Safety of Chiropractic Interventions: A Systematic Review

  title={Safety of Chiropractic Interventions: A Systematic Review},
  author={Liliana Olim Gouveia and Pedro Castanho and Joaquim J. Ferreira},
Study Design. Systematic review of reported adverse events. Objective. To evaluate the tolerability and safety of chiropractic procedures. Summary of Background Data. Despite the increasing popularity of chiropractic, there are few properly designed prospective controlled trials, and there is a disproportionate lack of evaluation of its safety profile. The literature reports multiple neurologic complications of spinal manipulation, some of which are clinically relevant and even life threatening… 


Preliminary evidence shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability.

A narrative review of the published chiropractic literature regarding older patients from 2001-2010.

This review found 188 retrievable articles available to practitioners to effectively care plan for their older patients, a better than three fold increase in the number of references found during a similar review conducted at the end of the previous decade.

Acute Thoracic Aortic Dissection After Chiropractic Intervention: A Case Report.

A case of a fatalThoracic aortic dissection following thoracic chiropractic manipulation is presented, and the patient’s family was informed that data concerning the case would be submitted for publication, and they provided consent.

Standardization of adverse event terminology and reporting in orthopaedic physical therapy: application to the cervical spine.

Tackling harm reporting within physical therapy using cervical manual therapy as an example is focused on theoretical considerations and evidence in terms of harm reporting.



Risks associated with spinal manipulation.

Frequency and Clinical Predictors of Adverse Reactions to Chiropractic Care in the UCLA Neck Pain Study

The results suggest that adverse reactions to chiropractic care for neck pain are common and that despite somewhat imprecise estimation, adverse reactions appear more likely to follow cervical spine manipulation than mobilization.

Chiropractic spinal manipulation for neck pain: a systematic review.

  • E. Ernst
  • Medicine
    The journal of pain : official journal of the American Pain Society
  • 2003
The notion that CSM is more effective than conventional exercise treatment in the treatment of neck pain was not supported by rigorous trial data.

Prospective investigations into the safety of spinal manipulation.

  • E. Ernst
  • Medicine
    Journal of pain and symptom management
  • 2001

Ophthalmological adverse effects of (chiropractic) upper spinal manipulation: evidence from recent case reports.

  • E. Ernst
  • Medicine
    Acta ophthalmologica Scandinavica
  • 2005
Upper spinal manipulation is associated with ophthalmological adverse effects of unknown frequency andOphthalmologists should be aware of its risks and Rigorous investigations must be conducted to establish reliable incidence figures.

Side-effects of chiropractic spinal manipulation: types frequency, discomfort and course.

Results from this preliminary study indicate that reactions to spinal manipulation may be relatively common but benign in nature and of short duration.

Frequency and Characteristics of Side Effects of Spinal Manipulative Therapy

It was unusual that symptoms commenced later than on the day of or the day after treatment, were of long duration, or that they resulted in reduced activities of daily living in this study.

Manipulation and Mobilization of the Cervical Spine: A Systematic Review of the Literature

Cervical spine manipulation and mobilization probably provide at least short‐term benefits for some patients with neck pain and headaches, and the potential for adverse outcomes must be considered because of the possibility of permanent impairment or death.

Adverse reactions to chiropractic treatment and their effects on satisfaction and clinical outcomes among patients enrolled in the UCLA Neck Pain Study.