The International Chiropractors Association (ICA), working in close cooperation with the Connecticut Chiropractic Council (CCC), the Connecticut Chiropractic Association (CCA) and the American Chiropractic Association (ACA), has sought to bring the debate on this issue back to the science and research data, which strongly indicates that any such warning is simply not called for or appropriate based on the clinical safety record.

Respected researcher and epidemiologist J. David Cassidy, DC, PhD, Dr.Med.Sc, testified as a key witness at the hearings. The objective of his testimony was to bring to the Board’s attention the compelling body of scientific data that is most relevant to the issue; the sum of which is that the research record does not support a mandated warning. 

“The most recent research (Neck Pain Task Force Report of the Bone and Joint Decade 2000-2010, a United Nations & WHO sanctioned study) indicates neck manipulation is safe and effective form of health care” according to Matt Pagano, DC chiropractic profession spokesperson.

Speaking as an expert witness and consultant to the International Chiropractors Association (ICA), but with the support of all of the chiropractic organizations (American Chiropractic Association, Association of Chiropractic Colleges, Foundation for Chiropractic Progress, Life West, New York College of Chiropractic, Parker College of Chiropractic, Palmer College of Chiropractic, University of Bridgeport College of Chiropractic) involved in the hearing process, Dr. Cassidy addressed key facts and issues on the basis of the existing science and research record, to which he has been a significant contributor on the issue before the Board. The objective of his testimony was to bring the discussion on an emotional issue back to the science and the objective research record.

Dr. Cassidy joined an extensive list of witnesses representing the chiropractic profession, including William J. Lauretti, DC, James J. Lehman, DC, MBA, J. Clay McDonald, DC, JD, MBA, Gerard W. Clum, DC, Stephen M. Perle, DC, MS, and Gina Carucci, DC, MS, DICCP, who appeared on behalf of the Connecticut Chiropractic Association (CCA) and George Curry, DC, FICA, who appeared on behalf of the Connecticut Chiropractic Council (CCC).

“The chiropractic profession unequivocally supports a patient’s right to be informed of the material benefits and risks of any type of healthcare treatment – not just chiropractic. Legislation or regulatory mandates governing informed consent should apply to all healthcare providers and all treatments in equal measure. A new law, regulation or mandate, however, highlighting one specific treatment by a specific health care profession that carries with it an extremely rare association, with no causal link identified in the research, is simply not good public health policy. It would set an unnecessary precedent for all health care providers, procedures and products that would be virtually impossible to implement”, said Pagano.

The existing informed consent standards in Connecticut allow for the best opportunity for shared decision making between a patient and their health care provider. Further, the chiropractic organizations participating in the hearing process all believe informed consent is more than a piece of paper; it is a process. It should occur in the context of a discussion between a doctor and a patient, and it should be appropriately documented.

In a finding highly relevant to the issue before the Connecticut Board of Chiropractic Examiners, the study demonstrated that patients suffering from headache and neck pain are no more likely to suffer from a stroke following a visit to a chiropractor than they are after a visit to a family medical physician. Therefore this implies that there are factors other than the type of care provided by doctors of chiropractic. It’s important to note that millions of patients safely benefit from chiropractic care every year—they are able to return to their normal activities and enjoy a better quality of life.

Dr. Cassidy was an investigator with The Bone and Joint Decade 2000-2010 Task Force on Neck Pain & It’s Associated Disorders of the World Health Organization (WHO). The work of this international task force whose study affirms the safety and benefits of chiropractic care for people with neck pain - a condition which is frequently treated by doctors of chiropractic was released February 2008. The Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders initiated this new population-based, case-control and case-crossover study, which appeared in the Feb. 15, 2008, edition of the journal Spine.

The study—which analyzed nine-years’ worth of data from a population of 110 million person-years—concluded that vertebrobasilar artery (VBA) stroke is a very rare event and that the risk of VBA stroke associated with a visit to a chiropractor’s office appears to be no different than the risk of VBA stroke following a visit to the office of a primary care medical physician.

The study goes on to say that any observed association between a VBA stroke and chiropractic manipulation, as well as its apparent association with PCP visits, is likely due to patients with an undiagnosed vertebral artery dissection seeking care for neck pain and headache prior to their stroke.

The organizations representing the chiropractic profession believe this most recent evidence should help to dispel any myths on this issue, as well as provide more data to support the safety and effectiveness of chiropractic procedures.

As a profession, doctors of chiropractic remain committed to expanding the research and clinical understanding of the VBA, because even one cerebral vascular incident that could have been detected early is one too many.


Source, International Chiropractic Association, please visit www.chiropractic.org