(Daytona Beach, FL)

Is it normal or okay to have more pain after an adjustment than before I had it? I had an adjustment yesterday and my lower back was very "stiff". He did his adjustment and when he was done I was in extreme pain and could hardly walk. He said it was because the muscles didn't know what to do yet....Today, I am still in pain, although it is better, and cannot bend to put on shoes or socks...I have never experienced feeling worse after an adjustment and this is a new Doctor, so I am just curious if this is really acceptable...

Dear Friend,
A certain amount of "after-pain" lasting perhaps up to 24 hours is not uncommon. Longer than that is certainly not acceptable. Well, let's be gracious and say two days.

But acute, severe pain after the treatment is surely not the norm, but yes it does occasionally happen. It's one of the reasons that the wise doctor is fairly conservative and gentle in the initial phase of treatment until s/he get's to know the patient's back. Each is individual and has its quirks.

You say it is improving, so I wouldn't be too anxious at this stage. You make no mention of increased leg pain, that I would consider in a more serious light.

In the meantime, use ice for pain-control (an icepack in a tea-towel for about 20-30 minutes), try not to bend, be careful not to sneeze (blow your nose if you feel a sneeze coming on), sit less, perhaps much less.

One last thought: after the treatment, your back will be vulnerable for at least a few hours and sometimes a day or two. You didn't do anything silly immediately after the treatment? Sometimes the doctor gets the blame, but in reality the patient sneezed, or went and played a game of golf...

Discuss this thoroughly with your chiropractor at the next visit. If you feel he does not take your concerns seriously, then I would go elsewhere.

To be quite honest, every back is unique, and the clinician has to work that "this works" and "that makes it worse". Provide you feel s/he is thinking, considering, taking his time, be patient. If you are being rushed in and out, no examination, no history, (take a look at his notes: does he write down exactly what tests were positive and how he treated you?)

In short, is he conscientious, thorough and careful with your body. You obviously have been to other chiropractors before, so you know what I mean. If the answer is yes, then be patient... if not, well you know what to do. Vote with your feet.

I hope this has contributed.

Dr B

PS: I don't buy that "the muscles don't yet know what to do".


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Jan 14, 2011
Doesn't seem right..
by: Anonymous

In my experience of over 25 years going to chiropractors, when I'm worse after an adjustment, something was wrong w/ the adjustment. My own beloved chiropractor that I've been seeing exclusively for many years now (after a few tries with some not-so-good ones first) does not adjust my low back because when I have had him do so on a few occasions I felt a lot worse so I just leave that area alone. Luckily I don't have much trouble there.

My trouble area is my neck and there are times he can fix it on one visit by adjusting 1-2 vertebrae but sometimes he goes overboard and moves them too far or in the wrong direction. I know by the next day (never longer than that) if the adjustment was correct or not. If not I call and go back and since I know and trust him I will return until he gets it right. Which he always does (sometimes right away sometimes after a few visits).

If what's happening to you is muscles, then ice or ibuprofen would ease the pain. Does it? If not, my guess is he did the adjustment incorrectly or something. Low back seems to be a tough area for many chiros to get right (just from my experience). He may not be a good chiropractor for you (since you said he's new). You might want to go elsewhere if you aren't feeling better very soon.

Just my opinion, take it or leave it! Good luck.

Every spine is unique, one responds well to adjustments, another to Thompson drop protocol, some to traction, some to massage, some don't get better with anything that I can do, and very occasionally someone may get worse.

They don't call it a "practice" for nothing. We practise on you, dear patients! Seriously though, if Michelangelo could say at 85 "I'm still learning" then that's good enough for me. Few of us were much good in our first months, and for some years in practice, I certainly wasn't. It takes a lot of acumen, judgement, skill, wisdom to be a good doctor, and that applies just as much to a chiropractor as a surgeon, a gynacologist... and most difficult of all your family doctor. They have to be a specialist of the whole body.

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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