It can be a pain in the neck, if you will, sifting through the claims and counterclaims that litter the battleground between medical doctors and chiropractors.
The perennial spat between the two groups of health professionals flared up again yesterday when Edmonton neurologist Dr. Brad Stewart took aim at one aspect of chiropractic treatment.
Stewart held a press conference asking Health Minister Gary Mar to ban chiropractic upper-neck manipulation.
The procedure can cause strokes and other serious complications and is sometimes fatal.
Patients need not expose themselves to a potentially dangerous treatment that has no benefit, Stewart argued.
The vast majority of people can get relief from uncomplicated neck and back pain through massage or physiotherapy, Stewart said.
"No one will be deprived in any way if this procedure is withdrawn," he insisted. "No one has ever died because they didn't have their neck manipulated."
Joining him at the press conference were the widow and two sons of Dr. Ron Grainger, a 69-year-old Calgary physician who died of a stroke in 2001 after a neck manipulation.
His family believes the chiropractic procedure caused his stroke. Les Shaw, president of the College of Chiropractors of Alberta, says the stroke had nothing to do with Grainger's neck manipulation.
In the end, who really knows? But there have been other unexpected deaths after chiropractic neck adjustments in recent years and neurologists are sounding the alarm.
In 1996, a 45-year-old Toronto woman suffered a stroke and died a couple of weeks after having a neck adjustment for migraines.
In January, a coroner's jury ruled her death was accidental and not due to natural causes. Among its recommendations, the jury proposed that chiropractors obtain written, informed consent from patients before performing the procedure.
In Saskatchewan, in 1998, a 20-year-old woman fell unconscious and died from a torn artery following a neck manipulation for lower-back pain.
Medical doctors look after the "disasters" that occur after neck manipulations, said Stewart, who tried to save the young woman's life.
Studies have documented "countless" incidents of strokes and other serious consequences of neck adjustments, he said.
There are chiropractors who agree that such procedures are potentially dangerous but they're afraid to speak out, fearing a backlash from chiropractic regulators who support neck manipulation "from cradle to grave," he claimed.
"There is not a single reason why someone with no neck pain to begin with or at most a headache, should have a stroke and die," said Stewart. Well, perhaps not, but complications set in and people die routinely from adverse events associated with all sorts of medical procedures.
Shaw, of the College of Chiropractors of Alberta, pointed out that there is a far greater risk of serious complications from anti-inflammatory drugs than chiropractic adjustments.
"We have never denied that there is a risk," said Shaw. But the risk is negligible and most doctors refer patients to chiropractors, he said.
Mar is staying out of the dispute, said a Health Ministry spokesman, adding the minister relies on the professions' regulatory bodies to set safety standards.
Ironically, Grainger advised his patients not to have neck manipulations, said his widow, Madeline. But he sought help from a chiropractor because he was "desperate," she said.
Quibble all you want about risk. In the end, people in excruciating pain will do just about anything to stop it.