MD, PhD, FMedSci, FSB, FRCP, FRCPEd

The risks of consulting a chiropractor have regularly been the subject of this blog (see for instance here, here and here). My critics believe that I am alarmist and have a bee in my bonnet. I think they are mistaken and believe it is important to warn the public of the serious complications that are being reported with depressing regularity, particularly in connection with neck manipulations.

It has been reported that the American model Katie May died earlier this year “as the result of visiting a chiropractor for an adjustment, which ultimately left her with a fatal tear to an artery in her neck” This is the conclusion drawn by the L.A. County Coroner.

katie-may-ist-mit-34-jahre-gestorben

According to Wikipedia, Katie tweeted on January 29, 2016, that she had “pinched a nerve in [her] neck on a photoshoot” and “got adjusted” at a chiropractor. She tweeted on January 31, 2016 that she was “going back to the chiropractor tomorrow.” On the evening of February 1, 2016, May “had begun feeling numbness in a hand and dizzy” and “called her parents to tell them she thought she was going to pass out.” At her family’s urging, May went to Cedars Sinai Hospital; she was found to be suffering a “massive stroke.” According to her father, she “was not conscious when we got to finally see her the next day. We never got to talk to her again.” Life support was withdrawn on February 4, 2016.

Katie’s death certificate states that she died when a blunt force injury tore her left vertebral artery, and cut off blood flow to her brain. It also says the injury was sustained during a “neck manipulation by chiropractor.” Her death is listed as accidental.

Katie’s family is said to be aware of the coroner’s findings. They would not comment on whether they or her estate would pursue legal action.

The coroner’s verdict ends the uncertainty about Katie’s tragic death which was well and wisely expressed elsewhere:

“…The bottom line is that we don’t know for sure. We can’t know for sure. If you leave out the chiropractic manipulations of her neck, her clinical history—at least as far as I can ascertain it from existing news reports—is classic for a dissection due to neck trauma. She was, after all, a young person who suffered a seemingly relatively minor neck injury that, unbeknownst to her, could have caused a carotid artery dissection, leading to a stroke four or five days later… Thus, it seems to be jumping to conclusions for May’s friend Christina Passanisi to say that May “really didn’t need to have her neck adjusted, and it killed her.” … Her two chiropractic manipulations might well have either worsened an existing intimal tear or caused a new one that led to her demise. Or they might have had nothing to do with her stroke, her fate having been sealed days before when she fell during that photoshoot. There is just no way of knowing for sure. It is certainly not wrong to suspect that chiropractic neck manipulation might have contributed to Katie May’s demise, but it is incorrect to state with any degree of certainty that her manipulation did kill her.”

My conclusions are as before and I think they need to be put as bluntly as possible: avoid chiropractors – the possible risks outweigh the documented benefits – and if you simply cannot resist consulting one: DON’T LET HIM/HER TOUCH YOUR NECK!

108 Responses to Top model died ‘as a result of visiting a chiropractor’

  • You forgot to mention that she fell from a height and hit the side of her neck, causing the blunt force trauma. But I guess if you use TMZ as your reference, thats what you get. Sensationalised and biased reporting.

    • if you read my post again, you will find this: [she] “suffered a seemingly relatively minor neck injury that, unbeknownst to her, could have caused a carotid artery dissection…” you also find that initially there was uncertainty as to the cause of her death. and you will finally find that the uncertainty was cleared up by the autopsy and the coroner’s verdict: Katie May died earlier this year “as the result of visiting a chiropractor for an adjustment, which ultimately left her with a fatal tear to an artery in her neck”. so what is your problem? oh, I see! you are a chiro and fear for your cash-flow?

      • …and I am in good company; the BBC just reported this (http://www.bbc.co.uk/newsbeat/article/37707212/queen-of-snapchats-death-caused-by-neck-manipulation-says-coroner):
        The former Playboy Model died in February.

        The 34-year-old had been admitted to hospital after suffering a stroke and passed away four days later.

        Documents from the coroner, as seen by gossip website TMZ, appear to reveal she died from a tear to a neck artery sustained before the stroke.

        It reports this happened during a “neck manipulation by chiropractor”.

        It claims she died when this injury cut off the blood supply to her brain.
        She had previously tweeted her followers for advice about a neck injury on 29 January.

        A verdict of accidental death has been recorded by the coroner.
        There’s been no comment from Katie May’s family so far.
        The social media star had nearly two million followers on Instagram and appeared in publications like Playboy and Sports Illustrated.

        As well as modelling, she also worked for the magazine that launched her social media career after a cover shoot.
        She told the Huffington Post: “I worked hard to have a career that I was proud of and when the economy collapsed, our PR company closed.
        “I knew that I no longer wanted to work for someone else in a 9-5 job.
        “Modelling is not as glamorous as one would think, I have learned. It’s incredibly competitive.
        “However, I was feeling a bit ‘judged’ as being a ‘model’ so being able to grow my business and work with other influencers and brands and negotiate for myself – that really has created a dream job with the marriage of the two sides of the industry.”

    • Then show me, please, evidence, that neck “adjustment” can compensate such trauma! Real evidence, not anecdotal. And explain the mechanism, because it is pretty clear, what happens after trauma, so if chiropractors can counteract effects of trauma, it can be explained.
      You don’t believe chiropractors are beneficial? But, judging from your comment you at least are certain that they cannot cause any trauma or exacerbate the existing one. But why?

    • You forgot to mention that she fell from a height and hit the side of her neck, causing the blunt force trauma. But I guess if you use TMZ as your reference, thats what you get. Sensationalised and biased reporting.

      What a pathetic piece of pompous patronising!

      The part of the story about Katie May having hit “the side of her neck” was probably a fabrication. From what I have seen there was no confirmation of direct trauma. Even if it were the case, a direct blow to the neck may injure the carotid artery but it is exceedingly unlikely to injure the deep vertebral artery as is explicitly stated in the report was what killed Katie May.
      Coroners are not fools who write something in a report of an investigation of cause of death that might have extremely serious legal consequences for those involved. They need to be very careful not to write something that might not hold water in court.
      This young mother of a seven year old was in effect killed by a chiropractor’s manipulation of her cervical spine. There is no reason to doubt that anymore.

      If you want an even less “sensationalised and biased reporting” of chiropractic related stroke cases, here’s another victim of chiropractic denial*

      Here’s Sandy Nette’s story:
      http://www.medicaldaily.com/chiropractor-causes-complete-paralysis-46-year-old-woman-develops-locked-syndrome-after-therapy-rips

      There’s lots more…
      Scott Tatro:
      https://scottslockedin.com/Home_Page.html and http://www.wsaw.com/home/headlines/85253187.html
      Janet Levy:
      https://www.verywell.com/a-stroke-survivors-story-from-despair-to-hope-to-action-3145894
      Jennifer Saake:
      http://strokeofgrace.blogspot.se/2015/03/immediate-prayer-need.html
      Kevin Sorbo:
      https://youtu.be/cvmVnfJpY8E
      Christa Orsino:
      https://youtu.be/hPeOTomSU0A

      … these are only a few minutes worth of Googling for survivors of clearly chiropractic related strokes.
      I could go on and find scores of stories of victims who did not survive but I really don’t like link-dumpers, so look for yourselves.
      The barrel is hot and the gun is smoking and it is in the hands of chiropractors worldwide! They just k-lack intelligence and manhood to realise they would do much better by advising against cervical manipulation, ot only because of the rare but extreme consequences but because research cannot confirm its efficacy.

      * If you missed the link I star-marked above, then I recommend having a look. It is frighteningly revealing.

  • If she had fallen from a height and landed on her neck, the Chiropractor should have never adjusted her neck so soon after a trauma like that. The same day and twice in 48 hrs????

    • I endorse 100%.
      No practitioner can have it both ways.
      If the treatment they used was necessary and had at least a reasonable chance of benefit, they have to accept complications which arise are down to them.

      But should this case go to court I imagine the chiropractor will be asked, “Tell me what you thought you were doing. What evidence did you have that this patient had a ‘subluxation’ which might reasonably have benefited from any form of ‘adjustment’ whatsoever?
      Did you inform her of the risks she was taking, did she give fully informed consent?
      What do you say to those who suggest that neck injuries such as these will probably improve in any event, and that you are a charlatan seeking to make money from the vulnerable?

  • I hope that Katie May’s family sue the chiropractor who killed her and that the outcome of the suit is disclosed. I also hope that her Death Certificate will be published online, as has 39-year-old chiropractic victim John Hoffman’s, http://www.chiropracticstroke.com/victims.johnhoffman.php . Also, the Autopsy Report of 30-year-old chiropractic victim, Jeremy Youngblood, has been published online http://www.chiropracticstroke.com/pdf/Youngblood%20Death%20Certificate.pdf

    Meanwhile, here are some valuable links on the subject of complications of neck manipulation which cannot be denied by chiropractors…

    Dozens of published case reports in the scientific literature (covering c. 70 years):
    http://www.vertebralarterydissection.com/VAD-research/chiropractic-stroke-and-death.pdf

    A loose directory of reports of other deaths and catastrophic injuries associated with neck manipulation:
    http://www.ebm-first.com/chiropractic/risks.html

    Evidence that inappropriate neck manipulations are rife:

    QUOTE
    “Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them (11). And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment.”

    Ref: Spinal manipulation for the early management of persistent non-specific low back pain — a critique of the recent NICE guidelines, Edzard Ernst, Int J Clin Pract (18th August 2009). Reference (11) is Ernst E. Chiropractic: a critical evaluation. J Pain Sympt Man 2008; 35: 544–62. Page 6 of the paper mentions a report that indicates that only 11% of all cervical manipulations are “appropriate” and gives the reference Coulter I, Hurwitz E, Adams A, et al. The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND, 1996:18e43.

    (In fact, spinal manipulations in general don’t seem to be appropriate: http://edzardernst.com/2015/08/chiropractic-spinal-manipulation-placebo/ )

    U.S. chiropractors have no patient adverse event reporting systems due to a loophole:
    http://www.ebm-first.com/chiropractic/risks/1842-letter-from-britt-harwe-president-chiropractic-stroke-awareness-group-csag.html

    A summary of the only, and largely useless, chiropractic adverse event monitoring systems that are currently in place:
    http://tinyurl.com/6dhcxdc

    A chiropractor confesses: if [I] were to tell patients that “I can kill you”, then “half of them would walk out”
    http://www.ebm-first.com/chiropractic/risks/464-amani-oakleys-closing-in-the-lana-dale-lewis-inquest.html

  • “Sensationalised and biased reporting.”

    I wonder if they teach denial and distortion of the facts at chiropractor school? They certainly seem to have extremely robust psychological defences.

    Looking forward to reading the reactions of this blogs resident chiropractors to this story. Waits with expectation…

  • Not really a big fan of Chiro’s, I’m a DPT, but this study was recently published if you are keeping up with the topic. Neurologists usually bash chiros in my area. Believe the authors are Neurologists.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/

  • Katie May’s tragic death at the hands of a chiropractor will hopefully bring some much needed publicity to this subject, but I fear it will take the stroke and/or death of an extremely high profile celebrity, politician or sports figure to really break into the public consciousness.

    • It took the deaths of Michael Jackson and Prince to raise the consciousness of the public at large about the dangers of creating addicts by practitioners of “modern medicine.”

      Speaking of high-profile sports figures and their chiropractic physicians, Dr. Wm. Moreau was the Chief Medical Officer for the record-setting US Olympic team. By all accounts he performed spectacularly in his position. Perhaps the chiro-bashing dullards on this site(Hi, Kyle!) might wish to comment?

      Be well

      • @ Logos-Bios

        Thank you for highlighting a key difference between real medicine and quackery. Opioids are effective at treating pain, but they come with risks including addiction and abuse. This is why doctors struggle to strike the right balance in their prescribing. Contrast that with chiropractic neck manipulation: ineffective with risk of serious harm and often used for conditions unrelated to the neck or for “maintenance”.

        A young woman is dead and a child is left without her mother because because we’ve allowed anti-science quacks to assault people with impunity. Chiropractors are unable or unwilling to police themselves so it’s incumbent upon the rest of us to force changes. Unfortunately, even Katie May’s death is not getting the media attention it deserves. In the meantime Prof. Ernst’s conclusion to the post is a wise one to heed: “avoid chiropractors – the possible risks outweigh the documented benefits – and if you simply cannot resist consulting one: DON’T LET HIM/HER TOUCH YOUR NECK!”

        • @ Odd Frank

          I note that Odd Frank retreated from his red herring regarding chirpractic’s 19th Century beginnings as being somehow relative to, well, anything; he might be wiser than his oft-posted drivel implies.

          “Chiropractic is a medical non-starter,” belched Odd Frank. Perhaps Odd Frank would care to comment on off-label prescribing within “modern medicine” as a medical non-starter as well?

          I liked and laughed at the Dunning and Kruger reference he injected into the conversation. I had thought about using it myself regarding the many pseudo-intellectuals(including you) on this site, but I held back from doing so. In case Odd Frank hasn’t realized, nothing I’ve posted and nothing in my practice bears resemblance to the delusional, biased conceptions he has about mainstream chiropractic, or my own practice, in the USA. Chiropractic practice has changed considerably here and, like medicine, it has morphed and advanced its practice standards considerably over the last 40 years. Odd Frank won’t acknowledge this, however, even though he is quick to point out medicine’s advances (from bloodletting and thalidomide “treatments”). Odd Frank is a hypocrite, although I do enjoy his liguistic contortions as he attempts to make himself appear relevant in a topic about which he is an intellectual Neanderthal.

          Be well, Odd Frank

          • You repeatedly exemplify the definition of the term “gibbering idiot”.

            I have no doubt that your accuracy in the manipulation of reply buttons is on a par with your accuracy in the manipulation of vertebra.

          • “Chiropractic is a medical non-starter,” belched Odd Frank. Perhaps Odd Frank would care to comment on off-label prescribing within “modern medicine” as a medical non-starter as well?”

            sorry to necro this…

            I’m not Odd Frank, but I’ll take a crack at that.

            The difference between chiropractic and off-label prescribing is…

            off label prescribing is STILL based on our knowledge of biochemistry and how the human body works. So we know that chemicals with low inherent risks that are prescribed to treat one symptom, could indeed easily treat another that relies on the same, demonstrated, chemical pathways.

            chiropractic?

            ain’t got none o that. It is based on nothing but wishful thinking, period. it has zero biological basis for action.

            so then, the moron who posted that “challenge” is both ignorant of human biology, AND ignorant of how medicines work from a biochemical perspective.

            probably a chiropractor.

          • @Ichthyic

            “off label prescribing is STILL based on our knowledge of biochemistry and how the human body works.”

            Precisely! Amtimicrobial agents are a splendid example of this. Licensed indications for a given antimicrobial agent may represent only a narrow range of infections, but if lab tests indicate a bug infecting a patient is susceptible to a given agent, that makes a potent case for use that is technically “off label”.

            (I’ve given up responding directly to Logos-Bios: he only ever reiterates the same two arguments.)

    • @Kyle

      Opioids are indeed effective in treating pain and are medically necessary in some patients. Perhaps the RX’s for them should be limited to Pain Management specialists? After all, it is they who purportedly have the expertise in managing patients whose pain levels require such medication. Unfortunately, the majority of the RX’s are written by quack MD’s who are GP’s.

      Kyle laments the difficulty of such “quack prescribing”(my description) of these dangerous drugs as being one of striking the right balance…..now that’s RICH! Tell that to the many people who have become addicted and who have died by the overprescribing of these drugs by MD’s to patients who look to their doctors for evidence-based answers, not for a ticket to addiction or to a cemetary. These truths are easily Googled, as is the relative safety(compared to many medical procedures) of cervical SMT when performed by a skilled chiropractic physician.

      I agree that this lady’s death should be studied. I’m certain a jury will eventually determine if the chiropractic doctor was negligent or guilty of malpractice. The lady’s death is indeed a tragedy.

  • It might be good idea at this time to take a read of ORAC/Dr David Gorski’s previous blog on this event which is very well written and thought out! He looks at the time line in detail then discusses Katie Mays case, association and causation!
    http://scienceblogs.com/insolence/2016/02/08/did-chiropractic-manipulation-of-her-neck-cause-katie-mays-stroke/
    There is also the recent systematic review and Meta-analysis by neurosurgeons cited by ManualMedGuy above:
    http://www.cureus.com/articles/4155-systematic-review-and-meta-analysis-of-chiropractic-care-and-cervical-artery-dissection-no-evidence-for-causation
    @Blue Wode
    The assessment by Harriet not once mentions that the authors of the above systematic review are Neurosurgeons. She constantly refers to them as “THEY” and it comes across as the chiropractic profession burying its head in the sand instead of coming from outside the profession!
    This is a very important topic and the poor quality of medical reporting of adverse events is an issue as is the medical bias and dogma noted by the neurosurgeons! Interesting to see these words coming from neuro’s!
    We had a discussion here in Australia in regards to an accurate standardized adverse event reporting system across all professions (including physiotherapy) which I and many within my profession support. It was in 2014 and earlier this year I followed up with a doctor to find out what had eventuated. He replied that there was sniveling from the hospitals over who would fund it and it went no further! Frustrating!
    https://www.mja.com.au/journal/2014/200/4/need-chiropractic-adverse-events-reporting-system-australia

    • “It might be good idea at this time to take a read of ORAC/Dr David Gorski’s previous blog on this event which is very well written and thought out! He looks at the time line in detail then discusses Katie Mays case, association and causation!”

      Ask David Gorsky to do a thought out write up on following:

      http://nextshark.com/thai-model-sues-hospital-plastic-surgery-permanently-disfigures-face/
      http://www.oddee.com/item_96576.aspx
      http://www.therichest.com/rich-list/most-shocking/6-shocking-medical-mistakes-involving-celebrities/

      When he completes this writing, I will provide another 30 such reports and after that another 300 such reports. All based on doctors from the orthodox stream.

      Dr. Ernst can help provide customized feed back.

    • thanks!
      so the quack was the coroner and the true expert was the chiro?!?

    • @ Critical_Chiro

      The paper by the neurosurgeons is further scrutinised here:
      https://www.sciencebasedmedicine.org/chiropractic-ignoring-the-precautionary-principle-since-1895/

      QUOTE
      “The authors of the study at hand were concerned that the joint Position Paper published in Stroke by the American Heart Association/American Stroke Association, “Cervical Arterial Dissections and Association With Cervical Manipulative Therapy,” which suggested an association between stroke and spine manipulation, did not include a meta-analysis, nor did it seek to classify studies and grade the body of evidence. They sought to remedy that situation. They searched the literature and found 253 articles. Seventy-seven were judged by all reviewers to be non-relevant. Four articles were judged to be class III studies, and two were rated class II. And all of them showed an association between chiropractic and stoke.

      All.

      Let me repeat.

      It showed an association between stroke and chiropractic.

      For a useless procedure that should give one pause.

      But the quality of the studies was judged to be poor and at risk for bias.

      So? All the arrows point the same direction. Again, for a useless therapy based on fictions, the results, as mentioned in the first line of the discussion.

      The results of our systematic review and meta-analysis suggest a small association between chiropractic care and CAD.

      Very concerning.

      But then it gets weird as they then rationalize away the results. And these are neurosurgeons, not chiropractors.

      They go from:
      Our analysis shows a small association between chiropractic neck manipulation and cervical artery dissection.

      To:
      This relationship may be explained by the high risk of bias and confounding in the available studies, and in particular by the known association of neck pain with CAD and with chiropractic manipulation.

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

      To:
      Belief in a causal link may have significant negative consequences such as numerous episodes of litigation.

      But if all the data points the same way, a lack of belief that chiropractic manipulation would lead to the utilization of a dangerous and useless therapy, with subsequent strokes in people who might not have otherwise had one.

      What is a more significant negative consequence? Litigation because patient had a stroke associated with chiropractic or chiropractors no longer using a useless intervention because it might hurt people. As if THAT will ever happen. These authors evidently think litigation is worse than a stroke. That perhaps says something about the nature of medical litigation.”

      • @Blue Wode
        The debate is in regards to association and causation and poor quality of medical reporting of possible chiropractic adverse events! Any dissection in progress will present as neck pain! As has been said by @fedup after the initial trauma to the neck caused by the fall the chiro should not have touched the neck! Even though she went to the hospital first and was discharged I would not have assumed that possible red flags had been ruled out! I don’t trust anyone!
        It would be interesting to see the coroners report and the chiropractors clinical notes! Here we have AustLii to search for court documents, I wonder if there is something similar in the US?
        If chiropractic treatment is for mythical subliuxations then the risk/benefit is as you say unacceptable! If it is for chronic pain management and rehab where the patient comes in, gets treated, is given rehab and self management strategies and then discharged then the risk/benefit and cost benefit studies stack up well for chiropractic compared to alternate treatments!
        Litigation then it is definitely high on a neurosurgeons mind as the same level of insurance for me is $2000 while for a neuro here its around $125,000 and that is after the government has paid 50% for them. I dread to think what their premiums are like in the US!

        • Critical_Chiro wrote: “Any dissection in progress will present as neck pain…for chronic pain management and rehab where the patient comes in, gets treated, is given rehab and self management strategies and then discharged then the risk/benefit and cost benefit studies stack up well for chiropractic compared to alternate treatments!”

          No, the risk/benefit is still unfavourable. As we know that screening methods for patients who present with a pre-existing dissection are unreliable, the only conclusion that can be arrived at is that chiropractors should not manipulate necks under any circumstances.

          Critical_Chiro wrote: “If chiropractic treatment is for mythical subliuxations then the risk/benefit is as you say unacceptable!”

          Indeed, and that problem is HUGE. Notwithstanding customers with neck pain, just look at all those with *low back pain* who are having their lives put at risk…

          QUOTE
          “Chiropractors view the spine as an entity. Where they diagnose ‘subluxations’, they will normally manipulate and ‘adjust’ them (11). And ‘subluxations’ will be diagnosed in the upper spine, even if the patient suffers from back pain. Thus many, if not most back pain patients receive upper spinal manipulations. It follows that the risks of this treatment should be included in any adequate risk assessment.”

          Ref: Spinal manipulation for the early management of persistent non-specific low back pain — a critique of the recent NICE guidelines, Edzard Ernst, Int J Clin Pract (18th August 2009). Reference (11) is Ernst E. Chiropractic: a critical evaluation. J Pain Sympt Man 2008; 35: 544–62. Page 6 of the paper mentions a report that indicates that only 11% of all cervical manipulations are “appropriate” and gives the reference Coulter I, Hurwitz E, Adams A, et al. The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND, 1996:18e43.

          The chiropractic industry should be ashamed of itself.

          • @Blue Wode
            Have to agree with you in regards to patient coming in for low back pain or a sore big toe and getting their upper cervical spine treated by a hole in one vitalist chiro or any other vitalist chiro for that matter!

            “No, the risk/benefit is still unfavourable. As we know that screening methods for patients who present with a pre-existing dissection are unreliable, the only conclusion that can be arrived at is that chiropractors should not manipulate necks under any circumstances.”
            A thorough history and examination that looks for red flags is far more important than any screening test! Comparing Chiropractic risk/benefit and cost benefit to the alternative treatments is important Blue! Judicious use and only when clinically indicated is also important! Also discharging the patient once better!
            Recently listened to Scott Haldeman (DC, MD, PhD, Neurologist) at the COCA/CA conference and he sees crunch time for the vitalist chiro’s in the US within the next 5 years! He said that they are in for a shock if they do not change the way they practice!

      • A Canadian study, reported in the October 2, 2001 issue of the Canadian Medical Association Journal (CMAJ), puts the risk of stroke following neck adjustment at 1 in every 5.85 million adjustments. The study, which is based on patient medical files and malpractice data from the Canadian Chiropractic Protective Association, evaluated all claims of stroke following chiropractic care for a ten year period between 1988 and 1997.

        “This study is based on the most factual evidence available for determining the risk of stroke associated with neck adjustment,” said Dr. Paul Carey, one of the principal authors of the study. “There has been much recent speculation about this risk, and some neurologists have expressed concern that the risk may be higher than previously believed. This study indicates that there is no cause for undue alarm, and that the risk may, in fact, be considerably lower than previously thought.”

        The study identified 23 reported cases of stroke following neck adjustments (also known as cervical manipulation), as diagnosed by the treating physician, over the ten year period. This was compared to the estimated 134.5 million neck adjustments performed by chiropractors in Canada over the same time frame.

        Today’s publication points out that earlier surveys of neurologists who reported stroke following chiropractic treatment were not rigorous, and did not review patient charts to determine the type of adjustment that was performed, or even whether an adjustment was performed during the chiropractic visit implicated in the stroke.

        “Unnecessary alarm has been created by the release of unpublished data in the past based on flawed methodology,” explained Carey. “While it is possible that the experience of chiropractors does not reflect all strokes that occur following neck adjustment, this most recent study establishes such an extremely low degree of risk that patients can feel confident about the safety of neck manipulation performed by chiropractors.”

        Carey pointed out that other very common treatments for headache, and neck and back pain carry much higher risks of serious complications.

        He also noted that the study supports the recent research published in CMAJ by the Institute for Clinical Evaluative Studies which found that the incidence of stroke associated with neck adjustments is so rare, it was not possible for the researchers to establish a meaningful rate of occurrence despite the high number of cervical adjustments that are performed.

        The study, titled “Arterial dissections following cervical manipulation: the chiropractic experience” was authored by Scott Haldeman, DC, MD, PhD, FRCP; Paul Carey, DC; Murray Townsend, BSc, DC; and Costa Papadopoulos, MHA, CHE.

        Blue Wad’s interpretive “spin” regarding cervical SMT and CAD is laughably bogus. One simple way to evaluate the potential for negative outcomes of a precedure performed by a certain profesion is to view malpractice insurance rates; there is little wiggle room for research bias for insurers which care only about their own profit. I wonder if Blue Wad would care to venture a guess as to whether a murderous, profit-driven chiro pays more or les than an altruistic family doc practicing within the domain of “modern medicine”?

        Be well, Blue

        • Logos-Bios wrote: “A Canadian study, reported in the October 2, 2001 issue of the Canadian Medical Association Journal (CMAJ), puts the risk of stroke following neck adjustment at 1 in every 5.85 million adjustments.”

          That study wasn’t very helpful. Here’s why:

          QUOTE
          “A chiropractor-authored review of malpractice data provided by the Canadian Chiropractic Protective Association, for example, concluded that a chiropractor will be made aware of an arterial dissection only once per 5.85 million cervical manipulations. This stroke-manipulation ratio is widely quoted by chiropractors, despite the fact that court-litigated cases do not reflect the total number of manipulation-related strokes, most of which are unreported or undetected.”

          Ref: https://www.sciencebasedmedicine.org/neck-manipulation-risk-vs-benefit/

          And here’s one of the problems with manipulation-related strokes going undetected:

          QUOTE
          “Sometimes the damage is immediate and the patient collapses on the chiropractor’s table. Sometimes mild symptoms start immediately and progress after the patient leaves the chiropractor’s office. Sometimes the tear is a small one and it clots over; then days later the clot breaks loose, travels to the brain and causes a delayed stroke. By this time, the patient may not connect his sudden collapse to the previous visit to the chiropractor… Chiropractors do not follow up on every patient. Patients who have delayed strokes may never see their chiropractor again, so chiropractors would naturally tend to underestimate the risk. Many of these diagnoses are missed because the vertebral arteries are not typically examined on autopsy.”

          Ref: https://www.sciencebasedmedicine.org/chiropractic-and-stroke/

          Logos-Bios wrote: “Blue Wad’s interpretive “spin” regarding cervical SMT and CAD is laughably bogus…”

          Logos-Bios, out of interest I ran your use of ‘Blue Wad’ past my teenager. She replied, “pretty immature, isn’t it?”.

          Sadly, though, I doubt that her response will give you much pause for thought.

          • “This stroke-manipulation ratio is widely quoted by chiropractors, despite the fact that court-litigated cases do not reflect the total number of manipulation-related strokes, most of which are unreported or undetected,” cited Blue. Unfortunately, this obtuse, pasted quote does not answer the posed question as to why chiros pay significantly less than GP’s if the former render life-threatening, death-inviting treatments. The remainder of his post was anecdotal and speculative; in other words, drivel.

  • The coroner’s report said it. She died of a blunt force trauma. Since when does a neck adjustment cause this type of trauma? Yes Im a chiro, and i deliver many adjustments for years. No one, receives any blunt force trauma, vertebral artery dissection. So no, chiropractic does not cause any of these, just bad practitioners. Just as there are in the medical or any other para medical field too. Why dont you look into how many deaths under medical care? Why dont you scutinise your own? Defend your own patch for a change?

    • read up about fallacies, please; e. g. ‘tu quoque’
      alternatively, read what the coroner said: she died as a result of visiting a chiropractor’!
      alternatively, use your brain: a therapy’s worth is not in the relative lack of harm, it is determined by the risk benefit balance!

      • Fallacy: chiropractic physicians’ only value is administration of SMT for appropriate NMS disorders. Fact: chiropractic physicians’ primary responsibilities are to diagnose a patient’s problem, determine if the problem is amenable to conservative chiro/ancillary treatment, and decide whether additional imaging/lab/electrophysiologic testing or referral are warranted. Only after a clinical diagnosis has been established do mainstream chiros develop a proper treatment plan which may or may not include SMT. Of course such decisions are made by physicians, not by therapists. Good ol’ Edzard would have his like-minded, chiro-hating drones on this site believe that chiropractic = SMT, and nothing more. Yet he wouldn’t claim that a GP’s only value is in his/her legal ability to write RX’s, when, in fact, it is in his/her ability to diagnose(and then prescribe) the nature of a patient’s condition. Edzard is a real hoot! Biuased, but a real hoot nonetheless. I LMAO when I read most of his comments.

        Be well

    • @Andrew

      What’s a ‘blunt force trauma’?

    • Andrew on Friday 21 October 2016 at 10:12 has a vested interest;

      http://www.sportsandchiro.com.au/ where these are the “skills” (note fifth from the bottom);
      Sports Chiropractic
      Exercise Prescription
      Human Anatomy
      Active Release Technique
      Trigenics
      Strength & Conditioning
      Dry Needling
      Myofascial Release
      Tennis Elbow
      Golfers Elbow
      Sciatica
      Rotator Cuff Injuries
      impingement syndrome
      Frozen Shoulder
      compartment syndrome
      Carpal Tunnel Syndrome
      Repetitive Stress Injury RSI
      Chiropractic
      Low Back Pain
      Active Release
      Back Pain
      **Neck Pain**
      Fitness
      Rehabilitation
      Sports Injuries
      Headaches

      There are, however, some risks as the website states;

      The therapies offered by the practitioners at North Sydney Sports and Chiropractic have a long history of practice; however as with all treatments there are some inherent risks. These include:
      Aggravation of an existing condition
      Headache
      Rupture to disc
      Sprain/Strain to disc or ligament
      Infection
      Stroke or stroke-like symptoms
      Relaxed or sleepy feeling
      Bruising or muscle soreness
      Sprain/strain to muscle or tendon
      Fracture

  • I just read that the American Chiropractic Association offered condolences to May’s family, but defended chiropractic neck procedures (http://www.nbcwashington.com/news/national-international/NATLPlayboy-Model-Katie-Mays-Death-Caused-By-Chiropractic-Procedure-397902781.html?platform=hootsuite&_osource=SocialFlowTwt_DCBrand): “Our sympathy goes out to the family of Katie May,” they wrote in a statement. “With respect to the safety of neck manipulation, it’s important to understand there are risks and benefits to all treatments; however, the best available evidence indicates there is no causal relationship between neck manipulation and stroke. Millions of neck manipulations are performed safely in the U.S. every year, providing patients relief from common forms of neck pain and headache, and helping them to get back to their normal activities,” the statement continued.
    My comments to this:
    1) “risks and benefits” – yes, what are the benefits of neck manipulation for a patient who has just twisted her neck?
    2) “the best available evidence indicates there is no causal relationship between neck manipulation and stroke” – what evidence would that be?

  • This death is truly a tragedy. Time will tell if the chiropractic physician had ignored any clinical signs which might have contradicted the type of SMT he employed or whether this might have been an entirely unanticipated outcome resultant to no error on the part of the doctor.

    Unexpected outcomes occur in all areas of healthcare as evidenced below per the Jerusalem Post:

    A 28 year old man died of a heart attack soon after the end of bariatric surgery at Hadera’s Hillel Yaffe Medical Center to shorten his stomach so he could lose weight.
    The man, a resident of the area, suffered from chronic illness.
    His surgery was performed by a team of senior surgeons and was “successful without any unusual event.” However, an acute heart attack — a possible complication after the surgery — took place and killed him on the spot, despite efforts to resuscitate him. The hospital informed the Health Ministry as required.

    This outcome was also tragic!

    • ” Time will tell if the chiropractic physician had ignored any clinical signs which might have contradicted the type of SMT he employed or whether this might have been an entirely unanticipated outcome resultant to no error on the part of the doctor.”
      you don’t need time to tell – I can tell you: there is no good reason for manipulating the neck of a patient; there is no proven benefit. [the ‘doctor’ or ‘physician’ was a chiro btw.]

      • Apparently Edzard has failed to understand that the doctor whose patient died will likely be reviewed and possibly sued if he was negligent in performing cervical SMT for her condition. Once the facts of the case’s handling are known(hint: Edzard doesn’t know them!), the medical/chiropractic board and/or a jury will decide the matter. As Geir has stated, sometimes negative outcomes occur; furthermore, sometimes such outcomes occur despite proper management by a doctor. In other words, Edzard, your posted snipe at me belied even a minimalist understanding of cause and effect. Time will indeed tell if the Chiropractic physician was negligent or guilty of malpractice.

    • Logos-Bios said:

      Time will tell if the chiropractic physician had ignored any clinical signs which might have contradicted the type of SMT he employed or whether this might have been an entirely unanticipated outcome resultant to no error on the part of the doctor [sic].

      No, time will tell whether chiros and their supposed regulators learn anything from this tragedy. I doubt it very much.

    • Bariatric surgery works, chiropractic does not.

      • My sister was convinced she was overweight at 200 lbs. at 5’4″. Her bariatric surgeon enticed her to have surgery to regain her youthful figure. She was healthy, aside from carrying excess weight. She was 34 years old at the time of her death at the hands of her surgery from complications.

        The surgery was entirely elective and my sister did consent to it. Unfortunately, she had been brainwashed by the before-after pictures her surgeon had advertised.

        Mr. Bjorn Geir says that bariatric surgery works and chiropractic doesn’t. Well, I’ve had bad discs in my neck for years and had to have many injections into my neck at a rate of two to three sets per year for only marginal relief. At least $6500 per year was spent on the injections. Since I started having chiropractic treatment, I’ve not had to have any injections for three years now. I’m still alive. My sister’s dead because of a bariatric surgeon.

        • My sister’s dead because of a bariatric surgeon.

          I am very sorry to hear that, but it does not say anything other than ANY surgical procedure is always associated with risks. These risks are well known and always explained to all patients.

          Bariatric surgery in capable hands is relatively safe but obesity increases the risks of surgery markedly and many of the patients we are dealing with are very high-risk cases of morbid obesity, so the fact that there is morbidity and mortality involved should not come as a surprise to anyone.
          There are charlatans in this business as in any other. I know a few.
          The very reason I got involved in bariatric surgery in the first place is that patients from my country had been going for surgery in North America by a surgeon who was performing inappropriate operations and not taking proper care of his patients. One of them died in a hotel room. This does not mean that all american bariatric surgeons are bad. This was almost two decades ago and since then we have been improving the safety and effectiveness of these operations immensely.
          We are helping very obese, sick individuals and desperate people who have tried everything and the morbidity and mortality rate is not higher than in other abdominal surgery e.g. gallbladder removal.
          The risk/benefit ratio of bariatric surgery could be quantified. The numerical result of such a calculation of course depends on how you define efficacy and how you count risk and benefit. The risk of operative mortality (within 30days) in my part of the world is 1/2888,9 (18/52000) according to the SOReg (Swedish obesity surgery registry) If you divide that figure with the ratio of acceptably beneficial result (you can calculate this figure in a million different ways), say 90%, our last estimate in our own operated cases, you get the figure 0,000385 (which of course tells you just about nothing but this is a real, calculable number 🙂
          Bariatric surgery has been shown to increase life expectancy and improve and even cure many obesity related diseases namely diabetes, sleep-apnea, hypertension and so on, so there is much more to success in this kind of surgery than weight loss alone. I just received the second of three planned reports for 2015 from the SOReg. This latest report deals with, among other things, the resolution of comorbidities and life expectancy. It is very positive reading 🙂
          If anyone wants to have a look, the reports (in Swedish) can be found here: http://www.ucr.uu.se/soreg/index.php/arsrapporter

          BUT…!!
          The risk/benefit ratio of chiropractic cannot be calculated because you cannot divide by zero.
          Let’s keep to the risk of vertebral artery dissection (which of course the poor chiro’s heatedly dispute) and say very conservatively that this risk is in the ballpark of 1/6.000.000
          Anything from 1/300.000 to 1/6.000.000 has been estimated but we’ll give it the benefit of doubt and take the lowest estimate. Now, we wish to compare this with our estimate of the risk/benefit of bariatric surgery.
          If you try to divide 1/6.000.000 with the benefit of cervical manipulation, you get into trouble because there is no or negligible benefit. You simply cannot divide with zero. If there were any benefit, it would long since have been demonstrated in proper trials by chiropractors

          ………..
          With full respect to your sorrow “Quantum”, the fact that your sister died in conjunction with a certain type of surgical procedure is totally irrelevant to the discussion at hand, of whether chiropractic or any other manipulation of the cervical spine is safe and efficacious.
          Trying to make and burn a straw man out of the fact that I work in a particular branch of surgery and thereby drawing the attention away from the much more serious matter of chiropractor’s ignoring the risks of their ministrations is simply childish, even more so coming from someone who has not the courage to express him- or herself without hiding behind a silly nickname.

        • The trouble is that random anecdotes on the internet don’t mean all that much.

          A friend of mine went to a chiropractor and when they tried to manipulate his neck they actually pulled his head off!

        • Unethical, incompetent bariatric surgeons’ outcomes will likely not be addressed on this site, Quantum. This forum focuses on perceived errors in paramedical fields; discussing medical errors is tantamount to sacrilege among most contributors here.

          I’m sorry for your loss at the hands of a bariatric surgeon who presumably had been licensed as a practitioner of “modern medicine.” I hope Geir’s words, “Bariatric surgery works, chiropractic does not” will give you some solace.

          • Logos-Bios’ preoccupation with obesity surgery is evident. I hope it only stems from his/her(?) dislike of me.

            “…discussing medical errors…” is not the topic of this blog. I engage in that discussion elsewhere and you can rest assured that I work diligently for the promotion of safety and improved outcome in my field of expertise.

            Bringing this kind of argumentation into the discussion of the safety and utility of chiropractic or of any of the scores of other unproven, unlikely, oft promoted healthcare creations dealt with in this blog, is a childish ‘tu quoque’ type of fallacy.
            It is perhaps best likened to arguing that because airplanes sometimes fail, broomsticks and flying carpets are a better alternative.

          • Geir loves to play the Tu Quo Que card even when its use is misplaced. Geir apparently doesn’t assimilate clearly written language very well: my post to which he regurgitated his tu quo que claim was obviously addressed to Quantum, a person who lost his sister to a bariatric surgeon’s procedure; my statements were meant for Quantum. Since my post was relative strictly to Quantum’s statements, Geir’s claim is farcical. No surprise here.

      • Geir,

        I don’t dislike you; I don’t even know you personally. It’s your presumption of knowledge, minimal as it is, about chiropractice which makes you “low-hanging fruit” in serious discussions about the profession.

        I would hope that you are an outstanding surgeon who cares greatly for his patients. Ignorantly blathering on as you do about chiropractice suggests that you need to inform yourself as to how it’s practiced in mainstream America.

        One must simply laugh at the extremes to which anti-chiro folks(Geir et al) will go in attempting to spin every negative perception or random negative outcome regarding the chiropractic profession as emblematic of the profession at large. We have medical subspecialties such as Geir’s bariatric surgery in which even the most friendly researchers purport .2-.5% deaths within a month of surgery. Some studies have uncovered that 4.6% of post-surgical patients die within a year. Of course such reporting doesn’t even take into account the attributing by bariatric-surgery stakeholders of post-surgical deaths to “other” causes; were the “logic” of contrived cause and effect applied to bariatric surgery in the way some here are applying it to chiropractic cervical manipulation, it would be clear to even the uninformed that such surgeries should be considered at least as dubious from a mortality standpoint. I wonder why malpractice insurance for chiropractic physicians is but a fraction of that paid by bariatric surgeons if, in fact, chiropractic care is so dangerous?

        • L-B is evidently not the sharpest knife in the drawer. I guess (s)he reads my comments but the comprehension is clearly limited and highly selective.
          L-B has repetitively been trying to divert the discussion away from that of risk-blind chiropractors by accusing me as a critic of chiropractic of being a myself a practitioner of purportedly perilous surgery. This is called “waving red herrings”and applying “tu-quoque” type argumentation, which is childishly immature at best.

          The figures this chicken-brained commenter quotes for mortality in obesity surgery without even giving any references, are far from being correct, at least not to the situation today in areas where surgery for obesity is practiced properly. They may have been true over twenty years ago in low-volume, open surgery (non-laparoscopic). They are certainly not true in Scandinavia and Europe in general. I gave earlier the latest official data in Sweden, which show a 0,035% 30-day mortality*. The service I work in is even lower than that. Remember we are talking about surgery of a very high-risk population of morbidly obese and problems are to be expected, yet this is today considered low-risk. Technology and knowledge has come far in those past decades. Today, as I said before, bariatric surgery is not more dangerous than most other abdominal surgery. Why would the publicly funded health-care system in Sweden pays for bariatric surgery for those who need? They pay for nothing unless it is supported by hard facts they themselves check and control. It would be very strange for the Swedish social system indeed if this practice was so perilously poor and deadly as L-B tries to paint it. Our outcome is constantly monitored by the SOReg database I mentioned earlier. If we had even as low as 0,2% 30-day mortality (the lowest figure L-B mentioned) we would be stopped immediately and we would soon have to find another line of work because the regional governments would start sending patients elsewhere.
          The latest SOReg reports are in Swedish but will be available in English further on. (See the English pages)

          * The reason I spend time providing this information is partly to demonstrate the stark contrast to the practice of chiropractic, which is totally devoid of any such outcome control anywhere. It would of course be devastating to the business but had chiropractors been monitored by such a system as SOReg – Scandinavian Obesity Surgery Registry, we might today know whether neck manipulation is associated with morbidity and mortality or not.

          It will be no use continuing to bash bariatric surgery on this blog. I will simply reply in the future with a reference to this comment.

          • Geir again deflects as per usual. I have mentioned the bariatric surgery statistics, with references, in previous posts, yet the moronic Geir failed to adequately respond to them. Now the dolt suggests that references had not been provided; imagine that!

            Geir must indeed be a smooth-brained fellow who simply can’t comprehend that the practice of mainstream chiropractic in the USA might be different than that in whatever country in which he works. Geir is welcome to his own opinions, laughably specious as they are, about US mainstream chiropractic. He is also expected to stand up for his sub-specialty. However, the use of such surgeries to improve appearance of low self-esteem, otherwise healthy patients as advertised by such surgeons carries with it a mortality risk far greater than that of cervical SMT. The dullard Geir has stated, “Bariatric surgery works…” Quantum and his/her dead sister(dead at the hands of a profit-driven bariatric surgeon) must surely appreciate Geir’s advocating for abdominal surgery for the purpose of enhancing physical attractiveness.

            Geir has stated he will not respond to the bashing of bariatric surgery on this blog; he will simply reference his last post. Ol’ Geir loves to dish it out, but when his own profession is criticized, he reflexively resiles into full denial and retreat. Good ol’ Geir….a classic bully with no chops. Priceless!

          • Typical how quacks loose their composure when their claptrap is succesfully thwarted. This one seems to have taken heavily to the bottle before blaring out its latest chagrin. Edzard’s law at work 😎

            … and by the way, Geir is only my middle name.

          • LMAO……Geir can’t conjure a cogent reply so he “loses composure” and lobs the “quack” descriptor at me. I expected nothing more of the dolt; he met my expectations. Of course he still is loathe to admit the much higher death rateof patients post bariatric surgery than post cervical SMT. Still ROTFLMAO…..Geir is humorous…in a pathetic sort of way.

            Be well, dear Geir(I couldn’t care less if Geir was your first, middle, or last name).

          • Remember we are talking about surgery of a very high-risk population of morbidly obese and problems are to be expected, yet this is today considered low-risk.

            I could not agree more.
            Every medical procedure carries risk, whether by performing it or by withholding it. Accusing surgeons of causing death is fine, as long as one looks at the death rates caused by not performing surgery as well. Isn’t that the difference between surgeons and chiroquacks? After surgery, the death rates fall, whereas the death rates rise after chiroquackery.
            Chiropractic is like recreational drug use: it may be pleasurable – probably even more so for the quack performing it – but one stands a better chance at a happy, healthy and long life without it.

          • It’s a shame that ol’ Bart(BBVB) hasn’t read Quantum’s post. His/her sister’s bariatric surgery was performed for cosmetic purposes as she had been healthy prior to the bariatric surgeon’s having killed her.

            BBVB of course plays padawan for Geir. When one of this site’s anti-chiro dullards(in this case, Geir) is on the wrong end of an argument, it is predicatble that another of his “buds” will attempt a rescue. LMAO

          • I couldn’t care less if Geir was your first, middle, or last name

            Of course you don’t. Facts don’t interest you. You are a quack-promoter, which means your favourite fantasies are the only things that matter and also meaning you have either dismal intelligence or a criminal mind, perhaps both.
            This blog post is about the deadly consequences of a quack practice that has no unique benefits. None. Even one death in a trillion is therefore one too many, and there are many more. It should be treated like smoking or climbing Mount Everest: no demonstrable benefits, very many demonstrable and demonstrated negative effects. It has no place in healthcare, only in questionable entertainment.

        • Bart’s Friday post represented perhaps the best that dolt has to offer: spurious opinions and defamatory gibberish. Perhaps he would like to try to prove his ridiculous allegations that I am a quack-promoter?

          Sadly Bart, like many others in this forum, comments on subjects about which he is almost entirely ignorant. Mainstream chiropractice is not what he thinks it is; had he taken the time to assiduously read my posts in this and previous threads, he would would have found(but likely not have admitted) that VSC is nowhere in my professional vocabulary. Of course Bart is too lazy to do so; it’s more fun for him to moronically claim negative characteristics about an entire profession(and me) when he is obviously ill-equipped informationally to do so legitimately. He is good for a few giggles occasionally, however.

          • Sadly Bart, like many others in this forum, comments on subjects about which he is almost entirely ignorant.

            Let’s assume, for the sake of argument, that all your blather about me is entirely correct.
            What does that tell us about the reliability, effectiveness, efficacy and safety of chiropractic, something you have consistently failed to provide credible information about?

          • @ Bart

            A PM&R doctor is more than a tool to deliver ESI’s and Trp injections. A chiropractic doctor is more than a tool to deliver SMT. Both of the afore-mentioned skills are only technical, and the real talents of physicians involve arriving at an accurate diagnosis for their patients and presenting those patients with evidence-based treatment options.

            Many of my patients never receive SMT. Those who have pain, but also adequate spinal joint function, might be actively rehabbed, given HEP, referred for pain management, referred for surgery, or merely counseled regarding lifestyle changes which would improve their presenting complaints.

            A large proportion of my patients are referred by GP’s and PM&R’s specifically for SMT. Those patients have been fully worked up but have not improved with meds, traditional PT, and/or paraspinal injections. The referring medical physicians send the patients to me as a provider of a service(SMT) which is not really performed well by non-chiro docs.

            BTW, I’ve provided information regarding the safety of SMT. Would you care to prove that I am a “quack-promoter”?

            Be well

  • other comments on neck manipulation and stroke (http://www.health.com/celebrities/chiropractic-adjustment-stroke-katie-may?xid=socialflow_twitter_health):
    But there is a chance, albeit very small, of potentially fatal complications. “It is known within the chiropractic and allopathic medical professions that cervical (neck) spinal manipulation can result in serious injury or death,” says Kimberly Washington, MD, a physician and chiropractor with the Osher Center for Integrative Medicine at the University of Southern California. “Though fortunately, this occurrence is very rare.”
    The odds are about 1 in 1 million, she wrote in an email to Health, but “estimates range from 1:200,000 to 1:3,000,000 with no clear consensus.”
    According to Health’s medical editor, Roshini Raj, MD, a stroke may occur when a chiropractic manipulation overstretches arteries in the neck, leading to a rupture or a clot that prevents blood from reaching the brain. If you’re worried, you can always ask your chiropractor to avoid your neck, she suggests.

  • Logos-Bios wrote: “This stroke-manipulation ratio is widely quoted by chiropractors, despite the fact that court-litigated cases do not reflect the total number of manipulation-related strokes, most of which are unreported or undetected,” cited Blue. Unfortunately, this obtuse, pasted quote does not answer the posed question as to why chiros pay significantly less than GP’s if the former render life-threatening, death-inviting treatments. The remainder of his post was anecdotal and speculative; in other words, drivel.”

    @ Logos-Bios

    By not thinking through my previous reply, you have succeeded in proving my point.

    • Blue’s “point” was off-point and did not specifically address my posed question. Try harder, Bluesy.

      • Logos-Bios wrote: “Blue’s “point” was off-point and did not specifically address my posed question. Try harder, Bluesy.”

        @ Logos-Bios

        I did address your question, but I don’t mind going over my points again, no least because, hopefully, they will help to inform unwitting members of the public (most of whom will have to rely on ineffective chiropractic regulatory bodies to ‘protect’ them).

        So, in addition to my previous reply to you which indicated that insurers are likely to be aware of only the tip of the iceberg regarding complications arising from chiropractic…

        QUOTE
        “Sometimes the damage is immediate and the patient collapses on the chiropractor’s table. Sometimes mild symptoms start immediately and progress after the patient leaves the chiropractor’s office. Sometimes the tear is a small one and it clots over; then days later the clot breaks loose, travels to the brain and causes a delayed stroke. By this time, the patient may not connect his sudden collapse to the previous visit to the chiropractor… Chiropractors do not follow up on every patient. Patients who have delayed strokes may never see their chiropractor again, so chiropractors would naturally tend to underestimate the risk. Many of these diagnoses are missed because the vertebral arteries are not typically examined on autopsy.”

        Ref: https://www.sciencebasedmedicine.org/chiropractic-and-stroke/

        …surely it goes without saying that medical doctors pay higher insurance rates due to many of their interventions being invasive?

        There is then this to consider:

        QUOTE
        “Doctor-bashers use their numbers to argue that alternative medicine is safer. Maybe it is. I suppose not treating at all would be safer still. It depends on how you define “safe.” To my mind, a treatment is not very “safe” if it causes no side effects but lets you die. Most of us don’t just want “safe:” we want “effective.” What we really want to know is the risk/benefit ratio of any treatment.
        The ironic thing is that all the statistics these doctor-bashers have accumulated come from the medical literature that those bashed doctors have written themselves. Scientific medicine constantly criticizes itself and publishes the critiques for all to see. There is NOTHING comparable in the world of alternative medicine.
        When errors are identified, doctors take actions to prevent them. We are constantly trying to reduce the number of medication errors, the number of unnecessary surgeries, the overuse of antibiotics, etc. It’s one thing to say that more efforts are needed. It’s something else to condemn all of modern medicine because we imperfect humans have not managed to entirely eliminate all errors.
        I’ll be the first to admit that there is a great deal wrong with modern medicine, but it makes more sense to fix what is wrong than to reject the whole shebang. Alternative medicine is not a rational alternative; it’s a belief system with a very poor track record.
        If the doctor-bashers want to play statistics, how about comparing death rates with modern scientific medicine to death rates with alternative medicine and death rates with no medicine at all. That might really be interesting!”

        Ref: https://www.sciencebasedmedicine.org/death-by-medicine/

        And here’s something else for you to think about: reports of deaths after chiropractic treatment are “about three times the number of deaths from trovafloxacin, an excellent antibiotic abandoned in the U.S. as too dangerous”
        Ref: https://www.sciencebasedmedicine.org/compare-and-contrast/

        Logos-Bios, if you don’t know by now that the risk/benefit ratio for neck manipulation is unfavourable, then here’s a reminder for you from further up this page:
        http://edzardernst.com/2016/10/top-model-died-as-a-result-of-visiting-a-chiropractor/#comment-82772

        I suggest that you keep going round in a loop on this thread – similar to the recent referencing style that Björn Geir decided to adopt in his dealings with you – until the penny finally drops. Failing that, you may just have to accept that you aren’t as smart as you think you are.

        • Bluesy, I’m no medical doctor-basher; I have great respect for medicine and for medical physicians, and not only because my daughter is a Med-Peds resident. I do have distaste for folks in any profession who attempt to denigrate practices in other fields as quackery, dishonest, profit-driven, etc. when exactly the same criticisms(and then some) they level at others apply to their own.

          Did I read correctly that you wrote that an MD’s procedures are more invasive than those of chiro docs and that such validates increased malpractice rates? I agree that many specialists perform highly technical and invasive procedures. If you would re-read my previous posts you would see that I have been referring to GP’s in my comments. Most GP’s do not perform highly invasive procedures except in emergencies. Ergo, you have still left adequately explained the marked difference in malpractice rates between GP’s and chiros, especially since you seem to base your goal of trying to condemn cervical SMT as being a high-risk procedure relative to stroke and VAD.

          I doubt you have considered that there are myriad manipulative techniques within the chiropractic profession for treatment of cervical dysfunction. Many, if not most, are very light-force and would be less deleterious to verteral artery viability and intraluminal blood flow than playing tackle football or hyperextending one’s neck while having his hair washed at a salon. I have no problem with the further study of cervical SMT, but the current, well countenanced, research on the procedure as performed by mainstream chiropractic physicians clearly evinces the risk of VAD/stroke to be quite minimal. 1/5.85 millio(1 x 10 to the negative 5 %) deaths is a bit better than the 4.6% of deaths stoked by the actions of some profit-driven bariatric surgeons, wouldn’t you say?

          You actually listed a citation from Edzard…..ROTFL!

          You are much smarter than Geir; he should be YOUR padawan. Still, chiropractic malpractice premiums are significantly lower than those of GP’s because competent chiropractic treatment is safe. As far as”going round in a loop on this thread,” your use of an Edzard citation suggests that you’re folding your cards. Be well.

          • Logos-Bios wrote: “Bluesy, I’m no medical doctor-basher; I have great respect for medicine and for medical physicians… You actually listed a citation from Edzard…..ROTFL!”

            With regard to Professor Edzard Ernst, MD, PhD, FMedSci, FSB, FRCP, FRCPEd (Maddox Prize winner, Nature journal), it is evident that that respect isn’t universal.

            Logos-Bios wrote: “Most GP’s do not perform highly invasive procedures except in emergencies.”

            Unlike chiropractors, they see very sick patients on a daily basis and have the responsibility of triaging them. IOW, they have patients’ lives in their hands.

            Logos-Bios wrote: “I doubt you have considered that there are myriad manipulative techniques within the chiropractic profession for treatment of cervical dysfunction.”

            I would venture that many chiropractors are lazy and go straight for the neck snap (which far too many still believe is a panacea). For example, Fig. 2 here is rather telling:
            http://ptjournal.apta.org/content/79/1/50

            Indeed, I understand that some in the chiropractic industry refer to this style of ‘care’ as “stack ’em, rack ’em, and crack ’em”.

            Logos-Bios wrote: “Many, if not most [manipulative techniques] are very light-force and would be less deleterious to verteral artery viability and intraluminal blood flow”

            Until that ‘many’ and ‘most’ become *ALL*, chiropractors have a problem.

            Logos-Bios wrote: “chiropractic malpractice premiums are significantly lower than those of GP’s because competent chiropractic treatment is safe.”

            The message still isn’t getting through to you, is it? See:
            http://edzardernst.com/2016/10/top-model-died-as-a-result-of-visiting-a-chiropractor/#comment-82772

        • Bluesy, I loved your 9:05 Friday post. It was loaded with snark and vacuous of cogency. In other words, it was a typical post from you. You do make me smile, though.

          Be well

          • Logos-Bios wrote: “I loved your 9:05 Friday post. It was loaded with snark and vacuous of cogency. In other words, it was a typical post from you. You do make me smile, though.”

            @ Logos-Bios

            What a strange attitude you have. I can’t find anything to smile about when I scrutinise a quack industry that can kill or wreck lives. See:
            http://edzardernst.com/2016/10/top-model-died-as-a-result-of-visiting-a-chiropractor/#comment-82772

          • Yawn….Bluesy implies, without proof, that chiropractic is a quack industry that can kill or wreck lives, as though such infinitesimally rare occurrences of post-cervical-SMT morbidity/mortality countenances his drivel. Medical errors account for over 250 K deaths in the US and represent the 3rd leading cause of death in the country. Off-label prescribing by drones within “modern medicine” is considered appropriate by many within the profession. There are some who disagree, however.

            Off-label prescribing can also harm patients, however. According to a report in Archives of Internal Medicine 2006; 166(9): 1021-1026, the potential for harm is greatest when an off-label use lacks a solid evidentiary basis. A 2006 study examining prescribing practices for 169 commonly prescribed drugs found high rates of off-label use with little or no scientific support. Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.” More than half the respondents in a survey of academic medical centers reported that innovative off-label prescribing raised concerns in their institutions, such as lack of data, costs, and unfavorable risk-benefit ratios. When substantial uncertainty exists about off-label applications, patients are at risk of receiving harmful or ineffective treatments.

            It seems our medical brethren are quite guility of “hocus pocus”(dare I say, quackery?) practices when it suits them…or when their drug reps buy them expensive lunches while extolling the virtues of their peddled products for off-label use. Never mind the lack of large-scale RCT’s, or even small RCT’s; somethimes even a decent cohort study is lacking in support of “physician judgment” sans evidence-based criteria for treatment. I can’t wait for Bluesy’s claim of tu quo que.

            Regale us again, Bluesy, about the death-inducing quackery that is chiropractic, but be sure to produce definitive statistics which evince that there are more chiro-related deaths and injuries than those relative to just this single dubious area of medicine: off-label prescribing.

            Be well, Bluesy.

  • Logos-Bios wrote: “…Bluesy…”

    @ Logos-Bios

    I suggest that you read this recent post written by Professor Ernst:
    http://edzardernst.com/2016/10/the-12-defences-of-charlatanry/

    Snippet:

    THEY WILL TRY TO RIDICULE THE CRITIC. Readers of this blog will have noticed how some commentators belittle their opponents by giving them laughable nicknames thus undermining their authority. The obvious aim is to make them look less than credible. Charlatans are like little children.

    THEY WILL CLAIM THAT IN OTHER AREAS OF HEALTHCARE THE EVIDENCE IS ALSO NOT CONVINCING. The ‘tu quoque’ fallacy is popular for distracting from the embarrassingly negative evidence in quackery – never mind that problems in the aviation industry are no argument for using flying carpets.

    Keep it going, Logos-Bios, with every post you are painting yourself into a corner.

    • Nice attempt at deflection, Bluesy. Sadly for you, such was too apparent to have been effective.

      I shake my head in disbelief that you would use Edzard’s opinions regarding discourse as some type of authority. Edzard is credible when he reports facts, sans opprobium regarding professions he subjectively despises. Unfortunately, he seldom reports simply facts without annexing defamatory snark which is sucked up by the unquestioning drones on this site. I respect Edzard’s(or anyone’s)confirmed, stated facts; his opinons regarding paramedical disciplines are self-serving and spurious, however, and I therefore largely and justifiably discount them.

      “A Doral woman died Wednesday after undergoing surgery at Vanity Cosmetic Surgery in Westchester.
      Maria Christian, 32, was rushed to Kendall Regional Hospital after she went into cardiac arrest toward the end of a tummy tuck procedure, according to the clinic.” Now this could be viewed as simply a tragic accident since this patient was seemed to have been in perfectly good health at the time of the operation; I would view it as such. However, the biased Edzard and his acolytes(er, you) have chosen to not view a death purportedly due to cervical SMT as a tragic accident, but, rather, to the well documented-as-safe chiropractic procedure. Those of your prejudiced ilk would not call for never letting a plastic surgeon or his team perform any significantly invasive procedures; instead you would view it as merely an accident. Many in the medical profession are much like America’s Democrats: they circle the wagons when their compadres endure negative outcomes, yet they rejoice in those outcomes if it gives them an opportunity to score points against a competing health discipline.

      Be well, Bluesy

      • Logos-Bios wrote: “Many in the medical profession are much like America’s Democrats: they circle the wagons when their compadres endure negative outcomes, yet they rejoice in those outcomes if it gives them an opportunity to score points against a competing health discipline.”

        @ Logos-Bios

        I don’t understand why you think that chiropractic is a ‘competing’ health discipline.

        When compared to medicine, chiropractic is a much narrower field and the robust data that are in for it show that it cannot be justified.

        Let’s have some decent evidence for an intervention that’s uniquely chiropractic before we discuss any comparisons with medicine’s shortcomings.

        See http://edzardernst.com/2016/10/top-model-died-as-a-result-of-visiting-a-chiropractor/#comment-82772

        • “When compared to medicine, chiropractic is a much narrower field”. Not according to its founder. ‘Straight’ chiropractors, who swallow the ‘subluxation’ myth may or may not comprise a minority of practitioners, but the 2008 flare-up between the British Chiropractic Association and Simon Singh brought to light that even the BCA then claimed that that their members can help treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying.

          • There goes Odd Frank again referencing the chiropractic profession of the 19th Century. Note he didn’t recount non-sterile trepanation and bloodletting procedures that his “modern medicine” forebears advocated. Fast forward to the 21st Century and we can see that medicine has evolved nicely from its primitive beginnings and chiropractic is attempting to do the same. Of course, chiropractic pretty much self-funds its research and medicine enjoys the fact that the majority of the financial burden of research is born by taxpayers, drug manufacturers(surprise!), etc.

            Were Odd Frank to research the marked increase in clinical/scientific research involving chiropractic over the last 40 years, he would realize, but likely not admit, that chiropractic has changed considerably as evidence of what works, what doesn’t work, and what might work has become more available. Frank’s incessant references to founding chiro principles represent canards of the highest order. Then again, I expect nothing more from Frank.

          • @L-B
            Medicine was never one person’s big idea. Its “primitive beginnings” date back millennia. By contrast, chiropractic was pulled out of just one man’s ass in the late 19th–early 20th century. It made no sense in the first place but Palmer (and his son) found it made plenty of money.

            Were Odd Frank to research the marked increase in clinical/scientific research involving chiropractic over the last 40 years, he would realize, but likely not admit, that chiropractic has changed considerably as evidence of what works, what doesn’t work, and what might work has become more available.

            This year, the amount of research done on chiropractic is only 2.6 times as much as is done on homeopathy and barely 30% of research into acupuncture (see this blog post). The Cochrane database of systematic reviews has just 19 entries for chiropractic, all of which indicate the research is either methodologically inadequate or shows limited or no benefit to patients. I fully realize just how considerably chiropractic has changed as evidence of what doesn’t work becomes available: not at all.

          • @Odd Frank

            Frank continues to be inconsistent in his blather. He and others on this site basically consider chiropractic physicians to be technical deliverers of SMT…period. Of course they don’t consider MD’s to be human conduits from which pills can be pushed, nor should they. Physicians diagnose and offer treatment recommendations/RX’s; they are not defined only by their most commonly performed professional activity.

            Frank again digresses to chiropractic’s 19th Century beginnings at which time the profession was “pulled out of just one man’s ass,” according to him. He claims that medicine was never one person’s big idea, as though such a statement erases the multitude of medical-quackery disasters which have festooned the history of “modern medicine.” (he even nonsensically attempted to bolster the reputation of yesteryear medicine by stating that medicine’s “primitive beginnings date back millenia”). I’ve listed many of these in past threads so I won’t repeat them here. To utilize Odd Frank’s view of chiropractic as referring to those who utilize SMT, such SMT practices also date back to the BCE years; thus SMT was not conjured by D.D. Palmer but, rather, modified to include a healing philosophy which has been largely let go of by mainstream chiropractic via research techniques which were not available in 1895.

          • @Logos-Bios

            Is that supposed to be a response to my argument against your ‘point’ that “Were Odd Frank to research the marked increase in clinical/scientific research involving chiropractic over the last 40 years, he would realize, but likely not admit, that chiropractic has changed considerably as evidence of what works, what doesn’t work, and what might work has become more available.”?

            There is very little respectable research into chiropractic, but you don’t realize the fact, nor admit it. You just return with a stream of invective, ad hominem gags and endless, tiresome, tu quoques. For a while I tried not responding to your blatant trolling on this blog, but your thick-headed failure to recognize that chiropractic is a medical non-starter that rests largely in the hands of Dunning & Kruger types overcame my self-restraint.

        • @Bluesy

          Please define what you mean by a “uniquely chiropractic” intervention. Just about everything that chiros do is also done by allopaths and other medical practitioners, including PT’s.

  • Chiropractors seem keen to launch anti medicine diatribes when defending chiropractic but I wonder where they go for help if they were to suffer a broken leg or a needed treatment for a child with meningitis?

    • Here’s one answer.

    • Well, I’d go to one of my best friends for my broken leg; he’s an orthopedic surgeon whose brother happens to be a chiropractic physician. For meningitis, I’d go to the ER of the hospital at which my wife is a senior PT, and a close friend is the medical director of ER services. Why do you ask, James?

      • So you would be at the front of the queue (line) asking for help from “modern medicine”. The same modern medicine that you are on this forum trying your best to denigrate.

        Reminds me of this;
        https://www.youtube.com/watch?v=ExWfh6sGyso

        • @ James

          I know what a queue is, thank you.

          I’m not trying to denigrate medicine, and not only because many of my friends and family(my daughter is a med-peds resident and my wife is a PT) work within it; I respect the profession greatly, as well as the many open-minded professionals who embody it, few of whom post on this forum, apparently(lol). I am simply addressing the ignorance of many on this site and point out the outright hypocrisy of the many “zeros” who post drivel and heavily spun “conclusions” about mainstream chiropractice as it exists in the USA. Most of the complaints about mainstream chiropractice, and attempted forays into its past for the purpose of making the profession appear “mystical,” have been evinced to have parallels within medicine’s history. Pots which complain about kettles should realize that they often are both the same color.

          Be well, James

    • IMO, Katie May’s family are correct to sue for seven figures as it is becoming increasingly apparent that she should never have had her neck manipulated – IOW, all the contraindications were likely present beforehand, including an existing unfavourable risk/benefit profile for the procedure and an acknowledged current lack of reliable screening methods prior to manipulation. I hope that her family’s lawyers are reading this thread.

      Meanwhile, if the website of the chiropractor who allegedly treated Katie May is anything to go by, treating pinched nerves appears to be a priority with all the clinic’s chiropractors:

      QUOTE
      “When your spine is out of alignment, it can ‘pinch’ the nerves causing pain, discomfort or dis-ease. When the nerve is pinched’ then the signals from the brain or spinal cord can’t fully reach the muscles or organs and thus does not allow the body to reach its full potential. This is similar to a garden hose when kinked and the water barely dribbles out instead of the full flow of water.
      Chiropractic aligns the spine thus relieving the pressure on the nerve (or un-pinching the nerve.) This decrease in pressure allows for an increase of information to the nerves. This increase of information (I.E. temperature signals, energy, immunity…) is then passed to the muscles and organs so the body reaches its full potential.”

      Ref http://www.backtototalhealth.com/chiropractic/

      • Who knew that immunity passes through nerves like water in a garden hose?

        Sounds a lot like the sort of magical thinking that some chiropractors claim the profession abandoned years ago.

        • “Who knew that immunity passes through nerves like water in a garden hose?”

          Much as money passes through air, from your back pocket to theirs.

      • If the chiropractic physician was negligent or is thought to have committed malpractice, it is likely that he/she will be successfully and rightfully sued. I’m sure that this forum’s most active “actors” will follow the story and rejoice if a lawsuit results in a loss for the chiropractic defendant.

  • Logos-Bios wrote on Saturday 05 November 2016 at 15:24: “Please define what you mean by a “uniquely chiropractic” intervention. Just about everything that chiros do is also done by allopaths and other medical practitioners, including PT’s.”

    @ Logos-Bios

    Unlike ‘allopaths’ and other medical practitioners, including PTs, the majority of chiropractors continue to support the industry’s pseudoscientific beginnings.

    Bearing in mind that the inventor of chiropractic, DD Palmer, claimed, “I occupy in chiropractic a similar position as did Mrs. Eddy in Christian Science. Mrs. Eddy claimed to receive her ideas from the other world and so do I… we must have a religious head, one who is the founder, as did Christ, Mohamed, Jo. Smith, Mrs. Eddy, Martin Luther and others who have founded religions. I am the fountain head. I am the founder of chiropractic…” (ref http://www.chiro.org/Plus/History/Persons/PalmerDD/PalmerDD's_Religion-of-Chiro.pdf ), the current data on chiropractic practices show clearly that the majority of chiropractors don’t adopt an approach that is based on science.

    For example, a recent study by McGregor et al, which many chiropractors claimed showed that only 18% of chiropractors delivered inappropriate treatment…
    Ref: http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-14-51
    …turned out not to be the good news that chiropractors had hoped for. Significantly, the study stated:

    QUOTE
    “As with any investigation, this study has limitations. First, although the response rate was good at 68%, it remains unclear what practice perspectives and behaviours are associated with non-participants. Also, although the sample was randomly selected and stratified according to the number of licensed practitioners in each province, the sample represented only approximately 12 percent of practitioners from each province. As always, there is the possibility that despite the randomization scheme, a unique sample was selected, and generalizability is a possible concern.”

    Certainly, the results were somewhat inconsistent with other available data:
    http://tinyurl.com/pts2ns5

    Indeed, McGregor’s 1st, 3rd, 4th, 5th, and 6th subgroup descriptions don’t seem to exclude the unethical chiropractor element. IOW, 5 of the 6 subgroups could easily indulge in chiroquackery – (1) “Wellness”, (3) “general probs”, (4) “organic-visceral”, and (5/6) “subluxations”.

    Also, according to Science Based Medicine author, Jann Bellamy: “The survey was of Canadian chiropractors, most of whom graduated from Canadian Memorial Chiropractic College, which appears to have a more orthodox orientation than, for example, Life or Palmer…the groups not included in the unorthodox category doesn’t mean the others are necessarily free of unorthodox views.”

    As for the recent Chiropractic Observation and Analysis Study (COAST) which claimed to provide “an understanding of current chiropractic practice”, Harriet Hall (MD) at Science Based Medicine, who authored the post in the following link, has pointed out that the study…

    QUOTE
    “…tells us that a substantial number of chiropractors use quack methods, and the ones who do obviously can’t be science-based. It tells us that children are being treated with chiropractic in the absence of any evidence that it is effective…The study leaves many questions unanswered and raises some new ones; and it doesn’t provide any evidence to support the claims that chiropractic is being “reformed”.”

    Ref: http://www.sciencebasedmedicine.org/chiropractic-reform-myth-or-reality/

    @ Logos-Bios, as I always ask when I post such links, do you have any better data?

    Meanwhile, the above raises an obvious question: what justifies chiropractic?

    IMO, it is surplus to healthcare requirements. Indeed, according to one retired chiropractor, it could be in deep trouble in the next few years in the United States:

    QUOTE
    “Physical therapy, by 2020, will be provided by physical therapists who are doctors of physical therapy and who may be board-certified specialists. Consumers will have direct access to physical therapists in all environments for patient/client management, prevention, and wellness services. Physical therapists will be practitioners of choice in patients’/clients’ health networks and will hold all privileges of autonomous practice…There can be cooperation between chiropractors and other practitioners of manual therapy if everyone works under the common denominator of science and if treatment methods are standardized. Subluxation-based chiropractors whose goal is to improve health by removing nerve interference may use any one of a variety of esoteric techniques, making cooperation difficult or impossible. Until the chiropractic profession as a whole is properly defined and specialized and its practitioners uniformly limited in use of acceptable treatment methods, across-the-board cooperation between evidence-based manual therapists and chiropractors is not feasible.”

    Ref: http://jmmtonline.com/documents/HomolaV14N2E.pdf

  • @Blue Wode
    Interesting comment from Sam Homola!
    Scott Haldeman at a recent seminar noted that the subluxation based chiropractors will be in for a shock within the next 5 years if they don’t change the way they practice! Burying their heads in the sand at religious gatherings like Rubicon Group will not delay the inevitable!

  • My ex-wife suffered a minor stroke from chiropractic treatment causing a dissected carotid artery. After that I read that chiropractic treatment was the second biggest cause of dissected carotid arteries after motor vehicle accidents. After that experience I don’t doubt that the death of this unfortunate young lady could easily have been caused by the chiropractor.

  • The case histories keep accumulating: http://www.kwwl.com/story/35214577/2017/04/Friday/young-mom-in-critical-condition-after-stroke
    Let’s assume the majority, all if you like, cases of VAD occurring immediately or shortly after manipulation of the cervical spine with therapeutic intent all had predisposition for VAD. It is very likely that a number of them had not progressed to VAD had the VA not been stretched unnecessarily.
    In light of the fact[sic] that manipulation of the type that can stretch the VA has never proven efficacious, this kind of manipulation is not indicated in any situation and therefore the cases of VAD are PREVENTABLE BY NOT PERFORMING CERVICAL MANIPULATION!!!
    If chiropractors were honest people they had long ago put a moratorium on cervical manipulation. But chiropractors prioritize money before honour.

    “Chiropractic” is the name of a collection of lucrative parlour tricks an uneducated charlatan called DD Palmer invented over a century ago to replace magnetic healing.

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