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Science, Art, and Philosophy of Chiropractic


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Chiropractic causes stroke?

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.

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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.)

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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.)

9780312374808This 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. )

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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.

 

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Chiropractic Adjustment-Side affects, Reactions, Adverse Reaction

The chiropractic adjustment is a special procedure that a Chiropractor does to correct or relieve your underlying problem called subluxation. The Chiropractor spends years mastering to correct a subluxation. Subluxation causes pressure on your nerves and causes other symptoms health conditions. Some Chiropractors adjust many segments for up to 7-10 segments. Chiropractor with more scientific and specific approach adjusts fewer segments to get the most positive outcome. As an analogy, we say that adjusting the spine is like a hammer and a bent nail. We can quickly fix the problem by smashing the nail and bend the nail even more and we can never go back to fix it again. Or a more corrective adjusting is like gentle tapping and nudging can get the nail into the correct spot without bending the nail further. Here are following Chiropractor’s approach, who will be specific and scientific:

  • In which direction is the vertebra out of alignment?Spine
  • What is the minimal amount of force necessary for re-alignment?
  • Is it better to adjust facing down or on their side?
  • Are there any factors which would prevent the adjustment?
  • Is the client relaxed enough for the adjustment?

An experienced Chiropractor has a checklist in their mind and goes through them quickly. As Chiropractors are more experienced, as they go through their mental checklist another factor plays is their intuition after many adjustments they have done in the past. An adjustment from one chiropractor may feel different when given by another. Simply due to physical differences of the Chiropractor being short or tall, different hand sizes, or any other can make a different chiropractic adjustment.

Side Affect:

After an adjustment, some people experience a feeling of deepening peace and relaxation. This relaxed feeling may last for the rest of the day or week and may lead to deep, refreshing sleep. Others have at times felt warm feeling flowing to various parts of their bodies that are very soothing. Some feel very energetic and do all their chores and business that day with light, happy feeling.

Others may find that their symptoms have begun to disappear, that the problems that they came to the office for have begun to lessen after the first visit. This is never to be confused that the problem is gone for the rest of your life. Just like working out and building muscles, healing takes time. There are also some people who do not feel any different after an adjustment. People with chronic problems usually do not see the immediate results right away. This does not necessarily mean that they are not benefiting from their adjustments, an absence of no effect after an adjustment just means that they’re not feeling any external reactions.Ask-your-doctor-if-getting-adjusted-is-right-for-you

Reactions:

Another set of people, usually a minority, may feel discomfort, muscle soreness or even some pain and they may experience a headache or some other uncomfortable feeling. There are many reasons and they are the following:

  1. You may be experiencing a detoxification: Cleansing of your body starts to initiate after the adjustment. When toxins and poisons leave the body systems, there may be the increase in discomforts such as a headache, sniffles, a slight fever, strong feeling of drowsiness, lethargy or any similar reactions. There is an increase in blood flow to get rid of the toxins from the body systems, they tend to have an external reaction that is noticeable.
  2. The muscles are starting to realigning the spine. After a Chiropractic adjustment, often the muscles that haven’t worked for many years may be in a weak state. Now that the muscles are starting to work again they may become sore or “charlie horse.” This condition is temporary and will soon disappear after muscles have strengthened themselves.
  3. The nerves that were compressed for a long time are now coming back to life. Old injuries that haven’t healed completely may be reawakened in order for more complete healing to start. It is often times old memories and feelings associated with the original injury may also come to the surface.

Adverse Reaction:

There are claims online stating that there are severe complications such chirotable290x196as stroke, neck pain, bleeding in the brain, headaches. Most of these online articles do not have much evidence and objective facts that are only for shocking people in the media. Although, if a Chiropractor was not being careful and reckless with the Chiropractic adjustments, there can be problems that can be created. There are chiropractic offices that tend to adjust the same locations or adjust as many as 10 segments or joints each visit. Some are not utilizing any examination before they adjust or after they adjust. When Chiropractors are specific and scientific, the adverse reactions are less likely to occur.

“Any person can learn to hit the high spots, replace and displace vertebrae, relieve one disease and cause another. Let us as chiropractors, show the world that chiropractic is a science….Why not be specific….Why not combine the science of chiropractic with the ART of adjusting?” – D.D. Palmer (Founder of Chiropractic Profession)

“Chiropractic is not easy. It is a scientific approach. In order to get those things right, they have to be so right. None of us can be too careful. Too many of the chiropractors are unwilling to really study enough to truly understand spinal mechanics.” –C.S. Gonstead ( Known as “Miracle Man,” Founder of Gonstead Chiropractic Technique)