Case reports of adverse effects after chiropractic spinal manipulation usually come as publications in peer-reviewed medical journals. As such they tend to documents that are factual, detached and clinical. This is an intended effect and is meant to increase objectivity; at the same time it omits all of the directness and emotions that are associated with such incidences which can, of course, be important. Here is a case report that is dramatically different. It is a story told by a sibling of the victim (both had been having manipulations for migraines regularly) on this website. As I think it is poignant, I have not changed anything except for shortening it slightly.
My youngest brother has been receiving chiro for… long, however last week he received very, very aggressive neck adjustments 3 times in a row. The last one left him feeling off and he felt like it worsened his migraine. He called me asking if I had ever had an adjustment worsen a headache and I said yes, once or twice. He then told me it was creating a different vision issue than his regular migraine aura. I told him get to emergency ASAP. He had a full stroke 15 minutes later. At the age of 29 years. Thank God he went to ER, he told me he almost went to try to sleep it off after he hung up the phone.
An MRI and CT scan showed that the stroke was NOT a clot that was already formed and agitated/released by the neck adjustment. But that the adjustment had actually caused a large tear in his vertebral artery and that it had in turn caused bleeding into his brain and consequently the stroke.
The doctor told him that had he not come in right when he did, he would most certainly have died or in the best case scenario, been a vegetable.
I realize that perhaps the chiropractor did not realize how aggressive he was being or even consider the trauma he could cause. Or maybe, he made a poor judgement call, he is only human. I have since consulted my own chiropractor, who sadly, is of the opinion that it’s just not possible for a chiropractor to cause such trauma and that it simply was an issue waiting to happen and that the adjustment just ‘helped’ it along. He stated over and over that chiro CANNOT cause a stroke. I am scared enough to not go back. I find physio to help my neck more anyway.
The other part is, the ER doctor told my brother that he has seen what he considers to be an alarming increase in chiropractic related strokes and vertebral artery tears. I realize that nowhere NEAR even 90% of all patients adjusted have this issue, but it definetely exists and it IS scary.
I expect that several apologists will now accuse me again of being alarmist, but I do wonder how often such cases happen and remain unreported. I am certainly not aware that this case has been published in a peer-reviewed journal.
138 Responses to An unusual case report of a stroke caused by chiropractic neck manipulation
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incisive
“the best case scenario, been a vegetable”
“He stated over and over that chiro CANNOT cause a stroke.” There it is then. The evidence of a chiropractor.
@ Frank Odds on Friday 12 February 2016 at 15:38,
Do you mean a chiropractor who may consider themself a “primary healthcare provider”?
🙂
Hi Ezard still alive after all that aromatherapy treatment at the Royal Marsden. Those must be the only MRI and CT scanners in the world that can show, that a chiropractic adjustment “caused” a large tear in someones vertebral artery. Perhaps these scanners could explain what “caused” my cancer? Whats even stranger is how a tear in the vertebral artery could cause “bleeding into his brain”. Surely the bleed would be at the site of injury as there was “no clot”? Perhaps you could explain the mechanism that caused the brain to bleed from dissection in the vertebral artery, when this artery is located in the neck and if anything injury is going to reduce blood flow to the brain ??
good news!
glad you are alive and hopefully well!!!
1) the causal relationship was not concluded by a machine but by the neurologists who reported the case.
2) the vertebral artery enters the skull via the foramen magnum and continues under the same name for a while. the way they reported the case, I presume the dissection might have included this section of the artery.
How could a chiropractic “manipulation” cause a tear in the 4th segment of the vertebral artery?
see comments above
No “comments above” explain this to me.
However, I seem to pick up on a presumption that a rotary cervical “manipulation” is what causes vertebral artery dissection and intimal tearing.
Do you have evidence or access to chart notes/documentation that this was the type of “manipulation” given to this specific person?
@ Derry
You have as much information on this case as we have. Please read carefully the original account and the preceding discussion.
Do you have any evidence that says the sister is not telling the truth or that it was something other than classic chiropractic manipulation that the chiropractor applied?
Why should we doubt that it was chiropractic manipulation that immediately preceded the adverse event and is a very credible cause of it. Is there any reason to suspect that the chiropractor did something else than “forceful neck manipulation” or to doubt the veracity of the sisters account? Or maybe the victim just tripped and fell and then went to a hair stylist who was a bit careless with the comb?
Well Dr. Geir I believe that a site that is so passionately evidence based should be careful with conjecture and assumptions. I see many arguments end with “show me the evidence.” This case shows a glaring double standard. When that point is brought to surface, there is a massive firing squad defending why it is okay in this one particular circumstance.
This would not be much of an issue if manipulative and aggressive terms such as “cult” and “charlatan” were not applied to others attempting to have a conversation and defend something that they believe to be true.
There are many different ways that chiropractors have been taught to adjust the cervical spine. There is a major ASSUMPTION here that “a violent twisting of the neck, as seen in videos posted here” was performed. I must ask, where is the evidence?
I imagine a very angry “cult-like” flood of posts will soon follow in defense of this.
@ Merbles chiro,
“There are many different ways that chiropractors have been taught to adjust the cervical spine.”
So there are many ways? Is there a right way or does any old way work?
Anyway, how does one “adjust” a vertebrae? Does it move to a different position, temporarily or permanently? How do you know? Do you take X-rays before and after to show this to the people you faff about with?
Come on, what is your website so everyone can see what you get up to? I don’t think you are game to show anyone on this forum.
Did anyone say that the present case had a tear in the fourth segment (intradural) of the VA?
Neck manipulation of the chiropractic kind may cause intimal tears in the third segment where it passes the c2-c1-cranial foramina. Hemodynamic pressure may extend an intimal tear forward into the 4th (intradural) segment. What is more, that segment is thinner and may rupture and cause subarachnoid bleeding according to information I recently was given and is also referred here:
https://en.wikipedia.org/wiki/Vertebral_artery_dissection
Dr. Ernst stated: “the vertebral artery enters the skull via the foramen magnum and continues under the same name for a while. the way they reported the case, I presume the dissection might have included this section of the artery”
What is a “neck manipulation of the chiropractic kind?”
Merbles chiropractor,
“What is a “neck manipulation of the chiropractic kind?””
A violent twisting of the neck, as seen in videos posted here. The same kind you perform.
What is your website so we can scrutinise all aspects of your beliefs, or is that too risky because of the nonsense we will see?
What Derry might be getting at there, is that there are chiropractors who have invented their own variations on the upper cervical adjustment theme, avoiding the dangerous component. First there are the gizmo-techno guys who like to impress with an “advanced” apparatus. Two similar methods I’ve come across are called the “Grostic” and the “Atlas Orthogonal”.
Both are really the same gizmo with different makes of an electric-drill like looking apparatus that applies a minute jolt or sudden, short push via a little rod that’s applied to the atlas area.
Something similar to and just as uselessly silly looking as the handheld adjustment clicker we have so often seen. That’s not manipulation, that’s an example of “fools with tools” 🙂 Here’s another incredible demonstration of a “safe chiropractor” prodding a toddler with a similar apparatus. Please rise from your seats, all you who think she is effectively helping the child’s ear problem.
Then there’s something called the NUCCA method that seems to consist of simplyapplying light pressure with the side of the hand (hypothenar eminence) to the side of the neck below the ear of the customer. The customer in the video declares she feels nothing so probably that´s what happens… exactly nothing.
And then we have the Gonstead variant of manhandling the head and neck, which seems to mostly avoid the rotational component. I saw a video where a chiro was demonstrating the finer points of this technique and declared blatantly that the rotation was the dangerous move and should be avoided! I don’t want to spend time finding it again so take my word for it 🙂
I suspect these methods were developed because the “inventors” had subliminally understood that the common extension-rotation, high velocity, low amplitude type of manipulation might simply be dangerous.
So what have we?
Part of the chiropractic core seems to be carefully avoiding the dangerous application of force and pretending to do something to the neck without really exerting any significant force, while a portion, which we do not know the proportion of, likes to impress with a hefty crack-producing twisting manipulation followed by the usual “now didn’t you feel the release?” or some variation on that suggestive verbal reinforcement that keeps the cash flowing. Often they are heard declaring that the improvement might be delayed some weeks and it would be good to come back for regular (money bringing) repeat adjustments.
Before retiring to bed I really have to find one of my favourite videos of a risk avoiding, cheating charlatan playing doctor and patient with a little child.
Note especially the “cervical adjustment” The fool thinks his child fondling is boosting the kids immune system!!!?
You couldn’t make this sh*t up :/
Here goes:
https://youtu.be/HReRIF8mK3s
@Bjorn
Thanks a lot for this video. Apart from the (certifiable?) lunacy on display throughout, I was particularly impressed by the chiridiot’s frequent reference to “opening things up”. He tells us that chiropractic “is really good at opening up the immune system and the nervous system”. Later, he briefly touches the child’s back and says “that’s gonna open up digestion”.
I do wonder what it is about the nervous system, the gut and the immune system that needs opening. Perhaps you could lend him a large surgical knife, then he could really open up some bits and pieces (shades of Jack the Giant Killer?).
Seriously, do all those years of careful chiropractic training produce people whose basic concept of medicine is to “open up” various functions that are already open, or the patient would be dead?
I wonder if YouTube-advertising chiropractors are an especially stupid subgroup of DD Palmer disciples or if they represent the average nutjob? I’ve gone through a lot of these videos to find examples and demonstrations and I have to say that each is more jaw dropping silly than the other. Blatant doctor bashing, lies about medicines and medical science, subluxation fairy-tales, silly apparatus, boastful claims of impossible cures and sometimes plain delusions of grandeur are ubiquitous in the YouTube chiropractic demonstrations.
Here’s one of the gizmo-guys. A real Texan with a bloated ego and high thoughts of himself. He has a large collection of YT demonstrations of his grandiose practice and it seems to be luring people from all over the world who are desperately looking for help. One of his fantasies is that he can cure hiatal hernia, a structural and functional problem where the upper opening of the stomach does not function properly with regurgitations, heartburn and other difficult symptoms. Alas, many surgeons bungle operations for this. It’s not an easy field and one has to be very careful in setting indications and doing the right procedure the right way. I have performed hundreds of laparoscopic hernia repairs , many of them for previously bungled or recurrent cases and had quite satisfying results. (I don’t do this kind of work any more).
Notice how this charlatan uses an electric, reciprocating jigsaw that can be bought for $20 and in other videos he uses an orbital sanding tool. (Without the saw-blade and sandpaper of course)
Trust inspiring? Nah, I don’t think so.
There is no way in the world this external prodding and pulling will affect any significant improvement, let alone lasting cure, for hiatal hernia. The patient in this video says he has had at least 4 surgeries and met 50 doctors. One may speculate as to wether his main problem lies somewhere above the jaw rather than in his belly, but that is impossible to conjecture. He may be the victim of an initially bungled surgical attempt, which is unfortunately to easy in this field.
I wouldn’t call this therapy, I’d call it a sting operation!
https://youtu.be/DNdIaVyXHKw
Dr. Geir, thanks for that wonderful breakdown and narrative building videography! It seems you may have missed the larger point at hand here. If I wanted to pit techniques against one another I could have done that in my post (albeit in probably a more chiropractically inclined and experiential way). However, that was not my intention.
The point: no one on this thread knows what happened in that room because there is no legitimate documentation. The description given by a (justifiably) emotional sister is not going to be the most accurate portrayal of what actually occurred. This story, containing a significant lack of evidence, is then used as an avenue to get all of your disdain for chiropractors out in the open (again&again&again). Soon follows the cry for “evidence” from anyone attempting to cease the endless onslaught. Doppelmoral.
Yawn. Frank, grow up! Stop with the vitriolic attacks on personality and get back to the issue being discussed. There is simply no need to demand personal information from someone in a pathetic attempt to claim to win a point.
Bjorn …you admit there are bollocks medics about. There are twits in every profession if you look hard enough.Why so aggressively criticise one? It is simply not sensible to make these sweeping generalisations about any group.
Our profession is more than one technique, Iceland is more than one gobby surgeon and America is more than shit home videos…….
@ Merbles chiro
“If I wanted to pit techniques against one another I could have done that in my post (albeit in probably a more chiropractically inclined and experiential way).”
Why don’t you want to give the URL of your website? Are you ashamed of it? Is it embarrassing? Why won’t you disclose?
@Kay chiro
“Yawn. Frank, grow up!”
Someone else on this blog wrote the same this to me. They practiced some strange alt-med, weren’t attached to reality, struggled with logic and reason, and had a superior air. They also thought using this attack was a way of stymying further critique. You fit the mold of the earlier poster, and to paraphrase Stephen Fry when he said of people who say they are offended, “who gives a f….”. Now, get of your imperious high-horse and be sensible.
“Stop with the vitriolic attacks on personality and get back to the issue being discussed. There is simply no need to demand personal information from someone in a pathetic attempt to claim to win a point.”
I know you are a chiro but that is no reason to not be able to comprehend simple prose (oh shite, maybe it is.) I asked for Merbles website to find out what other beliefs s/he holds about chiropractic. S/he may be a subluxationist, as might you. S/he and you may be anti-vaxxers, or use those silly little clicky doo-dads, or make outrageous claims about what chiro can allegedly treat. I didn’t think this needed explaining because I said this at the time, but, it seems, you never know the level of comprehension some do not have.
“Bjorn …you admit there are bollocks medics about. There are twits in every profession if you look hard enough.Why so aggressively criticise one?”
You haven’t read much of this blog. The point, made repeatedly, is whether the risk/benefit ratio makes undertaking some treatment worthwhile. For chiros, it isn’t normally about too much risk because faffing about with peoples’ backs and dispensing placebos, for the most part, is not dangerous. Except when someone dies through a neck twist and then all defences are out; :it couldn’t be chiro because it doesn’t happen”. Oddly enough, in some emergency departments in Australia, people admitted with some neck/stroke complaints are asked whether they have seen a chiro before admission. I must catch up with that person again shortly.
“It is simply not sensible to make these sweeping generalisations about any group.”
Except when, after 121 years, there is still no good evidence of efficacy of the service that group provides. A religion (in his own words), started by a criminal in strange and totally implausible circumstances, based on vitalism and a non-existent condition, with claims it can treat many conditions unrelated to the spine, and you can’t see a problem with this?
“Our profession is more than one technique, Iceland is more than one gobby surgeon and America is more than shit home videos…….”
No, chiro is more than one technique and, from the videos on this blog and chiros’ websites, comedically ridiculous.
That “gobby surgeon” operates on people to save their lives most of the year; how many lives did you save yesterday, last week, last month, last year, or in the last 10 years. Yes, the same “gobby surgeon” I would happily want to operate on me if my life was under threat. Maybe, you would prefer the skills of Richard Lanigan if you need a tumour removed from your thorax; surely, his subluxation treating skills are all you need?
America IS more than shit videos; it has the lunatic religious right, lunatic gunmen who go on murderous rampages, two leading presidential candidates who are both loons (not Sanders, he makes sense), endemic obesity, a minimum wage of about $5 an hour, no universal healthcare, and the regular shooting of people who have a dark skin colour. Is it any wonder, the USA is one of my least favourite countries? The land of the free…… free to exploit, discriminate, and shoot.
“get back to the issue being discussed.”
Oh yes, this gem. Well kay chiro, what have you contributed except some anecdote that contributes nothing?
I am a Chiropractor. A lady visited me today and thanked me for saving her life: on new years Eve she came to me with neck pain and complained of numbness in her fingers. After visualising reduced ulnar and radial artery flow on ultrasound I sent her immediately to the GP with a letter explaining my concerns. The hospital later confirmed a carotid aneurysm and stenosis of the brachial artery. She made it thought surgery last week thankfully without having a stroke.
For every case study with one result there is a case study with another. We are a varied profession and we treat many, many patients between us every year. If only outcomes like the one above could be as publicised as much as others.
Yep, she could have gone to a doctor and bypassed you altogether, with the prospect her condition was diagnosed sooner and operated on sooner. All you did was delay the treatment she urgently needed. Yeah, thanks for that.
No – she had been to a doctor – who told her to see a chiropractor (having told her it was a trapped nerve!)
Sounds like a rather poor doctor to me.
Which proves what?…
1. That there are many idiot doctor’s who think chiropractic is something which you can refer difficult patients to when you don’t want to be bothered with them? We already know that sad fact. There are about 970000 physicians in the US, almost 22 times more than there are chiropractors. Go figure.
2. That there exist the rare chiropractors who know that pat’s with neurological signs or other signs of serious disease shouldn’t be touched with a barge pole but referred to real healthcare. We already knew that.
3. That there is a chiropractor out there who is equipped and trained to quantitatively measure arterial blood flow with ultrasound. Interesting indeed. Requires quite some training to do properly. We never heard of one before. Why would a chiropractor invest in such an expensive instrument? Symptoms, signs, differential palpation and perhaps a cheap non-quantitative doppler stethoscope would be quite adequate to sort out the patients with peripheral circulatory problems?
Is quantitative doppler flowmetry considered standard tools and training for chiropractors nowadays?
“Is quantitative doppler flowmetry considered standard tools and training for chiropractors nowadays?”
Curious how, every time someone asks a reasonable question, the weeks pass with only silence for an answer.
She is having care with the physiotherapist now instead? I am a physiotherapist, studying Chiropractic atm. The scary thing is, while I was working as a physiotherapist, my boss was performing cervical manipulations on his patients. I asked him; did you study as a manual therapist? No he said, my friend thought me this manipulation. (!!) These are the practicioners who don’t know when NOT to touch patient’s necks; these are the practioners you should critize and be carefull of.
How often do medical doctors make mistakes? The amputate the wrong leg? The prescribe the wrong medication, this is a much bigger problem for patients then this 1 in a million case. You might do some research about that.
@ Kate on Monday 15 February 2016 at 20:37
“I am a physiotherapist, studying Chiropractic atm”
Why, so you can call yourself “Doctor” without having earned it??
“How often do medical doctors make mistakes? The amputate the wrong leg? The prescribe the wrong medication, this is a much bigger problem for patients then this 1 in a million case. You might do some research about that.”
You might do some research too, as well as exercising some critical thinking. Parroting bullshit does not add to your credibility, nor, for that matter, does your lack of writing skills.
Situation example 1:
A doctor operates on a wrong leg.
=> All hell brakes loose. The medical community immediately admits failure and the incident is thoroughly analysed and action taken. The doctor may be put on probation and all routines are seen over and improved in order to diminish the risk. If negligence can be suspected, the doctor can even face criminal charges.
We have many checklists and routines and double checks to try to avoid mistakes and errors. If they happen anyway, we admit failure and take measures to improve safety and we are even subjected to invasive scrutiny to rule out criminal liability.
Situation example 2:
A chiropractor tries to remedy chronic migraines by repeatedly manipulating the neck. The customer, shortly after the third manipulation that week, complains to his sister that the neck manipulations were forceful. Minutes later he is brought to the hospital with a life threatening stroke due to a vascular injury that very probably could have been caused by the forceful manipulation of the neck.
=> The chiropractic community bends over backwards to contradict any guilt and no one initiates an inquiry. In blog discussions about the case, fellow chiropractors even blame the sister for exaggerating or making parts of her story up because she is upset!? Of course she is upset, but there is no reason for her to make anything up. Her story is clear as can be.
We cannot dismiss he suspicion of “chirogenic” injury just because we have no video or eye-witness account of what happened at the chiropractics office. We have to deduce that the chiro and his customer weren’t arm-wrestling or playing chess. A chiropractor manipulates, that’s what chiropractors usually do, right? We cannot deny the overwhelming likelihood that what happened there was the administration of chiropractic manipulation, right?
The stroke happened very shortly after the manipulation.
None of our chiropractic commentator friends seem to see the need to take any measures whatsoever to analyse this or other similar incidents or take action to lessen the possible risks of neck manipulation. Instead they deduce that such incidents must be caused by the VAD being present before they saw the chiro or the victims tripped and hit their head and neck on the way from there or some similarly silly unfounded, alternate explanation.
Anyone else think our resident chiro-supportive commentators, like the chiropractic community in general, are in deep and deadly denial about the frightening possibility of chirogenic stroke?
I had a very strange set of symptons after an adjustment. My balance faltered, I could not navigate myself to the next place I had to go. I tried to make several left turns while driving but kept turning right. I have no memory of leaving the chiropractor’s office or paying my bill. It took about 20 minutes for my head to start to clear, and be able to drive to my destination. When I called the chiropractor to report my circumstances, guess what happened – nothing. They never called back, or even tried to explain to me what might have happened. Doing some research (I live in Canada), I have found that chiropractor keeps no records of TIAs. (TIA being pure conjecture on my part), as a consumer group we have no idea how often this happens, there is no way to track this. Does this sound like a group of professional who have their patients well being at the fore front of their practice?
Thank you for your story lfjarron.
As you have probably seen in here we are very concerned about these conspicuous risks that chiropractors blatantly keep ignoring, denying and contesting. They are understandably in full defensive mode as the consequences of admitting risks of any kind from chiropractic manipulation may prove detrimental not only to their income but pride and honour as well.
I am very concerned about this episode of serious neurological symptoms you describe!
Have you discussed it with your doctor? It is important to rule out some kind of predisposition in a case like this. I would at least consider a CT angiogram of your head and neck vasculature and an ultrasound of the neck arteries to rule out possible predisposing lesions that the manipulation might have affected. An embolus from a carotid lesion may be one explanation for your attack, that certainly may have been a TIA. I recommend you contact your doctor and discuss this and ask for an investigation if not already done. I would also report the episode and the chiropractors lack of concern and action to local/regional health authorities even if it may be unlikely to lead to much more than the shrugging of shoulders. At least demand an investigation into chiropractor’s record keeping and adverse event reporting 😉
Come Edzard you know as well as I do that because they patient happened to visit a chiropractor, lay in a MRI tube, had their hair washed or whatever it does not demonstrate a causal link, that one followed the other. As you are fond of reminding us chiros, just because someone reports their pain feeling better after spinal manipulation, we should not assume it is because of the manipulation and larger studies are needed, before one could claim scientifically a causal relationship.
Fortunately large studies have been done on brain hemorrhage and the causes are well documented; 1)Head trauma injury is the most common cause of bleeding in the brain for those younger than age 50. 2) High blood pressure . This chronic condition can, over a long period of time, weaken blood vessel walls. Untreated high blood pressure is a major preventable cause of brain hemorrhages. 3) Aneurysm, this is a weakening in a blood vessel wall that swells. It can burst and bleed into the brain, leading to a stroke. 4)Arteriovenous malformations; weaknesses in the blood vessels in and around the brain may be present at birth and diagnosed only if symptoms develop.5) Amyloid angiopathy. This is an abnormality of the blood vessel walls that sometimes occurs with aging and high blood pressure. It may cause many small, unnoticed bleeds before causing a large one.
Strokes like this are extremely common in the UK. As you say the vertebral artery, enters the skull through the foramen magnum, merging at the pontomedullary junction to form the basilar artery which divides into two posterior cerebral arteries at the upper pons. So if the dissection happened inside the skull the tear would have been in the basilar artery not the vertebral artery. Dissection of the basilar artery is extremely rare and presenting symptoms are subarachnoid hemorrhage, brainstem compression, or ischemia. This bleed would appear to have happened further into the brain and could not have been related to the manipulation this patient had, unless the chiropractor hit the the patients head forcibly which I would have thought would have been mentioned in the history.
The anatomical evidence would appear to suggest this person had a brain haemorrhage and made the connection to anecdotal evidence linking stroke to manipulation. They had seen a chiropractor prior to the hemorrhage and as no one had explained the anatomical relationship between the vertebral artery and the internal blood supply to the brain assumed the manipulation had caused the hemorrhage.
Lanigan is a subluxationist. Where are you now C_C?
@R. Lanigan
Your Google expedition failed to discover what doctors are taught in medical school.
Bleeding into the damaged area of the brain is a well known complication of an ischemic stroke. It’s called hemorrhagic transformation, a well recognised phenomenon.
Next question!
As Frank states I am a “subluxationist” not an anatomist so I have to look things up that I cant remember from the colouring books. The report it states there was no “clot”, so how do you conclude Bjorn that this was an “ischemic stroke”.
The post states “MRI and CT scan showed that the stroke was NOT a clot that was already formed and agitated/released by the neck adjustment. But that the adjustment had actually caused a large tear in his vertebral artery and that it had in turn caused bleeding into his brain and consequently the stroke”
So Bjorn I am hoping you can explain to me how an arterial dissection in the neck without a clot, can cause an internal brain hemorrhage? and is “A well recognised phenomenon”, if you could show me something on “Google” or Pub Med happy to read it
@R. Lanigan
I am wondering if I should be surprised at your helplessness in finding information?
A simple search on WP for the keyphrase I gave you (“hemorrhagic transformation”) would have led you to this short explanation in the piece about intraparenchymal hemorrhage of the brain: https://en.wikipedia.org/wiki/Intraparenchymal_hemorrhage#Acute_intraparenchymal_hemorrhage
The following link will produce a Google search of relevant material. The first score of hits looks quite informative and may keep you occupied for days.
https://goo.gl/cqUsGy
You may be right Bjorn, perhaps 36 cylces of chemotherapy that did not work, has left me “helpless”, you know how it is with medical treatments sometimes they dont work and have terrible side effects. In fact the radiation treatment caused a malignant melanoma over the tattoo mark, on the other hand it could be the cannabis oil I took instead, that has left me like this; So as you presumably have read all of this evidence, pretend I am a patient and in lay language explain how damage to one vertebral artery could cause this event. Remember there are is another vertebral artery so the dissection in one artery would not have cut off the blood supply to the basilar artery which would continue to supply blood to the brain. You believe the manipulation caused the the brain hemorrhage and as there was no clot, so how exactly would this happen anatomically ?
Richard,
You will get very little sympathy from me (and, I suspect, some others).
You have pedalled this subluxation nonsense your entire working life as a chiropractor, that it exists, that it is the cause of all body ills, but you can fix them and, with it, most ailments. Well, it seems as though allopathy has saved your life, however, you persist with the delusion of subluxations.
What does it take to show you the problem with your thinking?
This sentence caught my eye and I came to think:
Sure. If a person is hit by a truck, it is reasonable to deduce that the broken bone was caused by that encounter and not falling on the street before being hit or off the stretcher on the way to hospital.
If hundreds of people have a confirmed history of being “adjusted” to the neck by a chiropractor immediately before suffering an extremely serious VAD stroke, it is more than reasonable to suspect chirogenic injury – Especially if there is a very plausible mechanism of injury.
Chiropractors deny this.
I think some chiros will only accept that neck adjustments cause problems if they see it happening with their own eyes in an MRI scanner whilst they manipulate… even then, they’ll claim ’twas the magnetic field wot could have done it (or the way the technician pressed the start button) and, anyway, that’s just one person…
‘ I presume the dissection might have …..’
Ah..good old presumption Edzard.there seem to be an awful lot of it flying around in your little anecdote here. As we all know the evidence confirms that despite associations there is no evidence of causality. Unless you believe that GPs cause dissections by handing over their prescriptions as there appears to be an even bigger association between arterial dissection after visiting a GP. Of course one concludes rightly that GPs don’t ‘ cause ‘ stroke, only that those pro dromo of stroke tend to have headache and neck pain and visit a clinician.. Ie the patient brings a disection to the clinic, not the other way round
http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0063-x
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271108/
@ Dr David Newell ( https://uk.linkedin.com/in/dave-newell-09660523 )
Professor Ernst is demonstrating the precautionary principle in the interests of patient safety, not least in view of what your two (biased) links above have already told us…
https://www.sciencebasedmedicine.org/chiropractic-and-stroke-the-question-is-not-answered/
Dear Blue. There are degrees of bias in every piece of evidence. Thats a given. However, the degree of bias in the 2 reports I cite is an order of magnitude less than what you are presenting here. You know that Edzard, I know that and anyone with any expertise in critiquing research also knows that. This may not be the case for Blue, so I understand his confusion. The reality is that the case for manipulation ‘causing’ stroke has been scuppered scientifically for some time and evidence only gets stronger that the sell by date of the idea has expired. Maybe you and Edzard should move. There are other issues more pressing than promulgating views that have been shown to be unsupported. And on that note. I will take my own advice and bid you adieu.
” And on that note. I will take my own advice and bid you adieu.”
He isn’t a doctor but he is very (self) important, despite his poor writing skills.
…could almost be a real doctor!
David Newell PhD wrote: “I know that and anyone with any expertise in critiquing research also knows that”
If you were an expert in critiquing research, you’d display a cautious attitude rather than revealing your own wishful thinking that “the case for manipulation ‘causing’ stroke has been scuppered scientifically for some time and evidence only gets stronger that the sell by date of the idea has expired”.
I am confident in this supposition in the same way I am confident in the supposition that the MMR vaccine is unlikely to cause autism and the case for this idea has essentially been proven through robust epidemiological and biological evidence….. Would you not agree Blue or are you a secret antivaxxer?
Blue,
Newell isn’t a doctor, despite his obvious fondness for undeserved pomposity.
Dear Frank
I have a PhD and am entirely justified in using the title. May I suggest the pomposity is somewhat of a mirror to yourself rather than me.
Own goal, Frank. Stop digging!!!!!!!!!!
Dave,
Richard Rawlins and the Prof (and many others) are also eminently qualified, but neither uses a title. Richard (sorry to drag you into this) was a Mr, consultant orthopaedic surgeon, and the Prof has quite a few after his name, however, they don’t rely on Argument from Authority to impress. There are many others who can refer to themselves as Dr, Prof, MD, Consultant, MSc, et al BUT DON’T.
Oh yes, what were you saying, “May I suggest the pomposity is somewhat of a mirror to yourself rather than me.”. (If I was unkind and crass, in Australian colloquial terms, I would describe you as a “tool”.)
For gawd’s sake, you are a chiro, a purveyor of a cult created by a crook who pre-empted L. Ron Hubbard.
GG (or Camel Turd, as pointed out by Bjorn and which I prefer),
Look above (no, not for your god, DD Palmer, the post above) before you become enamoured of your cleverness.
No surprise you rushing to the assistance of another dill, oops, chiro. By-the-way, where in UnZud do you faff about with people’s backs?
David Newell PhD wrote: “I am confident in this supposition in the same way I am confident in the supposition that the MMR vaccine is unlikely to cause autism and the case for this idea has essentially been proven through robust epidemiological and biological evidence….. Would you not agree Blue…?”
I don’t agree. The evidence has not been robust enough to prove that neck manipulation doesn’t cause VAD. Also, many chiropractors – and their regulators – seem to find it acceptable to rely on anecdotal or extremely weak evidence where it supports chiropractic treatment, but where similar evidence suggests that serious complications (e.g. stroke), and even fatalities, can result from chiropractic treatment, they are quick to dismiss it. That is hardly ethical.
David Newell PhD wrote earlier: “There are other issues more pressing… ”
I would agree that there are issues *equally* as pressing, e.g. the chaotic state of chiropractic nationally and globally…
http://www.zenosblog.com/2016/02/the-scotland-college-of-chiropractic-out-of-kilter-with-science/
Also, given that ‘adjusting’ the neck is one of the main focuses of subluxationist chiropractors, there’s this to consider with regard to chiropractic back pain patients:
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.]
And let’s not forget that the evidence for spinal manipulation for back pain is looking less and less favourable…
http://edzardernst.com/2015/08/chiropractic-spinal-manipulation-placebo/
http://www.bodyinmind.org/spinal-manipulative-therapy-a-slow-death-by-data/
Doesn’t look good, does it?
Dear Frank
Incorrect again!. I’m not a chiropractor. And eluding to the fact that you might, if crass enough call me a tool, does not detract from the fact that you just have. Silly and indeed, crass man. Given your approach it is clear that any other contributions from yourself may be safely ignored.
@Dr Dave
“I’m not a chiropractor.” No, it seems you’re the Director of Research at the Anglo-European College of Chiropractic, whose clinic “is one of the largest chiropractic treatment and teaching facilities in Europe.” I guess your denial is indeed an ‘eluding’ statement. At least, that’s what I’m ‘alluding’ to.
In fact, you were kind enough to welcome Edzard to speak at your college early last year. He wrote about the experience in this blog. “My own impression of the day is that some of my messages were not really understood, that some of the questions, including some from the tutors, seemed like coming from a different planet, and that people were more out to teach me than to learn from my talk. One overall impression that I took home from that day is that, even in this college which prides itself of being open to scientific evidence and unimpressed by chiropractic fundamentalism, students are strangely different from other health care professionals. The most tangible aspect of this is the openly hostile attitude against drug therapies voiced during the discussion by some students.” Your comments in this thread support, in particular, the second sentence of that paragraph.
Sorry Dave,
I did Google you earlier but could not find your qualifications. I assumed working at the AECC meant you would be a chiropractor, and more so given your impassioned defence and promotion of chiropractic. Being a FRCC also drove me to this conclusion. I apologise for this terrible slur on your character, integrity and professionalism. I would also heartily object to this term being used in relation to me.
Having now found your quals, I see you have; BSc, MSc, and your PhD is in molecular biology awarded in 1986. From here (http://www.zoominfo.com/p/Dave-Newell/1543475068), it says; “Director of Research, Dave graduated from Plymouth University with a PhD in molecular biology in 1986. He has taught at several chiropractic institutions including the AECC where he has delivered undergraduate science subjects as well as the evidence informed practice thread running throughout the undergraduate and post graduate education.”
The obvious question arising out of this information is; why is a PhD in science working in quackery; not only working, but teaching, and joining the RCC (have I made an error in Fellow of RCC?) and also the FEAC (European Academy of Chiropractic)? Why would someone abandon the principles of science and willingly participate in this witchcraft? Is it the money? After all, many people have compromised their principles for money, so you wouldn’t be Robinson Crusoe there. Only you know the answer to this conundrum.
Your support of chiropractic also renders your stance questionable, at the least. When the prof delivered his address at the AECC, you responded with this, inter alia;
“You came over as someone who had strong views, a fair amount of which we disagreed with, but that presented them in a calm, informative and courteous manner as we did in listening and discussing issues after your talk. I think everyone enjoyed the questions and debate and felt that some of the points you made were indeed fair critique of what the profession may need to do, to secure a more inclusive role in the health care arena.
…………………………….
In this aim, your talk was important in shining a more ‘up close and personal’ torchlight on our profession and the tasks ahead whilst also providing us with a chance to debate the veracity or otherwise of yours and ours differing positions on interpretation of the evidence.”
What I thought were fair comments from the prof about chiropractic, you said, “a fair amount of which we disagreed with”, and “debate the veracity or otherwise of yours and ours differing positions on interpretation of the evidence”.
I called you a tool because of your use of the title Dr when many others are as entitled, if not more so, but choose not. For the reasons cited here and above, I am now of the view that you are, indeed, a bigger tool than I had thought, and one who cannot write all that well either.
SOME CHIROS OBJECTED TO SIMON SINGH’S DOCTOR!
they claimed he was misleading the public!!!
but I have never seen him use this title [he has a doctorate in physics, I believe].
The evidence as you well know Blue, says that chiropractic care is as good as any other approach for Low Back Pain and Neck pain.
As for subluxationist chiropractors, I would agree with you that those espousing the approach specifically highlighted in your quote are without substantive evidence and such a practice would not be one that I would feel comfortable defending. However that is not the approach of the VAST majority of chiropractors in the UK who are primary care clinicians trained over a 5 year period to Masters level, spending on average 25 hours or more in lectures, tutorials and practical classes per week, learning and refining a wide range of clinical skills from diagnosis to rehabilitation, manipulation to psychological support and exercise based interventions, evidence based health care to professionalism to name but a few. Indeed here is a link to an excellent document for those that are interested in the range of skills typically exhibited by chiropractors in the UK and its DOESN’T include anything like the approach that you quote Blue. http://rcc-uk.org/wp-content/uploads/2015/10/RCC-Chiropractic-Competencies-and-Skills-_-LBRP-_-2015.pdf.
It’s easy for anyone to cherry pick quotes to support their views but in science we try not to do that as it brings with it overwhelming bias and a huge risk of not representing the truth. But, I guess you knew that Blue already?
1) chiros are NOT primary care physicians; this is just wishful thinking and dangerous at that.
2) chiropractic care is as BAD as any other approach for Low Back Pain and Neck pain.
2) VAST majority – any evidence?
I am keenly awaiting Dave Newell’s evidence that the vast majority of UK chiropractors practice ethically. He has to provide better evidence than a 2007 survey which revealed that 76% of UK chiropractors deemed traditional chiropractic beliefs (chiropractic philosophy) to be important. That same survey gave a figure of 63% for chiropractors who considered the fictitious ‘subluxation’ lesion to be central to chiropractic intervention, and, interestingly, it also revealed that the responding chiropractors considered asthma (64%), gastro-intestinal complaints (61%) and pre-menstrual syndrome (PMS) (70%), as conditions that could benefit from chiropractic management (although opinions on the treatment of osteoporosis (43%), obesity (26%), hypertension (42%) and infertility (30%) were less conclusive). As for childhood musculoskeletal and muscular conditions, infantile colic, otitis media and asthma, they were perceived to benefit from chiropractic intervention by more than 50% of the respondents. You can read the results of the entire survey here:
http://wansbeckchiropractors.co.uk/pdf/Nov02.pdf
[Ref. Aranka Pollentier and Jennifer M. Langworthy, The scope of chiropractic practice: A survey of chiropractors in the UK. Clinical Chiropractic, Volume 10, Issue 3, Pages 147-155. September 2007]
Dave Newell PhD wrote: “I would agree with you that those espousing the approach specifically highlighted in your quote are without substantive evidence and such a practice would not be one that I would feel comfortable defending.”
So what is being done about closing down such practices? Or do chiropractors and their regulators not care? I ask because the General Chiropractic Council’s apparent leniency in recognising the education standards of the McTimoney College of Chiropractic, which has a ‘traditional philosophical preference’, seems to be due to its (very recent) admission that, as a statutory regulator, it has no detailed information about the make up of the UK chiropractic profession and its registrant base. See page 14 here:
http://www.gcc-uk.org/UserFiles/Docs/Council%20Meetings/2015/Sept%202015%20agenda%20and%20papers.pdf
The above information is lifted from here:
http://www.zenosblog.com/2016/02/the-scotland-college-of-chiropractic-out-of-kilter-with-science/
@ Dave Newell PhD
How does that protect patients and the public?
COULD IT BE THAT DAVE IS JUST A TINY BIT BIASED?
My understanding Edzard is that Primary Care is defined as a clinician that is the first port of call for patients seeking help. A dentist for example is a Primary Care Provider as articulated by such a definition and in this regard chiropractors occupy precisely this position for those patients seeking help for for back pain and other MSK problems. Because of this position they are required to have high diagnostic skills in order to be able to determine if their treatment is appropriate or whether to refer on to more appropriate care, in much the same way that a dentist would refer on oral cancer to their GP who then would refer to an oncologist. Unless of course you contest that dentists are primary care providers???
RE: BAD/GOOD/EQUAL…semantics and a weak argument
RE: Unorthodox minorities..you have seen this before I know Edzard but seem to keep forgetting it. http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-14-51
this is from Wikipedia [not ideal, but I am in a hurry]:
The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary healthcare strategy. Primary care involves the widest scope of healthcare, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care…
In the United Kingdom, patients can access primary care services through their local general practice, community pharmacy, optometrist, dental surgery and community hearing care providers. Services are generally provided free-of-charge through the National Health Service. In the UK, unlike many other countries, patients do not normally have direct access to hospital consultants and the GP controls access to secondary care.[7] 599 GP practices closed between 2010–11 and 2014–15, while 91 opened and average practice list size increased from 6,610 to 7,171.[8]
I DON’T SEE ANY CHIROS MENTIONED
@ Dave Newell PhD
Re unorthodox minorities, the paper you cite doesn’t say what you think it says.
For example, it states: “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 do seem somewhat inconsistent with the other available data:
http://tinyurl.com/pts2ns5
Most significantly, McGregor et al’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”.
Indeed, 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.”
@Dr Dave
This business of “primary care provider” is becoming enervating! Edzard has now spelt out the meaning of the term as defined by Wikipedia. You are quite right that a dentist is a primary care provider: people go to a dentist when they have symptoms affecting their mouth in general — more often their teeth and gums in particular. They know that’s what dentists deal with. A general practitioner is a primary care provider: people go to a GP when they have symptoms anywhere. They know that’s what GPs deal with.
A chiropractor is indeed a primary care provider: of chiropractic. But chiropractic is a load of pseudomedical nonsense based on the notion that spinal adjustments can cure most, if not all illnesses. If you’re claiming solely to offer musculo-skeletal manipulations for back pain, why not call yourself a ‘musculo-skeletal practitioner’ or something similar? The answer is because chiropractors have established a reputation among the gullible and you don’t want to take the tiniest action that might lose you that clientele.
Your worst post here so far is to claim you are not a chiropractor. Initially I responded to it lightly, because — unlike the other Frank — I had not delved deep enough to discover your FRCC. But for someone who is paid to work full time in a chiropractic institution and bears the qualification to claim directly ‘I am not a chiropractor’ is grade A deceit, which seems to be a characteristic of the ‘profession’.
I presume you make the claim because you don’t yourself directly crack spines or thump babies with a click-and-diddle stick. I think the word ‘dissembling’ may be operational here.
“…the VAST majority of chiropractors in the UK who are primary care clinicians trained over a 5 year period to Masters level, spending on average 25 hours or more in lectures, tutorials and practical classes per week, learning and refining a wide range of clinical skills from diagnosis to rehabilitation, manipulation to psychological support and exercise based interventions, evidence based health care to professionalism to name but a few.” And charging around £40 a pop for the privilege, where the NHS can offer similar outcomes for nothing.
Some of what you say (“primary care clinicians”, “wide range of clinical skills”) sounds rather close to people practising medicine without a licence. But you don’t need to worry. Thanks to the bizarre way UK law works that is an offence only if people unlicensed as medical doctors attempt to offer orthodox therapies.
@ Dave (not a chiropractor or a medical doctor, thanks Blue)
You said;
“However that is not the approach of the VAST majority of chiropractors in the UK who are primary care clinicians trained over a 5 year period to Masters level, spending on average 25 hours or more in lectures, tutorials and practical classes per week, learning and refining a wide range of clinical skills from diagnosis to rehabilitation, manipulation to psychological support and exercise based interventions, evidence based health care to professionalism to name but a few.”
Who cares if they spend 25 hours a week in classes? What are the entry standards, and, more importantly, what body ensures assessments are conducted to an acceptably high standard? If the dunderhead chiro who used to live across from me is any indication, standards aren’t that high. Could a would-be chiro students get into physio, occ therapy, or medicine? (It is a rhetorical question.)
Dr Dave Newell wrote: “As for subluxationist chiropractors, I would agree with you that those espousing the approach specifically highlighted in your quote are without substantive evidence and such a practice would not be one that I would feel comfortable defending.”
@ Dave Newell
Bearing in mind that you are on record with the following…
QUOTES
“During the ECU General Council meeting in Stockholm in late November David Newell informed the national presidents of the situation. It is now time to confront some of the extreme views and practices in our profession, said Dr. Newell.”
“What we most definitely do not need is a description of what chiropractors do that involves ideas about a vitalistic life-force flowing up and down the spine, particularly if the removal of ‘subluxations’, as some call them, are explained as the causative agents of the restoration of life flow, which is what the extreme vitalists would tend to think…”
Link http://www.ecupresidentblog.com/2014/12/dr-newell-if-not-science-then-what-magic.html
What is being done to confront chiropractic practices in the UK such as those revealed here:
http://www.zenosblog.com/2016/02/the-scotland-college-of-chiropractic-out-of-kilter-with-science/
You have confessed that you’re not comfortable defending such practices, but are you comfortable confronting them?
What is being done to outlaw them?
It’s important to know what action is being taken, otherwise patients and the public are not being protected.
It’s good to see this post highlighting the human toll of chiropractic cervical manipulation. The devastating effects on real people can get lost in the statistics. And it’s not only strokes that result from these high-velocity, low-amplitude (HVLA) thrusts. I was injured over three years ago by a chiropractor doing this very maneuver. It’s been a life-changing injury: constant neck pain, headaches, left-sided face pain and loud ringing in my left ear. My life has been hell at times. Apparently there was no arterial dissection, but also no clear diagnosis and no clear path forward. (I would have preferred having a transient ischemic attack as a co-worker had after being manipulated by a chiropractor.) Of course I was not warned about any risks with chiropractic manipulation, so there was no informed consent.
I’m aware of recorded stroke from cervical manipulation dating back to 1927 and deaths from chiropractic manipulation reported since at least 1947. It seems like 89, or even 69 years is enough time for chiropractors to have instituted a system for reporting injuries and deaths. Instead, they continue to minimize or deny the problem. Given that there is little to no efficacy with neck manipulation and that there are safer alternatives, it’s long past time to abandon this practice. If it was a drug it would have been pulled off the market by now. Since chiropractors are unable to regulate themselves, it’s incumbent upon the rest of us to have these cervical HVLAs outlawed or severely restricted. In all cases, informed consent must be mandatory.
@ Kyle C
Sorry to hear about your injury. FYI, complications arising from neck manipulation have been known about since 400BC. Keep scrolling down this link:
http://www.vertebralarterydissection.com/VAD-research/chiropractic-stroke-and-death.pdf
@ Blue Wode
Thank you for the link. What a sad list of destroyed lives. And yet, chiros like Richard Lanigan refuse to even admit the risk of cervical manipulation. I guess if one’s livelihood depends on fiction it’s necessary to do everything possible to deny reality.
Dear Kyle C
They have instituted a system. I believe the scientific approach is to be informed rather than just opinionated . http://rcc-uk.org/cpirls/
@ Dave Newell PhD (not a chiropractor or medical doctor)
Are you being serious? That reporting system is so unreliable that it’s as good as useless…
http://www.ebm-first.com/chiropractic/uk-chiropractic-issues/1888-british-chiropractic-association-members-attitudes-towards-the-chiropractic-reporting-and-learning-system-a-qualitative-study.html
I’d say it’s worse than useless: it gives a veneer of respectability, a notion of safety, while providing neither of these two qualities.
Is this voluntary and what are the penalties for failure to submit a reportable incident?
Re Professor Ernst’s World Health Organisation comment above. It’s worth remembering that it’s less than impressed with chiropractic/spinal manipulation:
http://www.ebm-first.com/chiropractic/various-concerns/1848-world-health-organisation-who-says-that-the-consequences-of-the-chiropractic-subluxation-are-hypothesized.html
I got involved in this discussion, to point out that in my opinion the sequel of events described above is not possible. An “arterial dissection in the vertebral artery without a clot”, causing an internal brain hemorrhage is not possible, period. People are entitled to their opinions on chiropractic and I am not trying to change anyone’s minds, Dave Newel is welcome to try, but I suspect he is wasting his time.
I am just saying what is described above is not anatomically possible, I am happy to be proved wrong and learn something new. This is similar to another case Edzard posted earlier in the month describing bilateral carotid artery dissection, as I commented this could not have been caused by normal spinal manipulation, the spinal joints are posterior, the carotid artery anterior and this type of injury is normally caused by severe trauma like whiplash or strangulation.
All I am asking is for someone to explain the exact mechanism, how chiropractic manipulation could cause these events. Rather than just state patient saw a chiropractor or a dentist so they must be related?
I accept their is anecdotal evidence of people having a stroke post chiropractic treatment, however idiopathic strokes are very common so why not blame chiropractors or dentists for them . I have suspected one once and sent the patient to A&E, before someone says, time was wasted coming to me, NHS cuts meant they could not get an appointment with their GP and came to me. I have practiced in the same area and check the entire spine on every patient I see, in fact after over twenty years and thousands of patients I have never had an adverse event or insurance claim. If I thought there was any causal evidence, I would not manipulate my young children and I would have to consider Blue Wodes suggestion of the “precautionary principal”, that evidence is not there . If the “precautionary principle” was applied as stringently as Blue wode suggests, for anecdotal evidence , I am not sure what medical doctors would do every day?
Richard Lanigan wrote: “If the “precautionary principle” was applied as stringently as Blue wode suggests, for anecdotal evidence, I am not sure what medical doctors would do every day?
Hello Richard, I’m glad to see that you’re still with us “after all that aromatherapy treatment at the Royal Marsden”. 🙂
Here’s medicine’s answers to its critics:
Part 1
http://www.sciencebasedmedicine.org/answering-our-critics-part-1-of-2/
Part 2
http://www.sciencebasedmedicine.org/answering-our-critics-part-2-of-2-whats-the-harm/
And here’s a snippet from Death by Medicine:
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.”
Link http://www.sciencebasedmedicine.org/death-by-medicine/
@Richard Lanigan
“This is similar to another case Edzard posted earlier in the month describing bilateral carotid artery dissection, as I commented this could not have been caused by normal spinal manipulation”
This won’t satisfy you, but bilateral carotid artery dissection in a 54-year-old-man is described in this article:
http://thejns.org/doi/pdf/10.3171/2011.8.JNS111212
“All I am asking is for someone to explain the exact mechanism, how chiropractic manipulation could cause these events.”
Isn’t this something chiropractors themselves should be investigating?
What exactly would it take to convince you of a causal relationship between cervical manipulation and stroke? If an MRA showed a patient with patent cervical arteries right before a chiropractic manipulation and an MRA right after the manipulation showed dissection, would that convince chiropractors or would it be chalked up to the walk from or to the MRI machine?
“I have practiced in the same area and check the entire spine on every patient I see, in fact after over twenty years and thousands of patients I have never had an adverse event or insurance claim.”
How do you know there have been no adverse events? Do you follow-up with every patient who doesn’t return?
Hi blue Wode , I am doing fine thanks. Actually I stopped the aromatherapy and chemo when it started to Loose sensation in my hands and I realised I was not imagining those “subluxations”, I started taking Cannabis oil, the day of my predicted demise passed without incident last June and my last 2 scans have been clear. Not jumping around yet chanting the benefits of the oil, however as with chiropractic my observations, anecdotes if you like, tells me there is something in it and it’s safe, however it’s not like the stuff I smoked in the 70s, and if you take too much you are off your head for up to 14 hours, I am not on it now haha
Yes Kyle, as my practice is predominantly what’s called maintainable, patients come in every few months, so when they cancel they tell us why. During the economic recession practice dropped by 40% and no doubt because of my own illness, most cancellations were over money, not one because I had hurt them.
With respect I take all your evidence on board, but it’s the above case that we are discussing which interests me and may be relevant to some of the other examples you are presenting. The issue is not what caused the arterial desertion in the above patient, it’s what caused their brain haemorrhage and I say the mechanism described above is not possible as described without a clot. I make the same assertion about the other post with the bi lateral carotid artery dissection. I can’t see how spinal manipulation could have caused those 2 particular cases and would love to hear an explanation, I believe Bjorn Gier Has some qualifications in the area , perhaps he can help as he says I am just looking it up on google
@R. Lanigan
I truly sympathise with you, as I do for anyone who is burdened by cancer. Your words about your disease however and especially the content of your website have made me very upset. I will explain how and why.
I have myself spent a large part of my professional life, operating on cancer victims (among them many rectal cancers like yours). I have lost dear friends, my father and many other relatives to cancer. So I have a big stake in the cancer game. I am also at risk, like anyone else, of having to face this diagnosis one day.
Therefore I take it VERY personally when I am confronted with cancer related myths, quackery, stupidity or just plain and simple fraud being perpetrated on cancer victims.
I have seen all too many cancer patients put their fate in the hands of amateurs and fools who prey on their desperation and lure them to spend money, time and quality of life on misguided, useless and very often harmful quackery. Most of these fools are not psychopathic charlatans. Many of them are of course narcissistic personalities and/or obviously afflicted by grandiose delusions. But most are just plain folks who slept through science classes in grammar school and got off on a misguided “mission”, locked in quackery by the shackles of cognitive dissonance.
I am truly devastated when I see victims of cancer led to believe that oncologists and surgeons (as me) could be shamelessly promoting useless and harmful medical treatments for no other benefit than their own and the big bad companies that pay them to be stupid!
I take the stupid and belligerent “Slash/Cut, Poison and Burn” trope very personally.
Therefore it is, after seeing it on your website with all the overbearing, self-righteous talk full of misconceptions, myths and deceptions, very difficult for me to address you with mutual respect.
I see that a large part of your ideas about the nature and effects of cancer therapy is based on gross misunderstanding, misinterpretation of the information you were given and wishful, quackadelic thinking, colouring your perception.
You blabber on about “the medical cartel”, about percentages that you obviously do not understand and about your use of alternative therapy as if you knew better than everyone else, especially the experts who helped you. You completely misunderstand the concept of survival and you obviously have gotten it all wrong when suspicion of relapse was later found to be (happily for you) false.
How dare you insinuate that the surgery, chemotherapy and radiotherapy that hopefully and probably have saved your life, was suggested and administered to you with anything other than your benefit and well being in mind?
How dare you write here that the “36 cycles of chemotherapy…did not work” when you in another comment say that your “…last 2 scans have been clear”?! – Rectal cancer, even advanced stages are often curable, albeit with tough and testing methods and at some cost as you have experienced. From what I can see it is already five years from your diagnosis and you might bl-y well be cured! Are you not grateful for that??
Even if you had a new metastasis turn up in your liver, which may happen many years on, or even in some other localisation, you can still be saved by surgery if the circumstances allow! Rectal cancer is that way. Please remember this when you talk about “slashing” surgeons.
Why in the name of humanity do you think that you know cancer treatment better than people who have studied hard, trained relentlessly and worked endless hours on developing and testing life-saving surgery, chemotherapy and radiotherapy to save yours and others lives??
I suggest you read the book “The Emperor of all maladies: A Biography of Cancer” by Siddhartha Mukherjee.(less than $9 paperback on Amazon) If afterwards, you still think we are giving cancer patients bad medicine, then you must be stupid beyond help.
How dare you suggest that I and tens of thousands of physicians, surgeons and scientists all over the world are all part of a conspiracy “cartel” hiding purportedly effective cancer remedies e.g. cannabis oil??
The notion is not only stupidly irrational, it is deeply insulting to us health care providers. How do you think such a global conspiracy could survive for long when everyone wants to have the possibility of being cured of cancer?
How dare you propose that cancer patients use cannabis oil or other unproven figments of quackery rather than proven medical therapies when it is so easy to find detailed, truthful information from experts all over the world that says otherwise?!? Try this for a starter and then read on at that site. This is written by honest, hard working people, many of whom have relatives and dear one’s with cancer. Do you really think the totality of health professionals around the world are all wrong and you and other self-promoting “students” of Google University are by default right?
How dare you suggest that your radiotherapy did more harm than good just because you developed a skin malignancy in the radiation field.
You should thank your great oncologist or whoever the observant doctor was that noted that lesion and probably saved your life, again!!
What is there to say you didn’t induce your peripheral neuropathy yourself by needlessly mixing aromatherapy with your chemotherapy. Some chemotherapy agents are neurotoxic. That’s because they are potent, poisonous stuff. It’s needed, for crying out loud! Aromatic essences contain all kinds of potentially poisonous, potent stuff, some of it even cancerogenic. Some of the lipophilic, volatile stuff in these uncontrolled concoctions may just as well have potentiated the inherent neurotoxicity of your life saving chemotherapy!!! No one knows of course. I am putting forth my own educated-guess-theory. But the possibility is real and plausible. It is plain stupid to think that volatile chemical mixtures with uncontrolled ingredients can help with cancer. Aromatherapy has never been proven (there’s lots of make-believe research of course) effective against any human ailment. Aromatherapy is only “a thing” because greedy psychopaths have deviously marketed and promoted it as health-remedies using plain lies about its properties.
Your doctors have, from all I can see, saved your ruddy life and you have the gall and guts to ungratefully rant about their difficult treatment being ineffective and about the expected side effects of the potent treatment instead of thanking your saviours!
Cancer treatment is certainly harsh and difficult most of the time. If you were not warned beforehand about the unwanted effects it is of course deplorable but does not warrant your discreditable lack of gratitude to modern medicine. Had you been diagnosed a few decades ago, you would probably have succumbed to your rectal cancer long before its fifth anniversary.
Cancer is deadly serious business which should be left to experts.
Later I will finish my explanation of why I consider it reasonable to suspect that the case we are discussing here is not only plausible but almost certainly caused by the chiropractic neck manipulation.
Bjorn you know nothing about my relationship with my oncologist, surgeon or my cancer story from the few posts I have done on rectalcancer.me. However your ignorant ill informed comments about me and my experience of cancer have motivated to write the book I have been threatening to do for a number of years now. You should know patients hate thinking about their cancer, its like having a monkey on your back and every so often you get a reminder, but as you have gone there I will respond on my blog in the coming days and I ralise how important it is for people who find themselves where I was in April 2011.
Yes i use the term Slash, Burn and Poison, when talking to my doctors. Fortunately they are not as sensitive about my “wit” as you seem to be and I have a great relationship with them, a sense of humour is perhaps one of the reasons i suspect they are so good at their jobs. Cant see you being my doctor somehow, they understand doctors are there to serve their patients and not the other way around.
No where on my blog have I criticised their efforts, on my behalf or “claimed cannabis cured my cancer”. You obviously lack a sense of humour, because everybody who read that particular post, thought the story of my first week on the cannabis oil was funny, that was 18 months ago and I have not updated my progress. I was supposed to die in June last year. I had chemo to stop spread in 2011 it worked for a few months, I was given the all clear but after a few months it was back, with a terminal diagnosis. I stopped the chemo after 6 cycles because of the neuropathy and now i have been clear for twenty four months. You believe that it was the chemo that did not work the first time, I am not so sure, but no where will you find me saying cannabis oil or anything else “cured” my cancer, nowhere. Its always there in the background, did you not learn that at medical school.
These are the facts, I have not had aromatherapy, its an old joke between me and Edzard going back to a discussion we had 2 years ago. Aromatherapy, reflexology and some other CAM treatments are available to cancer patients at the Royal Marsden in London as part of their “Evidence” based approach to cancer treatment . I have read “The Emperor of all Maladies and I agree its a brilliant book. Dont you find it odd they are using the same methods they were using a hundred years ago. slash, poison (mustard gas), burn (radiation cancer) in 2016, admittedly these treatments are delivered in a far more sophisticated manner. Did you not question the motivation of those guys basing a leukemia treatment on observations of victims of mustard gas poisoning in WW1, similar to my observations on cannabis oil. Thanks for the material you are going to love my response Bjorn
” I was supposed to die in June last year”
I don’t think so. what they may have told you is a prognosis which is based on statistics. the average of cancer victims with your cancer site and stage had that prognosis. your comments merely indicate how little you understand of real medicine, I fear.
[or was that supposed to be funny too? and perhaps I have no sense of humour, just as Bjorn?]
Bjorn, I refuse to be dragged down to your level and make personal insults. I have a masters in health promotion from Brunel University and have an excellent cancer team who have explained the 22 months, I know only too well every time I have a small head ache or a pain that the cancer could be back; thats why I have never gone out and claimed my cancer was cured as you stated, however it has taken longer to come back this time for whatever reason, I have done better than the statistical average. The fact you believed I did not understand this and took it upon yourself to put me straight, knowing hardly anything about my case, just the few bits you read on a blog I find staggering and I am going to make a complaint to your regulatory body in Iceland. You should really use a pseudonym as many of your colleagues do, if you are going to make comments like that in public.
“I am going to make a complaint to your regulatory body in Iceland”
Only a grub like you would.
I have learned much from this discourse and it is not the kind of experience that leaves a good feeling.
As I said before, cancer is a serious matter. Richard Lanigan seems to be one of those persons who are deeply entrenched in an ungrateful attitude towards reality to reality and thrive on a self-serving satisfaction with their own presumed superiority. He has made a parody of the harsh reality that has literally saved his life and cannot recognise the magnitude of scientific hard work that has led to methods, albeit difficult, that have saved his life and saved him from a most terrible death.
I am being very open and straightforward with this. That is because I know the reality he is distorting to satisfy his own agenda.
His last comment has convinced me of the futility of having any kind of mutually respective discussion with him, Therefore he is from now on, as far as I am concerned, only a perversely interesting “conversation piece”. Interesting because he displays so clearly what is wrong with being lenient or tolerant towards “alternative” health-measures and non-scientific approaches to health and disease.
Contemplate this:
Someone who says such nonsense is not saying it because they are ill informed. They say it because they are holding forth a deranged fallacy that satisfies their need for feeling superior and important.
I already mentioned a book I asked him to read before writing more daft drivel of this sort. The book is a truthful story of how cancer research has made it possible to cure deadly diseases (cancer is not one disease) and brought about fantastic changes in many of the cancer diseases, not the least in childhood cancers.
R.L. seems totally ignorant to the fact that a lot has happened since the time when a cancer like his killed people in the most horrendous way. I had a patient a long time ago whose rectal cancer, by negligence had been given the chance to progress untreated and invaded his sacral bone. This affected the nerves to his nether regions in a most horrendous way, giving him excruciating, relentless pain. Absolutely nothing could be done for the excruciating pain other than pumping herbal medicine into him.
Yes, I said “herbal medicine” because that is what is actually often used today, herbal medicine that works. Herbal medicine that works is not “alternative medicine”, it is real medicine, purified, standardised and quality controlled. The rest of the herbal sortiment is good for making soup and spicing lamb chops.
I gave this patient increasing doses of this magnificent medicine, a brown liquid that I had to order specially made for such massive doses. It costs almost nothing and is not restricted by any patent. Nevertheless it is one of the most commonly used medicines in the world. It is absolutely non-toxic so you can give however much of it, if you only keep in mind to adjust the dosage to fit the tolerance of the patient. Its only real drawback is its potential for addiction.
In the end, he was getting massive doses in a continuous drip. It kept his evil pain tolerable at least. It helped him live the last weeks in relative palliation until death eventually took him away from us.
R.L.’s disgraceful lack of gratefulness for modern medicine, that has made it possible for him to escape such a fate is nothing less than despicable. Instead of thanking science and his fellow humans who have worked hard to make his cure, he sneers at them and brags about knowing better himself.
“R.L.’s disgraceful lack of gratefulness for modern medicine, that has made it possible for him to escape such a fate is nothing less than despicable. Instead of thanking science and his fellow humans who have worked hard to make his cure, he sneers at them and brags about knowing better himself.”
No surprise there. He is a subluxationist so his sense of reality is so distorted he wouldn’t recognise reason if he fell over it. It seems, though, reality peeps through when HIS life is at risk, though the rest of humanity only needs his all-powerful subluxation treatments for all of their ills.
I am constantly amazed at the degree of delusion in this world.
Now why should I take even more time and explain to Richard Lanigan that his understanding of the case(s) discussed here is completely wrong? He has misread most of the text and based his incredulity on pure misunderstanding
He questions the possibility that the injury could have been caused by chiropractic manipulation. He is very wrong. They most certainly could and most probably were caused by overzealous neck manipulation performed by a chiropractor.
Now, I am sitting on a trans-Atlantic flight, angry as a bee after perusing of R.L’s stupid, pompous website and writing my wrath out for him (see previous comment). I should really be using my MacBook for finishing a somewhat tricky data analysis from our surgical audit but let’s see if I can put together a walk-through of this case that anyone with a modicum of mental abilities should comprehend.
I will explain why I am so absolutely convinced that it is not only likely that the presently discussed case is a vertebrobasilar injury and stroke caused by chiropractor performed neck manipulation, the likelihood of it borders on certainty.
R.L. carries on about there not having been any clot. Of course there was a clot, and likely lots of them. The sister does not say anywhere that there was no clot involved. She said (emphasis mine):
These are the words of the victim’s sister, reflecting how she remembers and interprets what the doctors told her. The sister might have misunderstood the information and erroneously uses the word “bleeding”. It is quite possible that it was both, i.e. an ischaemic stroke with a later bleed into a damaged area. In other words a Hemorrhagic transformation occurred.
Ok let’s go through the presented facts of this case one by one and analyse. V stands for the victim, S for his sister who wrote all we know about this.
1. V was treated for true migraine (the aura’s that S mentions confirms this) He was treated by someone calling himself a chiropractor.
=> The therapist was almost certainly a trained and certified chiropractor.
2. The treatment for migraine had been going on for almost a decade.
=> The victim was being treated for chronic/relapsing symptoms. No indication in S’s account of new symptoms. (and no indication of successful migraine treatment as it had obviously been ongoing for almost a decade)
3. The three last adjustments had been “very, very aggressive”. How did S know that? The brother very likely told her when he felt bad after the third “adjustment” just before he succumbed to a “full stroke”.
=> The chiropractor had most likely not been using a clicker device or other forms for benign, gentle make-believe manipulations. Extraordinary force was applied, as noted by the victim and related to his S.
4. Shortly after the third in a series of forceful “neck adjustments” within one week, the victim had acute onset of unusual visual disturbance/ impairment and unusual headache.
=> These symptoms point to an acute disturbance in the rear of his brain, an area fed by the vertebral arteries
5. Following this, the victim “suffered a full stroke”.
=>The problem was not only a transient, ischaemic attack (TIA) i.e. self-limiting, short lived circulatory disturbance by small clots, which would have subsided shortly and left no sequelae. It was a continuing circulatory failure to parts of his brain causing imminent damage to brain tissue.
6. Very sensitive studies showed “…a large tear in his vertebral artery.” This was not guesswork. This was a clearly and objectively confirmed case of VAD. No other known trauma was involved and the symptoms happened directly after a repeated, forceful “neck adjustment” by a chiropractor
=> There is no reason to try to guess another factor causing the VAD other than the forceful adjustment by a chiropractor. There is no mention of other trauma and the symptoms were not present before the therapies started.
=> A clot or rather clots formed on the damaged inner surface of the vertebral artery, probably already after the first or second adjustments. It is more likely because it takes some time for the clots to build up. WHile they stay in place it is unlikely that V had any remarkable symptoms. The clots dislodged at the third adjustment and entered the posterior part of his brain, causing increasing, widespread circulatory compromise. S says he complained right after the manipulation. Brain tissue can function without oxygen and glucose (i.e. circulation) supply for only 2-3 min’s before the brain cells start turning off. After an hour or so, the cells start to die.
7. The victim happily got medical attention in time for rescue measures to have a successful effect:
=> This tells me that he received successful treatment right away. Most likely a catheter was placed into the arterial system towards the occluded parts and powerful clot-dissolving medicine was injected directly towards the clots (this is called ‘thrombolysis’). As R.L. points out, the circulation to most areas of the brain comes from more than one direction. When an acute occlusion happens from one side, the other may help delay damage but never suffices to save the whole stiuation. Slowly progressive occlusion however is compensated with collateral circulation opening up.
8. The sister talks about “bleeding”.
=>This may, as I pointed out before, be a misunderstanding on her behalf or it may be that the thrombolysis caused some bleeding in areas where brain tissue, including small vessels, had been damaged by ischaemia. If such areas are not in critical places and if they are small enough, the damage will heal and the brain has remarkable recuperative powers.
Another explanation for S talking about “bleeding” may be that so called hemorrhagic transformation ensued. This is where ischaemic infarcts (brain tissue damaged by circulatory occlusion) start to bleed about 24-48 hours after onset of stroke, even if no clot-dissolving treatment was given. This usually worsens the prognosis severely.
As an afterthought, I believe that the part about bleeding must be based on S’s misunderstanding.
So Bjorn we are in agreement then the reported sequence of events as reported in the post above are incorrect and the sister must have misunderstood, thats what I have been saying all along, I have not said the vertebral artery dissection was impossible, I stated clearly a number of times that a brain haemorrhage without a clot, was not caused by a neck manipulation, I guess you did not read my comment properly either.
The stroke theoretically could have happened as you describe, my concern would be, with your theory now, is you were more than happy to jump on what you thought had happened, rather than what had been described in the post. I believe that what Google calls; “confirmation bias” and have seen it often during the last five years while undergoing treatment for cancer.
In this data analysis you are doing for you surgical audit, what is the risk of stroke? I was amazed when I was signing the consent forms for my rectal surgery, stroke was the biggest risk factor. As an expert in data analysis, which I am obviously not, would you call the evidence Edzard and Blue Wode have presented, as demonstrating a “causal relationship” between stroke and manipulation or is it a “temporal relationship”??
What utter nonsense. Your understanding of what I wrote is totally wrong. The only thing I said the sister might have misunderstood is the part about bleeding. Even if she didn’t, it is quite consistent with the near certainty that the chiropractor almost killed the victim. Yes, I said “almost killed” because that is what is most consistent with the sisters account.
You seem to be be suffering from either or both some kind of cognitive impairment that blinds you to those parts of a text that do not fit your delusional beliefs and from something resembling pseudologia fantastica, which allows you to thoughtlessly make up whatever nonsense that you think promotes your preconceived, irrational ideas and quackadelic hallucinations.
I am confused Bjorn? I thought we were in agreement, which part of my comment is “utter nonsense”? the bit where I am agreeing with you that; “the stroke theoretically could have happened as you describe” or that I am assuming that there is a difference between a “causal relationship” and a “temporal relationship” .
Did I upset you asking about the risk of stroke from cancer surgery, you seemed to know so much about cancer treatment?
“I am confused…”
YES, YOU CAN SAY THAT AGAIN!
Björn,
Please stop? You are wasting your time on this imbecile.
Don’t forget, he is a chiro, not just any sort of chiro but a subluxationist, as well as gawd-fearing xian. If anyone knows how to distort and cherry-pick, it will be him.You have far more productive and worthwhile things to do than wasting time explaining something to someone who , not only does not understand, does NOT want to understand. It will, indeed, cause him cognitive dissonance if anything should actually penetrate his abstruse nature.
YOU ARE WASTING YOUR TIME ON LANIGAN, THE MORON.
@Björn
Hear, hear! Your two long posts are tours de force. I found both of them moving, particularly the first. How indeed does a person so clearly blessed with the intellectual acumen of a soiled handkerchief dare to stick so tenaciously to his idiotic beliefs. People like Lanigan sould be forced to practise what they preach. When they’re ill they should be subjected to diagnosis by crystals and applied kinesiology. For treatment they should be able to take their choice from any of the therapies they so enthusiastically espouse. But they should be forbidden from access to medical care that can effectively postpone their deaths.
Richard Lanigan: if you’ve got so much to say about how terrible proper medicine is, for goodness sake keep the heck away from it. Put your illness where your arrogant, ignorant mouth is.
Not sure if this is the place to add another anecdote, but I’m a molecular biologist (PhD, NOT MD) and my best friend is a surgical pathologist (MD). I’ve seen a case like that – on her table, several years ago. Woman in her 40s, and quite dead at the time. My friend showed me the case as a warning because I was (still am) suffering from migraines and considered trying chiropractical intervention – what could go wrong, right? Well, that woman was dead from a massive stroke following a tear in her vertebral artery – I saw the tear with clotting around it from the bodies attempts to repair it. I saw the blood clot higher up in the brain. I saw the damaged area of the brain. It’s easy to see on a brain right in front of you on a table. The history leading up to this stroke practically read identical to the one told above – aggressive manipulation, worsening of the headache, visual impairment etc., except that she didn’t go to the ER in time but tried to “sleep it off”. She never woke up again.
The pathologists who had to find cause of death stated clear cut causal connection between the chiropractic manipulation and death.
The case was never published.
Needless to say I never ever went near a chiropractor.
THANK YOU!
needless to say also that this confirms the suspicion that under-reporting of even fatal cases could be huge.
My point all along here is, the way the events were described was not possible. She put in capital letters “NOT a clot” and there was a brain haemorrhage. If the post had stated a clot from a dissection had caused a stroke, then the discussion would have been, was the dissection caused by the manipulation, which was the discussion Dave Newel was having, with Edzard and Blue Wode. Bjorn Geir believes there must have been a clot to have caused the brain hemorage, but I repeat NOT was emphasised about the clot in the original post and there are a number of other causes of brain haemorrhage. So the Post as described is not accurate, there is nothing to stop anybody speculating as to what did caused the haemorrhage but the poster was clear NOT a clot. Bjorn Geir states the poster may have misunderstood about the clot, as I say all things are possible.
To clarify…
R.L.’s vain attempts at turning the evidence are sad but typical examples of logical reverse-somersaults that quacks often make when trying to win a discussion that is against them. In reality they are driven by a need to alleviate the subliminal hurt produced by cognitive dissonance that arises when their fantasy world is threatened by evidence and reason.
Luckily most readers of this blog are no idiots and see through such rhetorical failures, but let’s for the record explain how R.L. is shooting far below the goal, making a complete fool of himself in front of the audience by inane cheating.
R.L. writes:
RL takes three words out of context and omits the rest of the sentence (in bold): “NOT a clot that was already formed and agitated/released by the neck adjustment.”
The sister is simply recounting what the doctors had explained, that this was not a case of a clot that had already formed before the chiropractor came in and started forcefully manhandling his neck. Her words are clear as can be. The rest of the story supports this too. This has been explained numerous times for R.L. but it does not fit his agenda so he ignores it.
As for the part about bleeding, I have already at length explained two well known mechanisms that may explain how a bleeding can fit into this story. It is in no way inconsistent with the overwhelming suspicion that this stroke was directly caused by (overzealous) chiropractic neck “adjustment. In addition it is also likely that the sister may simply have misunderstood the doctors and there was no bleeding component involved in the injury. It is really beside the point whether bleeding was involved because all available evidence supports strongly the suspicion of chiropractic injury.
R.L. seems too disturbed by his idée fixe to assimilate such simple facts and carries on digging himself deeper into a hole of denial.
Another patient you have not spoken to Bjorn and are again making lots of assumptions about their history taken from an anonymous post on a beauty blog. So you are saying you know for certain that there was in fact a clot and it was formed after the manipulation and have no other possible theories as to why this might have happened. Don’t they teach differential diagnosis at Med school anymore. Fair enough, perhaps you could also tell us who is going to win this years Grand National, I hear things went bad for you after the crash.
Lanigan,
Seriously, you think you are qualified to argue with a surgeon with as much experience as Björn?
Unlike you who faffs about with people’s spine seeking out and “adjusting” a condition that does not exist, Björn cuts people open and performs “surgery”; you may be recently familiar with it, the performance of which helped save your life.
“Don’t they teach differential diagnosis at Med school anymore.”
Apart from demonstrating your inability to use correct punctuation, it shows your detachment from reality. While Björn does, indeed diagnose real diseases caused by real conditions, all of your diagnoses come back to one condition, “subluxation”. One might ask; what is the point of a chiropractor learning to diagnose when there is only one answer?
I disagree. I have been a chiropractor for 21 years, and have not caused a stroke, nor do I know a chiropractor who has caused a stroke. Newer research tends to state that the CAD is already occurring prior to the visit to the chiropractor, and that MD’s and DC’s have the same incidence for in-office stroke. Meaning that the patient walked into the office with the symptoms of neck pain or headaches, and later that day or withing a few days had the stroke.
This is the latest study I have seen, just today.
http://www.cureus.com/articles/4155-systematic-review-and-meta-analysis-of-chiropractic-care-and-cervical-artery-dissection-no-evidence-for-causation#.VsOtDCwqml4.facebook
Can it happen? Probably. Is it common, No it is not. The incidence is very low, and according to several studies, you have the same risk of having the stroke walking into a medical doctor’s office or a chiropractor’s office. The point is, all doctors should be more aware of the presenting symptoms, because we all have the same problem of the occurring stroke after the visit.
So, put down the pitchfork, no witch hunt today. What was once thought only a “chiropractic problem” is now known to be the same problem across the board, regardless of the letters behind the name.
“I have been a chiropractor for 21 years, and have not caused a stroke, nor do I know a chiropractor who has caused a stroke.”
How do you know that with certainty? Do you have a follow up program to monitor all of your “treatments”? (We know the answer.)
“Newer research tends to state that the CAD is already occurring prior to the visit to the chiropractor, and that MD’s and DC’s have the same incidence for in-office stroke. Meaning that the patient walked into the office with the symptoms of neck pain or headaches, and later that day or withing a few days had the stroke.”
Are you going to hang your hat on one review? Many wouldn’t but, typically, chiros do only if it isn’t critical of them.
“The incidence is very low, and according to several studies, you have the same risk of having the stroke walking into a medical doctor’s office or a chiropractor’s office. The point is, all doctors should be more aware of the presenting symptoms, because we all have the same problem of the occurring stroke after the visit.”
As mentioned repeatedly on this blog, the foremost consideration should be risk/benefit ratio. What benefit is there from chiro against the risks? What benefit is there of chiro full-stop?
” all doctors”? Self-explanatory.
https://www.youtube.com/watch?v=tNDFvwQIuL8
🙂
Do you have the same creativity when you make shit up in your “treatment rooms”?
Are you a subluxationist too?
Hilarious. Is making comic but wrong videos part of the skillset of chiropractors?
Thanks :0) my previous career.
@Frank Collins
I had my 3 children vaccinated and I do not use the “clicky doo-dad”. the rubber end fell off several years ago. I claim to treat only what the ASA deem acceptable, both in my advertising and in my office. When I see complaints that I know need further medical attention I refer them rapidly, dependant on the seriousness of the situation. These have included to date: a Slipped Capital Femoral Epiphysis, 3 patients with blocked femoral arteries, one blocked popliteal artery, an abdominal aneurysm (dissecting) and the recently mentioned Carotid aneurysm…oh several stress fractures, labral tears (both glenoid and acetabular) and a few thoracic compression fractures (osteoporotic) which I most certainly did not manipulate. I could go on.
This answers your later question about saving lives, however I did not join my profession to save lives: I joined to change quality of life – I do not hold onto the subluxion theory and my preferred targets are to reduce pain and improve function. A good day in the office for me is when someone struggles in staring at the carpet and is upright and comfortable when they leave. No doubt this will leave me open to criticism from others for being a “medico-practor” or a wannabe medic – so be it. I’m very content.
Many of the above conditions present as BMX symptoms. Some patients may have seen their GP first and had a missed diagnosis – this is not saying the medic involved is a fault, we have the luxury of being able to see a patient for longer and I more frequently see MSK conditions meaning it is perhaps more obvious when something is not mechanical. I don’t think we can always expect a patient to be able to self diagnose accurately before consulting a professional – otherwise A/E, NHS 111 and the ambulance service would have it sorted.
“Except when, after 121 years, there is still no good evidence of efficacy of the service that group provides. A religion (in his own words), started by a criminal in strange and totally implausible circumstances, based on vitalism and a non-existent condition, with claims it can treat many conditions unrelated to the spine, and you can’t see a problem with this?”
Again, some individuals in a group are more progressive than others. And as for dodgy starts, correct me I am wrong in believing that Surgeons started off as Barbers?
I might agree with you about America. I am not sure of your nationality, but in the UK if we have a complaint made against us it will be investigated and the findings made public. I believe to date, no British Chiropractor has been found guilty of causing an stroke?
My initial point was that this case is one individual story, and there may well be many other cases of chiropractors PREVENTING vascular accidents by their actions. We just don’t shout as loud. My second point was that demanding websites from someone in the manner you did comes across as threatening. Your mum should have told you not to give out personal details over the internet.
@Bjorn
” Why would a chiropractor invest in such an expensive instrument? Symptoms, signs, differential palpation and perhaps a cheap non-quantitative doppler stethoscope would be quite adequate to sort out the patients with peripheral circulatory problems?” Is quantitative doppler flowmetry considered standard tools and training for chiropractors nowadays?
– No. it isnt. I am not interested in fast cars and my wife prefers caravanning to foreign holidays. Got to spend the inheritance on something so I bought a diagnostic unit to further my interest in MSK ultrasound. It has the ability to measure blood flow and while I am fully aware that I have no expertise in vascular flow if it helps support my existing diagnosis then why not? I had already used the stethoscope.
@Frank Odds
“Is quantitative doppler flowmetry considered standard tools and training for chiropractors nowadays?”
please see above.
“Curious how, every time someone asks a reasonable question, the weeks pass with only silence for an answer”
sorry Frank 2, it’s been a busy week or so.
@ kay on Sunday 28 February 2016 at 11:37
“I do not use the “clicky doo-dad”. the rubber end fell off several years ago”
You had one though.
“however I did not join my profession to save lives: I joined to change quality of life”
You could have done trained as a physiotherapist or Occupational therapist and maintained your integrity too.
“we have the luxury of being able to see a patient for longer”
All this means is that there aren’t enough real doctors.
“And as for dodgy starts, correct me I am wrong in believing that Surgeons started off as Barbers?”
Yes, some did but as science progressed, so did medicine, unlike chiropractic. To be blunt, the oh-so clever point you tried to make is childish and stupid, as well as contemptible. Are you embarrassed having written it? I would be.
“My initial point was that this case is one individual story, and there may well be many other cases of chiropractors PREVENTING vascular accidents by their actions. We just don’t shout as loud.”
Your logic just gets worse. As there is no reporting system, who knows what harm chiros do. The patients die elsewhere, usually in a hospital.
“My second point was that demanding websites from someone in the manner you did comes across as threatening.”
Asking for a public document is threatening? Asking for the contact information which someone readily gives out to drum up business is threatening? Are you serious. I was prepared to give you the benefit of the doubt, however, after going through this point-by-point, I’m now convinced you are just as loopy and detached from reality as all of the other chiros who just make stuff up when it suits them.
“Your mum should have told you not to give out personal details over the internet.”
Since my mum is 80 and had me when she was fairly young, the answer is, “no”. The implication is, however, abundantly clear and intended to offend. Are you trying to be a patronising arse or is my statement in the previous paragraph holding true?
By-the-way, what is your website URL since you have nothing professional to hide? Also by-the-way, I am in Australia, also home to chiro loons (a tautology since the words are interchangeable).
Hi Frank,
is this one of those “clicky doo-dads”, that you are referring to? http://physioworks.com.au/treatments-1/physiotherapy-instrument-mobilisation-pim
At least these physios are moving forward from the outdated, archaic and unscientific, “shake, bake and fake”, that makes up most of their profession today.
More physios are moving toward chiropractic-type of therapies, than chiros using the “rubba-dub-dub” approach of modern physiotherapy.
Didn’t you read the whole page?
What is your website so we can see what witchcraft you use?
Do you mean these chiros?
http://www.abc.net.au/news/2016-01-18/chiropractic-board-of-australia-under-investigation/7096366
@ Frank C
“As there is no reporting system, who knows what harm chiros do. The patients die elsewhere, usually in a hospital”
Very ignorant of how we practice in Great Britain. I estimate that I have performed around 50’000 cervical manipulations. Not one of my patients has died as a result……and I would know if they had died! I know when any of my patients pass away – their relatives or carers usually contact us to let us know! We don’t just sit there and wonder why they didn’t show. The only complaint that has ever been made against me was by a techno geek in a town 200 miles away, who wouldn’t recognise my face or name, with an axe to grind.
Australian….figures. My web address is attached to the video. Next time you are over here you are more than welcome to stop in for a cup of tea and spend a morning with us and some patients. I’ll even dust off the clicky doo-dah.
I’m back to work for a while now. Be kind. Maybe cuddle a Koala or something to help the anger management.
K x
@ kay on Monday 29 February 2016 at 20:54,
Thank you for the link. We now know you are this Kay (spelled with a capital, I’m not “out there” enough to discard the conventions of language); Kay Pearce – http://maristowchiropractic.com/the-team The bit about about wife and three kids threw me but all good. My lesbian friends don’t have kids.
First things first though.
“I estimate that I have performed around 50’000 cervical manipulations. Not one of my patients has died as a result……and I would know if they had died! I know when any of my patients pass away – their relatives or carers usually contact us to let us know! We don’t just sit there and wonder why they didn’t show. The only complaint that has ever been made against me was by a techno geek in a town 200 miles away, who wouldn’t recognise my face or name, with an axe to grind.”
50,000 cervical manipulations? Wow, that is a hell of a lot of placebos and paid for all of them. No wonder you are smiling so broadly in your photo. You lay claim to the title ‘doctor” and you haven’t ever had to cut skin, drain pus, tell someone they will die shortly, attend to a situation where someone’s guts are splattered across the road, or stick a large needle into a person’s privates, yet you are still a “doctor”? Bjorn, take note; you don’t have to split people from a-hole to breakfast to help them, just faff about with their spines and you have a good income.
“Australian….figures.”
I didn’t know Australia was such a bad thing. There are many of your country-fellows who seem to disagree, given the huge numbers of them here. I have many English/British friends who don’t share your seeming disdain for this place.
“My web address is attached to the video.” Indeed, it is; a veritable wonderland of “interest”.
“Next time you are over here you are more than welcome to stop in for a cup of tea and spend a morning with us and some patients. I’ll even dust off the clicky doo-dah.”
My very good friend has moved out of Clifton (Bristol) where we visited a few years ago to run a major division of an aeronautical company which, incidentally, relies on science to function, not stuff she dreams up.
“Maybe cuddle a Koala or something to help the anger management.”
There are two problems here. One, you don’t cuddle koalas unless they are very tame because they can hurt you badly, and two, I’m not angry. The wild, unsupported assertion doesn’t augur well for your rationality. I was expecting better from you than the old poisoning-the-well but you are an alt-med so it is to be expected, I suppose.
Right, back to you. Your website says you are an inventor and here is the blurb from your web page;
“Kay has been a European Instructor for Graston Technique and in 2012 formed Kinnective Limited with her good friend and former college class mate, Donna Strachan. Together with physiotherapist Mike Chisholm, the Kinnective team regularly instructs elite sports teams across the UK.”
http://kinnective.co.uk/
“Designed by Practitioners for Practitioners, providing feedback never achieved before, Kinnective has outstanding features.
Using instruments to release soft tissues is certainly not a new idea as they have been used for centuries throughout the world. There are writings indicating Egyptians used objects to manipulate the body as far back as 3000BC.
Crafted from stainless steel, the Kinnective Therapy Instrument has been developed over a number of years with an emphasis on multifunctionality. The benefits of a single instrument are clear but usually necessitates a compromise on product. Not with the Kinnective. It is specifically designed to produce optimal ergonomics, feedback and flexible application in clinical practice. Welcome to the Future of Soft Tissue Treatment!”
Ha, you don’t need the clicky thing because you invented another bogus piece of equipment (crap). Invoking the Argument from Antiquity too; how original.
More from your website;
“Chiropractic treatment is suitable for all ages and is adapted to each individual patient. Our youngest patient to receive treatment was a baby, just a few days old, and we regularly see patients well into their 90’s. As every problem is different, so is every treatment plan – no two patients are treated exactly the same. Some individuals will be expected to make a complete recovery. Others will be recommended ongoing care, perhaps every three months, to help prevent the reoccurrence of the problem once it has been resolved.”
A baby only a few days old? You really have dipped into the world of loons.
You also do the Graston Technique;
https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=6&cad=rja&uact=8&ved=0ahUKEwif57_TiZ_LAhXLEpQKHTgCDvoQtwIIQTAF&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3Ddpazksg–JA&usg=AFQjCNHLLRVgMCle7f06qrI_mpH62A_92g&sig2=Ql2snuHAp3btEKiES81Cvw
This is just another shaped metal stick which you pinched to “create” the Kinnective.
Under any scrutiny, you are also an “A’ grade loon. You may be a nice person, however, I draw the line at having “cup of tea” with loons so detached from reality they have their own separate universe.
“Crafted from stainless steel, the Kinnective Therapy Instrument has been developed over a number of years with an emphasis on multifunctionality.” I think a good, solid spoon would be equally useful, to judge from the video. Or maybe a spanner.
more useful!
you can eat with a spoon, and tighten bolts with a spanner.
I just looked at the Graston Technique video. Surely that’s gua sha he’s doing? (Or should I say Gua Sha? I’m becoming confused after all the Reiki/reiki business.)
I’m beginning to get a strong urge to increase my ‘wellness’. I need someone to stick needles in my back while someone else scrapes mewith a bit of metal, and a third person yanks my head up and round swiftly. That should make me supremely fit for a few weeks. Or do readers think I should eat some dietary supplements too?
You would have to complete your treatment with a good dose of nutrients to slim down, more to muscle up, vitamins to the max and beyond, a coffee rne!a to clean you out and finally a drop of water to detox. Alternatively you could save your money.
Assuming you are on the point of retirement that is more than four dangerous manipulations a day for no purpose.
You say that relatives/carers would usually contact you which means that at least some of the time they don’t thus invalidating your claims of no deaths because you would know.
Carers would indicate you treat the elderly, a demographic far more likely to die of stroke than the average, surely at least some of them have died from stroke. How do you determine it had nothing to do with your neck manipulation?
@Kay
Yikes, my assumption of your age is obviously way out if you left college in 2001!
That means you performed over 13 cervical manipulations a day excluding the time spent in your sporting endeavours. Do all your customers get the neck twist?
The thought that anybody can be awarded a BSc and an MSc from an anti science college is ridiculous, education is truly being dumbed down.
On 28 February 2016 at 11:37:03 kay wrote: “I claim to treat only what the ASA deem acceptable, both in my advertising and in my office.”
@ kay
What evidence did you use as a basis for this ‘treatment’?
QUOTE
“Our youngest patient to receive treatment was a baby, just a few days old”
http://maristowchiropractic.com/treatment
A
foolchiropractor with a tool is still afoolchiropractor.When someone pretends to be a car mechanic and sells such services, the authorities come and interfere. When someone plays doctor and starts waving tools and selling make-believe medicine…
The “authorities” such as the Consortium for the Accreditation of Sonographic Education? (whose course I have completed and whose exams I have passed? or the British Medical Ultrasound Society who accepted me as a member? I don’t need to pretend to be a doctor – nor do I want to. I treat/rehab the conditions I identify as appropriate and refer those I don’t to the local surgery, whom I have a very good working relationship with.
p.s you must have had a little cheeky bubble at my video didn’t you? (yours are getting a little samey)
“MSK ultrasound”
What next; an MRI machine, CAT scanner, laparoscope, full operating theatre………………………………………….?
@ blue wode
the patient mentioned was referred to me by a midwife from the local maternity unit. He had CMT. My treatment was very similar to that described in this research: Outcomes of asymmetry in infants with CMT
KyeongSoo Lee, PT, MSc1), eunJung Chung, PT, PhD2), Seongeun Koh, MD, PhD3), Byoung-hee Lee, PT, PhD4)*
charcot-marie-tooth disease is a genetic condition. the treatment can only be palliative using lots of physiotherapy and possibly surgery – if I remember correctly from long ago when I had several such patients.
CONGENITAL MUSCULAR TORTICOLLIS!
kay wrote: “My treatment was very similar to that described in this research….”
From the abstract:
“The purpose of this study was to assess the outcomes of asymmetry in infants with congenital muscular torticollis (CMT). [Subjects] A total of 102 patients with CMT under the age of 6 months were studied. [Methods] Asymmety was evaluated by determining the difference in the thicknesses of the two sternocleidomas-toid muscles (DTSM) using ultrasonography, head tilt (HT) based on a physical examination, and the torticollis overall assessment (TOA). Patients received ultrasound and massage therapy for 30 minutes, in conjunction with passive stretching exercises, 3 times a week. [Results] The DTSM, HT, and TOA scores were significantly different after treatment. Pretest DTSM, HT, and TOA scores and pre-posttest change scores for DTSM, HT, and TOA scores were correlated with treatment duration in infants with CMT. [Conclusion] The findings of this study suggest that treatment duration is correlated with asymmetry evaluation parameters (DTSM, HT, and TOA) in infants with CMT. We propose that these results will help in reducing the treatment duration, and also in improving communication between doctors and therapists during the diagnosis and evaluation of torticollis.”
Ref: http://tinyurl.com/jghqffy
Outcomes of asymmetry in infants with congenital muscular torticollis. Journal of Physical Therapy Science . 2015, Vol. 27 Issue 2, p461-464. 4p. Author(s): KYEONGSOO LEE; EUNJUNG CHUNG; SEONGEUN KOH; BYOUNG-HEE LEE
That looks fairly benign to me. However, given that there is no standardisation in chiropractic practice, and that there are no reliable adverse event reporting systems, I am not convinced that chiropractors should be allowed anywhere near infants with torticollis…
“Doctors are calling for chiropractors to stop treating children after a Melbourne infant’s neck was broken during a chiropractic adjustment that went horribly wrong. Melbourne paediatrician Chris Pappas said he cared for a four-month-old baby last year after one of her vertebrae was fractured during a chiropractic treatment for torticollis – a wry neck, which is usually harmless in babies.”
Ref: http://www.theage.com.au/national/chiros-warned-off-treating-children-20130928-2ulcx.html
“An infant with congenital torticollis (twisted neck) underwent chiropractic manipulation, and within a few hours had respiratory insufficiency, seizures, and quadriplegia.”
Ref: http://www.ncbi.nlm.nih.gov/pubmed/1735825?dopt=Abstract
If you had read the post thoroughly you would have seen that I specified that I did not adjust the infant in question.
“the patient mentioned was referred to me by a midwife from the local maternity unit.”
A nurse strikes again. They should stick to things they know, which isn’t much. The study was conducted by physiotherapists in what seems a properly conducted study. Any referral, preferably by a doctor, should have been to a physiotherapist, not a wannabe physio.
The next question is why didn’t you decline and send the parent to a physio?
“A nurse strikes again. They should stick to things they know, which isn’t much. The study was conducted by physiotherapists in what seems a properly conducted study. Any referral, preferably by a doctor, should have been to a physiotherapist, not a wannabe physio.”
That is your opinion; a very judgemental and immature one.The next question is irrelevant to this thread, however, to answer: I had the skills to provide the necessary treatment, I understood the condition and I was aware of the current literature regarding best practice.
“That is your opinion; a very judgemental and immature one.”
Says you, a person who “invented” a scraping stick and gave it some wanky name. Is it “mature” to steal some hare-brained idea, make it slightly different, and flog it as an invention? Please, if you are going to attempt to insult me, do more than this half-arsed effort?
“The next question is irrelevant to this thread, however, to answer: I had the skills to provide the necessary treatment, I understood the condition and I was aware of the current literature regarding best practice.”
What are you going to poke your unqualified nose into next time? Is Bjorn under threat for thoracic surgery?
Your responses just get sillier and sillier. You appeared to have some modicum of rationality in your firsts posts, but, it seems like all chiros, you too are an A grade loon who doesn’t understand the limits of your training, skills, and intelligence. Give a dill the title of “doctor” and they think they are real doctors, rather than alt-meds at the fringes of reality.
@ Frank C
The web page clearly states Dr of Chiropractic. It is a title I have been awarded and may use as such whether you like it or not. I am happy to use it with or without your approval.
“I didn’t know Australia was such a bad thing. There are many of your country-fellows who seem to disagree, given the huge numbers of them here. I have many English/British friends who don’t share your seeming disdain for this place”
I didn’t say it was a bad thing. I don’t think it is a bad thing. Although it made me chuckle that this is the assumption you defensively jumped to. I merely meant that it explains your ignorance regarding Chiropractic in my country/hemisphere. Australia is a very long way away to be standing on a pedestal and making judgements. Lighten up about the Koalas – it was tongue in cheek.
“Ha, you don’t need the clicky thing because you invented another bogus piece of equipment (crap).”
So it’s not just Chiropractors you are on the bandwagon about. I would be more than happy to discuss with you the justification of using instrument assisted soft therapy for treating connective tissue. Email me and i will send you some pdfs…. assuming you understand the composition of collagen, and are aware of the nomenclature of fascia? Apologies, I am not aware of you background so I would not know what level to pitch to – the understanding of the consultant rheumatologist I was lecturing to last week, the sports massage therapist at the Cardiff United or the international rugby player I treated last week?
Your feedback regarding our Kinnective Instrument is noted, though we have had many more positive review from those that have used it, and are trained to do so. Our customers include the English Institute of Sport, The RFU, Welsh RFU and Manchester City FC. To name a few.
” I think a good, solid spoon would be equally useful, to judge from the video. Or maybe a spanner.”
Yes Frank 2 : some choose to use spoons (usually ceramic), …a spanner…bit rough don’t you think? And indeed – Graston (and others) do not claim to be anything different than Gua Sha – except from the intention of use. Gua =scrape Sha = redness (from the petechial response created.). These days we do not seek the “sha” as histological studies have shown it to be unnecessary in order to create the desired change in fibroblastic activity. Stainless steel merely provides the user with a greater degree of feedback from the tissue involved and are more hygienic. It’s a choice of the individual.
“A baby only a few days old? You really have dipped into the world of loons”
please see reply to Blue Wode. I did not perform a high velocity l rotatory thrust on this child.
If anyone would like to further discuss my practice or dissect my website I would be more than happy to do so. However Franks personal probing has diverted from my points which remain:
1) Has anyone evidence of a Chiropractor being found guilty of causing a stroke through treatment in the UK? I would be interested in learning from this case study.
2) Not one of my patients, currently in my care has ever died or disappeared off to hospital without me being aware of it. A patient at my clinic is either discharged, in which case they are no longer my patient or they remain in contact with us. Not one of my patients has had a stroke while undergoing a course of treatment. I would know this – we have a small community and I know our patients and their families very very well. Not much happens in Westbury without one of our staff knowing about it.
Having noticed that some of those posting in this thread have been doing so on this site since 2014 it has become clear to me that several contributors will not be content to have polite intellectual debate or respectfully discuss opposing views but are long term serial antagonists. I do wonder what has happened within some of your lives to agitate such hostility towards others so far removed from your own circumstances.
Sadly the thread has lost it’s context and become more of a targeted dissection of my own character. Which while I have been happy to discuss, I feel some of you are only here to validate your own positions and are not open minded enough to refrain from insults and personal opinions. Initially interesting and at times an entertaining thread, but one which now contains too much hysteria and too little fact to be of use or interest. For these reasons I will bid you farewell and unsubscribe from posts.
My final thought : A man is likely to mind his own business when it is worth minding. When it is not, he takes his mind off his own meaningless affairs by minding other people’s business. — Eric Hoffer
did you really just say ‘INTELLECTUAL’?