Dear Ms. Gamage,
On behalf of chiropractors in British Columbia and across Canada, we are writing to address the claims made about chiropractic care in the Tyee article “The Potentially High Risks of Alternative Health Care,” published on October 24, 2023.
In the interest of patient safety and public awareness, we would like to share some information and evidence that refutes misinformation about chiropractic care in your article.
Canadians rely on more than 9,000 licensed chiropractors to provide effective, evidence-based treatments which promote health, alleviate pain, and improve their quality of life. To become a Doctor of Chiropractic (DC), one must complete a rigorous four-year post-graduate training, including national standardized educational requirements, and pass a provincial licencing examination.
As established musculoskeletal experts, chiropractic patient care begins with an assessment and diagnosis to inform a safe and effective treatment plan guided by their clinical training and expertise, the best available scientific evidence, and their patient’s preferences.
This treatment plan may include spinal manipulation, which is an established form of chiropractic treatment under British Columbia’s Health Professions Act.
Despite claims made in the article, it has been reported that millions of spinal and cervical manipulations are performed safely every year, providing patients with relief from common forms of neck pain and headache, and helping them get back to their normal activities.
Chiropractic care has been proven safe and effective for a range of conditions, including neck pain and some types of headaches. The World Health Organization (WHO) recently recognized chiropractic and the role that chiropractors are playing internationally regarding low back pain and rehabilitation: https://rdcu.be/dpyKZ
In addition, chiropractic care is recommended for the management of acute and chronic pain in British Columbia’s Guidelines for Managing Patients with Pain in Primary Care – Part 1.
For your reference, we append a list of independent research studies that refute or clarify the correlation of chiropractic treatments, such as spinal manipulative therapy, to the risk of stroke:
- Chiropractic care and the risk of vertebrobasilar stroke: results of a case–control study in U.S. commercial and Medicare Advantage populations, published in 2015 stated, “The findings showed no significant association between chiropractic visits and VBA stroke for either population or for samples stratified by age.”
- Risk of Carotid Stroke after Chiropractic Care: A Population-Based Case-Crossover Study, published in 2017, also found “no excess risk of carotid artery stroke after chiropractic care [and stated that] associations between chiropractic and [primary care physician] visits and stroke were similar and likely due to patients with early dissection-related symptoms seeking care prior to developing their strokes.”
- Risk of Vertebrobasilar Stroke and Chiropractic Care, published in 2008, found that “The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke.” It also concluded that the researchers “found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.”
In addition, the Centre for Effective Practice (CEP) developed an evidence-based clinical tool for physicians and nurse practitioners entitled, Manual Therapy as an Evidence Based Referral for Musculoskeletal Pain. This tool documents the expertise of chiropractors and the value of chiropractic care in delivering evidenced-based care to patients with neck, shoulder and back pain.
We would be happy to discuss this topic further with you should you have questions and to put you in touch with a researcher who can discuss relevant studies, if desired.
Best regards,
Dr. Jabeen Jussa, DC, Chair, British Columbia Chiropractic Association
Dr. Ayla Azad, DC, CEO, Canadian Chiropractic Association