As with all health care providers I have to have “informed consent” from my patients before I treat them. This means that their condition and the benefits and risks of treatment are explained to them. They are also advised as to what their treatment alternatives might be and the risks of their condition going untreated before they “consent” to care. As a chiropractic physician this means that I have to explain the benefits and risks of spinal manipulation. Actually, the risks associated with spinal manipulation are extremely rare.
Many studies over the years have touted the benefits of spinal manipulation. Those studies have shown manipulation to be not only highly effective for treating spinal conditions but also to be beneficial to returning people back to work quicker and at less cost. The crux of this article however is to discuss “risks”.
The most common injury associated with spinal manipulation, particularly in the cervical spine, is stroke. Even though there has been much concern placed on this of late the truth of the matter is that studies have not shown a direct causal relationship between chiropractic spinal manipulation and stroke. Unfortunately, a patient who may be getting ready to have a stroke, could be experiencing symptoms that would be similar to a cervical musculoskeletal complaint- which is a common problem that someone would present to a chiropractor for treatment. Chiropractors are trained to screen patients who may be at risk of stroke. They will take a careful history and will perform tests and procedures to determine if a particular patient is at risk. They would then make the judgement as to whether spinal manipulation would be appropriate for that patient and their condition. Per a recent Canadian study there was no more risk of stroke from a visit to a chiropractor’s office than there was to a family physician’s. The actual risk of stroke is so low that a patient would be more likely to suffer serious injuries in an auto accident driving to the office if they lived over one mile away.
A very common medical treatment for neck and spine pain is the use of NSAID’s or non-steroidal anti-inflammatory drugs. Advil (Ibuprophen), Alleve (Naproxen) and Indocine commonly prescribed NSAID’s. They are considered generally safe and are amongst the most prescribed drugs in this country but the risks associated with them are more than 100X greater at 400 in 1 million risk than those associated with chiropractic spinal manipulation. The most common and serious adverse effects from NSAID’s are gastrointestinal ulcerations, hemorrhage and perforations. A recent study in The New England Journal of Medicine estimated that greater than 103,000 patients per year were hospitalized in the US for serious gastrointestinal complications due to the use of NSAID’s with an estimated 16,500 deaths occurring annually. This would rank them as the 15th most common cause of death in this country. Further putting the risk into perspective lets look at other healthcare risks- overall mortality rate for spinal surgery 7 in 10,000 with a death rate from cervical spine surgery 4-10 in 10,000. Risk of death associated with non-healthcare activities are- soccer/ football 1 in 25,000, motorcycling 1 in 50 and skiing 1 in 430,000.
The low risk of injury from chiropractic spinal manipulation is also reflected in malpractice rates. Malpractice rates are determined by the number of claims made against a particular group of healthcare providers by patients. The average rate for chiropractors across the United States is $1500.00 with rates for general practitioners ranging from $10,000 to $20,000 per year.
Thus, taking into account all of the above information, chiropractic spinal manipulation is not only an effective treatment for spinal pain but is also one of the safest. Should you have any concerns in regards to the safety and efficacy of chiropractic please ask your chiropractor to take some time to discuss them with you.
Dr. David D. Godwin
Chiropractic Physician
2907 South Main St.
Salisbury, NC 28147
704-633-9335