Chiropractic is Safe

Often times the question comes up:

Does chiropractic cause stroke?  or maybe someone told you it causes “cervical artery dissection (CAD).”

Chiropractic has been under attack since its inception in 1895.  It gets great results, is safe, and is free of harmful side effects.  It has had an amazing track record over the past 120 years, giving people hope when other professions have given up on them.  Despite the miraculous stories, anecdotal evidence, case studies, research reviews, and documented safety and efficacy there will always be haters.  

The following, isn’t my opinion, but the latest research in regards to the fallacy of chiropractic causing strokes.      

To get started, one important thing to clarify is the difference between a “Manipulation” and a “Chiropractic Adjustment.”  

According to the World Health Organization:

• a manipulation is defined as “a manual procedure involving directed thrust to move a joint past the physiological range of motion, without exceeding the anatomical limit.”  

• an adjustment is defined as “any chiropractic therapeutic procedure that ultimately uses controlled force, leverage, direction, amplitude and velocity, which is applied to specific joints and adjacent tissues.  Chiropractors commonly use such procedures to influence joint and neurophysiological function.”

At Atlas Specific Spine Center, we utilize a very specific analysis and technique to make very accurate adjustments to the spine.  We do not manipulate anything.  

To quickly put this question to rest, I want to share a few recent research articles.

A lot of the accusation and review of research that come out speak of ‘association’, acknowledging that causality has not been established between chiropractic adjustments and stroke or cervical artery dissection.  Furthermore, if one reads into the research, the forces generated by manipulative procedures are less than those encountered by going through normal ranges of motion.

Here are two articles to reference for further understanding that there is no evidence for causation of stroke, or cervical artery dissection and the chiropractic adjustment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/

 A few points about this systematic review of the literature:  

• The authors are all neurosurgeons, in which have no competing interest to do the research.
• In conclusion, “Our systematic review revealed that the quality of the published literature on the relationship between chiropractic manipulation and CAD is very low.”
• “There is no convincing evidence to support a causal link, and unfounded belief in causation may have dire consequences.”

https://www.tandfonline.com/doi/full/10.1080/07853890.2019.1590627

• Out of the Journal Annals of Medicine, assumptions that cervical manipulation cause cervical artery dissection are “based on case studies which have been unable to establish direct causality.”  
• This research challenges health care professionals to step up their competency, understanding, and clinical skills, saying “It is paramount that all clinicians, especially manual therapists who utilize cervical mobilization and/or manipulation techniques, are well informed of the possible red flags and are capable of referring patients to essential medical examinations and treatments.”

Atlas Specific Spine Center is trained in recognizing symptoms of occurence of a stroke, a stroke in progress, and the suspicion of cervical artery dissection.  We will never guess about your health.  We take a thorough case history, complete an extensive chiropractic neurospinal exam, which includes advanced testing such as: digital x-ray analysis, infrared thermography studies, surface electromyography (sEMG), and heart rate variability (HRV).  

Lastly, I would also like to share my malpractice insurance premium with you.  This year, my premium through Chirofutures Malpractice Insurance is a grand total of $729.  If the incidence of stroke, cervical artery dissection, or other bodily harm were significant, wouldn’t you think my comprehensive coverage would higher?  If you do a simple google search, you will quickly find that the medical profession, in general, has significant yearly malpractice insurance premiums.  Perhaps this is related to the study out of John Hopkins in 2016 showing medical errors to be the third leading cause of death in the United States.  You can read more about the study here:  Iatrogenic Death.  I guess that’s another blog post in itself. 

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