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Did Chiropractic Kill This Young Model?

Katie May was a successful model, with spreads in Playboy and Sports Illustrated, plus a huge Instagram and Snapchat following. Last week, the 34-year old woman died after experiencing several strokes. She was young and seemed to be in good health, so what happened?

Her family told TMZ that May had a torn carotid artery, according to her doctors. The family said it may have occurred due to a fall she experienced two weeks prior. But it’s worth noting that May visited a chiropractor just a few hours before being rushed to the hospital, according to her own Tweets and a report from her close friend, who told the press that the nurse assisting May told her that chiropractic-induced strokes happen all the time.

I am not a doctor, and even if I was, it would be wholly unprofessional to state with any degree of certainty about what exactly happened in this specific case. But I can tell you what we know about chiropractors.

First of all, chiropractic care was invented with the belief that you could cure pretty much any ailment in the body by adjusting the spine. Stomach ache? Spinal adjustment. Heart problems? Spinal adjustment. Burst appendix? Let’s just wiggle that spine around a little more. Needless to say, all this is bullshit.

Some chiropractors (but probably not most) don’t believe that anymore, but they continue to believe that spinal adjustments can help with any ailment related to posture, headaches, backaches, or other muscle aches.

The preponderance of scientific evidence shows that when it comes to backaches, chiropractic is equal to or not quite as good as simple massage therapy.

When it comes to headaches and neck aches, it’s bullshit. And not only that, but it’s dangerous bullshit.

Chiropractors in the US are not doctors, meaning they do not have to go to medical school prior to calling themselves chiropractors and offering to snap your neck for zero benefit. And fucking around with the neck is incredibly dangerous. Dr. Edzard Ernst, formerly a champion of alternative medicine, published a study in 2010 examining the results of chiropractic neck treatments and found that the benefits of it don’t outweigh the very clear risk of death due to stroke following “treatment.”

In other words, chiropractic is a 19th century practice with no unique benefits that offers a small risk of an untimely death.

Did chiropractic kill Katie May? I don’t know. But I do know that there’s enough there that I hope her family considers getting the authorities involved to investigate the chiropractor who adjusted her neck just hours prior to her death. It’s a tragic case, but apparently we need a high-profile disaster before the world starts to really pay attention to the dangerous quackery of chiropractic.

Rebecca Watson

Rebecca Watson

Rebecca leads a team of skeptical female activists at Skepchick.org. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.

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15 Comments

  1. February 22, 2016 at 7:06 pm —

    Leaving aside the opportunity cost inherent in all alternative medical modalities, it can cause a friggin’ stroke! And yet it’s among the most common alternative medical modalities in North America; all 50 states have licensed chiropractors.

  2. February 22, 2016 at 7:13 pm —

    Actually, D.D. Palmer, the ‘inventor’ of Chiropractic (he was sued for practicing Osteopathy without a license, the two are THAT similar) seemed to think that bunions might be treated by cracking the feet…

    For years, reform groups in chiropractic have tried to get their colleagues to change neck-cracking techniques or drop the practice. As I recall, just limiting the degree of rotation eliminates the risk of arterial injury that causes the steady trickle of strokes and deaths after neck cracking. Those vulnerable have anatomical variations which can’t be seen on an X-ray, but even they would be reasonably save if chiros stopped cranking necks around as far as they do.

    The reformers have been ignored or even blacklisted by their ‘comrades.’ The most ambitious group: the Orthopractic Society, which included osteopaths, chiros, physiatrists, and physical therapists who ‘did’ spinal manipulation, finally had to fold.

  3. February 22, 2016 at 8:48 pm —

    An analysis from someone who is a doctor:
    https://www.sciencebasedmedicine.org/did-chiropractic-neck-manipulation-kill-katie-may/

    The final sentence:
    “It is certainly not wrong to suspect that chiropractic neck manipulation might have contributed to Katie May’s demise, but it is incorrect to state with any degree of certainty that her manipulation did kill her.”

    • February 23, 2016 at 10:39 am —

      I’m still a bit a noob here, so let me get this straight:
      the reason science disagrees with Rebecca Watson is because there’s a single science article in a magazine I haven’t heard of that did a systemic review of 253 studies only to be left with 5 articles where only 1 agrees with the authors conclusion. And for whatever reason that one class 3 article is weighted so much that the study effectively ignores the 4 other articles. I don’t know what it is, but there’s something fishy about this…

      • February 23, 2016 at 3:59 pm —

        Exactly. Cureus is a weird little journal with ridiculously short and impractical turnaround times. The article cited by Cory Ellerbroek had peer review completed within just 10 days, and was published online just 8 days later. I have read the article, and the “systematic review” methodology presented is, basically, complete bollocks: providing a short list of search terms used without explaining why those and not others were selected, and without explaining whether (and what) combinations of terms were used, should ring alarm bells for most scientific reviewers. e.g. why “spinal manipulation” but not also “spine manipulation” and “manipulation of the spine”? And in the Results section, the authors claim that 77 out of 253 articles were dismissed as irrelevant – which alone shows a flaw in their systematic review process – but give no explanation as to what criteria they used to determine relevance. Also, Figure 1 in the article actually contradicts this – suggesting not 77, but 184 out of 253 were dismissed. So, at least 69 articles were reviewed – but what articles? They are not listed, The References section lists just 27 references. Very little of the findings in the report can therefore be tested (there should, at very least, be an appendix with all returns from the systematic review listed). The paper also clearly states that the authors found an association between chiropractic manipulation and risk of artery dissection, but they claim that they find no evidence of causality in the articles they reviewed – however, it is not clear whether any of the articles they reviewed actually looked for causality. I’ve watched Rebecca’s video – I can conclude that there is no evidence that chiropractic has given her cat worms, but that would be utter nonsense, since that was absolutely not discussed in the video. I could go on, but basically the Cureus paper is bullshit.

  4. February 23, 2016 at 12:26 am —

    Okay, I completely agree that using spinal adjustment to treat the array of disorders that chiropractors try to treat is absurd. And neck adjustments always freaked me out anyway. BUT, I have always gotten immediate relief from lifelong battles with sciatica and crooked hips with a lower back adjustment. Is there no use for it whatsoever? I guess youre saying if I (was richer and) just get more massages I’d be better off?

    • February 23, 2016 at 1:14 am —

      My lay-person understanding is that physical therapy will do more for you in the long run.

    • February 23, 2016 at 7:36 am —

      It could be a simple case of the placebo effect. That doesn’t mean you should stop doing it if it works for you – even knowing it might be a placebo doesn’t fully eliminate the effect. But as Jac said, physical therapy or massage therapy might get the job done better.

    • February 23, 2016 at 9:07 am —

      If your insurance covers chiropractors then it may also cover therapeutic massage that is prescribed by a doctor. Even if it’s not covered, massages from trained masseuses can be pretty cheap relative to an office visit copay – $60 for an hour massage is about what I expect to pay at a massage-focused practice (ie, not at a spa). By contrast, my specialist copay is $35.

  5. February 23, 2016 at 8:25 am —

    Aw, it sounds like Rebecca, the author, could use an adjustment! What a shame that she is perpetuating ignorance, in the form of her opinion, that holds no basis in reality, nor in the understanding of the profession and success of the field of chiropractic. Your site claims to be about critical thinking–but unfortunately, there really is no educated “critical thinking” going on in this piece! Just layers of uninformed opinion in lieu of research based, factual information. It may serve the author to spend time reviewing chiropractic success cases that saved patients from addiction to narcotic pain killers or debilitating surgeries. Use the power of your pen to speak actual truth, not to spew your own personal, uniformed, ignorant rant about a profession that SAVES lives on a regular basis, while your asteroid is orbiting the sun.

    • February 23, 2016 at 4:46 pm —

      Are you saying Rebecca should have her neck cracked?

      ‘Cause that sounds like a threat.

      I would like to see some proof that chiropractic manipulation has ever “saved patients from addiction to narcotic pain killers or debilitating surgeries” in any way that an osteopath, physical therapist, or massage therapist couldn’t do as well.

      In other words, is there any reason for pseudo-doctors like chiropractors to exist?

  6. February 23, 2016 at 4:16 pm —

    Just adding in some personal experience here. I went to a chirporactor in Ireland (fully ‘qualified’) on the recommendation of my then girlfriend, as I was suffering from transmandibular joint disorder (which for me caused clicking and stiffness of the jaw, which occasionally would lock for up to 24 hours). I was young and dumb and should have seen it as a warning at the time, but it was only in hindsight that I realised that before manipulating my spine, not one single question was asked by the chiropractor about my health, physical condition or medical history. Clearly, it is important to know whether someone has had spinal difficulties or injury or recent back pain before you go shifting the alignment of their vertebrae – otherwise, at best, you risk adding to a existing problem, and at worst you could fucking paralyse someone. Nevertheless, I have since learned that this lack of curiosity is perfectly normal amongst chirporpactors. Anyway, at the end of pulling and pushing of my back, my jaw was still stiff. So, after saying “open wide and let me see”, the chiroporactor put her fingers in my mouth and without warning viciously twisted my lower jaw sharply to left and right, and dislocated it. After several weeks in extreme agony, involving multiple surgeries to repair nerves and ligaments and enable me to eat solid food again, I filed a suit to recover medical costs and lost income from time off work. The chirporactor was vigorously defended and supported by her peers, and I had to drop the case since I just did not have the financial resources to enter into a long legal battle.
    So, I tend to be a bit skeptical of chirporactic bullplop after that experience.

  7. February 24, 2016 at 9:52 am —

    First of all, Katie May’s case is tragic, but due to confidentiality laws it’s likely we will never know all the details of her case. However, from the numerous articles I’ve read, it appears she had a dissection of the carotid artery following a significant fall and injury to her neck. At least one article reported she went to the emergency department immediately after the fall and was discharged without treatment.
    If this is a group of skeptics reading this blog, it seems you should be more responsive to actual evidence rather than second-hand rumors, sketchy reports from celebrity news sites and innuendo. If that’s the case, let’s look at some actual evidence (references can be found by pasting the PMID # in Pubmed.gov):
    Several large epidemiological studies have shown no excess risk of stroke in people who have recently received chiropractic neck treatment compared with patients who have recently received care from a primary care medical physician. One large study (PMID:18204390) looked at the medical records of 11 million people in Ontario, Canada over a nine year period and concluded that any observed association between a stroke and a patient’s visit to either a chiropractic physician or a family physician was not directly caused by any treatment performed. Instead, any association was likely due to patients with an evolving artery dissection seeking care for symptoms such as neck pain or headache that sometimes take place before the stroke occurs.
    Another epidemiological study (PMID:26085925) looked at the medical records of nearly 39 million members of a large health insurance plan, and found no significant association between chiropractic visits and cervical artery stroke, although there was a significant association found between a visit to a primary care physician and this type of stroke. This study also concluded that this association was likely due to patients with early symptoms seeking care before the actual stroke occurs.
    As for the effectiveness of chiropractic care for neck pain (which generally includes cervical manipulation, mobilization, massage and exercise), one landmark comprehensive analysis was supported by the Neck Pain Task Force of the International Bone and Joint Decade, an international multidisciplinary organization (PMID:18204386). This study found that mobilization, manipulation, and massage are effective treatments for neck pain.
    In contrast, the same review concluded that there was “not enough evidence to make a determination” about the helpfulness of NSAIDs, opioids and other drugs commonly used for treatment of neck pain, all of which have risks of significant complications.
    In conclusion, there is good epidemiological evidence that the odds of having a stroke following a visit to a doctor of chiropractic are no greater than the odds of having a stroke following a visit to a primary care doctor. In addition, there is biomechanical evidence that cervical manipulation stretches the carotid arteries less than routine activities, making it unlikely that a cervical manipulation can physically cause an arterial dissection (PMID:23140796).
    Doctors of chiropractic are educated in a four-year post-graduate program that includes comprehensive study of anatomy with human dissection, physiology, diagnosis and clinical treatment. It includes a two-year clinical internship, which may include experience at VA hospitals and other medical facilities.
    Far from being “dangerous quackery”, chiropractic is a licensed and regulated profession that offers patients a safe, conservative option for common conditions. There is good evidence that a chiropractic approach to neck pain is at least as effective as a conventional pharmaceutical approach, with no greater risk of complications.

    Bill Lauretti, DC
    Associate Professor, Chiropractic Clinical Sciences
    New York Chiropractic College

  8. February 24, 2016 at 8:57 pm —

    Spinal Manipulation Therapy MIGHT be good for some things. Mobilizing the joints, or just stimulating circulation to the deep muscles, MIGHT do some good for some things.

    But Chiropractic is a whole ‘philosophical’ and pseudoscientific package. The ‘subluxations’ that Chiro pamphlets show (in DRAWINGS not photos or Xrays) would be fatal, not hidden causes for ordinary diseases.

    Modern Chiros routinely move the goalposts by turning ‘subluxation’ into a mystical condition like ‘blocked’ chakras, or ‘unbalanced’ humours.

    Non chiros do spinal manipulation. Osteopaths, Physical Therapists, ‘traditional’ ‘Bone Setters’ and a few MDs. Some are as whacky as DD Palmer, others feel empirically justified, and pay attention to reasonable standards of caution.

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