Chiropractic Spinal Manipulation & Stroke

Chiropractors are not the only physicians performing cervical spinal manipulative treatment. Actually, non-professionals, layman, and sports travelers are performing spinal manipulative treatment (SMT). Some people do it to themselves. So whoever is spreading the word that chiropractors cause strokes when performing cervical manipulation are perturating an anti-chiropractic campaign.

Other medical physicians are osteopaths, orthopedists, physiatrists and physical therapists. The prudent physicians of all the above professions will rule out contraindications of SMT prior to any treatment.

It is unfair and belligerent to single out chiropractors like that, especially how advanced our education and excellence of performance of our physicians is in the new millennium.

Risk Factors for Stroke

• Age: Stroke risk doubles in each successive decade after 55 years of age.
• Sex: Stroke is more prevalent in men than in women.
• Race/ethnicity: African Americans and some Hispanic have higher stroke death rates compared with European Americans.
• Family History: Family history of stroke associated with higher stroke risk.

• Hypertension: A major risk factor for stroke, with increased relative risk of 2-4 for people aged 50-70 years.
• Smoking: Increase relative risk of 1.8.
• Diabetes: Increased relative risk of 2-6 folds in diabetics.
• Carotid artery disease: Neck ceratoid arteries with atherosclerosis increases risk.
• Heart disease: People with heart problems (e.g. coronary heart disease) have high stroke risk.
• Sickle cell disease: Increases stroke risk.
• Hyperlipidemia: Abnormal blood lipids and lipoproteins increase stroke risk.

Less well documented or Potentially Modifiable Risk Factors

• Obesity: Increases stroke risk, especially abdominal obesity.
• Physical inactivity: There is increasing evidence that an inverse relation exists between level of physical activity and stroke.
• Poor diet/nutrition: Healthy diet of at least 5 servings of fruits and vegetables may reduce stroke risk.
• Alcohol abuse: This can raise blood pressure and increase stroke risk (especially hemorrhagic stroke).
• Hyperhomocystemia: Increasing evidence suggests this increasing stroke risk.
• Drug abuse: can cause cerebral emboli.
• Hypercoagulability: Several blood factors may increase risk of clot formation.
• Inflammatory processes: Several markers of inflammation (e.g. C-reactive protein, cytokines, activated T cells and macrophages) have been linked to elevated stroke risk.

Other obvious mistakes are slipping from a poor, normal or mechanical contact point, excessive force, not using pre-manipulation testing by bringing patients to a maximum range of motion before that gentle thrust, poor line of drive, especially going against the line of drive of the vertebral facets and of course greed.

Dr. Andrew Rodgers, BS, MS, DC, is a National Certifed Chiropractic Expert Witness with over 34 years of experience. He has worked on over 30 malpractice cases on the proper standard of care.

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