Back Out Gracefully

An attempt at chiropractic consultancy in Southland schools didn't do too well after their dubious practices were debated by the local community.

Two local chiropractors contacted 30 Southland schools to offer free scoliosis screening for pupils. The following notice was circulated to parents at one school which took up the offer:

We have received the following notice from Dr. J. McKay and Dr. S. Porter - Chiropractors in Invercargill. The screening will take three minutes per child and is free. It is open to all age groups within the school... Scoliosis is a lateral (sideways) curvature of the spine. It affects children's (people's) overall health and development. It may also possibly lead to progressive spinal deformity. Early detection and appropriate treatment are very important.

The procedure for screening is simple: the chiropractor or Nurse looks at the child's back standing and bent forward. Any abnormality noted may mean a problem and the child should be seen for further evaluation. If your child has a possible curvature, you will be notified immediately.

Reading this notice from my child's school, and the follow-up which stated that 155 of the approximately 200 pupils on the roll had opted for screening, gave considerable cause for concern. How could schools consider an offer which was quite clearly an attempt to tout for business? After contacting the school, I felt that the only possible reason was ignorance on the part of the principal and the school's board of trustees.

It is not surprising that such ignorance exists; it is shared by the general public. Indeed, teachers and others in the education service may be forgiven for such ignorance. Among the benefits they may claim under the Education Benevolent Society's health insurance scheme are the costs incurred in treatment and consultations given by chiropractors or those registered with the New Zealand Register of Acupuncturists Inc., the Association of Natural Remedies Inc., the Register of Natural Therapists — Naturopaths and Classical Homeopaths, the New Zealand Homeopathic Society and others.

"What's all the fuss?" you may ask, "It surely can't do much harm." Possibly not directly, but imagine the alarm caused to parents by a follow-up letter suggesting "possible curvature". Especially in light of the statements in the original circular that, "it affects overall health and development" and "it may also lead to progressive spinal deformity."

These are emotive words which play on fear. How many parents would worry if they were notified that their child had freckles (these may also affect overall health and development) or played rugby (which may also lead to spinal deformity)?

Few people understand that chiropractors are only concerned with subclinical scoliosis. According to Southland Area Health Board orthopaedic surgeon Murray Fosbender, in the Southland Times, "although four percent of people have some degree of spinal curvature, only three in 100,000 need active treatment. So only a few of the large number of cases of curvature of the spine that may be picked up are going to progress to any significant degree."

There is also no evidence that manipulation or other chiropractic remedies help the curvature.

Through contacting the schools, local doctors, physiotherapists, members of Skeptics, and the Southland Times, the issue was well debated locally.

Only those schools which did not seek advice or which acted prematurely took up the chiropractors' offer. Of 30 schools which were approached, fewer than 10 bothered to reply and only three have agreed to scoliosis screenings. Indeed, in light of the debate, even this small number may even be reduced. Either way, local people are better informed about the whole issue.

Incidentally, there is an informative and interesting chapter on chiropractice by E. S. Crelin in Examining Holistic Medicine (Prometheus Books, 1989).

Russell Dear is an Invercargill skeptic.