Stroke Risks From Spinal Manipulation Unknown
WebMD News Archive
May 22, 2000 -- Could going to the chiropractor for a spinal adjustment increase your risk for a stroke? The chiropractic industry has been under fire over the past few years due to an untold number of strokes -- and in some cases deaths -- blamed on spinal manipulation. One specific procedure performed by chiropractors, known as extension rotation and torque, is under attack.
In one case, a 20-year-old Canadian named Laurie Jean Mathiason died in 1998 after she received a spinal manipulation, from a chiropractor, for treatment for an injury she received after falling down stairs. She complained of sudden neck pain after her last treatment, passed out, and then died within a few days, without regaining consciousness.
Critics say this incident is only one of many similar incidents. "The problem is, nobody knows how common it is," long-time chiropractic critic Stephen Barrett, MD, tells WebMD. "The chiropractic profession either does not keep track of, or won't reveal, the actual figures. Their largest malpractice insurer will not give out the figures despite numerous attempts to obtain them."
The chiropractic profession says the risks are very well known -- and they're small. Jerome F. McAndrews, national spokesman for the American Chiropractic Association and a member of the board of directors of the profession's leading malpractice insurance company, tells WebMD there have been only 130 incidents of manipulation-caused stroke in history. McAndrews says of those, 46% were done by nonchiropractors such as osteopaths, orthopaedic surgeons, and physical therapists -- even though chiropractors perform 94% of all manipulations.
"By comparison, your odds of dying in an accredited American medical hospital from medical mistakes, are 5,000 in one million," says McAndrews.
Greg Tinker, a medical litigator in Seattle for 26 years, calls the numbers used by the chiropractic industry "phony statistics and faulty analysis." Tinker tells WebMD, "their numbers are based on some bizarre estimates based on reported cases and the reported cases are only the ones admitted by the chiropractors' insurance companies. I'm certain it is only the tip of the iceberg."
Tinker has represented three women who have suffered strokes after chiropractic treatments. "All involved strokes of young women with no other stroke risk factors other than chiropractic cervical manipulation."
McAndrews says during his 44-year chiropractic career, similar charges are made periodically "by those who would like to continue hurting our profession using these accusations that are simply not accurate. Spinal manipulation is, in fact, perhaps the safest health care procedure in recorded history."
Here is what is at the core of the issue: There are four arteries involved in the neck. Two carotid arteries are in the front of the neck and two vertebral arteries in the back of the neck. The two vertebral arteries are the most vulnerable, since they wind around the bones of the neck.