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What are the negative effects of chiropractic?

Chiropractic is a form of alternative medicine concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine. While chiropractic can provide relief from certain conditions, it does carry some risks. In this article, we will examine some of the potential negative effects of chiropractic treatment.

Risk of Serious Neurological Damage

One of the most serious risks associated with chiropractic is the potential for damage to the nervous system. Chiropractic manipulation applies controlled force and movement to the spine and other joints. This can sometimes cause injury to the vertebral artery, which supplies blood to the brain.

While rare, chiropractic adjustment of the neck has been linked to dissection or injury of the vertebral artery. Vertebral artery dissection reduces blood flow to the brain, which can result in a stroke. Estimates suggest the risk of stroke after neck manipulation is 1 in 1 million to 1 in 2 million cervical adjustments.

Symptoms of vertebral artery dissection following chiropractic treatment can include sudden and severe headache, neck pain, dizziness, ringing in the ears, facial numbness, and difficulty speaking. Medical evaluation and treatment is urgently needed if these symptoms arise after neck manipulation.

Risk of Herniated Disc

Spinal manipulation as performed by chiropractors also carries a risk, although small, of herniated disc. A herniated disc occurs when the jelly-like interior of a spinal disc ruptures through a weak area of the tough outer wall, causing it to bulge. This can irritate or compress the spinal nerves, resulting in symptoms like numbness, tingling, weakness, and severe pain.

While spinal manipulation treatments are not a direct cause of disc herniations, they can aggravate pre-existing disc issues. As such, patients with known disc problems should consult with a medical doctor before pursuing chiropractic therapy.

Delay of Conventional Medical Care

Another potential risk with chiropractic care is delaying or opting out of other standard medical treatments. Serious conditions that need proper medical attention could potentially go unnoticed or undiagnosed if a patient relies solely on chiropractic therapy.

For example, someone with severe neck pain after an auto accident may see a chiropractor and undergo repeated adjustments. However, the pain could be stemming from a fracture or other injury that requires immediate medical care. Relying solely on chiropractic in this scenario delays proper diagnosis and increases risk.

Temporary Post-Treatment Soreness

It’s quite common to experience some mild to moderate soreness or stiffness at the site of manipulation following chiropractic treatment. This is not necessarily cause for concern and should resolve within 24-48 hours.

However, if the pain is severe or radiates down an arm or leg, this could be indicative of injury and the chiropractor should be alerted immediately. Ongoing pain after chiropractic treatment always warrants follow up.

Aggravation of Pre-Existing Conditions

For some people, chiropractic manipulation may irritate a pre-existing condition or injury. This can occur if the chiropractor unknowingly performs an adjustment in an area where there is already nerve impingement or tissue damage.

Common examples include aggravating an existing disc herniation or worsening joint degeneration. Flare ups of inflammatory back pain related to conditions like ankylosing spondylitis are also possible. Patients should always inform the chiropractor of any pre-existing issues to prevent aggravation.

Fatigue and Drowsiness

Some patients report feeling tired or drowsy after chiropractic treatments, especially early on when treatment plans involve multiple sessions in a week. While not dangerous, fatigue can negatively impact quality of life.

The exact reason for post-chiropractic fatigue and drowsiness is unclear. It may be related to the body’s neuromuscular response to manipulation. Luckily, it is usually a temporary symptom that resolves as the body adapts to regular treatments.


Chiropractic adjustments of the neck can sometimes lead to headaches after treatment. Potential causes include strain on the muscles and joints of the upper neck or irritation of the nerves exiting the cervical spine following manipulation.

Post-chiropractic headaches are usually dull and achy as opposed mild and throbbing like migraines. Taking over-the-counter pain relievers and using ice packs on the neck and head helps alleviate this type of headache.

Joint Subluxations and Rib Fractures

Forceful spinal manipulation also carries a slight risk of joint subluxation or fracture. This typically involves the ribs, collarbone, hips, wrists, or small joints of the hands and feet.

Precautions like avoiding adjustments in weak, osteoporotic bones helps prevent fracture. Patients who experience a cracking sensation or sharp pain during manipulation should speak up immediately as this can signal joint injury.

Local Discomfort

Some chiropractic patients experience localized discomfort, including soreness or muscle tightness near the area of manipulation. Discomfort may also present as slight swelling or bruising.

These types of reactions are generally mild and last just a couple days. They can be relieved with rest, alternating cold and heat therapy, and non-prescription anti-inflammatory medication.

Spinal Cord Injury

In exceptionally rare cases, chiropractic manipulation of the neck may damage the cervical spine and spinal cord. Symptoms of spinal cord injury include sudden loss of sensation, muscle function, or bladder control.

However, a direct causal relationship between chiropractic care and spinal cord injury is difficult to establish. Only about 30 cases linking chiropractic to spinal cord damage have ever been reported. The chances are extremely low, estimated at 1 in 10 million to 1 in 100 million.

Strain of Muscles or Ligaments

Chiropractic manipulation applies controlled force in an attempt to move joints into their proper alignment. This process can sometimes overstretch muscles or ligaments, causing strain, inflammation, and pain.

Adjustments that involve multiple sharp thrusts increase the risk of muscle and ligament strain. Symptoms include tenderness to the touch, swelling, and difficulty moving the affected area. Gentle stretching and anti-inflammatory medication helps relieve this type of reaction.

Development of Reliance

Some critics argue that chiropractic therapy causes patients to become dependent on ongoing manipulation. The concern is that people may come to rely on frequent chiropractic adjustments to manage health conditions best treated with other methods.

For example, a patient with chronic migraines may become reliant on regular chiropractic neck adjustments to help relieve symptoms. However, medication and stress management therapies are likely better treatment options in most migraine cases.

Financial Cost

Compared to most medical services, a single chiropractic session is relatively affordable, costing anywhere from $30 to $100. However, expenses add up quickly if frequent, long-term adjustments are necessary.

Many insurers limit chiropractic coverage to just 12-20 sessions per year. Patients who lack insurance or have used up their chiropractic benefits end up paying all costs out-of-pocket. This presents a financial burden for some households.

Infection Risk

As with all hands-on procedures, chiropractic adjustments carry a small risk of infection. Transmission occurs if chiropractic tables and tools are not properly sanitized between patients. Using disposable sanitary covers and gloves helps minimize risk.

Factors like skin breaks, open wounds, or compromised immunity increase a patient’s susceptibility to infection. Fortunately, diligent hygiene practices make infection extremely unlikely in most chiropractic settings.

Dizziness and Nausea

Some chiropractic patients experience temporary dizziness, balance issues, and nausea after certain manipulations, especially those involving the upper cervical region.

This occurs when manipulation disrupts normal circulation of cerebrospinal fluid around the brain and spinal cord. Symptoms usually dissipate within several minutes to hours after each treatment session.


As mentioned previously, neck manipulation raises concerns about potential stroke risk if it damages arteries supplying the brain. Chiropractors typically manipulate the cervical spine carefully to avoid this complication.

However, pre-existing conditions like vessel weaknesses or aneurysms may increase stroke risk with neck adjustments. Patients should seek medical guidance about the safety of chiropractic given their own health history.

Drop in Blood Pressure

Rarely, chiropractic manipulation of the cervical or thoracic spine leads to a sudden drop in blood pressure, causing lightheadedness. This seems to occur when the manipulation stimulates certain nerves that influence cardiovascular function.

The blood pressure decline is transient and not considered dangerous for most patients. However, those prone to fainting should be cautious with upper spine manipulation.


Chiropractic is widely considered safe for conditions like back pain, neck pain, headaches, and osteoarthritis. However, as with any medical therapy, potential side effects and risks exist.

To minimize risks, patients should be forthright about all health conditions and concerns. Licensed chiropractors should have thorough patient intake procedures and utilize proper techniques.

With informed, shared decision-making regarding risks versus benefits, most people can safely experience positive results from chiropractic care.