safety of chiropractic care

Arterial dissections following cervical manipulation: the chiropractic experience. Haldeman S, Carey P, Townsend M, Papadopoulus C. CMAJ 2001: 905-6.

This study showed that the risk of stroke from chiropractic cervical adjustments is extremely rare and that the risk of dying from several painkillers is greater. The risk of stroke from cervical manipulation was determined to be 1 in 5.85 million which is lower than the risk of being struck by lightning.

Perspectives: an overview of comparative considerations of cerebrovascular accidents. Rome PL, Chiropractic Journal of Australia, Sept. 1999:29(3), pp87-102.

This is a literature review in which the safety of spinal care is compared with medical procedures.

The authors review one study in which the death rate of CVA (cerebrovascular accidents) for the general population was compared with the death rate of CVAs in chiropractic patients. The rate of fatal vertebral artery damage following cervical Spinal Manipulative Therapy was calculated to be 0.00025% (1 in 400,000) in the US. This was compared to deaths from CVA in the general US population of 0.00057% (1 in 176,900 CVAs).

Patients under chiropractic care therefore had a lower rate of CVAs than those of the general population so chiropractic care may be considered protective from CVAs for patients.

The authors state: On analysis, spinal manipulation is one of the most conservative, least invasive and safest procedures provided within the health care professions. A potential risk of catastrophic side-effects from SMT is substantially less than for any of the medical procedures or interventions listed in the tables accompanying this paper.
Risk factors and precipitating neck movements causing vertebrobasilar artery dissection after cervical trauma and spinal manipulation. Haldeman S, Kohlbeck FJ, McGregor M. Spine 24(8):785-794. 1999.

The primary cause of the very rare incidence of vertebral artery injury after neck movements is most likely underlying weakness in the artery than a specific form of neck movement.

Sudden movements (as in sports, falls, manipulations) or slow but sustained movements such as painting the ceiling, back a car, intubation under anaesthesia or a shampoo at the hairdresser’s have been reported to precipitate this condition.

“…the literature suggests that chiropractic is not only very safe but much safer than medical and other professional management of low back pain.”

From the Manga Report by health economist Pan Manga, Ph.D. (funded by the Ontario Ministry of Health), 1993.

Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient. (Risk of complications in pediatric patients under chiropractic care). Pistolese Richard A. Journal of Vertebral Subluxation Research, 2(2), June 1998 p. 73-81.

How safe is chiropractic care for children? In this paper both the number of chiropractic adjustments children have had and the risks of neurological/vertebrobasilar complications or injury are compared. It was found that in the period 1966 to 1977 over half a billion adjustments were delivered to children with an injury rate of one in 250 million.

From the abstract:

This paper has reviewed literature concerning the occurrence of neurological and/or vertebrobasilar (N/VB) complications in patients receiving either specific chiropractic adjustments and/or non-specific manipulations of the spine. This topic was chosen due to the potentially severe consequences of N/VB complications, regardless of etiology….The number of pediatric visits, extrapolated to also include the periods between 1966 and 1977, was estimated to be 502,184,156….The estimated risk to the pediatric chiropractic patient in this category of (N/VB) complication was estimated to be approximately 1 in 250 million pediatric visits that a N/VB complication would result.

Comment: A 1 in 250 million chance of injury means the patient has a far greater chance of being hit by lightning than having an injury from a chiropractic adjustment. In discussion with the author, it was stated that the above statistics may actually be low and the chance of injury even less than 1 in 250 million. I know of no healing art with such a safe healing record.

Copyright 2004 Koren Publications, Inc. & Tedd Koren, D.C.