hodgkin’s lymphoma. GPs should offer blood tests and a chest X-ray to rule these out. Other conditions associated with night sweats include anxiety and thyroid disease.
But if night sweats have persisted for a long time, particularly a number of years, doctors become less concerned – especially if there are no further symptoms. It’s also reassuring when a symptom comes and goes, as symptoms of a serious illness would persist all the time.
Alcohol is more likely to cause sweating as it causes blood – and therefore heat – to flow to the skin.
For those with a long-running issue, medical treatments may be suitable. These include Botox, which is injected into the affected areas, blocking the chemical signals from the nerves that stimulate the sweat glands.