How Safe is Chiropractic Care?
Myth Busting – How SAFE is Chiropractic?
Back and neck pain is a common problem in our population and trying to decide on a treatment option can be difficult. Finding a treatment that involves manual therapy or medication and the question of safety of these therapies needs to be considered. The incidence of back pain can be as high as 63.9% (1) of people in their lifetime and the ramifications of this to their quality of life can be huge. We thought it was time we spoke about how safe chiropractic care is.
The Public Perception of Chiropractic Safety
There is a public feeling that chiropractic care is not safe and that the risks of serious side effects. Stroke is one of the concerns people have. We look at the safety of chiropractic care in this blog and share what some of the literature is saying.
Our priority is the safety of people as we work out if and how chiropractic can help. We definitely take this concern seriously and in my personal career I can happily say that my care has not resulted in one single case of serious side effects.
What does The Chiropractors’ Association of Australia (CAA) say
In 2016 Association put out a media response for the safety and effectiveness of chiropractic care in our community.
There are over 12 million visits to chiropractors in Australia annually. The CAA state that ‘chiropractic care is a low risk modality of health care.’ ‘There have been few if any serious adverse events reported in medical literature in the past twenty years.’
Our regulatory board AHPRA (Australian Health Practitioners Regulation Agency)
This board is what all health professionals, including GPs, surgeons, chiropractors, dentists, osteopaths, nurses and physiotherapists are regulated under. Any complaints people make, on any level, will go to AHPRA.
In the 2014-15 period their figures showed that a 1.5 per cent of registered chiropractors were the subject of a notification in 2014-15. This is a very low percentage.
What does WHO (World Health Organisation) say
WHO states ‘When employed appropriately chiropractic care is a safe and effective form of health care.’
How Safe is Chiropractic for Low Back Pain (LBP)?
Low back pain is a common complaint that people see a chiropractor for. Research has shown that the safety of treatment by a chiropractor for this condition is favourable. A resent paper in the BMJ looked at the effectiveness and safety of spinal manipulative techniques (SMT) with other therapies. They included 47 randomised controlled trials with 9211 participants between the age of 30-50. The results of showed “Most of the observed adverse events were musculoskeletal related, transient in nature, and of mild to moderate severity.” (2)
What about Strokes & Chiropractic?
The research to date indicates that there is no causation between chiropractic neck adjustments and strokes. Chiropractors do not cause strokes.
In Europe they conducted a national survey on the safety of chiropractic adjustments of the neck. The study included 19,722 patients and their treatment outcomes. They concluded that:
“There were no reports of serious adverse events. Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low.” (3)
In fact one study showed how Chiropractic may possibly help Stroke Victims
In a recent randomised control cross over study with 12 stroke victims that all had a weak ankle, in particular the plantar muscles were weak on one side. Pointing the foot down was difficult for these people because the weak plantar muscles. The results showed a significant increase in muscle strength after only one chiropractic adjustment, whereas the control group did not experience any increase in strength. The researchers also discovered that the changes did not occur at the spinal level, but at the cortical, or brain level. The chiropractic ‘adjustment’ applied to the subluxated or stiff spinal joints stimulated the nerves in the brain that controlled the muscles in the foot. (4)
In my opinion chiropractic may have a positive impact on the improvement of their rehabilitation and definitely more research needs to be done in this area of stroke victims rehabilitation.
What about NSAIDS medications for Back Pain Relief
Taking medication can be a fast and easy option for some to give some relief. However this recent study published in the Annals of the Rheumatic Diseases has put the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) for spinal pain. They found that there was some effectiveness in relieving back pain but “the difference in outcomes between the intervention and the placebo groups is not clinically important (5)”
There’s a likelihood that NSAIDS could be doing more harm than good. “Patients taking commonly used anti-inflammatory drugs are 2.5 times more likely to suffer from gastro-intestinal problems such as stomach ulcers and bleeding (6)”.
How Do Chiropractors Limit the Risks
The care that we deliver at Errol Street Chiropractic is very much patient centred care. When we are assessing the possible risk factors we take many things into consideration, including:
- The age of the person
- Their health state
- Health history
- History of falls
- Evidence of degeneration or spinal deformity
- Sensitivity to pain
We let people know that after the first visit they may feel slight discomfort. The reason for this is because the adjustment increases movement in the joints that have not moved for a period of time, which can cause some inflammation. This inflammation may create some mild discomfort, similar to what you may feel if you undertake a new exercise.
We love to help the people achieve their health goals. We can then work towards their health goals only once we’ve taken into account all the considerations mentioned about,
1. Australian Chiropractor Association, Consumer Research Survey: July 2020 2. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. Rubenstein et al BMJ 2019 Mar 13;364:l689. https://pubmed.ncbi.nlm.nih.gov/30867144/ 3. Safety of chiropractic manipulation of the cervical spine: a prospective national survey. Haymo et al Spine (Phila Pa 1976) 2007 Oct 1;32(21):2375-8; discussion 2379. doi: 10.1097/BRS.0b013e3181557bb1. 4.Holt,K. Et al “The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients,” Scientific Reports, 9, Article Numbers: 2673(2019) 5.Machado GC, Maher CG, Ferreira PH, et al “Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis,” Annals of the Rheumatic Diseases, Published Online First: 02 February 2017. doi: 10.1136/annrheumdis-2016-210597 6. Taylor, A (2017), “Back pain medications do more harm than good, study finds,” Sydney Morning Herald, http://www.smh.com.au/national/health/back-pain-medications-do-more-harm-than-good-study-finds-20170202-gu3uhr.html retrieved 9 February 2017