Is Chiropractic Safe?
What can go wrong, how often, the stroke question, and how we decide when not to adjust.
The short answer
For most people with back and neck pain, chiropractic care is safe when it follows a proper exam. The most common side effect is short-lived soreness. Serious problems are rare. The stroke concern is real but very rare, and a large population study found no higher stroke risk after seeing a chiropractor than after seeing a family doctor. Some people should not have certain adjustments, which is why the exam comes first.
What side effects are common
Mild soreness or stiffness for a day or two after treatment is the most common side effect, similar to how muscles feel after new exercise. It usually fades on its own. Tell us if it does not, because it changes what we do next.
Can a chiropractor make a herniated disc or pinched nerve worse?
It can happen if a disc or nerve problem is missed and treated the wrong way. That is the main reason we examine your nerves (strength, reflexes and sensation) before treating, and why we read your MRI ourselves when you have one.
For a disc herniation, we choose techniques that do not load the injured disc, and we stop and refer you if your nerve signs get worse. Most disc herniations improve without surgery; see what to do if your MRI shows a herniated disc.
Can a chiropractor cause a stroke?
This is the most common worry, so here is what the best evidence shows. A rare type of stroke can follow a tear in an artery in the neck (a cervical artery dissection). Early on, a tear like this often causes neck pain or a headache, which is exactly what sends people to a chiropractor or a family doctor.
A study of the entire population of Ontario, Canada, over nine years found 818 of these strokes across more than 100 million person-years, which is extremely rare. People under 45 who had the stroke were more likely to have seen a chiropractor beforehand, but they were just as likely to have seen a family doctor. The researchers concluded that people with an early, undiagnosed artery tear were seeking care for the neck pain it caused, and they found no evidence of excess risk from chiropractic care compared with primary care.
We still take it seriously. We screen for warning signs of an artery problem before any neck treatment, and we use gentle, non-thrust techniques for anyone who prefers them.
Who should not have certain adjustments
- Signs of fracture, spinal cord compression or worsening nerve loss
- Warning signs of an artery problem in the neck
- Severe osteoporosis, some inflammatory arthritis, or recent spine surgery at that level
- Fresh car-crash injuries that have not been screened for instability
Many of these patients can still be helped with gentle mobilization, soft-tissue work and exercise. Some need a different specialist first, and we will tell you when that is the case.
How we keep care safe
Every new patient gets a history and an orthopedic and neurological exam before treatment. We take X-rays when the exam calls for it, not by routine. You can always ask for a gentler, non-thrust approach, including for your neck. We re-test you about every 4 weeks with the same measurements we took at the start. If you are not measurably better, we change the plan or refer you to the right specialist. We do not keep treating just to keep treating.
Common questions
Is chiropractic safe for a herniated disc?
Usually, when the disc problem is properly diagnosed first and treatment avoids loading the injured disc. We test your nerves before treating, read your MRI if you have one, and refer you if nerve signs worsen.
Can a chiropractor make my back worse?
Short-lived soreness is common. Real worsening is uncommon and is most often linked to a missed diagnosis, which is why a thorough exam comes before any treatment.
Can a chiropractor cause a stroke?
This kind of stroke is extremely rare. A population study of Ontario found 818 such strokes over more than 100 million person-years, and no higher risk after chiropractic visits than after family doctor visits. We screen for warning signs and offer non-thrust neck techniques.
Do I have to get my neck cracked?
No. We use gentle, non-thrust techniques whenever you prefer them or the exam suggests them.
Are chiropractors worth it?
For many kinds of back and neck pain, chiropractic care is a reasonable, evidence-supported option. The value depends on an accurate diagnosis, a clear plan and measured progress, which is why we re-test about every 4 weeks.
Sources
- Cassidy JD, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008;33(4 Suppl):S176-83.
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McClean Chiropractic Spine Care Specialists · 385 N 500 W, Provo, UT 84601 · Directions