Notification of serious adverse reactions in the literature generally takes the form of case reports or retrospective studies. The main limitation of what can be deduced from this is the difficulty of establishing causal relationships between the intervention and the side effect. These restrictions may be due to the fact that the side effect is generally reported by the medical specialist who subsequently administered the patient and not by the manual therapist who delivered the intervention. Benign side effects after manual spine treatments are relatively well characterized in adult patients. Evidence has been assessed as “high quality” based on consistent findings from RCTs and observational studies that transient benign side effects are common . However, there are gaps in the available literature regarding predicting side effects.
Communicating to patients about the risks of manual treatment in the spine is an important yet challenging element of informed consent. This scoping assessment was designed to characterize and summarize the available risk literature and to describe the implications for clinical practice and research. While many people receiving chiropractic treatments report only on better health and reduced pain, there may be some minor side effects from spine manipulation.
For an appropriate perspective, the risks of chiropractic neck treatment should be compared to the risks of other treatments for similar conditions. For example, even the most conservative “conventional” treatment for neck and back pain, prescribing non-steroidal anti-inflammatory drugs, can pose a significantly greater risk than manipulation. A study found an annual mortality rate of 4 / 10,000 for NSAID-induced ulcers in patients treated for non-rheumatic diseases such as musculoskeletal pain and osteoarthritis; this extrapolates up to 3,200 deaths in the United States annually. Dr. Albuquerque stated that, for the patient he saw, the stroke that occurred after the chiropractic adjustment deteriorated with the adjustment or that there was a new arterial injury. Albuquerque said that Americans handle chiropractors more than 250,000,000 times a year.
No significant associations have been found in the past week with the reception of chiropractic services in elderly patients. Rubinstein SM, Peerdeman SM, from Tulder MW, Riphagen I, Haldeman S. A systematic review of risk factors for cervical artery dissection. Haldeman S, Kohlbeck FJ, McGregor M. Stroke, brain artery dissection and cervical spine manipulation therapy.
Hurwitz EL, Morgenstern H, Vassilaki M, Chiang L-M. Side effects on chiropractic treatment and its effects on satisfaction and clinical outcomes in patients enrolled in UCLA nek pain study The two series of prospective cases42.43 confirm the results of several previous studies50 showing that mild to moderate adverse reactions occur in a large proportion of patients receiving spinal manipulation. These side effects are transient and not serious, but affect many patients seriously. 42.50 Risk-benefit analyzes of spinal manipulation should therefore take into account not only serious complications, but also side effects.
The methodological framework for the scope reviews proposed by Arksey and O’Malley was followed for this review . Within this, the main limitation was that a single reviewer made the selection of records, the selection for inclusion in the assessment and extraction of relevant data . A duplicate process would have increased confidence that studies have been correctly recorded or excluded and that data has been extracted accurately. The likelihood of incorrect study selection was reduced by meeting detailed inclusion and exclusion criteria. However, some uncertainties were found regarding the allocation of assessments as systematic or non-systematic.
Studies show that the benefits of chiropractic care may include relief from low back pain and other forms of back pain, neck pain and headache. The treatment plan may include one or more manual adjustments where the physician manipulates the joints, using sudden, controlled force to improve range and movement quality. Many chiropractors also include nutritional advice Chiropractor Athens and exercise / rehabilitation in the treatment plan. Chiropractic care goals include restoring function and preventing injury in addition to relieving back pain. Chiropractic adjustment can be effective in treating low back pain, although much of the research conducted provides only a modest benefit, similar to the results of more conventional treatments.