Can relieve a back pain turns into drama? For Carissa Klundt, an American mother, the answer is tragically yes. His last visit to a chiropractor in fact ended in an injury that could have been fatal to him.
Pain and fainting after a cracking
Following an operation to withdraw breast implants, Carisa consults a chiropractor to soothe her back pain. But during a session, a cracking at the neck changes his life. “As soon as it happened, I knew that something was wrong”she confides in Daily Mail.
She first thinks of a muscle elongation. But in the hours that follow, nausea, fainting and intense pains are linked. Her husband takes her to the emergency room. In the hospital, the diagnosis fell: tear of the vertebral artery, a serious accident that can lead to a stroke. Hospitalized in intensive care, Carissa suffers from aphasia and remains in bed for long weeks. Even today, she keeps consequences.
A case already seen before before
This is not the first time it has happened. In France also in an article published in 2019 in the Journal of Critical Care Medicinedoctors of the Reims University Hospital described the case of a 34-year-old patient, having developed a “locked-in syndrome” after a manipulation of cervicals by a chiropractor. The verdict was severe: vertebro-basilaire vascular accident, a form of stroke. “”It only takes poor manipulation or malformation so that the walls of the artery peel off. This causes a hematoma, then a stroke. For this patient, the consequences were irreversible “commented Dr. Guillaume Giordano Orsini, co -author of the article.
A difficult link to establish, but real
Asked about this type of accident, Vincent Roche, physiotherapist and osteopath, remains cautious: “Is a tear of the vertebral artery possible with chiropraxia? Yes. Can we prove it formally? It is more complicated”. Some retrospective studies are indeed a link between cervical manipulation and arterial dissection, while recalling that these incidents are very rare.
“But we find in these patients who have undergone dissection, a recent passage in the chiropractor … just like a passage to the hairdresser (the head in the tank) or even after a reverse by car, he describes. It’s multifactorial. “
The expert assures him, these tears can also occur spontaneously, especially in people with collagen disorders or following a minor trauma. Difficult to target chiropraxia as the only risk.
A benefit-risk report to question
If the cervical manipulations of “grade 5” – those that produce a crack – can provide temporary relief, their efficiency remains debated. “There is a neurophysiological effect in the cracking that can relax and calm the pain. But is it worth the risk, even tiny, to finish quadriplegic or worse? The question is legitimate.”
Vincent Roche insists: in France, an osteopath can only handle with a medical prescription. This is not the case for chiropractors, who can intervene in first intention. “What many ignore is that we do not put a vertebra in place. It is a marketing image, not a medical reality”.
Inform, for informed consent
Beyond the debate on practices, it is the need for enlightened consent that stands out and should take place at the start of each session. “If we really explained to all patients the benefits, the risks, the uncertainties, I think that many would refuse this type of manipulation” estimates our expert. Carissa Klundt did not imagine such an outcome. Today, she militates for better information and a more informed choice. “I don’t want to blame, but educate. I would never have thought it could happen to me.”
An outcome that should also make practitioners cogitate themselves. “All external techniques, whether it is drug, therapeutic, is potentially dangerous. Accidents are rare but they exist. This is why you have to be formed. This requires a complete examination, on history, pathologies, weaknesses. It is not so much the technique that is dangerous, it is to identify the people to whom it should not be done” Also indicated Frédéric Srour, a physiotherapist, in one of our previous articles.