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Side Effects of Chiropractic Treatment

An increasing number of studies have been done in the last few years on both the effectiveness and safety of chiropractic manipulation:

"It is now documented that spinal manipulation may have a positive effect on some back problems. Consequently, its use has been recommended as a clinically effective and economically useful method of treatment. The rate of serious accidents after spinal manipulation performed by chiropractors has been reported in the literature as very low. The most serious accidents are those affecting the cerebral blood supply, because they can have serious, permanent or even lethal consequences. American insurance data2 indicates that the incidence of stroke is one per 2 million treatments of the neck, whereas a Danish study3 using several sources for ascertainment arrived at an estimate of one irreversible cerebrovascular accident per 1.3 million treatments of the neck." 1

This study1 set out to assess the "common" and "abnormal" side effects following spinal manipulation. The researchers recorded the "self-reported unpleasant reactions" of 625 patients (1,858 visits), as well as the time of onset, duration, and severity of the symptoms.

In all, about half of the patients reported some type of symptom. "Reactions to spinal manipulation are common and benign. They typically arise and disappear shortly after treatment (usually gone the day after treatment). The most common reactions are local discomfort in the area of treatment (two thirds of reactions), followed by pain in areas other than that of treatment, fatigue or headache (10% each). Nausea, dizziness or 'other" reactions are uncommonly reported (<5% of reactions)."

  1. Leboeuf-Yde C, Hennius B, Rudberg E, et al. Side effects of chiropractic treatment: a prospective study. Journal of Manipulative and Physiological Therapeutics 1997;20(8):511-515.
  2. Klougart N, Leboeuf-Yde C, Rasmussen LR. Safety in chiropractic practice. Part I: The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988. Journal of Manipulative and Physiological Therapeutics 1996;19:371-377.
  3. Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. Journal of Manipulative and Physiological Therapeutics 1995;18:530-536.