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Stroke linked to neck work
60 neurologists speak out against manipulation by chiropractors
Montreal Gazette
"The chiropractor will tell you what you want to hear - that it's natural, no drugs, no surgery," says Dollard des Ormeaux physician Dr. Murray Katz. However, more than 60 neurologists from across Canada are warning that chiropractors inadvertently cause stroke, even death as a result of upper neck manipulations.

At the Tiny Tots Medical Centre, Dr. Murray Katz is often asked by parents whether they should send their children to a chiropractor.

The claims seem almost too good to be true: deft spinal manipulations can alleviate everything from bed wetting and clumsiness to recurring ear infections and frequent colds.

"The chiropractor will tell you what you want to hear - that it's natural, no drugs, no surgery," the Dollard des Ormeaux physician said.

"It's a nice message, but it's not what your child needs. The bottom line is that the emperor has no clothes: neck manipulation does nothing to affect these conditions."

A group of more than 60 neurologists from across the country went a step farther yesterday, warning that chiropractors inadvertently cause stroke, even death. They estimate that up to 250 Canadians suffer strokes each year as a result of upper neck manipulations by chiropractors.

"When you're in private practice, you see complications from chiropractic manipulation constantly," said Edmonton neurologist Brad Stewart.

"A young guy came to see me this morning after going to a chiropractor because he had a problem with his hand. He had a crushed nerve under his arm from using a crutch and yet the chiropractor manipulated his neck.

"There is no rational use for this," Stewart added.

The Alberta Association of Radiologists and the Canadian chiefs of pediatrics have both issued previous warning about the dangers of chiropractic manipulation. The neurologists, all members of the Royal College of Physicians and Surgeons, issued their warning after observing an increasing number of chiropractic complications, Stewart said.

Chiropractors defend their techniques as safe and say they're willing to collaborate with physicians.

"The real issue here is the protection of the public, and chiropractic (care) has an enviable safety record," said Jim Duncan, executive director of the Canadian Chiropractic Association.

"Strokes can be caused spontaneously by cradling a phone in your ear, turning around to back up your car or playing a golf game. Within health care, there is no intervention that does not carry some degree of risk."

Duncan estimated the risk of stroke at one in 2 million chiropractic adjustments.

However, Stewart said that estimate is based on old data. He put the risk of stroke at one in 5,000, based on the number of consultations annually and data supplied by the Heart and Stroke Foundation of Canada.

"The chiropractors are clinging to this old, outdated information and they are refusing to accept the new figures," he said.

At issue is whether manipulating the neck can damage the vertebral artery, which rises to the stem of the brain in two right-angle turns.

Stewart contends that chiropractors twist the neck beyond its natural limits, tearing the artery in a sudden, jerky motion.

"When you tear the artery, you get a blood clot forming within the artery," he explained. "Usually within a few days, but it can be up to three months, the blood clot dislodges, goes up and lodges in the smaller part of the brain. Some people can die from this. Others suffer a stroke."

Katz conceded that a chiropractor can ease lower back pain, but he said the benefits are minimal.

Chiropractors are increasingly marketing their services to children. A brochure by the Ontario Chiropractic Association recommends that parents send their infants to a chiropractor "as soon as possible after birth. Chiropractic care at an early stage could prevent many common childhood disorders from developing."

The brochure then suggests that chiropractic care can alleviate irritability, colic, constipation and some respiratory conditions in infants. In children, the brochure states that it can improve poor concentration and ease sinus problems and stomach aches.

Chiropractors are also distributing a "chiropractic coloring book" that tells the story of a girl named Mary who has been in bed all day. At the end of the story, Mary is pictured smiling and petting her dog after seeing a chiropractor.

Duncan stressed that chiropractic care is not a "cure-all and was not presented as a cure-all.

"Children suffer from ailments as adults do. Some of those are related to the areas of the joints and the spine, and children can be assisted with the alleviation of pain, as can adults with respect to chiropractic (care)."

- Aaron Derfel's E-mail address is

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