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Foundation Position Statement on Chiropractic & Stroke

 

There is no human experimental evidence that chiropractic adjustments or neck manipulations are causally related to strokes. The claims and statements that have been made and that have been interpreted by plaintiff attorneys and plaintiff experts to contend a link are based largely on anecdotes, case reports, and case controlled studies.

 

A multitude of systematic distortions (biases) may effect the results and conclusions drawn from case-control studies. Other criteria must be used to determine whether a purported association is actually causative because an association does not prove causation. At this point in time due to the rarity with which vertebrobasilar accidents occur within this population, experimental evidence in humans and prospective cohort studies examining the hypothesis that chiropractic adjustments cause stroke - do not exist. In fact, recent research shows no evidence of excess risk of VBA stroke associated with chiropractic care as compared to primary care.

 

Regarding advising on risks - a risk should be disclosed if a reasonable patient in what the doctor knows or should know to be the patient’s position, would be likely to attach significance to the risk or cluster of risks in deciding whether to forego the proposed therapy. Patients and doctors must make this decision based upon appropriate information. Since there is no human experimental evidence that chiropractic adjustments or neck manipulations are causally related to strokes, it is inappropriate to require a doctor to suggest that such a risk exists. 

 

Further, chiropractors utilize a number of techniques to address joint dysfunction and vertebral subluxation. Many techniques do not employ the type of manipulation that has been alleged to be a factor in vertebrobasilar accidents. This adds to the inappropriate nature of such a disclosure.