Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury

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J Manipulative Physiol Ther 1995 (May);   18 (4):   203–210

Terrett AG

School of Chiropractic and Osteopathy,
Faculty of Biomedical and Health Sciences,
RMIT University,
Bundoora, Australia

This Full Text article is reprinted with the permission of National College of Chiropractic and JMPT.   Our special thanks to the Editor, Dr. Dana Lawrence, D.C. for permission to reproduce this article exclusively at Chiro.Org

You may also want to review Wenban’s more recent article:

Inappropriate Use of the Title Chiropractor and Term Chiropractic Manipulation in the Peer-reviewed Biomedical Literature

OBJECTIVE:  This study was conducted to determine how the words chiropractic and chiropractor have been used in publications in relation to the reporting of complications from cervical spinal manipulation therapy (SMT).

STUDY DESIGN:  The study method was to collect recent publications relating to spinal manipulation iatrogenesis which mentioned the words chiropractic and/or chiropractor and then determine the actual professional training of the practitioner involved.

METHOD:  The training of the practitioner in each report was determined by one of three means: surveying previous publications, surveying subsequent publications and/or by writing to the author(s) of ten recent publications which had used the words chiropractic and/or chiropractor.

RESULTS:  This study reveals that the words chiropractic and chiropractor commonly appear in the literature to describe SMT, or practitioner of SMT, in association with iatrogenic complications, regardless of the presence or absence of professional training of the practitioner involved.

CONCLUSION:  The words chiropractic and chiropractor have been incorrectly used in numerous publications dealing with SMT injury by medical authors, respected medical journals and medical organizations. In many cases, this is not accidental; the authors had access to original reports that identified the practitioner involved as a non–chiropractor. The true incidence of such reporting cannot be determined. Such reporting adversely affects the reader’s opinion of chiropractic and chiropractors.

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From the Full-Text Article:


Among the health professions, chiropractic has an impressive safety record for its 99-yr existence [1, 2]. Chiropractors in Australia are aware that complications can occur after spinal manipulation therapy (SMT), and, as responsible professionals, they have investigated and instituted procedures to minimize their occurrence [2-19]. In fact “the incidence and mechanisms are better reported in the chiropractic literature than elsewhere” [20].


This paper presents cases from the medical literature and popular press in which medical authors have incorrectly reported the facts regarding manipulation injuries of the cervical spine. The method of investigation was to study recent publications which reported cervical spine manipulation accidents. In those that used the words “chiropractor” or “chiropractic,” attempts were made in each reported case to determine the profession to which the practitioner belonged. This was done by referring to previous or subsequent publications or by trying to contact the actual author of ten recent English language publications (six of whom replied). This investigation reveals that many cases of complication after manipulation described in the medical literature as “chiropractic complications” are found to, be, on closer inspection, either

(a)   medical misrepresentation of the literature
(Examples 1–24);

(b)   inaccurate reporting by medical authors
(Examples 25–36) or

(c)   inaccurate reporting by medicolegal journalists
(Examples 37–40).


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