A 2019 Annals of Internal Medicine review found no evidence that chiropractic cervical adjustments cause stroke or cervical artery dissection. The risk is no greater than after visiting a primary care physician. Careful screening for early warning signs like headache and neck pain helps identify patients who need further evaluation.
How safe is a chiropractic adjustment and can it cause a stroke? These are big questions on the minds of patients and physicians and chiropractors and has been for many, many years. But an exciting new piece of research released by the Annals of Internal Medicine showcase Chiropractic is absolutely safe and a cervical artery dissection, which can happen to the vertebral arteries and that's what we commonly associate with a stroke, is exceptionally unlikely to happen in a chiropractic clinic. As a matter of fact, they found and stood behind previous research which showcases you are just as likely to suffer from a cervical artery dissection in a primary care office as you are in a chiropractic clinic. So this new research was released just this year in 2019 and the title is A Risk Benefit Assessment Strategy to Exclude Cervical Artery Dissection and in Spinal Manual Therapy A comprehensive review. So these researchers looked back at many other studies that were many were longitudinal. Some of them included over 20,000 patients with over 50,000 adjustments given with no serious adverse events. They reference another study which showcases a CAD or a cervical artery dissection is only probable to happen in one in a multi million case. And when we look at that, we say is there causation, causation or is that just coincidence? And this research paper seems to indicate that chicken and the egg conundrum, where many of the symptoms typically associated with a cervical artery dissection are what drive people initially to visit their primary care doctor or their chiropractor. They this can be headache, neck pain, stiffness, challenges with cognition. These are common symptoms associated with what causes people to pick up the phone and call their primary care physician and a chiropractor. But it also these are some of the symptoms associated with a cervical artery dissection. So they found no causation whatsoever between receiving a chiropractic adjustment and having any sort of cervical artery dissection or stroke or. But what they did lay out was a very clear plan of action to minimize those risks. So what is that plan of action? It comes down to two words. History taking. Taking a fantastic history. Understanding what your patients are dealing with is absolutely crucial to making the best medical decision for them. These researchers put together a fantastic chart in and I will link this paper down below and they identify what are some of the environmental risk factors and what are some of the inherited risk factors that a patient might have. And all you have to do is look at those and say, hey, does this match you if you are the patient or does this Match my patient, if you are the physician. And then they bring up a couple other things. If you have two or more of some of these distinct symptoms, as they call them, then it would be a great idea to, to get a second opinion as quickly as possible to be on the safe side. However, if you answer these questions and you do not fall in this algorithm, then you are safe to receive manual therapy or what we would traditionally call a chiropractic adjustment. So this is just one more piece of research. Again, this came out in the Annals of internal medicine in 2019. It's a comprehensive review. They look at all of the literature, all of the research papers and ever done that tie into manual therapy, adjusting the neck and cervical artery dissection. And what they found is to date, there is no causation and the risk or the likelihood of undergoing a stroke or a cervical artery dissection is no greater visiting a chiropractor than it is visiting a primary care physician. So the act of going through an adjustment, as we know today, does not increase that risk whatsoever. But also, all chiropractors and physicians of all types should continue to be diligent, ask the right questions of their patients, and make the best clinical decisions so that there is no confusion between neck pain and headache or starting down the road of a stroke. The better that we can do as a profession, as physicians to identify those patients earlier on, the better off the patient will be. But rest assured, knowing going to a chiropractor is absolutely safe. And, and make sure that your chiropractor is asking fantastic questions, taking a good case history and doing a great evaluation to make sure he or she is giving you the best plan of action.
