RESPONSE TO SUSAN MARTINUK'S ARTICLE IN THE
CALGARY HERALD
From the
albertastroke@neck911.com research group of physicians and family victims of chiropractic highest neck manipulation.
On June 21, 2007 Dr. John William Kinsinger published an article in the Calgary Herald, an Alberta Canada newspaper. The title was “Cracking Necks Destroys Lives”. The article focused of the role of deadly philosophy of David and B.J. Palmer that manipulating the highest neck was a cure all. It also explained how the Colleges of Chiropractic fail to regulate in the public interest. Finally it criticized the Minister of Health of Alberta for failing to regulate chiropractic claims. The article also mentioned the six restrictions that the families and neurologists wish the Minister to impose on chiropractic highest neck manipulation.
In response, on July 18, 2008 Susan Martinuk, who does not have any medical training but describes herself as being “related to chiropractors and have undergone chiropractic treatments on many occasions” wrote an article also published in the Calgary Herald. Thus she is reporting her own purely anecdotal experience, the very thing she is accusing Dr. Kinsinger of doing.
We have attached the article by Dr. Wallace Sampson and Dr. J. William Kinsinger, CHIROPRACTIC HIGHEST NECK MANIPULATION DOES CAUSE STROKE AND DEATH. PRODUCING QUACK SCIENCE FOR QUACKERY. It exposes the study that Martinuk refers to.
Also available from
neckmanipulationstroke@gmail.com is the history of chiropractic highest neck manipulation.
THE SPIN THAT MARTINUK WROTE (in italics)
He (Dr. Kinsinger) made a collection of statements about chiropractic based on the individual case of Sandra Nette, an Edmonton woman who apparently suffered a stroke after a neck manipulation.
WHAT THE EVIDENCE IS
Dr. Kinsinger’s article focused on the root causes of chiropractic strokes using Sandra Nette as an example. The role played by chiropractic education, the Palmer philosophy and the lack of government regulation were the essential issue.
He claims chiropractic is a non-scientific profession, which is particularly ironic since he fails to provide much scientific evidence to support his own claims.
The most fundamental essential belief of chiropractic is vertebral subluxations.
Scientifics in every field of medicine, neuro-anatomy, neurologists, paediatricians, radiologists, etc. have clearly found that such subluxations do NOT exist. Not a single medical school or respected scientist accepts chiropractic claims as to the way they see the nervous system functioning.
The largest and most recent studies on chiropractic care and stroke were published in Spine (February 2008), the leading international journal for orthopedic surgeons and those in related fields
“Spine” is a well known dumping ground for chiropractic articles. In no way is it a “leading international journal”. There was no new “studies” but simply a collection of past chiropractic claims. NONE of the chiropractic studies examined the particular technique of highest neck manipulation, the type we are concerned about.
The result of this vast review? Cervical neck manipulation is a recommended treatment for neck pain.
There were no new studies. Neck manipulation was mentioned as being
recommended in chiropractic “studies”. It was no more effective than doing nothing or reading a book on neck pain. In fact, massage has been shown to be more effective and of course safer.
The task force also conducted the largest original study on chiropractic manipulation and stroke. At issue are claims that manipulating the neck can tear the vertebral artery, thereby producing a blood clot that can cause a stroke.
There was NO original study reviewed by the task force. “Spine” also published a study done by chiropractor David Cassidy which used billing numbers from Medicare visits to try to prove a statistical relationship between visits to physicians and visits to chiropractors and the incidence of strokes. Of course one has nothing to do with the other as the strokes seen in doctors offices were not caused by the medical doctor while those VBA were caused by chiropractic neck manipulation. Using actual hospital records rather then billing codes, a similar “study” showed in a three year period of time in Germany 36 cases of chiropractic neck manipulation stroke. 1 patient died and 1 was in a persistent vegetative state: J Neurol. 2006 Jun;253(6):724-30. Epub 2006 Mar.
At issue are claims that manipulating the neck can tear the vertebral artery, thereby producing a blood clot that can cause a stroke.
There is absolutely no doubt that neck manipulation causes strokes and deaths. Seventy years of scientific reports, three Coroner reports in Canada alone and the warnings of neurologists all across Canada from cases seen in their offices proves this beyond any doubt.
But these tears can occur spontaneously and one can have a tear and not realize it since the first symptoms are headache and neck pain. They are extremely rare events, so there is no practical way to screen a population for such occurrences and, consequently, vertebral tears are primarily diagnosed after a stroke. By evaluating 10 years of data, researchers showed there is an increased association between chiropractic visits and stroke.
Aneurysms which are a weakness in the wall do spontaneously and suddenly
rupture without warning. However, vertebral and carotid artery dissections
almost never spontaneously dissect and some respected authorities feel this never really happens without some preceding event. As well, most chiropractic neck manipulations involve bilateral dissection in both arteries at the same time. This would NEVER (99.9%) be a spontaneous event but would only be the result of a neck manipulation. If there is some weakness in an artery and no way to know beforehand, this is all the more reason NOT to manipulate the highest neck area.
But -- and this is the key point – there was an even stronger association between physician visits and stroke.
As stated before, physician often see people who are going to have a stroke, based on any visit in a year which is the time frame the chiropractors used. This proves nothing. It is like saying that diabetes or cancer or heart disease are more common after seeing your doctor than after seeing a chiropractor.
A second key point is that an association (as showed by this study) is not cause. Rather, the increased association between stroke and visits to a doctor or chiropractor was attributed to the fact that people who are already experiencing neck and head pain due to a spontaneous artery tear are more likely to go to a medical doctor or a chiropractor to seek help.
As stated before most chiropractic neck manipulations involve bilateral dissection in both arteries at the same time. This would NEVER (99.9%) be a spontaneous event but would only be the result of a neck manipulation.
If there is some weakness in an artery and no way to know beforehand, this is all the more reason NOT to manipulate the highest neck area.
There was no statistical difference between having stroke and a visit to a chiropractor or a physician, but since physicians don't manipulate necks, these data essentially show that neck manipulation is a nonfactor in strokes from vertebral artery tears.
This statement makes no sense whatsoever. The issue is very clear. A person walks into a chiropractors office, has the neck manipulated, feels sudden neck pain, nausea, vomiting, dizziness, has a stroke, is seen in hospital, tests prove the exact site of the stroke is where the neck was manipulated. End of story.
Readers should also know that Kinsinger is not a disinterested party. Rather, he is a doctor from Oklahoma who has been a frequent critic of chiropractors through the media.
Dr. Kinsinger is a highly trained medical specialist. He is also consulted by leading medical and political figures on health care issues. This is the familiar chiropractic attack against anyone who is critical of chiropractic. She is in effect saying that if you are critical your opinion does not count.
In fact, if one looks at published literature on the kind of strokes that Kinsinger attributes to chiropractic care, there are individual case reports of those who suffered a stroke after a visit to a beauty parlour.
This is an argument AGAINST neck manipulation. If a stroke can happen just
from the position of your head at a beauty parlour, so much more can it happen if someone is taking your head and twisting it beyond your personal control.
It's time for Kinsinger to enter the 21st century and look at the scientific evidence there is, not just matter about how it doesn't exist.
Perhaps it is time for chiropractic to enter the 21 century and give up its quack and dangerous beliefs.
*****
The Scientific Review of Alternative Medicine
Editor in Chief
Wallace Sampson MD
and
J. William Kinsinger M.D.
CHIROPRACTIC HIGHEST NECK MANIPULATION DOES CAUSE STROKE AND DEATH. PRODUCING QUACK SCIENCE FOR QUACKERY
Quack science written by health care professionals is at times published in well respected journals. There are hundreds of studies claiming the effectiveness of homeopathy preparations. The theory is that these work because they are diluted. Yet, at a basic dilution of only 16C, a solution of 1/100 is diluted 16 times; there is the equivalent of one drop in the oceans of a million earths. So despite the studies, there is more urine from a shark swimming on Mars than the ingredients on the bottle. Tap water for free or two ounces of homeopathy for $20 produce the same result.
While homeopathy may be harmless, chiropractic neck manipulation is not. Simple anatomy tells us that chiropractors twisting the highest neck (the area from the base of the skull to the two next neck vertebrae) do cause stroke and death by damaging the neck arteries that supply the brain. Seventy years of published scientific data, (see
www.neck911usa.com) three Inquests just in Canada alone, the concern publicly expressed by neurologists all across Canada, confirms this and are the tip of the iceberg.
Just as most back pain is in the lower back, so most neck pain is in the lower neck. Chiropractic highest neck manipulation is a belief system not a therapy. This belief that by cracking the highest neck area one can restore the body to health and treat everything from AIDS to Attention Deficit Disorder is based on the false theory of disease being caused by so called vertebral subluxations, misaligned vertebrae causing nerve dysfunction. Without subluxations there is no need for highest neck manipulation being done repeatedly on everyone from newborn babies to senior citizens.
This subluxations highest neck philosophy is taught today in every chiropractic school practiced by almost every chiropractor and is fully supported by the regulatory bodies that are supposed to protect the public. In the words of the vice-president of the College of Chiropractors of Ontario, “Subluxation based or evidence based, limited care or full spectrum care” the College of Chiropractors of Ontario “could not care less”, as long as members comply with all CCO standards of practice, policies and guidelines”. Go to the public website of the Alberta College of Chiropractors, type in the word “stroke” and you get zero information. These are licensing Boards that are supposed to protect the public? The chiropractic highest neck manipulation issue has never been about black-sheep in every profession. Just like homeopathy, chiropractic subluxations do not exist except perhaps on Mars. Defending such neck manipulation is the most prominent example of the need to produce quack science to defend quack beliefs. Millions of dollars are being spent to try to produce evidence that chiropractic highest neck manipulation is effective for everything, that it does not cause stroke and death and that side effects such as these are very rare.
The latest study, done by chiropractors and even a neurologist claims that if you saw your doctor, who never touched your neck, then a chiropractor who did, the risk of a stroke is equal from having seen your doctor or a chiropractor. The lead author, a chiropractor, in a companion study claims that even though the incidence of strokes went up, the amount of bills chiropractors sent to government went down therefore chiropractors are not causing strokes. Hence a simple solution is to stop paying chiropractors, a trend that almost all Canadian provinces have now adopted and we would have no more neck manipulation strokes. Unfortunately this does not work.
Another study which roped in the University of Calgary claimed to prove a stroke cannot happen, was done on 80-99 year old cadavers with a chiropractor gently moving the head through a limited range of motion. These subjects were already dead, thus proving that dead people can’t have a stroke and die twice due to a chiropractic neck manipulation. The best criticism of this study was stated by another chiropractor, Christopher Good of New York Chiropractic College. “We cannot interpolate these results into a living system” (JMPT June 2003. Pa. 338-340). He goes on to say that “we are simply deluding ourselves and misleading others”.
To try to prove strokes are rare, another study even published in the Canadian Medical Association Journal claims the risk of stoke was 1 in 5.85 million manipulations. This study was done mainly by a malpractice insurance company salesman, also a chiropractor, who based his statistics on those who actually sued. If you did not sue, the stroke did not happen.
According to this logic we know the number of AIDS cases in Africa, not by blood tests, but by the number of babies who have sued their mothers for feeding them breast milk with the AIDS virus in it.
Risk also has qualitative and not just quantitative aspects to it. Most chiropractic strokes are in young women in perfect health. They have no need to be exposed to any risk. The statistics used by chiropractors are also based on the total number of individual manipulations not risk per person. With this logic, someone smoking a cigarette in Chicago would reduce the risk of lung cancer in a three pack a day smoker in Toronto.
Another study claims that if they did not have their necks manipulated people would have to take dangerous anti-inflammatory medications or need neck surgery. This of course is untrue, as most neck pain can be treated without either. In regard to surgery, the comparison is faulty.
There is no condition of the neck that needs neck surgery, such as a tumour, blood vessel abnormality, a ruptured disc or trauma that would be better treated by twisting and turning the upper neck. Anti-inflammatory medications are used mainly for things such as menstrual cramps and rheumatoid arthritis neither of which can be treated by high neck manipulation. Chiropractors claim to be able to treat everything from ear infections, sinusitis and spinal subluxations by neck manipulation, conditions for which no physician would ever prescribe an anti-inflammatory medication. Chiropractors have never produced a single instance of a person who had a stroke or died following the prescribing of anti-inflammatory medications for the purpose of treating high neck pain.
Academic integrity is essential. The University of Alberta and the University of Toronto may be surprised to know that the Canadian Chiropractic Association claims that these Universities fund “University chairs in chiropractic”. Someone who works there may have a chiropractic degree and does research but seeing that chiropractic is not taught at these Universities such claims serve only to muddle and tarnish their academic reputation. This twisting of the academic truth was front and center of the chiropractors failed attempt to have York University host a school of chiropractic.
Chiropractors will never give up their philosophical belief in highest neck manipulation. Responsible scientists have to stop deluding the public by co-operating in quack studies. Government has to impose a scientific standard just as exists for all prescribed medications, which means in effect no subluxations chiropractic highest neck manipulation.
Dedicated to the memory of Laurie Jena Mathiason who died a violent and unnecessary death in 1998 as a direct result of a chiropractic neck manipulation.
J. William Kinsinger MD
Wallace Sampson MD.
BIOGRAPHY NOTES
Wallace Sampson, M.D., is a clinical professor emeritus of medicine at Stanford University and editor-in-chief at the Scientific Review of Alternative Medicine. Sampson studies and teaches about unscientific medical systems and aberrant medical claims. He sits on the board of directors of the National Council against Health Fraud, and is affiliated with several other professional organizations that protect consumers from bogus healthcare claims and products.
Dr. Wallace Sampson is a highly-respected and well-known authority in numerous medical fields, including oncology, hematology, and pathology. He has held, and currently holds, responsibility positions in a wide variety of medical institutions and activities. He was formerly the Associate Chief of Hematology and Medical Oncology at the Santa Clara Valley Medical Center, and a Clinical Professor of Medicine at Stanford University School of Medicine. Dr. Sampson is also a prominent and active member of numerous professional organizations devoted to the protection of consumers from fraudulent healthcare products and claims. He has the ability to address a variety of audiences, and has written for publications as diverse as JAMA and the Saturday Evening Post.
John William Kinsinger M.D. is a Board certified anesthesiologist practicing in the State of Oklahoma and a past president of the Oklahoma Society of
Anesthesiologists. He is part of a large world-wide group of academics and physicians doing research into dangerous practices of some types of alternative medicine. He has published several editorial articles in the National Post newspaper in Canada and in the Scientific Review of Alternative Medicine. He wrote a journal published scholarly paper (Preserving Academic and Scientific Integrity at Florida State University) about the failed attempt by Governor Jeb Bush to start a school of chiropractic in Florida in 2005.
http://healthwatcher.net/chirowatch...nse to Martinuk article in Calgary Herald.pdf
