By Jeremy Laurance, Health Editor, The Independent Digital (UK)
13 March 2001
People who seek treatment for neck or back pain from a
chiropractor, osteopath or physiotherapist offering spinal
manipulation may be putting themselves at risk of a stroke or
other serious injury.
Although the risk is small, the consequences can be
devastating, leading to stroke, nerve damage, partial paralysis
and lasting disability, a new study suggests.
The popularity of spinal manipulation has soared in the past
decade and tens of thousands of people now consult
therapists every year. But no systematic study of the risks of
the treatment they provide has been done in Britain.
A pilot survey of 239 consultant neurologists found 24 who
recalled at least one case of a serious neurological
complication after manipulation of the cervical spine (the neck)
occurring in the 12 months from August 1998 to July 1999.
The commonest injury was a stroke caused by damage to the
arteries in the neck or the blood vessels in the brain.
One woman admitted to hospital four hours after having her
neck manipulated was found with damage to her vertebral
artery, which was blocked by a blood clot. Next morning she
was barely conscious and had to have surgery to reduce the
swelling in her brain. She was left with problems walking.
All the cases were within 24 hours of manipulation. The
researchers, from the department of complementary medicine
at Exeter University headed by Professor Edzard Ernst, are
now planning a long-term study to establish the true scale of
the danger from spinal manipulation.
Clare Stevinson, who led the pilot study, published in the
Journal of the Royal Society of Medicine, said it was only
manipulation of the neck that carried the risk, and it seemed to
be higher when the head was rotated sharply. "Trying to avoid
practitioners who use the rotational technique might be one
way of reducing the risk," she said.
The British Association of Chiropractors said the study did not
examine the profession or qualifications of those doing the
manipulations, nor why they were done, and did not check the
medical histories of the patients affected. Sue Wakefield, the
director, said: "Chiropractic is safe in skilled hands. In other
studies around the world, the risk has been shown to be
between one and three per million manipulations. People
twisting their neck to reverse a car can suffer the same effect.
"The association would welcome robust and thorough
research into this subject."
