Chiropractic and the Risk of Stroke

by The Orange Chiropractor on December 5, 2010

Newborn receiving her first chiropractic adjustment (C1)

Newborn receiving her first chiropractic adjustment (C1)

Chiropractic Cervical (neck) Adjustments and the Risk of Stroke

In an attempt to discredit chiropractic and discourage people from seeking care from doctors of chiropractic, some proponents of allopathic or “Western Medicine” continue to disseminate (spread) misleading information about a possible link between cervical (neck) adjustments and strokes.

It is the position of The World Chiropractic Alliance that such misinformation is a deliberate and unethical scare tactic which does not stand up to critical analysis. Even if we restrict our investigation to just cervical (neck) adjustments — which have been the focus of many of the media and medical attacks — the only reasonable conclusion which can be drawn is that chiropractic adjustments do not post any significant risk of stroke and are remarkably safe.

A stroke occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to an area of the brain. The lack of blood causes brain cells to die. There are nearly 795,000 first ever or recurrent strokes each year in the U.S. and more than 150,000 deaths are directly related to strokes (1).

To link these strokes to chiropractic is absurd, however, since numerous published scientific and medical studies indicate that the incidence of a cerebrovascular accident (CVA) or stroke is estimated at between 1 to 3 incidents per million adjustments.

One study covered a period of 28 years, while another involved reviewing about 110 million chiropractic visits. The results of all these studies show conclusively that the risk of stroke from a chiropractic adjustment is so small as to be statistically insignificant. It has been estimated that it is even less than that of “beauty parlor stroke syndrome” — a rare occurrence triggered when a customer leans her head back on a sink to get her hair washed.

In reality, even the 1-3 incidents per million adjustments figures may be too high, since it is erroneous to equate correlation with cause. That is, if a person suffers a stroke after receiving a chiropractic adjustment, it is not necessarily proof that the adjustment caused the stroke. In an article entitled “Adjustments, Strokes, and Errors in Medicine” (The Chiropractic Journal, July 2000), Christopher Kent, D.C., explained, “The fact that a temporal relationship exists between two events does not mean that one caused the other.”

In addition, medical researchers frequently misunderstand the critical differences between specific chiropractic adjustments and cervical manipulation. Doctors of chiropractic are highly trained in the use of the adjustment, which is the specific application of force to facilitate the body’s correction of nerve interference. Manipulation is the forceful passive movement of a joint beyond its active limit of motion. Since it doesn’t imply the use of precision, specificity or the correction of nerve interference, it is not synonymous with chiropractic adjustment.

Finally, many of the cases cited by medical researchers as being “chiropractic treatments” were actually spinal manipulations rendered by non-chiropractic practitioners. According a research report in the Journal of Manipulative and Physiological Therapeutics, “manipulations” administered by a Kung Fu practitioner, GPs, osteopaths, physiotherapists, a wife, a blind masseur, and an Indian barber had been incorrectly attributed to chiropractors.

The report explained that, “The words chiropractic and chiropractor have been incorrectly used in numerous publications dealing with SMT injury by medical authors, respected medical journals and medical organizations. In many cases, this is not accidental; the authors had access to original reports that identified the practitioner involved as a non-chiropractor. The true incidence of such reporting cannot be determined. Such reporting adversely affects the reader’s opinion of chiropractic and chiropractors.” (Terrett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. JMPT 1995;18:203.)

Despite their apparent desire to malign chiropractic and link adjustments with the risk of stroke, even medical researchers have had to admit that chiropractic care carries far less of a stroke risk than medical treatment. “Indeed, most interventions by allopathic physicians have a higher complication rate than chiropractic interventions,” said Philip Lee, M.D., a co-investigator of a research survey presented at the American Heart Association’s 19th International Joint Conference on Stroke and Cerebral Circulation.

Based on the scientific evidence readily available today, it is clear that chiropractic adjustments pose no significant risk of strokes and are far safer in this regard than most medical treatments. The World Chiropractic Alliance calls upon the medical establishment to provide factual data to the public and restrain from using scare tactics in a blatant attempt to continue its long-standing history of opposition to chiropractic and other disciplines which threaten its monopoly on the health care system.

A review of studies involving chiropractic adjustments and stroke

The Council on Chiropractic Practice concluded, “The panel found no competent evidence that specific chiropractic adjustments cause strokes.” (“Vertebral Subluxation in Chiropractic Practice. Council on Chiropractic Practice Clinical Practice Guideline No. 1.” 1998.)

According to the National Institute of Neurological Disorders and Stroke, the estimated incidence of strokes in children under 14 years of age is 2.52 per 100,000 per year. Roach ES, deVeber G, Riela AR, Wiznitzer M: Recognition and treatment of stroke in children.

A study in the Journal of Vertebral Subluxation Research estimates the risk of neurological and/or vertebrobasilar complications in pediatric chiropractic to be approximately 1 in 250 million. Pistolese RA: Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient. Journal of Vertebral Subluxation Research 1998;2(2):77-85.

The RAND corporation estimated that the risk of stroke from chiropractic adjustments was “one in a million.” (“The appropriateness of manipulation and mobilization of the cervical spine. Santa Monica, CA: RAND Corporation 1996: xiv. (6).)

Over a ten-year period, Danish researchers found only five cases of “irreversible CVA after chiropractic treatment.” Based on this, they estimated a risk of one stroke per 1,320,000 neck adjustments. (“Safety in chiropractic practice. Part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988,” Journal of Manipulative and Physiological Therapeutics, 1996; 19: 371-7.)

Based on a survey of 64 California neurologists, Albers, M.D., estimated the stroke-chiropractic correlation to be “one in every 500,000 manipulations.” Co-investigator Philip Lee, M.D. noted, “Indeed, most interventions by allopathic physicians have a higher complication rate than chiropractic interventions.” (“Neurologic complications following chiropractic manipulation: A survey of California neurologists,” Neurology 1995; 45: 1213-5.)

The author of a Canadian study found 13 documented CVAs related to chiropractic care in Canada, and no deaths, over a five-year period. Since some 50 million cervical adjustments were given by Canadian chiropractors during that time period, he concluded that a reasonable estimate of risk was one serious neurological complications per 3 million neck adjustments. (“A report on the occurrence of cervical cerebral vascular accidents in chiropractic practice.” Journal of the Canadian Chiropractic Association, 1993; 37 (2): 104-6.

Researchers in Holland concluded that the overall rate of complications from chiropractic adjustments was one in 518,886. (“Complications in Manual Medicine: A Review of the Literature,” Journal of Manual Medicine, 1991; 6: 89-92.)

No strokes or any other significant complications were found during an examination of 168,000 cervical adjustments during a 28-year period. (“Chiropractic therapy: diagnosis and treatment,” Aspen Publishers, 1990: 61.)

A review of more than a half-million treatments over a nine-year period at the Canadian Memorial Chiropractic College outpatient clinic found no incidents of strokes or serious incident. (“Vertebral Artery syndrome,” published in the book “Upper cervical syndrome: chiropractic diagnosis and treatment.,” Baltimore: Williams and Wilkins, 1988: 195-222.)

A survey which included 203 Swiss practitioners and an estimated 1.5 million cervical manipulations, found a rate of one serious complication per 400,000 cervical manipulations, without any reported deaths. (“How dangerous is manipulation to the cervical spine?” Manual Medicine 1985; 2: 1-4.)

Not a single case of vertebral artery stroke or serious injury was found during a study which involved approximately 5 million cervical manipulations from 1965 to 1980 at The National College of Chiropractic Clinic in Chicago. (“Complications arising from manipulation of the cervical spine,” Journal of Manipulative and Physiological Therapeutics 1980; 3: 213-19.)

Chiropractic for the entire family is extremely safe, effective and affordable. For more information on how you may benefit from chiropractic care please contact Dr. Marcus Ettinger at (714) 639-4360 or go to


It’s time to kick some vi-rass!

by The Orange Chiropractor on November 8, 2010

Advanced Healing Center of Orange County

Colds and Flu Season 2010/2011

Achy, fatigued, filled with mucous, sore throat, coughing, runny nose, missing school or work, fever, stomach ache, diarrhea, vomiting, loss of appetite, shots, drugs, miserable and just plain pissed off. Doesn’t being sick sound fun? Well, it could easily be all wine and roses if you take the proper, preventative steps.

Yes, it’s that time of the year again – “Cold and Flu Season”, and I just wanted to remind everyone that I have put together a natural “preventative” protocol to fight-off colds and flu (for adults and kids). Now, not tomorrow, is the time to get going on this – for ultimate protection! The products are all natural and the possibility of side-effects is practically zero. The combo ($38-50 total) is Liquid Vitamin D Forte*, a special probiotic powder (caps also available) and chewable vitamin C (w/rutin). This may seem very basic and how can this work, but at therapeutic doses this actually moves the body from a straw house, to a stick house, to a brick house. Brick house people don’t get sick. I have been using this protocol for the past ten years w/my patients and the ones who follow it haven’t been affected by the flu, or if they did, it was very mild. Q: I’m I getting the flu shot? “Ah, that would be a no!”

There are specific additions that can be taken and will be recommended on an individual basis. Diet, exercise, chiropractic adjustments are also very important. If you or anyone you know would like a natural approach, rather than a vaccine, I would love to help.

*Adequate Vitamin D is the most important nutrient your body needs to stay healthy and avoid colds and flu this winter. To find out your current levels, you can order a test directly from my office.

Vitamin D blood test is available:

1. Normally $221. For you, the 25-OH Vitamin D test is $69. This is paid by cash, check credit card.
2. Please call our office to get a requisition sent to you or it can go directly to the lab – 714-639-4360.
3. Take the requisition to your closest LabCorp blood draw station.
4. Your lab results will be emailed to you.
5. Your results should be >50 ng/mL
6. Phone or office consults to discuss your result with Dr Ettinger are also available. Call 714-639-4360 for more information.

What’s in the regular flu shot?

Egg proteins: including avian contaminant viruses.
Gelatin: can cause allergic reactions, including anaphylaxis.
Polysorbate 80 (Tween80™): can cause severe allergic reactions, including anaphylaxis. Also associated with infertility in female mice.
Formaldehyde: known carcinogen.
Triton X100: a strong detergent.
Sucrose: table sugar.
Resin: known to cause allergic reactions.
Gentamycin: an antibiotic.
Thimerosal: mercury is still in multi-dose flu shot vials.

Do flu shots work?

Not in babies: In a review of more than 51 studies involving more than 294,000 children it was found there was “no evidence that injecting children 6-24 months of age with a flu shot was any more effective than placebo. In children over 2 yrs, it was only effective 33% of the time in preventing the flu.

Reference: “Vaccines for preventing influenza in healthy children.” The Cochrane Database of Systematic Reviews. 2 (2008).

Not in children with asthma: A study 800 children with asthma, where one half were vaccinated and the other half did not receive the influenza vaccine. The two groups were compared with respect to clinic visits, emergency department (ED) visits, and hospitalizations for asthma. CONCLUSION: This study failed to provide evidence that the influenza vaccine prevents pediatric asthma exacerbations.

Reference: “Effectiveness of influenza vaccine for the prevention of asthma exacerbations.” Christly, C. et al. Arch Dis Child. 2004 Aug;89(8):734-5.

Not in children with asthma (2): “The inactivated flu vaccine, Flumist, does not prevent influenza-related hospitalizations in children, especially the ones with asthma…In fact, children who get the flu vaccine are more at risk for hospitalization than children who do not get the vaccine.”

Reference: The American Thoracic Society’s 105th International Conference, May 15-20, 2009, San Diego.

Not in adults: In a review of 48 reports including more than 66,000 adults, “Vaccination of healthy adults only reduced risk of influenza by 6% and reduced the number of missed work days by less than one day (0.16) days. It did not change the number of people needing to go to hospital or take time off work.”

Reference: “Vaccines for preventing influenza in healthy adults.” The Cochrane Database of Systematic Reviews. 1 (2006).

Not in the Elderly: In a review of 64 studies in 98 flu seasons, For elderly living in nursing homes, flu shots were non-significant for preventing the flu. For elderly living in the community, vaccines were not (significantly) effective against influenza, ILI or pneumonia.

Reference: “Vaccines for preventing influenza in the elderly.” The Cochrane Database of Systematic Reviews.3 (2006).

What about the new Swine Flu shot?
Some of the new H1N1 (swine flu) vaccines are going to be made by Novartis. These shots will probably be made in PER.C6 cells (human retina cells) and contain MF59, a potentially debilitating adjuvant. MF-59 is an oil-based adjuvant primarily composed of squalene.

* All rats injected with squalene (oil) adjuvants developed a disease that left them crippled, dragging their paralyzed hindquarters across their cages. Injected squalene can cause severe arthritis (3 on scale of 4) and severe immune responses, such as autoimmune arthritis and lupus.

1. Ref: (1): Kenney, RT. Edleman, R. “Survey of human-use adjuvants.” Expert Review of Vaccines. 2 (2003) p171.
2. Ref: (2): Matsumoto, Gary. Vaccine A: The Covert Government Experiment That’s Killing Our Soldiers and Why GI’s Are Only the First Victims of this Vaccine. New York: Basic Books. p54.

Federal health officials are starting to recommend that most Americans get three flu shots this fall: one regular flu shot and two doses of the vaccine made against the new swine flu strain. School children who have never had a flu shot are targeted for four shots in the fall – twice for seasonal flu, twice for pandemic swine flu. (July 15, 2009 news)

HHS Secretary Kathleen Sebelius has been talking to school superintendents around the country, urging them to make plans to use buildings for mass vaccinations and for vaccinating kids first. (CBS News, June 12, 2009.)

Contact Dr. Ettinger @ 714-639-4360 or by e-mail –


11 steps to follow of a healthier back

by The Orange Chiropractor on July 22, 2010

Below are 11 easy steps, that if followed, will improve the overall integrity of your back while at the same time reducing the potential for the development of degenerative arthritis, low back injury and low back pain.

  1. Always warm-up and stretch before exercise or other strenuous physical activity. If you are beginning an exercise program for the first time or are starting back after a prolonged period of inactivity, begin your program with routine low-impact exercises. Yoga, swimming, speed walking, or stationary bike riding 30 minutes a day can increase muscle strength, posture and flexibility. Ask your chiropractor for a list of low-impact, ‘core stabilizing’ exercises appropriate for your age. Core stabilizing exercises focus on strengthening, in tandem, the lower back and abdominal musculature.
  2. Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
  3. At home or work, make sure your work surface is at a comfortable height for you.
  4. Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
  5. Wear comfortable, low-heeled shoes with supportive arches.
  6. Sleep on your side or back to reduce any curve in your spine. Always sleep on a firm surface.
  7. Drink eight, eight ounces of purified water each day. 75% of the weight of the upper body is supported by water volume that is stored in the disc core; 25% is supported by fibrous material around the disc. (Batmanghelidj MD)
  8. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting or when setting the object down.
  9. Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that stresses lower back muscles. Sufficient daily intake of vitamin D, magnesium, calcium and phosphorus, along with weight-bearing exercise will help promote new bone growth.
  10. If you smoke, quit. Smoking reduces blood flow and oxygen to the muscles and spine, causing the muscles and intervertebral ‘spinal’ discs to degenerate.
  11. Visit a chiropractor for routine check-ups. Keeping your spine and other joints of the body are in proper alignment and moving freely with unrestricted range of motion will reduce ware and tear by keeping the body bilateral and symmetrical; it will also promote unrestricted nerve and blood flow throughout the body


Integrative Medicine, Weight Loss, Chiropracitc and Nutrition

by The Orange Chiropractor on June 27, 2010


Integrative Medicine, Weight Loss, Chiropractic and Nutrition – Orange County, CA


Ultra Lite Program – Day 40

by The Orange Chiropractor on June 27, 2010

It’s the morning of day (40) on the Ultra Lite program and I’m now down another half pound, 14.5 lbs total weight-loss – weighing in at 160 lbs. The great thing about being a biochemist/doctor is the fact that I can use modern chemistry, anatomy and physiology to my advantage. This advantage not only helps me but every client I put on this program.

I am six days into my maintenance phase, and for the last three I have added 2 glasses of red wine a day. The reason for this is that I have not had any wine this past month and I am going on a three day wine tasting trip, next weekend. I really don’t want to be passed-out after the first hour, so I need to build-back a little tolerance to alcohol.

Here is where chemistry comes in. Bringing the body into ketosis or maintaining ketosis is only possible if the level of carbohydrates, proteins and fats ingested, being converted into glucose (blood sugar), stays below a certain threshold. I have been in ketosis for a little over five weeks now. The fact that I have stayed in ketosis even though I have had two glasses of wine the past three nights, proves that my body, especially my brain, is requiring more glucose (blood sugar) than I am providing it, through my food and beverage intake. My increased exercise, cardio and weight training, level has kept by body liberating fat, supplying ketone bodies, to compensate for the low blood glucose, even though there is the addition of the increased daily carbohydrate intake from the wine.

My energy level and clarity of thought is still the same.

I have also converted back to my morning breakfast shake, which I have had as my daily breakfast for years. Ingredients:

Whey Protein Isolate (ISO 100) – 1 Scoop
Lecithin Granules (non-GMO) – 1 Tbsp (normally 2 Tbsp)
Flax Seed Oil (organic, cold pressed) – NOT RIGHT NOW, but normally 1 Tbsp
Molecularly Distilled Fish Oil – 1 Tsp
Spirulina – 1 Tbsp
Vitamin D3 Emulsion – 6,000IU’s
Psyllium Husk Fiber – 1 heaping Tbsp
Konjac Soluble Fiber – 1 Tsp
Acai Powder, Organic Freeze Dried – 2 Tsp
Probiotic Defense, Now Foods – ½ Tsp


Ultra Lite Program – Day 34

by The Orange Chiropractor on June 27, 2010

It’s the morning of day (34) on the Ultra Lite program and I’m now down another 1lb, a total of 14lbs lost – 160.5lbs. Now is the time I move into the Ultra Lite maintenance phase. My goal is to maintain my weight, a little may be lost, while dropping body fat. Heavy weight training at the gym and lots of cardio will be the key.

The wild part of this is that I am just a few pounds shy of what I weighed my senior year of high school. The difference though is that the weight is more muscle than fat.


Ultra Lite Program – Day 27

It’s the morning of day (27) on the Ultra Lite program and I’m now down another .5lb, 13lbs total – 161.5lbs. My original goal weight was between 160-165lbs and a body fat of 10%. My estimate is that I will have to hit 155lbs to reach 10%. Diego Sanchez, watch out. January 15, 2010 – […]

June 27, 2010 Read the full article →

Ultra Lite Program – Day 25

It’s the morning of day (25) on the Ultra Lite program and I’m now down another .5lb, 12lbs total – 162.5lbs. I am totally amazed that I could drop 12lbs in just 25 days, and this is for a guy who really didn’t need to lose weight. I know people are looking for fads like […]

February 11, 2010 Read the full article →

Ultra Lite Program – Day 23

It’s the morning of day (23) on the Ultra Lite program and I’m now down 11.5lbs – 163lbs. My body fat is down to 13%. I have till March 5th to see where I’ll end-up. Then 3 days of wine tasting in Sonoma, followed by 7 days at Dreams in Puerto Vallarta. Ultra Lite when […]

February 11, 2010 Read the full article →

Ultra Lite Program – Day 19

It’s the morning of day (19) on the Ultra Lite program and I’m now down 11 lbs – 163.5 lbs. Eleven pounds may not sound like that much until you try walking around with two five pound bags of sugar, for 8 hours. Try it for just 10 minutes and see how you feel. Here […]

February 11, 2010 Read the full article →