09 May 2008

Chiropractic Warnings, or: Trouble Communicating Skepticism

I get the feeling that I'm very bad at discussing skepticism-related issues with my family. I always fear that either I'm too timid, or in passion and urgency I lose credibility. This is a case of the latter, if either. Maybe you can take a look and let me know what you think.

This is a particularly difficult case, because we know the object of my skepticism personally: Kent, neighbor and chiropractic kinesiologist. I know that some chiropractors are evidence-based and honest about the limits of chiropractic adjustment; Kent is not one of those chiropractors. As far as I know, he subscribes to both Vertebral Subluxation (the idea that body ailments are caused by nerve blockages, which can be cured by mechanical adjustment) and Applied Kinesiology (the idea that muscle strength can be used to diagnose and prescribe treatment for body ailments). I recall he once adjusted my mother, claiming to be treating her allergies. Normally I wouldn't have made too big a deal over this. I'm not likely to use a chiropractor ever again, but Kent's a good person with some probable talents as a physical therapist; I wouldn't begrudge my family's visiting him, despite some of the kooky theories he practices.

But this article from Science-Based Medicine has been staring me in the face for the past week and a half, and I couldn't bring myself to say "what's the harm?" anymore. The article describes a specific statistical correlation (with mechanism) between neck adjustment and basilar stroke.

So today I finally got up the nerve to compose and send the following email to certain members of my family. The damage is already done, but feedback is still appreciated.

And consider this addressed to you, too, if you happen to visit a chiropractor.


Chiropractic adjustment can kill you. I'm not exaggerating.

I've recently learned about a specific risk associated with chiropractic neck adjustment. The vertebral arteries that pass through the neck actually loop through holes on the sides of the neck vertebrae. This tethering kinks the vertebral arteries, and makes them particularly susceptible to injury. If the artery tears, it causes a type of brain stem stroke called a basilar stroke, which often strikes young (average early 40s) and can be fatal.

There is a clear link between chiropractic neck adjustment and basilar stroke. A quick, forceful thrust from a chiropractor stretches the artery rapidly and can induce tearing. Sometimes the stroke occurs immediately and the victim collapses on the chiropractor's table, whereas other times the damage is delayed.

It is estimated that 20% of basilar strokes are attributable to chiropractic adjustment (about 1,300 cases per year in the US). However, the link has not been properly studied; in the past, few doctors asked their stroke patients about their chiropractic history, and so many cases have gone unreported.

I don't know about you, but I've never heard any warning from Kent (or any chiropractor) about the risks associated with neck adjustment.

Maybe the risk is small. But here's a dirty little secret: neck adjustment has NO demonstrable benefit whatsoever. It derives from the chiropractic principle of subluxation (supposed nerve blockages caused by abnormalities of the spine), which is pure pseudoscience. So even the most minuscule risk isn't worth taking.

The bottom line is, chiropractic neck adjustment does no good, but can sometimes do incredible harm. I love you all, and would hate to see you come to any unnecessary harm. Please, I beg of you, do not let any chiropractor touch your neck. Never, ever. Not even Kent. He may tell you the benefits outweigh the risk, but he's wrong, and he can't force you to let him adjust your neck. It's your body, take care of it.

For more information on the link between chiropractic and stroke, see this link: http://www.sciencebasedmedicine.org/?p=94

Love to you all,

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