Stroke and Spinal Manipulation A recent article in The Annals of Internal Medicine reviewed 39

studies showing that spinal manipulation, the most commonly practiced chiropractic procedure, was no more effective than cheaper alternatives, such as exercise (Assendelft, Morton, Yu, Suttorp, & Shekelle, 2003). Roughly 3 % to 11 % of Americans visit a chiropractor every year. It has been estimated that by the end of this decade the United States will have approximately 100,000 chiropractors. The Institute for Social Research at Ohio Northern University performed a survey of North American chiropractors, which found that adjustments were believed to improve conditions such as tension headaches, migraines, otitis media, and asthma. Spinal manipulation is provided at every visit by 54.3 % of chiropractors. The general perception is that spinal manipulations are believed to help visceral conditions by 62.1 % of North American chiropractors. The inherent risk to providing spinal manipulation, such as stroke, paralysis, an