Stroke from Neck Manipulation?
by
George DeFranca, DC
Recently the possibility of having a stroke following neck manipulation has been highlighted in the media. Although stroke from cervical or neck manipulation is a concern, its incidence is not only uncommon, it is very rare. Unfortunately, the media neglects to inform the public that some studies estimate its occurrence to be at 1 out of 400,000 to 1:5,000,000 manipulations! Furthermore, death from this form of treatment is so rare that it is hard to estimate an incidence, although some have estimated it to be at 1 out of 20,000,000 manipulations. A recent study determined that the chances of getting a stroke after seeing a primary care physician vs. a chiropractor are the same. They found out that these people were already in the process of stroking when they visited their doctor and their stroke did not have to do with anything the practitioner did.
To put those figures into perspective, let us construct a scenario where every car in the westbound lane of the Massachusetts turnpike passes through a clinic and has a cervical disc surgery performed on the occupant. On the other hand every car that passes though a clinic on the eastbound lane has a cervical manipulation performed on its occupant. Let's assume that the frequency of cars is 100 per hour in both lanes. Therefore, we have a situation in which there are 100 procedures performed per hour in each lane, one for cervical disc surgery, and the other for cervical manipulation.
Under these conditions, we would have to wait only 1 hour and 27 minutes before our first DEATH is caused in the westbound lane, ie., the cervical disc surgery procedure. If instead of surgery, the patients were given simple over the counter NSAID drugs we would notice our first fatality due to treatment in 1 day and 16 hours.
To experience our first stroke, not death, caused by cervical manipulation we would have to wait 833 days or 2.28 years. By contrast, the first death in the eastbound or cervical manipulation lane would occur after 22.8 years of waiting.
Put another way, if each step a person took represented a single treatment given, and about 2.5 feet make up an average step, a person would have to walk only 58 steps before someone having cervical disc surgery would die. By contrast, a person would have to walk 319,968 steps or 151.5 miles before suffering a stroke or 3,200,768,736 steps (that’s billion!) or 1,515,515.5 miles before dying when comparing cervical manipulation. That is equivalent to 60.6 times around the world!
What the media fails to do is put this information in context. Studies document that DEATH, not just stroke, can occur in 1 out of 4000 cases involved with the taking of NSAID drugs. NSAID drugs include aspirin, motrin, advil, naprosyn, etc. These are common over the counter medications that are advertised daily ad nauseum on television and radio advertisements. In addition, 1 out of 145 surgeries for cervical or neck disc disease can result in DEATH. Death from being hit by lightning per year is estimated to be 1 out of 2,000,000. The chances of DYING from being hit by a car as a pedestrian are 1 out of 20,000.
Cervical manipulation had been demonstrated to be a safe and effective treatment for a variety of musculoskeletal disorders including neck pain and headaches. The fact is that a person has a much greater chance of dying from taking certain common drugs that are widely advertised, a common neck surgery, or being hit by lighting or a car than from having a stroke as a consequence of cervical manipulation.
George DeFranca, DC
Recently the possibility of having a stroke following neck manipulation has been highlighted in the media. Although stroke from cervical or neck manipulation is a concern, its incidence is not only uncommon, it is very rare. Unfortunately, the media neglects to inform the public that some studies estimate its occurrence to be at 1 out of 400,000 to 1:5,000,000 manipulations! Furthermore, death from this form of treatment is so rare that it is hard to estimate an incidence, although some have estimated it to be at 1 out of 20,000,000 manipulations. A recent study determined that the chances of getting a stroke after seeing a primary care physician vs. a chiropractor are the same. They found out that these people were already in the process of stroking when they visited their doctor and their stroke did not have to do with anything the practitioner did.
To put those figures into perspective, let us construct a scenario where every car in the westbound lane of the Massachusetts turnpike passes through a clinic and has a cervical disc surgery performed on the occupant. On the other hand every car that passes though a clinic on the eastbound lane has a cervical manipulation performed on its occupant. Let's assume that the frequency of cars is 100 per hour in both lanes. Therefore, we have a situation in which there are 100 procedures performed per hour in each lane, one for cervical disc surgery, and the other for cervical manipulation.
Under these conditions, we would have to wait only 1 hour and 27 minutes before our first DEATH is caused in the westbound lane, ie., the cervical disc surgery procedure. If instead of surgery, the patients were given simple over the counter NSAID drugs we would notice our first fatality due to treatment in 1 day and 16 hours.
To experience our first stroke, not death, caused by cervical manipulation we would have to wait 833 days or 2.28 years. By contrast, the first death in the eastbound or cervical manipulation lane would occur after 22.8 years of waiting.
Put another way, if each step a person took represented a single treatment given, and about 2.5 feet make up an average step, a person would have to walk only 58 steps before someone having cervical disc surgery would die. By contrast, a person would have to walk 319,968 steps or 151.5 miles before suffering a stroke or 3,200,768,736 steps (that’s billion!) or 1,515,515.5 miles before dying when comparing cervical manipulation. That is equivalent to 60.6 times around the world!
What the media fails to do is put this information in context. Studies document that DEATH, not just stroke, can occur in 1 out of 4000 cases involved with the taking of NSAID drugs. NSAID drugs include aspirin, motrin, advil, naprosyn, etc. These are common over the counter medications that are advertised daily ad nauseum on television and radio advertisements. In addition, 1 out of 145 surgeries for cervical or neck disc disease can result in DEATH. Death from being hit by lightning per year is estimated to be 1 out of 2,000,000. The chances of DYING from being hit by a car as a pedestrian are 1 out of 20,000.
Cervical manipulation had been demonstrated to be a safe and effective treatment for a variety of musculoskeletal disorders including neck pain and headaches. The fact is that a person has a much greater chance of dying from taking certain common drugs that are widely advertised, a common neck surgery, or being hit by lighting or a car than from having a stroke as a consequence of cervical manipulation.