Conservative Care

Chiropractic Manipulation Risks

Thanks to KevinMD for bringing this report on cervical spinal manipulation and stroke to my attention.

Cervical (neck) manipulation is a recognized and popular pain relief treatment, with an estimated 250,000 chiropractic visits each year and nearly one third of these ending up with some type of cervical manipulation, usually to treat neck pain and/or headache. This form of therapy typically involves high-velocity, low amplitude thrusts to the spinal joints in the neck. Stroke is a rare (an estimated 1 in 100,000 to 1 in 2 mm cases) but well-documented potential problem that can occur immediately or within a few days after cervical manipulation, and can result in death or serious neurological impairment.

This is a reminder to select your practitioner carefully. A treatment doesn't have to be surgery to involve serious risks. Make sure that you do your homework on your chiropractor. For example, at least make sure that they are licensed to practice in your state, have completed their continuing education requirements, and check to see if there have been disciplinary actions against them. You can find this information from your state's Chiropractic Board of Examiners. You should be able to find your state board on your state's website, and the chiropractor should be able to give it to you too. Make sure your chiropractor is accredited by the Council on Chiropractic Education. Personally, I would also research the chiropractor's reputation with as many local primary care physicians and spine specialists as I could.

While I am focusing on chiropractors, some physcial therapists, osteopathic physicians, and other specialists also do spinal manipulation, and I would check the out just as thoroughly.

Checking out your healthcare practitioner's background is not a guarantee against anything going wrong, but it's certainly a good start. (You would do at least as much research as this before buying a new car, right?)

Source: "Cervical Spine Manipulation: An Alternative Medical Prcoedure with Potentially Fatal Complications" Southern Medical Journal 2007;100(2):201-203. Lippincott Williams & Wilkins.

Posted by: Stephanie Burke, www.spine-health.com

Additional reading:

[url:1636,type=|node|,content=|How to select the best chiropractor|]

[url:1633,type=|node|,content=|What to expect at the first chiropractor consultation|]

Subject: I agree that you should

I agree that you should check out ANY doctor that you plan on seeing. There is risk to any procedure, regardless of the professional doing it. You can even have problems after a simple teeth cleaning. The fact remains that Chiropractic care is the safest form of natural health care around.

Subject: Yes, this is a very well

Yes, this is a very well written article. But, the facts still speak for themselves. Chiropractic adjustments are very, very, safe. But, with proper screening procedures and patient education, we can reduce the risks even more.

Subject: I thought this was a great

I thought this was a great objective article. I am going to send some of these points and a link out to my patients on our mailing list to read more about the topic.

Subject: I have had two broken backs

I have had two broken backs requiring surgery. I also had a third back surgery to excise an abnormal bone growth. When I was a child my parents took me to the chiropractor often, it really helped my neck/back pain. As an adult, I have often wondered if the "snapping and twisting" of my spine didn't help lead to my broken back, that I will never know. However as an adult, I have only seen a chiropractor twice, and it was painful. I do however get regular physiotherapy and osteopathic manipulations from my D.O. I personally feel more comfortable with a true medical doctor, who has had a lot more schooling, rather than a chiropractor. I agree with the article, checking out ANYONE who is going to work on your spine is a MUST DO step to health. M.D.'s are not infalable, so do your homework upfront!

Subject: Hi everyone, ?r?nI am an

Hi everyone, ?r?nI am an osteopath trained in the UK and pleased not to be a Dr.. Risk of Cervical spine manipulations ? according to certain review : 1 "chance" out of 1.5m to die from a cervical manipulation (young woman at risk !) . In France you have more chance to die from being struck by a lightning ! risk of dying from complication using NSAID or Paracetamol for a neck or back pain > 500 out of 1m. In the US every year 16000 people die from reactions from painkillers(gastric bleeding and liver intoxication)! I would say that you should practice it (spinal manipulation) only when it is necessary and too often the manipulation is a shortcut. Did you know that a stomach or an anterior tilt of the liver or a Csection scar can lead to restriction in the neck and then give neck pain ? (little test for the practitioner : if your patient complains from a neck pain ask him to rotate his head while sitting, then lift his diaphragm and ask him to rotate his head at the same time. if any change or improvement occurs in the pain or degrees of rotation then no need to manipulate the Cspine the problems comes from beneath the diaphragm! )Many practitioners just "crack" the neck, why ? because the patient keeps coming back ! he finds a bit of relief (2-3 days maybe 1 week) and then the vertebrae is out again. fantastic for the practitionner ! in one month the list of patient is full and so is his wallet ! I have seen many patients who had a neck or upper back problem. They were seeing a Dr "something " up to three times a week for 1 month and the treatment last for 15 min ! the second month was only two treatments a week... ?r?n?r?nI can tell you from being an osteopahic student in the past that when you continuously manipulate the spine , you keep irritating it and making it hypermobile and that is definitively a problem. ?r?n?r?nSo How to choose a good practitionner ? ?r?nTry them !!! choose the one who you have affinity with.?r?n?r?nDo not believe someone who tells you that you need more than one treatment a week (he cares for your wallet)because it takes at least a week to recover from a good treatment. Generally you should not have more than 5 (that is already a lot !) treatments within the next 2 months. ?r?n?r?nThe Title Dr is a Title that brings respect and admiration, it is as well a fantastic commercial tool don't forget ! Personally I prefer to see an open-minded non-Dr than a close-minded Dr.?r?n?r?nDon't be appealed by excessive advertissment and TV add !?r?n?r?nIf the practitioner cares about you he should be with you for at least 30 minutes during the treatment, and the practitioner should not only treat the spine but as well the whole body if he is really "Holistic !"?r?n?r?nIf the practitioner refer to you as a client then again you are wallet with neck, spine and legs. You are a Patient and our duty is to help you.?r?n?r?n?r?nHope this will be helpful?r?nTake care ?r?nPierre

Subject: A truly unbias professional

A truly unbias professional researched opinion is that of the malpractice insurance companies. They say Chiropractic, in large numbers, is much, much safer then any other health care provider. Most Chiropractors pay around 2000.00 dollars a year for malpractice whereas MD's(GP) will pay twice that for one month. And for a Ortho. there malpractice is around 10x that of a Chiropractor and it has nothing to do with how many people the see in there office, its risk.

Subject: Thank you all for your

Thank you all for your thoughtful comments.?r?nI wrote this blog post to point out that there is one potentially very serious, albeit rare, risk to manipulation, because patients typically think more of invasive procedures as having risks, and those types of risks are covered quite extensively throughout the articles our site.?r?nThanks again for your helpful comments and for reading this blog - Stephanie

Subject: I have been going to

I have been going to chiropractors off and on for about a year now, after suffering whiplash from a car accident. Thank you for this info - it's helpful to research any treatment you get. And on that note... my mother is considering back surgery, so I've been doing research in that area as well... I found this news clip and am curious about the validity of it...?r?n?r?nhttp://www.thenewsroom.com/details/359271/Health?c_id=jlt

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