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Chiropractic Safety


By: Dr. Robert Neposlan

If you have read any previous articles, you know I like questions. And so here’s one. What does Chiropractic have to do with living well? Well, if you’re living with any kind of pain then I want to go out on a limb and suggest that we could probably agree, you’re not “living well”.

How prevalent is pain in our living experience?

Statistics show that over 80% of Canada’s population will miss at least one day’s work sometime in their lifetime because of low back pain. While I have no references, I know thousands more will miss work because of neck pain, headaches and other forms of musculoskeletal conditions. I would say that the prevalence is very high.

While the incidence of musculoskeletal complaints are high, utilization of chiropractic services is fairly low. I read somewhere years ago that it may be as little as 10-20% of the population. Given the prevalence of these disabling conditions it should not be this way. Particularly when we consider what the current research shows.

An Exhaustive Research Paper

One exhaustive research paper was published back in 1998 by professors Pran Manga Ph. D. (Health Economics) and Doug Angus, Director Masters Program in Health Administration, University of Ottawa. I would like to quote from these researcher’s findings. “We have presented much evidence that NMS (Neuro Musculoskeletal Disorders) are prevalent and costly. They cause a disproportionate amount of chronic illness and disability. We then presented sophisticated studies and analysis, especially those by Santo and Smith, demonstrating that chiropractic care is significantly more cost- effective than medical care with a common scope of practice. We also sited evidence favoring chiropractic in terms of safety and patient preference.

Is it Safe??

As I read this conclusion a word stuck out and I thought back to comments/concerns I occasionally hear from people and that is the issue of Chiropractic safety. Is it safe to go to a chiropractor, particularly if you have an issue involving neck pain? And here again I want to reference not only Dr. Manga’s research but also research of the World Health Organization published in SPINE (February 2008) the leading international journal for orthopedic surgeons and those in related fields. An international task force of researchers and scientist-clinicians representing 14 disciplines (including neurology, rheumatology, epidemiology, chiropractic etc.) from 9 countries considered almost 32,000 research citations and then carefully appraised more than 1,000 of them to synthesize the best available scientific evidence on neck pain and the most efficacious means of treating it. The result of this review? In one line, cervical manipulation (chiropractic adjustment) is a recommended treatment for neck pain.

The task force also conducted the largest original study on chiropractic and stroke. At issue was the idea that a hand delivered chiropractic adjustment of the neck can tear the vertebral artery thereby producing a blood clot, which can lead to strokes. Being an instrument adjustor, I have never feared or hesitated to adjust a patient… even patients considered high-risk candidates for stroke. In my practice a patient lays prone or face down on a table. There is no rotation or extension of the neck which is the mechanism that is hypothesized to bring about a tearing of the vertebral artery. However, in fairness to chiropractors that adjust by hand I think it’s important to present the research findings.

The researches evaluated 10 years of data…and guess what?

They did find an increased association between chiropractors and stroke. BUT, read carefully, they found a stronger association between physician visits and stroke.

In addition, the research showed there was no statistical difference between having a stroke and a visit to a chiropractor OR a physician, but since physicians don’t adjust necks, these data essentially show that neck adjustments are a non-factor in strokes from vertebral artery tears.

Another key point here is in the use of the word association. Association as shown by the study is not a cause. Rather the increased association of a stroke and a visit to a chiropractor or physician was attributed to the fact that these people were ALREADY having symptoms of neck pain and headaches before they ever went to the doctor or chiropractor. These people were ALREADY demonstrating symptoms of a stroke before they ever walked into the chiropractic or physician’s office.

A final point: Your chiropractor is a highly trained primary care physician. As such, he/she is trained to detect and spot those risk factors and/or symptoms in a patient’s history that are consistent with the risk of a stroke. I have more than once referred a patient to their medical doctors when their history dictated. I’m sure this is no different for my colleagues in practice.

And so, if you are living with any kind of pain, don’t let here-say prevent you from living well. Chiropractic has been shown to be a safe and cost effective choice for treating musculoskeletal disorders (i.e. headaches, neck, back pain etc). That’s what the RESEARCH shows!!!

I hope this helps you or someone important too you… LIVE WELL. Until next week…

Be well,

Dr. Rob

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