Is Chiropractic Safe?

As with any form of medical treatment, questions about the safety of chiropractic care often arrise. Many research studies have been performed looking at the general safety of chiropractic care and comparing chiropractic care with medical care.

Chiropractic and Tissue Damage

In December of 2014, Disease Markers published a study which examined tissue damage markers after patients received a chiropractic adjustment.  As you probably know, most spinal manipulation involves thrust-manipulation also called a high velocity low amplitude (HVLA) manipulation. This study looked at tissue damage markers pre-treatment, post-treatment, and post-treatment +2 hours.  The treatment groups included a control group, a group receiving a cervical spine adjustment, and a group receiving a thoracic spine adjustment.

“Our data show no changes in any of the studied damage markers.” 

As you can see in the graphic at the bottom of the page, the researchers found no indication of tissue damage after patients received a chiropractic adjustment. The full research article can be found here:

Tissue Damage Markers after a Spinal Manipulation in Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial

Chiropractic and Stroke

While the media and some in the medical profession have pushed a correlation between cervical manipulation and stroke in the general population, the literature does not support a cause-and-effect relationship between cervical manipulation and stroke.

The landmark study, Risk of Vertebrobasilar Stroke and Chiropractic Care, was published in the European Spine Journal in 2008 (article here). This study looked at associations between chiropractic visits and stroke and contrasted chiropractic care with primary care physician (PCP) visits and stroke. Researchers studied incident of stroke in patients admitted to Ontario hospitals over a nine-year period from 1993-2002.

They found three important points in the research:

1. Stroke is a very rare event in the general population.
2. The increased risks of stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain seeking care before their stroke.
3. No evidence of increased risk of stroke associated with chiropractic care compared to primary care.

What points number two and three mean, are that most patients suffering a stroke presented with headache or neck pain symptoms. Both of these symptoms are commonly treated by chiropractors and PCPs and are also possible symptoms associated with stroke. This details the importance of spending adequate time with the patient, understanding the details of a patient’s symptoms, and performing a detailed exam and evaluation to determine the difference between musculoskeletal neck pain or tension headaches and neck pain or headaches associated with the beginning of a stroke.

According to a detailed article on the topic on WebMD, “Neck manipulation is associated with about one death per 1 million people due to cervical artery dissection. By comparison, nonsteroidal anti-inflammatory drugs (NSAIDs) cause 153 stroke deaths per 1 million people, narcotic medications cause 53 stroke deaths per 1 million people, and spinal surgery of the neck causes 500 stroke deaths per 1 million people.” Chiropractic care is very safe for the treatment of neck pain and headaches, as well as a wide range of other musculoskeletal and orthopedic conditions, and it is more safe than traditional medical interventions by comparison.