Plethora or paucity? The BCA and bedwetting

The BCA have, at last, released their much heralded “plethora” of evidence.  They preface this with an incredible statement, which includes the following gems: 

“In the spirit of a wider scientific debate, and having taken appropriate professional advice, the BCA has decided that free speech would be best facilitated by releasing details of research that exists to support the claims which Dr. Singh stated were bogus. This proves that far from there being “not a jot of evidence” to support the BCA’s position, there is actually a significant amount. 

It has never been the BCA’s case that the evidence is overwhelmingly conclusive. It is the BCA’s case that there is good evidence. […] 

[…] The BCA welcomes full, frank and open scientific debate. […]”

That’s good then, the BCA will welcome my frank take^* on their summary of the evidence for chiropractic helping children with nocturnal enuresis. 

Defending chiropractic?

The Great Chiropractic Debate rumbles on in the pages of the New Scientist.  This week Richard Brown, a Chiropractor and vice-president of the BCA, has a comment piece entitled, “Defending chiropractic”. 

It is worth looking at it as an exemplar of fallacious argument and claims about Chiropractic practise that do not stand scrutiny.  For instance, he uses a typical quack defence: critics claim that chiropractic lacks evidence, but they overlook, “the fact that many accepted medical interventions have little or no research evidence to support them.”

Martineau chiropractic to check with the BCA

As part of my brief survey of the claims Chiropractors make for the treatment of bedwetting (nocturnal enuresis) in children I contacted Martineau Chiropractic (Cached URL).  They claim that “research has shown chiropractic to be an effective treatment” for “bed wetting”.  Of course, it has shown no such thing. 

I have had a brief and interesting reply^*: 

“Thankyou for looking at our website, I hope you enjoyed it. I shall be taking advice from my professional association regarding the content of the website […]” 

More Bedwetting Bogosity*

I was pretty surprised to find that many Chiropractors claim to treat bedwetting (nocturnal enuresis) in children.  They often cite studies published in their own ‘academic’ journal to back up this claim.  After finding that even these studies do not really support the chiropractic treatment of this condition, I wondered how Chiropractors justify offering this treatment: so I decided to contact an un-scientifically chosen^** sample of chiropractic clinics, pointing out the weakness of the evidence and asking them to consider correcting any errors in the way that they were representing it.   I also wanted to see how open they would be to the idea of including good conventional advice on their websites, as a service to their customers. 

Chiropractic: a bogus* treatment for bedwetting?

A wide variety of claims are made for chiropractic treatment.  One that really surprised me is that it can be used to treat bedwetting (nocturnal enuresis) in children.  I really struggle with the basic plausibility of this claim.  I mean, how can spinal manipulation control whether a child pees in their sleep, or not? 

So I decided to see whether this is a bogus^* treatment, or not. 

Some Basic Facts

Although this complaint can cause stress^** and social isolation for a child, the UK NHS Choices website says that bedwetting is very common in children.  It usually affects those under six or seven years old. Fortunately, it usually stops by the age of seven or slightly later. They estimate that around, “one in seven children aged five, and one in 20 children aged 10, wet the bed.”  Boys are more commonly affected than girls.  Older children can also have this problem.