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Adverse Events Following Chiropractic – THE TRUTH

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By: Colby Staubs DC

Chiropractic management has been shown in the scientific literature to be a safe and effective treatment for a variety of conditions in the spine and extremities.  There seems to be a disparity between what the science is showing and the emotionally charged rhetoric that is found in certain circles.  The most probable reason behind this is the inconsistency in published evidenced when compared to other clinical trials.

In a recent study by Rubinstein  (2008), the author stated, “The synopsis provides an overview of the benign and serious risks associated with chiropractic care for subjects with neck or low-back pain” (p.461). There are a few main areas that are of concern which was the focus of this systemic review.

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Vertebrobasilar Artery (VBA) Stroke – “In an expanded analysis of the Ontario population-based study, which spanned a 9-year period representing more than 100 million person-years of observation, only 8 cases of VBA stroke were observed in subjects younger than 45 years exposed to chiropractic care within a week before their stroke.  In those older than 45 years, no association was found between chiropractic visits and VBA stroke” (Rubenstein, 2008, p. 462). An article by Cassidy (2008) stated “Overall, 4% of cases and controls had visited a chiropractor within 30 days of the index date, while 53% of cases and 30% of controls had visited a PCP within that time” (Cassidy et al., p.S178).  Does this mean that PCP’s caused stroke in 54% of patients while chiropractors caused 4%?  Obviously not…Similar findings were also confirmed in the most recent 2011 study published in Spine.

Cervical Disc Herniation – “Data are limited to individual cases and case series.  There is no evidence at this time to suggest that this condition is necessarily a consequence of chiropractic care or spinal manipulation” (Rubenstein, 2008, p. 462).

Lumbar Disc Herniation/Cauda Equina Syndrome – “The risk for a serious adverse event, including lumbar disc herniation, has been estimated to be approximately 1 per million patient visits…” (Rubenstein, 2008, p. 462).

Finally, the author references a systemic review published in 2002 in the Annals of Internal Medicine stating, “One systemic review found no serious complications reported in more than 70 controlled clinical trials” (Rubenstein, 2008, p. 462).


  1. Rubinstein, S. M. (2008). Adverse events following chiropractic care for subjects with neck or low-back pain: Do the benefits outweigh the risks? Journal of Manipulative and Physiological Therapeutics, 31(6), 461-464.
  2. Cassidy, J. D., Boyle, E., Côté, P., He, Y., Hogg-Johnson, S., Silver, F. L. & Bondy, S. J. (2008). Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Spine, 33(4S), S176-S183.
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