Is Chiropractic Care safe?

Is chiropractic safe for adults?  How about for children?  These are legitimate questions that people ask.  However, these questions can often evoke emotional responses fed by sensationalistic media coverage.  The purpose of this piece is to help answer these questions using SCIENCE and REASONING rather than emotion so that we may help clear up this issue.    We have a lot of information, so let's get right to it!

This paper discusses the safety and benefits of chiropractic care for children: 

"Of the 812 clinical cases, 717 indicated experiencing an improvement with their presenting symptoms, while 9 patients reported treatment-related aggravations. These were described as "soreness" or "fussy." No treatment-related complications were reported.  Seventy-four cases had reported improvements unrelated to their presenting complaints and described as increased range of motion, improved sleep, improved immune function and improved patient mood."

Alcantara J, Ohm J, Kunz D. Treatment-related aggravations, complications and improvements attributed to chiropractic spinal manipulative therapy of pediatric patients: a practice-based survey of practitioners. Focus on Alternative and Complementary Therapies 2007; 12 (Suppl 1): 3.

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According to this study, the estimate for a possible neurological adverse effect to a child from receiving an adjustment is extremely rare:

"This paper has reviewed literature concerning the occurrence of neurological and/or vertebrobasilar (N/VB) complications in patients receiving either specific chiropractic adjustments and/or non-specific manipulations of the spine..... there would be a chance of approximately 1 in 250 million pediatric visits that a N/VB complication would result."

Pistolese RA. Risk assessment of neurological and/or vertebrobasilar complications in the pediatric chiropractic patient. J Vertebral Sublux Res 1998;2(2):73-81.

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After a study of stroke reports during a 10 year period, according to the authors the risk of stroke following a neck adjustment is very rare - about 1 in 5.85 million neck adjustments. 

"The likelihoodthat a chiropractor will be made aware of an arterial dissectionfollowing cervical manipulation is approximately 1:8.06 millionoffice visits, 1:5.85 million cervical manipulations..."

Haldeman S, et al. Arterial dissection following cervical manipulation: a chiropractic experience. Can Med Assoc J 2001;165(7): 905-06.

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Is there any kind of treatment that is completely free of potential adverse effects?  Probably not.  Just for comparison, let's look at some statistics for commonly used medications. 

"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone."

Recent Considerations in Nonsteroidal Anti-inflammatory Drug Gastropathy,

 American Journal of Medicine 1998 (Jul 27); 105 (1B): 31S-38S. 

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Here is what the author of this study comparing neck adjustments to taking NSAIDs concludes:

"Conclusion: The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence that indicates NSAID use is any more effective than cervical manipulation for neck pain."

Dabbs V, Lauretti WJ. A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manipulative Physiol Ther. 1995;18 :530 -536.