Research Briefs
Chiropractic Profession Responds to Stroke Article
Chiropractors and chiropractic organizations responded strongly to an article
by W.S. Smith et al in the May 13 issue of the journal Neurology titled “Spinal
manipulative therapy is an independent risk factor for vertebral artery dissection.”
The authors contend that there is a relationship between cervical manipulation
and a rare type of stroke. They used a retrospective case series analysis using
surveys and phone calls to patients diagnosed with strokes and basically asked
them if they had a their necks manipulated prior to their stroke.
The article did not stop at the issue of strokes but instead extended its recommendations
to the care and treatment of all neck problems by chiropractors.
“There are a number of concerns with this article after cursory review.
The most significant, I think, is not necessarily the stroke issue per se, but
the fact that they say since there is no demonstrated benefit from getting your
neck manipulated for any reason, its clearly not recommended since you could
get a stroke from it,” said Dr. Keith Rau, a professor at Life University.
Smith, the lead author of the study, which was included in the May 12 medical
news section of WebMD, had this to say. “Some neurologists think chiropractors
are causing a lot of strokes, but we think it is a very low risk. I don’t
think it is so low that a patient doesn’t need to be informed about it,”
he said. “The consequences of stroke can be enormous. People should be
aware that spinal manipulation increases risk of stroke. Anybody who does a
procedure of any kind that carries a risk should tell their patients about that
risk.”
Daryl Wills, D.C., the president of the American Chiropractic Association, submitted
his criticism in a letter to The Washington Post: “The best estimates
of the odds of suffering a serious complication from a chiropractic neck treatment
are about one incident out of every two million treatments—the same odds
that you will die in a commercial airline crash. Even the most conservative
conventional medical treatment for neck and back pain—prescription non-steroidal
anti-inflammatory drugs (NSAIDs)—are hundreds of times more likely to
cause a serious reaction than the drug-free chiropractic approach to these conditions.”
Not everyone associated with the chiropractic profession was as critical of
the study however. Scott Haldeman, D.C., was quoted by WebMD on May 12 as saying,
“I think the basic information in the Smith study is very important. It
does confirm that there is a temporal relationship between stroke and spinal
manipulation that we cannot rule out.” But, Scott cautioned, “Their
evidence that spinal manipulation is a major cause of stroke is very weak. The
risk is not zero, and none of us are suggesting there isn’t some risk.
What we have basically got here is a situation we have to put into perspective.”
In contrast, the World Chiropractic Alliance (WCA) took perhaps the strongest
stance against the article. According to Terry A. Rondberg, WCA president, in
a May 16 WCA press release, the news media has become a co-conspirator in medicine’s
war against chiropractic. “Newspapers, magazines, the Internet, television
and news shows are using press releases from the medical and pharmaceutical
industries without bothering to ask questions about the validity of the research,”
wrote Rondberg. “The court ruling prevents the AMA from attacking us openly,
so the campaign by the medical industry has gone underground, with the media
doing the bulk of its dirty work.”
Research Reveals Possible Link Between Infertility and Spinal Problems
New research reveals spinal health may influence fertility changes and encourages
those considering parenthood to seek a thorough chiropractic spinal evaluation.
The
online Journal of Vertebral Subluxation Research (jvsr.com) recently announced
the publication of diverse case studies and commentaries documenting positive
responses to chiropractic care among infertile women, regardless of factors including
age, history and previous intervention.
These research articles demonstrate how undetected physical, mental, chemical
and emotional stress over time can act as insults and contribute to vertebral
subluxations, which cause nerve interference and may distort proper bodily function
and well-being. The histories of the women in these studies included stress from
motor vehicle accidents, childhood falls, blocked fallopian tubes, scoliosis,
and work stress that affects both mind and body.
Madeline Behrendt, associate editor of JVSR and content editor for this special
issue, said: “There is such a strong need for this research. I asked 50
women in my community if they knew where in the spine the nerves to the reproductive
organs are located. None of them had ever been told this basic information, but
they all wanted to find out, they knew it had implications for their health. I
urge all those struggling with the burdens of infertility to read this research.”
The research will be published throughout summer 2003 and is available at jvsr.com,
an online, peer-reviewed scientific journal.
Schools & Organizations Collaborate on Wellness Research
The Council on Chiropractic Practice, Life University, Sherman College of Straight
Chiropractic and Florida Atlantic University are teaming up for a collaborative
project to explore the potential of developing a gold standard for wellness based
health care.
The proposed project would enable the investigators to develop the infrastructure
for a five-year program encompassing a large, practice and institution based evaluation
of the general health and wellness benefits of vertebral subluxation-centered
chiropractic, as distinct from specific medical symptom relief (e.g., low back
pain, headaches, etc.). The practice-based design will allow the collection of
a large statistical sample (in excess of 30,000 patients under care) to control
for sociodemographic, prior existing condition, co-treatments, etc. and, using
standardized, patient-centered, health/wellness questionnaires, to directly examine
cross-cultural health beliefs and behaviors. Subject enrollment and data gathering
will include women and children to examine outcomes and potential disparities
in these groups.
The Project Addresses a National Dilemma
The cost of medical care in the United States exceeds several billions of dollars
annually. The strategies employed by medicine are focused on the prevention, early
detection, diagnosis, and treatment of specific diseases and conditions.
In contrast, the focus of this project will be on the enhancement of health as
opposed to the treatment or prevention of disease. The primary goal of the project
is to explore procedures that may facilitate the ability of patients to deal effectively
with stress, enhance function and foster independence.
The results of several studies suggest that chiropractic care may result in significant
savings of health care dollars. An analysis of an insurance database compared
patients receiving chiropractic care with non-chiropractic patients. The study
consisted of senior citizens over 75 years of age. It was reported that the persons
receiving chiropractic care reported better overall health, spent fewer days in
hospitals and nursing homes, used fewer prescription drugs and were more active
than the non-chiropractic patients. The chiropractic patients reported 21 percent
less time in hospitals over the previous three years.
Another study surveyed 311 chiropractic patients, aged 65 years and older, who
had received chiropractic care for five years or longer. Chiropractic patients,
when compared with US citizens of the same age, spent only 31 percent of the national
average for health care services. There was a 50 percent reduction in medical
provider visits. The health habits of patients receiving maintenance care were
better overall than the general population, including decreased use of cigarettes
and decreased use of nonprescription drugs.
Potential benefits of the research include reduced medical costs, improved productivity
and the development of effective techniques for coping with stress. Investigators
will implement the projects at several major American research institutions, including
Florida Atlantic University (medical and nursing schools), Life University and
Sherman College of Straight Chiropractic, with these institutions bringing a comprehensive
collection of expertise and resources to the project. For more information contact
the Council on Chiropractic Practice at ccp-guidelines.org.
Provide
your feedback on this article.
© Copyright 2003 Today's Chiropractic