Have you ever heard someone say that getting a chiropractic adjustment can lead to a stroke? It's a common fear, but the truth is that this connection is largely based on misinformation and misunderstandings about how the body works.
First, let's start by defining what a stroke is. A stroke is a medical emergency in which blood flow to the brain is disrupted, leading to brain damage or death. There are two types of strokes: ischemic, which is caused by a blocked blood vessel, and hemorrhagic, which is caused by a blood vessel bursting.
Now, let's talk about chiropractic care. Chiropractic is a form of alternative medicine that focuses on the treatment and diagnosis of mechanical disorders of the musculoskeletal system, particularly the spine. One of the most common procedures performed by chiropractors is a spinal adjustment, also known as a manipulation. During this procedure, the chiropractor uses their hands to apply controlled force to a joint of the spine, which helps to relieve pain and improve functionality.
So, what's the connection between chiropractic care and strokes? In rare cases, people have reported having a stroke after receiving a chiropractic adjustment. However, it's important to note that the vast majority of these cases have involved individuals who already had underlying health conditions, such as an artery in the neck that was already partially blocked, that put them at higher risk for a stroke.
In fact, numerous studies have shown that the risk of having a stroke after a chiropractic adjustment is extremely low. A 2010 study published in the Journal of Manipulative and Physiological Therapeutics found that the risk of stroke following a chiropractic adjustment was less than one in a million. In comparison, the risk of stroke from taking aspirin, a commonly used pain reliever, is estimated to be about 1 in 100,000.
So, what can we conclude from all of this information? While it is possible to have a stroke after receiving a chiropractic adjustment, the risk is extremely low and is no higher than the risk associated with other common activities, such as taking a pain reliever. If you have concerns about the safety of chiropractic care, it's always best to speak with your doctor or chiropractor to discuss your individual health history and risk factors.
In conclusion, the connection between chiropractic care and strokes is largely based on misunderstandings and misinformation. With a low risk and numerous benefits, including pain relief and improved functionality, chiropractic care can be a safe and effective form of alternative medicine for many people.
Source: Murphy D. R. (2010). Current understanding of the relationship between cervical manipulation and stroke: what does it mean for the chiropractic profession?. Chiropractic & osteopathy, 18, 22. https://doi.org/10.1186/1746-1340-18-22
Evolving Understanding and Studies Show Inconsistent Results
The understanding of the relationship between cervical manipulation and vertebral artery dissection (VADS) has evolved over time. Initially, case reports were published which linked cervical manipulation therapy (CMT) to VADS. Some of these reports incorrectly identified the treating practitioner as a chiropractor and attributed CMT as the cause of the dissection. However, other reports also attributed the cause of VADS to other mechanical events.
Retrospective surveys were then conducted to further understand the relationship between CMT and VADS. The first survey of members of the Swiss Society for Manual Medicine estimated the rate of slight and important complications to be 1:40,000 and 1:400,000, respectively. A survey of California neurologists reported a 37% response rate and 21% of respondents reported at least one case of stroke. A 10-year retrospective survey of chiropractors in Denmark estimated the incidence of cerebrovascular incidents to be one case per 362 chiropractor years and one case per 1.3 million cervical treatment sessions.
A biomechanical study was performed to measure the strain on the vertebral artery during cervical manipulation. The study found that the average strain during CMT was 6.2% greater than that at rest, but unlikely to tear or otherwise mechanically disrupt a normal vertebral artery. Other studies, such as a retrospective review of 23 cases of VADS, estimated that one in 48 chiropractors were exposed to such cases, compared to one in two neurologists. The authors concluded that this selection or referral bias likely explained the difference in perception of VADS between neurologists and chiropractors. However, none of the studies discussed are adequate to assess risk and investigate a causal relationship between CMT and VADS.
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