Professor Edzard Ernst's study, which
concluded that manipulation does not work and may be dangerous
in some circumstances (report, Mar 22), was incomplete as
it included a review of just 16 selected studies from the
very many more high-quality studies which arrive at precisely
the opposite conclusion.
That the European Commission Research
Directorate-General, the health ministries of most European
countries, as well as those of the US, Canada and others,
do recommend spinal manipulative care would indicate an adverse
degree of selection bias in the study.
At our centre, differing
health professionals work alongside one another and conclude
that each has a role to play in the treatment of spine and
joint conditions. Manipulation, along with other medical treatments,
has the potential to cause harm if inappropriately applied.
There is, however, a consensus in the research community that
spinal manipulation is indeed a safe treatment. Much unnecessary
distress is caused by such studies to the thousands of patients
relying on these professionals.
PETER HAMLYN
Consultant neurosurgeon
GERARD HALL
Consultant rheumatologist
Article from the Times Online