Strokes and Chiropractic

Is Chiropractic safe?

 

 

 

Stoke from Chiropractic? or accident?

“A coroner has determined that Playboy model and “Queen of Snapchat” Katie May died in February at 34 years of age from a stroke after a chiropractor treatment ruptured one of her arteries while manipulating her neck.” -Forbes

Many of you have already asked:

“Did you see the Playboy model who died after visiting a Chiropractor?”

“Doc I’m concerned… Doc is it safe…? Doc I’m not sure if I want my neck adjusted now”

These are just a sample of the comments that I have heard over the last week after Yahoo released an article on Katie May, a former Playboy model who suffered a stroke in January of this year.

Let me break down why this is a far more complicated issue than the article alludes to.

Katie May

Katie sadly passed away on Feb 1st, 2016 after suffering a spontaneous carotid dissection. She also suffered from a fall during a photoshoot just days prior and as she tweeted she felt like she had a “pinched nerve” in her neck. She had visited the hospital was discharged and saw a chiropractor the next day. 

The coroner’s report stated that Katie had suffered a carotid dissectionrelated to neck trauma. One thing that has to be understood is there is very little correlation with stroke and Chiropractic. The correlation in literature surrounds the vertebral basilar artery not the carotid. Chiropractic has never been implicated in the medical literature for a role in carotid dissection. It would take a substantial amount of force to cause a carotid desiccation. The Chiropractic Adjustment is just not force full enough to cause this kind of damage!

Vertebral Basilar Artery:

There is very little evidence to suggest a correlation of the risk of stroke and Chiropractic care. The statics do not support a causative relationship.  Most of the literature suggests that the correlative nature of chiropractic and stroke has to do with the early symptoms of a stroke. For example some of the earlier symptoms of stroke are headaches and neck pain, two of the most common reasons a patient will see a Chiropractor. Sadly those patients are already having a stroke and would have had one had they seen a chiropractor or not. For this reason strokes in a Chiropractic office  are no more frequent then the family physicians office. 

Here is one example of the nonsense I have read on line surrounding this case.

“She really didn’t need to have her neck adjusted, and it killed her,” Passanisi said. “And the scary thing is that the nurse told me it happens all the time.”

Here are a few examples of the statistics related to stroke:

Risk of Stroke:

  • Chiropractic Manipulation: .0000000012% or 3 in 165,000,000
  • Getting Hair Cut: .00003 % or 3 in 100,000
  • Neck Surgery: .0001% or 1 in 10,000

Note: Statistics sourced from the New England Journal of Medicine.

Department of Neurosurgery, Penn State Hershey Medical Center. Concluded in Feb of 2016:

“There is no convincing evidence to support a causal link between chiropractic manipulation and CAD.”

Source: https://www.ncbi.nlm.nih.gov/pubmed/27014532

“And the scary thing is that the nurse told me it happens all the time.”

Based on what you have read is it reasonable to conclude that this is an event that happens all the time?

I do not believe that a 3 in 165,000,000 occurrence rate is enough to conclude it happens all the time!

Compare that to the relative risk of death related to combined NSAIDS / ASPRIN use of 153 per 1,000,000 it’s hard to even draw a statistical comparison of risk. You are far more likely to die from your Aspirin than a neck adjustment.

The relative risk vs benefit is so far tipped in favor of the manipulation. While there will always be a certain group of people who are at greater risk of suffering a stroke, the Chiropractor is well trained to screen for and refer out as necessary.

I hope this clears up some of the real data surrounding Chiropractic and stroke. This is just another example of sensation sells and the media is running with it.
-Dr. Justin Johnson