November 2004 – Some data behind chiropractic care:
So, before you send “a strong signal to the health and insurance industries that safer non-drug, non-surgical treatments should be considered whenever possible”, be familiar with the evidence behind these treatments first. Chiropractic care certainly has its place, and I have many patients who swear by it. However, it should not replace conventional therapy just yet.
Related posts:
- Dr. RW with a FAQ on woo
- Classic post: Cut Medicare payments for doctors, you’ll have fewer doctors
- A cost effectiveness institute
- ACP: Putting effectiveness into the health care equation: Rational or rationing?
- Will comparative effectiveness research really save money?
- We need comparative effectiveness research, or, I agree with Paul Krugman for the first time ever
- Front of the line
KevinMD.com on Facebook
{ 7 comments }
Chiropractic is kind of like Elvis. About 10% of the population believes that Elvis is alive. I would hazard that about the same percentage of the population believes in this quackery.
So have the chirofrauders determined what a chiropractic “subluxation” is yet? I have yet to see any objective double blind study showing that there is is any scientific evidence showing the existence of the bread and butter of this field.
Hey, I never thought Elvis was alive! But one does have to wonder why a woman would name her child, with her new husband, after her dead husband? Navarrone is his name, Elvis’s middle name was Arron…Does seem strange…:)
I talked to a patient once who had an acute, repairable AAA picked up by a chiropractor; another sustained a carotid dissection because of an c-spine “adjustment.” I advise patients to go the “traditional” route first, many need to hear those words.
If you gave a random assortment of 1000 normal spinal xrays to chiropractors, and asked 50 chiropractors to evaluate them, all 50 of them would find “subluxations” in the normal films.
Its a total sham industry. Yes, it helps with back pain, but so does regular massage. Chiropractors try to wrap up their fancy massage therapy in science.
Why pay $150 for a chiro when you can get the same result for $25 at your local massage parlor?
Yeah. Instead of a carotid artery dissection at the chiro you might actually get a “happy ending” at the massage parlor.
Volume 25, Issue 8, Pages 504-510 (October 2002)
4 of 8
ABSTRACT
FULL-TEXT PDF (99 KB)
CITATION ALERT
CITED BY
RELATED ARTICLES
EXPORT CITATION
EMAIL TO A COLLEAGUE
Internal forces sustained by the vertebral artery during spinal manipulative therapy☆
Bruce P. Symons, DC, Tim Leonard, Walter Herzog, PhDca
Abstract
Background: Spinal manipulative therapy (SMT) has been established as a clinically effective modality for the management of several musculoskeletal disorders. One major issue with the use of SMT is its safety, especially with respect to neck manipulation and the risk of stroke in the vertebrobasilar system. Objectives: Our objectives were to quantify the strains and forces sustained by the vertebral artery (VA) in situ during SMT. Study Design: This was a cadaveric study. Methods: Six VAs were obtained from 5 unembalmed postrigor cadavers. The cephalad/distal (C0-C1) and caudad/proximal (C6-subclavian artery) loops of the VA were carefully exposed and instrumented with a pair of piezoelectric ultrasonographic crystals. The strains between each crystal pair were recorded during range of motion testing and diagnostic tests and during a variety of SMT procedures. The VA was then dissected free and strained on a materials testing machine until mechanical failure occurred. Results: SMT performed on the contralateral side of the cervical spine resulted in an average strain of 6.2% ± 1.3% to the distal (C0-C1) loop of the VA and a 2.1% ± 0.4% strain to the proximal (C6) loop. These values were similar to or lower than the strains recorded during diagnostic and range of motion testing. Failure testing demonstrated that the VAs could be stretched to 139% to 162% of their resting length before mechanical failure occurred. Therefore the strains sustained by the VA during SMT represent approximately one ninth of the strain at mechanical failure. Conclusions: SMT resulted in strains to the VA that were almost an order of magnitude lower than the strains required to mechanically disrupt it. We conclude that under normal circumstances, a single typical (high-velocity/low-amplitude) SMT thrust is very unlikely to mechanically disrupt the VA. (J Manipulative Physiol Ther 2002;25:504-10)
A groundbreaking study on vertebral artery dissection (VAD) and stroke following chiropractic office visits is pending publication in Spine and the European Spine Journal. The study, conducted as part of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders, looked at the association between chiropractic office visits and the incidence of vertebral artery strokes. “Current research suggests that dissections are probably multifactorial in origin,” said Task Force President Scott Haldeman, DC, MD, PhD. “They appear to occur in a person with a genetic predisposition to arterial dissection. They also appear to require a second factor such as viral infection or possibly estrogen.
Related Results
Neck Pain Task Force…
Article titles in…
Article titles in…
Dental x-rays identify…
Santa Fe, N.M.,… Most Popular
Articles in Health
Fuel your workout: …
Soothe a dry, itchy …
Cocktails and …
The sour truth about …
The, six best …
More » They can then be triggered by a minor head movement, including activities of daily living, an adjustment or an examination of the neck.”
According to the study authors, their findings suggest that the risk of suffering a stroke following a chiropractic treatment might be due to the fact that a VAD is already in progress prior to the chiropractic adjustment. The dissection results in neck pain that brings the patient to the chiropractor’s office seeking relief.
The authors also documented only a handful of stroke cases following chiropractic cervical manipulation in a massive study population spanning nearly 100,000,000 person-years. Even more impressive, the data suggest that while spinal manipulation may increase the risk of an embolism in those with a VAD in progress, which can then lead to a stroke, the association between the stroke and the office visit was no higher in patients who seek the care of a chiropractor than in patients who seek the care of a general physician.
Bottom line Dr. Kevin, educate yourself….the empirical evidence will set you free!
Dr. Karen PhD (Neuroscience)
Chiropractic back pain treatment is effective like conventional medicine in relieving pain. Chiropractic care naturally reduces the stress on the muscles, allowing them to loosen and this also reduces the pressure on the bones. Many sicknesses can be treated with chiropractic. I believe in chiropractic treatment as it is really helping my friend.
Comments on this entry are closed.