Dangers of Chiropractic Neck Manipulations

By Dr David Laing Dawson

Some years ago my father, then in his 80’s, suffered dizziness and syncope following a visit to his chiropractor. Now, I didn’t know he went to a chiropractor, or I would have been all over him before this. But this time, he had a neck adjustment and I found out because of the symptoms it caused afterward.

I made him promise to never visit a chiropractor again. I explained the anatomy of the neck to him, and the fragility of his arteries, cartilage and bones at his age.

When patients tell me they go to chiropractors I tell them, okay, but do not let them “adjust” you. Go for the massage, the muscle stretching. No adjustments. Especially the neck. Do not let them go near your neck. There are rather important things running up and down your neck.

Had my father died from his neck adjustment it would not have made the news. Because of his age we may never have known the cause. He lived till the age of 95 and died of cancer surrounded by his children and grandchildren.

But I see in the news a beautiful woman and mother (Katie May)  just died from a neck adjustment. She developed what she called a “pinched nerve” in her neck on a photo shoot and went to see her chiropractor who “adjusted” her neck. The adjustment tore an artery and she died.

Do not let chiropractors go near your neck.

Adjustments are nonsense procedures of course. And when it involves the neck, also dangerous.

What chiropractors tell you they are doing when they “adjust” your spine, they are not doing. In fact, they cannot do it. Or to put it another way, if they actually had the strength to force a shift in the alignment of your vertebrae, this procedure would be even more dangerous. It would risk the integrity of the spinal cord. But they don’t have  the strength to do that, except when the cartilage is brittle, the ligaments are old and infirm, the muscle wasted, and the bone is porous – as in aging. (Although I must admit there is a moment in many violent thrillers when one character breaks the neck of another in what looks suspiciously like a “cervical spine adjustment”.)

Those “pinched nerves” we talk about are seldom pinched nerves. They are inflamed ligaments and muscles from acute or chronic stress. The muscle may be in spasm. An acute muscle spasm can be stretched out as I do with my calf when I awaken in the night with a cramp, and trainers do on the football field. Other than that the inflamed, sore muscle or ligament responds to heat and rest, and, when persistent, anti-inflammatories.

That crick in the neck we get from sleeping awkwardly? Same thing. And left alone it will heal. There is no need for serious intervention. Especially interventions that are

1. Entirely bogus and 2. Very dangerous.

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12 thoughts on “Dangers of Chiropractic Neck Manipulations

  1. Osteopaths do much the same manipulations. Are they also bogus ?

    Having had both chiro & Osteopathic txs, I’ve experienced the benefits of both.I’d have to disagree with you without further evidence that they are myths. Also, in the case of Osteopaths , I’m sure they must have a medical basis for their txs. Not all of the chiro or osteo txs involve adjusting the spine or vertabrae .

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  2. please read attached It’s the third time when I hear that is’s quite dangerous to go to the chiropractor. Neck alignment or spine alignment are very dangerous!

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  3. This is a horrible article. You don’t seem to know much about chiropractic besides what the dogmatic medical profession has taught you. Adjustments have been shown in the research to be safer than over the counter ibuprofen. You prescribe drugs every day with more deleterious effects than an adjustment would ever cause. Not to mention, the drugs you prescribe and services you often render do nothing to strengthen the patient’s body or heal the source of their illness, but rather mask symptoms and keep them coming back to your cash cow. Get a little more education on what chiropractic is really about and how it works, and maybe you’ll save yourself from making ridiculous claims like the ones in the above article. Visit http://chiropracticadvocate.com/ if you really want to understand chiropractic and not just pretend you do.

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    1. Posting on behalf of Dr David Laing Dawson:

      Well then, I think you have given me permission to be less polite than usual. The link you reference is a Promo site. Period. An advertisement. It is no more reliable or truthful than a Donald Trump speech.

      I have looked into, researched chiropractic practice, read many of the claims made and the “scientific” rationale for chiropracty, including adjustment. I also know something of the actual anatomy and physiology of the human body.

      I stopped reading chiropractic literature when I got to the dangling of newborns by one leg to see which way their heads turned, and all the nonsense about Chakra and energy points, and then some ridiculous and dangerous claims about treating diabetes and other medical illnesses.

      To be fair some medical doctors seem to have forgotten the importance of an encouraging smile, a bit of hope, careful listening and touch in the healing arts, in their rush to evidence based medicine. They are reluctant to be and to use placebo. The often just give it straight: “70 % will get better with rest and time alone, 20% will take longer and follow a pattern of remission and relapse, 10% will follow a chronic pattern.” They make the false assumption that we are sensible, sane, rational human beings, grounded in reality.

      Hence, I think, the remarkable flourishing of ancient healing arts in the 21st century. Many of which were invented long before we had the slightest clue how the body actually works. And all of which, when actually tested, including acupuncture, turn out to be placebos.

      So, I do not oppose healing. A kind word, a tone of optimism, a bit of magic. I do not oppose hands on, for we humans, like other primates, and my two boxer dogs, thoroughly enjoy being touched. We know good touching stimulates the release of serotonin and dopamine and endorphin, while quelling the stress hormones and prolactin.

      So by all means, offer magic, kind words, optimism. Stretch muscles, flex joints, massage lightly and deeply. It is all good placebo. (Although some chiropractic treatment and stretching of joints, I suspect, turns an acute problem into a chronic one – therefore needing weekly “treatments”.)

      But in doing this, do not make ridiculous unfounded claims. Do not do anything remotely dangerous for a minor malady. Stay away from the neck. And do not claim you have anything to offer beyond massage and hope. When you have a sound scientific study (with adequate controls) to prove something beyond a placebo effect, let me know.

      Liked by 1 person

      1. (1) “The spinal cord as organizer of disease processes” Korr IM. J Am Osteopath
        Assoc. 1976 Sep;76(1):35-45.
        (2) “Cerebral metabolic changes in men after chiropractic spinal manipulation”
        Alternative Therapies Health Medicine 2011 Nov-Dec;17(6):12-7.
        (3) Haavik Taylor, H. & Murphy B.A. (2007) “Cervical spine manipulation alters
        sensorimotor integration: A somatosensory evoked potential study” Journal of
        Clinical Neurophysiology, 118(2):391-402
        (4) “The impact of positive sagittal balance in adult spinal deformity” SPINE 2005
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        (5) Biedermann H. “Kinematic imbalances due to suboccipital strain in
        newborns” J. Manual Med (1992) 6:151-156.
        (6) J Manipulative Physiol Therapeutics 2007 (May); 30 (4): 263–269
        (7) “Atlas vertebra realignment and achievement of arterial pressure
        goal in hypertensive patients” Journal of Human Hypertension (2007) 21, 347–
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        (8) “Hyperkyphotic posture predicts mortality in older communitydwelling
        men and women” J Am Geriatr Soc. 2004 Oct;52(10):1662-7.
        (9) The association between cervical spine curvature and neck pain
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213543/
        (10) Straightened cervical lordosis causes stress concentration: a finite element model study
        http://www.ncbi.nlm.nih.gov/pubmed/23355324
        (11) Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis
        http://www.ncbi.nlm.nih.gov/pubmed/26876295
        (12) Journal of Orthopedic and Sports Physical Therapy
        1981 Volume:3 Issue:2 Pages:67–72
        “Effects of Immobilization on the Extensibility of Periarticular Connective Tissue”
        Robert Donatelli, MS, PT, Helen Owens-Burkhart, MS, PT
        (13) J Gerontol A Biol Sci Med Sci.
        2013 Jul;68(7):869-75. doi: 10.1093/gerona/gls253. Epub 2013 Jan 28
        “Spinal posture in the sagittal plane is associated with future dependence in activities of daily living: a community-based cohort
        study of older adults in Japan.”
        Kamitani K, Michikawa T, Iwasawa S, Eto N, Tanaka T, Takebayashi T, Nishiwaki Y
        (14) Nature 523, 337-341 (16 July 2015) “Structural and functional features of central nervous system lymphatic vessels”
        Antoine Louveau, Igor Smirnov, Timothy J Keyes, Jacob D. Eccles, Sherin J. Rouhani, J. David Peske, Noel C Derecki, David Castle, James W.
        Mandell, Kevin S. Lee, Tajie H. Harris & Jonathan Kipnis

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    2. Posting on behalf of Dr David Laing Dawson re the studies provided by Dr Carr

      Dear Marshall Carr DC
      You responded to my challenge to send me some actual scientific studies demonstrating the efficacy (and anatomical underpinnings) of some chiropractic claims. So it behooves me to read those for which you provided a link. I did this.
      Here are the abstracts followed by my interpretations:

      1. In this study, we propose a finite element analysis of the complete cervical spine with straightened and normal physiological curvature by using a specially designed modelling system. An accurate finite element model is established to recommend plausible approaches to treatment of cervical spondylosis through the finite element analysis results. There are few reports of biomechanics influence of the straightened cervical curve. It is difficult to measure internal responses of cervical spine directly. However, the finite element method has been reported to have the capability to quantify both external and internal responses to mechanical loading, such as the strain and stress distribution of spinal components. We choose a subject with a straightened cervical spine from whom to collect the CT scan data, which formed the basis of the finite element analysis. By using a specially designed modelling system, a high quality finite element model of the complete cervical spine with straightened curvature was generated, which was then mapped to reconstruct a normal physiological curvature model by a volumetric mesh deformation method based on discrete differential properties. Then, the same boundary conditions were applied to do a comparison. The result demonstrated that the active movement range of straightened cervical spine decreased by 24-33 %, but the stress increased by 5-95 %. The stress was concentrated at the facet joint cartilage, uncovertebral joint and the disk. The results suggest that cervical lordosis may have a direct impact on cervical spondylosis treatment. These results may be useful for clinical treatment of cervical spondylosis with straightened curvature.

      Okay, this one is very difficult to read and make sense of. Our cervical spines have a nice natural curvature. With age and other influences it can gradually straighten. These researchers seem to have created a computer model of a specific patient and extrapolate from this that when the cervical spine is straight its movement is decreased by 24 to 33 percent. (Anybody over 60 can tell you that, by the way). And the “stress” is increased by 5 to 95%. Terrific. We know this. After 60, swiveling the head to look out the rear window is difficult and sometimes a bit painful. It is a computer model. Tells us nothing.

      2. Degenerative changes of the cervical spine are commonly accompanied by a reduction or loss of the segmental or global lordosis, and are often considered to be a cause of neck pain. Nonetheless, such changes may also remain clinically silent. The aim of this study was to examine the correlation between the presence of neck pain and alterations of the normal cervical lordosis in people aged over 45 years. One hundred and seven volunteers, who were otherwise undergoing treatment for lower extremity problems in our hospital, took part. Sagittal radiographs of the cervical spine were taken and a questionnaire was completed, enquiring about neck pain and disability in the last 12 months. Based on the latter, subjects were divided into a group with neck pain (N = 54) and a group without neck pain (N = 53). The global curvature of the cervical spine (C2–C7) and each segmental angle were measured from the radiographs, using the posterior tangent method, and examined in relation to neck complaints. No significant difference between the two groups could be found in relation to the global curvature, the segmental angles, or the incidence of straight-spine or kyphotic deformity (P > 0.05). Twenty-three per cent of the people with neck pain and 17% of those without neck pain showed a segmental kyphosis deformity of more than 4° in at least one segment—most frequently at C4/5, closely followed by C5/6 and C3/4. The average segmental angle at the kyphotic level was 6.5° in the pain group and 6.3° in the group without pain, with a range of 5–10° in each group. In the group with neck pain, there was no association between any of the clinical characteristics (duration, frequency, intensity of pain; radiating pain; sensory/motor disturbances; disability; healthcare utilisation) and either global cervical curvature or segmental angles. The presence of such structural abnormalities in the patient with neck pain must be considered coincidental, i.e. not necessarily indicative of the cause of pain. This should be given due consideration in the differential diagnosis of patients with neck pain.

      Okay. What they found in a group over 45 years of age is that the loss of cervical lordosis (the straightening of the cervical spine) was NOT associated with an increased complaint of pain. Both groups (nicely curved cervical spine, straight spine) reported pain to the same degree. Meaning the loss of curve in the cervical spine is not a specific source of neck pain.

      3.) BACKGROUND Because loss of cervical lordosis leads to disrupted biomechanics, the natural lordotic curvature is considered to be an ideal posture for the cervical spine. The vertebral arteries proceed in the transverse foramen of each cervical vertebra. Considering that the vertebral arteries travel in close anatomical relationship to the cervical spine, we speculated that the loss of cervical lordosis may affect vertebral artery hemodynamics. The aim of this study was to compare the vertebral artery values between subjects with and without loss of cervical lordosis. MATERIAL AND METHODS Thirty patients with loss of cervical lordosis and 30 controls matched for age, sex, and body mass index were included in the study. Sixty vertebral arteries in patients with loss of cervical lordosis and 60 in controls without loss of cervical lordosis were evaluated by Doppler ultrasonography. Vertebral artery hemodynamics, including lumen diameter, flow volume, peak systolic velocity, end-diastolic velocity, and resistive index, were measured, and determined values were statistically compared between the patient and the control groups. RESULTS The means of diameter (p=0.003), flow volume (p=0.002), and peak systolic velocity (p=0.014) in patients were significantly lower as compared to controls. However, there was no significant difference between the 2 groups in terms of the end-diastolic velocity (p=0.276) and resistive index (p=0.536) parameters. CONCLUSIONS The present study revealed a significant association between loss of cervical lordosis and decreased vertebral artery hemodynamics, including diameter, flow volume, and peak systolic velocity. Further studies are required to confirm these findings and to investigate their possible clinical implications.

      This one is more complicated. When the cervical spine is naturally curved the arteries on either side naturally curve with the spine. When the spine loses this curve and becomes straight the course of the arteries likewise becomes straight. (Actually looking at the diagrams of bone and arteries in the neck should make anyone say, “Stay away from my neck.”) Applying doppler ultrasonography to the flow of blood in these arteries shows that there is a difference in the pattern of flow between the blood in the straight pipes vs the blood in the curved pipes. (remember this is arterial blood pulsing in waves as per the heart beat). Doh. However, the end diastolic velocity was the same. Please note that the end diastolic velocity (along with a systolic velocity) is THE important measurement of what is getting to the brain.

      So fluid dynamics is different in different shaped pipes. But same amount of blood at the same pressure is coming out the other end.

      NONE of this. NONE of this provides any evidence that you should be messing with peoples necks.

      On the other hand, patients of chiropractors should look at those diagrams of vertebrae and arteries and consider whether anyone should be twisting them.

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      1. Wow, you don’t seem to have much to do. You’re thinking a lot more about me than I am about you. Meanwhile, I’ve adjusted 300 patients in 3 days this week and they all seem to be doing great with their cervical adjustments. I didn’t read your long-winded response, by the way. I’m too busy making a difference in peoples lives to violently peg away at the keyboard like you seem to have done. Your nervous system is probably in dire need of some maintenance, you should probably make an appointment with a chiropractor. Happy Thanksgiving.

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      2. P.S. Here’s some reading to fill your time.
        (1)http://www.cureus.com/articles/4155-systematic-review-and-meta-analysis-of-chiropractic-care-and-cervical-artery-dissection-no-evidence-for-causation
        (2)https://www.ncbi.nlm.nih.gov/pubmed/18204390
        (3)http://chiromt.biomedcentral.com/articles/10.1186/s12998-015-0063-x
        (4)https://www.ncbi.nlm.nih.gov/pubmed/25494315

        Liked by 1 person

    1. So, you do admit to running an assembly-line practice. Did you pay a practice promotions group to help you do that? It’s pretty clear that if it’s a cash only practice, that you have a fiscal responsibility to report all your income to the State and the IRS.

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