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Mystery solved: Chiropractic manipulation of the neck did cause Katie May’s death from stroke

Eight months ago, I asked the question: Did chiropractic manipulation of her neck cause Katie May’s stroke? Now, it appears, I know the answer, and the answer is yes:

Katie May, a model who posed for Playboy and gained a massive following on Snapchat, suffered a “catastrophic” stroke in early February and later died after being taken off life-support. Now, TMZ reports reports that a visit to the chiropractor left her with an injury that precipitated the stroke.

TMZ obtained May’s death certificate, which says that she suffered a blunt force injury during a “neck manipulation by [a] chiropractor.” That injury tore an artery in her neck and cut off blood flow to her brain, which led to the stroke that killed her.


Several of you e-mailed me news reports of the coroner’s finding (as well as other stories referencing the TMZ story). To be honest, I had forgotten about this story, not having heard anything about it since I blogged about it in February, and I was surprised at how this update came seemingly out of the blue. I would have loved to see the actual autopsy report, rather than a snippet of it quoted by TMZ and other magazines, but I take what I can get.

Before this story, I have to admit that I didn’t know who Katie May was, but I did learn that she was known as the “Queen of Snapchat,” for her posting of photos of herself in which she was scantily clad. Indeed, between Instagram and Snapchat, she had quite the social media empire going. At the time of her death, she was only 34 years old and left behind a seven year old daughter. It was a horrible, tragic tale. May was young and building a business, and her death was completely unnecessary, making it even more depressing to contemplate.

Here’s what happened. Late last January, May was doing a photo shoot. It’s unclear exactly how it happened, but somehow it did happen. May fell—hard—and hit her neck or head on something. Afterward, she complained of neck pain that was intense enough that she apparently went to the emergency room to be checked out. Actually, stories differ here, with what her family said, namely that she never sought medical care. Be that as it may, we do know that May went to a chiropractor for a neck adjustment, as she Tweeted soon afterward:

Two days later, May responded to a fan who asked how her neck was feeling:

So May went to her chiropractor on February 1. That evening, she collapsed and was rushed to the hospital. It was a Monday. By Thursday evening, she was removed from life support, and died a few hours later.

If you read my previous post on the Katie May, you might remember that I spent a lot of verbiage in my own inimitable fashion going over a couple of questions. First, was it a stroke from chiropractic manipulation that killed Katie May? Second, what is the evidence base covering chiropractic manipulation and stroke? As part of the second discussion, I pointed out that, while the evidence base supporting chiropractic manipulation as a cause of strokes due to occlusion of the vertebral or basilar arteries is pretty convincing, the evidence that chiropractic manipulation can cause carotid artery injury is much less convincing.

It’s also less plausible, too, given that there is a clear physical mechanism for injury to the vertebral arteries. To help you see why, I thought it would be worthwhile to post this picture again, laying out the anatomy of the vertebrobasilar system. Basically, two very important arteries that supply blood to the brain pass through the two highest vertebrae, the atlas (C1, so named because it was thought to support the head the way the mythical Atlas held up the earth) and the axis (C2). Importantly for understanding how chiropractic could cause vertebrobasilar strokes, the vertebral arteries are tethered to the spine and make a big loop around the atlas before entering the skull and merging to form the basilar artery (click to embiggen):

Vertebral artery anatomy. The arrows point to the vertebral artery. Note how it bends around bony protrusions.
Vertebral artery anatomy. The arrows point to the vertebral artery. Note how it bends around bony protrusions.

It’s not difficult to see how a rapid rotation of the head could potentially stretch the basilar arteries. Generally, chiropractors describe this as “high velocity, low amplitude” (HVLA), which it is, but, given the constraints of vertebral artery anatomy, high amplitude is not required to cause injury. With HVLA, it is quite possible to tear the intima (the lining of the artery consisting of vascular endothelial cells). Intimal tears become “sticky” for platelets, leading them to lodge there and start to form a clot. This is the same reason atherosclerotic plaques can lead to strokes when they are in the carotid artery and can cause myocardial infarctions (death of heart muscle; a.k.a., a heart attack) when in the coronary arteries. The “rough” area of the plaque is thrombogenic; i.e., has a tendency to attract platelets and cause clots. When a clot forms in such an injured area of intima, regardless of where the artery is, one of three things can happen. It can resolve completely, which is what usually happens; it can resolve but leave a narrowed segment of the artery as it resolves; or it can break off and flow further downstream, there to lodge where the artery narrows and block blood flow. When that happens in the brain, it’s called a stroke.

Now, take a look at chiropractic neck manipulation:

And here’s another example:

And still more:

You get the idea. If you cringe when you hear the pop during the violent twist given to the neck, you’re not alone. So do I. It is that “high velocity, low amplitude” (HVLA) twist that can injure the intima of the artery, setting up the condition for a stroke. What surprises me is that the risk isn’t much higher than what studies show. The human body is more resilient than one would imagine, and, absent pre-existing atherosclerotic disease, the risk remains low. On the other hand, given that there is no benefit from HVLA chiropractic neck manipulation, the risk-benefit ratio is basically infinity, because the potential benefit is zero. Also, the risk might be small, but, as Katie May shows us, the the consequences of that risk can be catastrophic.

Another aspect I discussed was whether Katie May’s stroke could have been due to the trauma she suffered at her photo shoot a day or two before her first chiropractic manipulation. Now that we know, assuming that TMZ is accurately relaying the results of the coroner’s report, that May had a tear in her left vertebral artery, it’s almost certain that the chiropractor accidentally killed her through neck manipulation. That is what the coroner concluded, that this injury to her vertebral artery occurred during chiropractic neck manipulation.

In the end, there is no longer any reasonable doubt. Katie May’s death was unnecessary and due to her subjecting herself to the quackery that is chiropractic.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

209 replies on “Mystery solved: Chiropractic manipulation of the neck did cause Katie May’s death from stroke”

Medical examiners’ autopsy reports are generally considered to be a matter of public record. You should be able to get a copy of the report upon request, but, of course, I do not know the details of the law in every state.

Sad to hear about it, but unfortunately it’s not exactly surprising. Neck injuries are already dangerous, intentionally pulling and twisting without real understanding of the underlying tissues or potential damage already present is just… ugh. But then again these aren’t real doctors so expecting them to keep the same level of professionalism is just as insane.
Also, I think you accidentally left out the picture at the start of your explanation, Orac.

“What surprises me is that the risk isn’t much higher than what studies show.”

While I don’t doubt that stroke due to chiropractic manipulation damaging neck arteries is highly uncommon, one suspects it is underreported especially in the elderly, who have more risk factors which are suspected instead of the manipulations they may have had over a period of time.

As Orac notes, this devastating complication of neck cracking is indefensible given the lack of evidence for clinical benefit.*

*chiros like to cite a study claiming that neck cracking lowers blood pressure, without mentioning that it was a small, short-term pilot study employing a specialized technique not in general use by chiros.

science judge, jury and executioner. who are you, really? An AMA board member Pharma-science pimp?

I can’t watch that stupidly dangerous neck-wrenching that chiroquackters do. There is so much in the neck (besides those arteries) that can be damaged by the arrogant stupidity of chiros.

[email protected]: I’m with you on that. A few years ago Orac had a short post which included a video of chiropractic being practiced on a duck. I commented at the time that the duck wasn’t faring much better than Daffy did at the hands of Hugo the Abominable Snowman. The important difference being that when it happens to a cartoon duck it can be considered Amusing Injuries. When it happens to a living creature, let alone a human … I’ll just say that the concept is so sick, if I had that practitioner’s address I’d send him a get well card.

Out of curiosity, I attended equine chiropractic lectures at our state veterinary conference 3 wks ago…
In complete seriousness the presenter explained that Palmer practiced thousands of adjustments on CHICKENS, since if he messed it up, at least someone could have the “patient” for dinner! (nervous laughter all around)
Now I have known clients who swear by chiro for their horses (hence my interest), but obviously it would be much more difficult for human to inflict trauma on equine spine using only bare hands (which is all that this lecturer endorsed).
Unfortunately there are idiots out there striking horses w/levers & mallets!

Sincere question: are there situations in which chiropractic adjustment does have demonstrated benefits? E.g., could they in any circumstances help, say, back issues? I keep hearing conflicting things on this.

@Quackattack : if Orac really was all this, don’t you think he would have been much more directly accusing in his earlier article about this case ?

A number of years ago our local paper did a story on one of the local chiropractors who travelled to Haiti to do a charity clinic. He proudly stated that he did over 50 neck manipulations the first night, even though there was not enough time to evaluate the recipients of his “care” first. Utter incompetence exemplified.

@Dorit: there have been some studies showing that chiros can have a positive effect on occurances of short-term, acute back pain. On the other hand, the effects aren’t any different than those obtained by a good, certified PT or licensed massage therapist. Probably the only benefit I see is my insurance will pay for the chiro or PT visits, not the LMT.

Giving props to the PTs, I know they always institute a home exercise program for the patient. I haven’t ever gone to a chiro so I don’t know if they do the same.

My friends who go to chiros swear by their regular adjustments but look at me blankly when I ask if they have a home program. So my guess is the chiros like to keep the suckers patients coming in rather than teaching them to prevent future problems.

@MI Dawn:

So my guess is the chiros like to keep the suckers patients coming in rather than teaching them to prevent future problems.

Of course they do. A few years ago, Clay Jones wrote an article at SBM about “chiropractic practice building” describing how they do that. A friend of mine found it sufficiently illuminating to stop seeing a chiro and go to a PT.

@Quackattack

Orac wrote a perfectly reasonable post on a risky chiropractic maneuver that appears to have cost this young woman her life. Now comes Quackattack, reaching deep into his or her bag of oratorical skills, to cry “Pharma Puppet!” Let’s review Quackattacks brilliant riposte:

“science judge, jury and executioner. who are you, really? An AMA board member Pharma-science pimp?”

Note how Quackattack deftly dissected Orac’s argument and constructed a brilliant defense of cervical HVLA maneuvers in particular and chiropractic in general.

I stand in awe. Oh wait. That isn’t awe, it’s pig manure.

My doctor recommended a chiro after I had terrible neck pain after being rear ended. My insurance paid for it, so I went and I did fell better enough to continue when I went to California, and later when I moved to North Carolina.

But getting an adjustment always made me nervous, and the NC chiros (I saw several) scared me to death. My California chiro, it may surprise you to read, never pushed other woo on me. He merely suggested diet and exercise to lose weight and improve muscle tone.

My NC chiro was full on woo. Charts showing how manipulation affected this nerve, affecting this organ system and I knew it was all bogus. Then the display stands selling very expensive vitamins and other stuff I never bought. He was rough, and he terrified me.

I dropped chiro like a hot brick. Never again.

“science judge, jury and executioner. who are you, really? An AMA board member Pharma-science pimp?”

Note how Quackattack deftly dissected Orac’s argument and constructed a brilliant defense of cervical HVLA maneuvers in particular and chiropractic in general failed the conventional intelligence test.

FTFY.

“science judge, jury and executioner. who are you, really?”

I’m thinking of changing my username to Cunning Old Fury.

A Chiropractor next door to my favorite coffee shop also “adjusts” dogs. I’ve watched him come out front to treat dogs that people bring, primarily tapping on their back with s rubber mallet. The owners swear their old or arthritic animals feel better, or have more mobility.

I’m thinking of changing my username to Cunning Old Fury.

They prefer to be called “kindly ones”.

Eric @7 — I’m sure I’m not the first to point out that practicing chiropractic on a duck adds a whole new dimension to the term “quackery”.

The author stated: “it’s almost certain that the chiropractor accidentally killed her through neck manipulation.”

This is a pretty serious allegation. Is there any way a blood clot could have been initiated by the fall only to dislodge a few days later? In a way completely unrelated to the chiropractor?

I don’t know much about the clotting process, except that fibrin and Vitamins A, K, and C are involved.

I pop my neck all the time for relief of neck pain. Swear by it. But the way I do it is pretty benign. I simply put the back of my head under a table and my arms above it similar to the way a cop might tell you to put your hands behind your head. I relax my neck and push with my arms above the table and my head below. My neck pops. That is when the disk’s are compressed. After a while of doing this it doesn’t pop anymore because my neck never get’s a chance to become compressed and I don’t have any of the pain associated with the compression. So while I don’t agree with chiropracs claims of curing disease, I suspect the relief they give patient’s is real at least when it comes to back and neck pain. Because what they do probably decompresses joints in a round about way similar to what I do. So for someone who doesn’t know how to do this, and the extraordinary claims of curing disease as an added benefit. It probably seems like a great deal.

Haha this article is so bias it’s hilarious. Youre a 1,000 times more likely to die going to a hospital than a chiropractor. The 3rd leading cause of death in the US is medical errors by MDs. http://www.bmj.com/content/353/bmj.i2139
Your chances of a stroke from a chiropractor is less than .00000008%. There’s plenty of studies on this. Use any scientific journal. Studies show that patients who have died from a stroke after an adjustment had pre existing conditions. There are plenty of benefits for neck adjustments and published journal articles show it that as well. Instead of reading this guys poor article, here is a published journal article on the risks.http://www.sciencedirect.com/science/article/pii/S0161475408003473

Here’s another profession article since the author was too lazy to do anyou research on his/her own.
http://www.sciencedirect.com/science/article/pii/S1050641112000557

1 out of 25 chiropractors in a 50 year span of practicing will have a patient with a preexisting fall or condition that sets then up to have a stroke. The average chiropractor gives 80 adjustments a day. 240 days of work a year gives 19,200 adjustments a year leave you at 960,000 adjustments in ONE chiropractors lifetime. Katie May was roughly 1 out of 24 million people who got adjusted. Read the published articles I posted.

There still might be more to the mystery. Katie May might have had an underlying disorder of her arteries which predisposed her to dissection. One I am familiar with is Fibromuscular Dysplasia (FMD), which affects mainly women of all ages. It can be found in any arterial bed and commonly in the carotids and vertebrals. Those diagnosed with it are to avoid chiropractic manipulations, roller coasters, yoga, etc., anything that causes stress and torquing of those affected arteries. Unfortunately, the diagnosis comes after a medical crisis – stroke, coronary dissection, etc. and in some cases during autopsy if the coroner is familiar with the manifestations of the disease. It would be interesting to note whether the autopsy report described tortuosity, beading (dilation and stenosis), S-curve of those arteries. Very sad story, but hopefully more information with surface.

Katie S @ #22 — Yes, the medical examiner’s report was specific about the cause being directly related to the chiropractic manipulation, albeit an accidental cause of death, for what that’s worth.

Vertebral artery tears/strokes is a very uncommon type of stroke. When it does occur it is usually related to a minor injury or awkward movement. Examples include; putting your head back at a beauty salon to have your hair washed, turning your head while driving to see what’s behind you, or even possibly a chiropractic adjustment. When this occurs it usually leads to unilateral neck pain. This pain will often bring a patient to a doctor’s office (Primary care or Chiropractic). Over the next few days, after the initial trauma to the artery, a clot develops then breaks (embolism) away causing an acute tear in the artery and the stroke (in the brain). In this case, it is far more likely that she suffered the vertebral artery injury during her fall. She then went to the Chiropractor for treatment and the stroke is unrelated to the treatment itself. Likely, she would’ve had the same result if she went to a primary care physician and did not see a Chiropractor at all. Very few doctors would order vertebral artery ultrasound to have diagnosed it. Even fewer doctors would be able to get the test actually performed before the stroke occurred. The medical examiner will not be able to support his/her position in court. The case will probably never go to trial (nor should it.)

Chiropractic care is very safe, many studies prove this.Medicine is the 3rd leading cause of death in the US, studies prove this. its interesting to see the medical bigotry and outdated dogma being presented as fact. Ive been in practice for 17 years. Ive given thousands of neck adjustments. http://www.cureus.com/articles/4155-systematic-review-and-meta-analysis-of-chiropractic-care-and-cervical-artery-dissection-no-evidence-for-causation

nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.

Makary said he and co-author Michael Daniel, also from Johns Hopkins, conducted the analysis to shed more light on a problem that many hospitals and health-care facilities try to avoid talking about.

Although all providers extol patient safety and highlight the various safety committees and protocols they have in place, few provide the public with specifics on actual cases of harm due to mistakes. Moreover, the Centers for Disease Control and Prevention doesn’t require reporting of errors in the data it collects about deaths through billing codes, making it hard to see what’s going on at the national level.

[Does your surgeon have enough practice to operate on you?]

The CDC should update its vital statistics reporting requirements so that physicians must report whether there was any error that led to a preventable death, Makary said.

“We all know how common it is,” he said. “We also know how infrequently it’s openly discussed.”

Kenneth Sands, who directs health-care quality at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, said that the surprising thing about medical errors is the limited change that has taken place since the IOM report came out. Only hospital-acquired infections have shown improvement. “The overall numbers haven’t changed, and that’s discouraging and alarming,” he said.

[A doctor removed the wrong ovary, and other nightmare tales from California licensing records]

Sands, who was not involved in the study published in the BMJ, formerly known as the British Medical Journal, said that one of the main barriers is the tremendous diversity and complexity in the way health care is delivered.

May 2016cover Consumer Reports recently investigated California licensing records and found that many doctors who were still practicing were on probation for serious violations of patient safety.
“There has just been a higher degree of tolerance for variability in practice than you would see in other industries,” he explained. When passengers get on a plane, there’s a standard way attendants move around, talk to them and prepare them for flight, Sands said, yet such standardization isn’t seen at hospitals. That makes it tricky to figure out where errors are occurring and how to fix them. The government should work with institutions to try to find ways improve on this situation, he said.

Firstly, an injury happens when a doctor doesn’t do a proper history, exam and x-rays. Unfortunately, not everyone does that and I personally would not see one of those doctors. Even so, injury is extremely rare.
That being said, not one of those videos is showing a chiropractor that is adjusting properly and it is an embarrassment to the profession that those guys are posting these videos.
And what did you say earlier about us being inferior PT’s? Ha! I find it interesting that PT’s in every state are trying to get it passed that they are allowed to do manipulations to the spine. Why, if adjustments don’t do anything, would they want to do that? Interesting. Well you want a bad adjustment go to one of those guys who do a weekend class and get a certificate then try to go and adjust. PT’s are glorified personal trainers and you can get any stupid exercise they give you by going to YouTube. Give me a break.
To say chiropractic is quackery and pseudoscience is ignorance. You have obviously not seen the research of every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments. I won’t go into the endless list. Literally endless. Traditional acupuncturist manipulate the spine and spinal manipulation can be dated back to the ancient Egyptians.
Not because chiropractic heals a certain ailment but because balance is restored to the body and the body itself does the healing. It’s real simple.
So asthma and other things you mentioned in the previous post IS related to the spine because everything is related to the spine. That is where the central nervous system is which is the lifeline of the body, the communication line of body. If the central nervous system can’t relay nerve impulses from the brain to the organs and then back to the brain at 100% then it can’t be optimal and any number of things can develop. Again, real simple concept.
If all the miraculous healing that have been reported were not true why would this profession be as large as it is and around since 1895? Why does Nike hire a chiropractor and send him to the olympics to take care of all the athletes it sponsors?
Why does every professional sports team have a chiropractor?
Why are you so mad? Because you chose the wrong profession?
Find a Gonstead practitioner and find out what chiropractic really is.
Lastly, you want to talk about what is harmful? Why don’t we talk about how many people die every year from medicine. 20,000 from prescription drugs every year. 20,000!!! However, is that the TOTAL number of deaths caused by conventional medicine is an astounding 783,936 per year. Wake up people!!! Don’t be distracted by all the medical bull they are shoving down your throat!
I’ll take my great diet and a chiropractic adjustment any day.

Philip @ 27

You are hypothesizing that she tore her vertebral artery in the fall. If this was the case, do you think it was a good idea for the chiro to be adjusting her neck?

Are neck adjustments conta-indicated in the case of neck pain or headache after a traumatic injury?

Without details of the autopsy findings, we are not in a position to question the findings of the medical examiner.

The number of cases of stroke from vertebral artery tear temporally linked to chiropractic manipulation continues to grow. While you will not find anyone here who will overstate the strength of anecdotal evidence, I think you have to concede that it is at least PLAUSIBLE that chiropractic high velocity neck manipulation could cause a vertebral artery tear. Your post indicates that you, like the bulk of the chiropractic community, prefers to dismiss these cases as coincidence, rather that face up to the POSSIBILITY that neck manipulation, every once in a while, is killing otherwise healthy young individuals. Unfortunately, every single DC I’ve spoken to about this issue is in complete denial mode.

Until chiropractic acknowledges this possibility and seriously attempts to answer the question as to the safety and effectiveness of its practices, then expect the medical community to continue to view your chose profession with a degree of disdain.

A couple of decades ago, the allergist community faced up the the fact that allergy shots had the disturbing tendency to, every once in a rare while, cause a fatal allergic reaction. The profession set about addressing the problem head on by collecting data on these events, understanding the risk factors, developing guidelines, and setting contraindications for administering allergy shots. Every year, members of the professional societies are surveyed regarding shot reactions , both within their own clinics, but also regarding any within their community. These efforts have resulted in a dramatic decline in the number of fatalities.

http://www.ncbi.nlm.nih.gov/pubmed/26948485

I should point out that, unlike neck manipulation, the benefits of allergy shots are well established and have been proven in numerous well controlled trials.

If you chose to defend your professional practices, then don’t do it by pretending that nothing could possibly be wrong. Establish a registry of cases, actively solicit reports, and above all, you desperately need to establish through rigorous clinical trials that: a) what you are doing has benefit and b) establishes and quantifies the risk .

Capt.

Marc Rogers @28: You echo a point made earlier, that people die in hospitals, but people almost never die at the chiropractor.

May I suggest that this is at least in part because when you’re in a car accident, the ambulance takes you to a hospital, not a chriopractor? Yes, there is risk to medical procedures, but that is because there is also known benefits. For example: all surgery has risks that include death. But many surgeries are also life-saving.
Chiro has risks, as described above, but how many lives has it saved?

Medicine must do better, but be honest, in an emergency, you’re still going to call 911.

Wow, how is it that we are completely ignoring the fact that prior to the adjustment, she fell * hard * and hit her head/neck?? Gee, wonder if that kind of blunt trauma might have ultimately caused her death…??

Cameron:

The 3rd leading cause of death in the US is medical errors by MDs.

Marc Rogers:

Medicine is the 3rd leading cause of death in the US, studies prove this.

You guys know each other?

To say chiropractic is quackery and pseudoscience is ignorance.

Is this your “applied kinesiology” joint, Sean?

Why does every professional sports team have a chiropractor?

Please list the chiropractors who are part of the regular-season medical team for every Major League Baseball franchise.

There is a reason that no university will associate with a chiropractic school. They have gotten where they are by having good political lobbyists and not by science.
People who work in neuro know that there are many many cases of this which are not correctly attributed to the chiropractor because the stroke doesn’t happen immediately, it’s usually delayed.

Earlier comment… ” She then went to the Chiropractor for treatment and the stroke is unrelated to the treatment itself. Likely, she would’ve had the same result if she went to a primary care physician and did not see a Chiropractor at all. ”
Thanks for answering my question. Now do you think that ORAC would have written two articles on that event?

This is an exceedingly rare event, and when something like this happens tho a vaccinated child, it is called an “anecdote” and brushed aside.

I sense double standards. For a website posing a representative of science, I would expect to see some statistics to impress upon us the idea that chiropractic-induced stroke might be something worth our consideration.

What is the chance of a fatal complication as a result of being prescribed opiates for this; and what is the relative risk ratio when compared to chiropractic manipulation?

“This is an exceedingly rare event, and when something like this happens tho a vaccinated child, it is called an “anecdote” and brushed aside.”

A key difference is that in chiropractic-induced strokes, there is an established mechanism for stroke occurring in the setting of cervical artery damage, as well evidence of a forceful maneuver having occurred in the absence of any other explanation for such trauma. In many cases of “vaccine injury” there is no logical mechanism and no good association (temporal or otherwise) with vaccination.

Exceedingly rare serious complications due to vaccination occur secondary to a medically valuable and evidence-based intervention. Exceedingly rare* and devastating complications due to chiropractic neck-cracking are secondary to a procedure without demonstrated value. I hope you can see the difference.

*the evidence we have suggests that stroke due to chiropractic manipulation is “rare”; how “exceedingly rare” it is depends on recognition and reporting.

What seems to missing in this discussion seems to be the fact that there is now very high level of evidence that chiropractic manipulation doesn’t cause strokes. The most thorough study on the subject (a systemic review & meta-analysis) published earlier this year found that there is no evidence that chiropractic causes strokes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/.

More really strong evidence that there is no link between chiropractic & stroke was published last year when researchers analysed the data from over a million patient records & found that people were no more likely to suffer a stroke after seeing a chiropractor than after seeing a medical practitioner. https://www.ncbi.nlm.nih.gov/pubmed/25596875

What we do know is that when the vertebral artery starts to rupture from other causes, this often causes neck pain & headaches etc. This prompts the patient to seek care from a health practitioner, often a chiropractor. The rupture will then progressively evolve over a period of several days before resulting in a stroke – not as a result of the practitioner’s interventions. An example of this was recently published in BMJ. In this case report a patient presented to hospital emergency department & was dismissed with a diagnosis of migraine. A few days later she presented to a chiropractor who made the correct diagnosis of vertebral artery rupture in evolution, quite probably saving the patient’s life. https://www.ncbi.nlm.nih.gov/pubmed/25596875

In the tragic case of Katy May the blame on the chiropractor seems all stem from one trashy gossip magazine reporting of the coroner’s findings that the stroke was caused by the manipulation. The coroner’s report needs to be publically released before anyone jumps to conclusions. I would suggest that a more probable explanation is that Katie’s stroke was initially caused by the significant trauma that she suffered when she fell hard & hit her head hard during the photo shoot. She hurt herself badly enough to go the emergency room before consulting the chiropractor. The chiropractor was probably in the wrong place at the wrong time with a patient who was undergoing an evolving vertebral artery rupture.

Actually, I’d hardly call that second study high level evidence, given its retrospective nature and design. As for the meta-analysis, in actuality, the meta-analysis did find a weak association between chiropractic neck manipulation and stroke and then spent the entire discussion trying to explain it away—unconvincingly, in my assessment.

As Orac pointed out, even if the risk of injury or death from that sort of manipulation is low, it’s not worth the risk because there is no benefit.

For those of you who like those odds, how about a bet? We each put up $100, and then get a computer to generate a random number between 1 and 50,000. If the random number is 8749, you give me $100. If it’s any other number, we each keep our money.

You only have one change in 50,000 of losing, so how about it?

Sean @29:
every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments

One seldom sees such commitment to a grift.

Why does every professional sports team have a chiropractor?

NZ chiropractors spend a lot of time whinging about the All Blacks’ focus on winning games, and their refusal to have anything to with the scam.

#35-36 why yes Narad, that is my practice. Why? You need help with something?
You want me to list the 27 teams that have a chiropractor on staff? You want me to tell you the players I’ve personally seen?
Do some research

Who gives a damn what some athletes believe?

As we saw at the Olympics, there are athletes who believe in cupping.

Many professional athletes pray to a god to win and thank that god if they do well.

Several years ago, an NHL hockey team used to sit under a pyramid before games to “channel the energy of the universe” or some such twaddle.

There are athletes who have “lucky socks” or some other ritual they must perform before games or they believe they won’t perform well.

You want me to list the 27 teams that have a chiropractor on staff?

Indeed we do. Around here, people who make claims of fact are told to put up evidence supporting those claims. So name those teams.

every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments

This is true in the preventative sense that for any given disease there is a “SPECIFIC chiropractic adjustment” that will prevent you from contracting or developing it.

Katie May, for instance, as a result of the specific chiropractic adjustment she received, will never develop cancer, or beri-beri, or epizootic sniggers. Or anything else.

You want me to list the 27 teams that have a chiropractor on staff?
Indeed we do

We would like a lot more than that, in that our informant told us initially (with his bare face hanging out) that “every professional sports team [has] a chiropractor”. 27 teams? He can identify the staff chiropractor for every professional sports team in the world, or he can shut the feck up.

In response to Orac’s comments at #41…. I’m pleased to see that you concede that the highest level of evidence available the subject of chiropractic neck manipulation causing stroke shows only weak association. (ie. The Church et al meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4794386/). However, with respect, I’d suggest that you should question whether you are allowing your personal beliefs cloud your judgement when you dismiss the Church et all conclusion that there is ‘no convincing evidence’ that chiropractic manipulation causes cervical artery rupture as the authors trying to explain away any association at all. Church & all of his five co-authors are neurosurgeons. For what exact reason would you suggest that the authors purposefully try to skew their conclusions?

As for the Whedon study https://www.ncbi.nlm.nih.gov/pubmed/25596875, you dismiss this because it was a retrospective study. Well it’s kinda hard to do a prospective study with 1,157,475 subjects! The study more than makes up for its retrospective nature by its vast volume of data analysis. You also criticise its design. This study is straight forward statistics. They analysed huge numbers of patient records & found that slightly fewer people had vertebrobasillar strokes following a visit to a chiropractor than following a visit to a general medical practitioner. The beauty of this sort of study is that it is just numbers. It is not open to bias in interpretation of results or being skewed by experimental methodology. What exactly is it that you object to in its design?

Now back to the Katie May tragedy. I’m interested to see that you make no response to my suggestion that it is more probable that Katie’s vertebrobasillar stroke was caused by hitting her head hard when she fell than the chiropractic treatment. Now we’ve established that, at best, there is only a weak association between chiropractic manipulation & vertebrobasillar strokes, while there is a clear & indisputable association between blunt head trauma & these strokes. So how can it possibly be logical to dismiss the fall to be the cause of the tragedy & be certain that the chiro did it?

I had a cervical chiropractic adjustment in 2012 that has left me with chronic pain and limited range of motion. Immediately after, felt really ill, bp 190/100. Called chiropractor and he said no available appointments to deal with issue but he would pray for me!!!! No more chiro for me. Despite what news saying. I think this stuff happens more often than reported. Cervical adjustments are just bad!!!

“…there is now very high level of evidence that chiropractic manipulation doesn’t cause strokes.”

Not quite.

http://www.forbes.com/sites/stevensalzberg/2015/03/02/nih-distorts-report-on-chiropractic-and-stroke-risk/#76a2f7b462af
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1905885/

“I’m interested to see that you make no response to my suggestion that it is more probable that Katie’s vertebrobasillar stroke was caused by hitting her head hard when she fell than the chiropractic treatment.”

I’m interested to see your conclusion that when a patient comes in with a history of minor cervical trauma, it’s appropriate and harmless to perform forcible chiropractic neck wrenching.

You want me to list the 27 teams that have a chiropractor on staff?

Given that you’ve just conceded that your assertion that “every professional sports team [has] a chiropractor” is false,* I think my work is done here.

* There are 30 MLB franchises.

Narad, I’m glad your done because you have had nothing to offer to this conversation. I know there are 30 teams. 27 of them have chiropractors on staff. Ok, you got me. Is that the stuff you really want to split hairs on? I think my point is made.

Bottom line for all the closed minded negative trolls on here is that chiropractic isn’t going anywhere. So continue to waste your time trying to discredit it. I’ll continue to grow my practice and serve my community, this nation and the world.

I don’t know why I bothered reading this hacks blog anyway. What a waste of time.

You have obviously not seen the research of every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments. I won’t go into the endless list.

I’d be interested if you could provide links to the research on the specific chiropractic adjustments that would cure the following diseases:
– Large B-Cell lymphoma
– Type 1 diabetes
– Type 2 diabetes
– Rabies

Thanks!

I don’t know why I bothered reading this hacks blog anyway. What a waste of time.

And the portions are so small!
(said no-one about an Orac post, ever).

I know there are 30 teams.

There are 30 franchises. These comprise over 100 professional teams.

Is that the stuff you really want to split hairs on? I think my point is made.

That you’re full of demonstrably preposterous shіt? Don’t think before writing? Have transcended “straight” chiropractic in terms of fraudulence in action?

Yes, this point has been made very well.

^ Hey, who’s the chiropractor for the Albuquerque Isotopes? The Lansing Lugnuts? I can’t wait.

^^ Finally,

Bottom line for all the closed minded negative trolls on here is that chiropractic isn’t going anywhere.

Yup, just like “applied kinesiology” and Roger McGuinn.

Nimrod, again nothing

O’Brien, there is no specific adjustment for those diseases. There is no diabeties bone or rabies bone and obviously you have named some things here that require medical attention. Type 2 diabeties though, can be prevented and often times reversed by eating properly. Don’t ask stupid questions. However, can the body better deal with disease if the nervous system is functioning properly? By all means.
Chiropractic doesn’t cure anything. It restores balance to the body and gives that person the ability to heal naturally.

Why would I list every single chiropractor associated with a pro sports team..? Look it up for crying out loud! It’s not like it’s hard to find. Start with your home town dum dums

And as for the douche talking about the All Blacks, I went to chiropractic college with 2!!! All Blacks and took the pitch with them!! So STFU!! Haha!

One final and a thing, cupping and all that other bullshit you saw during the olympics is not chiropractic.

“To say chiropractic is quackery and pseudoscience is ignorance. You have obviously not seen the research of every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments. I won’t go into the endless list. Literally endless.”

Sean is right. Chiros are “growing their practices” right and left, while leaving behind the simpleminded idea that spinal manipulation is only good to a limited extent for musculoskeletal complaints.

I’m starting to see the marriage of chiropractic and functional medicine (think “Bride of Frankenstein”), exemplified by chiros who are members of the International Association of Neurometabolic Professionals, which legitimizes the care of such disorders as type II diabetes and “Female Hormones” (never knew that one was a disease, but live and learn):

http://drtoddwilson.com/conditions/

Here’s another one, who has eschewed false modesty with a becoming section on his website “What Makes Me Unique And Effective” (among his successes is treating ADHD):

https://www.helpmychronicpain.com

The possibilities for making money through a combination of chiropractic and functional medicine are endless; I mean, literally endless.

Just make sure that in your ads, you call yourself “Doctor” a lot, and only mention the part about being a chiropractor in a line on the bottom in small print.

Namard, again you offer nothing

Why would I start the exhaustive list of chiropractictors associated with professional teams. It’s not like it is a secret! My goodness look it up, start with your home town

There is no diabeties bone or rabies bone chiropractic simply restores balance to the body so it has he opportunity to heal itself. Specific adjustments to a spine that is out of alignment allow that to happen if in case, that is what is causing interference to optimal health.

Some things obviously need medical attention but type 2 can be prevented and often times reversed through diet.

Many of you are confusing what chiropractic is. Definitely not cupping or some of that other garbage you saw during the olympics.

Lastly to the Kiwi. I went to chiropractic college with 2 All Blacks and played rugby with both as well.

My point was that athletes are not the brightest bulbs in the marquee and believe in all kinds of nonsense, from superstitions to cupping to, well, chiropractic.

Just because they’re athletes doesn’t mean they know or understand anything about science. That was my point in mentioning the cupping.

One famous hockey goalie does commercials for that homeopathic duck liver cold stuff. He swears it works.

Some teams MIGHT have a chiropractor available to humour their players who subscribe to the religion, but ALL teams have doctors, physiotherapists and medically-educated trainers behind the bench and in the dressing rooms.

I am very familiar with three professional teams here in my home town (I work in the media), know several players and former players, and have never heard either the teams nor the players mention chiro. They certainly don’t pay one on staff: if players want to go on their own, that’s their choice.

No Dorit. Come on man.

In my experience Woo, many athletes are extremely bright and very in tune with their bodies.

Why would I start the exhaustive list of chiropractictors associated with professional teams. It’s not like it is a secret! My goodness look it up, start with your home town

That’s not how it works here. You made a claim, so you stump up the proof for your claim.

Sean: “In my experience…many athletes are extremely bright and very in tune with their bodies.”

In my experience, athletes tend to be credulous about their health, as demonstrated by their affinity for dubious supplements,, titanium necklaces and various other woo. They turn to chiropractors and other fringe practitioners, as in the case of ex-Cleveland Browns quarterback Bernie Kosar, who was “cured” of chronic traumatic encephalopathy by a Dr. Rick Sponaugle, using a mystery IV drip and supplements (the “cure” apparently didn’t last long):

https://newrepublic.com/article/115527/nfl-concussion-crisis-doctors-use-alternative-medicine

Note that chiros have also found it lucrative to treat symptoms of brain injury:

“Where some doctors use potions, others rely on far-out machines. Ted Carrick, who calls himself a chiropractic neurologist, gained attention a couple years ago when NHL star Sidney Crosby credited him for helping him recover from a series of devastating concussions. Among the treatments Carrick used: strapping Crosby into a space-camp looking gyroscopic chair and spinning him, upside-down, around and around and around. Carrick says the wait to enter his clinics in Dallas, Texas, and Marietta, Georgia, can stretch to a year. When patients do finally get in, he charges them $1,000 per day. Most stay one to two weeks. Insurance companies do not pick up the tab.”

You should look into that, Sean. After a few years of that kind of practice, you could afford a villa that would put Mercola’s to shame.

But the Colorado Rockies do have directors for medical operations, physical performance, and a “psychical performance coach”.

I have a strong sense that that’s a typo.

Start here Julian….

htt[]://probaseballchiros.com/pbcs-chiropractors/major-league-chiropractors/

Then do your own research if you so concerned

*does own research*

I find it curious that the only person who refers to Joshua Akin as the Cubs’ “team chiropractor” is Joshua Akin. There is a news item describing him this way for the Bears, doing soft tissue work on… Jay Cutler.

The only things you’ve demonstrated with this routine are that (1) you’re not overly concerned with accuracy when it comes to making wild assertions and (2) some professional sports teams have a chiro in the Rolodex if somebody wants one.

What you have most certainly not demonstrated is that they are “straight” chiros, which moots your entire performance.

I’m sorry, are you claiming that chiropractic can treat rabies?

No Dorit. Come on man.

Repeat after me:

You have obviously not seen the research of every disease imaginable being eliminated or reduced drastically because of SPECIFIC chiropractic adjustments.

There is a news item describing him this way for the Bears, doing soft tissue work on… Jay Cutler.

Jay Cutler? Jay “we don’t vaccinate” Cutler? Married to Kristin “I feed my babies dangerous home-made formula” Cavalleri?

That Jay Cutler?

Funny no records about ER visit. Meds can cause strokes? Falls to head can cause strokes? Did the fucking ER work up the head injury? Did they miss something? Thats my guess. Bleed on brain? Im guessing easier to blame chiro then medical malpractice. Common things occur commonly. Dont be influenced by a bunch of wolves people. Ill testify in court about real medical records, autopsy reports, chiro records, actual scientific double blind studies, etc. Not a tweet supposedly from TMZ, Forbes article, post on Facebook, etc. Lawyers from big time hospitals can crush a small business owner. I call bullshit you all unless all evidence is present!

Shay,

If Cutler has been a regular customer of a chiropractor, that’s very likely where he got his anti-vaccine ideas. Most chiros are notorious for dissuading their customers from vaccination.

No doubt Sean, as a chiro, sees nothing wrong with Cutler’s (and his industry’s) anti-vax stance.

Jay Cutler? Jay “we don’t vaccinate” Cutler?

Heh, I forgot about all that. I don’t actually have any interest in football, but I have friends who do, so the first thing that occurred to me was complaints about his long-standing suckitude.

Ill testify in court about real medical records, autopsy reports, chiro records, actual scientific double blind studies, etc.

Can you provide any examples of your work as an expert witness? Remember where the money is; talent is always welcome.

If Cutler has been a regular customer of a chiropractor, that’s very likely where he got his anti-vaccine ideas.

That strikes me as a leap.

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