While serious adverse events, including fatalities, have been reported in connection with chiropractic adjustments, such occurrences are exceedingly rare. The vast majority of chiropractic interventions are performed without incident, and most patients experience either improvement or mild, temporary side effects. A balanced understanding of chiropractic care involves recognizing both its general safety profile and the statistical rarity of severe complications.
What is a Chiropractic Adjustment?
A chiropractic adjustment, also known as spinal manipulation, is a therapeutic procedure involving controlled force applied to a spinal joint. The primary goal of this technique is to improve joint motion, reduce nerve irritation, and enhance overall spinal function. Practitioners typically use their hands or a small instrument to deliver a precise, high-velocity, low-amplitude thrust to a specific spinal segment. This controlled force helps to restore proper alignment and movement to the vertebrae.
During an adjustment, patients often hear a “popping” sound, which is simply the release of gas from the joint capsule, similar to cracking knuckles. While manual thrusts are common, some chiropractors may use instrument-assisted techniques that involve less force.
The General Safety of Chiropractic Care
Chiropractic care is widely considered a generally safe therapeutic option for musculoskeletal conditions, particularly back and neck pain. When performed by a licensed and qualified practitioner, the risks associated with spinal manipulation are typically low. Many studies and reviews indicate that the most common side effects are mild and temporary. These minor reactions can include localized soreness, stiffness, or a mild headache following the adjustment.
These temporary symptoms usually resolve within 24 to 48 hours without any specific intervention. The overall incidence of serious adverse events is very low.
Understanding Extremely Rare Serious Risks
While generally safe, it is important to acknowledge that extremely rare, but serious, adverse events have been reported following chiropractic adjustments. The most significant of these rare risks, particularly associated with cervical (neck) adjustments, involves vertebral artery dissection (VAD). This condition occurs when a tear forms in the wall of a vertebral artery, which supplies blood to the brain. Such a tear can lead to the formation of a blood clot, potentially resulting in a stroke.
Estimates for the incidence of VAD leading to stroke after cervical manipulation vary, but they are consistently reported as extremely low. The exact causal relationship is complex and debated, as VAD can also occur spontaneously or from everyday activities like coughing or sudden head movements. However, the temporal association between some cervical adjustments and VAD events has led to continued caution and research.
Other very rare, but serious, complications can occur, though less frequently than VAD. Cauda equina syndrome (CES), a neurological condition affecting the nerve roots in the lower back, has been rarely reported following lumbar (lower back) adjustments. This syndrome, characterized by severe low back pain, numbness in the saddle area, and loss of bowel or bladder control, necessitates immediate medical attention to prevent permanent damage. Additionally, pre-existing conditions, such as severe osteoporosis, spinal tumors, or certain vascular anomalies, can heighten the risk of adverse events, making careful patient screening essential.
How to Ensure Safe Chiropractic Care
To help ensure a safe chiropractic experience, patients can take several proactive steps. First, selecting a licensed and appropriately credentialed chiropractor is important. Verifying their qualifications and good standing with their regulatory board ensures they meet necessary professional standards.
Second, providing a complete and accurate medical history to the chiropractor is important. This includes disclosing any pre-existing conditions, current medications, recent injuries, or any symptoms. A comprehensive understanding of the patient’s health allows the chiropractor to identify contraindications or modify treatment approaches to minimize risks. Open communication about any concerns or anxieties regarding the adjustment is also important.
Patients should actively engage in understanding their proposed treatment plan. Asking questions about the specific techniques that will be used, the expected outcomes, and any potential side effects can empower patients to make informed decisions.
Finally, it is important to be aware of red flag symptoms that warrant immediate medical attention after an adjustment. These include a sudden, severe headache, dizziness that doesn’t improve, numbness or tingling in arms or legs, difficulty speaking or swallowing, or sudden weakness on one side of the body. Promptly reporting such symptoms to a medical professional is advised.