Low Back Clinic claims questioned: Marketplace

Back-pain clinics across Canada are making claims about a machine offering a type of spinal decompression that U.S. authorities say is based on "junk science," an investigation by CBC-TV's Marketplace has revealed.
Dr. Hamilton Hall says no back treatment has an 89 per cent success rate. ((CBC))
Back-pain clinics across Canada are making claims about a machine offering a type of spinal decompression that U.S. authorities say is based on "junk science," an investigation by CBC-TV's Marketplace has revealed.

Marketplace spoke to more than a dozen back experts, including chiropractors and surgeons, who say they have concerns about the claims being made about various types of spinal decompression therapies on offer at private clinics.

Dr. Richard Liem, the founder of the Low Back Clinic, one of the largest chiropractic chains in Canada, claims a success rate of between 86 and 89 per cent among his clients.

"We have a very high success rate here at our clinic," said Liem.

But Dr. Hamilton Hall of Toronto, a leading Canadian back doctor, said there is no one medical treatment that can ensure that kind of success rate with lasting results.

"Either he believes this, in which case he's mentally weak, or he's a liar, he's a crook, he's out to scam you," Hall told Marketplace.

Liem started the Low Back Clinic with one outlet in Etobicoke, outside of Toronto. He now has eight clinics in Ontario, Winnipeg and Halifax, all marketing something called "non-surgical decompression therapy," where patients are strapped onto the DRX-9000, a machine made by Florida-based Axiom International.

According to the Low Back Clinic's website, the DRX-9000 uses "a method of spinal decompression, the table uses motors and rollers to manipulate the spinal column at precise locations, freeing up space between vertebrae and damaged spinal discs, giving them a chance to heal."

The treatment costs up to $5,000 for 20 sessions.

Experts interviewed by Marketplace say the treatment is basically a high-tech form of traction.

Patient Stephen S. was advised at a Low Back Clinic he should be treated with the DRX-9000, but was not first given a physical exam. ((CBC))

"They’re making claims that are not supported," said Hall, who noted that medical studies posted on the company's website would not stand the test of good science.

"Everything else here are case reports, anecdotes. You know, my Aunt Sally told me she liked it. And that’s not science, but it’s good marketing," he said.

While many injured backs will heal on their own, no treatment is 89 per cent effective, said Hall.

"If there was magic out there that would cure my patients so simply, so easily, so permanently, I would be part of it," he said.

In the U.S., some state authorities have cracked down on Axiom over its success rate claims concerning the DRX-9000.

Oregon's attorney general fined Axiom $100,000 US in 2006 and forced the company to stop advertising an 86 per cent success rate, saying studies did not support the claim.

In December 2009, Florida's attorney general filed a lawsuit against Axiom, seeking an injunction barring the company from marketing the machine under false pretences.

Florida's attorney general alleged Axiom made misleading statements, including that its DRX-9000 spinal decompression system was "the eighth wonder of the world."

"The study that was presented to support that claim was junk science. It wasn’t worth the paper it was written on," said David Hart, who heads the consumer health fraud unit in Oregon's attorney general's office. "As regulators, we have to be particularly concerned when vulnerable populations are targeted."

In Canada, Liem continues to make the same claim for success that Axiom was fined for in the U.S. He said the success rates his clinics claim are backed up by his own clients’ testimony.

"Our results with our patients have a very high success rate. Between 86 and 89 per cent success rate," he said. "We have the patients that have proved it themselves."

Marketplace went undercover with a prospective client to see how the Low Back Clinic operated.

An otherwise healthy man, Stephen S., 24, of Toronto, had suffered a disc herniation in his lower back and had been in pain for nearly a year when he decided to check out a Low Back Clinic.

Stephen first had Dr. Hall look at his case and check out his sore back.

Hall examined Stephen's MRI report and did a physical exam. He diagnosed a pinched nerve, which he said would continue to get better on its own with simple exercises.

With that assessment in hand, Stephen headed to the Low Back Clinic, armed with his MRI and X-rays. A chiropractor there looked at the scans but didn't conduct a physical exam. The recommendation was decompression therapy.

Stephen said he was surprised at the different recommended treatments.

"There was no like, you know, 'We're going to feel around here, let me see if what I see corresponds to the MRI report or even the X-rays.' And there was none of that. She just went kind of immediately into, 'OK, this is the only treatment for you," he said.

Marketplace asked Liem if it was typical to recommend treatment for a client without actually doing a physical exam. Liem was surprised.

"We take the quality of our patient care very, very seriously. If that is the case, we’ll take immediate and swift action," he said.

Some of the claims of the Low Back Clinic have caught the interest of the College of Chiropractors of Ontario.

After reviewing one complaint about the clinic, the college advised Liem that he "should be careful, as his claims "could be perceived to be misleading patients," according to documents obtained by Marketplace.

Health Canada did approve the DRX-9000 in 2003 for the treatment of lower back pain, but indicated in an email to Marketplace that it would revisit the case, saying it will "be reviewing the claims made about the DRX-9000."