Throughout my career, there has never been any issue which has raised more questions, caused more fear, dissent, anger, frustration, and misunderstanding as this issue has and continues to cause. Firstly, I have been a doctor of chiropractic for 27 years now and I am very proud of the services which I have had the privilege to provide to the public. Here is my take on this issue and I hope this will help dispel some of the confusion regarding this poorly understood issue.
In my opinion, there are two reasons why this issue is still lingering after research has proven that there is no direct relationship between a chiropractic adjustment of the neck and the development of a stroke. The first reason is professional bias; the second is ignorance of the facts. Let’s look at the first reason.
There is no doubt that the profession of chiropractic has and continues to be maligned by other professions. In my view, the lay community also has a long way to go in its acceptance of the chiropractic profession. However, it is more likely that any type of finger-pointing regarding this issue is going to come from other professions who do not particularly accept or respect chiropractic doctors.
Unfortunately, this is an issue that I continue to deal with and often times, it’s rather pointless to try and get others to accept you as an equal partner in the provision of health and wellness services. Biases such as this are usually based upon issues rather far removed from issues relating to professional competence, training, or knowledge base.
The second reason is that most people—professional, or lay—do not understand the facts, research, or the clinical evidence which are related to this issue. Chiropractic adjustments to the neck to treat headache, neck pain, whiplash, and injuries occurs with a great deal of frequency every day in the U.S. and Canada. Millions of treatments are given to thousands of patients annually and as a result, there are many very satisfied patients out there!
However, the estimated number of stroke or stroke-like events associated with a chiropractic visit seems to be varied depending upon who provides the statistics, as these are also biased. The estimated occurrence is between one and 400,000 to 5.6 million treatments. The most reliable evidence points to an occurrence of between one to one in five million treatments!
Now, these are complications and they include strokes or stroke-like symptoms and severe headache etc. So these numbers imply absolute risk, or how risky the treatment period is. Now, let’s look at the other forms of care for headache and neck pain.
Without getting too technical, it becomes obvious that over the counter and prescription drug use carries with it a much greater risk of harm than does chiropractic care. I am not even going to mention the risk that surgery can involve. This statistic implies relative risk, so how risky is chiropractic care relative to other forms of care for the same health issue? This is a very important principle regarding risk that you should always consider.
What about the word “risk?” What does it really mean? Well, there is an associated risk meaning that there has been a relationship established between item A and item B, but the nature of the relationship is unknown. Then there is a direct risk meaning a cause and effect relationship. So if you have item A, then item B can happen to you and the odds can be reliably calculated. The issue of chiropractic adjustments and stroke has always been in the first category of associated risk. However, other professions, the media, and the lay community have taken this and ran with it, literally implying that there is a causal relationship established when this has never been proven.
In a landmark research report published in Spine, Dr. D. Cassidy looked at the cases of stroke in Ontario hospitals from 1993-2002. Visits to chiropractor and family physicians for headache and neck pain were also tracked for each case. The research indicated that there was an associated risk of stroke between visits to the chiropractor and medical doctor which were due to the fact that patients suffering from neck pain and headache were already experiencing the early symptoms of stroke before it actually happened. There was no increased risk of suffering a stroke between chiropractic visits and visits to a family physician for the symptoms of neck pain or headache. In other words, the same likelihood that a patient was going to have a stoke occurred, whether they saw a chiropractor or physician!
Chiropractors are doctors trained to diagnose diseases and decide if you are a candidate for a certain treatment. If you are at a high risk for suffering a stroke or have a history of strokes or mini-strokes, chiropractic adjustments for your neck pain or headaches may not be a good idea. However, chiropractors can offer many other types of treatment which may be appropriate for you!
Source(s) for Today’s Article:
Tuchin, P.,“Chiropractic and Stroke, Association or Causation?” Medscapeweb site, Sept 17, 2013.
Tuchin, P.,“Chiropractic and stroke: association or causation?,”International Journal of Clinical Practice. September 2013;67(9): 825–833.