Is Chiropractic Care Safe?

Cervical (neck) adjustments are among the most researched areas of chiropractic care. A study of over 50,000 cervical adjustments across approximately 20,000 patients (Thiel et al., 2007) reported no serious adverse events.

That said, your comfort and preferences are always respected. If you'd rather not have a traditional neck adjustment, we have alternative techniques available, including instrument-assisted methods and gentle mobilisation. Let us know your preferences and we'll adapt the treatment approach accordingly.

This is an understandable concern and one we take seriously. The most important study on this question is Cassidy et al. (2008), published in the journal Spine, which analysed over 100 million person-years of data covering 818 vertebrobasilar artery (VBA) strokes in Ontario, Canada. The researchers found no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary medical care.

The study found that patients were equally likely to have visited a chiropractor or a GP in the days before a stroke, suggesting that the early symptoms of arterial dissection (neck pain, headache) prompt people to seek care from either type of practitioner before the stroke manifests.

A 2016 systematic review (Church et al., published in Cureus) applied formal causation criteria and concluded there was no convincing evidence to support a causal link between chiropractic manipulation and cervical artery dissection. In the 960,140-session study (Chu et al., 2023), zero stroke events were recorded.

Yes. There are certain conditions where spinal manipulation should not be performed, and others where techniques need to be modified. Conditions where chiropractic is typically not appropriate include acute fractures, spinal instability, severe neurological deficits, cancer-related spinal pain, acute myelopathy, cauda equina syndrome, and active bone infections.

Conditions requiring modified techniques include osteoporosis, joint hypermobility, inflammatory arthritis (such as rheumatoid arthritis), bleeding disorders or anticoagulant medication use, and radiculopathy with progressive neurological signs.

This is exactly why a thorough examination and health history are taken before any treatment begins. If chiropractic care is not appropriate for you, we will tell you and help you find the right type of care.

Chiropractic care can be appropriate for older adults when techniques are adapted to the individual. Many older patients benefit from gentle, low-force methods that accommodate conditions like reduced bone density or arthritis. A study of Medicare beneficiaries aged 66 to 99 (Whedon et al., 2015) found that the risk of injury was actually 76% lower after a chiropractic visit compared to a primary care physician visit.

During the initial assessment, factors like bone health, medication use, and existing conditions are carefully considered before any treatment approach is selected.

You should see a GP first if you're experiencing symptoms that suggest something beyond a musculoskeletal issue: unexplained weight loss, fever with back pain, loss of bladder or bowel control, severe or worsening neurological symptoms (such as progressive weakness or numbness), pain following significant trauma, or pain that doesn't change with position or movement.

If you come to us and our assessment suggests something outside our scope of practice, we will tell you directly and refer you to the appropriate healthcare provider. We work alongside GPs and other practitioners to make sure you get the right type of care.

Chiropractic care is a conservative, non-invasive approach that does not involve medication or surgical intervention. The American College of Physicians (2017) issued a clinical guideline recommending non-pharmacologic therapies, including spinal manipulation, as first-line treatment for low back pain before considering drug therapies. This recommendation was made in part because of the lower risk profile of manual therapies compared to the well-documented risks of long-term NSAID use, opioid dependence, and surgical complications.

Any comparison between treatments should be made on an individual basis. What's right for one person may not be right for another, and in many cases, different types of care complement each other.

Here is a summary of the key safety studies in the chiropractic literature:

We believe in transparency about what the evidence says. If you'd like to discuss any aspect of chiropractic safety, we're happy to have that conversation.