Are the techniques used by chiropractors safe and effective?

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According to the American Chiropractic Association, each year about 20 million Americans see a chiropractor with complaints about back pain, neck pain, headaches and sinus problems just to name a few. Although the procedures performed during a visit may result in relief, concern has been raised about the safety of one such technique often used by chiropractors called cervical neck manipulation or cracking the neck.

There is a general lack of large, rigorously designed studies looking into the effectiveness of these manipulations. While some studies suggest that they help to lower blood pressure, ameliorate headaches and migraines and help with back pain, other studies suggest that this technique may result in tears in the carotid or vertebral artery eventually leading to a stroke. However, the question still remains about how common this occurrence may be. According to a 2010 study published in the International Journal of Clinical Practice, there were 26 published cases of deaths after spinal manipulation, although that number may be higher as cases of adverse events may not be reported. And another study, published in 2008 in the European Spine Journal, found that among those individuals who had strokes following neck manipulation, the majority had demonstrated symptoms of stroke prior to the procedure.

According to Felipe Albuquerque, a neurosurgeon in Phoenix who has studied stroke injury, The epidemiology of these injuries is almost impossible to ascertain. Studies suggest their incidence to be between 1 in 100,000 and 1 in 6,000,000 manipulations.

In reaction to these inconclusive findings, Dr. Preston Long, a licensed chiropractor whose newest book, Chiropractic Abuse: An Insider s Lament was released by the American Council on Science and Health in October of 2013, says, Spinal manipulation of the cervical spine should never take place regardless of the level of stroke risk due to the fact there is no scientific evidence that it is beneficial. The risk of stroke greatly outweighs any personal belief in benefits. There truly is no need for chiropractic.

Ultimately, it comes down to discussing the risks of procedures with your doctor before making decisions about whether or not to have the procedure done. And Dr. Wade Smith, a neurologist and director of the UCSF Neurovascular Service, sums it up in a few words. If the practitioner does not want to discuss risks, then you shouldn t go to that person.