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Much has been made in the media over the past several years regarding the risk of strokes associated with chiropractic manipulation of the neck. While in very rare instances, chiropractic manipulation is associated with damage to the vertebral artery resulting in stroke, this is far from an implication of chiropractic treatment as the CAUSE of such strokes. In fact, various studies have shown that such incidents occur rarely (about as rarely as reported with chiropractic treatment) with ordinary daily activities such as turning one’s head when driving to look for traffic, or having one’s head tilted back in a shampoo bowl at a hair salon.
A new study published as a supplement to the February 15, 2008 edition of the prestigious medical journal Spine, now indicates that the risk of vertebral artery stroke is approximately equivalent when patients visit their family physician as it is to when patients visit a chiropractor. The finding comes from “The Bone And Joint Decade 2000-2010 Task Force On Neck Pain And Its Associated Disorders”. This Canadian study reviewed approximately 32,000 citations and performed critical appraisals of more than 1,000 studies in developing its 236 page report - a pretty “heavy-duty” look at the available research on neck pain.
The study analyzed a total of 818 cases of vertebral artery stroke admitted to Ontario hospitals over a nine year period, and it concluded that such strokes are a very rare event and, as stated earlier, the risk of such strokes associated with a visit to a chiropractor is no greater than the risk following a visit to a family physician’s office.
Now, some of you reading this may be wondering how this could be. After all, the treatment chiropractors do is a lot different than the treatment that family physicians typically do. Well, what you have to understand is that the vast majority of vertebral artery stroke cases are probably already underway BEFORE the patient ever gets to the doctor’s office!
You see, the early symptoms of this type of stroke usually consist of… neck pain and stiffness. Now, when someone has neck pain and stiffness, and they decide to seek out treatment, some go to a chiropractor, some go to a medical doctor, and then smaller numbers probably see acupuncturists, massage therapists, etc.. But because the incidence of this type of stroke is so rare, the health care providers who see the most patients will tend to have the highest chance of a vertebral artery stroke patient come into their offices. The health care providers who tend to see the most people with neck pain and stiffness are chiropractors and family physicians.
So, the person coming in who is in the midst of a vertebral artery stroke looks very much like anyone with a stiff, sore neck - a pretty common complaint in the offices of both chiropractors and family physicians. Unfortunately, there may be no other outward signs of a vertebral artery stroke that there is more going on than the typical sore neck. So, most chiropractors and family doctors alike do what they are trained to do - they examine the patient. The problem is that the examination process alone, which involves moving the head and neck in various ranges of motion, can potentially make the damage to the artery worse, and the stroke progresses from there. Even when the doctor does absolutely nothing that would potentially aggravate the condition, the damage to the artery may progress just as a natural consequence of blood pressure tearing the artery, and over time, the stroke symptoms become more apparent and move beyond simple neck pain to the more classic signs of stroke.
But because the symptoms often get worse during or shortly after the visit to the doctor, it is presumed that the doctor’s visit caused the stroke, when in actuality, the stroke caused the doctor’s visit.
So, what is the risk of stroke from chiropractic? Well, various studies have placed it at somewhere between one in 1 million to less than one in 5 million chiropractic visits. This latest study in Spine is consistent with those estimates. The reality is, you are in far greater risk from driving to your chiropractic visit than you are of suffering any significant injury or side-effect from chiropractic treatment!
But if you’re still worried about the potential risks of chiropractic, or you just don’t like the sounds that come from your spine when you get adjusted with “traditional” manual chiropractic techniques, there are low-force methods of chiropractic treatment that can be very beneficial and are extremely gentle and safe for even the most fragile of patients. For anyone fearful of manual chiropractic adjustments, I recommend looking into treatment with the ProAdjuster or with Activator Methods. Many people are pleasantly surprised by how quickly and easily chiropractic treatment can make them feel better. The safety and effectiveness of chiropractic make it an excellent option for the treatment of almost any kind of musculoskeletal pain, and it often is helpful in alleviating other conditions as well.
Stay tuned to my natural remedies blog for more on safe, effective natural healing methods.
In this second video I provide proof of my argument that athritis is not caused by aging, per se. If all of your joints are the same age, why do some joints develop arthritis and others do not, or at least do not to the same extent? It comes down to mechanical wear and tear (from traumas, poor posture, muscular imbalance, etc.) and/or lack of adequate nutrients for joint regeneration and repair. Getting older simply means you’ve had more opportunity to be exposed to these two actual causes of arthritis.
Mechanical wear and tear can be minimized through muscle and joint functional correction with chiropractic/osteopathy, massage, and movement therapies such as Alexander Technique and Feldenkrais.
Nutritional supplementation with antioxidants (especially vitamin C), and organic sulfur sources (such as glucosamine and chondroitin) are particularly important for providing the necessary building blocks for joint repair.
For specific recommendations, feel free to Contact Me.
As the video says, arthritis is caused by abnormal joint function and/or insufficient nutrient supply for the body to repair and rebuild joints. Nutrient deficiencies vary from person to person and getting the right nutrition for your particular problems is important. For a FREE email consultation on your case, Contact Me.
Stay tuned for more about arthritis on future blog entries.
The quote above comes from Robert Brown, Ph.D., one of my instructors when I was in chiropractic school. What Dr. Brown was referring to was that research and statistics, particularly biomedical research and statistics are subjet to all sorts of non-scientific and non-factual “twists” put forth by people with an agenda - and EVERYONE has an agenda - even if they don’t realize it or admit to it.
The point of this post is to make you aware that health-related research and statistics may not always mean what the source wants you to think they mean. To illustrate this, let me give you some examples.
One hotly debated issue in the nutrition field is whether farm raised fish are equivalent nutritionally to wild fish. For instance, about a year ago, I read an “advertorial” (a paid-placement article) that emphatically stated that farm raised salmon have the same amount of omega-3 fatty acids as wild salmon, according to nutrient analysis done by the U.S.D.A.. Yet I had just read an article that stated the opposite. Since both articles referenced the U.S.D.A. as the source of their statistics, I figured that someone was lying and all I had to do was check the U.S.D.A. analysis to find out who.Â
I was wrong - as it turns out, both articles were correct. How could that be, since they had made opposing claims? Well, according to the U.S.D.A., farm raised salmon does have about the same omega-3 content as wild caught - when you look at the amount of omega-3 for an equivalent weight of fish. The thing is, farm raised salmon has a much higher overall fat content than wild salmon, so the amount of omega-3 relative to the total fat content is much less in farm raised salmon than in wild salmon. So, the omega-3 content is about the same, but the omega-3 concentration is quite different.
Another example comes from a study that appeared a few years ago in the prestigious New England Journal of Medicine. This study was picked up in the popular media and the conclusions of the study were pretty widely reported on television and in many major newspapers. Basically, the study concluded that chiropractic treatment was no better than placebo (a placebo is a sham treatment with no therapeutic benefit) for asthma.Â
Now, I may be biased myself, but let’s look at what that study actually showed. First, the patients were not “run of the mill” asthmatics. They had “treatment-resistant” asthma, which means they had not responded to conventional medical treatment. I think it would be fair to say that these were especially tough cases. Second, the “placebo” they compared chiropractic treatment to was massage therapy. While far from conclusively proven, there has been indication that many asthmatics benefit from massage therapy, so the choice of massage as a placebo treatment is questionable at best. Finally, about half of these treatment-resistant asthma cases actually had a very good response in both the chiropractic and the massage treatment groups (thus the conclusion that chiropractic is no better than placebo). So, did this study prove that chiropractic treatment is worthless for asthma patients (as was how it was reported)? You be the judge. My take on it is that both chiropractic and massage are beneficial about half the time in asthma cases that have not responded to medical treatment. I think that’s pretty good - but I didn’t get to write the headlines.
One final example of how research can lead us astray. Several years ago, the “experts” proclaimed that eggs were terrible for your health, because high cholesterol is bad, and eggs are high in cholesterol. This concept persists to this day despite one little problem with that thinking… about 70% of the cholesterol in your blood is NOT from the food you eat - it’s made by your liver! Several studies have shown that eating eggs, even on a regular basis, does not significantly raise your cholesterol. So, we have all these people worried about their cholesterol (even though cholesterol in and of itself is really not that big of a deal - but that’s a topic for another time) and avoiding eggs in favor of eating cereal for breakfast. Most of that cereal is refined grains and a lot of it is high in sugar - which, to make a long story short, does far more to create health problems than eating eggs ever did.
So is medical research worthless? No, but it is important to realize that one study or statistic can be misinterpreted when taken by itself or outside the context of what else is known and what other studies have been done. My advice is to view any research or statistic reported in the popular media with a little skepticism and a willingness to look further if the findings might impact the way you choose to manage your health.
