Safety of Chiropractic Care

If you are worried about seeing a chiropractor because you think that chiropractic adjustments might be harmful or dangerous, read on as we look at the research literature on this topic to see what the science actually says.

Chiropractic care has an enviable safety record

Healthcare Options

Chiropractic care actually has an enviable safety record compared to other healthcare options. Based on the best systematic reviews of all the scientific literature, being hurt from seeing your chiropractor is extremely rare.

Safe Hands

So despite what some people think chiropractic has an enviable safety record and you can rest assured that if you go see your chiropractor, you’re in safe hands.

Video Transcript

When we look at the literature relating to chiropractic care we can see that it’s remarkably safe,1, 2 and it’s effective,3 and it’s associated with high levels of patient satisfaction.4 A number of studies have reported that chiropractic care is at least as effective as, if not more effective, than traditional medical management for patients with a variety of spine related issues.3, 5, 6

Chiropractic care actually has an enviable safety record compared to most other healthcare interventions.1, 2, 7

However, virtually all forms of healthcare are associated with some risk,8 so let’s look closer at this.

With the sort of manual or ‘hands on’ procedures that chiropractors use in everyday practice it’s logical that there is at least some risk that on rare occasions some people may suffer from an adverse event after seeing their chiropractor.9

A number of researchers have reviewed all of the published literature relating to the safety of chiropractic care. According to these reviews serious adverse events are very rare and most of the time the scientists weren’t sure if the chiropractic care actually caused the event or not.

Because serious adverse events are so few following chiropractic care it’s virtually impossible for researchers to accurately estimate how often they actually occur. So there are only rough estimates for serious adverse events. And these estimates from 1 in 20,000 to 1 in several million chiropractic visits.9  But let’s put this into perspective; another study has shown that people who have to go to hospital have as high as 1 in 3 chances of suffering from an adverse event.10

What is more common with chiropractic care is that some people can feel a bit stiff and sore after they’ve been adjusted but this usually goes away by itself.

So according to the best systematic reviews of all the science literature on this topic we know that being seriously hurt from seeing your chiropractor is extremely rare. In fact, the statistics tell us that you are about 10 times more likely to be seriously injured driving to and from your chiropractor’s office than you are from being seriously injured while seeing your chiropractor.11

Despite all of these studies showing how rare adverse events are with chiropractic care there are still some people who are worried a chiropractic adjustment could cause a stroke. This has also been studied very carefully. In 2 separate studies researchers looked at extremely large patient databases from insurance plans in Canada and America and compared over 2600 patients who had actually suffered from a stroke involving arteries in their neck and they compared them to people who hadn’t had a stroke.12, 13  They looked to see whether the people who had suffered a stroke were more likely to have seen a chiropractor or a medical doctor before suffering from the stroke.

What they found was that people who had suffered from one of these strokes were no more likely to have seen a chiropractor than a medical doctor before the stroke occurred. In some groups they were actually more likely to have visited a medical doctor than a chiropractor before the stroke.

So what does this mean? The studies suggest that patients who are suffering from a stroke after seeing a chiropractor are probably going to see the chiropractor because they had neck pain or headaches that had been caused by the early stages of the blood vessel damage that ultimately causes the stroke, so they were having a stroke in progress before they went to see the chiropractor. It also means that there is no greater risk of suffering from a stroke if you choose to visit a chiropractor compared to the risks of visiting a medical doctor.  

So if you, or someone you know is worried about seeing a chiropractor you can rest assured that chiropractic care is associated with very low risk of causing serious harm.9, 14 The risks are so rare that they cannot accurately be estimated9, 14 and of the risk estimates that have been made, most suggest that serious adverse events associated with chiropractic care happens perhaps every several hundred thousand visits.8, 9 Like any healthcare intervention some adverse events do of course occur with chiropractic care8 and these adverse events are generally minor and go away by themselves9 and don’t take away from the high levels of patient satisfaction associated with chiropractic care.4, 15 So despite what some people think chiropractic has an enviable safety record and you can rest assured that if you go see your chiropractor, you’re in safe hands.

  1. Rubinstein SM. Adverse events following chiropractic care for subjects with neck or low-back pain: do the benefits outweigh the risks? J Manipulative Physiol Ther. Jul-Aug 2008;31(6):461-464.
  2. Carnes D, Mars TS, Mullinger B, Froud R, Underwood M. Adverse events and manual therapy: A systematic review. Man Ther. 2010;15(4):355-363.
  3. Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. The spine journal. 2004;4(3):335-356.
  4. Gaumer G. Factors associated with patient satisfaction with chiropractic care: survey and review of the literature. J Manipulative Physiol Ther. Jul-Aug 2006;29(6):455-462.
  5. Haas M, Sharma R, Stano M. Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain. J Manipulative Physiol Ther. Oct 2005;28(8):555-563.
  6. Walker BF, French SD, Grant W, Green S. A Cochrane review of combined chiropractic interventions for low-back pain. Spine (Phila Pa 1976). Feb 1 2011;36(3):230-242.
  7. Rafter N, Hickey A, Condell S, et al. Adverse events in healthcare: learning from mistakes. QJM. Jul 29 2014.
  8. Jevne J, Hartvigsen J, Christensen HW. Compensation claims for chiropractic in Denmark and Norway 2004-2012. Chiropr Man Therap. 2014;22(1):37.
  9. Gouveia LO, Castanho P, Ferreira JJ. Safety of chiropractic interventions: a systematic review. Spine (Phila Pa 1976). May 15 2009;34(11):E405-413.
  10. Makary MA, Daniel M. Medical error—the third leading cause of death in the US. Bmj. 2016;353.
  11. Administration NHTS. Traffic Safety Facts 2012. Washington, DC: National Highway Traffic Safety Administration; 2013.
  12. Cassidy JD, Boyle E, Côté P, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Journal of manipulative and physiological therapeutics. 2009;32(2):S201-S208.

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