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Who’s Asleep Over at MedScape?

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Who’s Asleep Over at MedScape?

The Chiro.Org Blog

In general, I find the reporting at MedScape to be top notch, but I have significant problems with their 4-20-11 essay titled: “The Potential Complications of Chiropractic Therapy”.

Answer this question:

If I sneeze, and there is a car accident across the street,
have we discovered the *cause* of car accidents?

The scientific method would propose that we sneeze a hundred times, and count the car accidents.

That’s how you begin to determine if there is an actual relationship between one event (like drinking milk) and it’s potential consequences (like developing cancer).

The Bone and Joint Decade Task Force was appointed by the World Health Organization (WHO) to look at the causes of, and treatments for neck pain, and after years of review, they published their results in the prestigious Spine Journal. One of the most relevant articles (to this conversation) was titled:

Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-based Case-control and Case-crossover Study
Spine 2008 (Feb 15); 33 (4 Suppl): S176–183

CONCLUSION: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.

There was an association between chiropractic services and subsequent vertebrobasilar artery stroke in persons under 45 years of age, but a similar association was also observed among patients receiving general practitioner services. This is likely explained by patients with vertebrobasilar artery dissection-related neck pain or headache seeking care before having their stroke.

This Blog (and our website in general) has published regularly on this topic:

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

If Not Chiropractic Care, Then What’s Your Alternative?

Do You Still Beat Your Wife?

Chiropractic and Stroke Incidence

Respected Researcher Validates Chiropractic Standard of Care and Safety

We also have access to an interview with the author himself:

Podcast Interview with J. David Cassidy: No Increased Risk of Stroke With Chiropractic

This interview, with author, researcher and epidemiologist J David Cassidy, DC, DrMedSc, PhD, should quell the fears of even the most vehement critics who would normally carry on on by mis-quoting, ignoring, or twisting the existing scientific literature to suit their pre-conceived notions and biases.

The Stroke and Chiropractic Page has been online since early 1996, compiling the literature which documents how chiropractic care has been mis-labeled as the “proximal event” in reported cases of vertebral artery injury.

Most telling is Terrett’s seminal work Misuse of the Literature by Medical Authors in Discussing Spinal Manipulative Therapy Injury, which clearly demonstrates that many of the reported injuries ascribed to chiropractic actually occurred following care provided by MDs, PTs and even hair-dressers, even though the authors of those works knew the truth. Where I come from, that’s called bald-faced lying, not *misuse*.

The unadorned FACT is that there is ZERO scientific evidence that a chiropractic adjustment has EVER *caused* a stroke. None.

I hope the Editors at MedScape will publish a retraction and apology, while explaining how and why they missed mentioning the results published by the Spinal Task Force.

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.


  1. karl April 28, 2011 at 7:43 pm

    I get daily info. from MedScape. I’ve noticed that article regarding the potential complications regarding chiropractic therapy. I have many problems with this article, but I’m curious about why that article routinely comes up and/or there’s a link to this article along with other articles. In addition to that curiousity, I would like a logical explaination on why HVLA cervical manipulation performed by a doctor of chiropractic is different than a physical therapist. Call me cynica,l but I believe this is still more of the same and that is prejudice and linguistic propaganda toward chiropractic. First of all, Cassidy is clear that this is a “very rare event” and secondly you’re no more likely to have a stroke from a visit to the chiropractor then compared to a primary care physician. Having said all this I do encourage positional provocative testing.

  2. Maine Chiropractor May 6, 2011 at 8:48 am

    We were taught not to do positional provocative testing in chiro school because the test is now considered to be a risk factor for “causing” a CVA. I’m with you on MedScape. I get info from them all the time. This article was curious to me as well. It seems that cranks with an ax to grind have found there way onto that site as well.

  3. karl May 17, 2011 at 10:03 am

    @Maine Chiropractor.
    I appreciate your position regarding positional provocative testing for detection of VBI. Having said that I would contact your liability insurance provider and find out what they recommend. Its somewhat of a Catch-22. “You’re damned if you do and damned if you don’t”.

  4. Maine Chiropractor May 17, 2011 at 1:14 pm

    I agree.

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