Safety of Chiropractic Treatment

For those of you into facts and figures, I go into a bit more detail in the text below than in the video.

Although chiropractic treatment overall is as safe or safer than pretty much any other health care intervention (including the use of over the counter medications), there are a few risks.

Although most people fearful of chiropractic are concerned about being injured by an adjustment, by far the most common cause of malpractice cases against chiropractors is the failure to make a timely diagnosis and referral for medical treatment of a serious underlying health condition, such as cancer or heart disease.

I definitely do my best to be vigilant for the signs of such health threats and refer patients promptly for diagnostic workup and treatment when appropriate.

A common fear people have about chiropractic adjustments, particularly of the neck, is that the chiropractor will break their spine.

This is not actually something that’s been documented to happen except in extremely rare cases – typically in which the patient has been involved in a major traumatic accident and it’s most likely that the fracture was already present and was displaced, not actually caused, by the chiropractor’s adjustment.

Although television shows and movies make it look easy to break someone’s neck, it actually requires a large amount of force – much more force than chiropractors use when adjusting someone.

Even so, it’s important to tell your chiropractor about any injuries, traumas, and symptoms you might be having so that appropriate precautions can be taken during your evaluation and treatment.

Probably the most serious legitimate risk of chiropractic treatment itself is possible injury to the vertebral artery in the neck that can lead to a type of stroke.

Despite the tendency for chiropractic critics to imply this to be a common occurrence, the actual statistics from various studies place the risk at about 1 out of every 20,000 manual adjustments of the cervical spine.

I emphasized manual and cervical because low-force instrument-assisted adjustments of the neck have no documented risks of such strokes, nor is there any such risk of stroke from adjustments performed on other areas of the spine.

As a point of comparison, the estimated risk of actually dying from the use of over the counter pain relievers such as Ibuprofen each year is also about 1 in 20,000 (35-118 deaths per million, depending on the particular medication – see reference here).

Even with manual adjustments, the primary risk comes from extension (backward bending) and rotation of the neck.

These positions/movements have been known to produce strokes in settings outside of chiropractic treatment as well, such as with people having their hair washed at a salon, or turning their head quickly to look for traffic when driving.

Because of the potential issues with extension and rotation, I use a manual adjusting technique that minimizes these motions and reduces the small risk even further.

That said, if you’re concerned about the risk posed by neck adjustments but still want chiropractic treatment, I am happy to use low-force methods or avoid adjusting the cervical spine altogether to eliminate the risk.

This might slow down your progress somewhat, but we can usually still get the job done.

Other rare, but serious risks from chiropractic treatment can include things like broken ribs and fractures of other bones, especially when there was pre-existing trauma, tumors, or severe osteoporosis.

Likewise, aggravation of symptoms associated with pre-existing disc protrusions has also been known to occur.

By far the most common adverse events related to chiropractic treatment are temporary post-treatment muscle soreness and occasionally headaches associated with changes in mechanical function of musculoskeletal structures.

To give you a better idea of what the risks are in a real-world setting, I’ve been in practice for over thirty years now and I modify my treatment as needed to keep it as safe as possible for each patient.

I am very thankful to say that I have had a grand total of zero vertebral artery strokes, nor have there been any other serious adverse effects from my treatments over the course of my career.

The worst that’s been reported to me is the occasional case of muscle soreness lasting a few days to a week and there’s only a few of those that have really been bothersome to the patients involved – “a few” meaning I can count them on one hand in a given year.

As one particularly sore patient put it some years ago, he felt like he’d been hit by a truck for a week, but after that, he felt great!

Other than that, I’ve treated patients of all ages, and with a variety of health issues, including severe osteoporosis and even advanced bone cancer in the spine, all without any serious ill-effects.

Could that change at any time?

Unfortunately, the answer is yes.

No form of health care is completely risk-free and no health care provider is perfect, including me, but I do my best to provide care that’s both safe and effective and I think my track record indicates that.