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Chiropractic treatments are an effective option for treating spinal pain and some headaches. However, they may cause minor, temporary side effects, such as discomfort, stiffness, or headaches, and in rare cases, severe complications such as spinal cord injury, artery dissection, and stroke. Chiropractors are healthcare professionals who treat back and neck pain through spinal manipulation, which involves applying rapid force to the joints, often resulting in popping sounds. While this technique is generally safe, there are associated risks, including nerve damage and, in rare cases, life-threatening injuries. The frequency of adverse effects is unknown, with estimates varying from 6.4 per 10 million manipulations of the upper spine to 1 per 100 million manipulations of the lower spine.
| Characteristics | Values |
|---|---|
| Chiropractic treatment causing injury | Brachial plexus nerve injury, spinal cord injury, artery dissection, stroke, cauda equina syndrome, lumbar disk herniation, fracture, hematoma or hemorrhagic cyst, cord injury, nerve root injury, cervical spine dislocation, soft tissue injury |
| Chiropractic treatment causing minor side effects | Discomfort, stiffness, headache, muscle soreness |
| Chiropractic treatment risks | Risk of arterial dissection, life-threatening hemopneumothorax, vertebrobasilar accidents, traumatic injury |
| Chiropractic treatment "red flags" | Bleeding disorders, structural instability issues, inadequate physical examination, inadequate skills and training |
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What You'll Learn
Brachial plexus nerve injury
Chiropractic care is generally considered a safe and effective treatment option for people with brachial plexus injuries. This type of injury involves the stretching, compression, or tearing of the network of nerves that run from the spinal cord to the shoulder, arm, and hand. Chiropractors can help manage pain and prevent the worsening of symptoms through techniques such as soft tissue work, nerve flossing, joint traction, and e-stimulation. They may also recommend therapeutic exercises, stretches, and ergonomic changes to promote long-term wellness and prevent future injuries.
However, there have been reported cases of chiropractic adjustments causing or contributing to brachial plexus nerve injuries. In one case, a man in his 30s named Brandon sought chiropractic treatment for tight, sore shoulders, hands, and arms, as well as a pins-and-needles sensation in his hands. After a high-velocity maneuver or jolt during neck manipulation, Brandon lost motor function in his left arm and experienced muscle wasting. A nerve conduction study revealed partial denervation in the muscles supplied by the C5 and C6 spinal nerves, which contribute to the brachial plexus.
It is important to note that chiropractors are not physicians, but they do hold doctoral degrees in chiropractic care. While many patients find relief from chiropractic manipulations, excessive force or improper techniques can lead to serious injuries, including permanent neurological damage, strokes, or even death. As with any healthcare provider, it is essential to research the chiropractor's qualifications, experience, and reputation before undergoing treatment.
If you believe that you or someone you know has suffered a brachial plexus nerve injury due to chiropractic malpractice, it is advisable to seek legal counsel and consult with a medical professional for a thorough evaluation and appropriate treatment plan. Brachial plexus injuries can range from minor strains to major avulsions or ruptures, and prompt attention is necessary to optimize recovery and prevent further complications.
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Arterial dissection
Chiropractic treatments can cause minor, temporary side effects, such as discomfort, stiffness, or headaches. In rare cases, more severe events, such as spinal cord injury, artery dissection, and stroke, have been reported. Arterial dissection is a tear in the inner lining of an artery, which can cause blood to enter the arterial wall and form a blood clot. Arterial dissections are a rare but important cause of ischemic stroke, especially in younger patients.
Chiropractors are healthcare professionals who treat back and neck pain through manipulations of the spine and neck. These manipulations often involve high-velocity thrusts, where joints are adjusted rapidly, sometimes resulting in popping sounds. While the frequency of serious adverse effects is unknown, estimates vary from 6.4 per 10 million manipulations of the upper spine to 1 per 100 million manipulations of the lower spine.
The incidence of vertebral artery dissection due to chiropractic manipulation is difficult to determine. It has been estimated at 1 in 20,000 spinal manipulations, but the exact incidence is unknown. This is partly because people with neck pain may already have a vertebral dissection before seeking chiropractic treatment, making it hard to establish a causal link. However, research has found that the odds of a vertebrobasilar accident occurring within one week of visiting a chiropractor are increased by a factor of five for patients under 45.
There is currently no consensus on the management of vertebral artery dissections. Initial treatment typically involves heparin, followed by warfarin or antiplatelet therapy. However, the incidence of recurrent ischemic stroke in patients with a vertebral artery dissection is low and appears to be independent of the type of antithrombotic treatment used.
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Vertebrobasilar accidents
Chiropractic care is generally considered a safe and effective treatment for spinal and musculoskeletal issues. However, as with any medical procedure, there are rare but serious risks associated with spinal manipulation, one of which is vertebrobasilar accidents (VBA).
VBA can present with a range of symptoms, including dizziness, unsteadiness, and imbalance. More severe cases may present with double vision, slurred speech, or even a stroke. The symptoms of VBA are often immediate, occurring within seconds to minutes of the manipulation, but they can also develop over hours or days. It is important to note that VBA is a rare complication, and the vast majority of chiropractic patients will not experience any adverse effects. However, the potential risk underscores the importance of seeking care from a qualified and experienced chiropractor.
To mitigate the risk of VBA and other complications, it is essential to choose a reputable chiropractor with the necessary qualifications and experience. Before undergoing any spinal manipulation, patients should ensure their chiropractor has a detailed understanding of their medical history, including any pre-existing conditions or risk factors that could increase the chance of complications. Additionally, patients should be aware of the potential risks and benefits of spinal manipulation and provide informed consent before proceeding with any treatment.
The benefits of chiropractic care can be significant for many people, and the risk of VBA, while serious, is very low. Patients should discuss any concerns they may have with their chiropractor, who can provide personalized advice and ensure that the potential benefits of treatment outweigh any risks. Furthermore, patients should report any unusual symptoms following spinal manipulation, as early recognition and treatment of VBA can significantly improve outcomes.
In summary, vertebrobasilar accidents are a rare but serious complication of spinal manipulation, particularly neck adjustments. While chiropractic care is generally safe and effective, it is important to be aware of potential risks and to seek care from qualified and experienced practitioners. Patients should also be vigilant for any unusual symptoms following treatment and seek immediate medical attention if necessary.
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High-velocity manipulation
Chiropractic treatments may cause minor, temporary side effects, such as discomfort, stiffness, or headaches. In rare cases, they can also cause severe complications, including spinal cord injury, artery dissection, and stroke. The frequency of these severe adverse effects is currently unknown, but chiropractors have estimated that they occur in 6.4 per 10 million manipulations of the upper spine and 1 per 100 million manipulations of the lower spine.
One of the techniques used by chiropractors is spinal manipulation (SM), which involves a high-velocity, low-amplitude (HVLA) thrust delivered by hand to the spine or directly related joints. This technique is often accompanied by popping or cracking sounds. Spinal manipulation has been claimed to change anatomy, either in structure or position, and these changes may lead to clinical improvements. However, there is also evidence that spinal manipulation can be harmful. For example, a 2021 case report detailed a case of life-threatening hemopneumothorax occurring after chiropractic manipulation to the chest and spine. Another study found that in patients younger than 45 years, the odds of having a vertebrobasilar accident within one week of visiting a chiropractor were increased by a factor of five.
While high-velocity manipulation can be beneficial for some people, especially those with motion restrictions and subluxations, it is crucial to be aware of the potential risks and side effects. It is always advisable to consult with a qualified healthcare professional before undergoing any chiropractic treatment.
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Spinal cord injury
Chiropractic treatments can cause minor, temporary side effects, such as discomfort, stiffness, or headaches. These benign adverse side effects are usually mild to moderate and may resolve on their own. Around 50% of people who have spinal manipulation experience such effects.
However, in rare cases, people have also reported severe events, including spinal cord injury, artery dissection, and stroke. Research suggests a link between chiropractic treatments and the risk of arterial dissection, but more evidence is needed to prove causation. Arterial dissection is a tear in the inside wall of an artery in the neck and can be life-threatening. It can significantly increase the risk of a stroke.
There have been several reported cases of severe complications arising from chiropractic treatment. In one instance, a 48-year-old woman with chronic neck pain experienced sudden neck pain and generalised weakness during a chiropractic session. A neurologic examination showed tetraplegia with a C5 sensory level. A cervical spine CT scan revealed a fracture affecting the C5 and C6 vertebra, which was confirmed by an MRI to have resulted in a spinal cord injury.
In another case, a man in his 30s, named Brandon, went to a chiropractor for relief from tight, sore shoulders, hands, and arms. During the session, he felt a jolt and sudden burning sensation in his left arm. By the time he left the chiropractor's office, he had lost motor function in that arm. A nerve conduction study showed partial denervation (nerve damage) in the muscles supplied by the C5 and C6 spinal nerves, which contribute to the brachial plexus, a bundle of nerves that runs through each armpit to supply the upper extremity.
Chiropractors are healthcare professionals with extensive training and a comprehensive understanding of the spine, back muscles, and the related nervous system. They are qualified for the diagnosis and treatment of musculoskeletal conditions and are effective in managing acute and chronic neck or back pain, with or without neurological impairment. Chiropractic treatment can be used to speed up recovery in mild back injuries and improve mobility and relieve pain.
Chiropractic care can also play a role in spinal cord injury rehabilitation. Chiropractors can recommend rehabilitation exercises or physical therapy to stretch and strengthen the back and improve mobility. Ultrasound therapy, for example, can increase blood flow to the surrounding tissue, improve flexibility, and reduce swelling. Electrical muscle stimulation (EMS) is another therapeutic treatment used to rehabilitate spinal cord injuries by strengthening the surrounding muscles and tissue and reducing muscle spasms.
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Frequently asked questions
Chiropractic treatments may cause minor, temporary side effects, such as discomfort, muscle soreness, stiffness, or a headache. In rare cases, people have reported more severe events, including spinal cord injury, artery dissection, and stroke.
If you feel a chiropractor has caused you injury, or been negligent in their practice, you may be able to contact a medical malpractice attorney.
Chiropractors will pay close attention to your medical history and any co-existing conditions. They may decide to modify the treatment approach depending on your medical history. Bleeding disorders and structural instability issues can be red flags, as can inadequate physical examinations or a lack of skills and training on the chiropractor's part.
