How safe is chiropractic?

How safe is chiropractic or any other treatment for that matter?

There has been much rhetoric about how dangerous manipulation is, or could be, particularly of the cervical spine. What is important is the relative safety. Almost no treatment for any condition can be described as totally safe. Even drugs as common place as aspirin and anti-inflammatories cause a significant number of deaths every year, far in excess of a stroke after a chiropractic adjustment.

Chiropractic causes extremely few deaths. Statisticians have shown that you have about the same chance of dying from an adjustment as from being struck by lightening while playing golf; but it can happen.

It does happen, but it is very rare. 

Less than one in a million chance, and that makes the chiropractic adjustment one of the very safest treatments.

In comparison, the U.S. Department of Health and Human Resources stated that, on average, 17.14 percent of the 700 000 physicians in the United States causes one accidental death per year.

This page was last updated by Dr Barrie Lewis DC on 28th April, 2020.

How safe is chiropractic

How safe is chiropractic is a question that every potential patient should be asking, and of course of conventional care like drugs and surgery too. Whilst increased pain is not uncommon, catastrophic events are few and far between.

Actuarial reports

More important than all the rhetoric is the report of actuaries; the mathematicians who decide what insurance doctors should pay. Their calculations concerning the safety of chiropractic reveal that we should pay premiums of approximately $2000 per year. Some medical physicians pay over 100 000 dollars annually.

There are very few successful cases against chiropractors.

Is chiropractic totally safe? No, it is not but it is a great deal safer than taking anti-inflammatories or going for surgery. They too, however, have their merits and your chiropractor may sometimes refer you for medical care.

How safe is Chiropractic? Pretty, damn safe. However, you can fairly frequently experience increased pain after the first few treatments. In fact there is some research suggesting that if you do not have some after pain you may also not get much benefit from manipulative care.

But that is another story; I am not in agreement of the no pain, no gain philosophy.

Dr Scott Haldeman, medical neurologist and chiropractor, states that there have been 23 known cases of vertebral artery dissection in 10 years after a chiropractic adjustment of the neck.

However, he is of the opinion that these dissections were probably in progress before the treatment, rather than caused by the manipulation. During this time 135,000,000 cervical manipulations were given; a rate of less than 1 stroke after 6 million cervical adjustments.

In comparison, 16 000 Americans died in one year from gastric hemorrhage, directly from taking NSAIDs, not including those who died from heart and other complications of anti inflammatory drugs.


The only sensible conclusion is that chiropractic manipulation is a relatively but not perfectly, safe procedure for the treatment of neck pain and headache.

There are no perfectly safe procedures in any of the healing professions.


One in six million patients who have had a cervical manipulation will within three weeks have a stroke; are they connected? Some yes, most no say the experts. Yet how safe is chiropractic is still an important question, more for the DC than his patients.

Should this patient be considered high risk?

Vertebral artery.

The BONE and JOINT decade 2000-2010 World Health Organisation Task Force

The Task Force, a multi-disciplinary research body, evaluated a 1000 studies on neck pain before coming up with a report addressing the question How safe is Chiropractic for cervical spine conditions concluded with the the following statement:

We analyzed a total of 818 cases of Vertebro Basilar Artery (VBA) stroke admitted to Ontario hospitals over a 9-year period (more than 100 million patient-years of observation) in answer to the question, HOW SAFE IS CHIROPRACTIC?

"VBA stroke is a very rare event and that the risk associated with a visit to a chiropractor’s office appears to be no different from the risk following a consultation with the family physician."

A brush with stroke

A brave chiropractor reveals all in his first-hand shattering experience with Coalface STROKE; yet, because the wise DC behaved so astutely, all ended well.

An experience like this, or worse, will happen on average to about one in ten chiropractors on a single occasion in his/her whole lifetime in practice.


Vaccination remains a thorn in the flesh of Alternative Healthcare, and I'm not aware of a strong statement confirming or denying the value of vaccination from the mainline of the profession. Fringe Chiropractic continues to condemn it.

I was born into a Chiropractic family. Both my parents were DCs, and I was not vaccinated as a baby. I, together with eight other children who were jabbed, very nearly died of diphtheria at nine months old, saved only by a combination of good nursing and adjustments. Did they help? I believe so, though there is no research of course.

This month, in our small town in Holland, a healthy nine-year old boy died suddenly three days after a vaccination, resurrecting all the old fears. Thousands are now refusing to be jabbed.

Last month in one week three healthy children died within ten days of receiving a vaccination.

I am not abreast of all the facts, though I suspect at the end of the day, the enormous benefit to the majority, preventing the scourges of polio, small pox and many other diseases, should not be disregarded because of the side effects, albeit very serious, on a tiny minority.

Like Chiropractic, do the enormous benefits of vaccination not vastly outweigh the occasional serious side-effects?

Having said that, I personally do not recommend vaccination against non-serious diseases. Only recently a patient suffered a dreadful bout of influenza that lasted over a month after a 'flu injection. Worse, the most serious case of shingles that I have ever seen began shortly after a shingles vaccination.

In the Spring of 2009, the Dutch minister of health announced that he has ordered enough vaccine to vaccinate every man, woman and child twice against Mexican Swine flu. I'm not convinced that I'll be queueing up for my jabs!

Update: Half way through the programme, it was suspended, no reasons given.

How safe is Chiropractic? I suspect that death from vaccination is probably about as prevalent as stroke from a Chiropractic adjustment. Does that invalidate either?

Update:  Because of several strokes recently, after cervical manipulation by physiotherapists who had been to a few weekend courses, the Minister of Health in Holland is threatening to ban all cervical manipulation.

But, yes, they do occur after Chiropractic manipulation too, only very rarely. Less than one in a million neck manipulations. It's all about proper training.

Would you allow a chiropractor to remove your appendix after attending a few weekend seminars on the subject?

The RATIONALE for the "Chiropractic Adjustment"

Probably the biggest single medical critique is not "HOW SAFE IS CHIROPRACTIC?" but that there is no scientific basis for the "adjustment." They may have been the case once but now there is a huge amount of basic research confirming that fixated joints become arthritic much faster; and bombard the spinal cord with noxious input.


Of far greater concern is the dizzy patient.

An upper cervical subluxation can cause dizziness or vertigo; they're not quite the same but a more likely genesis is loose calcium crystals in the inner ear. For that (it's called BPPV) the treatment of choice is NOT manipulation but the Epley manoeuvres.

The test to differentially diagnose between an upper cervical cause and an inner ear cause is the Hallpike Dix test.

Chiropractic research indicates that upper cervical manipulation of the dizzy patient may often aggravate the condition. Hence the importance first to rule out an inner ear condition called BPPV as a cause of Vertigo Dizziness.

Benign Positional Paroxysmal Vertigo.

Rib pain treatment

Teddy needs a rib adjustment.

Even the most gentle and careful chiropractor will very occasionally crack a rib during rib pain treatment and not only in the elderly and osteoporotic. I admit to eight during 36 years in practice, two of which with hind sight should not have happened and could be described as negligent. All eight recovered completely with a few weeks, but with considerable gnashing of teeth! A bouquet of flowers went a long way. How safe is Chiropractic? Not perfectly safe.

None sued me. If every patient with cracked rib sued their chiropractor, there would be no more rib pain treatment and patients would have to suffer one of the most debilitating and painful conditions - a rib head subluxation, or sprung rib, is excruciating. Every breath ....

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