Questions and concerns about chiropractic safety is something that we need to address on a daily basis. As with any form of medical intervention there are risks that consenting clients need to be made aware of before choosing to proceed with care.
Chiropractic has undergone its fair degree of scrutiny over the years, a large part of it from the medical community. Over the last 25 years, at least 5 formal government studies from around the world have found spinal adjustment therapy to be safe, effective and cost effective. (1)
Are there risks associated with chiropractic neck adjustment?
A chiropractic neck adjustment applied by hand improves mobility, reduces muscle spasm and facilitates better alignment thereby relieving pressure and tension on the joints, soft tissues and nervous system.
When speaking of risk, specifically that of stroke it is important to consider the relative risk when compared to other forms of medical intervention. Almost all researchers and scientists studying this issue agree that whatever the risk of stroke in association with neck adjustment it is exceedingly rare. Ranges have been estimated at somewhere between 1 in 1,000,000 to 1 in 5,000,000 (2-5).
This is much lower than the risk from the following:
- Strokes from birth control pills 1 in 24,000 persons (6)
- Fatalities caused by NSAIDS (aspirin, Naproxen, Ibuprofen, Motrin) = 1 in 1,200 persons (7)
- Fatalities associated with spinal surgery = 1 in 145 surgeries (8)
- It is also significantly lower than the risks associated with many activities of daily living (9), for example
- Canoeing = 1 in 100,000 persons
- Playing soccer = 1 in 25,000 persons
- Driving a car (in the UK) = 1 in 5,900
Research into chiropractic neck adjustment effects
The only research that has attempted to measure the physical effects of the neck adjustment on the vertebral arteries and therefore chiropractic safety contradicts the existence of any casual relationship to stroke. A study in 2002 found that neck adjustment did not result in any strain sufficient to damage arteries, and in fact, may create less strain than neck movement during common activities of daily living such as reverse parking a car or hanging out the washing. (10)
Spinal adjustment is at the core of Chiropractic education and practice
Whilst other professions receive post-graduate training in spinal manipulation the chiropractic profession is the only health service provider group with spinal adjustment as its core education and practice. Chiropractic training in Australia is of similar length and depth as medical courses, but focus on promoting healthier lifestyles via better body function, rather than on drugs and surgery.
Chiropractic safety at Better Health
At Better Health chiropractic safety is at the very top of our list. Only the safest techniques and procedures are utilised and at risk people such as those with certain pre-existing conditions predisposing them to stroke are treated accordingly.
References, and further reading:
- Health Quality Council of Alberta. Satisfaction with Health Care Services: A Survey of Albertans. 2006. Ontario Workplace Safety and Insurance Board (WSIB) Program of Care for Acute Lower Back Injuries: One – Year Evaluation Report. 2004. Chiropractic in the United States: Training Practice and Research, U.S. Department of Health and Human Services. AHCPR Research Report, 1997. Manga P, Angus D, Papadopoulus C, Swan W. The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain. Ottawa: Kenilworth Publishing, 1993. Commission of Alternative Medicine. Legitimization of Vissa Kiropraktorer. South Africa, 1987. Thompson CJ. Medicare Benefits Review Committee. Australia: commonwealth Government Printer, 1979 (see http://www.ccachiro.org).
- Terrett AG. Current Concepts in Vertebrobasilar Complications following Spinal Manipulation. Des Moines, Iowa: National chiropractic Mutual Insurance Company, 2001.
- Haldeman S, Carey P, Townsend P, Papadopoulos C. Arterial dissections following cervical manipulation: the chiropractic experience. Canadian Medical Association Journal 2001; 165(7): 905-906.
- Hurwitz EL, Aker PD, Adams MH, Meeker WC. Shekelle PG. Manipulation and Mobilization of the Cervical Spine: a systematic review of literature. Spine 1996; 21(15): 1746-1759.
- Rothwell DM , Bondy SJ, Williams JI. Chiropractic Manipulation and stroke: a population-based, case-controlled study. Stroke 2001; 32(5): 1054-1060.
- Gillium LA, Mamidipudi AK, Johnston, SC. Ischemic Stroke Risk with Oral Contraceptives, a Meta-analysis. Journal of the American Medical Association 200; 284(1). The CCBC recognizes the difficulty in comparing pre-treatment and per-patient risk estimates; however, with some health-care interventions, particularly medication, per-treatment risks are meaningless, and so, unavailable.
- Tramer MR, Moore RA, Reynolds JM, McQuay HJ. Quantitative Estimation of Rare Adverse Events Which Follow A Biological Progression: A New Model Applied To Chronic NSAID Use. Pain 2000; 85: 169-182 (see http://www.elsevier.nl.locate/pain).
- RomePL. Perspectives: An Overview of Comparative Consideration of Cerebrovascular Accidents. Chiropractic Journal of Australia 1999; 29(3): 87-102.
- Dinman BD. The reality and acceptance of risk. Journal of the American Medical Association 1980: 233(11): 1226-1228.
- Symons BP, Leonard T, Herzog W. Internal Forces Sustained by the Vertebral Artery During Spinal Manipulative Therapy. Journal of Manipulative and Physiological Therapeutics 2002; 25(8): 504-510.