Chiropractic adjustments involve practitioners using their hands or instruments to apply controlled force to a joint, often in the spine. This aims to improve motion and alleviate discomfort. Concerns exist regarding potential adverse effects. This article explores reported outcomes, both minor and rare serious complications, from an evidence-based perspective.
Understanding Potential Adverse Events
Chiropractic adjustments can lead to various outcomes, from mild, temporary discomfort to rare, more serious complications. Common minor effects include localized soreness or aching in the treated area. This discomfort resolves within 24 to 48 hours. Other mild reactions include headaches, neck pain, fatigue, or temporary dizziness. These minor side effects are short-lived.
While minor reactions are common, rare but serious adverse events have been reported. These include a type of stroke from vertebral artery dissection, particularly after high-velocity neck manipulation. This involves a tear in an artery’s inner lining, leading to a blood clot and stroke. Other rare complications involve worsening a herniated disc or nerve compression. Improper adjustments could exacerbate existing conditions or cause new nerve damage.
Assessing the Likelihood of Damage
The incidence of serious adverse events following chiropractic adjustments is exceedingly low. The risk of stroke associated with neck manipulation is rare. Research indicates the stroke risk difference is small between individuals visiting chiropractors for neck pain and those seeing primary care physicians for similar pain. One estimate suggests a vertebrobasilar artery stroke incidence of about one case per 5.85 million manipulations. Other analyses place the risk of serious adverse events, including stroke, between 0.05 to 1.46 per 10 million manipulations.
For disc herniation, studies suggest the risk of spinal manipulation causing worsened herniation or cauda equina syndrome (a serious condition affecting lower spine nerves) is less than 1 in 3.7 million for lumbar disc issues. Individuals with neck or back pain, potentially symptoms of a developing disc herniation, often seek care from various practitioners, including chiropractors, before the condition fully manifests. Evidence indicates the risk of acute lumbar disc herniation after chiropractic visits is not higher than after primary care physician visits.
No medical procedure is entirely without risk. However, the safety record of chiropractic care is favorable.
Prioritizing Patient Safety
Reputable chiropractors implement several measures to minimize risks and prioritize patient safety. A thorough patient history review gathers information about past medical conditions, current symptoms, and any pre-existing health concerns. This is followed by a detailed physical examination, focusing on the spine and musculoskeletal system. In some cases, diagnostic imaging, such as X-rays, may be utilized to gain a more comprehensive understanding of the patient’s condition and to identify any contraindications for adjustment.
Informed consent is an important part of the process, ensuring patients understand the proposed treatment plan, its potential benefits, and any associated risks, including rare serious complications. Open communication between the patient and chiropractor is encouraged throughout care.
Patients play an active role in their safety by openly communicating their medical history, including any underlying conditions like severe osteoporosis, a history of stroke, or specific neurological symptoms. They should also report any new or worsening symptoms during or after treatment. Choosing a licensed, experienced, and reputable practitioner is important, as proper training and adherence to safety protocols reduce adverse events. These measures contribute to a safer environment for those seeking chiropractic care.