How safe is chiropractic or any other treatment for that matter?
There has been much rhetoric about how dangerous manipulation is, or could be, particularly of the cervical spine. What is important is the relative safety. Almost no treatment for any condition can be described as totally safe. Even drugs as common place as aspirin and anti inflammatories cause a significant number of deaths every year, far in excess of a stroke after a chiropractic adjustment.
Chiropractic causes very, very few deaths. Statisticians have shown that you have about the same chance of dying from a Chiropractic adjustment as from being struck by lightening while playing golf. It can happen; it does happen, but it is very rare.
Less than one in a million chance, and that makes the chiropractic adjustment one of the very safest treatments.
In comparison, the U.S. Department of Health and Human Resources stated that on average, 17.14 percent of the 700 000 physicians in the United States caused one accidental death per year.
How safe is chiropractic is a question that every potential patient should be asking, and of course of the conventional care like drugs and surgery too? Whilst increased pain is not uncommon, catastrophic events are few and far between.
More important than all the rhetoric is the report of actuaries; the mathematicians who decide what insurance premiums doctors should pay. Their calculations concerning how the safety of chiropractic reveal that chiropractors should pay insurance premiums of approximately $2000 per year. Some medical doctors pay over 100 000 dollars per year in premiums. There are very few successful cases against Chiropractors.
Is Chiropractic totally safe? No, it’s not, but it’s a great deal safer than taking anti inflammatories or going for surgery. They too, however, have their merits and your chiropractor may sometimes refer you for drugs or surgery.
How safe is Chiropractic? Pretty, damn safe. However, you can fairly frequently experience increased pain after the first few treatments. In fact there is some research suggesting that if you don't have some after pain you may also not get much benefit from manipulative care. But that's another story.
Dr Scott Haldeman, medical neurologist and chiropractor, states that there have been 23 known cases of vertebral artery dissection in 10 years after a chiropractic adjustment of the neck. However, he is of the opinion that these dissections were probably in progress before the treatment, rather than caused by the manipulation. During this time 135,000,000 cervical manipulations were given; a rate of less than 1 stroke after 6 million cervical adjustments.
In comparison, 16 000 Americans died in one year from gastric hemorrhage, directly from taking NSAIDs, not including those who died from heart and other complications of anti inflammatory drugs.
Conclusion: HOW SAFE IS CHIROPRACTIC ?
The only sensible conclusion is that chiropractic manipulation is a relatively, but not perfectly, safe procedure for the treatment of neck pain and headache. There are no perfectly safe procedures.
One in six million patients who have had a cervical manipulation will within three weeks have a stroke; are they connected? Some, yes, most no say the experts. Yet how safe is chiropractic is still an important question, more for the chiropractor than his patients; should this person be considered high risk?
The Task Force, a multi-disciplinary research body, evaluated a 1000 studies on neck pain before coming up with a report addressing the question How safe is Chiropractic? for cervical spine conditions concluding with the the following statement:
We analyzed a total of 818 cases of Vertebro Basilar Artery (VBA) stroke admitted to Ontario hospitals over a 9-year period (more than 100 million patient-years of observation) in answer to the question, HOW SAFE IS CHIROPRACTIC? has concluded that:
"VBA stroke is a very rare event and that the risk of VBA stroke associated with a visit to a chiropractor’s office appears to be no different from the risk of VBA stroke following a visit to a family physician’s office."
A brush with stroke...
A brave chiropractor reveals all in his first-hand shattering experience with Chiropractic Coalface STROKE ... yet, because the wise chiropractor behaved so astutely, all was well that ends well.
An experience like this, or worse, will happen on average to about one in ten chiropractors once in his/her whole lifetime in practice.
Vaccination remains a thorn in the flesh of Alternative Healthcare, and I'm not aware of a strong statement confirming or denying the value of vaccination from mainline chiropractic. Fringe Chiropractic continues to condemn it.
I was born into a Chiropractic family. Both my parents were chiropractors, and I was not vaccinated as a baby. I, together with eight other children who were vaccinated, very nearly died of diphtheria at nine months old, saved only by a combination of good nursing and chiropractic adjustments. Did they help ...? I believe so, though there is no research ...
This month, in our small town in Holland, a healthy nine-year old boy died suddenly three days after a vaccination, resurrecting all the old fears. Thousands are now refusing to be vaccinated. In one week last three healthy children died within ten days of receiving a vaccination ...
I am not abreast of all the facts, though I suspect at the end of the day, the enormous benefit to the majority, preventing the scourges of polio, small pox ... and many other diseases, should not be disgarded because of the side effects, albeit very serious, on a tiny minority.
Like Chiropractic, do the enormous benefits of vaccination not vastly outweigh the occasional serious side-effects?
Having said that, I personally do not recommend vaccination against non-serious diseases. Only recently a patient suffered a dreadful bout of influenza that lasted over a month after a 'flu injection. Worse, the most serious case of shingles that I have ever seen began shortly after a shingles vaccination.
In the Spring of 2009, the Dutch minister of health announced that he has ordered enough vaccine to vaccinate every man, woman and child twice against Mexican Swine flu. I'm not convinced that I'll be queueing up for my jabs!
Update: Half way through the programme, it was suspended, no reasons given.
How safe is Chiropractic? I suspect that death from vaccination is probably about as prevalent as stroke from a Chiropractic adjustment. Does that invalidate either?
Update: Because of several strokes recently, after cervical manipulation by physiotherapists who had been to a few weekend courses, the Minister of Health in Holland is threatening to ban all cervical manipulation.
But, yes, they do occur after Chiropractic manipulation too, only very rarely. Less than one in a million neck manipulations. It's all about proper training.
Would you allow a chiropractor to remove your appendix after attending a few weekend seminars on the subject?
The RATIONALE for the "Chiropractic Adjustment"
Probably the biggest single medical critque of Chiropractic is not "HOW SAFE IS CHIROPRACTIC?" but that there is no scientific basis for the 'adjustment'. They may have been the case once ... but now there is a huge amount of basic science research confirming that fixated joints become arthritic much faster, and bombard the spinal cord with noxious input. Read more ...
Of far greater concern is the dizzy patient. An upper cervical subluxation can cause dizziness or vertigo - they're not quite the same - but a more likely cause is loose calcium crystals in the inner ear. For that (it's called BPPV) the treatment of choice is NOT manipulation but the Epley manoeuvres.
The test to differentially diagnose between an upper cervical cause and an inner ear cause is the Hallpike Dix test.
Chiropractic research indicates that upper cervical manipulation of the dizzy patient may often aggravate the condition. Hence the importance first to rule out an inner ear condition called Benign Positional Paroxysmal Vertigo as a cause of Vertigo Dizziness.
Even the most gentle and careful chiropractor will very occasionally crack a rib during rib pain treatment and not only in the elderly and osteoporotic. I admit to eight during 36 years in practice, two of which with hind sight should not have happened and could be described as negligent. All eight recovered completely with a few weeks, but with considerable gnashing of teeth! A bouquet of flowers went a long way. How safe is Chiropractic? Not perfectly safe.
None sued me. If every patient with cracked rib sued their chiropractor, there would be no more rib pain treatment and patients would have to suffer one of the most debilitating and painful conditions - a rib head subluxation, or sprung rib, is excruciating. Every breath ....