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Distributed by the Foundation for Chiropractic Education and Research
PO Box 4689 Des Moines IA 50306 800-622-6309

For Immediate Release: October 22, 2001

 Contact: Robin R. Merrifield

1304 Perry Ave., Bremerton WA 98310

Phone: 800-343-0549 or 360-478-2716

Fax: 360-478-0834 E-Mail:

New Study Puts Stroke From Neck Adjustment
at Less than 1 in 5 Million Adjustments

Toronto, October 12, 2001 — A new Canadian study, reported in the October 2, 2001 issue of the Canadian Medical Association Journal (CMAJ), puts the risk of stroke following neck adjustment at 1 in every 5.85 million adjustments. The study, which is based on patient medical files and malpractice data from the Canadian Chiropractic Protective Association, evaluated all claims of stroke following chiropractic care for a ten year period between 1988 and 1997.

"This study is based on the most factual evidence available for determining the risk of stroke associated with neck adjustment," said Dr. Paul Carey, one of the principal authors of the study. "There has been much recent speculation about this risk, and some neurologists have expressed concern that the risk may be higher than previously believed. This study indicates that there is no cause for undue alarm, and that the risk may, in fact, be considerably lower than previously thought."

The study identified 23 reported cases of stroke following neck adjustments (also known as cervical manipulation), as diagnosed by the treating physician, over the ten year period. This was compared to the estimated 134.5 million neck adjustments performed by chiropractors in Canada over the same time frame.

Today’s publication points out that earlier surveys of neurologists who reported stroke following chiropractic treatment were not rigorous, and did not review patient charts to determine the type of adjustment that was performed, or even whether an adjustment was performed during the chiropractic visit implicated in the stroke.

"Unnecessary alarm has been created by the release of unpublished data in the past based on flawed methodology," explained Carey. "While it is possible that the experience of chiropractors does not reflect all strokes that occur following neck adjustment, this most recent study establishes such an extremely low degree of risk that patients can feel confident about the safety of neck manipulation performed by chiropractors."

Carey pointed out that other very common treatments for headache, and neck and back pain carry much higher risks of serious complications.

He also noted that the study supports the recent research published in CMAJ by the Institute for Clinical Evaluative Studies which found that the incidence of stroke associated with neck adjustments is so rare, it was not possible for the researchers to establish a meaningful rate of occurrence despite the high number of cervical adjustments that are performed.

The study, titled " Arterial Dissections Following Cervical Manipulation: The Chiropractic Experience" was authored by Scott Haldeman, DC, MD, PhD, FRCP; Paul Carey, DC; Murray Townsend, BSc, DC; and Costa Papadopoulos, MHA, CHE.

This release was prepared by the Canadian Chiropractic Protective Association (CCPA).
It is distributed by FCER with permission of CCPA. 

To view the article, browse to the web site of the Canadian Medical Association Journal here.

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