Chiropractic and Stroke

Association or Causation?

P. Tuchin


Int J Clin Pract. 2013;67(9):825-833. 

In This Article


Serious complications following spinal manipulative therapy (SMT) of the cervical spine, including stroke, are relatively rare. Estimates vary between 1 : 400,000 cervical spine manipulations and 1 : 5.6 million.[1,2] However, there is controversy on how frequent events such as stroke are, and whether there is a causal relationship with SMT. Even more controversy can be found specifically relating to chiropractic SMT and whether this has a higher risk than other types of SMT. Both sides of the debate appear to have extremists with a biased perspective. Previous articles have not provided a comprehensive review of the evidence for and against chiropractic. A recent article noted several weaknesses or inconsistencies in some articles discussing chiropractic treatment and stroke.[3] A critical review of a paper previously published in the International Journal of Clinical Practice has been conducted to provide evidence for the alternative theories regarding the safety of chiropractic SMT and whether there is a causal relationship with the stroke.[4] A critical review of the current literature will also help to assess any misconceptions or distortion of the results of studies on chiropractic and stroke.