Are Chiropractic Adjustments Safe?
/By Dr. Kelli
You’ve suffered from debilitating migraines for as long as you can remember. After a dreadfully long day of dealing with clients in the office, the pounding in your heard starts as abruptly as, yet, another ring of the phone. You’re venting to your colleague and they say, “I’m telling you…go see a chiropractor! It will help!”
You want relief but you’ve heard conflicting things about Chiropractic and you just don’t know if it’s safe…not to mention the thought of someone cracking your neck sends chills down your spine.
I hear you. You’re not alone.
“Is it safe?” is probably the most frequently asked question when it comes to chiropractic care and it is a good question. When seeking out treatment options you should 100% be asking those type of questions because YOU are the best advocate for your health and for your families health. So don’t be afraid to ask if it’s safe, what the risks are, what benefits it provides, or if there are any contraindications. In fact, I encourage it. I want you to make an informed decision. My goal as a healthcare provider is to educate and empower you to take control of your health so that you can live a life fully connected in mind, body and soul.
Alright, let’s talk chiropractic!
In chiropractic school we have 10 trimesters. Trimesters 1-3 were spent studying fundamental sciences and the basics of adjusting (how the joints move, what muscles they attach to, direction of movement, etc.) Trimesters 4-7 we moved on to more advanced courses and started learning hands-on adjusting. As you can probably imagine, practicing an adjustment on anything other than a living, breathing human being would be a tricky task. So we practiced on each other- our classmates. I say this because no one *really* knew what they were doing back then and experience was severely lacking but it was OK because we understood that chiropractic is safe.
HISTORY & EXAM
Before we get to the adjustment itself, I want to talk about what happens before an adjustment because it’s an important piece to understanding the safety of chiropractic.
Prior to that first adjustment, a thorough history and examination should always be performed to determine whether the patient is a good candidate for chiropractic care. At that point we can exclude any anatomical or neurologic anomalies that may require additional testing or referral to another provider. Additionally, it allows us to identify any red flags or contraindications, which include certain neurological conditions, cancers, fractures etc. In terms of safety, the purpose of the history and examination is to rule out ANY reason that manual adjusting may result in a negative outcome.
Only after it’s determined that the patient is a good candidate for care is an adjustment administered.
RISKS OF ADJUSTMENTS
Every single action we take has risks, whether you are commuting to work or taking Tylenol to relieve a headache. The important thing to consider is the risk to benefit ratio. We determined at some point in our life that the risk of getting into an accident while driving to work is offset by the benefit of having a job and providing for your family. So, every day we drive to work even though >40,000 people died in automobile accidents in 2020. The same goes for chiropractic adjustments--the benefits far outweigh the (rare) possible risks associated with it.
Adverse events is the term that medical research uses to describe negative side-effects. What research shows is that the risk of major adverse events with manual therapy (adjustments) is very low. When these rare risks do occur they typically include exacerbation of a slipped or herniated disc, spinal nerve compression and, in very rare cases, vertebral artery dissection (stroke). Again, when these occur, it is normally with patients who have pre-existing conditions. This brings home the point of why the history and exam are so important. Keep that in mind the next time you are frustrated completing pages of paperwork or when your chiropractor is asking you questions that you think are irrelevant to your complaint…there is a reason for the madness!
I know stroke is a big concern for a lot of people so I’ll touch on it here. Research has shown that people go to chiropractors with pain from a stroke in progress as opposed to a chiropractor actually causing the stroke. This is because stroke via vertebral artery tear is accompanied by severe head and neck pain, so guess who these patients go to see first? That’s right, the chiropractor. Additionally, a major study in Canada found that, statistically, patients were at higher risk of having a stroke after seeing their medical doctor than from seeing a chiropractor. Yet again, this is likely due to the fact that when they go to see their provider the stroke is already in progress. I’m going to sound like a broken record here but this is why chiropractors are trained to recognize stroke presentation and other red flags in the history and exam to keep you safe!
SIDE EFFECTS
If there is a reaction to the adjustment it is usually mild-moderate and lasts 24-48 hours including things like muscle soreness, stiffness, headache, local discomfort, radiating discomfort, and fatigue. I’ve found this to be consistent with my own personal experience. I have adjusted thousands of people and only a handful reported mild soreness after the adjustment. More often, they report side effects like less pain, better sleep, improved mobility, and decreased stress/tension.
Compare the side effects and risks of spinal adjustments with those of common over-the-counter NSAIDs and you might be surprised to find that chiropractic care is significantly less risky and, oftentimes, results in the same or better pain relief outcomes.
SO ARE ADJUSTMENTS SAFE?
Numerous research studies regarding the safety of manual adjustments have been performed over the years and the results remain consistent: Chiropractic is safe.
Every industry has their own horror stories and chiropractic is no different. However, that is the exception, not the rule. An estimated 35 million Americans receive chiropractic care annually and they consistently experience less spinal pain, headaches, stress, fatigue, trouble sleeping, ear infections, and more.
Take a look at some of our other posts to learn more about chiropractic and why you might want to get your spine checked!
Chiropractic and The Nervous System
How much schooling does a chiropractor need to have?
I’ve Never Been to a Chiropractor…What should I expect on the first visit?