Chiropractic Treatment and Patient Safety

Chiropractic care has a strong safety record and is widely accepted as a drug-free, surgery-free form of health care. However, no health treatment is completely free of potential adverse effects—even common non-prescription pain re lievers carry a risk. Fortunately, adverse effects associated with chiropractic adjustment are usually minor and short-term.

What is a neck adjustment and how do I benefit from this procedure?
A neck adjustment (also known as a cervical manipulation) is a precise manual procedure applied to the joints of the neck. Your chiropractor has received extensive training to perform this procedure. Neck adjustment works to improve the mobility of the spinal joints in the neck to reduce muscle tightness, restore range of motion and help relieve pressure and tension. Patients typically notice a reduction of pain, soreness and stiffness, improved ability to turn and tilt their head, and enhanced well-being.

What training do chiropractors have?
Chiropractors complete an intensive four to five year full-time program following university studies or graduation from CEGEP in Quebec. All chiropractors must pass national qualifying examinations and be provincially licensed in order to practice in Canada. Chiropractors are trained to take a medical history and assess your condition before making a diagnosis and proposing a treatment plan. Your chiropractor is trained to determine if a neck adjustment is right for you. He or she may decide to use massage, exercise or other therapies to treat your condition.

Is neck adjustment safe?
Yes, it is. Millions of neck adjustments are performed safely and effectively every year in Canada. Neck adjustment is performed well within the normal turning range of the head. There is less movement that it takes to look over your shoulder.

One of the most recent studies into the safety of neck adjustment further confirms the safety of this procedure1 This particular study, conducted in 2007, looked at over 19,000 chiropractic patients and tracked more than 50,000 neck adjustments. It found no instances of serious adverse effects. By way of comparison, neck adjustment is significantly safer than other commonly used health remedies. For example, long-term use of non-prescription pain relievers carries a far greater risk of serious complications than neck adjustment2.

Most patients experience immediate relief following an adjustment, however, some may experience temporary soreness, stiffness or slight swelling. In rare situations, patients may experience symptoms such as dizziness, local numbness, or radiating pain. If this happens to you, it is important to tell your chiropractor who can help you manage any effects of treatment.

I am worried about the risk of stroke from having my neck adjusted.
The most recent research into the rare cases of stroke found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician3. The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops.
This type of stroke is extremely rare and has been known to occur spontaneously. Research continues as to why in very rare cases, some people are susceptible when most of us are not.

How do chiropractors know who should not have a neck adjustment?
Your chiropractor will take a careful history of your health, your recent activities, and any unusual symptoms you may have before deciding whether an adjustment is right for you. Chiropractic treatment guidelines help doctors of chiropractic identify patients whose neck pain symptoms are unusual and provide clear advice on not to perform a neck adjustment. In these cases, the patient should be referred to a medical doctor for further testing. However, it is not always possible to distinguish ordinary neck pain from neck pain that may be related to pre-existing artery damage.

Why would neck adjustment have an effect on anything other than neck pain or headache?
Pain or discomfort in one area of the body may be linked functionally to discomfort arising from another area. That is why treating a problem in one part of the body may relieve symptoms in another part. If you look at a model of the spine, you can see that the spine is an interconnected structure. Adjustment at various points along the structure may be needed to help reduce stress on other parts of the spine and relieve discomfort.

Are all neck adjustment techniques equally safe?
Chiropractors are taught a variety of adjustment techniques and there is no evidence to suggest that any of these techniques is less safe than the others. Chiropractic techniques that are applied appropriately are effective and safe.




1. Safety of Chiropractic Manipulation of the Cervical Spine: a prospective national survey. Thiel HW, Spine, October 1, 2007, 32:21.
2. American College of Gastroenterology
3. Risk of Vertebrobasilar Stroke and Chiropractic Care. Cassidy JD. et al. Spine, February 15, 2008, Volume 33, Issue 4S Supplement.