Answers to Questions about Chiropractic:
Can Neck Adjustments Relieve the
Pain of a Chiari Malformation?

Samuel Homola, D.C.

Question

Thank you for a wonderfully written article ["Is the Chiropractic Subluxation Theory a Threat to Public Health?" in Scientific Review of Alternative Medicine, Vol. 5, No. 1, 2001] about the possible dangers of the overuse of chiropractic. I suffered a major health decline from this therapy.

I have a rare disorder called Chiari malformation which causes the lower part of the brain (cerebellum) to push down into the top of the spinal canal. This causes many symptoms, as can be seen on the Web site of the World ACM Association (WACMA). I also had syringomyelia, a disorder in which a cavity of fluid forms in the spinal cord.

I was diagnosed with Chiari malformation but my chiropractor looked at the MRI, chose to disregard it, and continue neck manipulation at 3 times a week for 8 months. At the end of the treatment, my cerebellar tonsils had descended from 3-4 mm to 15-20 mm. When I began treatment, my symptoms were mainly right arm weakness spreading to the left. At the end of treatment, my symptoms had greatly increased to include partial paralysis of both arms and legs, breathing problems, lessening of bladder control, and excruciating pain. My MRI documents how the cerebellar tonsils moved downward during the 8-month period, something that usually takes years to occur.

I believe the overuse of this treatment led to my quick decline and, as the number of visits increased, so did my symptoms. The WACMA site contains reports from people who describe how they suffered the same fate, even though they could not document it on MRI. Others report a more limited experience with chiropractic that did not cause harm that they know of or can document. In lieu of serious studies on the use of chiropractic for Chiari malformation—or for that matter any major neurological disorder—there appears to be great risk with such liberal use of neck manipulation. The general medical community knows little about this disorder, and nobody seems to be trying to educate chiropractors who stubbornly regard spinal manipulations as a cure-all.

The only thing that relieved my symptoms was surgery. I would have loved for a more alternative treatment to work, but nothing helped me outside the surgery. Because of the extent of the nerve damage, recovery for me was extremely slow and I suffered a great deal of pain. The pain took two years to go away. I still have residual problems because of the nerve damage, but there is no doubt that surgery was a resounding success as it saved me from a wheelchair or worse.

I wanted to let you know my story and thank you for the article. Because Chiari malformation patients have a rare disorder that the public and even the medical community know little about, we are at great risk in the hands of an aggressive chiropractor, especially one who is not associated with the mainstream medical community.

Answer

Barbara, thank you for sharing your story. It clearly demonstrates the importance of diagnosis and the danger of inappropriate neck manipulation. The weakness in your arms was a clear contraindication for neck manipulation. You are correct that there is great risk from the treatment of chiropractors who believe that neck manipulation is a cure-all.

Although many chiropractors do a good job caring for back pain, the average person is unable to distinguish a good chiropractor from a bad one. For this reason, stories such as yours can do a lot to help others avoid the mistreatment you suffered. In reading of your experience, my heart goes out to you. I can see that you are making good use of your bad experience by telling your story and reaching out to others who are suffering.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on February 22, 2002.