Author: Arman Hunter

Chiropractic Hazards

If you work in a physically demanding job, you may be more at risk for back or neck injuries. Chiropractors use spinal manipulation, soft tissue treatment, bracing, and nutritional advice to help you with your injuries.

One study of malpractice records found that serious complications from cervical spinal manipulation occur in only about one out of every two million treatments. However, more research is needed to understand how and why these complications occur. Click to learn more.


The vertebral arteries deliver blood and oxygen to the brain and spine. A torn vertebral artery can cut off blood flow and cause serious complications, including stroke and internal bleeding in the head. A vertebral artery dissection can occur in several ways, including mild trauma to the neck, infections, and medical procedures. It can also happen spontaneously.

A vertebral artery dissection is a condition that occurs when the inner layer of an artery tears and allows blood to enter the layer beneath it, forming an intimal hematoma (A). The blood may flow into the lumen of the artery (B) or the false lumen created by the dissection (C). The dissection can form a blood clot, interrupting blood flow and causing arterial ischemic stroke. In some cases, the false lumen can rupture and cause hemorrhagic stroke.

People with vertebral artery dissection often report a history of a minor precipitating event before the onset of symptoms. These events include coughing, sneezing, neck movements during chiropractic manipulation of the cervical spine, and trauma to the neck. It has been estimated that 1 in 20,000 spinal manipulations causes a stroke.

In most patients, the dissection is found in the extracranial vertebral artery. This type is typically associated with a better prognosis for neurological recovery than intracranial vertebral artery dissection, which can lead to severe dysfunction and subarachnoid hemorrhage. Patients with a connective tissue disorder, particularly Ehlers-Danlos syndrome, are at an increased risk of this injury.

  1. Stroke

A stroke occurs when an artery in the brain bursts, cutting off blood flow and depriving your brain of oxygen. Symptoms include blurred vision, numbness or weakness on one side of your body, and difficulty swallowing. Strokes are serious medical emergencies that must be treated quickly to prevent permanent damage and death.

The risk of having a stroke from chiropractic manipulation is extremely low. However, if you have an existing medical condition, such as heart disease, high blood pressure, or diabetes, your doctor may recommend against spinal manipulation. It is also important to tell your chiropractor about any ongoing medications you are taking or a recent surgery. You should not undergo chiropractic treatment if you have osteoporosis, spinal cord compression, or inflammatory arthritis, and you should never take anticoagulants or other blood thinners.

Several studies have linked neck manipulations to stroke. However, it is difficult to know if these strokes would have occurred anyway or were made worse by the treatment. Neurosurgeon Felipe Albuquerque, who has studied stroke injuries related to chiropractic manipulation, believes the cases of people who have had a stroke after chiropractic treatment are not just an “uncanny coincidence.”

To reduce your stroke risk, follow a healthy diet that includes plenty of fruits and vegetables. Do not smoke or use recreational drugs, and make sure you get regular health screenings to detect high-risk conditions like high cholesterol, sleep apnea, and hypertension.

If you think someone is having a stroke, call 911 immediately and ask them to speak clearly. Look for a droop on one side of their face and try to raise both of their arms. If one arm stays higher than the other, it is a sign that they are having a stroke.

Blood clots form to help wounds heal. They also protect parts of the body from damage. But when a clot isn’t needed, it can block blood flow and cause serious health problems. For example, clots in the brain can cause strokes, while those that block vessels to the heart may cause heart attacks.

Fortunately, doctors have made great progress in treating and preventing blood clots. You can lower your risk by avoiding certain foods, taking medication, staying physically active, losing weight, and not smoking. You can also take steps to reduce your risk of getting a clot after an injury or surgery. If you have a medical condition such as osteoporosis, spinal cord compression, or inflammatory arthritis or are on blood-thinning medications, get your doctor’s clearance before chiropractic manipulation.

The risk of blood clots increases with age but can affect anyone. Blood clots most often occur in the legs, arms, or groin veins. But they can also form in other places in the body, including the lungs. Clots in the lungs are called pulmonary embolisms (POOL-mo-nar-ee EM-bo-liz-um).

People with a high risk of blood clots or hypercoagulation include those with an illness that causes low red blood cell count or polycystic kidney disease. It’s also a problem for those who have undergone major surgery, are immobile for long periods, or take certain medicines, such as birth control pills or anticoagulants. Your doctor may recommend a test to check for abnormalities in the proteins that regulate bleeding or help dissolve clots. They might also order X-rays of the veins and blood vessels or use an imaging tool such as an ultrasound or CT scan.

Nerve damage can occur from a variety of sources, including spinal manipulation. When nerves are injured, they can no longer send proper messages from your brain to the rest of your body, which results in pain and dysfunction. This can cause muscle weakness, leading to falls or difficulty doing simple tasks, like fastening buttons. It can also cause tingling, burning, and other painful sensations. If the nerve is damaged to a degree that it can’t regenerate, surgery may be required to fix the problem.

In some cases, spinal manipulation can be so forceful that the outer covering of the nerve, called the epineurium, is disrupted. When this happens, electrical tests performed during surgery can often help determine the extent of the injury and if the nerve will heal itself or needs to be surgically repaired.

While the risk of serious complications from spinal manipulation is low, it’s important to consider all the risks involved before you undergo treatment. Many other treatments for musculoskeletal problems have higher risk factors than spinal manipulation, such as taking over-the-counter and prescription NSAIDs or other opioids for pain.

Wade Smith, a neurologist at the University of Toronto, says chiropractors should discuss the potential risks with patients before they perform cervical manipulation. Depending on the practitioner’s approach, this may include explaining the chance of an adverse event, such as a stroke or slipped disc. Smith says you should look for a chiropractor willing to do this and will tell you how many serious complications have occurred from neck manipulations based on malpractice history. He suggests you ask for a copy of the chiropractic board’s records to determine the chiropractor’s rate of serious complications.

Chiropractic is generally safe when performed by a trained chiropractor. Side effects are possible, including minor discomfort and mild muscle soreness, but these symptoms should disappear within a few days. A more serious side effect is the risk of a stroke or slipped disc from spinal manipulation, but this risk is low.

A chiropractor uses manual manipulation of the joints to ease spasms and tight muscles, improve joint mobility, and correct posture. They often use soft tissue therapy, hot and cold treatments, exercise and rehabilitative programs, and nutrition counseling to treat pain and promote overall wellness.

When a chiropractor manipulates a joint, they may hear a popping sound. This results from gas bubbles being released due to the change in pressure. This is similar to the sound produced when you crack your knuckles, but there is usually minimal if any, discomfort involved.

It’s important to talk to your doctor before receiving chiropractic treatment, especially if your condition could be affected by it. You should also contact your physician if you experience any side effects that don’t go away or worsen after chiropractic treatment.

Treatment for burns includes adequate analgesia, early nutritional support, and application of topical antimicrobials (for prevention). You should consider visiting a burn center if the burned area covers 20% or more of the total body surface area or if the injuries are deep, partial-thickness, or full-thickness burns. If necessary, you’ll receive dressings, grafts, and splints to prevent contractures as the wounds heal. You’ll also receive physical and occupational therapy to prevent immobility from scarring and help you return to normal life activities.