Today's post is a discussion of an article written by E. Ernst and published in the International Journal of Clinical Practice. In the article, Ernst performed a systematic review of cases where Chiropractic manipulations preceded death of a patient. Ernst searched multiple databases for any mention of a patient fatality following treatment by a Chiropractor, with no time limit on how far back the reports originated.
For a brief background, some deaths have been attributed to Chiropractic treatment, especially when the neck has been treated. The underlying mechanism is damage or 'dissection' of the vertebral artery in the upper neck due to a combination of twisting and extension. This motion, induced beyond the physiological limits in some patients, can lead to problems such as a stroke or even worse, death.
What Ernst found in his research was, twenty-six fatalities were published since 1934 in 23 articles. Now considering the time frame, approximately 77 years of published journal articles, to come up with 23 mentions of death attributable to Chiropractic treatment is extremely good and helps to confirm the overall safety of Chiropractic adjustments, especially for the neck. Now when I say, 'good' I say that in a relative term when you consider that thousands of deaths occur every year from the use/misuse of even over the counter medications like, Tylenol.
Now here is where I think readers will benefit from my honest point of view as a Chiropractor. Do I think there is a problem with Ernst's article. Yes. I will be the first to admit that in all probability, the number of strokes and/or deaths attributable to Chiropractic treatment is likely under-reported. By how much? Well I'm not sure. Especially when you are dealing with something as serious as death, y ou should be absolutely sure that a Chiropractic adjustment was the cause of a fatality. Here is where even Ernst commented on this in his article. He mentioned that, "the time between treatment and death ranged from 1 h to 58 days; in 10 cases, it was 1 day or less". What I'd like to point out is that 58 days is a long time to pass. After more than 8 weeks pass, can you say for certain that a Chiropractic treatment was indeed the cause of a death?
Overall, I'd like to discuss some tips for patients before they seek Chiropractic care, especially for the neck;
- Ask for a referral from family or friends. Knowing that someone you love and trust has received good care and success is important. That goes for just about anything.
- Ask the Chiropractor some poignant questions. If you're not sure, ask! Especially the Chiropractor's style of treatment. What can you expect? How much experience does he/she have? Will it be a manual adjustment or will an instrument be used?
- Will the Chiropractor do a thorough exam/history first? This is an absolute must!!! Some patients, under no circumstance should receive a Chiropractic adjustment to their neck. Any good doctor should be able to identify these patients based on a history and exam alone.
- How long will it take? Results can vary but the important thing is, the patient should see results. Have the Chiropractor explain a treatment plan to you. Look for regular follow-up or re-examinations so both you and your Chiropractor can monitor your progress.
Have any questions? In the Commercial Drive neighborhood of East Vancouver? Come by the office or visit the website,COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC
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