Dec 29, 2016 by spinalcare

Many of you have recently heard of chiropractic in the press and the undertone has not been positive. This has prompted us at Spinal Care to address some of the misconceptions and the negativity in the news and social media lately.

Much of the negative press revolves around chiropractic and the potential for stroke.  At the onset, we want to get one thing clear, there is NO research that supports direct correlation or causation between a chiropractic neck adjustment and stroke¹.  The confusion comes is understandable as the symptoms that indicate a potential stroke are also some of the most common reasons one visits a chiropractor: neck pain, headache and dizziness.  While many have assumed that the neck adjustment (the rapid mobilization of the joints) caused the stroke, it is far more likely that the stroke was in process before that person even got to the chiropractor’s office.

Why is VAD so BAD?
First, we must begin by explaining two arteries of the neck that bring blood from the heart to the brain and run through most of the vertebra of the neck, the vertebral arteries.  When there is a flap-like tear on the inside of one of the vertebral arteries the result is a vertebral artery dissection, or VAD.  In the case of a VAD, blood enters the artery wall causing it to thicken, which can eventually lead to a stroke.  The tears can develop because of trauma, genetics and/or lifestyle factors. There is no test done in the chiropractic office that can diagnose a VAD. However, symptoms associated with a VAD are as follows: head and neck pain, difficulty speaking, diminished coordination and visual loss.  It is important for any health care provider to ask the pertinent questions and determine if the symptoms are from a potential stroke in progress or other from other issues.   Many of these symptoms may not be present when the patient comes to the office.  The key is having a health care provider who asks the right questions.

One is more likely to get a VAD while looking up to star gaze or even while getting hair washed at a salon, than from getting a chiropractic adjustment. In fact, Walter Herzog from the University of Alberta at Calgary performed a study that looked at the impact on the vertebral artery during a chiropractic spinal manipulation and concluded a chiropractic adjustment causes less strain on the vertebral arteries than a simple range-of-motion test². A range-of-motion test is when the patient looks down at the floor, up at the ceiling, looks in either direction, and laterally bends the neck in either direction to assess the motion of the neck; it provides a gauge before and after treatment. The study is stating you can inflict more strain on the vertebral arteries by moving your neck than a chiropractor would induce during an adjustment.

The proof is in the medical malpractice
If you find that you still sense danger in the thought of going to a chiropractor, let us address medical malpractice and that should ease any residual doubt. The malpractice insurance premiums will vary depending on the medical doctor’s specialty and injury risk associated with that specialty. Per a continuing survey directed by Medical Economists in 2012, cardiologists paid a median annual malpractice premium of $19,400, while gynecologists paid $43,400.  Chiropractors pay less than $2,000 annually. Why would insurance actuaries set the lowest malpractice premiums for a profession that is “dangerous”?

Katie May’s unmasked story
The latest damaging story of chiropractic in the news involved playboy model and Instagram sensation, Katie May. The press reported Ms. May suffered a “nasty fall” during a photo shoot. She experienced intense neck pain following the fall and went to the hospital, and was released later the same day.  She later saw her chiropractor for neck pain.  It is likely that Ms. May could have experienced a VAD because of the fall. The Chief Coroner reported that a chiropractor shifted May’s neck, tearing her left vertebral artery. The tear blocked blood flow to May’s brain and caused the stroke, yet as known in the 2016 research, a chiropractor inducing the tear is far from likely; Ms. May’s fall and neck trauma is more likely the cause of the VAD – but that is a less enticing story.

Ensuring safety at Spinal Care
Spinal Care goes above and beyond to ensure patient safety in everything we do. Often patients ask why we ask so many questions at the first appointment.  Our goal is to rule out not only potential VAD but many other sinister conditions that could be causing the pain and/or limited motion.  Everything that is done during a patient visit at Spinal Care, from deep muscle work, therapies, rehab exercises, and the chiropractic adjustments, is evidence-based and shown to be safe and effective.  If anything serious is suspected during treatment, we discuss it immediately.  We also work with each patient individually to come up with a plan to is unique and effective for them.  While one patient may feel significant relief with a neck adjustment, others may not.  We have many tools to resolve pain and improve motion.  If any one tool is concerning to you, then we avoid it and approach the treatment from a different angle.  Our goal is to get you out of pain and restore motion as quickly, safely and efficiently as possible, and that process varies with each patient.

Works Cited

¹Church, Ephraim W., Emily P Sieg, Omar Zalatimo, Namath S. Hussain, Michael Glantz, and Robert E.
Harbaugh. “Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery
Dissection: No Evidence for Causation.” Cureus. U.S. National Library of Medicine, 16 Feb. 2016.
Web. 01 Dec. 2016.

²Herzog, W., T.r. Leonard, B. Symons, C. Tang, and S. Wuest. “Vertebral Artery Strains during High-speed,
Low Amplitude Cervical Spinal Manipulation.” Journal of Electromyography and Kinesiology 22.5
(2012): 740-46. Web.

³Starfield, Barbara, MD, MPH. “Is US Health Really the Best in the World?” JAMA. The JAMA Network, 26
July 2000. Web. 01 Dec. 2016.