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Getbig Main Boards => Gossip & Opinions => Topic started by: bodybuildermdpitt on June 10, 2008, 07:58:42 PM
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I have a clinical question I am thinking of researching with a colleague of mine. It deals with neck readjustments and CVAs (strokes). Have any of you guys had chronic neck readjustments from chiropractors? If so, what was the reason, and does it help? Also, did the chiropractor read any images for you, and try to diagnose you from his interpretation of the images? I am trying to start a study (obviously it is in its very early inception), as of now I am trying to get some basic brain storming ideas.
cheers,
bodybuildingmdpitt
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Is this another attempt of the AMA trying to discredit chiropractors?
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I have a clinical question I am thinking of researching with a colleague of mine. It deals with neck readjustments and CVAs (strokes). Have any of you guys had chronic neck readjustments from chiropractors? If so, what was the reason, and does it help? Also, did the chiropractor read any images for you, and try to diagnose you from his interpretation of the images? I am trying to start a study (obviously it is in its very early inception), as of now I am trying to get some basic brain storming ideas.
cheers,
bodybuildingmdpitt
I have adjusted over 135,000 patients in 18 years of being a chiropractor.
Never had one problem with one patient in any way.
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Not at all... actually quite the opposite. However, I have an inkling that chiropractors that don't have chronic patients, don't read there own images, and work together with MDs (not for but together), actually may be quite effective. Many studies have been coming out that discredit neck readjustments, but these studies don't control for a lot of factors. I think there may be some benefit to these readjustments, I am just trying to figure out these controls so they can be statistically applied to future studies and help explain past studies.
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I have adjusted over 135,000 patients in 18 years of being a chiropractor.
Never had one problem with one patient in any way.
I didn't get my happy ending, Doc.
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Not at all... actually quite the opposite. However, I have an inkling that chiropractors that don't have chronic patients, don't read there own images, and work together with MDs (not for but together), actually may be quite effective. Many studies have been coming out that discredit neck readjustments, but these studies don't control for a lot of factors. I think there may be some benefit to these readjustments, I am just trying to figure out these controls so they can be statistically applied to future studies and help explain past studies.
Statistically, a stroke MAY occur in one out of every 1 million neck adjustments.
And, people die EVERY DAY from/during surgery and/or medications.
Everything has +/-
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I've had back problems for years and several months ago started seeing a chiropractor 1-2 times a week and it's definitely helped. I can't lift 'till it gets better but it's worth it. Here's the EMG results from my first day.
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I didn't get my happy ending, Doc.
Sorry, bro, insurance doesn't pay for that in CT :)
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I've had back problems for years and several months ago started seeing a chiropractor 1-2 times a week and it's definitely helped. I can't lift 'till it gets better but it's worth it. Here's the EMG results from my first day.
Hey, that's great!
Can't see the emg results, tho.
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Statistically, a stroke MAY occur in one out of every 1 million neck adjustments.
And, people die EVERY DAY from/during surgery and/or medications.
Everything has +/-
That is an extremely inaccurate statement. Strokes occur actually at quite an alarming rate especially for patients under the age of 45. In fact, many studies have shown statistically significant results. I can PM you studies if you wish.
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That is an extremely inaccurate statement. Strokes occur actually at quite an alarming rate especially for patients under the age of 45. In fact, many studies have shown statistically significant results. I can PM you studies if you wish.
Nah. Thanks anyway.
I don't get caught up in all that jazz.
I am very conservative in practice, and just try to help as many people as I can.
Mike
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That is an extremely inaccurate statement. Strokes occur actually at quite an alarming rate especially for patients under the age of 45. In fact, many studies have shown statistically significant results. I can PM you studies if you wish.
no, please, share it with us all
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I've had back problems for years and several months ago started seeing a chiropractor 1-2 times a week and it's definitely helped. I can't lift 'till it gets better but it's worth it. Here's the EMG results from my first day.
Ahhh...the Myovision scan...I have one...great for patient education.
Yours doesn't look bad...usually want to match it with symptoms and progress in treatment.
You want the green bands to basically be balanced from side to side.
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Ahhh...the Myovision scan...I have one...great for patient education.
Yours doesn't look bad...usually want to match it with symptoms and progress in treatment.
You want the green bands to basically be balanced from side to side.
It was the x-rays that were bad but I don't have copies of those. My neck angle is wrong, my spine has a curve between the shoulder blades, and my hips are at the wrong angle as well, on top of my spine being twisted. :D
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It was the x-rays that were bad but I don't have copies of those. My neck angle is wrong, my spine has a curve between the shoulder blades, and my hips are at the wrong angle as well, on top of my spine being twisted. :D
Just make sure you have a good treatment goal...there is no need for lifetime treatment.
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I have adjusted over 135,000 patients in 18 years of being a chiropractor.
Never had one problem with one patient in any way.
Moosejay;
135Kpatients/18 years = 7,500/year= /50weeks= 150week=/5days=30 patients per day=/8hours=3.75 patients per hour-everyday, 50 weeks per year for 18 years.......Me thinks MJ exaggerating.
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Moosejay;
135Kpatients/18 years = 7,500/year= /50weeks= 150week=/5days=30 patients per day=/8hours=3.75 patients per hour-everyday, 50 weeks per year for 18 years.......Me thinks MJ exaggerating.
MooseJaw doesn't sleep, he's a neck snapping machine.
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MooseJaw doesn't sleep, he's a neck snapping machine.
My overall average is 143 patient visits per week. I have devoted the early portion of my life to work. No exaggeration....there are guys that see 500 per week.
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My overall average is 143 patient visits per week. I have devoted the early portion of my life to work. No exaggeration....there are guys that see 500 per week.
Can you post some kind of proof of your 135k patients? I'd love to see it. :D
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Not at all... actually quite the opposite. However, I have an inkling that chiropractors that don't have chronic patients, don't read there own images, and work together with MDs (not for but together), actually may be quite effective.
What do you mean dont read their own images?? As far as DC's working together with MD's....that will happen once MD's come around to accepting our practice. As an example of a patient JUST THE PAST WEEK who has had ringing in her ears for the last SIX MONTHS:
Patient (to her MD) : I would like to try chiropractic care
MD: I suppose, but I cant see how it will help
Patient: Why do you not think it will help
MD: There is no proof it helps. I think that you would be better off continuing with the Soma and possibly increasing your intake of ibuprofen.
Lets see...hmmm....as of today she has SIGNIFICANT less ringing in her ears. I am not saying that chiropractic is the be-all, end-all.....but why is it so bad to give it a try as a conservative, non-invasive approach??
Can you post some kind of proof of your 135k patients? I'd love to see it. :D
Hmmm....let see....for me...8yrs in practice....average about 300 - 350 patient visits per week. Proof? Not ONE case of stroke against me. Being that this is a VERY litigious (sp?) society....can you possibly think that if someone DID have a stroke I wouldnt be up to my ass in a lawsuit?
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Hmmm....let see....for me...8yrs in practice....average about 300 - 350 patient visits per week. Proof? Not ONE case of stroke against me. Being that this is a VERY litigious (sp?) society....can you possibly think that if someone DID have a stroke I wouldnt be up to my ass in a lawsuit?
So in 8 years you are claiming to have seen 124,000+ patients?
MooseJaw has been at it 18 years and he's only seen 135K patients, he also claims to work 80-90 hours a week. How do you manage to double his patients which he claims is about 143 per week? Do you work 160-180 hours a week? :o
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i have a best friend of mine who is a chiro and he does 3-4 patients a hour many days..
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i have a best friend of mine who is a chiro and he does 3-4 patients a hour many days..
4 patients, 10 hours, 40 per day, 200 per week, 10,400 per year, 8 years, 83,200 patients..........your "friend" is a slacker, MooseJaw and DF4L have him beat significantly, he needs to pick up the pace.
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Now wait a minute, he's claiming 135,000 unique patients or fucking patient visits? I don't think there are 135,000 people in the whole state of CT, are there? ???
;D
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What do you mean dont read their own images?? As far as DC's working together with MD's....that will happen once MD's come around to accepting our practice. As an example of a patient JUST THE PAST WEEK who has had ringing in her ears for the last SIX MONTHS:
Patient (to her MD) : I would like to try chiropractic care
MD: I suppose, but I cant see how it will help
Patient: Why do you not think it will help
MD: There is no proof it helps. I think that you would be better off continuing with the Soma and possibly increasing your intake of ibuprofen.
Lets see...hmmm....as of today she has SIGNIFICANT less ringing in her ears. I am not saying that chiropractic is the be-all, end-all.....but why is it so bad to give it a try as a conservative, non-invasive approach??
Hmmm....let see....for me...8yrs in practice....average about 300 - 350 patient visits per week. Proof? Not ONE case of stroke against me. Being that this is a VERY litigious (sp?) society....can you possibly think that if someone DID have a stroke I wouldnt be up to my ass in a lawsuit?
Good thing I have call tonight, I guess posting makes the night go by faster. I will address all the issues you have brought up. Chiropractics should not under any circumstance diagnose any ailment through their interpretation of scans (CT or even X-ray). Quite frankly, you don't have the training to do it accurately. To be taken seriously you need to have your scans read by MSK radiologists. Many, many studies have shown that, unfortunately, you guys do not have uniform diagnoses on simple MSK complaints. Secondly, you have to address this issue of laxity of the ligaments secondary to chronic manipulations. Although this may surprise you, manipulations have a place in medicine, and should be done through physiatrists. Physiatry is a science, and unfortunately the other is modern day "quackery."
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Nah. Thanks anyway.
I don't get caught up in all that jazz.
I am very conservative in practice, and just try to help as many people as I can.
Mike
I think it is called science not jazz. I could be wrong though.
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Moose,
I went to a chiropractor a few years ago for some adjustments and it was great relief for some back pain I had. My question is, how many times a month do you recommend people getting adjustments? Some people say it has to be an ongoing thing (like twice a month), can you elaborate on this?
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I have adjusted over 135,000 patients in 18 years of being a chiropractor.
Never had one problem with one patient in any way.
They're scared to tell you out of the fear that you might get angry and paralyze them. ;)
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So in 8 years you are claiming to have seen 124,000+ patients?
MooseJaw has been at it 18 years and he's only seen 135K patients, he also claims to work 80-90 hours a week. How do you manage to double his patients which he claims is about 143 per week? Do you work 160-180 hours a week? :o
I own two businesses
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Now wait a minute, he's claiming 135,000 unique patients or fucking patient visits? I don't think there are 135,000 people in the whole state of CT, are there? ???
;D
PV's
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Good thing I have call tonight, I guess posting makes the night go by faster. I will address all the issues you have brought up. Chiropractics should not under any circumstance diagnose any ailment through their interpretation of scans (CT or even X-ray). Quite frankly, you don't have the training to do it accurately. To be taken seriously you need to have your scans read by MSK radiologists. Many, many studies have shown that, unfortunately, you guys do not have uniform diagnoses on simple MSK complaints. Secondly, you have to address this issue of laxity of the ligaments secondary to chronic manipulations. Although this may surprise you, manipulations have a place in medicine, and should be done through physiatrists. Physiatry is a science, and unfortunately the other is modern day "quackery."
Young man: if you are going to be a doctor....may I suggest you concentrate on helping people instead of getting in pissing contests.
Your attitude is EXACTLY waht fucks up healthcare
Hope this helps (But I doubt It)
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I got an uncle in Cairo.....
He's a Cairopracter........nyuk nyuk nyuk
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Moose,
I went to a chiropractor a few years ago for some adjustments and it was great relief for some back pain I had. My question is, how many times a month do you recommend people getting adjustments? Some people say it has to be an ongoing thing (like twice a month), can you elaborate on this?
Nah. I go case-by-case. Whatever the patient needs.
If you keep on engaging in activity that causes the back problem, then, obviously, you'd need more.
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They're scared to tell you out of the fear that you might get angry and paralyze them. ;)
Doubt it. They just wouldn't return
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How many patients does Franco have?
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I have a clinical question I am thinking of researching with a colleague of mine. It deals with neck readjustments and CVAs (strokes). Have any of you guys had chronic neck readjustments from chiropractors? If so, what was the reason, and does it help? Also, did the chiropractor read any images for you, and try to diagnose you from his interpretation of the images? I am trying to start a study (obviously it is in its very early inception), as of now I am trying to get some basic brain storming ideas.
cheers,
bodybuildingmdpitt
Brainstorming!? From the title of this thread you've already made your conclusions. What do you need our input for? Legitimacy? ???
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How many patients does Franco have?
He has an associate. From what I understand he is not there much.
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How many patients does Franco have?
Hahahahah gayer than getting 'franco' to give you the 'Arnold Special' at his 'shop' ...er i mean 'office' .... ::)
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Brainstorming!? From the title of this thread you've already made your conclusions. What do you need our input for? Legitimacy? ???
And there you are.
Yes, I have never heard of any dangers regarding medicine.
Most deleterious observations come from $ motivations.
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Good thing I have call tonight, I guess posting makes the night go by faster. I will address all the issues you have brought up. Chiropractics should not under any circumstance diagnose any ailment through their interpretation of scans (CT or even X-ray). Quite frankly, you don't have the training to do it accurately. To be taken seriously you need to have your scans read by MSK radiologists. Many, many studies have shown that, unfortunately, you guys do not have uniform diagnoses on simple MSK complaints. Secondly, you have to address this issue of laxity of the ligaments secondary to chronic manipulations. Although this may surprise you, manipulations have a place in medicine, and should be done through physiatrists. Physiatry is a science, and unfortunately the other is modern day "quackery."
I KNEW IT!
I saw this coming a mile away... ::) ::) ::)
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I KNEW IT!
I saw this coming a mile away... ::) ::) ::)
Aww, leave him alone. He just feels threatened....
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Aww, leave him alone. He just feels threatened....
I just don't see what the point is?? ::)
How can he be so busy with medicine yet still find time to be a hater?! This is expressly why I don't get along with medical students...they're a "special breed"
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I just don't see what the point is?? ::)
How can he be so busy with medicine yet still find time to be a hater?! This is expressly why I don't get along with medical students...they're a "special breed"
Put it this way:
Everyone has something to offer in helping patients. He's wasting his time with the negativity.
He should concentrate on how he is going to pay his loans back with the advent of Nationalized health care.
Chances are, he won't be able to.
Let those thoughts keep him warm at night.
Moosejay Approved
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Just make sure you have a good treatment goal...there is no need for lifetime treatment.
It seems the Chiro I go to regularly right now, makes sense he has me doing excersise at home, Cerv traction, head weights, forming thingys you lay on, wooble chair. My xrays showed not much curve in neck, thoratic cob (bend in spine). So I have been being adjusted 3 times a week for the first 3 months then on to maintenece. The neck adjustments took some getting used to thats for sure.
I was always sceptical of chiros but now think they have lots to offer, they teach the whole lifestyle approach which makes sense also. This helped convince me they can help, when i did the wobble chair thing I noticed it would cause a pain in my left testicle when I moved to one side. After a while thinking not much of it told the DC and he said thats a pinched nerve. He adjusteted me on my side where they push bent legs down and after that the pain in the nuts was gone. It has come back a bit to a lesser degree now and then but much less than before and very infrequently now, it suprised me how well it worked.
Anyhow It seems they push that being adjusted is a lifelong thing, yeah it keeps the money coming in for them. But it makes sense to me especially if training heavy and stressing my spine pretty hard. Does 2 times a month sound about right for maintence? Im sure it varys with the individual. My insurance covers 40 visits a year so that should have me covered.
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Not sure if this was asked. I had prolotherapy done on my wrist. It hurt so bad during treatment but the end result was awesome and above what I suspected. My good friend also had it done on his shoulder when every other form of treatment did nothing, prolotherapy works wonders. Why is it that only chiropractors did this therapy and why was it illegal and so many chiropractors lost their license for doing it. Why didn't MD's use this therapy.
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Some more on chiropractic stuff. My old manager had severe asthma and he gained a lot of weight and when we traveled he always spent time in the hospital. He started seriously going to a chiropractor where he lives and the chiropractor helped his asthma and he lost all the weight and became a very successful bodybuilder. Whenever I put on an armwrestling meet I got a local chiropractor to sponsor the show and they would come in and massage the athlete after a match. The guys loved it and they all felt great so they could go compete more. If you see in the background of this picture you can see a big banner promoting the clinic in Ft Meyer we had. Funny thing is 15 years later I was at the Paris hotel here in Vegas and was walking into the casino when I saw one of the chiropractors from the clinic. He was a really cool guy.
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So in 8 years you are claiming to have seen 124,000+ patients?
MooseJaw has been at it 18 years and he's only seen 135K patients, he also claims to work 80-90 hours a week. How do you manage to double his patients which he claims is about 143 per week? Do you work 160-180 hours a week? :o
As I have said...PATIENT VISITS....thats what my practice sees per week. Some patients 3x/week.....some 1x/week....some 1x/month. As far as what my hours are.....9 - 12, 3 - 7 M/W/F.....3 - 7 Tu/Th.....and 9 - 12 on Sat.
As far as how do I manage? Simple....I dont get caught up chit-chatting a lot for 20mins per patient
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Good thing I have call tonight, I guess posting makes the night go by faster. I will address all the issues you have brought up. Chiropractics should not under any circumstance diagnose any ailment through their interpretation of scans (CT or even X-ray). Quite frankly, you don't have the training to do it accurately. To be taken seriously you need to have your scans read by MSK radiologists. Many, many studies have shown that, unfortunately, you guys do not have uniform diagnoses on simple MSK complaints. Secondly, you have to address this issue of laxity of the ligaments secondary to chronic manipulations. Although this may surprise you, manipulations have a place in medicine, and should be done through physiatrists. Physiatry is a science, and unfortunately the other is modern day "quackery."
Quackery...how did I know you were going to throw that in. As far as diagnosing "ailments" on film. I diagnose biomechanical problems and structural misalignments. If I see anything that I dont recognize or think could in ANY WAY be something other than normal tissue appearance....guess where it goes? A RADIOLOGIST. I get a full report back in 24hrs. Other than that I am qualified.
I would like to know where these studies are that show I cant properly diagnose a musculo-skelatal complaint properly. I wont get into anymore of this...because you sure attempted to not be very anti-chiro.....but each post you make has little "jabs" at my profession. One in which I have helped manythat HAVEN'T gotten the relief they asked their MD's for. So when you claim that we need to do XYZ in order to be taken seriously....I take offense to it.
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Quackery...how did I know you were going to throw that in. As far as diagnosing "ailments" on film. I diagnose biomechanical problems and structural misalignments. If I see anything that I dont recognize or think could in ANY WAY be something other than normal tissue appearance....guess where it goes? A RADIOLOGIST. I get a full report back in 24hrs. Other than that I am qualified.
I would like to know where these studies are that show I cant properly diagnose a musculo-skelatal complaint properly. I wont get into anymore of this...because you sure attempted to not be very anti-chiro.....but each post you make has little "jabs" at my profession. One in which I have helped manythat HAVEN'T gotten the relief they asked their MD's for. So when you claim that we need to do XYZ in order to be taken seriously....I take offense to it.
MDs are above chiros, you guys seem so defensive, like you have to prove something. All they ask is for proof, science will reveal the truth.
for the record, chiros are great, osteopaths better imo. Certainly not quackery, but all the energetic shit etc.. that some do is ridiculous
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As a child I grew up with headaches everyday and my parents took me to the chiropractor very often. He used the Pierce method which involves a scan and very specific adjustments. I think many do this now, but keep in mind this was 20 years ago.
My headaches disappeared somewhere around middle school age and I think it was mostly due to stress and diet.
On the negative, My mom had a disc ruptured from a chiropractor which resulted in back surgery. The same doctor that worked on Mario Lemieux, did my mom's surgery.
I also had a friend in VT that had a disc ruptured from a chiropractor. As he started to research, he found from reports in the hospital emergency room that it happens quite often.
I think they offer some good things, esp Active Release Techniques, but having them make these multiple adjustments on a regular basis is putting yourself at risk.
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It seems the Chiro I go to regularly right now, makes sense he has me doing excersise at home, Cerv traction, head weights, forming thingys you lay on, wooble chair. My xrays showed not much curve in neck, thoratic cob (bend in spine). So I have been being adjusted 3 times a week for the first 3 months then on to maintenece. The neck adjustments took some getting used to thats for sure.
I was always sceptical of chiros but now think they have lots to offer, they teach the whole lifestyle approach which makes sense also. This helped convince me they can help, when i did the wobble chair thing I noticed it would cause a pain in my left testicle when I moved to one side. After a while thinking not much of it told the DC and he said thats a pinched nerve. He adjusteted me on my side where they push bent legs down and after that the pain in the nuts was gone. It has come back a bit to a lesser degree now and then but much less than before and very infrequently now, it suprised me how well it worked.
Anyhow It seems they push that being adjusted is a lifelong thing, yeah it keeps the money coming in for them. But it makes sense to me especially if training heavy and stressing my spine pretty hard. Does 2 times a month sound about right for maintence? Im sure it varys with the individual. My insurance covers 40 visits a year so that should have me covered.
Yes...sounds like you have a good DC and as long as you keep pounding the iron, you may need continued care. Good luck!
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I've never been to a chiropractor and don't think I could get over my skepticism to do so. While I own the domain name fogarty.org, the domain fogarty.com use to be a chiropractic organization of some sort. They've since abandoned the site, so when mail bounces, senders say 'oh it must be .org'. So I get tons of chiro spam and inquires.
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Moosejay;
135Kpatients/18 years = 7,500/year= /50weeks= 150week=/5days=30 patients per day=/8hours=3.75 patients per hour-everyday, 50 weeks per year for 18 years.......Me thinks MJ exaggerating.
my chiro will see anywhere from 85-125 patients in a day, so me thinks you're an idiot!!
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my chiro will see anywhere from 85-125 patients in a day, so me thinks you're an idiot!!
wow, assembly line...um...medicine at it's best.
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How many patients does Franco have?
Franco used to practice on us in the gym for free while he was studying. It was great
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wow, assembly line...um...medicine at it's best.
Well, that is the nature of conventional medicine, these days, too. :-\
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How come none of the chiroprators answered my questions about prolotherapy
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Put it this way:
Everyone has something to offer in helping patients. He's wasting his time with the negativity.
If it was the case that Chiroprators are hurting patients, and he demonstrates that with research such that fewer people go to chriopractors and get injured then he would be helping patients right?
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How come none of the chiroprators answered my questions about prolotherapy
Because I am just logging on.
One of the pioneers of Prolotherapy, Lloyd Saberski, M.D., of Yale Pain Management, uses these sugar injections for maladies such as lateral epicondylitia with great success. Problem is, insurance does not pay as the 'reasearch' is not there.
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If it was the case that Chiroprators are hurting patients, and he demonstrates that with research such that fewer people go to chriopractors and get injured then he would be helping patients right?
Just as much as alerting people to anyone who was doing harm in any type of profession.
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wow, assembly line...um...medicine at it's best.
Yes, and you are very credible.
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MDs are above chiros, you guys seem so defensive, like you have to prove something. All they ask is for proof, science will reveal the truth.
Umm, other way around. I make more than the average MD...and if you think its not ALL about money...think again
for the record, chiros are great, osteopaths better imo. Certainly not quackery, but all the energetic shit etc.. that some do is ridiculous
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Not sure if this was asked. I had prolotherapy done on my wrist. It hurt so bad during treatment but the end result was awesome and above what I suspected. My good friend also had it done on his shoulder when every other form of treatment did nothing, prolotherapy works wonders. Why is it that only chiropractors did this therapy and why was it illegal and so many chiropractors lost their license for doing it. Why didn't MD's use this therapy.
Probably because it works ;)
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Just over 5 years in medical practice.
15 with medical school, residency and fellowship.
Have seen 5 vertebral artery dissections from chiropractic manipulation.
Something to think about.
I don't have any concrete numbers as to the actual incidence, but, I am sure it is much higher than the
one in several "millions" quoted by chiros.
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Just over 5 years in medical practice.
15 with medical school, residency and fellowship.
Have seen 5 vertebral artery dissections from chiropractic manipulation.
Something to think about.
I don't have any concrete numbers as to the actual incidence, but, I am sure it is much higher than the
one in several "millions" quoted by chiros.
Far, far outweighed by all the folks you guys fuck up with surgery and meds.
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Yes...sounds like you have a good DC and as long as you keep pounding the iron, you may need continued care. Good luck!
Thank you for the response doc and sorry about the tiff we had before.
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Far, far outweighed by all the folks you guys fuck up with surgery and meds.
BOOOOOOOOOOOOOOOOOOOOOOO OOM!!!!!!!!!!
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Moosejay;
135Kpatients/18 years = 7,500/year= /50weeks= 150week=/5days=30 patients per day=/8hours=3.75 patients per hour-everyday, 50 weeks per year for 18 years.......Me thinks MJ exaggerating.
owned
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Far, far outweighed by all the folks you guys fuck up with surgery and meds.
Going over my posts, I think i may have been a bit too harsh on your profession. I think conservative therapy is quite effective for ACUTE problems. However, chronic manipulations is plain "quackery." I would also like to admit that yes MDs make may mistakes. However, it is just stupidity to state that MDs make much more mistakes than chiropracters. You can look at the NFL, NBA, NHL, and all competitive NCAA programs. All of their sport medicine doctors are real doctors (usuallly orthopods), not one chiropracter. Although chiropracters work with these teams, they work UNDER the guidance of MDs. The problem with chiropracters is that you guys manipulate and mislead the general public. Your profession is not based on science, as defined by evidence based medicine. There is nothing wrong with SOME techniques of your profession, but the MAJORITY of your profession is just plain BULLSHIT. You know it and I know it. You can peddle your bullshit as much as you want, but at the end of the day you have to ask yourself if making money of other people's misery is worth the money. Money will come and go but your legacy of bullshit will smell forever. The only purpose of this thread to make aware to the general public that may be mislead by your crap. Clearly your defensive posts by you and your colleagues reiterates your insecurity and guilt of your profession. To others, do you really want to place your Central Nervous System on an individual that believes scientific research is "jazz."
cheers,
bodybuildermdpitt
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Yes...sounds like you have a good DC and as long as you keep pounding the iron, you may need continued care. Good luck!
Absolutely BULLSHIT. Wow, can you smell the bullshit as it comes out of your mouth.
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Absolutely BULLSHIT. Wow, can you smell the bullshit as it comes out of your mouth.
seriously though, could you share why it is you feel this way about chiropractors? Was there a specific incident or did you lose a ff to a chiropractor, what?
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seriously though, could you share why it is you feel this way about chiropractors? Was there a specific incident or did you lose a ff to a chiropractor, what?
chiropractic medicine is not evidence based for the most part but medicine in inherently intuitive, look at psychiatry. Polypharmacy and shotgun approachs are examples of partly intuitive practices, it is my problem when medicine is based on mostly intuitive practice and has to much individuality to allow for varied care. I have seen total body modification, vials of substances placed on the body, other retarded practices done by chiros on me. Claiming to cure allergies etc... all bullshit.
you can treat with spinal manipulations, but diseases of organ systems etc you cannot, how can you call yourself a doctor if you cannot treat multiiple aliments and offer some assitance for a wide variance of disease?
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seriously though, could you share why it is you feel this way about chiropractors? Was there a specific incident or did you lose a ff to a chiropractor, what?
After 4 years of undergrad, 4 of medical school, 10 (yes 10 years) years of residency, I became a doctor. I am a GI surgeon and you would not believe how many patients ask me solutions about the problems caused by you guys. STROKES, yes STROKES, caused by you guys is the new epidemic. Nothing irritates me more than planned and manipulative idiocy, perpetuated by your profession. Like the "electromagnetic" bullshit of the early 20th century, your bullshit is next. Do yourself a favor, take the MCATs and become a real doctor.
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After 4 years of undergrad, 4 of medical school, 10 (yes 10 years) years of residency, I became a doctor. I am a GI surgeon and you would not believe how many patients ask me solutions about the problems caused by you guys. STROKES, yes STROKES, caused by you guys is the new epidemic. Nothing irritates me more than planned and manipulative idiocy, perpetuated by your profession. Like the "electromagnetic" bullshit of the early 20th century, your bullshit is next. Do yourself a favor, take the MCATs and become a real doctor.
md's who do not embrace CAM to some degree will be left behind imo. Healthcare without prevention, nutrition, supplementation, stress control, counselling etc and just remedial measures is sorely lacking, hence people looking for alternatives. Alot of drugs suck.
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Absolutely BULLSHIT. Wow, can you smell the bullshit as it comes out of your mouth.
Really you are being pretty harsh on this subject. I think he is right that someone would need continued care when they are always pushing the body. I was always sceptical of chiros before, But the things they seek to do makes logical sense to me.
With MDs it is either drugs or surgery for the treatment, really they are just buying time and amusing thier patients with drugs till the body heals itself in most cases. Some of the surgical procedures are done very prematurely without trying alternatives, once they fuse your spine there is no going back. From what I understand the goal of chiro is to get your body working 100% by itself by opening up the entire CNS and having it working with out any bottlenecks.
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seriously though, could you share why it is you feel this way about chiropractors? Was there a specific incident or did you lose a ff to a chiropractor, what?
A patient of mine who clearly needed colon resection secondary to UC, but her bullshit chiropracter told her that changing her diet, colonics, with spinal manipulation will cure her.
explain that to me.
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Really you are being pretty harsh on this subject. I think he is right that someone would need continued care when they are always pushing the body. I was always sceptical of chiros before, But the things they seek to do makes logical sense to me.
With MDs it is either drugs or surgery for the treatment, really they are just buying time and amusing thier patients with drugs till the body heals itself in most cases. Some of the surgical procedures are done very prematurely without trying alternatives, once they fuse your spine there is no going back. From what I understand the goal of chiro is to get your body working 100% by itself by opening up the entire CNS and having it working with out any bottlenecks.
not true, all chronic conditions are incurable by the body, it is the bodies failed attempt at cure that creates the symptoms. In some disease the organic cause can be epiphenominal to an abstract entity such as thought patterns.
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Really you are being pretty harsh on this subject. I think he is right that someone would need continued care when they are always pushing the body. I was always sceptical of chiros before, But the things they seek to do makes logical sense to me.
With MDs it is either drugs or surgery for the treatment, really they are just buying time and amusing thier patients with drugs till the body heals itself in most cases. Some of the surgical procedures are done very prematurely without trying alternatives, once they fuse your spine there is no going back. From what I understand the goal of chiro is to get your body working 100% by itself by opening up the entire CNS and having it working with out any bottlenecks.
I am really not trying to be harsh. BUT THAT IS BULLSHIT. Keep on getting spinal adjustments and YOU WILL get a subluxation, and then you will feel REAL PAIN, and potential loss of bowel and urinary continence. I do not want to see you in my office for bowel incontinence due to these idiots. I am being harsh, but there is not other word to describe this profession. Honestly, arguing with these guys is like arguing with psychics. They know it is bullshit, I know it is bullshit, but they don't want their cash cow to die. I have nothing to gain by exposing these idiots, but if I can prevent one individual from going to these idiots, then these 3 minutes was worth it.
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Well, that is the nature of conventional medicine, these days, too. :-\
so what is the number of minutes you need to spend with a patient to give sound "conventional medicine" since you seem to be so well versed?
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chiropractic medicine is not evidence based for the most part but medicine in inherently intuitive, look at psychiatry. Polypharmacy and shotgun approachs are examples of partly intuitive practices, it is my problem when medicine is based on mostly intuitive practice and has to much individuality to allow for varied care. I have seen total body modification, vials of substances placed on the body, other retarded practices done by chiros on me. Claiming to cure allergies etc... all bullshit.
you can treat with spinal manipulations, but diseases of organ systems etc you cannot, how can you call yourself a doctor if you cannot treat multiiple aliments and offer some assitance for a wide variance of disease?
I was referring to the guy who started this thread with the single purpose of mocking chiropractors
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After 4 years of undergrad, 4 of medical school, 10 (yes 10 years) years of residency, I became a doctor. I am a GI surgeon and you would not believe how many patients ask me solutions about the problems caused by you guys. STROKES, yes STROKES, caused by you guys is the new epidemic. Nothing irritates me more than planned and manipulative idiocy, perpetuated by your profession. Like the "electromagnetic" bullshit of the early 20th century, your bullshit is next. Do yourself a favor, take the MCATs and become a real doctor.
whoa, take it easy there...you and smoked pole got it all wrong. Where did I say I was a chiropractor?!
Actually, i'm also an allopath...an allopath who appreciates our osteopathic, chiropractic, naturopathic brothers, but I guess my MPH doesn't allow me to consider medicine so confined and one sided. ;)
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md's who do not embrace CAM to some degree will be left behind imo. Healthcare without prevention, nutrition, supplementation, stress control, counselling etc and just remedial measures is sorely lacking, hence people looking for alternatives. Alot of drugs suck.
I agree....I'm just curious why you always post with so much medical jargain, it reads like a damn term paper :o Trying to impress anyone, or do you forget that not everyone on this board is an MD/DO? ::)
It's getbig, not studentdoctor...lighten up ;)
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A patient of mine who clearly needed colon resection secondary to UC, but her bullshit chiropracter told her that changing her diet, colonics, with spinal manipulation will cure her.
explain that to me.
That's it?!?!
That's what put you out?! You've got to be kidding me, you're on a mission against chiropractors because one of them gave one of your pts bad advice???
If you're ticked off about bad advice, why don't you go after personal trainers...you know how many PT's give out "medical advice", cause they're such experts ::)
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so what is the number of minutes you need to spend with a patient to give sound "conventional medicine" since you seem to be so well versed?
physical exam plus HPI in under 6 minutes...
BOOOOOOOOOOOOOOOOOM!!!!!!!!!!!!!!!!!!!!!!
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After 4 years of undergrad, 4 of medical school, 10 (yes 10 years) years of residency, I became a doctor. I am a GI surgeon and you would not believe how many patients ask me solutions about the problems caused by you guys. STROKES, yes STROKES, caused by you guys is the new epidemic. Nothing irritates me more than planned and manipulative idiocy, perpetuated by your profession. Like the "electromagnetic" bullshit of the early 20th century, your bullshit is next. Do yourself a favor, take the MCATs and become a real doctor.
Why is it that most MD's will always be sure to let their patients know of the dangers of a stroke when going to a chiropractor, but not to the hair salon? Be sure to let them know that only 1 in 20 million patients will get a stroke as a result of neck adjustments.
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That's it?!?!
That's what put you out?! You've got to be kidding me, you're on a mission against chiropractors because one of them gave one of your pts bad advice???
If you're ticked off about bad advice, why don't you go after personal trainers...you know how many PT's give out "medical advice", cause they're such experts ::)
In the future I hope chiro is not classified as alternative medicine, I have a feeling md's will not have a vendetta against it if this occurs. I will say there are many chiro's out there who continually bash conventional medicine(saying all drugs are bad for you ect.) and come off sounding no different then someone claiming a few needles put in a body can cure cancer. If the research in the future backs chiro(it looks like it will) then md's and chiros should work side by side to give patients optimal treatment.
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Going over my posts, I think i may have been a bit too harsh on your profession. I think conservative therapy is quite effective for ACUTE problems. However, chronic manipulations is plain "quackery."
Good point, I should probably tell my dad to stop taking the BP meds he was prescribed as his blood pressure is down now. ::)
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Good point, I should probably tell my dad to stop taking the BP meds he was prescribed as his blood pressure is down now. ::)
or maybe have him lay off the TACO BELL ;)
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I agree....I'm just curious why you always post with so much medical jargain, it reads like a damn term paper :o Trying to impress anyone, or do you forget that not everyone on this board is an MD/DO? ::)
It's getbig, not studentdoctor...lighten up ;)
meh i frequent some more advanced boards and when talking about medicine i tend to use proper terminology. if you look at some of my earlier posts i was one of the worst kinds of trolls. I certainly am not trying to impress anyone on this site, i just talk like that alot. Its actually a problem i forsee during patient intake, as i tend to use jargon as simple explanations make me feel like something is missing. I like to have questions answered with evidence and reasoning, not simple anecdotes. Geuss thats were it comes from.
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meh i frequent some more advanced boards and when talking about medicine i tend to use proper terminology. if you look at some of my earlier posts i was one of the worst kinds of trolls. I certainly am not trying to impress anyone on this site, i just talk like that alot. Its actually a problem i forsee during patient intake, as i tend to use jargon as simple explanations make me feel like something is missing. I like to have questions answered with evidence and reasoning, not simple anecdotes. Geuss thats were it comes from.
;)
gotcha, I guess that's why they're stepping up the whole "bed side manners" and patient interaction skills on the STEP II.
Me, I get tired being around it all day, and I enjoy escaping here to "unwind" with a few gayer than jokes and such ;D
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I am really not trying to be harsh. BUT THAT IS BULLSHIT. Keep on getting spinal adjustments and YOU WILL get a subluxation, and then you will feel REAL PAIN, and potential loss of bowel and urinary continence. I do not want to see you in my office for bowel incontinence due to these idiots. I am being harsh, but there is not other word to describe this profession. Honestly, arguing with these guys is like arguing with psychics. They know it is bullshit, I know it is bullshit, but they don't want their cash cow to die. I have nothing to gain by exposing these idiots, but if I can prevent one individual from going to these idiots, then these 3 minutes was worth it.
Even you have to admit there are way more bad doctors and doctors who are in it just to make money than there are bad chiropractors. My uncle just two weeks ago spent 9 days in the hospital with pain in his middle area. Doctors said it was a kidney stone. So they gave him medicine and said it would pass. Then they said it was a ruptured L2. Well after 9 days of not getting out of bed he called another guy who did acupuncture massage therapy. In 90 minutes my uncle get up out of bed and told everyone to fuck off and left the hospital. Now he feels better than he has in months. Doctors are in it for the money and really don't care much about the patient My personal experiences suck with doctors. Very incompetent and money hungry. I waited for one in his office for almost 4 hours. Once I got into his office I spent literally 37 seconds and he said he couldn't do anything (lymphodema(?) lower right leg) I later got a bill for $304. I called him and told his nurse to tell him to fuck off and if he wanted to come after me for the money then sue me. I would love to expose him. I never heard back from him. I truly think doctors are jealous of chiropractors cause they do take business away from them. But doctors are crooks so they will just charge someone else.
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Even you have to admit there are way more bad doctors and doctors who are in it just to make money than there are bad chiropractors. My uncle just two weeks ago spent 9 days in the hospital with pain in his middle area. Doctors said it was a kidney stone. So they gave him medicine and said it would pass. Then they said it was a ruptured L2. Well after 9 days of not getting out of bed he called another guy who did acupuncture massage therapy. In 90 minutes my uncle get up out of bed and told everyone to fuck off and left the hospital. Now he feels better than he has in months. Doctors are in it for the money and really don't care much about the patient My personal experiences suck with doctors. Very incompetent and money hungry. I waited for one in his office for almost 4 hours. Once I got into his office I spent literally 37 seconds and he said he couldn't do anything (lymphodema(?) lower right leg) I later got a bill for $304. I called him and told his nurse to tell him to fuck off and if he wanted to come after me for the money then sue me. I would love to expose him. I never heard back from him. I truly think doctors are jealous of chiropractors cause they do take business away from them. But doctors are crooks so they will just charge someone else.
I am done discussing this topic, I have said what I need to. Just be careful Onlyme, both of chiropracters and doctors. One manipulates peoples fears for there own gain and one manipulates science for their own gain. I guess it is best for one to choose the best poison. I am almost 40 years old now, and quite frankly excessive materialism has adversely affected my field, and you are right, but that is a completely new pandoras box. My only concern with chiropracters (bullshitters) is the manipulative way they use patients. I guess I have a subjective view due to my own experiences, and you have a subjective view due to your experiences. There is not point to talk about this anymore, the only way anyone will change their minds is to personally be proven otherwise.
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physical exam plus HPI in under 6 minutes...
BOOOOOOOOOOOOOOOOOM!!!!!!!!!!!!!!!!!!!!!!
Next time you see my wheeling my surgical instruments through the mall or catch me giving physicals in
a kiosk at a a convention center then i'll be "owned"
Till then i'm content to be doing what I do and reaping the rewards both from my patients and from my
banker which I can assure you are more than enough.
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Just had an adjustment on monday!!
Maybe next time I'll yell out "Look Ma, no stroke!!" just to piss my friend off. :)
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I have adjusted over 135,000 patients in 18 years of being a chiropractor.
Never had one problem with one patient in any way.
That's the most unbelievable statement I've heard in years. 135 000 patients and no adverse events! You must be Jesus or some other supernatural being. Either that, or you simply don't follow up your patients at all to register side-effects.
Based on the review cited below, 30 to 60% of the patients experience at least mild adverse events:
Ernst E. Chiropractic: A Critical Evaluation. Journal of Pain and Symptom Management 2008;35(5):544-562.
CD
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Aww, leave him alone. He just feels threatened....
I don't think so. It appears to me that chiropractic is not scientifically supported at all, based on the reviews I've seen.
CD
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so what is the number of minutes you need to spend with a patient to give sound "conventional medicine" since you seem to be so well versed?
Ouch. You seem to have me in your sights. Don't take it so personally. Conventional medicine - of which I am a subscriber - is now one of assembly line here in Canada. If, and when, I need to see my doc (who is a 1st-rate guy- "If you're not sick, don't come and see me") which is maybe every 3-5 years, I arrive with a good idea what is wrong, having done a bit of the legwork, and I leave after 5-10 minutes because I know he and his compadres have their hands full with a waiting room full of GOMERS. I'm just dealing with the situation as it stands, is all. Satisfied? :)
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A patient of mine who clearly needed colon resection secondary to UC, but her bullshit chiropracter told her that changing her diet, colonics, with spinal manipulation will cure her.
explain that to me.
I went in for right shoulder surgery.
They wrote, in black ink, "R" on my right shoulder.
Why do they do this, Mr. Angry wanna-be MD?
Because it so happens that sometimes, errant MD's amputate or perform surgery on the WRONG LIMB.
Don't worry, I really don't expect you to respond to this.
Get back to the books.
Oh, and no one really wants to hear from you again until you are OUT OF SCHOOL.
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That's the most unbelievable statement I've heard in years. 135 000 patients and no adverse events! You must be Jesus or some other supernatural being. Either that, or you simply don't follow up your patients at all to register side-effects.
Based on the review cited below, 30 to 60% of the patients experience at least mild adverse events:
Ernst E. Chiropractic: A Critical Evaluation. Journal of Pain and Symptom Management 2008;35(5):544-562.
Well, you are mediocre and must expect failuer in your life if you cannot believe success.
HTH
CD
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I am really not trying to be harsh. BUT THAT IS BULLSHIT. Keep on getting spinal adjustments and YOU WILL get a subluxation, and then you will feel REAL PAIN, and potential loss of bowel and urinary continence. I do not want to see you in my office for bowel incontinence due to these idiots. I am being harsh, but there is not other word to describe this profession. Honestly, arguing with these guys is like arguing with psychics. They know it is bullshit, I know it is bullshit, but they don't want their cash [/b] cow to die. I have nothing to gain by exposing these idiots, but if I can prevent one individual from going to these idiots, then these 3 minutes was worth it.
Hence, your motivation here. As I said, your anger stems from $, or what will be lack of it.
Just how do you propose to do your unbiased "study", as you laughbly call it, with such preconceived notions?
Answer: you won't.
You are a LIGHTWEIGHT. There are millions of people just like you.
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Thank you for the response doc and sorry about the tiff we had before.
No problemo, big guy. All good in the hood.
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Going over my posts, I think i may have been a bit too harsh on your profession. I think conservative therapy is quite effective for ACUTE problems. However, chronic manipulations is plain "quackery." I would also like to admit that yes MDs make may mistakes. However, it is just stupidity to state that MDs make much more mistakes than chiropracters. You can look at the NFL, NBA, NHL, and all competitive NCAA programs. All of their sport medicine doctors are real doctors (usuallly orthopods), not one chiropracter. Although chiropracters work with these teams, they work UNDER the guidance of MDs. The problem with chiropracters is that you guys manipulate and mislead the general public. Your profession is not based on science, as defined by evidence based medicine. There is nothing wrong with SOME techniques of your profession, but the MAJORITY of your profession is just plain BULLSHIT. You know it and I know it. You can peddle your bullshit as much as you want, but at the end of the day you have to ask yourself if making money of other people's misery is worth the money. Money will come and go but your legacy of bullshit will smell forever. The only purpose of this thread to make aware to the general public that may be mislead by your crap. Clearly your defensive posts by you and your colleagues reiterates your insecurity and guilt of your profession. To others, do you really want to place your Central Nervous System on an individual that believes scientific research is "jazz."
cheers,
bodybuildermdpitt
I have no insecurity. I am at the end of my career, at peace at how many I have helped and money I have made.
In CT, as a chiropractor, I have point of access to patients, can order all blood tests, urine, EMG, CT, MRI with without contrast...all tests and diagnostic studies. The state license says I am a "Physician".
But I don't get caught up in this shit. You do. And because of that, your patients(if you have any) will smell your 'Ivory Tower' attitude, and you will Fail.
Young man, understand this:
MANY , MANY of all types of doctors DO NOT MAKE IT.
I have. And I am about done.
What about you?
Think of all those loans you must pay back.
The years of incredible overhead you will pay.
Fucking your office manager, your second wife divorcing you.
Are you ready for the public dole?
I hope your country has a Government cheese program.
Dr. Moosejay Approved ;)
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Well, you are mediocre and must expect failuer in your life if you cannot believe success.
HTH
All clinicians who see a lot of patients experience adverse effects in some patients during or after treatment. This has nothing to do with mediocracy but with the imprecise nature of diagnoses and treatments as well as unforseable interaction between treatment and some parameter in the patient. This makes it hard to believe that you never have seen adverse effects.
CD
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What's the difference between a doctor and God?
God doesn't think he's a doctor ;D BOOOOOOOOOOOOOOOOOOOM!
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Even you have to admit there are way more bad doctors and doctors who are in it just to make money than there are bad chiropractors. My uncle just two weeks ago spent 9 days in the hospital with pain in his middle area. Doctors said it was a kidney stone. So they gave him medicine and said it would pass. Then they said it was a ruptured L2. Well after 9 days of not getting out of bed he called another guy who did acupuncture massage therapy. In 90 minutes my uncle get up out of bed and told everyone to fuck off and left the hospital. Now he feels better than he has in months. Doctors are in it for the money and really don't care much about the patient My personal experiences suck with doctors. Very incompetent and money hungry. I waited for one in his office for almost 4 hours. Once I got into his office I spent literally 37 seconds and he said he couldn't do anything (lymphodema(?) lower right leg) I later got a bill for $304. I called him and told his nurse to tell him to fuck off and if he wanted to come after me for the money then sue me. I would love to expose him. I never heard back from him. I truly think doctors are jealous of chiropractors cause they do take business away from them. But doctors are crooks so they will just charge someone else.
Much of it stems from this
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All clinicians who see a lot of patients experience adverse effects in some patients during or after treatment. This has nothing to do with mediocracy but with the imprecise nature of diagnoses and treatments as well as unforseable interaction between treatment and some parameter in the patient. This makes it hard to believe that you never have seen adverse effects.
CD
Of course there are adverse effects. I even tell them there will be increased soreness. I have NEVER heard of a colleague's pt stroking out, or had any of mine stroke out.
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moosejay you keep misinterpreting the fact that botched medical precedures are a symptom of a poor doctor not of the medical field, as i would suggest chiropractors complaints stem.
however, medicine is evidence based and has built itself on science and has mounds of evidence for its procedures. Chiropractic care has little evidence and a search of pubmed reveals it may be useless.
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moosejay you keep misinterpreting the fact that botched medical precedures are a symptom of a poor doctor not of the medical field, as i would suggest chiropractors complaints stem.
however, medicine is evidence based and has built itself on science and has mounds of evidence for its procedures. Chiropractic care has little evidence and a search of pubmed reveals it may be useless.
Ok. I'll play Devil's Advocate and point out that the AMA and it's relationship to medical malpractice is akin to police departments and 'internal investigations' - almost a forgone conclusion as to outcome. ;) :D
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I have no insecurity. I am at the end of my career, at peace at how many I have helped and money I have made.
In CT, as a chiropractor, I have point of access to patients, can order all blood tests, urine, EMG, CT, MRI with without contrast...all tests and diagnostic studies. The state license says I am a "Physician".
But I don't get caught up in this shit. You do. And because of that, your patients(if you have any) will smell your 'Ivory Tower' attitude, and you will Fail.
Young man, understand this:
MANY , MANY of all types of doctors DO NOT MAKE IT.
I have. And I am about done.
What about you?
Think of all those loans you must pay back.
The years of incredible overhead you will pay.
Fucking your office manager, your second wife divorcing you.
Are you ready for the public dole?
I hope your country has a Government cheese program.
Dr. Moosejay Approved ;)
First of all please address me by my proper title which is doctor, and I will address you by your proper title which is bullshitter. Mr. Bullshitter, I am not here to argue about my age or my credentials, I am here to argue about science, but talking to you is talking to a wall, since YOU DON'T PRACTICE SCIENCE. The most funny thing is that you can not come up with one scientific paper to support your chronic adjustments. You refer to scientific research as "Jazz." When you get sick, which you will Mr. Bullshitter, and you will come to me for help, I will help you. I have the knowledge and the training that you desperately seek. However, the wait to see me is at least 3 months, because I am that busy. You will take out your checkbook and beg and cry, and offer to give me your entire bank account to help you. However, I am sorry, but I make that much in one day, and quite frankly money doesn't motivate me (like you Mr. Bullshitter), it is the advancement of science and the need to actually help people. I can only physically operate 3 days a week, and I also need to live a life. As you sit there in pain for 3 months, then you will know and understand the pain and suffering your profession willingly places on other people for your own sick and private benefits. The difference between you and me is that I cure this type of pain, while you CAUSE AND EXPLOIT this pain for the mighty $$$. I hope you enjoy your future and sleep well at night.
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Just as much as alerting people to anyone who was doing harm in any type of profession.
yes. I'm just pointing out that criticism can be productive, and dismissing it as hating may endear you to urban adolescents but it is not a very convincing counter-argument.
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I have a clinical question I am thinking of researching with a colleague of mine. It deals with neck readjustments and CVAs (strokes). Have any of you guys had chronic neck readjustments from chiropractors? If so, what was the reason, and does it help? Also, did the chiropractor read any images for you, and try to diagnose you from his interpretation of the images? I am trying to start a study (obviously it is in its very early inception), as of now I am trying to get some basic brain storming ideas.
cheers,
bodybuildingmdpitt
Damn bro, I am surprised that you came on Getbig Gossip board to "ask a clinical question" ::) Pretty obvious that you had another agenda and want to stir up shit. I am beginning to think that you are a gimmick poster. In fact, I kind of hope that you are, since I know of no Dr's (and I know a few) who would waste their time to come on Getbig when they are soooooo busy as you say you are.
I can bore you with many personal stories that I know of how Dr's have cost or almost cost people their lives with misdiagnoses that should have been VERY easy to catch. You act like it is an epidemic with chiropractors causing strokes. The medical industry is quickly becoming a joke due to over prescribing of deadly pharmaceutical drugs put out by greedy drug companies and they are making the Dr's into nothing more than legal drug pushers.
There's an old saying that you may have heard, but it is worth repeating here. You know what they call a Dr who graduated last in his class? Doctor. :-[
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I also think doctors are jealous of chiroprators cause they spend less money becoming a chiropractor than a doctor does. A doctor is so in debt by the time they actually get to start making money that it is stressful.
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I also think doctors are jealous of chiroprators cause they spend less money becoming a chiropractor than a doctor does. A doctor is so in debt by the time they actually get to start making money that it is stressful.
is there something wrong with you? most doctors are not in it to make money and my peers rarely complain about money, you're off target my friend. No one is jealous of a profession with no scientific backing nor evidence for its treatments.
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No problemo, big guy. All good in the hood.
Which Connecticut hood are you from?
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First of all please address me by my proper title which is doctor, and I will address you by your proper title which is bullshitter. Mr. Bullshitter, I am not here to argue about my age or my credentials, I am here to argue about science, but talking to you is talking to a wall, since YOU DON'T PRACTICE SCIENCE. The most funny thing is that you can not come up with one scientific paper to support your chronic adjustments. You refer to scientific research as "Jazz." When you get sick, which you will Mr. Bullshitter, and you will come to me for help, I will help you. I have the knowledge and the training that you desperately seek. However, the wait to see me is at least 3 months, because I am that busy. You will take out your checkbook and beg and cry, and offer to give me your entire bank account to help you. However, I am sorry, but I make that much in one day, and quite frankly money doesn't motivate me (like you Mr. Bullshitter), it is the advancement of science and the need to actually help people. I can only physically operate 3 days a week, and I also need to live a life. As you sit there in pain for 3 months, then you will know and understand the pain and suffering your profession willingly places on other people for your own sick and private benefits. The difference between you and me is that I cure this type of pain, while you CAUSE AND EXPLOIT this pain for the mighty $$$. I hope you enjoy your future and sleep well at night.
The Yale MD's who I treat see me without a wait.
Hope this helps! :)
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is there something wrong with you? most doctors are not in it to make money and my peers rarely complain about money, you're off target my friend. No one is jealous of a profession with no scientific backing nor evidence for its treatments.
You,sir, have smoked way too much pole! :D
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Which Connecticut hood are you from?
New Haven/Hamden
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Damn bro, I am surprised that you came on Getbig Gossip board to "ask a clinical question" ::) Pretty obvious that you had another agenda and want to stir up shit. I am beginning to think that you are a gimmick poster. In fact, I kind of hope that you are, since I know of no Dr's (and I know a few) who would waste their time to come on Getbig when they are soooooo busy as you say you are.
I can bore you with many personal stories that I know of how Dr's have cost or almost cost people their lives with misdiagnoses that should have been VERY easy to catch. You act like it is an epidemic with chiropractors causing strokes. The medical industry is quickly becoming a joke due to over prescribing of deadly pharmaceutical drugs put out by greedy drug companies and they are making the Dr's into nothing more than legal drug pushers.
There's an old saying that you may have heard, but it is worth repeating here. You know what they call a Dr who graduated last in his class? Doctor. :-[
Good post
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is there something wrong with you? most doctors are not in it to make money and my peers rarely complain about money, you're off target my friend. No one is jealous of a profession with no scientific backing nor evidence for its treatments.
LMAO!!! ;D
Sorry, gotta disagree with you here my friend. Speaking from personal experience, i'd say that 95% of physicians are in it for the prestige, the RESPECT, the title......and oh yeah, the MONEY!!!! ;D
If this were really true, and if doctors were in it for really helping people, than I doubt most of them would be some of the worst, most selfish, back-stabbing people I've ever met :o
You don't have to be a brain surgeon to HELP SOMEONE (which is supposedly why they're all docs, right), when you can start with first having common manners, most of which lack or feel they are above.
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To me at least, it seems that many Chiropractors seem to be aware of the relationship between nutrition, lifestyle and pathology. Most, not all, MDs never seem to address these issues. Many people have disorders that came about from years of poor eating, stress, lack of exercise, nutritional deficiencies. Instead of addressing these problems, the MD will precribe a DRUG or offer surgery as the solution. When fat kids drinking tons of soda and eating buckets of sugar a day suddenly get diabetes, they're put on Insulin for life. No one ever thinks about maybe changing the kids diet so eventually his pancreas starts functioning properly again. Whatever problem some one has, a drug is prescribed. Eventually more disorders arise from the side effects of the drug. At least some Chiropractors have the common sense to try to see if the persons dietary or lifestyle habits have contributed to the person's illness. That's not so foolish if you ask me. Also if someone's vertebrae is out of whack, what's so bad about having it adjusted?
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To me at least, it seems that many Chiropractors seem to be aware of the relationship between nutrition, lifestyle and pathology. Most, not all, MDs never seem to address these issues. Many people have disorders that came about from years of poor eating, stress, lack of exercise, nutritional deficiencies. Instead of addressing these problems, the MD will precribe a DRUG or offer surgery as the solution. When fat kids drinking tons of soda and eating buckets of sugar a day suddenly get diabetes, they're put on Insulin for life. No one ever thinks about maybe changing the kids diet so eventually his pancreas starts functioning properly again. Whatever problem some one has, a drug is prescribed. Eventually more disorders arise from the side effects of the drug. At least some Chiropractors have the common sense to try to see if the persons dietary or lifestyle habits have contributed to the person's illness. That's not so foolish if you ask me. Also if someone's vertebrae is out of whack, what's so bad about having it adjusted?
That's a good point! Of course it's up to the individual, but on average, MD's don't know crap about nutrition! Which is really a huge surprise for me considering more than half of the top ten killers in the US being related to nutrition/lifestyle.
Med school is 4 years, and of that four years, about two days worth of lectures are on nutrition...that's it ::)
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To me at least, it seems that many Chiropractors seem to be aware of the relationship between nutrition, lifestyle and pathology. Most, not all, MDs never seem to address these issues. Many people have disorders that came about from years of poor eating, stress, lack of exercise, nutritional deficiencies. Instead of addressing these problems, the MD will precribe a DRUG or offer surgery as the solution. When fat kids drinking tons of soda and eating buckets of sugar a day suddenly get diabetes, they're put on Insulin for life. No one ever thinks about maybe changing the kids diet so eventually his pancreas starts functioning properly again. Whatever problem some one has, a drug is prescribed. Eventually more disorders arise from the side effects of the drug. At least some Chiropractors have the common sense to try to see if the persons dietary or lifestyle habits have contributed to the person's illness. That's not so foolish if you ask me. Also if someone's vertebrae is out of whack, what's so bad about having it adjusted?
As always, Chem, your words ring true
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You,sir, have smoked way too much pole! :D
HAHA good one Moose.
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is there something wrong with you? most doctors are not in it to make money and my peers rarely complain about money, you're off target my friend. No one is jealous of a profession with no scientific backing nor evidence for its treatments.
You are wrong. Just take it when a doctor won't see a patient without insurance (or hospital). Or how they gouge the insurance companies. How they make you go into the office for literally 3 minutes and charge you $140+ just to get a presrciption. Very few and I mean very few doctors do anything unless there is money involved. Until from 1976 till 1998 (when I got bit) I had been to a doctor 3 times (once in 1983 when I ruptured my L4 and L5, once in 1993 when I ruptured my achilles tendon and again around 1997 or so when I got a BB taken out of my finger I had in there since 1978 or so). I hate doctors. But since my bie I have had to go quite a few times.
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To me at least, it seems that many Chiropractors seem to be aware of the relationship between nutrition, lifestyle and pathology. Most, not all, MDs never seem to address these issues. Many people have disorders that came about from years of poor eating, stress, lack of exercise, nutritional deficiencies. Instead of addressing these problems, the MD will precribe a DRUG or offer surgery as the solution. When fat kids drinking tons of soda and eating buckets of sugar a day suddenly get diabetes, they're put on Insulin for life. No one ever thinks about maybe changing the kids diet so eventually his pancreas starts functioning properly again. Whatever problem some one has, a drug is prescribed. Eventually more disorders arise from the side effects of the drug. At least some Chiropractors have the common sense to try to see if the persons dietary or lifestyle habits have contributed to the person's illness. That's not so foolish if you ask me. Also if someone's vertebrae is out of whack, what's so bad about having it adjusted?
actually thats wrong info...
in Harrison's book of Internal Medicine the first treatment for that kind of kid would be lifestyle modification and drugs+insulin comes last, i don't know what kind of doctor your talking about , just stating the facts...
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Moosejay;
135Kpatients/18 years = 7,500/year= /50weeks= 150week=/5days=30 patients per day=/8hours=3.75 patients per hour-everyday, 50 weeks per year for 18 years.......Me thinks MJ exaggerating.
anytime I've gone in to get my back cracked... less then 5 min. I am sure he can get at least 8-10 visits in n hour
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anytime I've gone in to get my back cracked... less then 5 min. I am sure he can get at least 8-10 visits in n hour
Yeah the actual time on the adjustment table is very short, like you said less than 5 mins thats for sure, the actual time is more like 2 mins.
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http://www.medicalnewstoday.com/articles/11856.php
Some studies show that nearly 100,000 people DIE each year from medical errors.
To put this in perspective, since 2001 approximately 3,000 Americans have died from acts of terrorism.
During that same time frame, somewhere on the order of 500,000 Americans have died from medical errors.
I have no horse in this race.
My wife will be graduating dental school this year, which some would say is school for those that couldn't get into medical school.....so I suppose I can sympathize with both parties.
The truth of the matter is, people die every day in large numbers from various forms of health care malpractice. This comes from many reasons, not the least of which is the fact that "status" seems to hold much more weight for health care practitioners than "altruism" could ever hope to hold.
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http://www.medicalnewstoday.com/articles/11856.php
Some studies show that nearly 100,000 people DIE each year from medical errors.
To put this in perspective, since 2001 approximately 3,000 Americans have died from acts of terrorism.
During that same time frame, somewhere on the order of 500,000 Americans have died from medical errors.
I have no horse in this race.
My wife will be graduating dental school this year, which some would say is school for those that couldn't get into medical school.....so I suppose I can sympathize with both parties.
The truth of the matter is, people die every day in large numbers from various forms of health care malpractice. This comes from many reasons, not the least of which is the fact that "status" seems to hold much more weight for health care practitioners than "altruism" could ever hope to hold.
That's only because 'altruism' doesn't lobby Congress as successfully as the AMA. ;)
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http://www.medicalnewstoday.com/articles/11856.php
Some studies show that nearly 100,000 people DIE each year from medical errors.
To put this in perspective, since 2001 approximately 3,000 Americans have died from acts of terrorism.
During that same time frame, somewhere on the order of 500,000 Americans have died from medical errors.
lol, if you really wanted to put it into perspective you would've posted the number of people that see a doctor every year ;)
(home physicians, ER, family practice, private practices, hospitals etc.)
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lol, if you really wanted to put it into perspective you would've posted the number of people that see a doctor every year ;)
(home physicians, ER, family practice, private practices, hospitals etc.)
Would percentages be better?
25% of Medicare patients who were hospitalized from 2000 to 2002 and experienced a patient-safety incident died.
81% of the total 323,993 deaths among Medicare patients in those years who developed one or more patient-safety incidents were directly attributable to the incident(s).
Percentages remove some of the ambiguity that numbers can create.
The point isn't necessarily the numbers or the percentages. The point is that no health care professional is infallible.
All parties should recognize and consider this truth every time they're a "patient," regardless of the circumstances.
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bodybuildermdpitt,man i've got a question for you,what do you think about acupuncture? it is any good to treat minor musculars problems like infiammations,stiffness?
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http://www.medicalnewstoday.com/articles/11856.php
Some studies show that nearly 100,000 people DIE each year from medical errors.
To put this in perspective, since 2001 approximately 3,000 Americans have died from acts of terrorism.
During that same time frame, somewhere on the order of 500,000 Americans have died from medical errors.
I have no horse in this race.
My wife will be graduating dental school this year, which some would say is school for those that couldn't get into medical school.....so I suppose I can sympathize with both parties.
The truth of the matter is, people die every day in large numbers from various forms of health care malpractice. This comes from many reasons, not the least of which is the fact that "status" seems to hold much more weight for health care practitioners than "altruism" could ever hope to hold.
Okay, fine...I agree with that.
But here's why you can't simply compare medicine with other fields of healthcare.
How many terminally ill patients do other fields of healthcare deal with? Seriously, somebody goes to a chiropracter for a stiff neck, compared to someone coming in for end-stage renal disease, or DVT at a hospital. You're telling me the number of deaths in those two cases equal the same?! no! In fact, in that case I would tend to agree more with "bodybuildermdpitt" that the number of deaths due to malpractice in other fields is far less acceptible than in medicine. I hate to put this bluntly, but most of the time, ESPECIALLY with the poor, uneducated, and elderly, they don't come to see a doctor until it's too late...then when they die it's due to medical errors ::) please ::)
the point of my little rant is that no, medicine isn't perfect, but it's dealing with an entirely different set of problem than say chiropractors or naturopaths deal with, so you can't just compare the numbers.
Oh, and congrats to your wife ;)
I just had a friend get rejected from every dental school he applied to, so I know it's not easy
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the point of my little rant is that no, medicine isn't perfect, but it's dealing with an entirely different set of problem than say chiropractors or naturopaths deal with, so you can't just compare the numbers.
Oh, and congrats to your wife ;)
I just had a friend get rejected from every dental school he applied to, so I know it's not easy
Yeah, she's the brains in our outfit. Her path to dentistry is a bit odd. She was pre-law in undergrad and turned down a full-ride scholarship to law school to return to undergrad for dental pre-requisites.
It may appear that I'm siding with chiropractors, which isn't the case. There are many problems with the situations in this thread.
Physicians have the only job where they're not "allowed" to make a mistake.
Unfortunately, this seems to exaccerbate the "status" problem to fuel the scenario where physicians refuse to admit that they're not perfect.
With hiding sentinel events somewhat of a "learned skill" in hospitals, there is a lot of room for improvements for anyone that is involved in "treating" a patient.
I'm very pro physicians, especially the commitment in time, energy, and years to become one.
I'm very anti-arrogance and authoritarian statements though.
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New Haven/Hamden
that shit is gangsta.
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that shit is gangsta.
Yeah...some of New Haven is dangerous...but it has improved quite a bit.
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I'm very pro physicians, especially the commitment in time, energy, and years to become one.
I'm very anti-arrogance and authoritarian statements though.
I hear that! ;)
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Yeah...some of New Haven is dangerous...but it has improved quite a bit.
I grew up in Cleveland. We used to sit at the bus stop and talk about all the crazy shit those New Haven gangbangers did. Ruthless dudes!
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I grew up in Cleveland. We used to sit at the bus stop and talk about all the crazy shit those New Haven gangbangers did. Ruthless dudes!
REALLY?
That rep travelled that far?
Once, we were causing havoc on a city bus when we were, like, in 9th grade.
The bus driver had had enough...let us ALL out on a route called 'Congress Avenue'...lemme tell you...we were in prep school, and all were wearing ties.
I expected a real, down-home , Louisiana ass-kicking...but.,..somehow, we managed to get home alive.
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http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080613/chiro_lawsuit_080613/20080613?hub=TopStories
:(
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REALLY?
That rep travelled that far?
Once, we were causing havoc on a city bus when we were, like, in 9th grade.
The bus driver had had enough...let us ALL out on a route called 'Congress Avenue'...lemme tell you...we were in prep school, and all were wearing ties.
I expected a real, down-home , Louisiana ass-kicking...but.,..somehow, we managed to get home alive.
I watched a biography on N.W.A. and other pioneers of rap. The cite that Connecticut prep school bus near-scuffle as the inspiration for their own criminal tales.
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I watched a biography on N.W.A. and other pioneers of rap. The cite that Connecticut prep school bus near-scuffle as the inspiration for their own criminal tales.
Huh...I did not know that!
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Huh...I did not know that!
it's true. connecticut is where all this gangster shit began.
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it's true. connecticut is where all this gangster shit began.
I will have to check with my peeps on that
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Hmmm. Interesting article in today's Globe & Mail. An Alberta couple is not only suing their chiropractor, but instigating a $500-million class-action suit against the the whole profession! The game is afoot!
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Hmmm. Interesting article in today's Globe & Mail. An Alberta couple is not only suing their chiropractor, but instigating a $500-million class-action suit against the the whole profession! The game is afoot!
no big news any and every health profession is under some form of lawsuit at any given time, unfortunately these are the times we live in.
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To the doctors out there. What do you think of Chinese medicine and the use of herbs and acupuncture. Is that all bullshit too.
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no big news any and every health profession is under some form of lawsuit at any given time, unfortunately these are the times we live in.
Yeah, I know but this article seemed to suggest to me a bit of a tipping point, not the usual litigious free-for-all. Ah well, we'll see how it plays out.
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To the doctors out there. What do you think of Chinese medicine and the use of herbs and acupuncture. Is that all bullshit too.
You should know that any medicine that doesn't use pharmaceutical drugs and surgery as it's primary method of treatment will be viewed as "Bullshit" from the majority of traditional doctors. Most clinical trials and medical research is funded by pharmaceutical companies, so obviously the idea is to sell the doctors and the general public on using as much medications as possible. First of all, the average person isn't going to make the effort to insure he isn't suffering from nutritional deficiencies, doesn't know how to manage stress levels, doesn't know anything about maintaining a proper PH balance, doesn't understand the importance of getting proper rest or exercise. They get sick..and they want to go to a doctor to take a drug for an instant cure. Never mind it make have taken them years of improper lifestyle habits to manifest their disease. We live in a quick fix society and that's why we have the system we do. For the few that have true knowledge of health, they are less likely to get on the Medical Merry-go Round. Of course people who bring up these points are labeled "Health Nuts", as if it's nutty to seek understanding about disease prevention as opposed to pharmaceutically managing a symptom.
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You should know that any medicine that doesn't use pharmaceutical drugs and surgery as it's primary method of treatment will be viewed as "Bullshit" from the majority of traditional doctors. Most clinical trials and medical research is funded by pharmaceutical companies, so obviously the idea is to sell the doctors and the general public on using as much medications as possible. First of all, the average person isn't going to make the effort to insure he isn't suffering from nutritional deficiencies, doesn't know how to manage stress levels, doesn't know anything about maintaining a proper PH balance, doesn't understand the importance of getting proper rest or exercise. They get sick..and they want to go to a doctor to take a drug for an instant cure. Never mind it make have taken them years of improper lifestyle habits to manifest their disease. We live in a quick fix society and that's why we have the system we do. For the few that have true knowledge of health, they are less likely to get on the Medical Merry-go Round. Of course people who bring up these points are labeled "Health Nuts", as if it's nutty to seek understanding about disease prevention as opposed to pharmaceutically managing a symptom.
The funny thing is the person I go to his family has been in the business for 300 years. He has all kinds of old stuff handed down from his ancestors. He turned a 3 bedroom house into a herbal factory. He travels around the world collecting the best and most potent herbs and he does everything from this house. He sell it for $60 a gallon. At least that is what my mixture costs. He has more than 80 medical doctors come to him for his mixture. Several top executives including Steve Wynn is on a weekly consumption of this stuff. He is very well known and does absolutely no advertising. 100% word of mouth. It just shows that the people who charge everyone else for drugs in reality believe in the cures and treatments that aren't FDA approved. He also treat many of these same doctors and their relatives with acupuncture and massage therapy.
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The funny thing is the person I go to his family has been in the business for 300 years. He has all kinds of old stuff handed down from his ancestors. He turned a 3 bedroom house into a herbal factory. He travels around the world collecting the best and most potent herbs and he does everything from this house. He sell it for $60 a gallon. At least that is what my mixture costs. He has more than 80 medical doctors come to him for his mixture. Several top executives including Steve Wynn is on a weekly consumption of this stuff. He is very well known and does absolutely no advertising. 100% word of mouth. It just shows that the people who charge everyone else for drugs in reality believe in the cures and treatments that aren't FDA approved. He also treat many of these same doctors and their relatives with acupuncture and massage therapy.
That's interesting to know, kind of like where I read about some Oncologists that have come down with Stage 4 Cancer themselves, and have traveled to Germany for some cutting edge treatments as opposed to the failed standard chemotherapy and radiation protocols. As far as your doctor goes, there can be some very potent herbs out there, and if he wasn't getting results, people wouldn't be giving him referrals. Steve Wynn can obviously afford to go anywhere he wants and for some reason he believes in this guy. I think I read somewhere that you said you were starting to slowly get yourself to lose a bit of weight. If that's true, I hope you continue, for the sake of your health. My good friend, NPC judge and contest promoter John Organ just dropped dead of a massive heart attack at 49 a few weeks back. He had gotten fairly obese in the last few years and I never was able to get him to follow a diet. The ironic thing is he was still doing personal training and telling everyone else what to eat. Just stay on track bro, and keep slowly lowering those carbs a bit. And give up your hostility for Vince Goodrum LOL..bad for your blood pressure. Ha ha.
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That's interesting to know, kind of like where I read about some Oncologists that have come down with Stage 4 Cancer themselves, and have traveled to Germany for some cutting edge treatments as opposed to the failed standard chemotherapy and radiation protocols. As far as your doctor goes, there can be some very potent herbs out there, and if he wasn't getting results, people wouldn't be giving him referrals. Steve Wynn can obviously afford to go anywhere he wants and for some reason he believes in this guy. I think I read somewhere that you said you were starting to slowly get yourself to lose a bit of weight. If that's true, I hope you continue, for the sake of your health. My good friend, NPC judge and contest promoter John Organ just dropped dead of a massive heart attack at 49 a few weeks back. He had gotten fairly obese in the last few years and I never was able to get him to follow a diet. The ironic thing is he was still doing personal training and telling everyone else what to eat. Just stay on track bro, and keep slowly lowering those carbs a bit. And give up your hostility for Vince Goodrum LOL..bad for your blood pressure. Ha ha.
I am doing very good. And as for Goodrum, he doesn't even get my eyes to blink. He is one big reason why this place is fun for me. I mean I get to make fun of a guy who deserves being made fun of and I don't get in trouble. If anything he is a stress reliever.
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bizump for the recent threads about Chiros :-*
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Your Guide to Quackery, Health Fraud, and Intelligent Decisions Send This Page to a Friend
Chiropractic's Dirty Secret:
Neck Manipulation and Strokes
Stephen Barrett, M.D.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The injury often results from extreme rotation in which the practitioner's hands are placed on the patient's head in order to rotate the cervical spine by rotating the head [1]. The vertebral artery, which is shown in the picture to the right, is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection [2].
Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.
Published Reports
In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.
A 1993 review concluded that potential complications and unknown benefits indicate that children should not undergo neck manipulation [4].
Louis Sportelli, DC, NCMIC president and a former ACA board chairman contends that chiropractic neck manipulation is quite safe. In an 1994 interview reported by the Associated Press, he reacted to the American Heart Association study by saying, "I yawned at it. It's old news." He also said that other studies suggest that chiropractic neck manipulation results in a stroke somewhere between one in a million and one in three million cases [5]. The one-in-a-million figure could be correct if California's chiropractors had been averaging about 60 neck manipulations per week. Later that year, during a televised interview with "Inside Edition," Sportelli said the "worst-case scenario" was one in 500,000 but added: "When you weigh the procedure against any other procedure in the health-care industry, it is probably the lowest risk factor of anything." According to the program's narrator, Sportelli said that 90% of his patients receive neck manipulation.
In 1996, RAND issued a booklet that tabulated more than 100 published case reports and estimated that the number of strokes, cord compressions, fractures, and large blood clots was 1.46 per million neck manipulations. Even though this number appears small, it is significant because many of the manipulations chiropractors do should not be done. In addition, as the report itself noted, neither the number of manipulations performed nor the number of complications has been systematically studied [6]. Since some people are more susceptible than others, it has also been argued that the incidence should be expressed as rate per patient rather than rate per adjustment.
In 1996, the National Chiropractic Mutual Insurance Company (NCMIC), which is the largest American chiropractic malpractice insurer, published a report called "Vertebrobasilar Stroke Following Manipulation," written by Allen G.J. Terrett, an Australian chiropractic educator/researcher. Terrett based his findings on 183 cases of vertebrobasilar strokes (VBS) reported between 1934 and 1994. He concluded that 105 of the manipulations had been administered by a chiropractor, 25 were done by a medical practitioner, 31 had been done by another type of practitioner, and that the practitioner type for the remaining 22 was not specified in the report. He concluded that VBS is "very rare," that current pretesting procedures are seldom able to predict susceptibility, and that in 25 cases serious injury might have been avoided if the practitioner had recognized that symptoms occurring after a manipulation indicated that further manipulations should not be done [7].
A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8].
In 2001, NCMIC published a second edition of Terrett's book, titled, "Current Concepts: Vertebrobasilar Complications following Spinal Manipulation," which covered 255 cases published between 1934 and 1999 [9]. NCMIC's Web site claims that the book "includes an analysis of every known case related to this subject." That description is not true. It does not include many strokes that resulted in lawsuits against NCMIC policyholders but were not published in scientific journals. And it does not include the thoroughly documented case of Kristi Bedenbauer whose autopsy report I personally mailed to Terrett after speaking with him in 1995.
In 2001, Canadian researchers published a report about the relationships between chiropractic care and the incidence of vertebrovascular accidents (VBAs) due to vertebral artery dissection or blockage in Ontario, Canada, between 1993 and 1998. Using hospital records, each of 582 VBA cases was age- and sex-matched to four controls with no history of stroke. Health insurance billing records were used to document use of chiropractic services. The study found that VBA patients under age 45 were five times more likely than controls to (a) have visited a chiropractor within a week of the VBA and (b) to have had three or more visits with neck manipulations. No relationship was found after age 45. The authors discuss possible shortcomings of the study and urge that further research be done [10]. An accompanying editorial states that the data correspond to an incidence of 1.3 cases of vertebral artery dissection or blockage per 100,000 individuals receiving chiropractic neck manipulation, a number higher than most chiropractic estimates [11].
In 2001, British researchers reported on a survey in which all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of neck manipulation over a 12-month period. The 35 reported cases included 7 strokes involving the vertebrobasilar artery and 2 strokes involving a carotid artery. None of the 35 cases were reported to medical journals [12]. Edzard Ernst, professor of complementary medicine at the University of Exeter School of Sport and Health Sciences, believes that these results are very significant. In a recent commentary, he stated:
One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%. This extreme level of underreporting obviously renders estimates nonsensical [13].
In 2002, researchers representing the Canadian Stroke Consortium reported on 98 cases in which external trauma ranging from "trivial" to "severe" was identified as the trigger of strokes caused by blood clots formed in arteries supplying the brain. Chiropractic-style neck manipulation was the apparent cause of 38 of the cases, 30 involving vertebral artery dissection and 8 involving carotid artery dissection. Other Canadian statistics indicate the incidence of ischemic strokes in people under 45 is about 750 a year. The researchers believe that their data indicate that 20% are due to neck manipulation, so there may be "gross underreporting" of chiropractic manipulation as a cause of stroke [14].
In 2003, another research team reviewed the records of 151 patients under age 60 with cervical arterial dissection and ischemic stroke or transient ischemic attack (TIA) from between 1995 and 2000 at two academic stroke centers. After an interview and a blinded chart review, 51 patients with dissection and 100 control patients were studied. Patients with dissection were more likely to have undergone spinal manipulation within 30 days (14% vs 3%). The authors concluded that spinal manipulation is associated with vertebral arterial dissection and that a significant increase in neck pain following neck manipulation warrants immediate medical evaluation [15].
In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients who had experienced vertebral artery dissection associated with neck manipulation [16]. Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations. In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care. This report is highly significant but needs careful interpretation. Although it is titled "Vertebral dissections after chiropractic neck manipulation . . . " only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath. It is possible—although unlikely—that the nonchiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists' treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.
Two subsequent reports have added to this denial. In the first study, 377 members of the British and Scottish Chiropractic Associations and more than 19,000 of their patients were asked whether complications had occurred following neck manipulations. No strokes were reported, but symptoms that may have indicated neurologic involvement—headache (reported in 3.9% of cases), numbness/tingling of the arms (1.3% of cases), and fainting/dizziness/lightheadedness (1.1% of cases) were reported. About 400 patients who discontinued treatment could not be reached for follow-up, so what happened to them is unknown [17]. The second study compared insurance billing records and hospital discharge records and concluded that (a) the incidence of strokes was following primary-care (medical) visits was similar to the incidence of strokes following chiropractic visits, and (b) therefore the strokes that occurred in chiropractic offices were not caused by the treatment they received [18]. However, the study is meaningless because—unlike the German Vertebral Artery Dissection Study Group—the researchers did not examine clinical records and were not able to determine whether the diagnoses they tabulated were accurate or whether the strokes were related to the type of manipulation.
Are Complications Predictable?
Some chiropractors advocate "screening tests" with the hope of detecting individuals prone to stroke due to neck manipulation [19-21]. These tests, which include holding the head and neck in positions of rotation to see whether the patient gets dizzy, are not reliable, partly because manipulation can rotate the neck further than can be done with the tests. Listening over the neck arteries with a stethoscope to detect a murmur, for example, has not been proven reliable, though patients that have one should be referred to a physician. Vascular function tests in which the patient's head is briefly held in the positions used during cervical manipulation are also not reliable as a screen for high-risk patients because a thrust that further stretches the vertebral artery could still damage the vessel wall." In a chapter in the leading chiropractic textbook, Terrett and a conclude have stated:
Even after performing the relevant case history, physical examination, and vertebrobasilar function tests, accidents may still occur. There is no conclusive, foolproof screening procedure to eliminate patients at risk. Most victims are young, without [bony] or vascular pathology, and do not present with vertebrobasilar symptoms. The screening procedures described cannot detect those patients in whom [manipulation] may cause an injury. They give a false sense of security to the practitioner [22].
Several medical reports have described chiropractic patients who, after neck manipulation, complained of dizziness and other symptoms of transient loss of blood supply to the brain but were manipulated again and had a full-blown stroke. During a workshop I attended at the 1995 Chiropractic Centennial Celebration, Terrett said such symptoms are ominous and that chiropractors should abandon rotational manipulations that overstretch the vertebral arteries. But, as far as I know, his remarks have not been published and have had no impact on his professional colleagues.
The lack of predictability has been supported by data published by Scott Haldeman, DC, MD, PhD, a chiropractor who has served as an expert witness (usually for the defense) in many court cases involving chiropractic injury. In 1995, he published an abstract summarizing his review of 53 cases that had not been previously reported in medical or chiropractic journals. His report stated:
These cases represent approximately a 45% increase in the number of such cases reported in the English language literature over the past 100 years. . . . No clear cut risk factors can be elicited from the data. Previously proposed risk factors such as migraine headaches, hypertension, diabetes, history of cardiovascular disease, oral contraceptives, recent head or neck trauma, or abnormalities on x-rays do not appear to be significantly greater in patients who have cerebrovascular complications of manipulation than that noted in the general population [23].
Haldeman's main point was he could not identify any factor that could predict that a particular patient was prone to cerebrovascular injury from neck manipulation. This report was published in the proceedings of 1995 Chiropractic Centennial Celebration and was not cited in either the RAND or NCMIC reports.
In 2001, Haldeman and two colleagues published a more detailed analysis that covered 64 cases involving malpractice claims filed between 1978 and 1994 [24]. They reported that 59 (92%) came to treatment with a history of head or neck symptoms. However, the report provides insufficient information to judge whether manipulation could have been useful for treating their condition. Of course, malpractice claims don't present the full story, because most victims of professional negligence do not take legal action. Even when serious injury results, some are simply not inclined toward suing, some don't blame the practitioner, some have an aversion to lawyers, and some can't find an attorney willing to represent them.
What Should Be Done?
Chiropractors cannot agree among themselves whether the problem is significant enough to inform patients that vertebrobasilar stroke is a possible complication of manipulation [21,25]. In 1993, the Canadian Chiropractic Association published a consent form which stated, in part:
Doctors of chiropractic, medical doctors, and physical therapists using manual therapy treatments for patients with neck problems such as yours are required to explain that there have been rare cases of injury to a vertebral artery as a result of treatment. Such an injury has been known to cause stroke, sometimes with serious neurological injury. The chances of this happening are extremely remote, approximately 1 per 1 million treatments.
Appropriate tests will be performed on you to help identify if you may be susceptible to that kind of injury. . . . [26].
This notice is a step in the right direction but does not go far enough. A proper consent should disclose that (a) the risk is unknown; (b) alternative treatments may be available; (c) in many cases, neck symptoms will go away without treatment; (d) certain types of neck manipulation carry a higher risk than others; and (e) claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rationale.
In 2003, a coroner's jury concluded that Lana Dale Lewis of Toronto, Canada, was killed in 1996 by a chiropractic neck manipulation. Among other things, the jury recommended that all patients for whom neck manipulation is recommended be informed that risk exists and that the Ontario Ministry of Health establish a database for chiropractors and other health professionals to report on neck adjustments [27].
In 2005, the Canadian Chiropractic Association published a comprehensive clinical guideline for treatment of adult neck pain not due to whiplash.. Among other things, the document noted that very few studies have compared chiropractic treatment to no treatment, which means that it is difficult to determine the likely benefit of neck manipulation. The guideline also discussed risk factors and recommended that minimal rotation should be used when upper-neck manipulation is done [28,29].
In 2007, following an unnecessary neck manipulation, Sandra Nette developed "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube [30]. In 2008, she and her husband filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem [31].
The Bottom Line
As far as I know, most chiropractors do not warn their patients that neck manipulation entails risks. I believe they should and that the profession should implement a reporting system that would enable this matter to be appropriately studied. This might be achieved if (a) state licensing boards required that all such cases be reported, and (b) chiropractic malpractice insurance companies, which now keep their data secret, were required to disclose them to an independently operated database that has input from both medical doctors and chiropractors.
Meanwhile, since stroke is such a devastating event, every effort should be made to stop chiropractors from manipulating necks without adequate reason. Many believe that all types of headaches might be amenable to spinal manipulation even though no scientific evidence supports such a belief. Many include neck manipulation as part of "preventative maintenance" that involves unnecessarily treating people who have no symptoms. Even worse, some chiropractors—often referred to as "upper cervical specialists"—claim that most human ailments are the result of misalignment of the topmost vertebrae (atlas and axis) and that every patient they see needs neck manipulation. Neck manipulation of children under age 12 should be outlawed [32].
For Additional Information
Neck911USA.com: Dangers of neck manipulation.
Chiropractors Angry about bus ad
Reader Comment
From a former chiropractor:
I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure.
—Rob Alexander, M.D.
R
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;)
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Chiropractic's Dirty Secret:
Neck Manipulation and Strokes
Stephen Barrett, M.D.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The injury often results from extreme rotation in which the practitioner's hands are placed on the patient's head in order to rotate the cervical spine by rotating the head [1]. The vertebral artery, which is shown in the picture to the right, is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection [2].
Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.
Published Reports
In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.
A 1993 review concluded that potential complications and unknown benefits indicate that children should not undergo neck manipulation [4].
Louis Sportelli, DC, NCMIC president and a former ACA board chairman contends that chiropractic neck manipulation is quite safe. In an 1994 interview reported by the Associated Press, he reacted to the American Heart Association study by saying, "I yawned at it. It's old news." He also said that other studies suggest that chiropractic neck manipulation results in a stroke somewhere between one in a million and one in three million cases [5]. The one-in-a-million figure could be correct if California's chiropractors had been averaging about 60 neck manipulations per week. Later that year, during a televised interview with "Inside Edition," Sportelli said the "worst-case scenario" was one in 500,000 but added: "When you weigh the procedure against any other procedure in the health-care industry, it is probably the lowest risk factor of anything." According to the program's narrator, Sportelli said that 90% of his patients receive neck manipulation.
In 1996, RAND issued a booklet that tabulated more than 100 published case reports and estimated that the number of strokes, cord compressions, fractures, and large blood clots was 1.46 per million neck manipulations. Even though this number appears small, it is significant because many of the manipulations chiropractors do should not be done. In addition, as the report itself noted, neither the number of manipulations performed nor the number of complications has been systematically studied [6]. Since some people are more susceptible than others, it has also been argued that the incidence should be expressed as rate per patient rather than rate per adjustment.
In 1996, the National Chiropractic Mutual Insurance Company (NCMIC), which is the largest American chiropractic malpractice insurer, published a report called "Vertebrobasilar Stroke Following Manipulation," written by Allen G.J. Terrett, an Australian chiropractic educator/researcher. Terrett based his findings on 183 cases of vertebrobasilar strokes (VBS) reported between 1934 and 1994. He concluded that 105 of the manipulations had been administered by a chiropractor, 25 were done by a medical practitioner, 31 had been done by another type of practitioner, and that the practitioner type for the remaining 22 was not specified in the report. He concluded that VBS is "very rare," that current pretesting procedures are seldom able to predict susceptibility, and that in 25 cases serious injury might have been avoided if the practitioner had recognized that symptoms occurring after a manipulation indicated that further manipulations should not be done [7].
A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8].
In 2001, NCMIC published a second edition of Terrett's book, titled, "Current Concepts: Vertebrobasilar Complications following Spinal Manipulation," which covered 255 cases published between 1934 and 1999 [9]. NCMIC's Web site claims that the book "includes an analysis of every known case related to this subject." That description is not true. It does not include many strokes that resulted in lawsuits against NCMIC policyholders but were not published in scientific journals. And it does not include the thoroughly documented case of Kristi Bedenbauer whose autopsy report I personally mailed to Terrett after speaking with him in 1995.
In 2001, Canadian researchers published a report about the relationships between chiropractic care and the incidence of vertebrovascular accidents (VBAs) due to vertebral artery dissection or blockage in Ontario, Canada, between 1993 and 1998. Using hospital records, each of 582 VBA cases was age- and sex-matched to four controls with no history of stroke. Health insurance billing records were used to document use of chiropractic services. The study found that VBA patients under age 45 were five times more likely than controls to (a) have visited a chiropractor within a week of the VBA and (b) to have had three or more visits with neck manipulations. No relationship was found after age 45. The authors discuss possible shortcomings of the study and urge that further research be done [10]. An accompanying editorial states that the data correspond to an incidence of 1.3 cases of vertebral artery dissection or blockage per 100,000 individuals receiving chiropractic neck manipulation, a number higher than most chiropractic estimates [11].
In 2001, British researchers reported on a survey in which all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of neck manipulation over a 12-month period. The 35 reported cases included 7 strokes involving the vertebrobasilar artery and 2 strokes involving a carotid artery. None of the 35 cases were reported to medical journals [12]. Edzard Ernst, professor of complementary medicine at the University of Exeter School of Sport and Health Sciences, believes that these results are very significant. In a recent commentary, he stated:
One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%. This extreme level of underreporting obviously renders estimates nonsensical [13].
In 2002, researchers representing the Canadian Stroke Consortium reported on 98 cases in which external trauma ranging from "trivial" to "severe" was identified as the trigger of strokes caused by blood clots formed in arteries supplying the brain. Chiropractic-style neck manipulation was the apparent cause of 38 of the cases, 30 involving vertebral artery dissection and 8 involving carotid artery dissection. Other Canadian statistics indicate the incidence of ischemic strokes in people under 45 is about 750 a year. The researchers believe that their data indicate that 20% are due to neck manipulation, so there may be "gross underreporting" of chiropractic manipulation as a cause of stroke [14].
In 2003, another research team reviewed the records of 151 patients under age 60 with cervical arterial dissection and ischemic stroke or transient ischemic attack (TIA) from between 1995 and 2000 at two academic stroke centers. After an interview and a blinded chart review, 51 patients with dissection and 100 control patients were studied. Patients with dissection were more likely to have undergone spinal manipulation within 30 days (14% vs 3%). The authors concluded that spinal manipulation is associated with vertebral arterial dissection and that a significant increase in neck pain following neck manipulation warrants immediate medical evaluation [15].
In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients who had experienced vertebral artery dissection associated with neck manipulation [16]. Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations. In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care. This report is highly significant but needs careful interpretation. Although it is titled "Vertebral dissections after chiropractic neck manipulation . . . " only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath. It is possible—although unlikely—that the nonchiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists' treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.
Two subsequent reports have added to this denial. In the first study, 377 members of the British and Scottish Chiropractic Associations and more than 19,000 of their patients were asked whether complications had occurred following neck manipulations. No strokes were reported, but symptoms that may have indicated neurologic involvement—headache (reported in 3.9% of cases), numbness/tingling of the arms (1.3% of cases), and fainting/dizziness/lightheadedness (1.1% of cases) were reported. About 400 patients who discontinued treatment could not be reached for follow-up, so what happened to them is unknown [17]. The second study compared insurance billing records and hospital discharge records and concluded that (a) the incidence of strokes was following primary-care (medical) visits was similar to the incidence of strokes following chiropractic visits, and (b) therefore the strokes that occurred in chiropractic offices were not caused by the treatment they received [18]. However, the study is meaningless because—unlike the German Vertebral Artery Dissection Study Group—the researchers did not examine clinical records and were not able to determine whether the diagnoses they tabulated were accurate or whether the strokes were related to the type of manipulation.
Are Complications Predictable?
Some chiropractors advocate "screening tests" with the hope of detecting individuals prone to stroke due to neck manipulation [19-21]. These tests, which include holding the head and neck in positions of rotation to see whether the patient gets dizzy, are not reliable, partly because manipulation can rotate the neck further than can be done with the tests. Listening over the neck arteries with a stethoscope to detect a murmur, for example, has not been proven reliable, though patients that have one should be referred to a physician. Vascular function tests in which the patient's head is briefly held in the positions used during cervical manipulation are also not reliable as a screen for high-risk patients because a thrust that further stretches the vertebral artery could still damage the vessel wall." In a chapter in the leading chiropractic textbook, Terrett and a conclude have stated:
Even after performing the relevant case history, physical examination, and vertebrobasilar function tests, accidents may still occur. There is no conclusive, foolproof screening procedure to eliminate patients at risk. Most victims are young, without [bony] or vascular pathology, and do not present with vertebrobasilar symptoms. The screening procedures described cannot detect those patients in whom [manipulation] may cause an injury. They give a false sense of security to the practitioner [22].
Several medical reports have described chiropractic patients who, after neck manipulation, complained of dizziness and other symptoms of transient loss of blood supply to the brain but were manipulated again and had a full-blown stroke. During a workshop I attended at the 1995 Chiropractic Centennial Celebration, Terrett said such symptoms are ominous and that chiropractors should abandon rotational manipulations that overstretch the vertebral arteries. But, as far as I know, his remarks have not been published and have had no impact on his professional colleagues.
The lack of predictability has been supported by data published by Scott Haldeman, DC, MD, PhD, a chiropractor who has served as an expert witness (usually for the defense) in many court cases involving chiropractic injury. In 1995, he published an abstract summarizing his review of 53 cases that had not been previously reported in medical or chiropractic journals. His report stated:
These cases represent approximately a 45% increase in the number of such cases reported in the English language literature over the past 100 years. . . . No clear cut risk factors can be elicited from the data. Previously proposed risk factors such as migraine headaches, hypertension, diabetes, history of cardiovascular disease, oral contraceptives, recent head or neck trauma, or abnormalities on x-rays do not appear to be significantly greater in patients who have cerebrovascular complications of manipulation than that noted in the general population [23].
Haldeman's main point was he could not identify any factor that could predict that a particular patient was prone to cerebrovascular injury from neck manipulation. This report was published in the proceedings of 1995 Chiropractic Centennial Celebration and was not cited in either the RAND or NCMIC reports.
In 2001, Haldeman and two colleagues published a more detailed analysis that covered 64 cases involving malpractice claims filed between 1978 and 1994 [24]. They reported that 59 (92%) came to treatment with a history of head or neck symptoms. However, the report provides insufficient information to judge whether manipulation could have been useful for treating their condition. Of course, malpractice claims don't present the full story, because most victims of professional negligence do not take legal action. Even when serious injury results, some are simply not inclined toward suing, some don't blame the practitioner, some have an aversion to lawyers, and some can't find an attorney willing to represent them.
What Should Be Done?
Chiropractors cannot agree among themselves whether the problem is significant enough to inform patients that vertebrobasilar stroke is a possible complication of manipulation [21,25]. In 1993, the Canadian Chiropractic Association published a consent form which stated, in part:
Doctors of chiropractic, medical doctors, and physical therapists using manual therapy treatments for patients with neck problems such as yours are required to explain that there have been rare cases of injury to a vertebral artery as a result of treatment. Such an injury has been known to cause stroke, sometimes with serious neurological injury. The chances of this happening are extremely remote, approximately 1 per 1 million treatments.
Appropriate tests will be performed on you to help identify if you may be susceptible to that kind of injury. . . . [26].
This notice is a step in the right direction but does not go far enough. A proper consent should disclose that (a) the risk is unknown; (b) alternative treatments may be available; (c) in many cases, neck symptoms will go away without treatment; (d) certain types of neck manipulation carry a higher risk than others; and (e) claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rationale.
In 2003, a coroner's jury concluded that Lana Dale Lewis of Toronto, Canada, was killed in 1996 by a chiropractic neck manipulation. Among other things, the jury recommended that all patients for whom neck manipulation is recommended be informed that risk exists and that the Ontario Ministry of Health establish a database for chiropractors and other health professionals to report on neck adjustments [27].
In 2005, the Canadian Chiropractic Association published a comprehensive clinical guideline for treatment of adult neck pain not due to whiplash.. Among other things, the document noted that very few studies have compared chiropractic treatment to no treatment, which means that it is difficult to determine the likely benefit of neck manipulation. The guideline also discussed risk factors and recommended that minimal rotation should be used when upper-neck manipulation is done [28,29].
In 2007, following an unnecessary neck manipulation, Sandra Nette developed "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube [30]. In 2008, she and her husband filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem [31].
The Bottom Line
As far as I know, most chiropractors do not warn their patients that neck manipulation entails risks. I believe they should and that the profession should implement a reporting system that would enable this matter to be appropriately studied. This might be achieved if (a) state licensing boards required that all such cases be reported, and (b) chiropractic malpractice insurance companies, which now keep their data secret, were required to disclose them to an independently operated database that has input from both medical doctors and chiropractors.
Meanwhile, since stroke is such a devastating event, every effort should be made to stop chiropractors from manipulating necks without adequate reason. Many believe that all types of headaches might be amenable to spinal manipulation even though no scientific evidence supports such a belief. Many include neck manipulation as part of "preventative maintenance" that involves unnecessarily treating people who have no symptoms. Even worse, some chiropractors—often referred to as "upper cervical specialists"—claim that most human ailments are the result of misalignment of the topmost vertebrae (atlas and axis) and that every patient they see needs neck manipulation. Neck manipulation of children under age 12 should be outlawed [32].
For Additional Information
Neck911USA.com: Dangers of neck manipulation.
Chiropractors Angry about bus ad
Reader Comment
From a former chiropractor:
I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure.
—Rob Alexander, M.D.
R
Blood clot inducing meltdown beyond epic proportions.
-
Epic paying some skinny queer in manpanties to fix your back when an asian immigrant and $100 will do it right
-
an asian immigrant and $100 will do it right
And give you a happy ending as well. ;)
-
Epic paying some skinny queer in manpanties to fix your back when an asian immigrant and $100 will do it right
;D
-
HomeSearch
Your Guide to Quackery, Health Fraud, and Intelligent Decisions Send This Page to a Friend
Chiropractic's Dirty Secret:
Neck Manipulation and Strokes
Stephen Barrett, M.D.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The injury often results from extreme rotation in which the practitioner's hands are placed on the patient's head in order to rotate the cervical spine by rotating the head [1]. The vertebral artery, which is shown in the picture to the right, is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection [2].
Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.
Published Reports
In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.
A 1993 review concluded that potential complications and unknown benefits indicate that children should not undergo neck manipulation [4].
Louis Sportelli, DC, NCMIC president and a former ACA board chairman contends that chiropractic neck manipulation is quite safe. In an 1994 interview reported by the Associated Press, he reacted to the American Heart Association study by saying, "I yawned at it. It's old news." He also said that other studies suggest that chiropractic neck manipulation results in a stroke somewhere between one in a million and one in three million cases [5]. The one-in-a-million figure could be correct if California's chiropractors had been averaging about 60 neck manipulations per week. Later that year, during a televised interview with "Inside Edition," Sportelli said the "worst-case scenario" was one in 500,000 but added: "When you weigh the procedure against any other procedure in the health-care industry, it is probably the lowest risk factor of anything." According to the program's narrator, Sportelli said that 90% of his patients receive neck manipulation.
In 1996, RAND issued a booklet that tabulated more than 100 published case reports and estimated that the number of strokes, cord compressions, fractures, and large blood clots was 1.46 per million neck manipulations. Even though this number appears small, it is significant because many of the manipulations chiropractors do should not be done. In addition, as the report itself noted, neither the number of manipulations performed nor the number of complications has been systematically studied [6]. Since some people are more susceptible than others, it has also been argued that the incidence should be expressed as rate per patient rather than rate per adjustment.
In 1996, the National Chiropractic Mutual Insurance Company (NCMIC), which is the largest American chiropractic malpractice insurer, published a report called "Vertebrobasilar Stroke Following Manipulation," written by Allen G.J. Terrett, an Australian chiropractic educator/researcher. Terrett based his findings on 183 cases of vertebrobasilar strokes (VBS) reported between 1934 and 1994. He concluded that 105 of the manipulations had been administered by a chiropractor, 25 were done by a medical practitioner, 31 had been done by another type of practitioner, and that the practitioner type for the remaining 22 was not specified in the report. He concluded that VBS is "very rare," that current pretesting procedures are seldom able to predict susceptibility, and that in 25 cases serious injury might have been avoided if the practitioner had recognized that symptoms occurring after a manipulation indicated that further manipulations should not be done [7].
A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8].
In 2001, NCMIC published a second edition of Terrett's book, titled, "Current Concepts: Vertebrobasilar Complications following Spinal Manipulation," which covered 255 cases published between 1934 and 1999 [9]. NCMIC's Web site claims that the book "includes an analysis of every known case related to this subject." That description is not true. It does not include many strokes that resulted in lawsuits against NCMIC policyholders but were not published in scientific journals. And it does not include the thoroughly documented case of Kristi Bedenbauer whose autopsy report I personally mailed to Terrett after speaking with him in 1995.
In 2001, Canadian researchers published a report about the relationships between chiropractic care and the incidence of vertebrovascular accidents (VBAs) due to vertebral artery dissection or blockage in Ontario, Canada, between 1993 and 1998. Using hospital records, each of 582 VBA cases was age- and sex-matched to four controls with no history of stroke. Health insurance billing records were used to document use of chiropractic services. The study found that VBA patients under age 45 were five times more likely than controls to (a) have visited a chiropractor within a week of the VBA and (b) to have had three or more visits with neck manipulations. No relationship was found after age 45. The authors discuss possible shortcomings of the study and urge that further research be done [10]. An accompanying editorial states that the data correspond to an incidence of 1.3 cases of vertebral artery dissection or blockage per 100,000 individuals receiving chiropractic neck manipulation, a number higher than most chiropractic estimates [11].
In 2001, British researchers reported on a survey in which all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of neck manipulation over a 12-month period. The 35 reported cases included 7 strokes involving the vertebrobasilar artery and 2 strokes involving a carotid artery. None of the 35 cases were reported to medical journals [12]. Edzard Ernst, professor of complementary medicine at the University of Exeter School of Sport and Health Sciences, believes that these results are very significant. In a recent commentary, he stated:
One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%. This extreme level of underreporting obviously renders estimates nonsensical [13].
In 2002, researchers representing the Canadian Stroke Consortium reported on 98 cases in which external trauma ranging from "trivial" to "severe" was identified as the trigger of strokes caused by blood clots formed in arteries supplying the brain. Chiropractic-style neck manipulation was the apparent cause of 38 of the cases, 30 involving vertebral artery dissection and 8 involving carotid artery dissection. Other Canadian statistics indicate the incidence of ischemic strokes in people under 45 is about 750 a year. The researchers believe that their data indicate that 20% are due to neck manipulation, so there may be "gross underreporting" of chiropractic manipulation as a cause of stroke [14].
In 2003, another research team reviewed the records of 151 patients under age 60 with cervical arterial dissection and ischemic stroke or transient ischemic attack (TIA) from between 1995 and 2000 at two academic stroke centers. After an interview and a blinded chart review, 51 patients with dissection and 100 control patients were studied. Patients with dissection were more likely to have undergone spinal manipulation within 30 days (14% vs 3%). The authors concluded that spinal manipulation is associated with vertebral arterial dissection and that a significant increase in neck pain following neck manipulation warrants immediate medical evaluation [15].
In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients who had experienced vertebral artery dissection associated with neck manipulation [16]. Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations. In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care. This report is highly significant but needs careful interpretation. Although it is titled "Vertebral dissections after chiropractic neck manipulation . . . " only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath. It is possible—although unlikely—that the nonchiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists' treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.
Two subsequent reports have added to this denial. In the first study, 377 members of the British and Scottish Chiropractic Associations and more than 19,000 of their patients were asked whether complications had occurred following neck manipulations. No strokes were reported, but symptoms that may have indicated neurologic involvement—headache (reported in 3.9% of cases), numbness/tingling of the arms (1.3% of cases), and fainting/dizziness/lightheadedness (1.1% of cases) were reported. About 400 patients who discontinued treatment could not be reached for follow-up, so what happened to them is unknown [17]. The second study compared insurance billing records and hospital discharge records and concluded that (a) the incidence of strokes was following primary-care (medical) visits was similar to the incidence of strokes following chiropractic visits, and (b) therefore the strokes that occurred in chiropractic offices were not caused by the treatment they received [18]. However, the study is meaningless because—unlike the German Vertebral Artery Dissection Study Group—the researchers did not examine clinical records and were not able to determine whether the diagnoses they tabulated were accurate or whether the strokes were related to the type of manipulation.
Are Complications Predictable?
Some chiropractors advocate "screening tests" with the hope of detecting individuals prone to stroke due to neck manipulation [19-21]. These tests, which include holding the head and neck in positions of rotation to see whether the patient gets dizzy, are not reliable, partly because manipulation can rotate the neck further than can be done with the tests. Listening over the neck arteries with a stethoscope to detect a murmur, for example, has not been proven reliable, though patients that have one should be referred to a physician. Vascular function tests in which the patient's head is briefly held in the positions used during cervical manipulation are also not reliable as a screen for high-risk patients because a thrust that further stretches the vertebral artery could still damage the vessel wall." In a chapter in the leading chiropractic textbook, Terrett and a conclude have stated:
Even after performing the relevant case history, physical examination, and vertebrobasilar function tests, accidents may still occur. There is no conclusive, foolproof screening procedure to eliminate patients at risk. Most victims are young, without [bony] or vascular pathology, and do not present with vertebrobasilar symptoms. The screening procedures described cannot detect those patients in whom [manipulation] may cause an injury. They give a false sense of security to the practitioner [22].
Several medical reports have described chiropractic patients who, after neck manipulation, complained of dizziness and other symptoms of transient loss of blood supply to the brain but were manipulated again and had a full-blown stroke. During a workshop I attended at the 1995 Chiropractic Centennial Celebration, Terrett said such symptoms are ominous and that chiropractors should abandon rotational manipulations that overstretch the vertebral arteries. But, as far as I know, his remarks have not been published and have had no impact on his professional colleagues.
The lack of predictability has been supported by data published by Scott Haldeman, DC, MD, PhD, a chiropractor who has served as an expert witness (usually for the defense) in many court cases involving chiropractic injury. In 1995, he published an abstract summarizing his review of 53 cases that had not been previously reported in medical or chiropractic journals. His report stated:
These cases represent approximately a 45% increase in the number of such cases reported in the English language literature over the past 100 years. . . . No clear cut risk factors can be elicited from the data. Previously proposed risk factors such as migraine headaches, hypertension, diabetes, history of cardiovascular disease, oral contraceptives, recent head or neck trauma, or abnormalities on x-rays do not appear to be significantly greater in patients who have cerebrovascular complications of manipulation than that noted in the general population [23].
Haldeman's main point was he could not identify any factor that could predict that a particular patient was prone to cerebrovascular injury from neck manipulation. This report was published in the proceedings of 1995 Chiropractic Centennial Celebration and was not cited in either the RAND or NCMIC reports.
In 2001, Haldeman and two colleagues published a more detailed analysis that covered 64 cases involving malpractice claims filed between 1978 and 1994 [24]. They reported that 59 (92%) came to treatment with a history of head or neck symptoms. However, the report provides insufficient information to judge whether manipulation could have been useful for treating their condition. Of course, malpractice claims don't present the full story, because most victims of professional negligence do not take legal action. Even when serious injury results, some are simply not inclined toward suing, some don't blame the practitioner, some have an aversion to lawyers, and some can't find an attorney willing to represent them.
What Should Be Done?
Chiropractors cannot agree among themselves whether the problem is significant enough to inform patients that vertebrobasilar stroke is a possible complication of manipulation [21,25]. In 1993, the Canadian Chiropractic Association published a consent form which stated, in part:
Doctors of chiropractic, medical doctors, and physical therapists using manual therapy treatments for patients with neck problems such as yours are required to explain that there have been rare cases of injury to a vertebral artery as a result of treatment. Such an injury has been known to cause stroke, sometimes with serious neurological injury. The chances of this happening are extremely remote, approximately 1 per 1 million treatments.
Appropriate tests will be performed on you to help identify if you may be susceptible to that kind of injury. . . . [26].
This notice is a step in the right direction but does not go far enough. A proper consent should disclose that (a) the risk is unknown; (b) alternative treatments may be available; (c) in many cases, neck symptoms will go away without treatment; (d) certain types of neck manipulation carry a higher risk than others; and (e) claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rationale.
In 2003, a coroner's jury concluded that Lana Dale Lewis of Toronto, Canada, was killed in 1996 by a chiropractic neck manipulation. Among other things, the jury recommended that all patients for whom neck manipulation is recommended be informed that risk exists and that the Ontario Ministry of Health establish a database for chiropractors and other health professionals to report on neck adjustments [27].
In 2005, the Canadian Chiropractic Association published a comprehensive clinical guideline for treatment of adult neck pain not due to whiplash.. Among other things, the document noted that very few studies have compared chiropractic treatment to no treatment, which means that it is difficult to determine the likely benefit of neck manipulation. The guideline also discussed risk factors and recommended that minimal rotation should be used when upper-neck manipulation is done [28,29].
In 2007, following an unnecessary neck manipulation, Sandra Nette developed "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube [30]. In 2008, she and her husband filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem [31].
The Bottom Line
As far as I know, most chiropractors do not warn their patients that neck manipulation entails risks. I believe they should and that the profession should implement a reporting system that would enable this matter to be appropriately studied. This might be achieved if (a) state licensing boards required that all such cases be reported, and (b) chiropractic malpractice insurance companies, which now keep their data secret, were required to disclose them to an independently operated database that has input from both medical doctors and chiropractors.
Meanwhile, since stroke is such a devastating event, every effort should be made to stop chiropractors from manipulating necks without adequate reason. Many believe that all types of headaches might be amenable to spinal manipulation even though no scientific evidence supports such a belief. Many include neck manipulation as part of "preventative maintenance" that involves unnecessarily treating people who have no symptoms. Even worse, some chiropractors—often referred to as "upper cervical specialists"—claim that most human ailments are the result of misalignment of the topmost vertebrae (atlas and axis) and that every patient they see needs neck manipulation. Neck manipulation of children under age 12 should be outlawed [32].
For Additional Information
Neck911USA.com: Dangers of neck manipulation.
Chiropractors Angry about bus ad
Reader Comment
From a former chiropractor:
I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure.
—Rob Alexander, M.D.
R
I think a few people overdosed on meds and died from improper surgery as I read this
,,,but I could be wrong.
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Chiropractics is a scam. Get used to it CLOWN.
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Chiropractics is a scam. Get used to it CLOWN.
Check your facts 'elite_lifter' ::)
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Check your facts 'elite_lifter' ::)
O.K. Dr. "Chiropractor", we already figured it out. Go back to chasing ambulances. ::), I hope Chiropractic school was worth the 50k a yr you make. TOOL
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O.K. Dr. "Chiropractor", we already figured it out. Go back to chasing ambulances. ::), I hope Chiropractic school was worth the 50k a yr you make. TOOL
Wow..ambulance chaser...thats impressive. Perhaps you can make a comment about the research I have put forth on all of the other threads. Or will that get in the way of your daily binging on doughnuts?
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Wow..ambulance chaser...thats impressive. Perhaps you can make a comment about the research I have put forth on all of the other threads. Or will that get in the way of your daily binging on doughnuts?
Been many years since i've had a doughnut, CLOWN.
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Statistically, a stroke MAY occur in one out of every 1 million neck adjustments.
And, people die EVERY DAY from/during surgery and/or medications.
Everything has +/-
I had a stroke caused by a chiropractic neck adjustmen, 4-5 TIA's. I'm in the process of weighing my options now. Above the neck manipulation is a BAD thing!
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I had a stroke caused by a chiropractic neck adjustmen, 4-5 TIA's. I'm in the process of weighing my options now. Above the neck manipulation is a BAD thing!
DrugfreeforlifeisanIDIOT
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DrugfreeforlifeisanIDIOT
Good then you two IDIOTS should get along good!
:D
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DrugfreeforlifeisanIDIOT
Wow....what an impressive comeback 'elite_lifter'. Why I commend you for having gone years since a doughnut, I can't believe its been more than a few hours since having your boyfriends balls rested on your chin (or at least one of your chins)
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Wow....what an impressive comeback 'elite_lifter'. Why I commend you for having gone years since a doughnut, I can't believe its been more than a few hours since having your boyfriends balls rested on your chin (or at least one of your chins)
Hahhaha....."Elite Lifter" is currently in training for a marathon cock sucking session with his good buddy Derek Anthony!
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Wow....what an impressive comeback 'elite_lifter'. Why I commend you for having gone years since a doughnut, I can't believe its been more than a few hours since having your boyfriends balls rested on your chin (or at least one of your chins)
I prefer my wifes size d titties resting on my chin. Shouldn't you be cracking backs douchebag! Enjoy your 50k a yr. joke of a salary. Haha, stupid Chiro. ::)
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I prefer my wifes size d titties resting on my chin. Shouldn't you be cracking backs douchebag! Enjoy your 50k a yr. joke of a salary. Haha, stupid Chiro. ::)
Hahah...the only titties Elite has seen up close are those on Goodrum ;D
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I prefer my wifes size d titties resting on my chin. Shouldn't you be cracking backs douchebag! Enjoy your 50k a yr. joke of a salary. Haha, stupid Chiro. ::)
If by wife you mean you mean your boyfriend, and by titties you mean his man-boobs....we will all believe it. Shouldn't you be out showing us how 'elite' a lifter you are? ::)
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It sounds like elite lifter is bitter because he wanted to be a chiropractor but he couldn't pass the test or handle it. Typical spite.
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It sounds like elite lifter is bitter because he wanted to be a chiropractor but he couldn't pass the test or handle it. Typical spite.
Wrong, but a family member used to be a Chiro, so I know all about shamopractics. He was Smart and choose another profession long ago.
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Wrong, but a family member used to be a Chiro, so I know all about shamopractics. He was Smart and choose another profession long ago.
Probably because he suffered from the same delusional ideas that you do? Did you wake up to your usual pearl necklace again 'elite_penispuffer'?
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Probably because he suffered from the same delusional ideas that you do? Did you wake up to your usual pearl necklace again 'elite_penispuffer'?
::)
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::)
I figured thats all the response I would get out of you. Is it hard to type and smoke pole at the same time?
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Wrong, but a family member used to be a Chiro, so I know all about shamopractics. He was Smart and choose another profession long ago.
So your "family member" is now working with you as an esteemed garbage man ;D
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So your "family member" is now working with you as an esteemed garbage man ;D
Naw....'elite_fudgepacker' encouraged his family member to go to med school and become a proctologist. He volunteered himself any time, day or night, as a test subject not just for his family member....but the whole class. Mind you, he did this from the beginning of his pre-requisites all the way through graduation. He did say that he was doing it 'merely for scientific purposes'.
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Naw....'elite_fudgepacker' encouraged his family member to go to med school and become a proctologist. He volunteered himself any time, day or night, as a test subject not just for his family member....but the whole class. Mind you, he did this from the beginning of his pre-requisites all the way through graduation. He did say that he was doing it 'merely for scientific purposes'.
LOL....Yes, Elite is quite the "asshole" ;D
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I figured thats all the response I would get out of you. Is it hard to type and smoke pole at the same time?
What do you want a dissertation on Chiropractics, I wouldn't waste my time for internet assholes, Fuck off prick.
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What do you want a dissertation on Chiropractics, I wouldn't waste my time for internet assholes, Fuck off prick.
HA HA.....wouldnt waste your time....yet you keep posting on it. How is it I have provided you with research and facts, and all you can pull out of that worn out, stretched beyond recognition, punished ass of yours is that drivel?
Wow...elittle_penis_lift er is quite the failure.
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Just a very small part of why Chiropractics is a scam.
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Your Guide to Quackery, Health Fraud, and Intelligent Decisions Send This Page to a Friend
Chiropractic's Dirty Secret:
Neck Manipulation and Strokes
Stephen Barrett, M.D.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The injury often results from extreme rotation in which the practitioner's hands are placed on the patient's head in order to rotate the cervical spine by rotating the head [1]. The vertebral artery, which is shown in the picture to the right, is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection [2].
Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.
Published Reports
In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.
A 1993 review concluded that potential complications and unknown benefits indicate that children should not undergo neck manipulation [4].
Louis Sportelli, DC, NCMIC president and a former ACA board chairman contends that chiropractic neck manipulation is quite safe. In an 1994 interview reported by the Associated Press, he reacted to the American Heart Association study by saying, "I yawned at it. It's old news." He also said that other studies suggest that chiropractic neck manipulation results in a stroke somewhere between one in a million and one in three million cases [5]. The one-in-a-million figure could be correct if California's chiropractors had been averaging about 60 neck manipulations per week. Later that year, during a televised interview with "Inside Edition," Sportelli said the "worst-case scenario" was one in 500,000 but added: "When you weigh the procedure against any other procedure in the health-care industry, it is probably the lowest risk factor of anything." According to the program's narrator, Sportelli said that 90% of his patients receive neck manipulation.
In 1996, RAND issued a booklet that tabulated more than 100 published case reports and estimated that the number of strokes, cord compressions, fractures, and large blood clots was 1.46 per million neck manipulations. Even though this number appears small, it is significant because many of the manipulations chiropractors do should not be done. In addition, as the report itself noted, neither the number of manipulations performed nor the number of complications has been systematically studied [6]. Since some people are more susceptible than others, it has also been argued that the incidence should be expressed as rate per patient rather than rate per adjustment.
In 1996, the National Chiropractic Mutual Insurance Company (NCMIC), which is the largest American chiropractic malpractice insurer, published a report called "Vertebrobasilar Stroke Following Manipulation," written by Allen G.J. Terrett, an Australian chiropractic educator/researcher. Terrett based his findings on 183 cases of vertebrobasilar strokes (VBS) reported between 1934 and 1994. He concluded that 105 of the manipulations had been administered by a chiropractor, 25 were done by a medical practitioner, 31 had been done by another type of practitioner, and that the practitioner type for the remaining 22 was not specified in the report. He concluded that VBS is "very rare," that current pretesting procedures are seldom able to predict susceptibility, and that in 25 cases serious injury might have been avoided if the practitioner had recognized that symptoms occurring after a manipulation indicated that further manipulations should not be done [7].
A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8].
In 2001, NCMIC published a second edition of Terrett's book, titled, "Current Concepts: Vertebrobasilar Complications following Spinal Manipulation," which covered 255 cases published between 1934 and 1999 [9]. NCMIC's Web site claims that the book "includes an analysis of every known case related to this subject." That description is not true. It does not include many strokes that resulted in lawsuits against NCMIC policyholders but were not published in scientific journals. And it does not include the thoroughly documented case of Kristi Bedenbauer whose autopsy report I personally mailed to Terrett after speaking with him in 1995.
In 2001, Canadian researchers published a report about the relationships between chiropractic care and the incidence of vertebrovascular accidents (VBAs) due to vertebral artery dissection or blockage in Ontario, Canada, between 1993 and 1998. Using hospital records, each of 582 VBA cases was age- and sex-matched to four controls with no history of stroke. Health insurance billing records were used to document use of chiropractic services. The study found that VBA patients under age 45 were five times more likely than controls to (a) have visited a chiropractor within a week of the VBA and (b) to have had three or more visits with neck manipulations. No relationship was found after age 45. The authors discuss possible shortcomings of the study and urge that further research be done [10]. An accompanying editorial states that the data correspond to an incidence of 1.3 cases of vertebral artery dissection or blockage per 100,000 individuals receiving chiropractic neck manipulation, a number higher than most chiropractic estimates [11].
In 2001, British researchers reported on a survey in which all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of neck manipulation over a 12-month period. The 35 reported cases included 7 strokes involving the vertebrobasilar artery and 2 strokes involving a carotid artery. None of the 35 cases were reported to medical journals [12]. Edzard Ernst, professor of complementary medicine at the University of Exeter School of Sport and Health Sciences, believes that these results are very significant. In a recent commentary, he stated:
One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%. This extreme level of underreporting obviously renders estimates nonsensical [13].
In 2002, researchers representing the Canadian Stroke Consortium reported on 98 cases in which external trauma ranging from "trivial" to "severe" was identified as the trigger of strokes caused by blood clots formed in arteries supplying the brain. Chiropractic-style neck manipulation was the apparent cause of 38 of the cases, 30 involving vertebral artery dissection and 8 involving carotid artery dissection. Other Canadian statistics indicate the incidence of ischemic strokes in people under 45 is about 750 a year. The researchers believe that their data indicate that 20% are due to neck manipulation, so there may be "gross underreporting" of chiropractic manipulation as a cause of stroke [14].
In 2003, another research team reviewed the records of 151 patients under age 60 with cervical arterial dissection and ischemic stroke or transient ischemic attack (TIA) from between 1995 and 2000 at two academic stroke centers. After an interview and a blinded chart review, 51 patients with dissection and 100 control patients were studied. Patients with dissection were more likely to have undergone spinal manipulation within 30 days (14% vs 3%). The authors concluded that spinal manipulation is associated with vertebral arterial dissection and that a significant increase in neck pain following neck manipulation warrants immediate medical evaluation [15].
In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients who had experienced vertebral artery dissection associated with neck manipulation [16]. Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations. In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care. This report is highly significant but needs careful interpretation. Although it is titled "Vertebral dissections after chiropractic neck manipulation . . . " only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath. It is possible—although unlikely—that the nonchiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists' treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.
Two subsequent reports have added to this denial. In the first study, 377 members of the British and Scottish Chiropractic Associations and more than 19,000 of their patients were asked whether complications had occurred following neck manipulations. No strokes were reported, but symptoms that may have indicated neurologic involvement—headache (reported in 3.9% of cases), numbness/tingling of the arms (1.3% of cases), and fainting/dizziness/lightheadedness (1.1% of cases) were reported. About 400 patients who discontinued treatment could not be reached for follow-up, so what happened to them is unknown [17]. The second study compared insurance billing records and hospital discharge records and concluded that (a) the incidence of strokes was following primary-care (medical) visits was similar to the incidence of strokes following chiropractic visits, and (b) therefore the strokes that occurred in chiropractic offices were not caused by the treatment they received [18]. However, the study is meaningless because—unlike the German Vertebral Artery Dissection Study Group—the researchers did not examine clinical records and were not able to determine whether the diagnoses they tabulated were accurate or whether the strokes were related to the type of manipulation.
Are Complications Predictable?
Some chiropractors advocate "screening tests" with the hope of detecting individuals prone to stroke due to neck manipulation [19-21]. These tests, which include holding the head and neck in positions of rotation to see whether the patient gets dizzy, are not reliable, partly because manipulation can rotate the neck further than can be done with the tests. Listening over the neck arteries with a stethoscope to detect a murmur, for example, has not been proven reliable, though patients that have one should be referred to a physician. Vascular function tests in which the patient's head is briefly held in the positions used during cervical manipulation are also not reliable as a screen for high-risk patients because a thrust that further stretches the vertebral artery could still damage the vessel wall." In a chapter in the leading chiropractic textbook, Terrett and a conclude have stated:
Even after performing the relevant case history, physical examination, and vertebrobasilar function tests, accidents may still occur. There is no conclusive, foolproof screening procedure to eliminate patients at risk. Most victims are young, without [bony] or vascular pathology, and do not present with vertebrobasilar symptoms. The screening procedures described cannot detect those patients in whom [manipulation] may cause an injury. They give a false sense of security to the practitioner [22].
Several medical reports have described chiropractic patients who, after neck manipulation, complained of dizziness and other symptoms of transient loss of blood supply to the brain but were manipulated again and had a full-blown stroke. During a workshop I attended at the 1995 Chiropractic Centennial Celebration, Terrett said such symptoms are ominous and that chiropractors should abandon rotational manipulations that overstretch the vertebral arteries. But, as far as I know, his remarks have not been published and have had no impact on his professional colleagues.
The lack of predictability has been supported by data published by Scott Haldeman, DC, MD, PhD, a chiropractor who has served as an expert witness (usually for the defense) in many court cases involving chiropractic injury. In 1995, he published an abstract summarizing his review of 53 cases that had not been previously reported in medical or chiropractic journals. His report stated:
These cases represent approximately a 45% increase in the number of such cases reported in the English language literature over the past 100 years. . . . No clear cut risk factors can be elicited from the data. Previously proposed risk factors such as migraine headaches, hypertension, diabetes, history of cardiovascular disease, oral contraceptives, recent head or neck trauma, or abnormalities on x-rays do not appear to be significantly greater in patients who have cerebrovascular complications of manipulation than that noted in the general population [23].
Haldeman's main point was he could not identify any factor that could predict that a particular patient was prone to cerebrovascular injury from neck manipulation. This report was published in the proceedings of 1995 Chiropractic Centennial Celebration and was not cited in either the RAND or NCMIC reports.
In 2001, Haldeman and two colleagues published a more detailed analysis that covered 64 cases involving malpractice claims filed between 1978 and 1994 [24]. They reported that 59 (92%) came to treatment with a history of head or neck symptoms. However, the report provides insufficient information to judge whether manipulation could have been useful for treating their condition. Of course, malpractice claims don't present the full story, because most victims of professional negligence do not take legal action. Even when serious injury results, some are simply not inclined toward suing, some don't blame the practitioner, some have an aversion to lawyers, and some can't find an attorney willing to represent them.
What Should Be Done?
Chiropractors cannot agree among themselves whether the problem is significant enough to inform patients that vertebrobasilar stroke is a possible complication of manipulation [21,25]. In 1993, the Canadian Chiropractic Association published a consent form which stated, in part:
Doctors of chiropractic, medical doctors, and physical therapists using manual therapy treatments for patients with neck problems such as yours are required to explain that there have been rare cases of injury to a vertebral artery as a result of treatment. Such an injury has been known to cause stroke, sometimes with serious neurological injury. The chances of this happening are extremely remote, approximately 1 per 1 million treatments.
Appropriate tests will be performed on you to help identify if you may be susceptible to that kind of injury. . . . [26].
This notice is a step in the right direction but does not go far enough. A proper consent should disclose that (a) the risk is unknown; (b) alternative treatments may be available; (c) in many cases, neck symptoms will go away without treatment; (d) certain types of neck manipulation carry a higher risk than others; and (e) claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rationale.
In 2003, a coroner's jury concluded that Lana Dale Lewis of Toronto, Canada, was killed in 1996 by a chiropractic neck manipulation. Among other things, the jury recommended that all patients for whom neck manipulation is recommended be informed that risk exists and that the Ontario Ministry of Health establish a database for chiropractors and other health professionals to report on neck adjustments [27].
In 2005, the Canadian Chiropractic Association published a comprehensive clinical guideline for treatment of adult neck pain not due to whiplash.. Among other things, the document noted that very few studies have compared chiropractic treatment to no treatment, which means that it is difficult to determine the likely benefit of neck manipulation. The guideline also discussed risk factors and recommended that minimal rotation should be used when upper-neck manipulation is done [28,29].
In 2007, following an unnecessary neck manipulation, Sandra Nette developed "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube [30]. In 2008, she and her husband filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem [31].
The Bottom Line
As far as I know, most chiropractors do not warn their patients that neck manipulation entails risks. I believe they should and that the profession should implement a reporting system that would enable this matter to be appropriately studied. This might be achieved if (a) state licensing boards required that all such cases be reported, and (b) chiropractic malpractice insurance companies, which now keep their data secret, were required to disclose them to an independently operated database that has input from both medical doctors and chiropractors.
Meanwhile, since stroke is such a devastating event, every effort should be made to stop chiropractors from manipulating necks without adequate reason. Many believe that all types of headaches might be amenable to spinal manipulation even though no scientific evidence supports such a belief. Many include neck manipulation as part of "preventative maintenance" that involves unnecessarily treating people who have no symptoms. Even worse, some chiropractors—often referred to as "upper cervical specialists"—claim that most human ailments are the result of misalignment of the topmost vertebrae (atlas and axis) and that every patient they see needs neck manipulation. Neck manipulation of children under age 12 should be outlawed [32].
For Additional Information
Neck911USA.com: Dangers of neck manipulation.
Chiropractors Angry about bus ad
Reader Comment
From a former chiropractor:
I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure.
-
Just a very small part of why Chiropractics is a scam.
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Chiropractic's Dirty Secret:
Neck Manipulation and Strokes
Stephen Barrett, M.D.
Stroke from chiropractic neck manipulation occurs when an artery to the brain ruptures or becomes blocked as a result of being stretched. The injury often results from extreme rotation in which the practitioner's hands are placed on the patient's head in order to rotate the cervical spine by rotating the head [1]. The vertebral artery, which is shown in the picture to the right, is vulnerable because it winds around the topmost cervical vertebra (atlas) to enter the skull, so that any abrupt rotation may stretch the artery and tear its delicate lining. The anatomical problem is illustrated on page 7 of The Chiropractic Report, July 1999. A blood clot formed over the injured area may subsequently be dislodged and block a smaller artery that supplies the brain. Less frequently, the vessel may be blocked by blood that collects in the vessel wall at the site of the dissection [2].
Chiropractors would like you to believe that the incidence of stroke following neck manipulation is extremely small. Speculations exist that the odds of a serious complication due to neck manipulation are somewhere between one in 40,000 and one in 10 million manipulations. No one really knows, however, because (a) there has been little systematic study of its frequency; (b) the largest malpractice insurers won't reveal how many cases they know about; and (c) a large majority of cases that medical doctors see are not reported in scientific journals.
Published Reports
In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor. The survey was sponsored by the American Heart Association. A total of 177 neurologists reported treating 56 such patients, all of whom were between the ages of 21 and 60. One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo (dizziness). The usual cause of the strokes was thought to be a tear between the inner and outer walls of the vertebral arteries, which caused the arterial walls to balloon and block the flow of blood to the brain. Three of the strokes involved tears of the carotid arteries [3]. In 1991, according to circulation figures from Dynamic Chiropractic, California had about 19% of the chiropractors practicing in the United States, which suggests that about 147 cases of stroke each year were seen by neurologists nationwide. Of course, additional cases could have been seen by other doctors who did not respond to the survey.
A 1993 review concluded that potential complications and unknown benefits indicate that children should not undergo neck manipulation [4].
Louis Sportelli, DC, NCMIC president and a former ACA board chairman contends that chiropractic neck manipulation is quite safe. In an 1994 interview reported by the Associated Press, he reacted to the American Heart Association study by saying, "I yawned at it. It's old news." He also said that other studies suggest that chiropractic neck manipulation results in a stroke somewhere between one in a million and one in three million cases [5]. The one-in-a-million figure could be correct if California's chiropractors had been averaging about 60 neck manipulations per week. Later that year, during a televised interview with "Inside Edition," Sportelli said the "worst-case scenario" was one in 500,000 but added: "When you weigh the procedure against any other procedure in the health-care industry, it is probably the lowest risk factor of anything." According to the program's narrator, Sportelli said that 90% of his patients receive neck manipulation.
In 1996, RAND issued a booklet that tabulated more than 100 published case reports and estimated that the number of strokes, cord compressions, fractures, and large blood clots was 1.46 per million neck manipulations. Even though this number appears small, it is significant because many of the manipulations chiropractors do should not be done. In addition, as the report itself noted, neither the number of manipulations performed nor the number of complications has been systematically studied [6]. Since some people are more susceptible than others, it has also been argued that the incidence should be expressed as rate per patient rather than rate per adjustment.
In 1996, the National Chiropractic Mutual Insurance Company (NCMIC), which is the largest American chiropractic malpractice insurer, published a report called "Vertebrobasilar Stroke Following Manipulation," written by Allen G.J. Terrett, an Australian chiropractic educator/researcher. Terrett based his findings on 183 cases of vertebrobasilar strokes (VBS) reported between 1934 and 1994. He concluded that 105 of the manipulations had been administered by a chiropractor, 25 were done by a medical practitioner, 31 had been done by another type of practitioner, and that the practitioner type for the remaining 22 was not specified in the report. He concluded that VBS is "very rare," that current pretesting procedures are seldom able to predict susceptibility, and that in 25 cases serious injury might have been avoided if the practitioner had recognized that symptoms occurring after a manipulation indicated that further manipulations should not be done [7].
A 1999 review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors [8].
In 2001, NCMIC published a second edition of Terrett's book, titled, "Current Concepts: Vertebrobasilar Complications following Spinal Manipulation," which covered 255 cases published between 1934 and 1999 [9]. NCMIC's Web site claims that the book "includes an analysis of every known case related to this subject." That description is not true. It does not include many strokes that resulted in lawsuits against NCMIC policyholders but were not published in scientific journals. And it does not include the thoroughly documented case of Kristi Bedenbauer whose autopsy report I personally mailed to Terrett after speaking with him in 1995.
In 2001, Canadian researchers published a report about the relationships between chiropractic care and the incidence of vertebrovascular accidents (VBAs) due to vertebral artery dissection or blockage in Ontario, Canada, between 1993 and 1998. Using hospital records, each of 582 VBA cases was age- and sex-matched to four controls with no history of stroke. Health insurance billing records were used to document use of chiropractic services. The study found that VBA patients under age 45 were five times more likely than controls to (a) have visited a chiropractor within a week of the VBA and (b) to have had three or more visits with neck manipulations. No relationship was found after age 45. The authors discuss possible shortcomings of the study and urge that further research be done [10]. An accompanying editorial states that the data correspond to an incidence of 1.3 cases of vertebral artery dissection or blockage per 100,000 individuals receiving chiropractic neck manipulation, a number higher than most chiropractic estimates [11].
In 2001, British researchers reported on a survey in which all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of neck manipulation over a 12-month period. The 35 reported cases included 7 strokes involving the vertebrobasilar artery and 2 strokes involving a carotid artery. None of the 35 cases were reported to medical journals [12]. Edzard Ernst, professor of complementary medicine at the University of Exeter School of Sport and Health Sciences, believes that these results are very significant. In a recent commentary, he stated:
One gets the impression that the risks of spinal manipulation are being played down, particularly by chiropractors. Perhaps the best indication that this is true are estimates of incidence rates based on assumptions, which are unproven at best and unrealistic at worse. One such assumption, for instance, is that 10% of actual complications will be reported. Our recent survey, however, demonstrated an underreporting rate of 100%. This extreme level of underreporting obviously renders estimates nonsensical [13].
In 2002, researchers representing the Canadian Stroke Consortium reported on 98 cases in which external trauma ranging from "trivial" to "severe" was identified as the trigger of strokes caused by blood clots formed in arteries supplying the brain. Chiropractic-style neck manipulation was the apparent cause of 38 of the cases, 30 involving vertebral artery dissection and 8 involving carotid artery dissection. Other Canadian statistics indicate the incidence of ischemic strokes in people under 45 is about 750 a year. The researchers believe that their data indicate that 20% are due to neck manipulation, so there may be "gross underreporting" of chiropractic manipulation as a cause of stroke [14].
In 2003, another research team reviewed the records of 151 patients under age 60 with cervical arterial dissection and ischemic stroke or transient ischemic attack (TIA) from between 1995 and 2000 at two academic stroke centers. After an interview and a blinded chart review, 51 patients with dissection and 100 control patients were studied. Patients with dissection were more likely to have undergone spinal manipulation within 30 days (14% vs 3%). The authors concluded that spinal manipulation is associated with vertebral arterial dissection and that a significant increase in neck pain following neck manipulation warrants immediate medical evaluation [15].
In 2006, the Journal of Neurology published a German Vertebral Artery Dissection Study Group report about 36 patients who had experienced vertebral artery dissection associated with neck manipulation [16]. Twenty-six patients developed their symptoms within 48 hours after a manipulation, including five patients who got symptoms at the time of manipulation and four who developed them within the next hour. In 27 patients, special imaging procedures confirmed that blood supply had decreased in the areas supplied by the vertebral arteries as suggested by the neurological examinations. In all but one of the 36 patients, the symptoms had not previously occurred and were clearly distinguishable from the complaints that led them to seek manipulative care. This report is highly significant but needs careful interpretation. Although it is titled "Vertebral dissections after chiropractic neck manipulation . . . " only four of the patients were actually manipulated by chiropractors. Half were treated by orthopedic surgeons, five by a physiotherapist, and the rest by a neurologist, general medical practitioner, or homeopath. It is possible—although unlikely—that the nonchiropractors used techniques that were more dangerous than chiropractors use in North America. The authors suggested that the orthopedists' treatment was safer, but there is no way to determine this from their data. Regardless, the study supports the assertion that neck manipulation can cause strokes—which many chiropractors deny.
Two subsequent reports have added to this denial. In the first study, 377 members of the British and Scottish Chiropractic Associations and more than 19,000 of their patients were asked whether complications had occurred following neck manipulations. No strokes were reported, but symptoms that may have indicated neurologic involvement—headache (reported in 3.9% of cases), numbness/tingling of the arms (1.3% of cases), and fainting/dizziness/lightheadedness (1.1% of cases) were reported. About 400 patients who discontinued treatment could not be reached for follow-up, so what happened to them is unknown [17]. The second study compared insurance billing records and hospital discharge records and concluded that (a) the incidence of strokes was following primary-care (medical) visits was similar to the incidence of strokes following chiropractic visits, and (b) therefore the strokes that occurred in chiropractic offices were not caused by the treatment they received [18]. However, the study is meaningless because—unlike the German Vertebral Artery Dissection Study Group—the researchers did not examine clinical records and were not able to determine whether the diagnoses they tabulated were accurate or whether the strokes were related to the type of manipulation.
Are Complications Predictable?
Some chiropractors advocate "screening tests" with the hope of detecting individuals prone to stroke due to neck manipulation [19-21]. These tests, which include holding the head and neck in positions of rotation to see whether the patient gets dizzy, are not reliable, partly because manipulation can rotate the neck further than can be done with the tests. Listening over the neck arteries with a stethoscope to detect a murmur, for example, has not been proven reliable, though patients that have one should be referred to a physician. Vascular function tests in which the patient's head is briefly held in the positions used during cervical manipulation are also not reliable as a screen for high-risk patients because a thrust that further stretches the vertebral artery could still damage the vessel wall." In a chapter in the leading chiropractic textbook, Terrett and a conclude have stated:
Even after performing the relevant case history, physical examination, and vertebrobasilar function tests, accidents may still occur. There is no conclusive, foolproof screening procedure to eliminate patients at risk. Most victims are young, without [bony] or vascular pathology, and do not present with vertebrobasilar symptoms. The screening procedures described cannot detect those patients in whom [manipulation] may cause an injury. They give a false sense of security to the practitioner [22].
Several medical reports have described chiropractic patients who, after neck manipulation, complained of dizziness and other symptoms of transient loss of blood supply to the brain but were manipulated again and had a full-blown stroke. During a workshop I attended at the 1995 Chiropractic Centennial Celebration, Terrett said such symptoms are ominous and that chiropractors should abandon rotational manipulations that overstretch the vertebral arteries. But, as far as I know, his remarks have not been published and have had no impact on his professional colleagues.
The lack of predictability has been supported by data published by Scott Haldeman, DC, MD, PhD, a chiropractor who has served as an expert witness (usually for the defense) in many court cases involving chiropractic injury. In 1995, he published an abstract summarizing his review of 53 cases that had not been previously reported in medical or chiropractic journals. His report stated:
These cases represent approximately a 45% increase in the number of such cases reported in the English language literature over the past 100 years. . . . No clear cut risk factors can be elicited from the data. Previously proposed risk factors such as migraine headaches, hypertension, diabetes, history of cardiovascular disease, oral contraceptives, recent head or neck trauma, or abnormalities on x-rays do not appear to be significantly greater in patients who have cerebrovascular complications of manipulation than that noted in the general population [23].
Haldeman's main point was he could not identify any factor that could predict that a particular patient was prone to cerebrovascular injury from neck manipulation. This report was published in the proceedings of 1995 Chiropractic Centennial Celebration and was not cited in either the RAND or NCMIC reports.
In 2001, Haldeman and two colleagues published a more detailed analysis that covered 64 cases involving malpractice claims filed between 1978 and 1994 [24]. They reported that 59 (92%) came to treatment with a history of head or neck symptoms. However, the report provides insufficient information to judge whether manipulation could have been useful for treating their condition. Of course, malpractice claims don't present the full story, because most victims of professional negligence do not take legal action. Even when serious injury results, some are simply not inclined toward suing, some don't blame the practitioner, some have an aversion to lawyers, and some can't find an attorney willing to represent them.
What Should Be Done?
Chiropractors cannot agree among themselves whether the problem is significant enough to inform patients that vertebrobasilar stroke is a possible complication of manipulation [21,25]. In 1993, the Canadian Chiropractic Association published a consent form which stated, in part:
Doctors of chiropractic, medical doctors, and physical therapists using manual therapy treatments for patients with neck problems such as yours are required to explain that there have been rare cases of injury to a vertebral artery as a result of treatment. Such an injury has been known to cause stroke, sometimes with serious neurological injury. The chances of this happening are extremely remote, approximately 1 per 1 million treatments.
Appropriate tests will be performed on you to help identify if you may be susceptible to that kind of injury. . . . [26].
This notice is a step in the right direction but does not go far enough. A proper consent should disclose that (a) the risk is unknown; (b) alternative treatments may be available; (c) in many cases, neck symptoms will go away without treatment; (d) certain types of neck manipulation carry a higher risk than others; and (e) claims that spinal manipulation can remedy systemic diseases, boost immunity, improve general health, or prolong life have neither scientific justification nor a plausible rationale.
In 2003, a coroner's jury concluded that Lana Dale Lewis of Toronto, Canada, was killed in 1996 by a chiropractic neck manipulation. Among other things, the jury recommended that all patients for whom neck manipulation is recommended be informed that risk exists and that the Ontario Ministry of Health establish a database for chiropractors and other health professionals to report on neck adjustments [27].
In 2005, the Canadian Chiropractic Association published a comprehensive clinical guideline for treatment of adult neck pain not due to whiplash.. Among other things, the document noted that very few studies have compared chiropractic treatment to no treatment, which means that it is difficult to determine the likely benefit of neck manipulation. The guideline also discussed risk factors and recommended that minimal rotation should be used when upper-neck manipulation is done [28,29].
In 2007, following an unnecessary neck manipulation, Sandra Nette developed "locked-in syndrome," a condition that has been described as "the closest thing to being buried alive." She is fully aware of her surroundings and suffers at times from extreme pain. She cannot swallow, speak, or breathe without regular mechanical ventilation and suctioning of her secretions. She cannot move her legs or left arm. Slight use of her right arm enables her to use a computer keyboard to communicate through a voice synthesizer. Her plight is readily apparent in videos posted to YouTube [30]. In 2008, she and her husband filed a class-action lawsuit intended to stop inappropriate chiropractic manipulation and force Canadian regulators to deal with this problem [31].
The Bottom Line
As far as I know, most chiropractors do not warn their patients that neck manipulation entails risks. I believe they should and that the profession should implement a reporting system that would enable this matter to be appropriately studied. This might be achieved if (a) state licensing boards required that all such cases be reported, and (b) chiropractic malpractice insurance companies, which now keep their data secret, were required to disclose them to an independently operated database that has input from both medical doctors and chiropractors.
Meanwhile, since stroke is such a devastating event, every effort should be made to stop chiropractors from manipulating necks without adequate reason. Many believe that all types of headaches might be amenable to spinal manipulation even though no scientific evidence supports such a belief. Many include neck manipulation as part of "preventative maintenance" that involves unnecessarily treating people who have no symptoms. Even worse, some chiropractors—often referred to as "upper cervical specialists"—claim that most human ailments are the result of misalignment of the topmost vertebrae (atlas and axis) and that every patient they see needs neck manipulation. Neck manipulation of children under age 12 should be outlawed [32].
For Additional Information
Neck911USA.com: Dangers of neck manipulation.
Chiropractors Angry about bus ad
Reader Comment
From a former chiropractor:
I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure.
More doctors misdiagnose patients than chiropractors everyday of the week.
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where did u go to med school pitt?
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Dr. Stephen Barrett of Quackwatch Exposed In Court Cases
At trial, under a heated cross-examination by Negrete, Barrett conceded that he was not a Medical Board Certified psychiatrist because he had failed the certification exam.
This was a major revelation since Barrett had provided supposed expert testimony as a psychiatrist and had testified in numerous court cases. Barrett also had said that he was a legal expert even though he had no formal legal training.
The most damning testimony before the jury, under the intense cross-examination by Negrete, was that Barrett had filed similar defamation lawsuits against almost 40 people across the country within the past few years and had not won one single one at trial.
During the course of his examination, Barrett also had to concede his ties to the AMA, Federal Trade Commission (FTC) and Food & Drug Administration (FDA).
P R E S S R E L E A S E
FOR IMMEDIATE RELEASE
Date: October 13, 2005
Location: Allentown, Pennsylvania
Court Case: Stephen Barrett, M.D. vs. Tedd Koren, D.C. and Koren Publications, Inc.
Court of Common Pleas of Lehigh County for the State of Pennsylvania
Court Case No.: 2002-C-1837
Contact: Carlos F. Negrete
LAW OFFICES OF CARLOS F. NEGRETE
San Juan Capistrano, CA 92675
Phone: 949.493.8115
Fax: 949.493.8170
email: mediarelations@healthfreedomlaw.com
mediarelations@negretelaw.com
URL: www.healthfreedomlaw.com
www.negretelaw.com
Dr. Tedd Koren, DC.
Phone: 800.537.3001
267.498.0071 Fax: 267.498.0078
URL: www.korenpublications.co m
Subject: Quackwatch Founder Stephen Barrett loses Major Defamation trial in Hometown
In a stunning development, Lehigh Valley Pennsylvania Judge J. Brian Johnson on Thursday, October 13, 2005, tossed out nationally known self-proclaimed ‘consumer medical advocate’ Stephen Barrett’s defamation lawsuit just minutes before it was going to be considered by a local jury.
The lawsuit, filed in August 2002, against also nationally known Pennsylvania chiropractor, lecturer, researcher and publisher, Stephen Barrett sought unspecified damages against Koren and his company, Koren Publications, Inc. for statements that he wrote in his newsletter in 2001 about Barrett.
Barrett, a long-time nemesis of chiropractic, filed the lawsuit because of Koren’s publication that Barrett was ‘licensed’ and in trouble because of a $10 million lawsuit and because Barrett was called a ‘Quackpot’.
In his defense, Koren contended that the statements were true and not defamatory and that he had a First Amendment right to write them in his newsletter.
Thursday’s ruling by Judge Johnson represented a major reversal of the finding of an arbitration in August 2004 wherein a panel of three local private attorneys reviewing the case had found in favor of Barrett and awarded Barrett $16,500 in damages and that Koren should publish a retraction. That award was appealed by Koren.
Dr. Koren was represented by well-known health freedom San Juan Capistrano, California, attorney Carlos F. Negrete for trial and Washington, D.C. attorney James Turner of Swankin & Turner. Easton, Pennsylvania attorney Christopher Reid of Laub, Seidel, Cohen, Hof & Reid served as local counsel for the team and was co-counsel for the trial along with Negrete.
Turner and Negrete have been well known for their representation of clients in the health food, supplement and vitamin industries as well as representing naturopaths, nurses, dentists, physicians, chiropractors and complimentary therapists across the country.
Turner’s experience dates back the 1960s when he joined consumer advocate Ralph Nader and was one of the groundbreaking Nader’s Raiders that made consumer advocacy popular and brought about significant changes in manufacturing and consumer protection.
In making the ruling to throw out the case, Judge Johnson granted a rare directed verdict to the jury finding there was insufficient evidence to support Barrett’s claims. Judge Johnson indicated that this case was one of those rare times where such a motion was appropriate.
Barrett operates the web site www.quackwatch.org , www.chirobase.org and 20 other web sites and has been a long time critic of chiropractic calling much of it"quackery".
The victory to chiropractor Koren comes almost 18 years to the date that chiropractors received national attention with their victory against the American Medical Association (AMA) by obtaining an injunction against the AMA from an Illinois federal judge for engaging in illegal boycotting of doctors chiropractic in Wilk et al vs. AMA.
Barrett had been an outspoken supporter of the AMA at the same time that Koren had been a vocal advocate that the AMA has, in recent years, violated the spirit of the federal judge’s order.
After the ruling, Koren proclaimed that: I am overjoyed and enthusiastic that this nightmare is over and that the science, art and philosophy of chiropractic and the work of all of my colleagues have been vindicated.
“This case took a toll on my life and family, but I knew that I was right in publishing the truth.”
Dr. Barrett has no right to misinform the public about chiropractic and other natural healing arts or to try to silence anyone who criticizes him or tell consumers that he is not what he purports to be.
“I believe that it is not right to be silent when there is a duty to inform the public and let the truth be told.”
For years, Barrett has touted himself as a medical expert on ‘quackery’ in healthcare and has assisted in dozens of court cases as an expert. He also was called upon by the FDA, FTC and other governmental agencies for his purported expertise.
He was the subject of many magazine interviews, including Time Magazine and featured on television interviews on ABC’s 20/20, NBC’s Today Show and PBS.
He has gained media fame by his outspoken vocal disgust and impatience over natural or non-medical healthcare, including his criticisms of two time Nobel Prize winner Linus Pauling.
Dr. Tedd Koren is known for his writings and lectures on chiropractic science, research, philosophy, and chiropractic patient adjusting.
He is known for his Koren Publications chiropractic patient education brochures, posters, booklets, books and other products that are used in chiropractors’ offices throughout the United States and around the world.
Dr. Koren also co-founded a chiropractic college, is on the extension faculty of two chiropractic colleges, is published in chiropractic and bio-medical journals and has received numerous awards in his field. His web sites include www.korenpublications.co m and www.teddkorenseminars.co m
In his 2001 newsletter, Koren published articles that revealed that even though he touted himself as a medical expert, Barrett had not been a licensed physician since the early 1990s.
He also published that Barrett had been the subject of a $10 million racketeering lawsuit [that had been withdrawn] and called him a ‘quackpot’ for the contradiction of his website and lack of credentials.
Koren’s trial attorney, Carlos F. Negrete of San Juan Capistrano, California, is known for his defense of physicians, chiropractors, dentists, clinics and natural heath providers who practice what is known as complimentary & alternative medicine and holistic healthcare. Negrete has also handled groundbreaking cases against HMOs in California and has represented many celebrities and politicians.
At trial, under a heated cross-examination by Negrete, Barrett conceded that he was not a Medical Board Certified psychiatrist because he had failed the certification exam.
This was a major revelation since Barrett had provided supposed expert testimony as a psychiatrist and had testified in numerous court cases.
Barrett also had said that he was a legal expert even though he had no formal legal training.
The most damming testimony before the jury, under the intense cross-examination by Negrete, was that Barrett had filed similar defamation lawsuits against almost 40 people across the country within the past few years and had not won one single one at trial.
During the course of his examination, Barrett also had to concede his ties to the AMA, Federal Trade Commission (FTC) and Food & Drug Administration (FDA).
This was not the first time that Negrete was a trial attorney in a Barrett case. He also represented anti-fluoridation advocate Darlene Sherrell in a federal lawsuit filed in Eugene, Oregon by Barrett.
Barrett also lost in trial of that case. Negrete also represented Robert King of King Bio Natural Medicine of North Carolina and MediaPower (manufacturers of CalMax and Nu-Zymes) of Maine in cases filed by an organization led by Barrett, which were lost by Barrett's organization.
Barrett has also filed a lawsuit against Negrete and his client Dr. Hulda Clark (author of The Cure for All Diseases and The Cure for All Cancers) , which is now pending and awaiting trial in San Diego, California federal court.
After the Koren trial, Negrete stated: “The de-bunker has been de-bunked. I am pleased and satisfied with this outcome for Dr. Koren and am proud that Dr. Koren did not succumb to the pressures of the intimidation of Barrett’s legal wrangling. Not everyone can stand up to someone as well known as Barrett.”
Negrete continued, “It is another great day for health freedom and alternative healthcare around the world. I am especially pleased that this most important victory was in Barrett’s own hometown. It just goes to show you that there is justice anywhere, even when you are a visitor challenging the home team.
Barrett is a shill for the medical and pharmaceutical cartels and his bully tactics and unjustified discrediting of leading innovators, scientists and health practitioners should not be tolerated.”
Negrete said, “You can be assured that our legal team will be wherever health freedom advocates and practitioners are being persecuted. The tide is now turning and people are no long accepting that synthetic drugs are the only form of treatment are the only way to address health concerns.
"Every day, consumers are becoming more educated about the benefits of holistic and alternative methods. This is something that the medical establishment obviously fears and wants to crush with false propaganda.”
Koren said that he would now go back to his home in Pennsylvania to spend more time with his family and continue to write, research, and lecture on topics concerning chiropractic and healthcare and the experiences he has gained from this precedent setting legal battle.
He plans to give new lectures to chiropractors across the country who are under attack or have been subjected to governmental actions.
He also announced that he is forming a new organization aimed at informing and assisting chiropractors across the country.
The trial started on Monday, October 10, 2005 and ended on October 13, 2005 Barrett was represented by local Allentown attorney, Richard Orloski.
CHIROWNED!!!!
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http://www.quackpotwatch.org/quackpots/quackpots/barrett.htm
CHIROWNED AGAIN.....
PLEASE tell me you have more than just Quack-Barrett as your proof.....
Oh, by the way....the Mayo clinic actually contacted my office to be part of a study on possible help with chiropractic and MS. Wow..we must REALLY be a scam. ::)
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The FACTS still stand regardless, he just repoted them. I never claimed he was an expert.
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Quackbuster Barrett Loses Appeal, Leaves Town
Self-proclaimed Quackbuster, Stephen Barrett, MD, who was recently handed
crushing defeats by chiropractor Tedd Koren and Ilena Rosenthal, has
announced he is leaving his home town and operating base in Allentown,
Pennsylvania.
On June 11th, 2007, the Superior Court of Pennsylvania affirmed a lower
court dismissal of Barrett's defamation suite against Dr. Koren. Barrett's
case was so lacking in merit the judge blocked it from going to the jury.
Barrett simply had no case against Dr. Koren.
This followed another stunning defeat last month in California. There an
appeals court ordered Barrett and crony Terry Polevoy, MD to post bonds of
more than $400,000.00 after they lost a defamation case against Illena
Rosenthal virtually identical to the Koren case.
Perhaps the fact that lawyers and judges in Allentown are catching on to his
intimidation schemes explains why Barrett is moving to Chapel Hill, North
Carolina. Barrett can run but he can't hide. Chapel Hill collection
attorneys are already being asked to locate his assets to pay his unmet
legal obligations. Assets of other Quackwatch, Inc., principals might also
be sought.
CHIROWNED yet AGAIN!!!!
By the way....his 'accomplice' Allan, Bostwick (will NOT refer to him as doctor as he is a scum bag) is in hiding so he cant be served with lawsuit papers. Coincidentally MISTER Bostwick wrote an article for Barrett just before disappearing. Perhaps he is actually dead from a upper cervical adjustment?? Wow...wouldnt that be ironic.
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The FACTS still stand regardless, he just repoted them. I never claimed he was an expert.
Dude..pull VALID research off of pubmed.....not some bullshit from a guy who is an OBVIOUS scam artist like you claim chiros to be. I mean, come on...the guy claims NO INCOME from 1993 and forward..yet is brough on as an 'expert witness' when major medical companies go to trial. When I have been called for depositions, I get $375/hr. How much do you think he is getting?? Look at who you are aligning yourself with!!