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J R Soc Med. 2000 May; 93(5): 258–259.
PMCID: PMC1298004

Adverse effects of spinal manipulation.


Guidelines on acute back pain recommend spinal manipulation, but some commentators express concern that the adverse effects are under-reported. Eleven chiropractors distributed questionnaires to 108 consecutive new patients aged > 18 years, enquiring about adverse effects one hour, one day and two days after spinal manipulation. The forms were to be completed anonymously. 80 questionnaires (74%) were returned, 68 suitable for analysis. 28 patients reported adverse effects at one hour after treatment, the most common of which were extra pain (14) and radiating pain (9). 8 had reactions beginning the morning after. No serious adverse effects were reported. The adverse reactions, recorded in 53% of respondents, are those to be expected from a treatment that entails initial discomfort. They need to be set against the long-term benefits of spinal manipulation.

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Selected References

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  • Ernst E, Assendelft WJ. Chiropractic for low back pain. We don't know whether it does more good than harm. BMJ. 1998 Jul 18;317(7152):160–160. [PMC free article] [PubMed]

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