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J R Soc Med 2000;93:258-259
© 2000 Royal Society of Medicine

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Journal of the Royal Society of Medicine, Vol 93, Issue 5 258-259, Copyright © 2000 by Royal Society of Medicine

ORIGINAL ARTICLES

Adverse effects of spinal manipulation

AJ Barrett and AC Breen
Institute for Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, Bournemouth, UK.

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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