By Kate Wharmby Seldman
Visiting a chiropractor has long been a boon for people with sore backs and necks. But can this form of alternative treatment be dangerous, even when technically performed correctly?
Chiropractic medicine has been around since the 1890s, and involves adjusting the spine to correct misalignments – also called subluxations - of vertebrae that are causing pain and stiffness. The patient stands, sits, or lies on a table, and the chiropractor performs dynamic “cracking” motions by twisting the body or tapping on the spine. These movements are supposed to increase a joint’s range of motion and free pinched nerves: according to the chiropractor, once the spine is in alignment, the muscles will also realign themselves, especially if muscle soreness has come from a gait or position the patient has adopted to try not to aggravate pain.
One danger comes from manipulation of the neck. Some chiropractors, called upper cervical specialists, believe that the neck is the origin of many back problems, and so they’ll always adjust the neck. This can put strain on the arteries in the cervical vertebrae, which may cause strokes. Additionally, pain in the head or neck could also be related to problems with the vertebral or carotid arteries, and in these cases, manipulation of the neck vertebrae is especially dangerous. This is not a common occurrence, however: a 1996 study concluded that less than two in a million cervical spinal adjustments led to vascular injury or stroke. However, it’s also known that injuries due to chiropractic adjustments are underreported, which could mean the instances of such injuries are actually higher than two in a million.
A recent article in Self magazine told the story of a woman whose visits to a chiropractor for neck pain resulted in a stroke. The doctor who treated her, M. Mehdi Kazmi, M.D., who is an assistant clinical professor of neurology at New York’s Albert Einstein College of Medicine, said, “I see at least two cases like this or worse a year. Cervical manipulation is a preposterous thing to do, and it should be banned."
Other chiropractic-related injuries may involve the discs in the spinal cord. The Self magazine article mentions the case of Karen Santorum, former Pennsylvania senator Rick Santorum’s wife: she won a lawsuit against a chiropractor who gave her a herniated disc in her back during an adjustment. Another woman was left unable to swallow after a chiropractor’s visit, and now has to be fed through a stomach tube.
The chiropractic community does not believe spinal adjustments cause strokes. A 2008 clinical trial published in Spine journal backs up this belief. Frank Silver, who authored the study, said, "We didn't see any increased association between chiropractic care and usual family physician care, and the stroke." Silver is professor of medicine at the University of Toronto and director of the University Health Network stroke program.
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