A coroner has determined that Playboy model and “Queen of Snapchat” Katie May died in February at 34 years of age from a stroke after a chiropractor treatment ruptured one of her arteries while manipulating her neck.
Was this a rare, freak occurrence or a concerning risk of chiropractor neck manipulations? Unfortunately, the answers provided by some chiropractors in response to safety questions have only raised more concerns. Here are examples:
From an earlier Washington Post piece on the safety of chiropractic manipulations: The American Chiropractic Association says that “neck manipulation is a remarkably safe procedure.” Remarkably safe? What exactly does that mean? I don’t know too many things that are remarkably safe. Maybe dozens of extensively washed pillows are remarkably safe…as long as you don’t suffocate on them. Since everything has a risk, understanding safety means understanding the quantitative risk. Watching an episode ofGlee could make you vomit, which then could make you aspirate and develop pneumonia, which could threaten your life.
However, in general, watching Glee re-runs is considered to be reasonably safe because there have not been any such reported cases. By contrast, spinal manipulation does not appear to be as safe as watching Gleewith reports of deaths and a various adverse events including serious ones. But spinal manipulation may be safer than some other more dangerous procedures. And the risk can vary from patient to patient. Therefore, everything is relative. The problem is neck manipulations have been understudied compared to many medical procedures. You can provide evidence of how safe something may be. But calling something remarkably safe is remarkably absurd.
More from the same Washington Post article: The American Chiropractic Association continues, “While some reports have associated upper high-velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, recent evidence suggests that this type of arterial injury often takes place spontaneously, or following everyday activities such as turning the head while driving, swimming, or having a shampoo in a hair salon.” The difference is that you turn your head while driving every day, many times. (If you don’t turn your head while driving, please do not drive.) It is not as if people are busting arteries every day in their cars. Neck manipulations are much less frequent than turning your head, unless you somehow are having a chiropractor follow you around every day, manipulating you at every free moment. Therefore, if you want to compare the safety of turning your head or shampooing with neck manipulations, show us some numbers per event such as what is the number of arterial injuries per neck manipulation versus the number of arterial injuries per head turn or per shampoo.
Even more from the same Washington Post article: Stephen Perle, a spokesman for the American Chiropractic Association, said, “There is no such thing as ‘chiropractic stroke,’ any more than there is ‘unhappiness heartburn.’ Uh, actually studies have suggested that stress and emotional distress may play a role in “heartburn”, otherwise known as gastroesophageal reflux, as well as obesity (which can contribute to heartburn) and other medical conditions.
From a People magazine article about May’s death: Todd Sinett, Doctor of Chiropractic and author of Three Weeks to a Better Back, said, “Chiropractic care is statistically the safest mode of treatment for any type of treatment within the neck compared to injections or even medications.” What exactly does treatment “within the neck” mean and how exactly is neck manipulation inside the neck? Is your chiropractor actually Ant-Man? Does he or she climb inside your neck to administer the neck manipulation? Comparing chiropractic care with neck injections doesn’t seem to be a fair comparison. Not everyone with neck pain gets injections. How about comparing neck manipulation with standard physical therapy procedures instead? It is not clear whether chiropractic care is necessarily safer than physical therapy.More from the People magazine article:Robert Pomahac, Doctor of Chiropractic and CEO of MaxHealth LA, said “The only way to determine if the neck pain is coming from a vascular issue is to have every person get a CT angiogram.” No, there are other ways, such as a physical exam and magnetic resonance imaging (MRI) studies.
From a CBS News piece about May: Dr. Jeffrey Benton of the California Chiropractic Association. “There’s more deaths to opioid medications than there are to chiropractic manipulations.” Yes and there are also more deaths from obesity than chiropractic manipulation.What’s the point of saying this? Is this statement suggesting that the only alternative to chiropractic manipulations are opioid medications…which of course is just not true? Yes, there is an opioid medication epidemic. But you can’t just choose an epidemic, say that there are fewer deaths, and then claim that your procedure is therefore safe. Again, the comparison should be with other methods of handling the same problems such as physical therapy.
While routine chiropractor treatments, if done appropriately on the right patients, may not be very dangerous, everything has risks and more studies are necessary to better understand any risk involved and how this may change from patient to patient. Unfortunately, chiropractic treatments have not been studied as extensively as most medical procedures, so real scientific information is limited.
When a high profile death or adverse event occurs related to a medical treatment, the medical community frequently responds with scientific studies to further evaluate the treatment’s safety, even if previous studies had deemed the treatment relatively safe. We have seen treatments modified and pulled from the market after they passed clinical trials. Being part of the medical and scientific community means continuous learning and willingness to update opinions based on new scientific information. People, the environment, and health conditions continue to evolve and so must scientific understanding. And frankly like Donald Trump’s hair, much of the human body is still a great mystery.
Undoubtedly, the statements above do not reflect or represent everyone in the chiropractic community. There is probably a wide variety of personalities, competency, and thinking, ranging from those who use scientific approaches to those who view science as an annoyance. However, if the chiropractor community wants to be taken more seriously, then responses to incidents such as May’s death and questions about chiropractic safety should be more scientific than statements that are “remarkable” in the wrong ways.