Alternative medicines and therapies could be unsafe

Patients seeking alternative medical treatments, such as chiropractic manipulation, herbal remedies and acupuncture, should treat them with caution, an expert in the field has said.

Edzard Ernst, who is the only professor of complementary medicine in the UK and teaches at the University of Exeter, has said alternative medicines and therapies may be more unsafe than they appear to be.  

According to a research project that Ernst has carried out, almost half of medical trials failed to report when patients suffered adverse side effects from the treatments.

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One of Ernst’s main concerns was about the safety of chiropractic manipulation, which he said could have fatal consequences for patients if it was carried out incorrectly.

Speaking to The Guardian newspaper, he said: "I feel that chiropractors do have a strange attitude towards the safety of their interventions.

“When you read the literature, you see proclamations that spinal manipulation, according to chiropractors, is 100 percent safe."

He continues: “About 50 percent of patients seeing a chiropractor have adverse effects, which is staggering.

“In addition to these fairly mild adverse effects, which basically are pain at the site of manipulation and referred pain sometimes, which only lasts one or two days, we have about 500-700 cases of severe complications being reported.”

In total, Professor Ernst reviewed 60 randomised controlled trials of chiropractic treatments that took place between 2000 and 2011.

He discovered that of those 60, 29 had not mentioned anything about adverse side effects being experienced by patients.

“Not only does it violate basic rules of publication ethics, it also means that, due to under-reporting, our knowledge of adverse effects of alternative medicine is incomplete and not reliable,” he said.

“If investigators fail to report, we will not know.”

Ernst continued: “Therapeutic decisions ought to be taken not on considering the effectiveness alone but also you have to have effectiveness as a balance with the potential for harm.

“You have to do a risk-benefit analysis. When you under-report risk, this cannot possibly be done robustly.”

Ernst’s findings have been published in the Journal of the New Zealand Medical Associationand at the time of publication, the British Chiropractic Association was unavailable to comment.

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