March 16, 2023

"When you turn the neck side to side, those vessels will rotate within the bone. If you turn your head quickly or rotate quickly..."

"... like a car accident or manual manipulation or sport, the vessel can get abruptly torqued."

Said the neurosurgeon Betsy Grunch, quoted in "Is It Safe to Get Your Neck Manipulated by a Chiropractor? Most joint manipulations aren’t dangerous, but one rare complication can result in serious injury" (NYT).

In some cases, a [chiropractic] patient may be unaware that [arterial dissection] has occurred and the damage heals on its own. In others, a tear in the artery wall can cause a clot to form and result in a stroke and even death. It is unclear how common the complication is following chiropractic care — one estimate says that an arterial dissection occurs in one out of 1,000 neck manipulations, another says one in 5.8 million (three of the four authors on that study worked for chiropractic associations).

20 comments:

Aggie said...

I used to like seeing a chiropractor once in a while, but the neck manipulations have always given me the creeps. The last few times I've gone, I've asked them to use a percussor instead, or one of those small hand tools that is spring-loaded and >clicks< with low energy in the precise spot they press it. I can live with that one.

Gusty Winds said...

My Dad was a 40 year ER Physician. He always claimed Chiropractors were dangerous quacks.

I don't know if he's right. Just his qualified belief.

Motorcycles were always off limits in our household has well.

Yancey Ward said...

My youngest sister was involved in a head-on collision in 2014. At first, she appeared to be ok other than some fractured ribs and a broken ankle, but the doctors at Vanderbilt found she had dissected vertebral arteries- one was completely blocked by a clot, and the other was partially blocked. That night she had a cerebellar stroke on the left side. She survived the surgery, but she has some motor function, balance, and vision problems that are permanent today. Any neck injury should be taken seriously- it saved my sister's life.

Ice Nine said...

Chiropractic manipulation of the neck indeed puts the patient at risk for vertebrobasilar stroke. Rarely so, perhaps. But that stroke is a bad one to have. The odds are long but the stakes are high. Don't allow it to be done on you.

That said, Chiropractic spinal manipulation is very useful adjunctive treatment in run of the mill back strains. I say that as a 40 year (ER) MD, myself...who gets a chiro manipulation treatment every now and then. I also say that as the son of an Osteopath who was taught by his father how to do such manipulations. I have used it occasionally in my practice.

There is an abundance of Chiropractor quackery, *to be sure* - "curing" cancer, diabetes, etc; lots of herbal/vitamin peddling nonsense; gross overuse of x-ray... But I attest to Chiropractic working wonders when used appropriately.

The Neon Madman said...

The spine has 3 major functions:

1) to support the skull
2) to support the ribcage
3) to support the chiropractor

walter said...

An alternative to the standard Chiro is NUCCA.

Old and slow said...

Quacks, the lot of them.

William said...

The locus of neck pain caused by trauma or inartful manipulation is called a grunch, e.g., "I've got a grunch in my neck".

Humperdink said...

My last neck manipulation was my last and final visit to my previous chiropractor. It was so painful I was ready to punch him out. Neck manipulation out, lower back treatment in.

Rusty said...

Forget chiropractors. Find a good massage therapist instead.

Iman said...

In my teens, I was bodysurfing at Newport Beach and did that too-fast neck twist thing while going over a wave and remember a burning sensation and a weird, near blackout feeling that I never wanted to experience again.

Andrew said...

"Forget chiropractors. Find a good massage therapist instead" Al Gore.

Rob said...

Betsy Grunch should be the onomatopoeic name of a chiropractor.

donald said...

I went from Chiropractic to a blonde chick from Buffalo that OJ tried to pick up for years (She had worked for United as a ticket agent I believe). She looked like a taller Nicole. She was incredible and after about a year, the lower back pain went away. I ended up losing about fifty pounds after my wife died and between the two, it’s all gone. I lived with excruciating pain off and on for 30 plus years and then it was gone!

Aggie said...

I'll tell you what, though. I used to see a reflexologist back when I was working in the Caribbean, and East Indian chap (about half the population in the West Indies is East Indian). Had a grip like a pair of ice tongs, and he would spend about 40 minutes per foot. Amazing. Anyway one time he finished up and told me to stand. He got behind me and put his arms around mine, then behind the neck, almost like a half-Nelson. Then he kind of picked me up. I can't remember the exact manipulation, but every single vertebrae gave a 'crack', from bottom to top. It was almost analogous to a heavy zipper, the sound it made.

Wow! I was super energized for about an hour as a result, could not believe what an effect it had. My posture instantly felt renewed: Senses ultra-sharpened, everything brighter, felt like Superman. I was truly amazed, and any chiropractor I've ever spoken with since has been clueless what he did - they all say they've never heard of it.

Smilin' Jack said...

Twisting the spine around is, of course, a powerful tool in maintaining health. But be sure your chiropractor is well-trained. One wrong twist, and instead of curing your dandruff, it gives you cancer. Oops!

Michael K said...

I have seen a half dozen severe neck injuries by chiropractors when I ran the trauma center. Also, I want to emphasize the comment above about careful handling of neck injuries. When we got a trauma case in, the FIRST thing done was a lateral spine xray. My nephew was in a car accident just before Christmas. His sole injury was a C 5 spinal injury that has left him quadriplegic. He was seen in a local "trauma center" in Chicago and, because he was untouched visibly, they told him he was not injured and "faking" when he said he could not move his arms or legs. I don't know if they further injured him with ignorant handling. He was operated on the next day with a cervical spine fusion but has shown no improvement. He is in his 40s with three kids.

RigelDog said...

I have met TWO people who had the identical catastrophic nerve compression inflicted upon them by a Chiro manipulating their neck. The man I met eventually had surgery by a top specialist and got better after two years of pain and trying alternative treatments. The woman I know eventually had some vertebrae fused but unfortunately the nerve was damaged in the meantime and so while she has recovered the ability to swivel her head, unrelenting chronic nerve pain remains.

And yet government officials want to limit her access to the opiates she needs just to get through the day, just in case someone somewhere gets addicted.

Gospace said...

Had an acquaintance whose wide suffered just that injury and almost died. Yet- they continued going to the quack. IMHO chriroprator=quack. In NY chiropracty has to be covered by insurance according to the state. There's no transparency on how much my premium is increased because of that- but no one I now who sees a chiropractor sees them once or twice, then done. In fact, one of the courses in chiropractor college is how to keep a customer coming back for more... I see my doctor once a year for routine lab tests- because living in the Dictatorship of New York under Emperor Hochul I'm forbidden to walk into a lab and order those tests up on my own.

Rusty said...
Forget chiropractors. Find a good massage therapist instead.


Yep. For many problems, that is a solution. And for anything a chiropractor actually can do - and do safely - is a solution.

RigelDog said...
...
And yet government officials want to limit her access to the opiates she needs just to get through the day, just in case someone somewhere gets addicted.


A serious problem- not the addiction, but the inability to get needed pain relief. If it can't be cured- the best thing for the patient is to eliminate the pain. Some without pain, or for whom the pain is temporary, get addicted. I get a 10 day supply of oxycodone once a year or so from my VA practitioner. Last time was 9 months ago or so- still have half a bottle left. "Use as needed". And sometimes I do. Ibuprofen and tylenol are useless for me. Aspirin workd for headaches- which at age 60 I seem to have finally outgrown or something. Oxycodone for some pains, cyclobenzaprine for others. As needed. For some pains, one too many drinks also works. Alcohol- the original painkiller. Works great on toothaches.

For someone like your wife- in constant pain- so what if she also gets addicted? If it allows her to function, well, so what? From what I understand- for the purpose of getting high, higher and higher or more frequent dosing is required to get there. For actual pain relief- the same dosage constantly given works.

I especially don't understand the reasoning behing refucing strong painkillers to people in hospice for fear theyll get addicted. They'll be dead before the addiction affects their life. Let them live the rest of their life as pain free as possible.

walter said...

It's been a pretty shameful few years for allopaths...