Anything that helps can harm. Even physical therapy--widely perceived as the safest treatment in health care--has side effects and "unintended consequences". (This is code for--we discovered a problem we didn't know about the hard way.)

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I encourage all of you to have a frank discussion with me about anything you have heard or are concerned about. However, not all people are comfortable with that, and some would prefer to investigate for themselves, so I have created this space on our website to post both collated research and primary sources, hopefully with useful commentary.

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National Institute of Health

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The first place I would like to send interested parties is the National Institute of Health website for its section on chiropractic. They are an independent site with no obligations to chiropractors. Indeed they have strong financial and traditional ties to the American Medical Association, the significance of which will be discussed next.

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Let's take a look at the paragraphs on safety.

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Safety

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     Side effects from spinal manipulation can include temporary headaches, tiredness, or discomfort in the parts of the body that were treated.

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     There have been rare reports of serious complications such as stroke, cauda equina syndrome (a condition involving pinched nerves in the lower part of the spinal canal), and worsening of herniated discs, although cause and effect are unclear.

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     Safety remains an important focus of ongoing research:

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          A 2007 study of treatment outcomes for 19,722 chiropractic patients in the United Kingdom concluded that minor side effects (such as temporary soreness) after cervical spine manipulation were relatively common, but that the risk of a serious adverse event was “low to very low” immediately or up to 7 days after treatment.

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          A 2009 study that drew on 9 years of hospitalization records for the population of Ontario, Canada analyzed 818 cases of vertebrobasilar artery (VBA) stroke (involving the arteries that supply blood to the back of the brain). The study found an association between visits to a health care practitioner and subsequent VBA stroke, but there was no evidence that visiting a chiropractor put people at greater risk than visiting a primary care physician. The researchers attributed the association between health care visits and VBA stroke to the likelihood that people with VBA dissection (torn arteries) seek care for related headache and neck pain before their stroke.

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Sounds a bit scary. Possibility of stroke? That's serious! And I take it seriously. The key point is in the 2009 study mentioned above. People who went to their medical doctor versus the chiropractor were no more nor less likely to have a stroke within seven days of seeing the practitioner. The rates for seeing either were the same as the general populace seeking help for neck pain and headaches. (This study was performed and published by the Canadian Medical Association. Here is a direct link to the PubMed summary. The PubMed listing shows it as a 2008 article, not 2009)

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This study is by no means an only child either. A website called Chiro.org has collated a wonderful collection of stroke related research (scroll to the bottom ) as well as explanations of what strokes are and how they work. Despite the site being created by chiropractors--in fact my school, Logan College has a banner at the bottom of the page as a major sponsor--all of the articles have links to the primary research, including the full text (not just the summary) of the Canadian Study published in 2008.

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The basic take away here is

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• The Chiropractic profession is very concerned about the possibility of strokes being caused or triggered by our treatments.

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• We have spent a lot of time and money trying to identify who might be at risk, and/or if one method is safer than another.

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• The conclusions are repeated in multiple studies by people with differing bias (medical background vs chiropractic).

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• No relationship found by type or location of treatment. The most dramatic neck correction had the same odds as the gentlest Logan Basic (what I do) to the pelvis and low back. Area of body does not increase risk. Technique does not increase risk.

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• No relationship found by number of treatments. Could be your first. Could be number 5,000. Repeated use of chiropractic does not increase risk.

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• Short of performing Doppler Ultrasound studies on every patient every single treatment, there is no way to identify who is just having neck pain and a headache as opposed to who is only days away from a major incident.

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An additional point--the medical doctors also failed to identify the people at risk. In the 2008 study mentioned by the NIH above, some even went to the ER and were turned away. VBAI stroke is so rare, medical doctors and ER rooms do not check for it when someone comes in with severe neck pain and a headache.

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Which brings us to the next point.

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The Politics of Chiropractic Safety

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Chiro.org has the best summary of the war--and I do not exxagerate in the use of that term--between the medical profession and mine.
 

The war is mostly historical now. MDs take referrals although they don't yet give them. Patients mostly feel comfortable talking to their MDs about their chiropractors. But the history is there. Not that long ago, maybe 40 years, the Coucil on Quakery, the political arm of the AMA was buying up billboard space talking about how you'll get a stroke if you go to the chiropractor. They financed research with dishonest methodology (more on that in a minute) to try and end chiropractic as a profession. We won an anti-trust lawsuit in the 1980's which is why the Council went underground (you can still find them at Quackwatch.com), but their legacy continues in the research field.

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When looking for research or information on your own, check the following:

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1. Were all of the treatments included in the study performed by chiropractors? When unqualified personel are included, this will obviously skew the results.

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2. Do the conclusions match the data? Usually when a researcher wants to change a study result, they will often casually insert an incorrect assumption. For example: "Given that both groups were essentially the same" When they weren't. They are banking on you (and the review committee) not checking.their assumption.
 

3. Watch for scare tactics. As soon as I see a dramatic rendition of one person's tragedy, I get suspicious and check the rest of the article more thoroughly.

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These are the most common tactics used, of course there are more. However, this will weed out most of the dishonest reporting and research.
 

In the end, while anything that helps can harm, chiropractic is still one of the safest.