Stroke Soundbyte

The other day, I had a question from a primary care medical doctor who stated she has a “background” in Neurology [whatever that means J].  We were sitting around having lunch with the entire office staff and she said “hey, what’s your opinion on the stroke and neck manipulation thing?”  She said she was interested from an academic perspective. 

My answer had two components and this is what I said: 

“Right now, there is absolutely no evidence that spinal manipulation will injure a patient if the tissue is healthy.  So, the latest research out of a million plus patients in a Medicare study showed that there are no injuries reported in patients that have non-pathological tissue or healthy tissue.  So, the question really becomes IS there pathological issues or is there underlying unhealthy tissue that we need to be aware of.  So, that really relies on physical exam and differential diagnosis so that is why we do such a thorough exam, number one.”

“Number two is a recent study out of Penn State Neurosurgery stated that there was no causal link between the people that actually had stroke after chiropractic adjustment or manipulation in general, and their reasoning behind that was that most people that have vascular symptoms present to providers that see those symptoms such as chiropractors with neck pain and headache.”

“So, again, getting back, we have pathologically changed tissue and they are most likely having that event at the time of their treatment.  They are not having the event because of treatment and she was very happy with that so, just something to review and you should be able to say it that quickly, okay, because it is all based on evidence.”