Stroke Chiropractic

Chiropractors don’t raise stroke risk, research says.

Stroke chiropractic makes the point that patients die every day after even the most basic medical procedures, so it is never commented on. It's completely accepted that thousands of patients die daily after surgery and as a result of side effect of drugs.

For example 14 000 Americans die every year from gastric bleeds caused by anti-inflammatory medication. It's simply not newsworthy.

At a recent World Congress of Anaethestists in Cape Town, South Africa, the world's top surgeons are admitting that the incidence of serious cognitive dysfunction after surgery is very real, especially amongst the very young and the elderly. But stroke chiropractic is so rare that every incident, rare though they are, always reaches the press. That is precisely why chiropractic is so safe! The exception proves the rule: Chiropractic manipulation is one of the safest medical procedures.

Why is it so safe? Two reasons spring to mind. The first is simply that in the correct hands manipulation of the spine is relatively much safer than drugs or surgery. And secondly, because of the high standard of chiropractic education.

Is Chiropractic safe? Click here to view this short authorative video.

Background

The Vertebro Basilar Artery (VBA) threads its way through the vertebrae of the neck on the way to the posterior or basilar part of the brain, hence its name.

VBA stroke as it is called is an extremely rare event. One in a million manipulations of the neck. To put it into perspective: Stroke chiropractic may happen once in the whole career of one in ten chiropractors.

In comparison medicine's own research shows that a patient dies after medical treatment every year at the hands of one in five medical doctors. Every year!

As chiropractors we need to be vigilant, however, as neck pain and headache are common symptoms that VBA dissection is occurring, and a stroke is imminent.

Little is known about the incidence and time trends of VBA stroke diagnoses in the population. Chiropractic manipulation to the neck is believed to be a risk factor for VBA stroke, but no study has yet found an association between chiropractic utilization and VBA diagnoses at the population level. On the contrary ...

"Researchers conclude that: “We found no evidence of excess risk of VBA stroke associated chiropractic care compared to medical care.”

Stroke chiropractic is still being peddled by our critics as a common event after a chiropractic adjustment. It’s still considered ‘high risk’ having your neck adjusted.

Tens of millions of people worldwide receive chiropractic adjustments every day for relief of headache and neck pain. Yet medical critics claim that the risk of stroke is so high that manipulation should be severely curtailed because it is extremely dangerous!

Chiropractic care is popular for neck pain and headache, but may increase the risk for VBA dissection and stroke, critics of manipulation say.

However there is no increased risk of stroke chiropractic after manipulation of the neck, state two new Canadian studies, reporting in the world’s most influential medical journal, Spine.

Study I

Researchers say patients are no more likely to suffer a stroke following a visit to a chiropractor than they would after stepping into their family doctor’s office.

Stroke after manipulations is an important issue. Bone and Joint Decade 2000-2010, a team of internationally renowned specialists, mostly medical orthopaedists and researchers, including top chiropractors of course, initiated the research to enquire into the incidence of stroke, after earlier studies cast a cloud over the chiropractic profession suggesting there was a close link between stroke and manipulation.

Conclusion

Cassidy et al conclude: Stroke associated with the Vertebro Basilar Artery (VBA) is a very rare event in the population. It has been alleged that stretching or impingement of the VBA by manipulation could cause a chiropractic stroke. The researchers conclude that: “We found no evidence of excess risk of VBA stroke associated chiropractic care compared to medical care.”

Study II

A second study by Boyle PhD et al also reporting in Spine, comparing stroke due Vertebro Basilar Artery dissection in two Canadian provinces found that:

• In Saskatchewan, we observed a dramatic increase in the incidence rate in 2000 and there was a corresponding relatively small increase in chiropractic utilization.

• In Ontario, there was a small increase in the incidence rate; however, chiropractic utilization decreased.

Results

There were 818 VBA strokes hospitalized in a population of more than 100 million person-years (or 1 per 100 000).
In those aged <45 years, cases were about three times more likely to see a medical practitioner or chiropractor before their stroke than controls.
There was no increased association between chiropractic visits and chiropractic stroke in those older than 45 years.
Positive associations were found between medical practitioners visits and VBA stroke in all age groups. Practitioner visits billed for headache and neck complaints were highly associated with subsequent VBA stroke.

In conclusion

VBA stroke is a very rare event in the population. Authoritative sources speak of 1-2 / one million manipulations.
The increased risks of VBA stroke associated with chiropractic and medical practitioner visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to medical care.
At the ecological level, the increase in VBA stroke does not seem to be associated with an increase in the rate of chiropractic utilization.
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