Journal of Manipulative and Physiological Therapeutics
TITLE
Risk of Stroke After Chiropractic Spinal Manipulation in Medicare B Beneficiaries Aged 66 to 99 Years With Neck Pain
1.15 Million Patients
SOURCE
https://pubmed.ncbi.nlm.nih.gov/25596875/
REFERENCE
11
NICE
REFERENCE
123
organisation
Journal of Manipulative and Physiological Therapeutics
TITLE
Risk of Stroke After Chiropractic Spinal Manipulation in Medicare B Beneficiaries Aged 66 to 99 Years With Neck Pain
1.15 Million Patients
SOURCE
https://pubmed.ncbi.nlm.nih.gov/25596875/
DISC COMMENTARY
This large retrospective cohort study examined whether older adults who saw a chiropractor for neck pain had a higher risk of stroke afterwards, compared with those who saw a primary care physician instead. It used data from over 1.1 million Medicare patients aged 66 to 99.
What was studied?
The study compared stroke rates in the days and weeks after a chiropractic visit against rates after a visit to a primary care physician, among 1,157,475 Medicare beneficiaries with neck pain, tracking outcomes at 7 and 30 days.
What did they find?
In the week after a visit, people who saw a chiropractor had a slightly lower stroke rate than those who saw a doctor, 1.2 versus 1.4 per 1,000. At 30 days the rate was marginally higher in the chiropractic group, a difference judged probably not clinically meaningful.
Why it matters
Comparing real-world outcomes against a sensible alternative, seeing a doctor rather than a chiropractor, gives genuinely informative evidence. It shows no meaningfully elevated risk at population scale.
Why we included it
It supports honest, evidence-led conversations about safety: this scale of real-world data shows that small risks from neck treatment are broadly comparable to seeing a GP, rather than uniquely elevated.
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What was studied?
The study compared stroke rates in the days and weeks after a chiropractic visit against rates after a visit to a primary care physician, among 1,157,475 Medicare beneficiaries with neck pain, tracking outcomes at 7 and 30 days.
What did they find?
In the week after a visit, people who saw a chiropractor had a slightly lower stroke rate than those who saw a doctor, 1.2 versus 1.4 per 1,000. At 30 days the rate was marginally higher in the chiropractic group, a difference judged probably not clinically meaningful.
Why it matters
Comparing real-world outcomes against a sensible alternative, seeing a doctor rather than a chiropractor, gives genuinely informative evidence. It shows no meaningfully elevated risk at population scale.
Why we included it
It supports honest, evidence-led conversations about safety: this scale of real-world data shows that small risks from neck treatment are broadly comparable to seeing a GP, rather than uniquely elevated.