Definition of chiropractic adjustment
According to the World Health Organization (WHO is the leading authority in the field of health for work of an international character within the United Nations system), chiropractic adjustment is defined as: “Any act chiropractic using essentially controlled force, pressure, direction, amplitude and velocity, which is applied to joints and adjacent tissues.Chiropractors use these acts to act on articular and neurophysiological function. “
Chiropractic adjustments administered in an efficient and appropriate manner are safe and indispensable for controlling and treating a number of health problems. However, the manual protocols used in chiropractic have certain known risks and contraindications.
Why is chiropractic adjustment perceived as dangerous?
Because, in general, people have a hard time making the difference between what is dangerous and what is risky! Danger is defined as any potential source of harm, prejudice or bad effect to a person in certain situations, where the risk is defined as the probability that a person will suffer harm or adverse effects. harmful to one’s health in the event of exposure to danger. Risk assessment is the process of identifying hazards, examining or estimating the risks associated with a hazard and identifying appropriate ways to eliminate or control those risks.
To make an analogy simple to understand, there is a risk that a plane crashes on your house but it is not dangerous to live there since the chances that it happens, statistically, are almost zero.Therefore, there is a known risk or statistical probability, following a chiropractic adjustment, that a person is suffering harm or adverse health effects.
But this probability is so statistically tiny, that chiropractic adjustment is not dangerous when it is provided by a doctor in chiropractic who, through his comprehensive university training in the field of musculoskeletal diagnosis, allows him to consider the existence or not contraindications to adjustment and whether or not to use it according to clinical judgment.Contraindications to chiropractic adjustment range from non-indication when manipulation or mobilization have no positive effect but have no adverse effect, to absolute contraindication when they provide a real danger to the patient. existence of the patient. In many cases, chiropractic adjustment may be contraindicated on one part of the spine and have beneficial effects in another region. It should be remembered that in addition to using chiropractic adjustment, the chiropractor has a vast repertoire of manual techniques namely, manual traction, passive stretching, massage, ischemic compression of points trigger and reflex techniques dedicated to simplify pain and muscle spasms.
To put into perspective the risks associated with different situations
- David Ropeik, a risk communication instructor at Harvard University, concludes in 2006 that the chances of dying in a plane crash are one in 11 million;
- According to Ropeik, the chances of dying in a car accident are one in 5,000;
- The chances of dying in a shark attack are one in 3.1 million;
- According to Dr. Scott Haldeman DC, MD, PhD, FRCP (C), FCCS (C), FAAN, Professor Emeritus at the University of California, following a 10-year study, there would be a serious complication 5.85 million chiropractic adjustments;
- A traveler could fly, on average, once a day for 4 million years before succumbing to a deadly plane crash.
Each therapeutic intervention carries a risk
Unfortunately, for vertebral manipulation , some misinformed people or, even worse, ill-intentioned, let sometimes run untruths, to scare the patients.
Absolute contraindications to spinal manipulative therapy:
- anomalies such as dens hypoplasia, unstable os odontoideum, etc.
- acute fracture
- spinal cord tumour
- acute infection such as osteomyelitis, septic discitis, and tuberculosis of the spine
- meningeal tumour
- haematomas, whether spinal cord or intracanalicular
- malignancy of the spine
- frank disc herniation with accompanying signs of progressive neurological deficit
- basilar invagination of the upper cervical spine
- Arnold‐Chiari malformation of the upper cervical spine
- dislocation of a vertebra
- aggressive types of benign tumours, such as an aneurismal bone cyst, giant cell tumour, osteoblastoma or osteoid osteoma
- internal fixation/stabilization devices
- neoplastic disease of muscle or other soft tissue
- positive Kernig’s or Lhermitte’s signs
- congenital, generalized hypermobility
- signs or patterns of instability
- hydrocephalus of unknown aetiology
- cauda equina syndrome
Minimize risk to a minimum: risks associated with chiropractic adjustment or spinal manipulation
As you can see, these are conditions that occur infrequently in our patients but generally require the use of medical imaging such as radiography or magnetic resonance (MRI) to detect these conditions. contraindications to minimize the statistical risk.
Chiropractic adjustment or spinal manipulation is not dangerous, when done by a competent health professional, such as a doctor of chiropractic.
See a recently published study: “No Evidence Exists Between Chiropractic Care and Cervical Artery Dissection”
Studin., Owens W., Edwards J. (2019) No Evidence Exists Between Chiropractic Care and Cervical Artery Dissection, The American Chiropractor 41(10) pgs. 28, 30-32
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