Can a chiropractor cause a stroke?
This question has been a long and tortuous battle between the medical profession and chiropractic for many years. The result was that the chiropractic profession was put through the judicial court systems by the medical profession claiming chiropractors to be an unscientific cult. The result was chiropractic did not lose in court and the profession itself is much more accepted today than it was 100 years ago.
Popular media has taken up this on this drama between the professions and pulled out the story of chiropractic adjustment can cause a stroke. As this was inflammatory to the social media decades ago, it is the same today. Many writers and journalists misused scientific study that is published in a peer-reviewed journal as a rigorous research when sometimes it is just merely editorials expressing opinions.
Barber’s Haircut caused a Heart Attack?
Another common misuse of information is equating correlation with cause and effect. There is a logical fallacy where one event follows another, the first event caused the second event. This can be a basis for logical errors and superstitions. One can have myocardial infarction right after visiting the barber shop, then the barber cutting the hair caused the myocardial infarction. If we really wanted to force this argument, we can compile undisputed medical evidence of heart attack within weeks after visiting the barbershop. Now if we apply this to the issue of chiropractic adjustment and strokes it is another consideration.
This research from Neurology describes this logical fallacy with some of the research materials that were written in a published journal.
There was a survey when neurologists were asked the number of patients evaluated over the preceding of two years who suffered a neurologic complication within 24 hours of receiving a “chiropractic manipulation.” Fifty-five strokes were reported. The author stated, “Patients, physicians, and chiropractors should be aware of the risk of neurological complications associated with chiropractic manipulation.” (Lee K: “Neurologic complications following chiropractic manipulation: a survey of California neurologist.” Neurology 1995; 45:1213)
From a research standpoint, establishing a chiropractic manipulation causes stroke as a statement is very difficult. As Chesnut states: “A review of the literature regarding the relationship between chiropractic and stroke provides very little useful information. The vast majority of the published literature is comprised of case studies, case series, or case-control studies, none of which are capable of providing valid information regarding causation or risk. These type of studies can, of course, provide useful information with regard to suggesting a direction of future research, but they should never be interpreted as a valid means of determining causality. The only valid conclusion that can be reached from review of the available literature is that due to methodological shortcomings, there are literally no scientifically valid data that establish chiropractic adjustment as either a cause of stroke or as being associated with and increased risk of stroke.” (Chestnut J: The stroke issue: Paucity of valid data, plethora of unsubstantiated conjecture. J. Manipulative Physiol Ther 2004; 27; 368-72. )
There is no research article that has proven the relationship between chiropractic manipulation and stroke. We don’t have a method that proves this relationship regardless of opinion. There is more research on how chiropractic is not related to stroke. Jaskoviak reported that not a single case of vertebral artery stroke occurred in approximately five million cervical “manipulations” at the National College of Chiropractic Clinic from 1965 to 1980. (Jaskoviac P Complications arising from manipulation of the cervical spine. J Manipulative Physio Ther 1980;3:213.)
There are some research studies that include “manipulations” administered by Kung Fu practitioner, osteopaths, physiotherapists, a wife, a blind masseur, and an Indian barber were all incorrectly associated with chiropractors. Terrett stated that the words of chiropractic and chiropractor have been incorrectly used in numerous publications with injuries by medical authors from respected medical journals and organizations. (Terett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. J Manipuative Physiol Ther 1995; 18:203.)
This is what we call junk science being put up as legitimate science. Poor correlations from a biased scientific method in a published research do not produce a conclusion of chiropractic will cause a stroke. Every chiropractic adjustment does not correlate with a risk of a stroke. It is time to replace yellow journalism with scientific investigation. In fact, Cassidy’s studies suggest that people with a stroke in progress may visit a chiropractor complaining of a headache and/or neck pain. Neither a physician or chiropractor caused the stroke. (Cassidy JD, Boyle E, Cote P. et al : Risk of Vertebrobasilar stroke and Chiropractic Care. Results of a Population-Based Case-Control and Case-Crossover Study. Spine 2008;33(4S)S176-S183. )
Chiropractic has been associated with stroke from reports of medical literature for decades. The recent popular media seem to have led some gullible audience to accept this false and junk science at face value. Let’s be careful and examine that it will reveal the poor correlation between chiropractic and stroke. Stroke can happen anywhere at anytime and impossible to predict. Strokes can happen equally anyplace even at a coffee shop. So are you going to blame the coffee or maybe the chiropractor you saw a couple of days ago?
Most likely people blame chiropractors for stroke is because they are avoiding or spreading the liability when it happens in their clinic/hospital.