Chiropractic and the risk of stroke
ONE of my dedicated patients alerted me last week to an article published on a website attempting to directly link chiropractic adjustments to vertebrobasilar artery tears leading to strokes (CVA’s). It is preposterous to make such claims when these incidents can occur with something as ordinary as looking up to watch a bird fly in the sky.
Furthermore, one of the largest insurance providers of malpractice insurance painstakingly researched and found that these incidents actually occur only two times per 10 million chiropractic adjustments.
Conversely, they also discovered that medical procedures account for somewhere between 200,000 and 400,000 iatrogenic (physician caused) adverse effects, ranging from strokes to deaths. That is why in developed countries, medical malpractice insurance is exponentially more expensive than that for the chiropractors. We will cover more on those statistics in upcoming articles; but first, I have a duty to the public to address this issue with strokes and provide them some truth on the matter. Below is a reproduced article by the World Chiropractic Alliance:
“In an attempt to discredit chiropractic and discourage people from seeking care from doctors of chiropractic, some proponents of allopathic medicine continue to disseminate misleading information about a possible link between cervical adjustments and strokes.
It is the position of The World Chiropractic Alliance that such misinformation is a deliberate and unethical scare tactic which does not stand up to critical analysis. Even if we restrict our investigation to cervical adjustments — which have been the focus of many of the media and medical attacks — the only reasonable conclusion which can be drawn is that chiropractic adjustments do not post any significant risk of stroke and are remarkably safe.
A stroke occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to an area of the brain. The lack of blood causes brain cells to die. There are nearly 750,000 first ever or recurrent strokes each year in the US and more than 150,000 deaths are directly related to strokes.
To link these strokes to chiropractic is absurd; however, since numerous published scientific and medical studies indicate that the incidence of a cerebrovascular accident (CVA) or stroke is estimated at between one to three incidents per million adjustments.
One study covered a period of 28 years, while another involved reviewing about 110 million chiropractic visits. The results of all these studies show conclusively that the risk of stroke from a chiropractic adjustment is so small as to be statistically insignificant. It has been estimated that it is even less than that of “beauty parlor stroke syndrome” — a rare occurrence triggered when a customer leans her head back on a sink to get her hair washed.
In reality, even the 1-3 incidents per million adjustments figures may be too high, since it is erroneous to equate correlation with cause. That is, if a person suffers a stroke after receiving a chiropractic adjustment, it is not necessarily proof that the adjustment caused the stroke. An article entitled Adjustments, Strokes, and Errors in Medicine (The Chiropractic Journal, July, 2000), explained, “The fact that a temporal relationship exists between two events does not mean that one caused the other.”
In addition, medical researchers frequently misunderstand the critical differences between specific chiropractic adjustments and cervical manipulation. Doctors of chiropractic are highly trained in the use of the chiropractic adjustment, which is the specific application of force to facilitate the body’s correction of nerve interference.
Manipulation is the forceful passive movement of a joint beyond its active limit of motion. Since it doesn’t imply the use of precision, specificity or the correction of nerve interference, it is not synonymous with a chiropractic adjustment.
Finally, many of the cases cited by medical researchers as being “chiropractic treatments” were actually spinal manipulations rendered by non-chiropractic practitioners. According a research report in the Journal of Manipulative and Physiological Therapeutics, “manipulations” that were in fact administered by a Kung Fu practitioner, GPs, osteopaths, physiotherapists, a wife, a blind masseur, and an Indian barber had been incorrectly attributed to chiropractors.
The report explained that “the words chiropractic and chiropractor have been incorrectly used in numerous publications dealing with SMT injury by medical authors, respected medical journals and medical organisations. In many cases, this is not accidental; the authors had access to original reports that identified the practitioner involved as a non-chiropractor. The true incidence of such reporting cannot be determined. Such reporting adversely affects the reader’s opinion of chiropractic and chiropractors.” (Terrett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. JMPT 1995;18:203.)
Despite their apparent desire to malign chiropractic and link adjustments with the risk of stroke, even medical researchers have had to admit that chiropractic care carries far less of a stroke risk than medical treatment. “Indeed, most interventions by allopathic physicians have a higher complication rate than chiropractic interventions,” said Philip Lee, MD, a co-investigator of a research survey presented at the American Heart Association’s 19th International Joint Conference on Stroke and Cerebral Circulation.
Based on the scientific evidence readily available today, it is clear that chiropractic adjustments pose no significant risk of strokes and are far safer in this regard than most medical treatments. The World Chiropractic Alliance calls upon the medical establishment to provide factual data to the public and restrain from using scare tactics in a blatant attempt to continue its long-standing history of opposition to chiropractic and other disciplines which threaten its monopoly on the health care system.”
Below are the study results of the malpractice insurance provider that I mentioned in the beginning of this article. You be the judge:
Number of events per 10 million people in the USA:
• Death from spinal fusion surgery – 200,000
• Death from cervical (neck) surgery – 68,966
• Death from hospital mistake – 60,000
• Death from laminectomy (spine surgery) – 50,000
• Death from Aspirin, Tylenol, Advil, Aleve, or Motrin prolonged use – 8,333
• Paralysis or stroke from back or neck surgery – 7,143
• Death from automobile accident – 1,500
• Stroke from birth control pills – 417
• Getting struck by lightning – 14
• Death from aviation accident – 5
• Stroke from chiropractic adjustment – 2
So, one is 209 times more likely to experience a stroke from taking birth control pills than from receiving a chiropractic adjustment.
It is mind-blowing that one is up to 100,000 times more likely to be injured or killed from invasive medical procedures and surgeries, yet there exists articles attempting to dissuade the public from seeking natural, effective, and relatively extremely safe chiropractic care.
Don’t forget to “Ask Your Chiropractor” every week where your questions may be published and answered in subsequent articles. Address questions to: Dr Chris Davis, the Spinal Mechanic and lead doctor, at movethebone@gmail.com; or, Dr Michael Harvey, director, at dr.michael_harvey@yahoo.com