JMPT released a study this fall that every chiropractor, osteopath, and defense attorney should have in their malpractice defense file. The often-too-common scenerio feared by many a manipulator is a patient who comes in with neck pain, gets adjusted, and calls the next day complaining of shooting pain in the arm that 'wasn't there' before. Especially in litigious America, these cases find their way into courtrooms and generally end with ill feelings on one side or the other (not to mention the occasional dirty look at the grocery store... these people generally do have to live in the same town, afterall).
This case report by Murphy and Beres describes a patient who was referred by a neurosurgeon for nonsurgical treatment for a disc herniation in his neck with no myelopathy (nerve damage). Ten days later and before his appointment with the practitioner, the symptoms of myelopathy (such as numbness, burning, or tingling in the arms) began. The article suggests that the rush to blame the chiropractor for instigating nerve damage after adjusting a herniated area may not be such an open-and-shut scenario. In this case the myelopathy began between the initial neurological consult and the first adjustment as a natural course of the disease process. While it may not happen with every herniation, Murphy and Beres do present a very real case of how a non-emergency neck problem can turn south without anything being done to provoke it. One study alone will not exonerate a practitioner, but a combination of clear communication, solid documentation, and pieces of evidence like this may prevent feelings of resentment between doctors and patients if it were ever to happen again.
Reference:
Murphy DR, Beres JL (2008). "Cervical Myelopathy: A Case Report of a “Near-Miss” Complication to Cervical Manipulation." Journal of Manipulative and Physiological Therapeutics 31 (7), pp 553-557.
