The direct danger of chiropractic

[haggholm]

From the SBM article Compare and Contrast by Mark Crislip:

There were two reviews concerning chiropractic safety published recently. Safety of chiropractic interventions: a systematic review, which found

[…] The search identified 46 articles that included data concerning adverse events… Most of the adverse events reported were benign and transitory, however, there are reports of complications that were life threatening, such as arterial dissection, myelopathy, vertebral disc extrusion, and epidural hematoma. The frequency of adverse events varied between 33% and 60.9%, and the frequency of serious adverse events varied between 5 strokes/100,000 manipulations to 1.46 serious adverse events/10,000,000 manipulations and 2.68 deaths/10,000,000 manipulations.

…

That is impressive complication rates, although the authors suggest the data to support the rates are not robust, for an intervention that only has at best proven efficacy for low back pain and safer alternatives. Also published recently was Deaths after chiropractic: a review of published cases.

Twenty six fatalities were published in the medical literature and many more might have remained unpublished. The alleged pathology usually was a vascular accident involving the dissection of a vertebral artery.

That is about three times the number of deaths from trovafloxacin, an excellent antibiotic that we abandoned in the U.S. as too dangerous.

Emphasis added. Note that evidence generally seems to support chiropractic as a moderately efficacious treatment for low back pain on par with a massage, but ineffective for any other indication (though it is touted as allegedly effective for all manner of improbable symptoms). Thus, when evaluating the risk/benefit calculation for these deaths, keep in mind that these are at best deaths in exchange for temporary relief of back pain, and at worst deaths in exchange for profiteering by means of bogus treatments.