Chiropractic manipulation of the spine was once considered part of medicine’s fringe, a “bastardized form” of osteopathic medicine. But evidence of its benefits has helped the technique become more of a part of mainstream medicine, and its practitioners are licensed to perform duties. The actual word chiropractic dates to the Greek words for hand (cheir) and done (praktos), which together means “done by hand.”

An estimated 22 million Americans pay a visit to the chiropractor each year, seeking relief from back pain, neck pain, pinched nerves, disc problems and arm, leg and head injuries caused by sports injuries, accidents and strains.

Spinal manipulation as a form of healing dates back to ancient Greece, when Hippocrates called it a key to treating disease. The practice in America began at the beginning of the 20th century, when Daniel David Palmer became fascinated with the spine as a key to good health. He began studying ancient texts on the art and reviewing anatomy. Legend has it that his first patient was a deaf janitor. When Palmer examined the man, he noticed a bump near the spine. By manipulating it, he allegedly restored the man’s hearing. So began chiropractic medicine in America.

Palmer coined the phrase “subluxation” around 1907 to describe the ways spinal vertebrae and joints could put pressure on nerves and cause problems. He detailed the ways various spinal adjustments could help with those problems.

Today, subluxation is still used by many chiropractors to describe various issues that can be treated with chiropractic techniques, but some use such terms as spinal dysfunction, joint dysfunction and manipulative lesion to describe various issues. The treatments are considered safe when performed by a licensed and trained manipulator.


Chiropractic Concerns

Moving the neck with various jerking motions does have risks, and pressure on any area of the spine can create problems.

Some studies of chiropractic medicine have raised concerns over the practice of cervical neck manipulations, which may tear a carotid or vertebral artery leading to the brain. This can cause a blood clot that may lead to a stroke.

A 2010 study of post-chiropractic treatment deaths found that most of the deceased perished because a tear of a vertebral artery. That study found 26 published and seven unpublished cases but indicated that many more such problems may not have been reported or attributed correctly.

Similarly, a 2007 survey of adverse effects published in various medical journals found that spinal manipulation could lead to various problems, including strokes, and noted that problems were likely under-reported. A 2013 survey of 43 studies conducted between 2001 and 2011 seemed to back that up, with 707 strokes associated with cervical spinal manipulation.

That lack of data has led some to question whether chiropractic treatments are as safe as claimed. Not reporting the adverse effects of treatment is considered unethical by the medical community and creates a falsely positive notion of how safe chiropractic treatment may be.  

The conundrum is that clinical trials must support any claims for medical treatment. If there were no adverse effects from the treatment, that should also be reported. Some studies claim that as many as 50 percent of patients who visit a chiropractor may have adverse effects, including pain at the site of manipulation that goes away after a few days.


Among the problems that chiropractors can create are herniated discs or making an existing condition with spinal discs worse and compressing nerves in the lower spinal column (known as cauda equina syndrome).

Patients with certain pre-existing conditions are not advised to use chiropractic treatment for fear of aggravating their conditions. This includes people with severe osteoporosis, existing tingling, numbness or lack of strength in the legs or arms; those with cancer of the spine; people with an elevated risk of stroke, such as those who have already had one or currently have high blood pressure, diabetes or are extremely overweight; and those with spinal instability or other excessive motion in the area.

Signs of a Bad Chiropractor

As with any doctor, there are rules and licenses that must be obtained by a chiropractic practitioner. Here are a few rules:

1. Licenses should be prominently displayed in an easily accessible area. You should be able to see that the practitioner is up to date on the licensing requirements of your area.
2. A complete medical history should be taken - A competent chiropractor will want to know about medical history before doing any treatment.
3. Your case should be discussed before treatment. It is important to know how many visits will be required before beginning any regimen.
4. Costs of the treatments should be discussed. This includes whether the proposed treatments will be covered by insurance before any treatments begin.
   

5. The chiropractor should provide a method of contact. If there are any problems or adverse effects, you should have a way of contacting your practitioner immediately, whether via a 24-hour answering service or other means.
6. Chiropractors should present a professional appearance. Like doctors, licensed chiropractors undergo four to five years of study and a clinical trial working under experienced practitioners. State medical boards closely regulate them, and most offices resemble the clinical settings of traditional doctors. If the alleged chiropractor is part of a gym or other unusual setting, it’s best to ask questions before treatment.

As with any medical procedure, a patient is under no obligation to submit to any proposed treatment without careful thought and consideration. Chiropractic medicine is wonderful for certain conditions, but some practitioners make claims that may be beyond the science’s standard treatment of chronic back pain, spinal issues or neck problems. When in doubt, ask for a second opinion and do not undergo any uncomfortable treatment.