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

Home/Editorial, Iatrogenic Injury, NSAIDs/If Not Chiropractic Care, Then What’s Your Alternative?

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

The Chiro.Org Blog

SOURCE:   A Chiro.Org Editorial

Informed Consent involves discussing the risks and benefits of the treatment you propose (in my case, chiropractic) AND reviewing the risks and benefits of the alternatives, which are “conservative” medical care, which typically involves prescribing muscle relaxers, NSAIDs (nonsteroidal anti-inflammatory drugs), and less frequently, prescribing physical therapy.

Many patients who present to a chiropractor for the first time have already gone the medical route, with minimal or negative results. Today I would like to review the risks associated with the most commonly recommended pain relieving analgesics (NASIDs).

The newest study (Sept 2010) reporting adverse outcomes following NSAIDs use was conducted with a giant cohort…the whole population of Denmark, aged over 10 years old.   This study included strictly healthy individuals, excluding anyone who was admitted to a hospital within the past five years, or those who were prescribed chronic medications for more than two years.

Previous studies by these same researchers had found increased risk of myocardial events in those who used NSAIDs, but the current study also demonstrated significant increased risk of stroke.   In an interview with MedScape, the author stated: “This is very serious, as these drugs are very widely used, with many available over the counter” and also stated that “We need to get the message out to healthcare authorities that these drugs need to be regulated more carefully.” [1]

Another recent study from Australia found increased risk of ischemic and hemorrhagic strokes in those who used NSAIDs, from as low as a 20% increase in risk to as high as a 598% increase, depending on which compound was used. [2]

Even more disturbing is a report written by a rheumatologist, who reviewed the health outcomes of 11,000 arthritis patients at 8 participating institutions in the United States and Canada, and then titrated those results for all those who are being treated for rheumatoid arthritis…a tiny fraction of all those who take NSAIDs for pain relief. [3]

The distressing findings:

  1. 107,000 patients are hospitalized annually for NSAID-related gastrointestinal complications (internal bleeding).   This is a staggering 293 people every day, rushed to the hospital, with all the associated expense ($2.354 Billion dollars a year) for using NSAIDs for simple pain relief!

  2. 16,500 NSAID-related deaths occur each year among arthritis patients alone.   This is a staggering 45 people DYING every day, because they used NSAIDs for simple pain relief!   What a tragedy!   What a crime!

  3. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated, and it is certainly not emphasized by the popular or medical press.   As Deep Throat once advised, if you want to know why, then “Follow the Money!”

  4. Osteoarthritis (OA) and rheumatoid arthritis (RA) patients are 2.5—5.5 times more likely to be hospitalized for NSAID-related GI events

  5. The absolute risk for serious NSAID-related GI toxicity remains constant, and the cumulative risk increases over time with continued NSAID use

  6. There are no reliable warning signs – More than 80% of patients with serious GI complications had no prior GI symptoms

  7. Antacids and H2 antagonists do not prevent NSAID-induced gastric ulcers, and high-risk NSAID users who take gastro-protective drugs are more likely to have serious GI complications than patients not taking such medications

  8. The author concluded:Limiting NSAID use is the only way to decrease the risk of NSAID-related GI events (deaths)” [3]

I don’t think it gets any clearer than that.

NSAIDs are killing tens of thousands of people every year!

Previous studies have also demonstrated that patients taking a 500-mg/day dose of NSAIDs had a 2.5-fold increased risk of hospitalization from complicated gastric or duodenal ulcer, while those on the 750-mg/day dose had almost a threefold increased risk of “adverse” GI complications. [4]

When you consider that the typical medical recommendation for neck and low back pain is to take analgesics, and then you look at the significant risks for even short-term use, and then you think about the well-documented safety of chiropractic care [5], one has to scratch their head after hearing that a large managed care program (Kaiser) discontinued coverage for cervical manipulation. [6-7]

Perhaps they are cutting costs and improving Kaiser’s bottom line, but they are significantly increasing the odds that their policyholders will die of stroke or internal bleeding, because they no longer have any choice but to follow their MDs recommendation to use NSAIDs for their pain relief.

If I was a Kaiser policyholder, I assure you I would be hopping mad!   As it is, our role is to provide this information freely, so that Kaiser’s policyholders can make a legitimate case against them, in the event they become a victim of this money-saving scheme.

(NOTE: Several months later, after a massive angry response from subscribers, Kaiser reversed their decision and reinstituted chiropractic coverage to their policy-holders)


  1. NSAID Use Associated With Future Stroke in Healthy Population
    MedScape’s HEARTWIRE ~ September 8, 2010
    NOTE: Rregistration is FREE

  2. Increased risk of stroke associated with nonsteroidal anti-inflammatory drugs: a nationwide case-crossover study
    Stroke. 2010 (Sep); 41 (9): 1884-90

  3. Recent Considerations in Nonsteroidal Anti–inflammatory Drug Gastropathy
    American Journal of Medicine 1998 (Jul 27); 105 (1B): 31S–38S

  4. Widely Used Anti-Inflammatory Drug Risky Even in Small Doses
    reporting on “Naproxen use increases the risk for complicated gastroduodenal ulcers in a dose-dependent fashion”
    American College of Gastroenterology (ACG) 2009; Abstract P55

  5. The Safety of Chiropractic
    A Chiro.Org Editorial

  6. Kaiser, Chiropractic, and Chronic Neck Pain
    A Chiro.Org Editorial

  7. American Chiropractic Association responds to new Kaiser policy excluding cervical manipulation

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. Eugene Chiropractor September 26, 2010 at 10:51 am

    Well written. Too bad people don’t have to sign an informed consent every time they take a pill. Chiropractic is not with out risk, but it is incredibly safe compared to most alternatives.

  2. Allison Blatherton September 27, 2010 at 8:38 am

    I heard this story on the news just the other morning and it blew me away. These are such commonly prescribed medicines that carry such an incredible risk, it’s shocking this hasn’t been documented before. Thank you for posting this and spreading the message of risk that these products carry.

  3. Roy Davis September 27, 2010 at 1:01 pm

    Many prescriptions may be seen as safe by patients, although they may sometimes abuse them. Now we see that they may induce internal bleeding or stroke! That is a very is a serious matter. Thanks for the post!

  4. Broomfield Chiropractor September 27, 2010 at 5:09 pm

    This is more of the same bad news about a wide variety of prescription drugs. It’s unbelieveable that so many health care providers prescribe drugs that are widely known to be problematic over the long term.

    That’s one of the great things about Chiropractic treatment – there is virtually no risk of stroke, heart disease, or any other cumulative detrimental (and potentially fatal) effects.

  5. While it would be awakening for patients to have to sign some sort of consent to buy and take OTC meds the last thing we need is more bureaucracy in health care.

    The thing to do is simply let the results speak for themselves and continue sharing articles like this.

    Thanks Frank!

  6. Kukurin Chiropractic October 2, 2010 at 11:31 am

    The chiropractors in our office frequently ask each other for adjustments. If it wasn’t safe why would they have it done themselves on a regular basis?

  7. Graeme Gibson October 3, 2010 at 3:46 am


    Beautiful job done on this article. There is definitely a witch hunt continuing against our profession and a clear bias. I realize that the under publicized dangers of pharmaceutical drugs does not prove the safety of chiropractic, but it is important to recognize the hypocrisy of the medical and science critics.

    Graeme Gibson, D.C.

  8. doctors in Salinas October 8, 2010 at 10:12 am

    I am moved beyond tears at the sheer brilliancy of this blog. Thank you.

  9. Derek October 12, 2010 at 12:36 pm

    They way NSAIDs are advertised on TV, you would think they are a vital part of any health and wellness program. In the future, they may decide to fortify our cereal with Advil to keep us healthy.

  10. Free image hosting November 7, 2010 at 4:34 pm

    This is such a great resource that you are supplying and you give it away for free. I love seeing web sites that realize the value of supplying a high quality source for free. Thanks for this fantastic reference!

  11. seattle chiropractor November 8, 2010 at 5:36 pm

    Too many medical doctors neither cure nor care. Most medical research is organized, paid for, commissioned or subsidised by the drug industry and the food, tobacco and alcohol industries. This type of research is designed to find evidence showing a new product is of commercial value.

  12. […] If Not Chiropractic Care, Then What’s Your Alternative? […]

  13. Chiropractor Lynnwood March 22, 2011 at 7:51 pm

    Chiropractic is definitely the best option for most people when it comes to neuromusculoskeletal problems. I say “most” people because there are definitely people who would rather take drugs, even being fully aware of the risks and alternatives. That’s just how it goes.

    I don’t understand what’s keeping our profession from dominating spine care. We have a great scope of practice, great schools, lots of good research, lots of happy patients, and a happy, friendly attitude.

    Let’s keep providing a great alternative to drug care!

    RESPONSE from Frank

    I’m with you Dr. Gargan. I think the problem is the decades that the AMA spent undermining (lying) about us, and more recently the few nay-sayer websites that spend overtime gouging us at every turn.

    Clearly, they will never eliminate us, but so far they have been very effective in marginalizing us.

  14. Eugene Chiropractor DC May 18, 2012 at 7:24 pm

    And there you have it……just get all your medical advise from the TV and take that damn pills already. Well listed material.

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