Chiropractic is widely recognized as one of the safest
drug-free, non-invasive therapies available for the
treatment of back pain, neck pain, joint pain of the
arms or legs, headaches, and other neuromusculoskeletal
complaints. Although chiropractic has an excellent
safety record, no health treatment is completely free of
potential adverse effects.
The risks associated with chiropractic, however, are
very small. Many patients feel immediate relief
following chiropractic treatment, but some may sometimes
experience mild soreness or aching, just as they do
after some forms of exercise. Current literature shows
that minor discomfort or soreness following spinal
manipulation typically fades within 24 hours.
In addition to being a safe form of treatment, spinal
manipulation is incredibly effective, getting patients
back on their feet faster than traditional medical care.
A March 2004 study in the Journal of Manipulative and
Physiological Therapeutics found that chiropractic care
is more effective than medical care at treating chronic
low-back pain in those patients who have been
experiencing the symptoms for one year or less. In
addition, a study published in the July 15, 2003,
edition of the journal Spine found that manual
manipulation provides better short-term relief of
chronic spinal pain than a variety of medications.
Neck pain and some types of headaches are treated
through precise cervical manipulation. Cervical
manipulation, often called a neck adjustment, works to
improve joint mobility in the neck, restoring range of
motion and reducing muscle spasm, which helps relieve
pressure and tension.
Neck manipulation is a remarkably safe procedure. While
some reports have associated upper high-velocity neck
manipulation with a certain kind of stroke, or vertebral
artery dissection, recent evidence suggests that this
type of arterial injury often takes place spontaneously,
or following everyday activities such as turning the
head while driving, swimming, or having a shampoo in a
Patients with this condition may experience neck pain
and headache that leads them to seek professional
care—often at the office of a doctor of chiropractic or
family physician—but that care is not the cause of the
injury. The best evidence indicates that the incidence
of artery injuries associated with high-velocity upper
neck manipulation is extremely rare – about 1 case in
5.85 million manipulations.
To put this risk into perspective, if you drive more
than a mile to get to your chiropractic appointment, you
are at greater risk of serious injury from a car
accident than from your chiropractic visit.
It is important for patients to understand the risks
associated with some of the most common treatments for
neck and back pain—prescription nonsteroidal
anti-inflammatory drugs (NSAIDS)—as these options may
carry risks significantly greater than those of
manipulation. According to a study from the American
Journal of Gastroenterology, approximately one-third
of all hospitalizations and deaths related to
gastrointestinal bleeding can be attributed to the use
of aspirin or NSAID painkillers like ibuprofen.
Furthermore, surgery for conditions for which
manipulation may also be used carries risks many times
greater than those of chiropractic treatment. Even
prolonged bed rest carries some risks, including muscle
atrophy, cardiopulmonary deconditioning, bone mineral
loss and thromoembolism.
If you are visiting Dr. Conboy with upper-neck pain or
headache, be very specific about your symptoms. This
will help Dr. Conboy offer the safest and most effective
treatment, even if it involves referral to another
health care provider. If the issue of stroke concerns
you, do not hesitate to discuss it with Dr. Conboy.
Depending on your clinical condition, he can forego
manipulation, and instead can recommend joint
mobilization, therapeutic exercise, soft-tissue
techniques, or other therapies.
The American Chiropractic Asssociation believes that
patients have the right to know about the health risks
associated with any type of treatment, including
chiropractic. Today, chiropractic researchers are
involved in studying the benefits and risks of spinal
adjustment in the treatment of neck and back pain
through clinical trials, literature reviews and
publishing papers reviewing the risks and complications
of neck adjustment.
All available evidence demonstrates that chiropractic
treatment holds an extremely small risk. The
chiropractic profession takes this issue very seriously
and engages in training and postgraduate education
courses to recognize the risk factors in patients, and
to continue rendering treatment in the most effective
and responsible manner.
Source: The American Chiropractic
 Senstad O, et al. Frequency and characteristics of
side effects of spinal manipulative therapy. Spine 1997
 Cassidy D, et al. Risk of Vertebrobasilar Stroke and
Chiropractic Care. Spine 2008; 33:S176–S183.
 Haldeman S, et al. Arterial dissection following
cervical manipulation: a chiropractic experience. Can
Med Assoc J 2001;165(7):905-06.
 Lanas A, et al. A nationwide study of mortality
associated with hospital admission due to severe
gastrointestinal events and those associated with
nonsteroidal anti-inflammatory drug use. Am J
 Lauretti W. The Comparative Safety of Chiropractic.
In Daniel Redwood, ed., Contemporary Chiropractic. New
York: Churchill Livingstone, 1997, p. 230-8.