Month: April 2024

Is Chiropractic Treatment Dangerous?

by admin

Chiropractic is recognized as one of the safest, drug-free, non- invasive treatments available for headache, neck, and back pain. During the last 25 years there have been five formal government inquiries into chiropractic, all of which have found the profession to be both safe and effective.1 Based on the results of more than 85 studies into the safety and efficacy of chiropractic treatment, no other profession, including medicine, can demonstrate greater effectiveness or a better safety record for the treatment of spinal pain syndromes.

The risk of stroke from manipulation of the upper neck is small. Current published reports put the risk at between one or two out of one million treatments with the risk of serious consequences being even less likely.2

In fact, strokes may occur from normal everyday activities such as cradling a phone between your ear and shoulder during a prolonged conversation.3 Strokes have also been associated with simple activities such as having one’s hair washed at a beauty parlour, dental procedures, painting a ceiling, and turning one’s head while driving.4 Occurrences like this cannot be predicted.

Other likely treatments for head, neck and back pain carry a notably higher risk. For example:

  • The risk of gastrointestinal bleeding, caused by common pain relievers, such as ASA, is 400 times greater than the risk of damage from neck manipulation.5
  • Serious neurological complications from cervical spine surgery are more than 15,000 per million, and the mortality rate is almost 7,000 per million.6

Informed Consent

The chiropractor makes a diagnosis by taking a thorough health history and performing a physical examination. After determining any contraindications to treatment, an appropriate plan of care is developed.

Prior to starting treatment, chiropractors are required to obtain informed consent from their patients. A consumer’s choice of health care should always be based on informed consent. Health consumers must receive adequate and accurate information to assist them in evaluating their health care choices, and in balancing the relative risks of treatment options with the benefits.

Ongoing research

Chiropractic researchers continue to be actively involved in studying the benefits and risk of manipulation in the treatment of neck and back pain. Faculty from the Canadian Memorial Chiropractic College have played a leadership role in this research through participation in clinical trials and literature reviews.

Currently a large-scale, multi-disciplinary trial is underway to assess the efficacy of different types of treatment, including chiropractic care, for managing tension-type headache. In addition, the profession has published papers reviewing the risks and complications of cervical manipulation.

Attention has recently been directed to cervical manipulation by Dr. John Norris of the Canadian Stroke Consortium. His data, which is preliminary, and has yet to be analysed and published, will hopefully contribute to a better understanding of the relationship between cervical manipulation and stroke.

The chiropractic profession continues to conduct research that will ensure that care is provided as effectively and safely as possible.

May, 2000

 

1. Chiropractic in the United States: Training, Practice and Research, U.S. Department of Health and Human Services, AHCPR Research Report, Dec.1997.Chiropractic in New Zealand, Report of the Commission of Inquiry, Hasselberg PD, Government Printer, Wellington, 1979. Medicare Benefits Review Committee, Thompson CJ, Commonwealth Government Printer, Australia, 1986 Legitimization for Vissa Kiropraktorer, Commission on Alternative Medicine, SOU, 1987. The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain, Manga P, Angus D, et al. Commissioned by the OCA and funded by the Ontario Ministry of Health. Pran Manga & Associates, University of Ottawa, 1993.

2. The Appropriateness of Manipulation and Mobilization of the Cervical Spine: A Systematic Review of Literature, Hurwitz EL, Aker PD, Adams AH, Meeker WC, Shekelle PG, Spine, 21(15); 1753-1755, 1996. Risk Factors and Precipitating Neck Movements Causing Vertebrobasilar Artery Dissection After Cervical Trauma and Spinal Manipulation, Haldeman S, Kohlbeck FJ, McGregor M, Spine, 24(8); 785-794, 1999.

3. Carotid Artery Dissection due to Elongated Styloid Process, Zuber M, Meder JF, Mos JI, Neurology, Nov. 1999.

4. Beauty Parlour Stroke Syndrome: Report of Five Cases, Weintraub MI, Journal of the American Medical Association, 269:2085-86, 1993 Abrupt Change in Head Position and Cerebral Infarction, Sherman DG, Hart RG, Easton JD, Stroke, 12:2-6, 1981. Vertebral Artery Occlusion Following Hyperextension and Rotation of the Head, Okawara S, Nibbelink D, 5:640-42, 1974. Cervical Manipulation and Stroke, Stroke, 8:594-97, 1977.

5. A Risk Assessment of Cervical Manipulation v. NSAIDS for the Treatment of Neck Pain, Dabbs V, Lauretti WJ, Journal of Manipulative and Physiological Therapeutics, 18.530-36, 1995.

6. Ibid.

About Chiropractic FAQ

by admin

Content

  • Does chiropractic treatment require a referral from an MD?
  • How is chiropractic manipulation performed?
  • Can chiropractic treatment cure colds, earaches and other ailments?
  • Is chiropractic manipulation a safe procedure?
  • Is chiropractic treatment appropriate for children?
  • Does chiropractic treatment require x-rays?
  • Can chiropractic treatment provide a preventative function?

 

Does chiropractic treatment require a referral from an MD?

No. A patient does not have to be referred. Chiropractors are legislated as primary contact health professionals in every province in Canada. This means that patients can consult them directly. However, chiropractors often work closely with MDs, 44 per cent of whom refer their patients to chiropractors when they believe chiropractic treatment will help alleviate a patient’s condition.1

How is chiropractic manipulation performed?

Chiropractic manipulation is a manual procedure which utilizes the highly-refined skills developed during four intensive years of chiropractic education. The chiropractor uses his/her hands to manipulate the spine in order to restore or enhance spinal functioning.

Manipulation is a highly controlled procedure which rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient. Patients often note positive changes in their symptoms immediately following treatment.

Can chiropractic treatment cure colds, earaches and other ailments?

Chiropractic care cannot “cure” these conditions, but there is evidence to indicate that spinal manipulation may have a beneficial effect on a variety of conditions. More research is needed in these areas before definitive benefits can be claimed.

It is important to distinguish between primary treatment and treatment of secondary symptoms. For example, if a patient has an aching ear that is related to the musculoskeletal structures around the ear, and which is not the result of a bacterial infection, then chiropractic treatment may alleviate the pain. This would be considered primary treatment.

If there is ear pain caused by a bacterial infection, then chiropractic care is not the primary treatment, but may help alleviate some of the secondary – or referred – pain arising from the musculoskeletal reaction to the ear infection. This would be considered secondary treatment where chiropractic plays a complementary role in the treatment of a condition.

So, chiropractic care cannot cure a cold or an ear infection, but it may reduce the pain response. Similarly, chiropractic care can be of benefit in relieving musculoskeletal symptoms that are present with other chronic diseases such as cancer or AIDS.

Is chiropractic manipulation a safe procedure?

Chiropractic treatment is a drug-free, non-invasive approach to common musculoskeletal conditions such as neck and back pain. As such, it is a very low risk therapy. In extremely rare situations – between one or two out of one million treatments – there is a possibility that manipulation of the upper neck may contribute to a stroke.

Is chiropractic treatment appropriate for children?

There are many reasons why a child might benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from participating in sports which can cause back pain and discomfort. Chiropractic care is always adapted to the individual patient. It is highly skilled and, in the case of children, is very gentle.

While there is a wealth of clinical evidence that musculoskeletal treatment of infants has many positive effects, well-controlled studies are required to verify some of the benefits that are commonly seen in practice.

Most recently, a research report published in the Journal of Manipulative and Physiological Therapeutics concluded that “spinal manipulation is effective in relieving infantile colic.”2 The study was a randomized, controlled clinical trial with a blinded observer and compared the effect of chiropractic therapy with a commonly prescribed medication used to relieve colic.

A study of chiropractic as complementary therapy for children receiving asthma medication, concluded that spinal manipulation did not provide additional benefits.3 This study which was published in the New England Journal of Medicine in October 1998, is another example of how research continues to inform chiropractic treatment.

Does chiropractic treatment require x-rays?

Guidelines have been developed by the chiropractic profession with regard to the use of X-rays as a diagnostic tool. X-rays provide vital information to help determine a diagnosis but they are not required in every case. In fact, at CMCC from 1997 to 1998 fewer than 20 per cent of chiropractic patients received X-rays, and only 6 percent of patients under the age of 16 required an X-ray.

Use of X-ray as a diagnostic tool by chiropractors, and all other health professionals, is governed in Ontario by guidelines as set out by the Healing Arts Radiation Protection Commission (HARP). X-rays can play an important role in diagnosis but are only taken when a need has been determined by a careful case history and physical examination. Chiropractors receive 360 hours of education in radiology covering a full range of topics from protection to X-ray interpretation and diagnosis. Governments in every province have recognized the training and competence of chiropractors to perform X-rays and have granted them this right.

Can chiropractic treatment provide a preventative function?

Clinical experience suggests that individuals with chronic conditions such as osteoarthritis or recurrent neck pain, back pain or headaches experience less frequent and less severe symptoms when under regular chiropractic care. This also applies to individuals in highly stressful situations and those who experience repetitive physical and postural strain from their daily activities.

Whether ongoing chiropractic treatment can prevent back pain from occurring in the first place or prevent a previous condition from re-occurring requires further study.

May, 2000

 

1. Alternative Medicine and General Practitioners: Opinions and Behaviours, Vernoef MJ, Sutherland LR, Canadian Family Physician, 41:1005-11, 1995.

2. The Short-Term Effect of Spinal Manipulation in the Treatment of Infantile Colic, Wiberg JMM et al, Journal of Manipulative and Physiological Therapeutics, Vol. 22, No. 8, October 1999.

3. A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma, Balon J et al, The New England Journal of Medicine, Vol. 339, No. 15, October 1998.