Chiropractors Sparring over Immune-Boosting Claims


Stephen Barrett, M.D.
May 20, 2020

Many chiropractors claim that spinal misalignments—which they refer to as “subluxations”—can lower resistance to disease and that periodic spinal manipulation (which they call “adjustments”) can improve immunity by correcting the subluxations. In 1949, chiropractic’s developer, B.J. Palmer, wrote about this in a discussion of smallpox vaccination:

Physicians admit some people are immune; others are fertile culture grounds. Some resist better than others. Those who resist are stronger and more able to “throw off germs,” etc. And where does this resistance come from? . . . . An individual with a subluxation will resist less; and one without will resist more [1].

The percentage of chiropractors who still think this way is unknown but appears to be slowly decreasing. The colleges that aim to be science-based have abandoned it. The U.S.-based International Chiropractors Association (ICA), with 1,369 U.S. and 350 foreign members listed in its online directory, appears to be the largest group that espouses Palmer’s teachings. The World Federation of Chiropractic, which represents chiropractic organizations in about 89 countries, does not. On March 19, 2020, it stated:

No credible, scientific evidence that spinal adjustment/manipulation has any clinically relevant effect on the immune system was found. Available studies have small sample sizes and a lack of symptomatic subjects. At the time of writing, there exists no credible, scientific evidence that would permit claims of effectiveness for conferring or enhancing immunity through spinal adjustment/manipulation to be made in communications by chiropractors [2].

On March 20, the ICA issued a report that stated:

The ICA has previously provided clear reminders to its members of the importance of not advertising in any form the suggestion that chiropractic can cure, treat, prevent, or mitigate COVID-19 because the evidence to substantiate such a claim does not exist. The evidence does not exist because the research on COVID-19 and chiropractic has not been conducted [3],

However, it added—in boldface type—that “Chiropractic supports the whole person” followed by a quote from B.J. Palmer that “While other professions are concerned with changing the environment to suit the weakened body, chiropractic is concerned with strengthening the body to suit the environment.” This was followed by seven pages that (a) discussed studies of “immune function and chiropractic,” (b) claimed that chiropractors got “fantastic results from patients” in the 1918 influenza epidemic, and (c) concluded:

As an essential health care provider, the chiropractor is in a unique position to assist their patients during this time of heightened stress. Although there are no clinical trials to substantiate a direct causal relationship between the chiropractic adjustment and increased protection from the COVID-19 virus, there is a growing body of evidence that there is a relationship between the nervous system and the immune system. As a service to chiropractors around the world, and their patients, the ICA has committed to developing and maintaining this library of relevant scientific evidence.

The International Chiropractors Association calls upon all our colleagues within the profession to join with us in seeking greater research resources for our academic institutions. An increase in funding allotted through the current emergency pandemic appropriation and in future years will lead to the necessary clinical research required to validate the role of doctors of chiropractic in promoting health and vitality by stimulating a healthy immune response. 

One week later, the ICA posted a revised report that added a few more references [4].

Simply put, these reports are ingenious pieces of double-talk that say: “We know that chiropractic can help people with serious viral diseases, but we are not claiming this (wink-wink) because the clinical trials needed to prove this have not yet been done.” This message is misleading because clinical trials are unlikely to take place without a logical reason (such as preliminary evidence a plausible rational) to do them. The idea that chiropractors are in a “unique position” to help patients deal with the COVID-19 epidemic is also baloney.

In May, more than 150 chiropractic researchers from eleven countries criticized the ICA for suggesting that chiropractic care (primarily spinal manipulation), can have a meaningful impact on immune function. The researchers also called on regulatory authorities and professional leaders to take appropriate political and regulatory action against “direct or indirect unsubstantiated claims that spinal adjustments can boost immunity, or benefit patients with infectious diseases, especially coronavirus infections.” [5]

These sentiments were echoed by an international team of chiropractic students who wrote:

If disciplinary actions are not taken by regulatory bodies, public perception will continue to be that all chiropractors agree with the false claims made by a small, yet vocal minority. This inaction will result in the continual spread of these unfounded beliefs. We are concerned for the profession that we will be entering, as the profession’s reputation will be tarnished if swift action is not taken against these chiropractors. While we appreciate and support the regulatory bodies who have begun to take action against these dangerous claims, we call for further action and decisiveness. . . . We feel it is time for the profession to act before it is too late; . . . reporting such behaviour in order to protect the public interest and assist with regulatory enforcement [6]

In July, 71 more full-time researchers, early career researchers, clinician-researchers and graduate students added their names to the chiropractic research community  statement, bringing the total to 224 [7].

Meanwhile, the Canadian Chiropractic Association, the British Chiropractic Association, and six other national chiropractic organizations have called the ICA’s position on COVID-19 “a shocking violation of public health directives and undermine public trust in both chiropractic and public health” and have asked  the WFC consider whether to permit the ICA to remain a WFC member [8].

Questionable Web Site Claims

In May 2020, I searched with Google for chiropractic Web sites that contained the words COVID-19, coronavirus, adjustment, adjusted, immune, immunity, and/or subluxation. I found 126 clinics that offered services from a total of 263 chiropractors, of which 16 were ICA members. The claims included:

  • “Your immune system is your #1 defense against all bacterial and viral infections. . . . Regular chiropractic adjustments have been proven to boost your immune system”
  • “Measures to Minimize COVID-19 infection: 1. Receive regular frequent chiropractic adjustments to enhance your entire body performance including your immune system.”
  • Studies have shown getting adjusted improves your immune system by 200-400% each time you come in!
  • “One of the main causes of immune system problems comes from subluxations (compression of nerve pathways). Chiropractors may use a variety of spinal manipulation to help relieve this compression and in turn may boost your immune system!”
  • Now more than ever, you should be getting ADJUSTED. In times of immune system suppression, a patient should have their nervous system examined for subluxation several times per week to ensure they are free of interference.
  • “Evidence shows that people who receive regular adjustments report stronger immunity after beginning Chiropractic care.”
  • “The best weapons for the coronavirus and the flu begins with building a string immune system. . . . Evidence shows that people who receive regular adjustments report stronger immunity after beginning Chiropractic care.”
  • “Proactively boosting your immune system through chiropractic can help keep you healthy and strong during this time.”
  • “GET ADJUSTED! It is now more important than ever to stay on track with your weekly chiropractic adjustments. PREVENTION of sickness and dis-ease is key! In fact, we have several practice members receiving extra adjustments this month, to boost their immune system. We are eager to keep you well-adjusted through this time. With specific, neurologically-based chiropractic care, should you contract any illness, your healing and recovery times will experience a boost.”
  • The fact is, by boosting and strengthening your immune system right now, you can almost STOP any virus from entering your body (not just COVI D-19).”

To see the other pages I found, click here.

The Joint Chiropractic, a franchising company with about 1,150 chiropractors in 575 clinics nationwide, uses a more subtle pitch. The last suggestion on its page titled “4 Easy & Helpful Ways to Fight Coronavirus” states:
See the Chiropractor

Chiropractic care focuses on the function of the central nervous system, which just so happens to regulate every single function in your body. Regular chiropractic adjustments focus on the removal of spinal joint dysfunctions that can impact how your central nervous system communicates with the rest of your body. When your body is able to communicate freely and efficiently, then every system can work optimally to help you stay healthy. You cannot control the Coronavirus (or the flu or common cold either!) but what you can control are the things you do to support your own health. There’s no new way to outsmart a virus, all you can do is go back to the basics to help you stay healthy.

Though mild compared to most others I have found, this passage is still misleading. The nervous system does not control every single function in the body. Regular chiropractic adjustments do not promote general health. And chiropractors cannot enable the body to “communicate efficiently and freely.” Overall, the passage falsely suggests that something uniquely chiropractic can make you less vulnerable to COVID-19.

In June 2020, Australian skeptics published the names of 18 Australian clinics that had claimed to boost immunity by treating subluxations [9].

Chiropractic Board Warnings

In April 2020, a chiropractic team found that chiropractic licensing boards in eight states had warned against claiming that spinal manipulation or its influence on immune function provides protection from COVID-19. The states were Arizona, Arkansas, Minnesota, Ohio, Oregon, South Carolina, Texas, and West Virginia [10]. In July, a Los Angeles Times reporter indicated that he had contacted six local chiropractic offices as a potential patient seeking help in dealing with the coronavirus. His article reported: “Only one . . . said without hesitation or equivocation that its chiropractors can do nothing for the coronavirus or COVID-19. The rest . . . said that help was available via a chiropractor’s supposed ability to boost the immune system through spinal adjustments.” [11]

Government Enforcement Actions

Enforcement agencies worldwide are giving high priority to COVID-19-related schemes and scams. The actions against taken so far against chiropractors or their clinics include the following:

  • The College of Chiropractors of British Columbia, the regulatory body of British Columbia chiropractors, has issued a public notice that it is inappropriate for chiropractors to promote treatment or supplements as a means to boost the immune system and imply that this will prevent infection from the novel coronavirus.
  • The  College of Chiropractors of Ontario has sent 74 cease-and-desist orders to chiropractors who had advertised such claims.
  • The Oregon Department of Justice has secured a consent agreement that prohibited Sandra Johnson, D.C., of Bend Oregon from making promotional claims about products that refer to coronavirus or COVID-19.
  • The U.S. Attorney’s Office for the District of Texas has obtained a temporary restraining order to stop Ray L. Nannis, D.C., d/b/a Optimal Wellness Solutions from advertising that his sublingual homeopathic products can prevent and treat COVID-19 infections.
  • The U.S. Federal Trade Commission (FTC) has ordered Mathew Martinez, D.C., who operates the Absolute Health Clinic in Bristol, Washington, to stop advertising that stem cell therapy, intravenous vitamins C and D, and various other “immune-boosting” supplements can treat or protect against COVID-19 infections.
  • The FTC has ordered Epigenetics Healing Center (operated by Jay Goodfinder, D.C.) to stop claiming that intravenous treatments of vitamin C, vitamin D and glutathione and supplements of garlic, pycnogenol, and vitamin B12 are effective against COVID-19.
  • The FTC has ordered Tulsa Chiropractic Rehab to stop claiming that high-dosage vitamin C and various other supplements could protect them against COVID-19.
  • The FTC has ordered David Dahlman, D.C. d/b/a Hyde Park Holistic Center to stop claiming that supplement products sold by his online store can help prevent COVID-19 infection.
  • The FTC has ordered Active Lifestyle Clinic (operated by Todd Winton, D.C. and Jennifer Winton, D.C.)  to stop claiming that ozone therapy and chiropractic adjustments can help protect against COVID-19 by boosting immunity.
  • The FTC has ordered Fuller Life Chiropractic (operated by Ronald Dean Fuller, D.C,) to stop claiming on its Web site that “correcting subluxations through specific scientific chiropractic adjustments help to ensure that your nerve system, and, therefore, your immune system are functioning as close to their maximum innate potential as possible” and “increases your defenses against outside pathogens and increases your potential to stay healthy.”
  • The FTC has ordered Eric Nepute, D.C. to stop claiming that intravenous vitamin C  protect against COVID-19 by “supercharging” your immune system and that spinal adjustments “makes your immune system work better.”
  • The FTC has ordered the Natural Health Center of Clifton (operated by William Eickhoff, D.C. and three other chiropractors) to stop claiming that spinal adjustments, nutrient infusions, and acupuncture can help protect against COVID-19 by boosting the immune system.
  • The FTC has ordered Hackbart Chiropractic (operated by Daryl Hackbart, D.C. and Tyler Hackbart, D.C.) to stop claiming that “no other drug or vaccine can offer protection from sickness like a specific chiropractic adjustment.”
  • The FTC has ordered Back 2 Health Family Wellness Center (operated by Dennis Hupka, D.C. and Lisa Mazzella, D.C.) to stop claiming that regular spinal adjustments can help protect against COVID-19 by boosting immune function.

The FTC actions are noteworthy because the agency usually takes 1-2 years to process complaints, but the above cases—as well as others that did not involve chiropractors—were launched in less than two months. Six of the cases are additionally significant because they attack the core chiropractic immune-boosting claim discussed in this article; and three of these were among the 130 I reported to the FTC. It will be interesting to see whether the FTC acts against the others that I reported.

If you see any Web site which claims that chiropractic
methods—directly or indirectly—can prevent or
treat COVID-19, please send me an e-mail.

References
  1. Palmer BJ. The Bigness of the Fellow Within. Chiropractic Fountainhead, Davenport, IA, 1949, p 607.
  2. The effect of spinal adjustment/manipulation on immunity and the immune system: A rapid review of relevant literature. World Federation of Chiropractic, March 19, 2020.
  3. International Chiropractors Association. Immune function and chiropractic: What does the evidence provide? International Chiropractors Association, March 20, 2020.
  4. International Chiropractors Association. Immune function and chiropractic: What does the evidence provide?—Revised. International Chiropractors Association, March 28, 2020.
  5. Côté P and others. A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity. Chiropractic & Manual Therapies 28:21, 2020.
  6. Plener J and others. Chiropractic students call for action against unsubstantiated claims. Chiropractic & Manual Therapies 28:26, 2020.
  7. Côté P and others. More published full-time researchers, early career researchers, clinician-researchers and graduate students unite to call for actions against the pseudoscientific claim that chiropractic care boosts immunity. Chiropractic & Manual Therapies 28:48, 2020.
  8. Lange F and others. Letter to World Federation of Chiropractic, June 17, 2020.
  9. McCleod K, Vickers M. Immune to science. The Skeptic 40(2):18-20, 2020.
  10. Neff SM and others. Guidance concerning chiropractic practice in response to COVID-19 in the U.S.: A summary of state regulators’ web-based information. Chiropractic & Manual Therapies 28:44, 2020.
  11. Lazarus D. No, a chiropractor can’t cure COVID-19 (or diabetes, for that matter. Los Angeles Times, July 7, 2020.