Chiropractic and NSAIDs

Neck manipulations have always been speculated to cause stroke. However evidence shows that a common household product may be more dangerous.

Probably one of the most effective chiropractic adjustments is to the cervical spine. Because virtually every controlling and regulating nerve impulse of your body passes through the neck, subluxations here can have far-reaching effects. Yet, even with the impressive results, critics have warned that such adjustments were dangerous. That wrongheaded notion has been put to rest.

A recent Canadian study shows what we've always known. You're no more likely to suffer a stroke following a visit to a chiropractor than you would visiting a medical doctor.

Just published in the journal Spine, an international, peer-reviewed, bi-weekly periodical, the research looked at 818 Canadians who suffered a stroke from what is called an "arterial dissection." While rare, it's believed to be caused by torn arteries supplying blood to the brain. A clot forms, which subsequently dislodged, travels to the brain, blocking circulation.

While researchers confessed that they suspected a link between chiropractic care and stroke, they didn't find one.

According to the American Chiropractic Association, all available evidence demonstrates that chiropractic treatment holds an extremely small risk. The chiropractic profession takes this issue very seriously and engages in training and postgraduate education courses to recognize the risk factors in patients, and to continue rendering treatment in the most effective and responsible manner.

The type of adjustment that has been associated with strokes have been from a rotary adjustment, which is basically performed in a rotation type of maneuver. The preferred method of manipulation is a linear adjustment which means it is a direct adjustment.

Because the amount of strokes associated with spinal manipulations are so small, it is difficult to determine what kind of person who would be likely to have a stroke. In school we were advised that the highest risk factors would be a female, overweight, on birth control pills who smokes. To be honest this description for an individual is already unhealthy.

However the strokes associated with
Compared to chiropractic, the risk of... is greater by...
Death from spinal fusion surgery 100,000
Death from cervical (neck) surgery 34,483
Death from hospital mistake 30,000
Death from laminectomy (spinal surgery) 25,000
Death from prolonged Aspirin, Tylenol,
Advil, Motrin, Aleve use. 4,166
Paralysis or stroke from back or neck
surgery 3,571
Death from automobile accident 750
Stroke from Birth Control Pills 235
Get struck by lightening 7
Death from aviation accident 2 1/2

The National College of Chiropractic Clinic reported that over a 15 year period over 5 million neck adjustments were given without a single vascular injury.

There are tons of biased information floating around the internet about the risk of spinal manipulation, but most of the time they provide little or no scientific evidence.

Considering the general public lack of information supporting chiropractic treatment, many people are still taking a large amount of NSAIDS that cause a lot of internal damage and is also associated with a large number of hospitalizations and deaths. However, there is not a large effort to minimize the overuse of NSAIDS. In 1998, Dr. Singh of the Stanford University of Medicine reviewed the thousands of medical records of arthritis patients at 8 participating institutions. He concluded that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID are anti-inflammatory drugs that include Aspirin, Naproxen ("Aleve"), Ibuprofen ("Advil" and "Motrin")-related gastrointestinal (GI) complications (internal bleeding) and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally un-reported and the public remains at significant risk. If we calculate the costs (direct and indirect) associated with NSAIDs the cost is in the billions.

I have seen this problem when I worked in the hospital in the Intensive Care Unit. A significant amount of patients were taking Tylenol or Motrin for chronic musculoskeletal pain, commonly the neck and back. These patients were generally admitted for gastrointestinal bleeding which resulted in Anemia. When a person is anemic there is insufficient amount of blood circulating, resulting in lack of tissue perfusion and decreased oxygenation. If this condition persists, then the tissues will die leading to organ failure. Many anemic patients develop strokes and/or myocardical infarctions.

Considering the evidence that supports the risk involved with chiropractic as opposed to over-medicating with NSAIDs, chiropractic care must become the standard of care for spinal conditions. The end results would be decreased incidences of NSAID-related disorders and decreased costs.