Chiropractic Safety

Chiropractic care encompasses various non-drug and noninvasive treatments, making it one of the safest options for managing back pain, neck pain, joint pain in the arms or legs, headaches, and other neuromusculoskeletal issues. Although chiropractic treatments have a strong safety record, no healthcare intervention is entirely free of potential side effects. The risks associated with chiropractic care are minimal.

F4CP Safety Case Study

Safe and Effective

Many patients report immediate relief after chiropractic treatment, though some may experience mild soreness or aching similar to post-exercise discomfort, as well as occasional headaches or fatigue. Minor discomfort from spinal manipulation—a common chiropractic method—usually subsides within 24 hours.

Spinal manipulation is not only safe but also effective, helping patients resume their normal activities faster compared to traditional medical care alone. Research published in the Journal of the American Medical Association demonstrated that combining chiropractic care with standard medical treatment for low back pain results in more significant pain relief and disability reduction than medical care alone. Another study in the Annals of Internal Medicine found that spinal manipulative therapy and exercise are more effective for neck pain relief than pain medication.

Neck Adjustments

Chiropractors address neck pain and certain types of headaches using precise cervical (neck) manipulations, commonly known as neck adjustments. This technique enhances joint mobility in the neck, improves range of motion, and alleviates muscle spasms, thereby reducing pressure and tension. Patients often experience a reduction in pain, soreness, and stiffness, along with improved neck movement after treatment.

Cervical manipulation is very safe. Although some reports have linked high-velocity neck manipulations with a rare type of stroke due to a tear in cervical arteries, studies suggest that patients are no more likely to experience a stroke from chiropractic neck treatments than from visiting a primary care physician. The rare occurrence of such strokes is not uniquely attributable to chiropractic care and can occur spontaneously or during routine activities like turning the head while driving or swimming. The evidence shows that the risk of arterial injury from high-velocity neck manipulation is extremely low, with a review by neurologists from Penn State University concluding that no convincing evidence supports a causal link between chiropractic manipulation and cervical artery dissection.

Adding Perspective

When considering treatment options for neck and back pain, it’s important to weigh the risks associated with common alternatives such as prescription NSAIDs and opioids, which carry significantly higher risks than cervical manipulation. For example, a study in The American Journal of Gastroenterology found that about one-third of hospitalizations and deaths due to gastrointestinal bleeding are related to NSAIDs like ibuprofen. The CDC estimates that up to 25% of long-term prescription opioid users for non-cancer pain may struggle with addiction. Surgery poses risks far exceeding those of chiropractic care, and prolonged bed rest can lead to muscle atrophy, bone loss, and other complications.

A thorough review of scientific evidence indicates that chiropractic treatments, including manipulation, are supported by at least as much safety and efficacy data as other treatments like medications and surgery.

Ongoing Research

The American Chiropractic Association emphasizes that patients should be informed about the health risks of all treatments, including chiropractic care. Ongoing research involves clinical trials, literature reviews, and studies examining the benefits and risks of spinal adjustments for neck and back pain. Evidence consistently shows that chiropractic treatment carries an extremely low risk. The chiropractic profession is committed to patient safety, incorporating training and education to identify risk factors and provide effective care responsibly.

Talk to Your Doctor

When consulting a chiropractor for neck pain or headaches, provide detailed information about your symptoms to help determine the safest and most effective treatment, which may include referral to another healthcare provider. If concerns about stroke arise, discuss them with your chiropractor. Depending on your condition, they might suggest alternatives to manipulation, such as joint mobilization, therapeutic exercise, soft-tissue techniques, or other therapies.

References:

  1. Senstad O, et al. Frequency and characteristics of side effects of spinal manipulative therapy. Spine 1997 Feb 15;435-440.
  2. Goertz CM et al. Effect of usual medical care plus chiropractic care vs usual medical care alone on pain and disability among US service members with low back pain: A comparative effectiveness clinical trial. JAMA Network Open, 2018;1(1):e180105. doi:10.1001/jamanetworkopen.2018.0105.
  3. Bronfort G, Evans R, Anderson A, Svendsen K, Bracha Y, Grimm R. Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain: A Randomized Trial. Annals of Internal Medicine. 2012; 156(1):1-10.
  4. Cassidy D, et al. Risk of Vertebrobasilar Stroke and Chiropractic Care. Spine 2008; 33:S176–S183.
  5. Haldeman S, et al. Arterial dissection following cervical manipulation: a chiropractic experience. Can Med Assoc J 2001;165(7):905-06.
  6. Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh RE. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus. 2016 Feb 16;8(2):e498. doi: 10.7759/cureus.498. PMID: 27014532; PMCID: PMC4794386.
  7. Lanas A, et al. A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with nonsteroidal anti-inflammatory drug use. Am J Gastroenterol 2005;100:1685–1693.
  8. Boscarino JA. Risk factors for drug dependence among outpatients on opioid therapy in large US health-care system. Addiction. 2010 Oct;105(10):1776-82. doi: 10.1111/j.1360-0443.2010.03052.x. Epub 2010 Aug 16.
  9. Lauretti W. “The Comparative Safety of Chiropractic.” In Daniel Redwood, ed., Contemporary Chiropractic. New York: Churchill Livingstone, 1997, p.230-8.
  10. Hurwitz E, et al. Treatment of neck pain: noninvasive interventions. Spine 2008;33(4S):S123-S152.

Source

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