Chiropractic is a manipulative technique where the goal is to solve mechanical disorders of the musculoskeletal system, especially the spine. Throughout its history, chiropractic has faced various controversies and criticisms. Although this type of care has shown some safe and beneficial outcomes, there has been a certain narrative about its effectiveness over a longer period of time.
Her role continues to raise a number of questions:
- Should this be the first thing when someone needs treatment? Or should it only be used if other treatments don’t work?
- Do some people benefit more from chiropractic than others?
If you’re looking for answers about whether chiropractic is safe, just keep reading.
What is the truth about chiropractors?
Chiropractors are not doctors. However, they undergo extensive training and need a diploma to practice. Chiropractors are trained health professionals who use practical solutions to properly address spinal problems and help the body heal naturally.
Confirmed benefits of chiropractic
Chiropractic can reduce pain for individuals with certain current or chronic conditions, including:
- Pain in the lower back
Low back pain is one of the most common causes of disability worldwide. The American College of Physicians (ACP) (2017) recommends spinal manipulation for patients with low back pain. Also, as detailed in a published study conducted by Paige et al. (2017), spinal manipulation brought modest improvements in pain relief and functionality for people with acute low back pain. This is also supported by a study by Goertz et al. (2018), which was published in JAMA Network Open. Moreover, the study included 750 active-duty military personnel with back pain who were divided into two groups. One group received standard care, which included medication, self-care, and physical therapy, while the other group received standard care along with up to 12 chiropractic treatments. After six weeks of treatment, participants received standard and safe chiropractic care:
– Lower levels of pain intensity have been reported.
– Subjects experienced reduced disability and functional improvement.
I’ve been more satisfied with this type of treatment.
– Less painkillers were used. - Neck pain
Neck pain is also one of the most common reasons why elderly patients seek help from a chiropractor.
In a study by Hanelinea & Cooperstein (2009), elderly patients who received chiropractic treatment showed improvement in all measured outcomes from their initial assessment to final evaluation. Approximately half of the patients responded to the satisfaction questionnaire, with almost all expressing satisfaction or great satisfaction with the care provided. Most said they would opt for chiropractic again if faced with a similar problem in the future.
Another study examined the experiences of patients with chiropractic for chronic neck pain. It was found that patients generally had positive and safe experiences with chiropractic, especially in relation to communication and access to appointments. (Hais et al., 2019). - Headaches
Chiropractors often treat cervicogenic headaches and migraines. Cervicogenic headaches are secondary headaches because the pain usually originates elsewhere, often from the neck. Migraine headaches cause intense, throbbing pain and usually affect one side of the head. There aren’t many options without medication to deal with these chronic headaches. Many headache patients who consult chiropractors have the characteristics of recurrent headaches. A study by Bronfort et al. (2001) reviewed several studies to determine the effectiveness of spinal manipulation for chronic headaches. They found that spinal manipulation showed encouraging results in the treatment of tension and migraine headaches.
All research has its limitations!
… And chiropractic is no exception.
While certain studies support the effectiveness of chiropractic for back, neck pain, and headaches, they have also identified limitations.
In a study by Piage et al. (2017), there is a lack of high-quality research, insufficient detail in describing chiropractic manipulation, significant variation between studies, and uncertainty about the clinical significance of improvement. In addition, publication bias can be worrisome. Moreover, Goertz et al. (2018) stated that low back pain is complicated because it is difficult to know exactly what causes it for each person.
Comparing chiropractic to other treatments, such as regular medical care, is tricky because chiropractic involves practical techniques. It is also important to recognize that chiropractic treatment alone may not be comprehensive, as it often includes additional standard care.
On the other hand, Hanelinea & Cooperstein (2009) acknowledged the lack of a control group or comparison with other treatments in their study, which makes it difficult to determine the effectiveness of chiropractic care compared to alternative approaches. The study only evaluated short-term results of up to 26 weeks, so the long-term safe effects of chiropractic care for acute neck pain remain unclear.
A study by Hais et al. (2019) relied on patients to report their experiences, and some were paid to answer questions, which could affect the results. In addition, only some people who were eligible for the study participated, which could mean that those who joined had better and safer experiences with chiropractic. What’s more, the study was unable to separate data for patients with specific chronic conditions, making it difficult to apply the findings to all chiropractic patients with chronic pain.
Finally, Bronfort et al. (2001) found nine studies involving 683 patients with chronic headaches. The trials differed in quality, patient characteristics, treatments, and outcome measures, making it difficult to compare results. This suggests that we need more in-depth research to understand how well chiropractic works and to address these issues.
The next question is…
Is chiropractic safe?
Previous research seems to imply that chiropractic is not safe for everyone.
Notable risks and side effects associated with chiropractic adjustments have been observed, including:
- Headaches.
- Fatigue.
- Discomfort in the treated parts of the body.
In addition, rare but serious risks associated with chiropractic adjustment include:
- Cauda equina stroke syndrome, a condition involving pinched nerves in the lower part of the spinal canal, potentially leads to permanent paralysis.
- Exacerbation of herniated discs.
According to a 2011 report by the European Spine Journal, cauda equina syndrome, a rare complication of spinal manipulations, is characterized by nerve damage in the lower part of the spinal cord. However, only a few cases have been reported. Studies on chiropractic often show its benefits, but the presence of adverse effects suggests that chiropractic may not be suitable for everyone. Then, who are the right candidates to undergo chiropractic treatment and who don’t?
Who can go to a chiropractor for treatment?
Patients with the following conditions are possible good candidates for chiropractic:
- Sprains
Sprains and strains in the back are also common causes of lower back pain. One treatment option is chiropractic care, which often involves manipulation of the spine. Research shows that spinal manipulation can help relieve pain and improve function in people with acute low back pain, one of the most common types of back pain. - Cocidinia
To put it simply, “cokidynia” is pain in the tailbone. Most cases of pain in the tailbone are due to pelvic dysfunction. Discomfort from a tailbone injury can be exacerbated if nearby muscles become stiff and swollen. This can also lead to an imbalance or misalignment in the pelvic area, exacerbating pain and dysfunction. Chiropractic care can also effectively treat problems with the coccyx and pelvic joints. Chiropractors also use a variety of techniques to adjust and manipulate the pelvis and coccyx, in order to correct misalignments and restore functionality. Although these techniques may involve mobilization, gentle manual adjustments, or specialized instruments designed specifically to realign the pelvis. - Myofascial pain
Myofascial pain syndrome occurs due to tenderness and tightness in the myofascial tissues, leading to chronic pain. Myofascial release therapy is a practical treatment for managing myofascial pain syndrome. The goal is to relax, stretch and align the fascia, relieving pain and restoring a complete range of motion. - Sciatica
Sciatica is also a form of pain that originates in the back and extends down the leg. It is often triggered by pressure on the sciatic nerve or its roots in the spine. Generally, sciatica is not the result of a serious condition and usually resolves over time. Chiropractic adjustments can be effective and provide relief for someone who has sciatica pain.
In which cases should you not seek help from a chiropractor?
Chiropractic care primarily focuses on adjusting the spine to improve the health of the musculoskeletal system.
- Numbness, tingling, or loss of strength in the arm or leg
Chiropractic primarily focuses on adjusting the spine to improve musculoskeletal health. While it may be beneficial for certain conditions, it may not be effective for symptoms such as numbness, tingling, or weakness in the extremities. - Increased risk of stroke
Although strokes rarely occur due to chiropractic adjustments, rigorous manipulation of the cervix can cause arterial dissection in people predisposed to this condition. Arterial dissection is also a significant cause of ischemic stroke. - Known bone abnormality in the upper part of the neck
Modify or avoid chiropractic altogether if you have a known bone abnormality in the upper neck, such as congenital malformations or severe degeneration. - Osteoporosis
Chiropractic adjustments, which involve manipulating the spine, can pose a risk to people with osteoporosis because of their delicate bones. Roberts and Wolfe (2012) confirmed that osteoporosis is often considered a relative or absolute contraindication to this type of treatment, as the external force applied during the process can potentially lead to the collapse of the vertebrae. - Ankylosing spondylitis
Chiropractic treatment is generally not safe and is not recommended for the treatment of ankylosing spondylitis. Due to the fusion of the bones in the neck and spine, spinal adjustments performed by a chiropractor can inadvertently lead to fractures or dislocations, especially in relation to the neck. - Tuberculosis of the spine
Spinal tuberculosis, caused by Mycobacterium tuberculosis, is an infectious disease. Engaging in spinal manipulation during chiropractic adjustment may risk spreading the infection to other regions. - Spondylolisthesis
The potential risks of chiropractic solutions, especially those involving twisting movements, include the potential to worsen pre-existing conditions of the spine, cause muscle strain or sprain, and potentially result in injury or discomfort. - Lumbar spondylosis
Lumbar spondylosis is also a prevalent condition that affects millions around the world. Although uncommon, chiropractic care carries a risk of injury, especially during spinal manipulation, which can lead to muscle strain, ligament sprains, or nerve irritation. - Spondylolysis
Spondylolysis is a defect in the pars interarticularis, a segment of the vertebrae. Spinal manipulation may also pose an increased risk of fractures or dislocations in people with this defect. In spondylosis, the joints may become swollen and inflamed, leading to the avoidance of chiropractic treatments during these periods. Therefore, manipulation of the spine can pose a risk to people with spondylolysis.
You may also be wondering if this kind of treatment can be done to children.
Chiropractic is a controversial topic. Many people, even in the field of chiropractic, debate whether it is a good idea or not. Moreover, French et al. (2010) reviewed a series of journals called “Chiropractic Child Care”. They found limitations in chiropractic care for children, including the lack of a strong evidence base supporting chiropractic for pediatric patients and the controversial nature of the field within and outside the profession. The study raises concerns about the appropriateness of chiropractic treatment for children in the absence of solid evidence and emphasizes the importance of informed decision-making, clinician competence, and adherence to best practice guidelines for the treatment of pediatric patients. Therefore, choosing a qualified chiropractor who follows safety guidelines and takes into account individual health conditions is crucial to minimize risks.
How to choose a qualified and reputable chiropractor?
Several guidelines can help you choose a good chiropractor:
Recommendations : Start by asking your doctor for a list of chiropractor recommendations. Alternatively, seek referrals from family, friends, or other healthcare professionals.
Research the chiropractor’s level of education : When choosing a chiropractor, licensing is also a key aspect to consider as it indicates that the chiropractor is safe and possesses the necessary training, expertise and experience to provide chiropractic care.
Consider the chiropractor’s experience : The more experience the chiropractor has with the condition or procedure, the better your results are likely to be.
Consider gender : It is crucial that you feel at ease with the gender of your chiropractor because you will be talking about personal matters.
Evaluate the style of communication : Is the chiropractor approachable and kind? Does the patient feel at ease talking to the chiropractor? Does the chiropractor adequately respond to all patient inquiries? Does the chiropractor listen carefully to the patient’s full description of symptoms and preferences for treatment?
Read patient reviews : Patient reviews often tell about how easy it is to make appointments, how long they have to wait, whether the space is hygienically clean, and whether the staff is friendly. They also say whether patients trust the doctor, whether the doctor spends enough time with them, and whether the doctor answers their questions well.
Know what your insurance covers: Your insurance is also important. You may want to choose a chiropractor who works with your plan so that you can benefit the most and pay less money out of pocket for treatment.
Conclusion
Despite historical controversies and ongoing debates about its effectiveness, chiropractic has shown some positive and safe effects, especially in relieving acute and chronic pain, such as low back pain, neck pain, and headaches. However, there are limitations and risks, as evidenced by the lack of quality research and the occurrence of adverse effects. Therefore, the decision to undergo chiropractic treatment should be made with caution.
Did you know that some of your most common daily habits also contribute to back pain? It’s true! But, once you understand how and why, and make some easy adjustments, you can start to strengthen your back. That’s why you feel free to contact us to create daily habits for a healthy back!
Disclaimer:
The information presented here is not intended to diminish the benefits of chiropractic medicine, but to encourage caution and informed decision-making. Chiropractic has shown some positive effects in certain cases, but it is essential to take into account individual health conditions and consult with qualified practitioners who adhere to safety guidelines and best practices.
