Chiropractic Adjustments and the Risk of Strokes: Understanding the Consequences

Chiropractors are often sought after for relieving neck pain and other musculoskeletal issues. However, the high-velocity neck manipulations performed by some chiropractors can pose a significant risk, particularly in causing strokes. In this article, we will explore the potential dangers and the reasons behind these risks, as provided by Michigan Medicine neurologist Dr. Mollie McDermott.

High-Velocity Neck Manipulation and Vertebral Artery Dissection

Dr. Mollie McDermott, a neurologist at Michigan Medicine, warns that high-velocity neck manipulations can result in a vertebral artery dissection. This condition, wherein the blood vessel in the neck becomes torn, can lead to a stroke.

The cervical spine houses two arteries that supply blood to the brain: the vertebral arteries. In some individuals, these arteries may be old and somewhat blocked, putting them at higher risk during neck manipulations. A chiropractor performing a high-velocity adjustment, intended to relieve headaches or other issues, could inadvertently cause a dissection, leading to a potentially life-threatening situation.

Realistically Evaluating the Risks

Some critics claim that chiropractic-induced strokes are extremely rare, suggesting that the concern is exaggerated. However, statistics and reality do not align with these arguments. Dr. McDermott points out that if such incidents were common, the malpractice insurance costs would be exorbitant—untenable for most practices.

According to Dr. McDermott, her own malpractice insurance costs are less than $3,000 per year. This data underscores the comparatively low risk, though it must be acknowledged that the possibility of such an event still exists. The focus should therefore be on raising awareness and ensuring informed consent.

Consent and Risk Management

Dr. McDermott advises that there is no adequate test to determine whether a patient is at risk before a high-velocity adjustment. As a result, a consent form detailing the risks is essential._physiotherapists and chiropractors who perform aggressive adjustments are at higher risk, as they may unintentionally disturb arterial plaque, leading to stroke.

Instead of relying on high-velocity adjustments, practitioners can opt for lower-velocity techniques that often require multiple sessions but carry less risk. These techniques ensure that patients sleep better at night, knowing that the risks have been mitigated.

Advocating for Evidence-Based Practice

Dr. McDermott strongly recommends against seeking chiropractic care. She criticizes the ideology and practices of chiropractors, dismissing them as unscientific and based on pseudoscience, such as the concept of subluxations and the treatment of other organ systems like the heart, liver, and lungs.

She also raises concerns about chiropractors' advocacy for alternative treatments, such as homeopathy and anti-vaccination beliefs. The therapies offered by some chiropractors are not backed by scientific evidence, and aggressive neck adjustments pose a risk.

For those considering chiropractic manipulations, it is crucial to understand the risks and ensure informed consent. Lower-velocity adjustments, when necessary, should be performed with caution. Additionally, seeking evidence-based medical advice and relying on scientifically validated treatments are advisable for maintaining overall health and preventing potential complications.