Chiropractic care, often involving spinal manipulation, is a widely sought-after approach for musculoskeletal concerns like back and neck pain. While generally considered safe for most individuals when performed by trained and licensed practitioners, chiropractic adjustments, like any healthcare intervention, are not without potential, though rare, adverse effects. Understanding these potential outcomes helps patients make informed decisions about their care.
Temporary Discomfort Versus Serious Complications
Following a chiropractic adjustment, some individuals may experience mild and temporary side effects. These common reactions are typically not serious and indicate the body’s adaptation to treatment. Most frequently reported sensations include localized soreness or stiffness in the treated area, similar to muscle soreness after a new exercise routine. This discomfort usually resolves within 24 to 48 hours as muscles and joints adjust.
Other transient effects include fatigue or tiredness, lasting about a day, and mild headaches. Less than 5% of individuals might report temporary dizziness or faintness, often due to the nervous system’s response to spinal alignment changes. These minor reactions are considered normal and are predictable physiological responses to spinal manipulation.
Identifying Specific Concerns
While minor discomfort is common, more serious complications are exceedingly rare but have been associated with chiropractic care. One discussed concern is vertebral artery dissection (VAD), which can lead to a stroke. This occurs when a tear in the inner lining of the vertebral artery in the neck allows blood to enter the arterial wall, forming a clot that can impede blood flow to the brain. Symptoms of VAD include a sudden, severe headache unlike any experienced before, new neck pain, dizziness, blurred vision, or signs of stroke like weakness or difficulty speaking.
Research indicates the incidence of VAD after cervical manipulation is extremely low, estimated at 1 in 5.85 million to 1 in 8.06 million cervical manipulations or office visits. Some studies suggest the association might be coincidental, where individuals with early dissection symptoms (like neck pain or headache) seek chiropractic care just before a stroke fully manifests. The risk of VAD is comparable to that associated with routine activities or primary care physician visits.
Another rare but serious complication is cauda equina syndrome (CES), a medical emergency from compression of nerve roots at the base of the spinal cord. This condition can cause severe lower back pain, radiating leg pain, numbness in the groin and genital area (saddle anesthesia), and loss of bladder or bowel control. While case reports have linked CES to spinal manipulation, recent large-scale studies suggest chiropractic spinal manipulation is not a direct risk factor. Instead, patients with pre-existing low back pain may have an elevated risk of CES independent of treatment.
Disc herniation or worsening of an existing herniated disc is another potential, rare concern. A herniated disc occurs when the soft inner material of a spinal disc pushes through its outer layer, potentially compressing nerves. While chiropractic care is often sought for disc-related pain, in rare instances, manipulation could exacerbate an existing herniation or contribute to a new one. Symptoms of a herniated disc include pain, numbness, tingling, or weakness in the affected limb. Nerve impingement or damage, separate from dissection or CES, can occur, leading to persistent pain, numbness, tingling, or muscle weakness.
Steps for Patient Safety
Patients can take steps to minimize potential risks associated with chiropractic care. Selecting a qualified and licensed chiropractor is paramount, as proper training and certification contribute to treatment safety. Verify a practitioner’s credentials and ensure they are licensed in your region. A thorough initial consultation should include a review of your medical history.
Communicating all existing health conditions, past injuries, and current medications to the chiropractor is crucial. This information allows the practitioner to identify contraindications or modify treatment approaches to suit your health profile. Patients should ask questions about the proposed treatment plan, including techniques and expected outcomes. Understanding the procedures can help build trust.
During and after treatment, report any unusual sensations, discomfort, or unexpected symptoms to the chiropractor immediately. This open communication allows for prompt assessment and adjustment of treatment if necessary. If uncertain about a recommended treatment plan, seeking a second opinion from another healthcare professional can provide reassurance and perspective.
Recognizing When to Seek Medical Attention
Understanding when to seek immediate medical attention after a chiropractic adjustment is important, even though serious complications are rare. Certain “red flag” symptoms are not typical post-adjustment soreness and could indicate a more serious underlying issue requiring urgent evaluation. This prompt action can help prevent further complications.
Patients should seek immediate medical help if they experience a sudden, severe headache unlike any they have had before. Other concerning symptoms include new or worsening dizziness accompanied by nausea, vomiting, or blurred vision. The sudden onset or worsening of weakness, numbness, or tingling in the arms or legs, especially if it affects both sides of the body, warrants immediate medical consultation.
Difficulty walking, loss of balance, or problems with coordination that were not present before the adjustment are also significant warning signs. Furthermore, any new or worsening issues with bowel or bladder function, such as incontinence (inability to control) or retention (difficulty emptying), are considered medical emergencies and require immediate professional medical assessment.