Chiropractic Adjustments and Strokes

A review of studies involving chiropractic adjustments and stroke

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The Council on Chiropractic Practice concluded, "The panel found no competent evidence that specific chiropractic adjustments cause strokes." ("Vertebral Subluxation in Chiropractic Practice. Council on Chiropractic Practice Clinical Practice Guideline No. 1." 1998.)
According to the National Institute of Neurological Disorders and Stroke, the estimated incidence of strokes in children under 14 years of age is 2.52 per 100,000 per year. Roach ES, deVeber G, Riela AR, Wiznitzer M: Recognition and treatment of stroke in children.
A study in the Journal of Vertebral Subluxation Research estimates the risk of neurological and/or vertebrobasilar complications in pediatric chiropractic to be approximately 1 in 250 million. Pistolese RA: Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient. Journal of Vertebral Subluxation Research 1998;2(2):77-85.
The RAND corporation estimated that the risk of stroke from chiropractic adjustments was "one in a million." ("The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND Corporation 1996: xiv. (6).)
Over a ten-year period, Danish researchers found only five cases of "irreversible CVA after chiropractic treatment." Based on this, they estimated a risk of one stroke per 1,320,000 neck adjustments. ("Safety in chiropractic practice. Part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988," Journal of Manipulative and Physiological Therapeutics, 1996; 19: 371-7.)
Based on a survey of 64 California neurologists, Albers, M.D., estimated the stroke-chiropractic correlation to be "one in every 500,000 manipulations." Co-investigator Philip Lee, M.D. noted, "Indeed, most interventions by allopathic physicians have a higher complication rate than chiropractic interventions." ("Neurologic complications following chiropractic manipulation: A survey of California neurologists," Neurology 1995; 45: 1213-5.)
The author of a Canadian study found 13 documented CVAs related to chiropractic care in Canada, and no deaths, over a five-year period. Since some 50 million cervical adjustments were given by Canadian chiropractors during that time period, he concluded that a reasonable estimate of risk was one serious neurological complications per 3 million neck adjustments. ("A report on the occurrence of cervical cerebral vascular accidents in chiropractic practice." Journal of the Canadian Chiropractic Association, 1993; 37 (2): 104-6.
Researchers in Holland concluded that the overall rate of complications from chiropractic adjustments was one in 518,886. ("Complications in Manual Medicine: A Review of the Literature," Journal of Manual Medicine, 1991; 6: 89-92.)
No strokes or any other significant complications were found during an examination of 168,000 cervical adjustments during a 28-year period. ("Chiropractic therapy: diagnosis and treatment," Aspen Publishers, 1990: 61.)
A review of more than a half-million treatments over a nine-year period at the Canadian Memorial Chiropractic College outpatient clinic found no incidents of strokes or serious incident. ("Vertebral Artery syndrome," published in the book "Upper cervical syndrome: chiropractic diagnosis and treatment.," Baltimore: Williams and Wilkins, 1988: 195-222.)
A survey which included 203 Swiss practitioners and an estimated 1.5 million cervical manipulations, found a rate of one serious complication per 400,000 cervical manipulations, without any reported deaths. ("How dangerous is manipulation to the cervical spine?" Manual Medicine 1985; 2: 1-4.)
Not a single case of vertebral artery stroke or serious injury was found during a study which involved approximately 5 million cervical manipulations from 1965 to 1980 at The National College of Chiropractic Clinic in Chicago. ("Complications arising from manipulation of the cervical spine," Journal of Manipulative and Physiological Therapeutics 1980; 3: 213-19.)