Large study finds no added risk of rare artery tear following chiropractic neck care

 by University Hospitals Cleveland Medical Center

Getting your neck adjusted by a chiropractor does not appear to raise the risk of a rare but serious artery injury, according to a large observational study from a multidisciplinary collaboration including researchers at University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland Clinic and Duke University.

The study, published in Chiropractic & Manual Therapies, examined the association between chiropractor-administered spinal manipulation and cervical artery dissection, a relatively rare condition involving a tear in a neck artery that can lead to stroke.

Analyzing data from more than 862,000 adults who sought care for a new episode of neck pain or headache, the study found no evidence of an increased risk of cervical artery dissection among patients receiving chiropractor-administered cervical spinal manipulation compared with those prescribed ibuprofen.

Comparing two care approaches

Researchers analyzed health records and insurance claims from a U.S. database covering patients treated between 2010 and 2025. After excluding anyone with a prior history of cervical artery dissection or related conditions, they used statistical matching to build two comparable groups of more than 431,000 patients each: one that received chiropractic neck manipulation and one that instead received an ibuprofen prescription for neck pain or headache.

By matching the groups and balancing factors such as age, sex and other health conditions, researchers could rigorously compare outcomes between the two care approaches. In the final analytic sample, 31 patients in the chiropractic group and 58 patients in the ibuprofen cohort were diagnosed with a new cervical artery dissection within 30 days of follow-up.

"To address this complex clinical question, we formed a multidisciplinary collaboration, including authors representing chiropractic, cardiology, neurosurgery, physical therapy, orthopedic surgery and biostatistics, and developed and registered a formal research protocol, making this one of the most methodologically rigorous studies on the topic to date," said Robert Trager, DC, lead author and Buoncore Family Endowed Director of Chiropractic Medicine at University Hospitals Connor Whole Health.

"People often ask me whether chiropractic care for neck pain is safe," said Christine Goertz, DC, Ph.D., co-author and researcher at the Duke Clinical Research Institute. "This study is some of the best evidence yet that the answer to that question is yes."

Accounting for early warning signs

Several reasons make studying this question harder than it sounds. First, cervical artery dissection is a rare event, making it impractical to study using a randomized clinical trial. Second, benign neck pain and headache are common reasons to seek chiropractic care, but they can also be early warning signs of an undiagnosed artery tear.

Together, these factors make it difficult to evaluate causation. Because this bias was well established in prior studies, the research team took several steps to mitigate it, principally by restricting the study to adults seeking care for a new episode of neck pain or headache.

Ear infection: a retrospective study examining improvement from chiropractic care

 

• PMID: 8728460

Abstract

Objective: The aims of this study were to determine (a) if the patients improved while under chiropractic care; (b) how many treatments were needed to reach improvement; and (c) which factors were associated with early improvement.

Design: Cohort, nonrandomized retrospective study.

Setting: Private chiropractic practice in a Minneapolis suburb.

Participants: Forty-six children aged 5 yr and under.

Intervention: All treatments were done by a single chiropractor, who adjusted the subluxations found and paid particular attention to the cervical vertebrae and occiput. Sacral Occipital Technique-style pelvic blocking and the doctor's own modified applied kinesiology were also used. Typical treatment regimen was three treatments per week for 1 wk, then two treatments per week for 1 wk, then one treatment per week. However, treatment regimen was terminated when there was improvement.

Outcome measure: Improvement was based on parental decision (they stated that the child had no fever, no signs of ear pain, and was totally asymptomatic), and/or the child seemed to be asymptomatic to the treating DC and/or the parent stated that the child's MD judged the child to be improved. A data abstraction form was used to determine number of treatments used and presence of factors possibly associated with early improvement.

Results: 93% of all episodes improved, 75% in 10 days or fewer and 43% with only one or two treatments. Young age, no history on antibiotic use, initial episode (vs. recurrent) and designation of an episode as discomfort rather than ear infection were factors associated with improvement with the fewest treatments.

Conclusion: Although there were several limitations to this study (mostly because of its retrospection but also, significantly, because very little data was found regarding the natural course of ear infections), this study's data indicate that limitation of medical intervention and the addition of chiropractic care may decrease the symptoms of ear infection in young children.

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What Are the Health Benefits of Indian Gooseberry (Amla)?

 Amla, also known as Indian gooseberry, is one of the most antioxidant-rich foods on Earth. Though unfamiliar to many, particularly in Western countries, powdered and dried amla fruit is commonly used in Ayurvedic herbal preparations and the subject of hundreds of articles in the medical literature, including papers with hyperbolic titles like “Amla…a Wonder Berry in the Treatment and Prevention of Cancer.”

Are All Gooseberries the Same?

Indian gooseberries are not to be confused with Barbados gooseberries, Cape gooseberries, Chinese gooseberries (also known as kiwi fruit), Jamaican gooseberries, or Tahitian or star gooseberries.

Amla and Cancer

In vitro studies have shown that amla may have anticancer properties and not only appear able to block cancer cell growth, but also cancer cell invasion. Amla kills cancer cells but leaves normal cells alone. It was tested against six human cancer cell lines: lung cancer, liver cancer, cervical cancer, breast cancer, ovarian cancer, and colon cancer. When amla was dripped on cancer cells, the growth rates cut in half, then stopped completely. Amla then began killing off the cancer. By the end, more than half the cancer cells were dead. 

A Powerful Source of Antioxidants

Amla is, on average, the single most antioxidant-packed whole food on the planet. One teaspoon of gooseberry powder costs about four pennies and provides 1,500 units of antioxidant power, which is more than the average person gets in an entire week.

Reducing Our Cholesterol

Just 500 milligrams of powdered amla, which is about a tenth of a teaspoon, may work as well as Zocor, a leading cholesterol-lowering drug.

Improving Our Arterial Function

Amla may reduce artery stiffness, so it may be a good alternative to statins in individuals with diabetes who have artery dysfunction because of its benefits without the adverse effects of drugs, which may include muscle damage or liver dysfunction.

Amla and Diabetes

Some clinical research has also shown that amla powder may work as well as a leading diabetes drug—again without the side effects.

Better Digestion

Dyspepsia is a fancy word for an upset stomach—feelings of fullness, discomfort, nausea, bloating, belching—affecting up to one in five individuals. One teaspoon of dried Indian gooseberry powder three times a day may work as well as a gel antacid every three hours: significant decreases in peak acid output and a cutting of dyspepsia symptom scores in half.

Other Benefits

Indian gooseberries have also been found to have cough-, fever-, pain-, stress-, and diarrhea-suppressing effects.

Where to Find Amla

Amla can be purchased online or at Indian spice stores. Although some Ayurvedic herbal supplements have been found to be contaminated with heavy metals, none of the samples of powdered amla tested so far appear to be contaminated. Whole Indian gooseberries can be found in the frozen section of Indian grocery stores, but some find them inedible—astringent, sour, bitter, and fibrous all at the same time. The powder isn’t much tastier, but it can be disguised in something with a strong flavor, like a smoothie. Alternatively, amla can be packed into capsules.

Eating Amla Fruit

Amla can be bought in various forms: frozen, dried, sweetened, salted, pickled, packed in syrup, packed in nitrogen. Add a teaspoon of powder to smoothies, and you probably wouldn’t even taste it.