In response to a new study (discussed in the previous Spondylitis Association of America News item) claiming that chiropractic neck manipulation is a risk factor for strokes resulting from vertebral artery dissections, the American Chiropractic Association (ACA) issued a press release. The organization states that the study "is fraught with design flaws, provides little new and useful information, and needlessly alarms the public about a safe and effective form of treatment for neck pain and headaches."

Although not specifically addressed in this article, it is important to mention that chiropractic manipulation is generally not recommended for people with spondylitis because of the potential for serious complications.

The chiropractic profession says they welcome valuable research into the understanding of injuries, such as strokes, but claim that the recent study failed to uncover any new information that would significantly enhance the current body of research on this topic. While the authors of the study concluded that there was a relationship between a neck treatment and one rare type of stroke - a Vertebral Artery Dissection -- the ACA explains that this "unusual variety of stroke has also been associated with many other commonplace activities such as talking on the telephone, swimming, stargazing, overhead work, hair shampooing, and even sleeping."

In response to the author's claim that vertebral artery stroke appeared to be correlated with a chiropractic visit, the organization says that the stroke may not have been caused by the actual treatment.

They bring up results from a recent study in which researchers measured the forces transmitted to the vertebral artery during cervical spinal manipulation and found that the forces applied are one ninth of those needed to stretching or damage a normal vertebral artery. The ACA further explains that they are actually less than the forces measured during normal movements of the neck. "Many experts believe that it is physically impossibly for a competently performed neck adjustment to cause a vertebral artery dissection unless the artery already has a significantly preexisting weakness."

The ACA also emphasizes the safety of the procedure in question by noting that all available evidence demonstrates that the risk of major complications from chiropractic neck treatments is "extremely small." According to the organization, the best estimates of the odds are about 1 incident out of every 2 million treatments. In addition, patients with neck and back pain who "do nothing" can carry a risk, for instance, by possibly increasing disability and the abuse of prescription or illegal drugs for pain relief.

Furthermore, the ACA has taken an active role in educating doctors of chiropractic to "recognize possible risk factors and encourages all doctors of chiropractic to immediately refer any high-risk patients to other specialists for further evaluation."

In conclusion, the ACA made the following statement: "Although all available evidence demonstrates that there is an extremely small risk of major complications from chiropractic neck treatments, this is still an area of concern for the chiropractic profession. The ACA and the chiropractic profession will continue to work closely with other medical professionals on this matter, for the best interests of our patients."