Predictors of side effects to spinal manipulative therapy

Area of Science:

• Chiropractic and Manual Therapy
• Patient Safety and Adverse Events
• Clinical Predictors of Treatment Outcomes

Background:

• Spinal manipulative therapy (SMT) is a common treatment modality.
• Understanding predictors of SMT-related side effects is crucial for patient safety and informed consent.
• Previous research has explored adverse events, but prediction remains challenging.

Purpose of the Study:

• To investigate patient- and treatment-related predictors of side effects following spinal manipulative therapy.
• To differentiate predictors for common versus uncommon adverse reactions.
• To assess the clinical significance of identified predictors.

Main Methods:

• Prospective, clinic-based survey involving 102 chiropractors and 1058 patients in Norway.
• Data collected via patient interviews and standard questionnaires over up to six treatment sessions.
• Outcome variables (treatment reactions) cross-tabulated against patient demographics and treatment characteristics.

Main Results:

• Patient sex and treatment factors were identified as predictors of SMT side effects.
• Women reported reactions more frequently than men, with gender-specific reaction types.
• Reactions were more common during initial treatments, with multi-region or thoracic-only treatment; no predictors for uncommon reactions were found.

Conclusions:

• Specific patient and treatment-related factors can predict some side effects of spinal manipulative therapy.
• Further research is required to fully elucidate the clinical significance of these predictors.
• Predicting uncommon SMT side effects remains an area needing further investigation.