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Chiropractic Safety

How safe is chiropractic?

Chiropractic is recognized as one of the safest types of health care in the world. Numerous studies, including those funded by governments, universities and nonprofit research institutions, have proven it to be a successful primary therapy for neuromusculoskeletal conditions -- a therapy that is safer, in fact, than most medical procedures used to treat the same conditions. Chiropractic is also widely used as a complementary mode of care for a variety of other conditions and diseases and to promote overall health and well-being.

Is there a connection between stroke and chiropractic treatment?

Would you think twice about cradling the phone on your shoulder, checking your blind spot while backing into a parking space or getting your hair shampooed at a salon? The risk of stroke from chiropractic care is no greater than it is from any of these everyday activities.

The source of public concern in this regard is a condition known as vertebral artery syndrome (VAS), which occurs when sudden head movements disrupt the blood flow in the vertebral artery, possibly leading to stroke. As the above examples illustrate, the risk of this complication arising from upper cervical (or neck) manipulation by a chiropractor is extremely remote. According to the 1996 RAND report, "The Appropriateness of Manipulation and Mobilization of the Cervical Spine," only one out of every one million chiropractic patients experiences VAS. To put it another way, you are five times more likely to get hit by lightning than to suffer VAS at the hands of a chiropractor.

Up to 75% of chiropractic patients receive cervical manipulation as part of their individual chiropractic care. It may be performed as part of your care for total spinal health and wellness, or for specific causes such as muscle tension and stiffness, headache or injury. After a detailed history and examination, if there is any indication that you would be at risk, your chiropractor will not include a neck adjustment in your treatment.

How does the safety of chiropractic compare to other medical procedures?

In comparison to allopathic medicine, which uses drugs and surgery as an integral part of treatment, chiropractic presents far less risk. Consider, for example, that in the United States an estimated 140,000 people die each year from drug-related reactions. And the risk of death due to gastrointestinal complications from taking non steroidal anti-inflammatory drugs such as aspirin and ibuprofen is 400 times greater that the complication rate for people who receive cervical manipulation, while the mortality rate for people who undergo cervical spine surgery is 7,000 times higher.

Human error is another factor that tilts the safety balance in chiropractic's favor. In the United States, it is estimated that up to 98,000 Americans die yearly from medical errors -- a doctor accidentally making the wrong incision, a nurse administering the wrong medication, and so on.

But with all forms of treatment, whether allopathic or alternative, any risks, however slight, should not be ignored. While the methods used by chiropractors have proven to be safe in almost all cases, it is a constant concern for chiropractors to evaluate their patients to determine if treatment will cause an adverse reaction.

Can chiropractic adjustment damage your joints?

The answer is no. What's more, most chiropractic adjustments are painless. Often, the adjustment may feel good and can provide immediate relief from stiffness or tension.

While some people may get nervous about the "pop" that an adjustment can produce, the sound is not coming from the bones themselves. It's coming from a lubricant called synovial fluid that's found in every joint. That fluid contains dissolved gases. Separating joints creates pressure, which forces the gases to rapidly escape, creating the "pop."

You may have some discomfort during an adjustment, however, if you've had a recent injury, as adjustments can irritate inflamed tissue. As your body heals this should stop. Some people also experience odd sensations in their extremities after adjustments. This is a normal reaction to the relieving of pressure on nerves and is usually no cause for concern.

Can chiropractic adjustment lead to arthritis?

There is no evidence to suggest that chiropractic care and manipulation of the spine can lead to arthritis. On the contrary, chiropractors often care for people with arthritis by maintaining joint health. However, concern has been raised over the safety of people who try to adjust themselves, by cracking their own knuckles, for example. While people might have the right idea by trying to relieve pressure on the joints, only chiropractors can ensure an adjustment is performed safely, without possibly weakening or causing harmful friction to surrounding joint structures. The best advice: Don't try to do it yourself. Seek the expertise of your chiropractor.

Do chiropractors refer patients to other specialists?

Like other doctors, chiropractors belong to a large and growing network of health-care professionals and make referrals for patients when necessary. Chiropractors are well educated to recognize risk factors and signs of disease and will not hesitate to make a referral when it's in a patient's best interest.

References

Zuber, M., J. Meder and J. Moss. "Cartoid Artery Dissection due to Elongated Styloid Process." Neurology (Nov. 1999).

U.S. Department of Health and Human Services. "Chiropractic in the United States: Training, Practice and Research," Dec. 1997.

Coulter, I., E. Hurwitz, A. Adams, W. Meeker, D. Hansen, R. Mootz, P. Aker, B. Genovese and P. Shekelle. "The Appropriateness of Manipulation and Mobilization of the Cervical Spine." Santa Monica: RAND, 1996.

Shekelle, P. G., E. Hurwitz, I. Coulter, A. Adams, B. Genovese and R. Brook. "The Appropriateness of Chiropractic Spinal Manipulation for Low-Back Pain." Santa Monica: RAND, 1996.

Dabbs, V. and W. Lauretti. "A Risk Assessment of Cervical Manipulation v. NSAIDs for the Treatment of Neck Pain." Journal of Manipulative and Physiological Therapeutics, Vol. 18 (1995): 530-36.

Carson, J.L. and L.R. Willett. "Toxicity of Nonsteroidal Anti-inflammatory drugs: An Overview of the Epidemiological Evidence." Drugs, Vol. 46 (1993): 243-248.

Weintrob, M. "Beauty Parlor Stroke Syndrome: Report of Five Cases." Journal of the American Medical Association (1993): 2085-86.

Manga, Pran, D. Angus, et al. "The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain." Ottawa: University of Ottawa, 1993.

Gabriel, S.E., L. Jaakkimainen and C. Bombardier. "Risk for Serious Gastrointestinal Complications Related to the Use of Nonsteroidal Anti-inflammatory Drugs: A Meta Analysis." Annals of Internal Medicine, Vol. 115 (1991): 787-796.

Hasselberg, P.D., Report of the Commission of Inquiry. "Chiropractic in New Zealand." Wellington, 1979.

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