There are many consumers and healthcare professionals who would dispute the safety of chiropractic cervical adjustment. However, they should first consider the information from the RAND report in 1996.
According to the RAND report the overall estimate of the rate of serious complications as a result of cervical spine adjustments is 1 per 1 million adjustments. Of course, no health treatment is completely free of potential adverse effects. Even the common over-the-counter remedies carry a risk. The RAND report indicates chiropractic cervical adjustment is far safer than a number of medical treatments given for the same symptoms.
Chiropractic Care Safer
Studies reviewing the effectiveness of cervical adjustments found the best evidence indicates cervical adjustments for neck pain is much safer than the use of non-steroidal anti-inflammatory drug (NSAID) by as much as a factor of several hundred times.
The following risk comparisons were published in the Journal of Manipulative and Physiological Therapeutics, 1995:
- Long-term use of non-steroidal anti-inflammatory drugs for pain cause 1,000 serious complications and 100-200 deaths per million cases.
- Surgeries for neck and back pain cause 15,600 cases of paralysis or stroke per million cases, and 6,900 deaths per million.
Chiropractors maintain for the vast majority of adverse effects associated with spinal adjustment they are typically minor and short-lived. Yet, to date, there continues to be a number of consumers and healthcare practitioners suggesting chiropractic cervical spine adjustments are unsafe.
That said, the Canadian Chiropractic Association needs to continue discussions and open dialogue using media outlets and online publications to reach consumers to alleviate fears and misconceptions surrounding safety issues of cervical (neck) adjustments.
The following information is compiled from the Chiropractic Communications Working Group, which may help to clarify this issue and alleviate consumer's concerns:
There is a rare risk of stroke or stroke-like symptoms associated with adjustment of the neck. The most recent research published in 2001 in the Canadian Medical Association Journal puts the risk at one in 5.85 million adjustments.
Reports on the subject over the past 40 years present a range of estimates based on different research methodologies. However, all the published studies to date agree the risk is extremely low. Overall, a ratio of one to two cases per million neck adjustments represents a conservative and generally recognized estimate. Comparatively, that is less than your risk of getting struck by lighting, or, of dying while skiing or playing soccer.
Strokes have Many Causes
There are many risk factors for stroke including blood clotting problems, hypertension, smoking, high cholesterol, use of birth control pills, heart problems and trauma such as sports injuries or blows to the head from an accident. All carry a greater degree of risk than spinal adjustment.
And, a neck adjustment is done within the normal range of motion. Adjustment of a joint is a highly skilled procedure, which requires relatively little pressure.
Chiropractors are Highly Skilled
Chiropractic education in Canada involves an intensive four year program following three years of university undergraduate studies. By the time Canadian chiropractors graduate, they are among the most skilled in the world.
For more information contact the Canadian Chiropractic Association or your chiropractic association in your country. You may also want to consider reading the following article, "Risk of Vertebrobasilar Stroke and Chiropractic Care Results of a Population-Based Case-Control and Case-Crossover Study," by J. David, Cassidy, DC, PhD, DrMedSc, et al, published in Spine,Volume 33, Number 4S, 2008. A copy can be downloaded from the Canadian Chiropractic Association's web site.
