Chiropractors often argue that this education is as good as or better than medical physicians', but most chiropractic training is confined to classrooms with much time spent learning theory, adjustment, and marketing.[65] The fourth year of chiropractic education persistently showed the highest stress levels.[188] Every student, irrespective of year, experienced different ranges of stress when studying.[188] The chiropractic leaders and colleges have had internal struggles.[189] Rather than cooperation, there has been infighting between different factions.[189] A number of actions were posturing due to the confidential nature of the chiropractic colleges in an attempt to enroll students.[189][clarification needed]
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age,[147] but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions.[146][148] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS.[149] There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke.[15] While the biomechanical evidence is not sufficient to support the statement that CMT causes cervical artery dissection (CD), clinical reports suggest that mechanical forces have a part in a substantial number of CDs and the majority of population controlled studies found an association between CMT and VAS in young people.[150] It is strongly recommended that practitioners consider the plausibility of CD as a symptom, and people can be informed of the association between CD and CMT before administrating manipulation of the cervical spine.[150] There is controversy regarding the degree of risk of stroke from cervical manipulation.[15] Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven.[17] However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable[17] or definite.[16] There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation.[151] The incidence of internal carotid artery dissection following cervical spine manipulation is unknown.[152] The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke.[153] The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension.[154] Cervical intradural disc herniation is very rare following spinal manipulation therapy.[155]

Chiropractic Physician serving the Miami community for over twenty years.Whether you have an illness, pain, suffered a sport injury or an accident(auto mobile, work or slip and fall) or just want to approach health in a proactive way(wellness mentality) we are here to help you achieve your goals toward a healthy future. Neuropathy and weight loss programs.
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives. 
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