Tag Archives: Stroke

Is Chiropractic Safe?

This is a controversial question, though I’m not sure why. The short answer is, yes, it is safe. The easiest way to tell is to look at malpractice insurance premiums. Insurance companies don’t mess with risk. They charge an arm and a leg if they think you are a risk. Can anyone say preexisting condition? The average premiums for different professions will tell you who has risk of problems, and does not. Here let me show you some numbers (source):

Approximate Malpractice Insurance Premiums

OB/Gyn
$120,000
General Surgeon
$75,000
Internal Medicine
$20,000
Family Practice
$15,000
Chiropractors
$2000-4000

In fact through out many studies proper chiropractic treatment has not been shown to cause anything more than short term soreness at the site of treatment.

Now here’s where it gets controversial. And people may say, wait a minute studies have shown more than that. It’s true there have been rare serious problems seen after chiropractic treatments. The problem is that they are so rare that research has not been able to prove a causal link to chiropractic, or to rule it out. In fact the most recent and complete study showed that the biggest risk is no greater visiting a chiropractor than visiting a medical doctor (second source). These problems are so rare that it is nearly impossible to prove one way or the other.The big one that you’ll hear about is stroke, and the risk is estimated (due to lack of concrete evidence) to be somewhere between 1 in a million to 1 in 5 million. You can see how difficult it would be to do a study with 1 million chiropractic neck pain patients, let alone 5 million. In contrast, the mechanism of treatment seems like it could cause stroke in a predisposed patient, because in those predisposed people, simply turning your head to look at something could cause a stroke. Unfortunately there are no known tests to determine if a patient is at risk.

OK, so let’s put them out there. The possible risks of chiropractic treatment include, bruising, muscle strain, undefined soreness, headache, bone fracture, stroke. Now let’s put them in perspective. You are at least 5 times more likely to be killed by a freak asteroid falling on you than you are to have a stroke after seeing a chiropractor. Now how many people do you know that have been hit by asteroids? Bone fracture is another one of those rare things, and again will probably only happen when someone is predisposed. A person with osteoporosis, or suspected to possibly have osteoporosis, should not be adjusted with a full force method. This is why I usually leave this side effect out of the list when talking about proper chiropractic treatment. As for the headaches, soreness, and bruising, this kind of stuff will usually occur when a patient is unable to relax and the doctor uses a lot of force to get by that problem. It can occur in probably 30% of patients, because sometimes it is necessary to get the joint moving even knowing that the patient is unable to relax. This is something that should be discussed with the patient, and normally the soreness is less than 24 hours.

The last thing that I will say is that you should always bring negative effects to the attention of your chiropractor. Even if they are not caused by the doctor himself he should be aware of them, so that if they are serious he can take care of them or get you to an ER if needed. Some of the serious things to report are; intense pain, dizziness, vertigo, slurring of speech, vision changes, weakness, tingling, or numbness. They may be nothing, but you should let your doctor determine that.

Informed Consent

In Connecticut there is a debate over chiropractic and the topic of informed consent.  (News Article) The debate is not over whether there should be informed consent.  In fact, in the United States, informed consent is already mandatory for all health care providers.  Informed consent is supported by chiropractors.  It is in the best interest of our patients .  No!  This debate is over whether chiropractors should be forced to inform every patient of a risk of stroke.

There are many problems with this.

CAUTION: there are risks to drinking water!

The most obvious is that chiropractic is not known to cause stroke.  The only evidence even remotely related does not show that it causes stroke, but that there is an association.  The same association that exists with medical doctors (oh, and hair dressers).  So if it’s not known to cause it why would you force chiropractors to inform people of the risk.  I think I know the reason.

If it is required for chiropractors then it should also be required of all health care practitioners that have equivalent risks. Can you imagine walking into every doctor’s office and having to sign a paper that says that if you came to that office to see them for neck, head or upper back pain there is a possibility you could have a stroke after seeing this doctor. Either no one would go to doctors for those conditions or it would become so prevalent that the warning would become like the boy who cried wolf, useless.

Another problem is the actual risk level that we are talking about. The risk of having a stroke after seeing a chiropractor is somewhere in the region of 30-300 times less likely than you dying in a lightning strike.  Should I have to also warn my patients that they may aspirate  and die from that water I recommended they drink.

Defining what must be included in informed consent adds loopholes for dishonest people and destroys the purpose of informed consent, that of an honest and open conversation between a doctor and a patient.  Please doctors share the likely and serious risks with your patients.  Inform them, by all means.  Don’t get ridiculous.

Chiropractic Care Could Lower Blood Pressure

 

blood-pressure-cuffThis is really exciting. A study in Chicago by MDs found that a particular chiropractic adjustment was able to lower blood pressure an average of 17 pts. systolic and 10 pts. diastolic. That’s better than many medications on the market. I saw this research at the end of last year, this is the first video I’ve seen of it.

Apparently these chiropractors were noticing their patients BP improving after care, so they took it to their local hypertension specialists at the hospital and asked if it was even possible. They were familiar with a surgical technique of decompression that had similar results. If the same thing could be accomplished without surgery it would be wonderful. The results are not conclusive, but still worth investigating. original site

Great News: Chiropractic isn’t likely to kill you!

For those of you who are familiar with chiropractic this headline may seem funny to you. There is a chunk of the population that is extremely worried about this though. In fact there is a company called, the Chiropractic Stroke Awareness Group. They are very worried that Chiropractic may kill you by causing a stroke. The good news is that it won’t.

Chiropractic has never been shown to cause stroke, though it has also never been definitively ruled out either. The plain fact is that it is so rare that it is nearly impossible to study enough to prove causality. However there have been recent studies that indicate that chiropractic may lower your risk for stroke by decreasing hypertension. “This procedure [Chiropractic manipulation of the Atlas] has the effect of not one, but two blood-pressure medications given in combination,” study leader George Bakris, MD, told WebMD. “And it seems to be adverse-event free. We saw no side effects and no problems,” adds Bakris, director of the University of Chicago hypertension center. Full Article Here

To clarify, there are risks associated with chiropractic treatment. Those risks are less than the risk you take by taking a dose of Asprin, but they do exist. According to recent studies the risk of stroke following a chiropractic adjustment (not because of, but following) is 1 in 5.85 million. This study found that you are no more likely to suffer a stroke after visiting a chiropractor thatn you are after visiting your medical doctor. For perspective here is a comparative list:

Proven Possible Side Effects of…

asprin-vs-chiro.jpg
Additional information and studies can be found here.