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WARNING: Conducting an Orchestra Can Cause Vertebral Artery Dissection and Stroke

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WARNING: Conducting an Orchestra Can Cause Vertebral Artery Dissection and Stroke

The Chiro.Org Blog

SOURCE:   J Stroke and Cerebrovascular Diseases 2011 (Mar 24)

During the past decade, the issues of cerebrovascular accidents [CVAs] and spinal manipulation have become linked in a debate of ever-increasing intensity. A copious number of studies have investigated spinal manipulation as a putative causative factor of CVAs; however, a common theme among these is the failure to adequately explore the possibility that the majority of CVAs may be spontaneous, cumulative, or caused by factors other than spinal manipulation itself. The problem is only exacerbated by the sometimes hysterical reactions apparent in the mass media over the past three years in reaction to the flawed investigations. [1]

Previous studies have shown that vertebral artery dissections (VADs) have been “caused” by things as innocuous as:

Salon shampoos
Dental procedure
Watching aircraft
Telephone call
Bleeding nose
Overhead work
Cervical rotation while backing up a car
Roller coaster
Axial traction
Cervical extension for xrays or CTS
Hanging out washing
Traction and short wave diathermy

The current article now adds conducting an orchestra as another risk factor.

I certainly don’t want to make light of the suffering caused by a VAD. At the same time it boggles the mind that certain elements continue to publish slander against chiropractic care, when repeated reviews of the incidence of VADs proximal to chiropractic care suggest that it is orders of magnitude safer than the usual medical nostrums provided for neck pain relief. [2]

In fact, the most recent credible study reviewing risk ruled our chiropractic care as a potential cause of VAD after exposing arterial specimens to 1000 strain impulses of the same magnitude measured in cervical manipulation.

A pathologist, blinded to the experimental groups, assessed microstructural changes in those arteries using quantitative histology. Pearson analysis (a = .05) was used to assess differences in tissue microstructure between the groups. Cadaveric arterial tissues of New Zealand white rabbit with similar size, structure, and mechanical properties of human vertebral artery did not exhibit histologically identifiable microdamage when exposed to repeated (1000!) mechanical loading, equivalent to the strains observed in human vertebral artery during chiropractic cervical spine manipulative therapy. [3]

There are many more substantive articles like these at the:
Stroke and Chiropractic Page


1. Cerebrovascular Accidents: The Rest of The Story
International Spinal Trauma Conference ~ Anthony L. Rosner, Ph.D.

2. Is Cervical Spinal Manipulation Dangerous?
J Manipulative Physiol Ther 2003 (Jan); 26 (1): 48–52

3. Microstructural Damage in Arterial Tissue Exposed to Repeated Tensile Strains
J Manipulative Physiol Ther 2010 (Jan); 33 (1): 14–19

About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.

One Comment

  1. karl April 4, 2011 at 5:33 pm

    I highly recommend the podcast with Cassidy once a chiropractor and now a epidemiologist. This interview is a discussion about his study published in Spine 2008: Risk of Vertebrobasilar Stroke in Chiropractic Care. I believe it’s very important to understand there’s no more risk of stroke from chiropractic care and care from a family/primary care physician. Although “very rare”, I perform some provocative testing along with the patient history. There are plenty of special interests that have an interest in blaming chiropractic. I often ask critics about the use of high velocity low amplitude adjusting/manipulation of the cervical spine by physical therapists…….what I get is no-response or crickets. In this case, the procedure should be of topic not the practitioner but of course certain people are making a living on this topic. Fear sells.

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