What Should You Know About Potential Risks Before a Chiropractic Adjustment?
Before having a chiropractic adjustment, it is reasonable to want to understand both the potential benefits and the risks.
A chiropractic adjustment is a hands-on technique that applies a controlled force to a joint. Depending on the technique used, it may involve a quick movement that sometimes produces an audible clicking or popping sound.
Some people experience temporary soreness, stiffness or mild discomfort after treatment. Serious complications have also been reported, although their frequency and the degree to which treatment causes them are not always clear.
The risks of a chiropractic adjustment depend on factors such as the technique used, the area being treated, your medical history and your individual circumstances.
This is why an appropriate assessment, a clear explanation of treatment options and informed consent are important before proceeding.
What side effects can occur after a chiropractic adjustment?
Many people tolerate chiropractic treatment without significant problems. However, some experience short-term symptoms afterwards.
Temporary soreness or tenderness:
You may notice that the treated area feels tender or slightly sore after an adjustment.
This can be similar to the discomfort experienced after unfamiliar physical activity. It may settle without specific treatment, although the duration and intensity vary between individuals.
Stiffness or increased discomfort:
Some people report temporary stiffness or a short-lived increase in their existing symptoms.
This does not automatically mean that the treatment has caused damage. However, significant, worsening or persistent pain should not simply be dismissed as a normal response.
If symptoms are more intense than expected, contact your treating practitioner or seek appropriate medical advice.
Headache or fatigue:
Headache and tiredness have also been reported following manual therapy, including chiropractic treatment.
These symptoms can have different causes, so it is not always possible to attribute them directly to an adjustment.
New, severe or unusual symptoms warrant appropriate medical assessment rather than an assumption that they are simply a temporary side effect.
Are serious complications possible?
Serious complications following spinal manipulation have been reported, but they are considered uncommon. Their exact incidence is difficult to establish, and evidence about causation varies between complications.
The fact that a complication is uncommon does not make it irrelevant when considering whether a treatment is appropriate for an individual.
Potential serious complications can include injury to blood vessels, neurological injury and worsening of certain underlying spinal conditions.
The nature of the risk depends partly on the area treated and the technique used. Neck manipulation deserves particular consideration because of the important blood vessels, nerves and other structures in the cervical region.
A practitioner should take relevant symptoms and medical history into account before recommending any technique.
Who should be particularly cautious before an adjustment?
Chiropractic treatment is not a one-size-fits-all approach. Certain medical conditions, symptoms or circumstances may mean that an adjustment should be avoided, modified or deferred until further assessment.
These can include:
Known or suspected fractures.
Severe osteoporosis or significant bone fragility.
Certain spinal infections or tumours.
Suspected spinal cord compression or significant neurological problems.
Some inflammatory conditions affecting the spine.
Known or suspected vascular disorders relevant to the proposed technique.
Recent significant trauma.
New or unexplained neurological symptoms.
This is not an exhaustive list. The significance of each factor depends on the person’s condition and the proposed treatment.
If you take anticoagulant medication, have a bleeding disorder, have undergone recent surgery or have a complex medical history, make sure your practitioner knows before treatment.
Pregnancy, older age and previous spinal surgery do not automatically rule out every form of manual therapy, but they may affect which techniques are appropriate.
A practitioner should consider your individual circumstances rather than relying on a standard treatment approach for everyone.
Why your first assessment matters?
A chiropractic appointment should involve more than identifying a sore area and immediately treating it.
Before recommending an adjustment, a practitioner should consider your symptoms, medical history and examination findings to determine whether chiropractic care is appropriate.
Depending on your presentation, this may involve discussing:
When your symptoms began and whether they are changing.
Previous injuries, operations and relevant medical conditions.
Medications and other healthcare treatments.
Any numbness, weakness, balance problems or other neurological symptoms.
Activities that aggravate or relieve your symptoms.
Whether further investigation or referral is needed.
If your symptoms suggest a condition that requires medical assessment, an adjustment may not be the appropriate next step.
A careful assessment helps identify potential concerns, although no examination can eliminate every possible risk.
Do you have to agree to a chiropractic adjustment?
No. You should be able to make an informed decision about your care.
Informed consent means understanding the proposed treatment sufficiently to decide whether you want to proceed. This includes having the opportunity to ask questions about the expected benefits, potential risks, alternatives and what may happen if you choose not to have the treatment.
Before an adjustment, you can ask:
Why are you recommending this technique for my symptoms?
What are the potential benefits and risks in my circumstances?
Are there alternatives that do not involve spinal manipulation?
What side effects should I expect, and which symptoms would be concerning?
Is there a reason I should avoid this technique?
What happens if I decide not to proceed today?
You can decline a proposed technique or change your mind. Consent should be voluntary and ongoing, not treated as a one-off formality.
A practitioner should explain the treatment in a way you can understand and give you reasonable time to consider your options.
How can you make a more informed decision about chiropractic care?
You do not need to be an expert in spinal anatomy to make a considered decision.
Start by explaining your symptoms honestly, including any changes in sensation, weakness, previous injuries or relevant health conditions.
Ask for a clear explanation of the proposed technique and why it may be suitable for you. If you are uncomfortable with a particular movement, say so.
It is also reasonable to seek a second opinion or discuss the problem with your GP before proceeding.
Most importantly, judge a treatment recommendation on its suitability for your circumstances, not on promises of guaranteed results or claims that one technique is necessary for everyone.
FAQ
Is a chiropractic adjustment safe?
Safety depends on the individual, the condition being treated and the technique used. Many people tolerate chiropractic treatment without significant problems, but temporary side effects and rare serious complications have been reported. An appropriate assessment and informed consent are important before treatment.
What are the most common side effects of a chiropractic adjustment?
Reported short-term effects include soreness, stiffness, temporary discomfort, headache and fatigue. These effects vary between individuals. Severe, unusual or worsening symptoms should be assessed rather than automatically attributed to treatment.
Can a chiropractic neck adjustment cause a stroke?
Cervical artery dissection and stroke have been reported in association with neck manipulation. Research has found associations, but whether manipulation directly causes these events remains uncertain. Dissection can also begin spontaneously, and early symptoms may lead someone to seek treatment for neck pain or headache. Discuss the risks and alternatives before deciding whether neck manipulation is appropriate.
Should I have an adjustment if I have osteoporosis?
Significant osteoporosis or bone fragility may increase the risk of injury from certain manual techniques. Tell your practitioner about your diagnosis and any relevant investigations or fractures. A suitable approach may require modification or avoidance of particular techniques, and medical advice may be appropriate.
Can I refuse a chiropractic adjustment?
Yes. You can ask questions, request an explanation of alternatives, decline a technique or withdraw consent. You should not feel pressured to agree to treatment.
What should I do if I feel worse after an adjustment?
Mild, short-lived soreness can occur. However, contact your practitioner or seek medical advice if symptoms are significant, persistent or worsening. Seek emergency care for sudden severe headache or neck pain, new weakness, speech or vision changes, or other possible stroke symptoms.
If you are considering chiropractic care but have questions about the potential risks, it is reasonable to discuss those concerns before deciding on treatment. Wellbeing Chiropractic has clinics across Melbourne, Sydney and Brisbane. You can arrange an appointment to discuss your symptoms, medical history and available options, with recommendations based on your individual circumstances.
