Chiropractic may cause strokes

[Soapy Sam]

I just commented to AP re Chiropractic on another thread here. I do get the feeling (based mostly on what I read on this forum) that CP in the U.S. is a lot less regulated/ responsible/ mainstream than in the U.K. (Other opinions welcomed).

My one experience of CP (in the UK) is very positive. No nonsense, X-rays taken before treatment, a diagnosis that echoed what a physiotherapist had been telling me for years, simple manipulative treatment of a purely spinal problem and a massive (and seemingly permanent ) improvement in symptoms. The cost was less per hour than a garage mechanic would charge and appointments were made quickly and kept.

To expect spinal manipulation to help a sinus problem seems silly.

Neck manipulation can be quite violent, though nothing I experienced was worse than the sort of neck jolt I often get at work due to my so-called "safety " hard hat hitting an I-beam because it has obscured my upward and forward vision. I find it hard to believe that what was done to me could damage an artery. In an elderly person, this might be more likely.

There clearly is a risk involved with spinal (especially cervical) manipulation. It would seem silly to take a risk unless there is a reasonable likelihood of the treatment being beneficial. If you have a musculo skeletal problem, manipulation may help. If you have a sinus problem and go to a CP, you need to see a neurologist too, or a psychologist. You may be insane.

 

[Guest]

Dear Soapy Sam,

Neck manipulation can be quite violent, though nothing I experienced was worse than the sort of neck jolt I often get at work due to my so-called "safety " hard hat hitting an I-beam

I agree.

I'd also add that some skeptics, who obviously dislike chiropractic because of its historical roots (although, let's talk about conventional medicine's roots sometime...), claim the rate is soooo large, when in fact, one is much more likely to get a stroke from a non-chiropractic source. Some skeptics will try to relate those just to get rid of chiropractic.

You want strokes from a non-chiropractic source, let's look at some medicines.

Sincerely,

S. H.

 

[Nyarlathotep]

Good grief! Chiropractors in the US think they can treat sinus problems? What claims are these guys making?

I've got a better one. I once had a chiropractor honestly claim he could help my sons Down Syndrome.

I have no idea what he was thinking. Perhaps he was going to twist the spine until that lil' 27th chromosome popped off his genes.

 

[BillyJoe]

Let's not forget that some are treating infants for ear infections. As we all know, untreated ear infections can lead to irreversable hearing problems.

Certainly a misuse of Chiropractic (see popalot's post for the proper indications for chiropractic treatment - we may disagree about the mechanism but studies have shown that Chiropractic has been useful for treating neck and back problems) but, interestingly, recent medical evidence indicates that antibiotic treatment of middle ear infections is rarely useful and that middle ear infections rarely cause irreversible hearing loss.

 

[BillyJoe]

I'd also add that some skeptics, who obviously dislike chiropractic because of its historical roots....

You should probably ask sceptics about that. I think you might find that this is only a small part of their problem with chiropractic

.....although, let's talk about conventional medicine's roots sometime.

Well, lets talk about it. Certainly medicos don't mind, they talk about it with an ironic smile and perhaps a little nostalgia.....

.....[sceptics] claim the rate is soooo large, when in fact, one is much more likely to get a stroke from a non-chiropractic source.

Yes, it's a rare event. However some claim (wrongly) that chiropractic is totally ineffective and therefore claim (correctly) that there should be zero tolerance for side-effects.

You want strokes from a non-chiropractic source, let's look at some medicines.

Well you have to balance side effects against effectiveness. I think you may need some examples to bolster your claim.

 

[Zombified]

You need to understand the difference between relative risk and absolute risk. Many things cause strokes, some in large numbers. However, if you risk of stroke is relatively normal, you will increase it by six times (according to this study) if you have your neck manipulated. That is a considerable increase. That does not mean there are six times more strokes from manipulation than anything else, however.

Consider a million people, and just for the sake of example, assume they have a 1/1000 risk of a stroke, and that 5% get neck manipulations (fifty thousand). Their risk is 6 out of every thousand, or about 300 strokes. The remaining, unmanipulated get 950 strokes. The total number is greater because even though the individual risk is smaller, their numbers are a lot larger. Note that this is an oversimplified example with made-up numbers, but it should illustrate the difference.

I believe I've heard of studies that indicate that chiropractic is somewhat effective for the temporary relief of low back pain. I haven't heard anything about chiropractic being shown effective for neck pain (provide something if you know of it), nor that it is a suitable long term therapy. Also, it's not clear that its more effective than other methods, like massage or stretching, that are much less risky. So chiropractic is far from your only choice.

BillyJoe or Popalot, what would you think of a chiropracter who told his patients they needed weekly manipulations to correct supposed misalignments for which there were no symptoms at all, but which he claims will lead to back problems in later life? This isn't theoretical: I know at least one person seeing such a chiropracter.

 

[Dr. Popalot]

Zombefied,
I would tell you that there is no proof in any peer reviewed journal that there is such a thing as preventive care in the chiropractic field. Your friend is being misled. This doctor probably needs to be turned over to his board of examiners for disciplinary action.

Can MD's prevent future infections (years away) by giving anti-bioitcs today? How about preventive surgeries? If I pull on your shoulder will it prevent it from dislocating next month? If I drill into a healthy tooth will that prevent a future cavity?

If your friend likes the treatment then it about a useful as a massage, you get it because it feels good, but your not preventing anything.

 

[Dr. Popalot]

Zombefied,
I would tell you that there is no proof in any peer reviewed journal that there is such a thing as preventive care in the chiropractic field. Your friend is being misled. This doctor probably needs to be turned over to his board of examiners for disciplinary action.

Can MD's prevent future infections (years away) by giving anti-bioitcs today? How about preventive surgeries? If I pull on your shoulder will it prevent it from dislocating next month? If I drill into a healthy tooth will that prevent a future cavity?

If your friend likes the treatment then it about a useful as a massage, you get it because it feels good, but your not preventing anything.

 

[BillyJoe]

Dr. Popalot, I see you've posted my reply as well

Hmmm.....perhaps I let it stand (hoping I haven't been too uncritically swayed by your previous posts on this subject).

 

[Zombified]

I certainly agree with your opinion of "preventive" chiropractic adjustments, Pop.

 

[BillyTK]

Zombefied,
I would tell you that there is no proof in any peer reviewed journal that there is such a thing as preventive care in the chiropractic field. Your friend is being misled. This doctor probably needs to be turned over to his board of examiners for disciplinary action.

Can MD's prevent future infections (years away) by giving anti-bioitcs today? How about preventive surgeries? If I pull on your shoulder will it prevent it from dislocating next month? If I drill into a healthy tooth will that prevent a future cavity?

If your friend likes the treatment then it about a useful as a massage, you get it because it feels good, but your not preventing anything.

In the interest of fair discloure I'll admit to seeing a chiropractor (British variety, heavily regulated), typically a couple of appointments a year, and he's very clear that treatment is just that- treatment, not prevention. He can deal with the problems I'm experiencing but can do nothing to address their cause; that bit's down to me, by taking the right form of exercise, adjusting my posture and taking simple precautions such as making sure my chair and the computer on my desk are positioned correctly.

 

[BillyTK]

Good grief! Chiropractors in the US think they can treat sinus problems? What claims are these guys making?

I've since been corrected by my wife that where sinus problems are the result of muscle tension which stops the sinuses (sinii? is there a plural of sinus? is sinus the plural?) from working properly, then chiropractor could help by releasing the tension.

 

[BillyJoe]

BillyTK,

I've since been corrected by my wife that where sinus problems are the result of muscle tension which stops the sinuses from working properly, then chiropractor could help by releasing the tension.

Chiropractors cannot treat sinus problems. Fullstop.
Also, as far as I know, sinuses are not affected and can not be affected by muscle tension. They are merely spaces within the skull bones lined with mucous membrane and have no connection with muscles.

sinuses (sinii? is there a plural of sinus? is sinus the plural?)

"sinuses" is correct.

regards,
BillyJoe

 

[BillyTK]

BillyJoe,

Chiropractors cannot treat sinus problems. Fullstop.
Also, as far as I know, sinuses are not affected and can not be affected by muscle tension. They are merely spaces within the skull bones lined with mucous membrane and have no connection with muscles.

Seems like we're both right (and wrong):

Sinus Headaches and Sinus Pain Are Not Always What They Seem
Patients come to me complaining of sinus headaches. They point to the area over the eyes (where the frontal sinuses are) or the area under the eyes (where the maxillary sinuses are located) and ask for sinus relief. Actually, the sinuses are rarely painful due to infection. Even when you are blowing handkerchiefs of yellow pus, there is rarely pain. But, when there is a painful muscle in the back of the neck, the pain is radiated to the sinus area. The treatment is to get the neck well . We do this by checking the posture at work and reading - office typist chairs are good, soft couch chairs are bad, and lighting can be important too. Light from the ceiling or shoulder is good, glare from in front is bad. Then I have the patient do neck stretching; gently turn to see who is behind you. And head leaning onto the shoulder. This is best done in the shower, with the shower stream hard and comfortably hot., for 3 minutes.

(Of course, my wife is completely correct on this matter and any inaccuracies are wholly the result of my misinterpretation )

"sinuses" is correct.

regards,
BillyJoe

Thanks!

 

[Zombified]

Seems like we're both right (and wrong)

Those aren't sinus headaches, those are misdiagnosed muscle tension headaches. Migraines also sometimes get misdiagnosed as sinus headaches (they don't necessarily need to be severe), and those do not involve muscle tension, though muscle tension can be one of many triggers.

I am not aware of any actual evidence that chiropractic adjustment can do anything for muscle tension headaches, let alone any other kind. That some headaches involve neck muscles is not sufficient. There is zero chance it would do anything for a migraine.

Considering that most headaches can be treated with over-the-counter pain medication, taking the risk of unproven chiropractic manipulation seems rather foolish.

If your headaches are severe or frequent enough that you'd see someone about them, see a real doctor; you may need real treatment. A chiropracter does not have medical training and cannot diagnose what type of headache you might have.

 

[BillyTK]

Hi Zombified,

Those aren't sinus headaches, those are misdiagnosed muscle tension headaches. Migraines also sometimes get misdiagnosed as sinus headaches (they don't necessarily need to be severe), and those do not involve muscle tension, though muscle tension can be one of many triggers.

I am not aware of any actual evidence that chiropractic adjustment can do anything for muscle tension headaches, let alone any other kind. That some headaches involve neck muscles is not sufficient. There is zero chance it would do anything for a migraine.

Considering that most headaches can be treated with over-the-counter pain medication, taking the risk of unproven chiropractic manipulation seems rather foolish.

Maybe I should've been clearer on what I meant by "both right and wrong"! I'm wrong in suggesting "that where sinus problems are the result of muscle tension which stops the sinuses from working properly", but we agree that what presents as sinus headache can be muscular in origin. As a patient I'd be calling that a sinus headache.

If your headaches are severe or frequent enough that you'd see someone about them, see a real doctor; you may need real treatment. A chiropracter does not have medical training and cannot diagnose what type of headache you might have.

I'd certainly agree with your advice about seeing a doctor and that Chiropractors shouldn't be diagnosing headaches, but I'm not sure if it's the case that British chiropractors have no medical training; I suspect this is another of the many differences between typical US practice and British practice.