How Safe is Chiropractic?
By Dr. Scott E. Rosenthal
Due to the physical nature of chiropractic care and the fact that it involves performing maneuvers to the neck and back, people sometimes question its safety. As with any medical procedure, it is wise to consider the risks. Being an informed patient can help bring about better choices for yourself and your loved ones. Before we look into the safety of chiropractic, I’d like to provide some perspective.
The following is a list of the most common causes of death in the U.S. (including the number of people who die from these causes each year):
- Heart disease: 614,348
- Cancer: 591,699
- Chronic lower respiratory diseases: 147,101
- Accidents (unintentional injuries): 136,053
Not listed here as a major cause of death is medical care itself. Studies estimate that more than 400,000 Americans die prematurely each year from hospital errors. (1) Another study showed that use of nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen causes 16,500 deaths annually among arthritis patients alone. (2)
With so many “medical deaths” each year, it is fair to consider how safe each type of care is. This includes chiropractic. But, is there more of a concern than there should be? The answer requires understanding a dark history.
Chiropractic has a long history of representing a more natural approach to health and healing. Unfortunately, this has brought fierce opposition from those with competing views. To better understand the history, I direct you to several excerpts from a 2011 article published in the American Medical Association’s Journal of Ethics:
“Although the chiropractic profession now occupies a largely mainstream place in the health care spectrum of the United States, this has not always been the case. From its formation in 1895 by founder Daniel David (D.D.) Palmer, the chiropractic profession faced a plan of containment and elimination by the American Medical Association (AMA) that continued for nearly a century. It took an antitrust lawsuit filed against the AMA in 1976 to reveal the magnitude and scope of the AMA’s plan. Despite generations of organized medical opposition, chiropractors did what most other groups of professionals failed to do: they maintained a separate and distinct identity from the practice of medicine while growing in an otherwise hostile environment created by the AMA and its component state associations.” (3)
Although the chiropractic profession won the monumental case, the repercussions of the intense and illegal propaganda by the AMA can still be felt today. Delaware hospitals still fail to have a single Doctor of Chiropractic on staff. Despite the change observed by the AMA and movement of chiropractic further into the mainstream of today’s health care arena, forces still seek to tarnish the public trust. Continued attacks (likely from rogue medical sources) surface every few years making the unscientific accusation that chiropractic can cause strokes. Although unfounded, many in the media appear to have a feverish obsession to sensationalize these claims and blindly quote any medical physician with a defamatory opinion.
The most recent and comprehensive analysis of the safety of chiropractic can be found in a study conducted by the Department of Neurosurgery at Penn State Hershey Medical Center in February of 2016. The researchers found in regard to chiropractic and strokes:
“There is no convincing evidence to support a causal link, and unfounded belief in causation may have dire consequences.” (4)
Even though the scientific literature debunks the myth that chiropractic causes strokes, another question needs to be answered. How safe is chiropractic care overall?
A recent study published in the orthopedic journal, Spine, answers this question by looking at those most susceptible to injury, the elderly. Millions of Medicare recipients were studied by comparing the rate of injury seen when visiting a primary care physician as compared to a chiropractor. Chiropractic care was found to be significantly safer as summarized in the study’s conclusion:
“Among Medicare beneficiaries aged 66 to 99 years with an office visit risk for a neuromusculoskeletal problem, risk of injury to the head, neck, or trunk within 7 days was 76% lower among subjects with a chiropractic office visit than among those who saw a primary care physician.” (5)
If chiropractic is found to be this safe when compared to primary care physician visits, imagine if chiropractic was compared to common invasive medical approaches such as spinal injections and surgery.
The best evidence revealing the high level of safety seen with chiropractic care is not in a peer-reviewed medical study, government document or world health organization paper. It is seen in the premium bill each Doctor of Chiropractic receives yearly from his or her malpractice insurance company. Personally, I pay more money for my auto insurance than I do my malpractice insurance. According to insurance actuaries who calculate the premium amounts based on risk and past claim data, I am more of a risk to the public in my car on the road than in my office working on patients. One could conclude that a good litmus test for healthcare safety is whether the treatment is more risky than the car ride over.
There is no doubt that the United States is in a health care crisis. Not only is the current medical system unsustainably expensive to administer, but it is unacceptably harmful as well. More than ever, patients need to be vigilant with their own advocacy. In the year 2000, Americans filled 2.8 billion prescriptions. That’s about 10 prescriptions for every person and a number that should force everyone to think carefully about the choices they make. (6) Is it any surprise the death toll is so high? By doing a little research, asking yourself, friends and doctors if the treatment you are about to receive is the safest available, harm and death can be prevented.
Chiropractic has been around for years, survived decades of illegal attacks from competing forces and is proven highly effective. Trust is the greatest gift any individual or profession can receive, but must be earned. Extensive research, low insurance rates and decades of satisfied patients show that when it comes to safety, you can trust chiropractic!
- Journal of Patient Safety: September 2013 - Volume 9 - Issue 3 - p 122–128
- Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med 1998 Jul 27;105(1B):31S-38S
- Church E W, Sieg E P, Zalatimo O, et al. (February 16, 2016) Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus 8(2): e498
- Spine: 15 February 2015 - Volume 40 - Issue 4 - p 264–270