Zero out of twenty chiropractors compliant with regulatory advertising guidance

Misleading claims in the UK chiropractic profession has been a serious problem for many years and, in spite of plenty of guidance from the Advertising Standards Authority, continues to be a major issue. There are many different types of misleading claims, ranging from the treatment of babies to giving the impression they are doctors and even claiming to be able to boost the immune system. On 3^rd November 2021 the UK chiropractic regulator, the General Chiropractic Council (GCC), published a new advertising toolkit for chiropractors. It’s a pretty good guide but there is nothing new there that chiros shouldn’t already know. They should already be compliant with everything that’s in there. To test the current compliance level, I assessed a random sample of 20 London-based chiropractors against the new toolkit. Zero out of the 20 were compliant! There were a staggering 18 who I believe would warrant regulatory complaints and 2 who were “not that bad”. Although I’ve been tackling misleading claims in chiropractic for many years, I was surprised just how bad these results were. I really thought there would have been a few who were fully compliant and a reasonable number of the rest wouldn’t have been that bad. I was wrong. The amount of pseudoscience and misleading claims was shocking. Let’s look in a bit more detail.

Selecting the random sample

In order to select the random sample of 20 chiropractors, I used the “Find a chiropractor” tool on the General Chiropractic Council’s website. I then entered “London” in the “City” box and clicked on “See Search Results”. I then selected the first 20 chiropractors returned by the search, excluding the following:

• Unable to find a website or website only has contact info with no description of practice.
• Chiropractor listed as “not practicing” on GCC website.
• Chiropractor is purely an academic and does not treat patients.

Now you too can easily repeat my search and see for yourself just how bad these chiropractic practices are.

Assessing the chiropractors

I used the GCC’s advertising toolkit to produce a list of criteria against which to assess the chiropractors, including:

• Advertising for conditions outside of those that chiropractors are allowed to advertise to treat.
• Anti-vaccination stance
• Subluxation or “correcting alignment”
• Claiming to “treat the root cause”
• Suggesting that long-term care can prevent illness
• Claiming that chiropractic treatment can improve immunity
• Giving the impression that they are a doctor or equivalent to a doctor

Results

Out of 20 chiropractors assessed there were zero who were fully compliant. The most common issue was advertising to treat conditions outside of the “allowed” list. Every single chiropractor was in breach of this, some to a greater extent than others. Other breaches that were common included:

• Subluxation or “correcting alignment” – 55% (11 out of 20) made this claim
• Claiming to “treat the root cause” – 50% (10 out 20) made this claim
• Suggesting that long-term care can prevent illness – 40% (8 out of 20) made this claim
• Giving the impression that they are a doctor or equivalent to a doctor 45% (9 out of 20) made this claim

Thankfully, there were no chiropractors who made openly anti-vaccination claims on their website. However, it is likely that this would be sufficient to result in regulatory action and it’s therefore perhaps not unsurprising that no chiropractors would openly admit to being anti-vax. As to what happens when they see their patients, that is much harder to assess.

Some of the claims made by chiropractors were pretty extreme. For instance, the lead chiropractor at one practice said that he had a “special interest and training in neurology” and claimed to be able to treat “neurological conditions”. Now, chiropractors are not doctors and it should be very obvious that treatment of neurological conditions is way outside of their expertise.

Another example is these claims relating to babies from Northcote Chiropractic:

Fig 1. Very misleading info about “check-ups” on babies from Northcote Chiropractic

It’s all complete nonsense, but what parent reading this wouldn’t be scared into taking their child in for treatment?

Target Health Chiropractic repeated entirely false claims from the infamous Joseph Mercola:

Fig 2. False nutrition claims from Target Health Chiropractic

I have previously made an Advertising Standards Authority (ASA) complaint about one of the chiropractors in this sample, Putney Chiropractic. This doesn’t seem to have resulted in much improvement as they still make a whole range of misleading claims.

Overall, these results are awful. Not only were all chiropractors in breach of guidance from the regulator but the level of pseudoscience and misleading claims were extreme in a number of cases.

Conclusions

Some chiropractors claim that the problems within their profession are confined to a minority. What this survey shows is that this is very clearly not the case. Out of a random sample of 20 chiropractors, there were zero who were fully compliant. A significant proportion of this sample of chiropractors gave the impression that they are equivalent to a doctor (they aren’t) and more than half treat “subluxations” or “correct spinal alignment”. This isn’t supported by science or evidence.

I was genuinely shocked by just how bad the misleading claims were from this sample of chiropractors. Whilst a sample of 20 doesn’t mean that every UK chiropractor makes misleading claims, it does give an indication of just how much of an issue this is within the profession. Based on the results of this sample, I can only give the following advice: Please don’t visit a chiropractor.

UK osteopaths continue to operate far outside their expertise: they now think they can treat autism!

There are many and serious problems with the osteopathic profession in the UK. Even taking this into account, I was shocked and appalled to find that some of them now think they can treat autism. I recently came across the Paediatric sensory integration and GI dysfunction in autistic children course offered by the University College of Osteopathy (UCO). It’s important to remember that UK osteopaths are musculoskeletal therapists rather similar to chiropractors. They are not doctors and treatment of sensory integration, GI dysfunction and autism more generally is completely outside of their expertise. Let’s look a bit more closely at the course, and also the trainer.

The course

The aim of the course is to “give an overview of the signs and symptoms of Sensory Processing Disorders and Autism Spectrum Disorders as well as evidence for possible osteopathic interventions in both subjects”. Let’s be really clear straight away. There are NO osteopathic interventions that have been found effective for sensory processing or autism spectrum disorders (ASD).

The course goes on to suggest the use of “visceral osteopathic techniques on autistic children suffering from gastrointestinal symptoms”. Visceral osteopathy is based on the idea of relieving “imbalances and restrictions in the interconnections between the motions of all the organs and structures of the body”. If that sounds like nonsense, that’s because it is. Visceral osteopathy is implausible and has not been found effective for any health condition. As Edzard Ernst says in one of his posts on the subject: “Visceral osteopathy is not plausible and the best evidence available to date does not show it works. In my view, this means that we should declare it an obsolete aberration of medical history.”

I’m also concerned that the safety of visceral osteopathy has not been adequately assessed. At the very least, a non-medically qualified osteopath poking around in the abdomen of children with ASD has the potential to cause distress. I’m not aware of any research that addresses the potential harms of this treatment.

The trainer

The trainer for this course is an osteopath called Iona Bramati-Castellarin. She runs a private osteopathy clinic called IBC Care based in London. On her clinic website, as well as on Twitter, Facebook and Instagram, she makes a range of misleading health claims including osteopathy for autism, claims related to visceral osteopathy and referring to herself as “Dr”. I complained to the Advertising Standards Authority (ASA) about these misleading claims. They were very quick to respond and said they thought the advertising was likely to be in breach of the Advertising Codes. The ASA have contacted IBC Care and I can see that some changes have started to be made to their website. There is no longer an “autism clinic” on the site, which is good because no osteopath should ever run such a clinic.

Conclusions

This is not the first time that I have highlighted serious issues with the training offered by the University College of Osteopathy. I have written previously about their wholly inappropriate training to osteopaths in The Paediatric Respiratory System. Now they have run a course for osteopaths on the treatment of autism. There are many serious problems here, including:

1. Osteopathy has not been found effective for sensory integration, GI dysfunction or autism.
2. Osteopaths are not qualified to treat any of these conditions, which should instead be handled by a doctor.
3. The safety of some of the techniques being recommended has not been adequately assessed and raises concerns.
4. The trainer for this course was found in breach of advertising guidelines for misleading claims relating to the very subjects being taught.

I have long had serious concerns about the UK osteopathic profession but in attempting to treat autistic children they have stooped to a new low. I don’t doubt that there are some good osteopaths out there who focus on treating musculoskeletal problems in adults and try to be evidence based. Unfortunately, the very deep and serious systemic problems within the osteopathic profession lead me to believe that osteopaths like that are in a small minority. I think the safest option therefore is to not go to a UK osteopath at all and definitely not to take a child to see one! Instead, look for another professional who is better placed to help with your health needs.

Osteopathic practice makes misleading claims about acupuncture helping the immune and respiratory systems

During the current COVID-19 pandemic there is understandably a big focus on the immune and respiratory systems. Unfortunately, some practitioners are exploiting this pandemic for their own benefit by making unsubstantiated claims about their treatments helping these systems. One such example is Lymm Osteopathic Practice, which claimed that acupuncture can benefit the immune and respiratory systems and that this may be helpful during the COVID-19 pandemic. There is simply no evidence to support these claims. The acupuncturist (Daniel Windridge) went on to claim that he uses this in his practice to treat Asthma, COPD and Lung Sarcoidosis. Daniel even claimed that “results can be immediate”. These can be serious conditions and an acupuncturist is not qualified to treat them. They should instead be treated by a doctor.

Acupuncture beliefs and (lack of) evidence

Acupuncturists believe that there are specific “acupuncture points” that influence particular organs or parts of the body. This isn’t supported by science or evidence. In this particular case, the promoted idea is that there are twelve “immune acupressure points” and that by applying pressure to these points there will be improvement in the immune and respiratory systems. According to the article, five of the acupressure points are located on the arms and seven on the legs. I do wonder, what on earth makes someone believe that they can influence the immune system by pressing on different parts of the arms and legs? There is simply no plausible biological mechanism by which this could possibly happen and no evidence to support these claims. These (and any other) special “acupuncture” points simply don’t exist. The ideas behind them are based on pre-scientific beliefs and should have no place in modern healthcare.

Tackling these misleading claims

I reported this to the Advertising Standards Authority (ASA) on 29^th May via their COVID-19 specific complaint form. Unfortunately, this didn’t result in a change and the misleading claims remained on the Lymm Osteopathic Practice website. The acupuncturist also continued to promote this misleading information via his twitter account with regular tweets about the “immune acupressure points”. Given the seriousness of these claims I decided to make a further complaint to the ASA on 18^th July using their normal complaint form. This time around the ASA took action and contacted Lymm Osteopathic Practice to inform them that they had broken advertising rules and to provide guidance on the changes needed. The page has now been removed from the Lymm Osteopathic Practice website, which is good news.

If you would like to know more about the original claims, here is a screenshot of the first part of the article. (I also have further screenshots of the rest of it):

Although these particular misleading claims have been removed from the Lymm Osteopathic Practice website, many more misleading claims remain. For instance, look at this post about the treatment of a baby: https://www.lymmosteopathicpractice.co.uk/case-study-the-baby-with-sinus-problems/ It is worrying that any parent would think that they should take a baby with the following symptoms to an osteopath: “skin a strange shade of pink, with a bluey purple tinge, he also was subdued, lethargic and very floppy”. Osteopaths in the UK are complementary and alternative therapists, not doctors. According to the article, “There are several techniques that Osteopaths can employ to unblock sinuses”. This is nonsense. There are no osteopathic techniques that have been shown to be effective for unblocking sinuses. In this particular case, things turned out okay. However, it’s likely that this was just down to good luck rather than the actions of the osteopath. The outcome could have been very much worse and the baby should have been treated by a doctor straight away. The osteopath is now using this story to try and persuade other parents to take their babies in for treatment. This is potentially dangerous as maybe the outcome won’t be so good next time around. There are no infant health conditions for which osteopathy has been shown to be effective and no good reason to take any baby to an osteopath.

Conclusions

Osteopaths are regulated healthcare professionals and should not be misleading members of the public with unsubstantiated treatment claims. This includes claims made about their own treatments as well as by other therapists who work at their practices. Unfortunately, that is exactly what has happened here. Misleading claims like this are by no means an isolated incident within the osteopathic profession. I have previously reported on osteopaths and chiropractors making misleading claims about their treatments “boosting the immune system”. I have also written about many other misleading claims from the osteopathic profession such as giving the impression that they are doctors (they aren’t) and the leading UK osteopathic education institution training osteopaths to treat respiratory conditions in children. Not all UK osteopaths make these sorts of misleading claims but it is a problem that is far more widespread than should be expected from a regulated healthcare profession.

Acupuncture treatments won’t help the immune and respiratory systems. Not only is there no evidence to support these claims but there is no plausible biological mechanism by which this could possibly happen. In fact, there is little evidence to support the use of acupuncture for any health condition. Even in pain, the evidence on acupuncture is conflicting and inconclusive. It’s also important to be aware that acupuncturists are not doctors and any serious health conditions ought to be treated by a doctor.

During the COVID-19 pandemic, it is natural for people to look for ways to protect themselves by undertaking treatments that they hope will prevent and / or treat COVID-19. Unfortunately, this has led to the promotion of a wide range of “treatments” that do not actually help at all. If you find an acupuncturist, osteopath or chiropractor who claims that they can help you prevent or treat COVID-19 or that their treatments can benefit the immune system then please steer well clear.

AECC University College newborn feeding clinic continues to make misleading claims about treatment of babies by chiropractors

I have previously written about how inappropriate it is to have chiropractors working in a newborn feeding clinic. In order to address this, I complained to the Advertising Standards Authority (ASA) about the misleading advertising claims made by the AECC University College Newborn Feeding Clinic. In response to my complaint, the ASA got the AECC University College to make changes to their claims. However, it was quite clear that the changes made were merely superficial and did nothing to address the underlying issues with chiropractors “treating” infant feeding problems. I therefore complained to the ASA a second time, and again AECC University College was found in breach of advertising guidelines.

The AECC University College made some further changes to their advertising in response to this second complaint. However, in reality, it is virtually impossible for the information about the clinic to align with the available evidence because the entire clinic is based on chiropractors treating babies. There is no evidence base that supports chiropractors treating babies for feeding problems or any other health condition. The only way that the AECC Newborn Feeding Clinic could become evidence based is by removing chiropractors entirely. The AECC aren’t going to do that because they are a chiropractic college. Therefore, the AECC will keep tweaking the wording of their advertising until the ASA no longer finds issues with it. Will the AECC still be misleading the public when this point is reached? Absolutely! The entire basis of the clinic relies on deceiving the public into taking their babies to see a chiropractor for help with feeding problems.

Advertising guidelines do not prevent chiropractors from treating babies but it is clear that clinics like this are misleading the public. It is time that the chiropractic regulator, the General Chiropractic Council (GCC), stepped in to protect the public from these unsuitable treatments by applying a minimum age limit for chiropractic treatment.

Last updated 03/12/20

UK osteopath promotes conspiracy theories, anti-vaccination beliefs and uses unproven health screening techniques on unsuspecting patients

I have written previously about some of the unsuitable treatment approaches used by some osteopaths, such as cranial osteopathy. I recently became aware of an osteopathic practice that also uses a number of unproven health screening techniques. The practice in question is the Atman Clinic. The osteopaths at the Atman Clinic use cranial osteopathy and treat babies, both of which are nonsense and worryingly common within the osteopathic profession. The Atman Clinic additionally uses sound therapy, electroacupuncture and regulation thermometry to screen patients. These are not recommended screening techniques and have not been shown to be valid for diagnosing or assessing any health problems. In addition, the principle osteopath at the Atman Clinic, Geoffrey Montague-Smith, promotes a number of other unproven treatments, conspiracy theories and anti-vaccination beliefs via his Facebook account. All of this presents clear risks to members of the public.

Summary of conclusions:

1. Here is an osteopath who promotes a wide range of conspiracy theories, anti-vaccination beliefs and unproven health treatments to unsuspecting members of the public.

2. Health screening should be carried out by a doctor who has access to all relevant tests rather than an osteopath providing unproven and unscientific diagnostic techniques.

3. There is no good evidence that osteopathy or chiropractic provide any benefit for any infant condition or that these treatments can help with birth preparation.

Unproven health screening

The Atman Clinic offers a range of unproven health screening techniques including:

• Sound therapy – as well as being used for diagnosis it claims that this can be beneficial to reduce the recovery time, support healing and clear residual effects of trauma. It states “For the modern day practitioner the use of musical tuning forks on and off the body offers a diagnostic and therapeutic modality which is safe, reliable and effective”. If that sounds like nonsense, that’s because it is. There is no possible way that using musical tuning forks could provide any information about someone’s health.
• Electroacupuncture (EAV) / Vega Test – The Atman Clinic claims to be able detect inflammation, fatigue and tissue degeneration using this technique. They state “Elecrodermal screening uses an electronic probe to measure the electrical resistance at numerous points on the body (primarily the hands and feet). This technology is not an instrument used to diagnose disease. It does however measure the electrical current moving through the acupuncture meridians and as such gives information about the bioenergetics of the body.” There is no such thing as an acupuncture meridian so attempting to measure the electrical current moving through them isn’t going to be possible. In reality, the description provided by the Atman Clinic is a word salad of pseudoscience and there is no way that EAV could possibly provide any useful diagnostic information. The National Institute for Health and Clinical Excellence (NICE) has also warned against the use of these tests. The page goes on to say that based on the outcome of the EAV test, the osteopath may then recommend nutritional, herbal or homeopathic supplements. How often do we see this? A CAM practitioner that makes use of other completely unproven CAM treatments as part of their overall approach. From what I’ve seen, quite often. I imagine that rejecting conventional medical approaches to believe in one type of pseudoscience makes it more likely that you will be taken in by others.
• Regulation thermometry – The Atman Clinic claims that this is suitable for diagnosing ongoing health problems, investigating undiagnosed symptoms and that it will allow the assessment of various systems within the body. They state “Information is collected from over 100 points on the body. Various body tissues and organs are analysed by measuring skin temperature using the infrared sensor. This gathering of information is performed during and after a brief cooling period which acts as a mild stimulus to the body.” Again, this is pseudoscience of the highest order. It’s interesting that one of the main claims they make is for investigating undiagnosed symptoms. Very good though it is, modern medicine doesn’t always have the answers and sometimes it not possible to make a diagnosis. CAM practitioners, including osteopaths, know that people often visit them when they can’t get an answer to their symptoms from a doctor. It’s therefore common to see them offer to investigate undiagnosed / untreatable problems even though most of the treatments they offer have little or no evidence of effectiveness for any health condition.

Promotion of conspiracy theories, anti-vaccination beliefs and other unsuitable health treatments

The principle osteopath at Atman Clinic, Geoffrey Montague-Smith, promotes a number of other unproven treatments, conspiracy theories and anti-vaccination beliefs via his Facebook account. Here are just a few examples:

• He repeatedly promotes anti-vaccination beliefs, such as this: https://www.facebook.com/geoffrey.montaguesmith/posts/3147466048601542
• He suggests that 5G is dangerous (it isn’t): https://www.facebook.com/geoffrey.montaguesmith/posts/2902544556427027
• He promotes a book that provides misleading health advice and says that he doesn’t wear sunglasses because “Your brain doesn’t know it’s sunny if you block the light to the eyes. That makes you burn more easily”: https://www.facebook.com/geoffrey.montaguesmith/posts/2895980633750086 This is all complete nonsense.

It is totally inappropriate for any health professional to be promoting such misleading health advice. This has the potential to do significant harm to unsuspecting members of the public.

Cranial osteopathy, preparation for birth and treatment of babies

The use of cranial osteopathy and treatment of babies is worryingly widespread within the osteopathy profession. I have written about that previously on several occasions, such as The Perrymount Clinic and Moore Osteopathy. Cranial osteopathy is complete nonsense and there is no evidence that any osteopathic treatment provides any benefit for babies. It’s clearly a systemic problem within the profession as even the Institute of Osteopathy (professional membership organisation for osteopaths) was found in breach of advertising guidelines.

The Atman Clinic promotes cranial osteopathy suggesting that osteopaths can feel the involuntary motion within the body. That is, of course, impossible because such motion doesn’t actually exist. They further suggest that babies experience soft tissue tension, tight muscles and cramping and that osteopaths can examine babies for asymmetry, misalignment of cranial bones and muscular tension at the base of the skull and in the rest of the body. There is no evidence to back up these claims and no good reason to take any baby to an osteopath.

The Atman Clinic offers a “Birth Prep program” that claims to “help mothers achieve their ideal birthing experience”. In addition it claims that osteopathy can help with conditions that are specific to pregnancy including SPD, indigestion and nausea. There is no evidence to substantiate these claims and they are clearly in breach of Advertising Standards Authority (ASA) guidelines.

What action can be taken to tackle these issues?

I reported The Atman Clinic to the Advertising Standards Authority (ASA) for their misleading advertising claims. The ASA said “We have previously investigated and ruled upon advertising like this and we are concerned to see that it continues to appear”. The ASA have therefore referred my complaint to their Compliance Team who will work to address the misleading advertising.

The promotion of conspiracy theories and other unsuitable health treatments by Geoffrey Montague-Smith on his Facebook page is an issue that really ought to be tackled by the osteopathic regulator, the General Osteopathic Council (GOsC). Protecting the public is their primary function and here one of their osteopaths presents a clear risk to the public. They therefore ought to take immediate action to protect the public and fulfil their regulatory duty.

Conclusions

Osteopaths are health professionals and as such ought to provide rational, evidence-based advice to members of the public. Unfortunately, there are many problems within the osteopathic profession. Here is an osteopathic practice that uses completely unproven diagnostic techniques and the principle osteopath promotes conspiracy theories, unproven health treatments and anti-vaccination beliefs. This presents a clear risk to members of the public. It is important that the GOsC fulfils its duties as the regulator and takes immediate action to tackle this in order to protect members of the public from harm.