MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

It has been reported by several outlets that a young woman is fighting for her life after a chiropractic adjustment went horribly wrong. Caitlin Jensen had only recently graduated from University. When she went for what was meant to be a simple chiropractic adjustment on June 16, she suffered four dissected arteries in her neck, this damage led to cardiac arrest, stroke and her being without a pulse for over 10 minutes, requiring resuscitation.

She was rushed to the Memorial Hospital in Savannah, Georgia, where she was operated on. She was then taken to the neuro ICU in a critical condition with a traumatic brain injury. Every day since she’s been fighting. Currently, she is conscious and able to respond to verbal commands by blinking her eyes, as well as wiggling the toes of her left foot. However, most of her body remains paralyzed.

Her mother Darlene has been posting updates about her daughter’s condition on Facebook. On Saturday Darlene shared the latest news on the condition of her daughter. “She gave her best effort to smile today, and it was the most beautiful thing I’ve ever seen,” Darlene said. “She is progressing with her movements on the left side – wiggling and flexing. She can’t lift her arm yet, or turn her head. Her right side is unchanged – still no movement. Her face doesn’t move very much yet, but she can open her eyes widely to show surprise, and the left corner of her mouth tries to smile. Adorable. Still working on the pneumonia. The antiplatelet therapy seems to be going OK. We don’t see any signs of internal bleeding and are praying that it stays that way.”

And the day before, Darlene posted: “Two weeks ago tonight we didn’t know if Caitlin would make it through the night,” Darlene said. “Dire and catastrophic are two of the words that we heard from our ICU team. We knew they didn’t casually throw around words like that. But – she is alive, and every day is a little better. The accomplishments are both small and monumental at the same time. Today, she gave us a thumbs up. We have been working on this, and she got it! She also nodded again today. It helps to see these things because it reassures us that she is working hard to stay with us and recover. Caitlin is strong, disciplined, and well practised in exercising her brain, and I truly believe that her science background and all of her time studying is going to help her in this long journey. “

Studies have found that traumatic cervical artery dissection is one of the leading causes of stroke in patients under the age of 45, and recent chiropractic neck manipulation is among factors that can be associated with risk of vertebral artery dissection.

Following the tragedy, Caitlin’s mother, Darlene, launched a GoFundMe and has raised more than US$20,000 (AU $29,334 or £16,512) for her ongoing medical expenses.

It is clear that these news reports lack important medical details. What is equally clear is the fact that most such cases are never reported in the medical literature and are thus available only in this fragmented form. The reason for this lamentable situation is obvious: there is no post-marketing surveillance system for chiropractic (such a safeguard would be bad for business, of course).

Consequently, chiropractors across the globe continue to be able to say that such reports are unreliable. The medical literature, they are keen to point out, holds only very few case studies of serious risks of chiropractic spinal manipulation. Hence they falsely claim on every possible occasion that their adjustments are safe. The end effect is that many consumers continue to wrongly assume that chiropractic manipulations might be worth a try.

52 Responses to Catastrophic injuries after chiropractic treatment

  • I suggest that anyone reading this forward this to their friends and family members who are under treatment of chiropractors or plan to consult one.

    I can report at least one small success: an acquaintance of mine who had been consulting a chiropractor for several months(*) for upper back pain immediately ended all treatments when her chiro intended to ‘adjust’ her neck, and insisted that this intervention was necessary, even when she indicated that she did not feel comfortable about it – this was after I brought a previous article to her attention.
    (And oh, her back is much better now, without any special interventions.)

    *: The fact that her complaints did not substantially improve even after six or seven treatments also helped her to decide that chiropractic treatment was useless.

  • EE It is clear that these news reports lack important medical details.

    That is correct. If one is to assume causation there were intrinsic factors present in order for a properly performed cSMT (assumed) to damage all four arteries. If true, this appears to be more likely a case of an improper history and exam (which the article provided none of those details).

    “An underlying disease or triggering event was identified in 71%, most commonly trauma (35%, cervical manipulative therapy in 13%), infection (18%), fibromuscular dysplasia (16%), and hereditary connective tissue disorder (8%).”

    https://link.springer.com/article/10.1007/s00415-019-09269-1

    • chiropractors across the globe continue to be able to say that such reports are unreliable. The medical literature, they are keen to point out, holds only very few case studies of serious risks of chiropractic spinal manipulation. Hence they falsely claim on every possible occasion that their adjustments are safe. The end effect is that many consumers continue to wrongly assume that chiropractic manipulations might be worth a try.

    • @DC
      It is really very simple:
      – There is no evidence that cervical manipulation has any benefits(*).
      – There are strong indications that cervical manipulation comes with a small but non-negligible risk of very serious injuries.

      It should be clear to anyone with at least two functioning brain cells that at the very least, chiropractors should immediately stop messing with people’s necks. And it would even be better if you people would find a proper job instead of continuing this half-baked century-old quackery, because you stubbornly refuse to learn from the things you do wrong.

      *: There isn’t even good evidence that chiropractic treatment in general has clinical benefits over regular physiotherapy.

      • RR There is no evidence that cervical manipulation has any benefits(*).

        No evidence?

        combining different forms of MT with exercise is better than MT or exercise alone

        https://pubmed.ncbi.nlm.nih.gov/28826164/

        There was moderate level evidence to support the immediate effectiveness of cervical spine manipulation in treating people with cervical radiculopathy.

        https://pubmed.ncbi.nlm.nih.gov/25681406/

        Our review adds new evidence to the Neck Pain Task Force and suggests that mobilization, manipulation, and clinical massage are effective interventions for the management of neck pain.

        https://pubmed.ncbi.nlm.nih.gov/26707074/

        Upper cervical spine thrust manipulation or mobilisation techniques are more effective than control (low to high evidence), while thoracic manipulations are not.

        https://pubmed.ncbi.nlm.nih.gov/26059857/

        • @DC
          I don’t contest that mobilization and (slow, careful) manipulation of the head and neck region can help alleviate complaints. Properly trained physiotherapists have several techniques at their disposal for this.

          However, you quacks are the only ones who use forceful high-speed yanking of people’s heads, and no, your linked articles do not provide convincing evidence that this has significant benefits over less violent treatments. And because it very likely does cause serious harm and even death on a regular basis, the risk/benefit balance is negative, so you should stop using it.

          Sheesh … Is this so hard to understand?

  • I read it the first time.

    Such news reports often/always lack the necessary information to help determine the probability of causation. Even published case reports often fail in this regard.

    BTW. The case they referenced they used the 1 in 20,000. Not only is this an incomplete reference to the original author (he stated it could be up to 1 in 1 million) it isn’t backed up by any data that I can find. It was his opinion.

  • Seems neck manipulation is par for course, regardless if you tell them no. Most patients believe these chiropractors are medical doctors and know what is best for you. 25 years ago, prior to internet, they were full blown medical doctors in most peoples eyes, like I thought.
    You tell them no neck, you feel you are questioning their practice and cater to them.
    Many feel obligated for neck routine because of this, even today.

    • Jim: Most patients believe these chiropractors are medical doctors

      Any supporting evidence?

      Let me start you out…

      “Thirty-four percent (34%)…believed that chiropractors are as well trained as GPs….”

      January 2007Chiropractic Journal of Australia 37:135-140

      • I don’t know what your intention was in quoting this but if it means that 66% of whoever they were asking understood that chiropractors are not comparable to doctors, that can only be good.

  • There is an obsession on this forum with so called SCAM practitioners. Just because a man or woman happens to be trained and qualified in ‘conventional’ health care does not automatically mean they are a ‘God’ of some kind and cannot do any wrong. I could list many hundreds of malpractice events that I know about, relating to licensed, qualified and allegedly ethical physicians. I have given here just one recent example in order to provide some balance! This ‘doctor’ pleaded guilty to very serious harm of a patient that resulted in their death…
    https://www.bbc.co.uk/news/uk-england-manchester-62051001

  • A few months ago I had a skin lesion removed. I was given a list of possible adverse outcomes and some idea of the probability of these. Do chiropractors alert people to the risk of arterial dissection?

  • At the end of the day you push your agenda and avoid giving answers.

    Regardless of the controversy about whether SMT actually causes artery dissection or not you keep avoiding simple questions.

    from what frequency of severe reactions is a treatment considered unsafe and from what frequency does a treatment require by law to have a consent form signed.

    • ” the controversy about whether SMT actually causes artery dissection or not”
      I did not know there was a controversy – probably because I’m not a chiro.
      ONLY CHIROS THINK THERE IS ONE

  • I have repeatedly seen Chiros claim that patients are attending for Chiro neck manipulation due to pain from already developing arterial wall dissection. If we accept that this may be the case, how could anyone EVER intentionally deliver a high velocity force to the neck as “treatment” ? If there is already a dissection in progress, it’s almost guaranteed to worsen it, or throw off a clot.

    Either way, don’t ever apply high velocity force to the neck.

    • good point!

    • It sounds like you’re assuming the chiropractors in question are aware of the existing dissection and treat anyway.
      These aren’t chiropractors maliciously twisting necks with a known dissection. They are trying to help patients with neck pain and fail to adequately identify which patients might have signs of more serious conditions or underlying pathology.
      The problem is that dissections are difficult to detect without imaging. “There is no office examination to rule out CAD.” https://doi.org/10.1080/07853890.2019.1639807

      Medical doctors are not perfect either, and can miss the signs just as easily as a chiropractor, as this case study demonstrates. The GP, radiologist, and chiropractor missed the dissection on MRI before treatment with manipulation. Symptoms presented immediately after manipulation, and the dissection was then seen on a follow up MRI and confirmed to have been present on the first.
      https://doi.org/10.1007/s00415-022-10964-9

      • No – what Sue meant, I think, is that, headache being a symptom of dissection, one should not manipulate the neck of people who have headaches.

        • Or play golf, or do yoga, or paint a ceiling, or go to the dentist, or stretch, or have sex, or….

          Instead go to a MD and get NSAIDs, oh wait, don’t they cause strokes?

        • @Edzard – if that is what Sue meant, it’s a fair argument. I don’t happen to agree, but it is worth a discussion.
          Suggesting that chiropractors are knowingly manipulating patients with diagnosed dissections (which is how I read the comment) is a different matter, and would be cause for board sanctions and legal action (which I would support).

      • It’s like you deliberately ignored the bit about chiros claiming that they have people attending precisely because of a pre-existing arterial wall dissection…

        But that can’t be the case, can it?

        • @Murmur – I’m afraid I don’t understand what I’ve ignored. Are you saying that chiropractors have claimed to treat patients with a known arterial wall dissection? If so, please link to an example. Otherwise, please clarify what I’m missing.

    • Sue: If there is already a dissection in progress, it’s almost guaranteed to worsen it, or throw off a clot.

      1. Do you have any credible evidence that what you stated is true.

      2. Since the greatest strain on the VA occurs within normal ROM isn’t it more likely that ADLs would cause a worsening of a VAD or an emboli?

      3. Since neurological manifestations of a VAD may be delayed for a week or more and signs of a stroke from an emboli may also be delayed, how do you know cSMT was the primary factor?

      4. Do VAD strokes occur more often after cSMT than VAD strokes in the general population?

      5. Since VADs are known to be missed in ERs are chiropractors being held to a higher standard? If so, why?

  • The news is in the Belgian newspapers today, on July 14th. Thank you for your analysis, I use it and make a Dutch comment to warn our Flemish readers.

  • I invite regular readers of this forum to look beyond SCAM. This report of a Doctor attempting to murder a Surgeon seems hard to believe … but it’s true. Licenced medical practitioners are not ‘God’ as some folks believe. They might have a string of academic qualifications after their name, but letters are just that – they do not represent the ethical or moral standards that individual may possess. Remember Dr Shipman anyone? Here is the BBC report for your interest:
    https://www.bbc.co.uk/news/uk-england-nottinghamshire-62152106

    • criminal intent is entirely different from using treatments that kill.
      I suppose you know that but could not resist trolling a bit.

    • @Mike Grant

      This report of a Doctor attempting to murder a Surgeon seems hard to believe … but it’s true

      Doctors are human….duh! Tell us something new.

      They might have a string of academic qualifications after their name, but letters are just that

      The witch doctor I have been seeing for the past decade did not even pass high school. I don’t think he can read or write but so far he cured all my problems with a 100% success rate. You cant say that about any homeopath, chiro or an MD for that matter.

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