Side effects of chiropractic treatment: a prospective study

Area of Science:

• Chiropractic care
• Manual therapy
• Adverse events research

Background:

• Understanding patient responses to spinal manipulative therapy (SMT) is crucial for clinical practice.
• Previous studies have characterized SMT side effects, but further investigation is needed to confirm these findings.

Purpose of the Study:

• To investigate if the characteristics of unpleasant side effects following spinal manipulative therapy align with those identified in prior research.
• To provide a comprehensive overview of common and uncommon reactions to chiropractic SMT.

Main Methods:

• A prospective interview survey was conducted using standard questionnaires.
• Data were collected from 66 Swedish chiropractic practices, involving 625 patients across 1858 recorded visits.
• Patients self-reported unpleasant reactions, including onset time, duration, and symptom severity following spinal manipulation.

Main Results:

• Reactions to spinal manipulation are common, benign, and typically resolve within 24 hours post-treatment.
• The most frequent reactions include local discomfort (two-thirds of cases), followed by non-local pain, fatigue, or headache (10% each).
• Nausea, dizziness, and other reactions are infrequent (<5%). Reactions are more common in women and at the start of treatment series, particularly for patients with chronic issues.

Conclusions:

• Common and uncommon reactions to chiropractic spinal manipulation have been identified.
• These reactions are largely predictable and appear to be predominantly physiological in nature.
• The findings support the safety profile of SMT when considering patient-reported outcomes.