March 17, 2006 – Do you suffer from neck pain or stiffness, headaches or fatigue after going to your chiropractor? These side effects are underestimated, according to a study conducted in California on 336 patients treated in chiropractic for neck pain.
The study authors recommend that chiropractors use caution when a patient presents with a sore neck, and opt for mobilization rather than cervical manipulation, especially when the pain is acute.
In fact, they found that among study participants, nearly one in three (30.4%) experienced one or more of the 212 ailments recorded within 24 to 48 hours of treatment.
Cervical manipulations and, to a lesser extent, mobilizations resulted in worsening neck pain or stiffness in 25% of patients. They also caused headaches in 15.7% of subjects, fatigue (10%), radiating neck pain (6.1%) and dizziness (3.2%). These ailments, which generally lasted less than 24 hours, were rated moderately intense by patients and somewhat affected their daily activities.
Unreported side effects
These results did not surprise the Dr Edzard Ernst2, British expert in complementary medicine. He reports that several observational studies indicate that up to half of patients seeing a chiropractor suffer from side effects, usually minor.
“Chiropractors say that these effects are necessary for healing and that severe cases are rare, but we cannot be certain since they are, in large part, under-listed”, notes the Dr Enrst.
Rather, he said, the scientific evidence suggests that cervical manipulation can pose a considerable risk. “Due to the lack of convincing results as to its benefits, I believe its overall value is not positive,” he adds.
In an editorial published in June 20053 in Focus on Alternative and Complementary Therapies, the Dr Edzard Ernst pointed out that no independent review of studies on the safety of cervical manipulation has been published. He also cited an American forensic expert, who said chiropractic manipulations are responsible for most cases of stroke in people under 45.
No cause and effect, according to chiropractors
A link between stroke and chiropractic manipulation? “This is absolutely false,” retorts the president of the Order of chiropractors of Quebec, Normand Danis.
According to the guidelines4 that the Canadian Chiropractic Association has just published for its members, there would be no scientifically proven cause and effect relationship. “It appears that in cases of stroke, patients already present with an existing or progressing lesion, and the lesion could occur at any time,” emphasizes Normand Danis. According to him, the cases of stroke following a chiropractic treatment would be of the order of “one case per million to one case per ten million, according to studies”.
As for stiffness or aches that occur following chiropractic manipulation, they are just as normal, according to him, as those that one feels the day after physical activity.
Martin LaSalle – PasseportSanté.net
1. Hurwitz EL, Morgenstern H, et al, Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study, Spine, 1er July 2005, Vol. 30, No 13, 1477-84.
2. Dr Edzard Ernst holds a Chair in Complementary Medicine at the Peninsula School of Medicine, University of Exeter. He is also the editor of the British scientific journal Focus on alternative and complementary Therapies (FACT): www.quackwatch.org [consulté le 16 mars 2006].
3. Ernst E, The value of chiropractic, Focus on Alternative and Complementary Therapies, June 2005, Vol. 10, no2, 87-8. The editorial is available at http://journals.medicinescomplete.com [consulté le 16 mars 2006].
4. For more details on these guidelines: www.ccachiro.org. [consulté le 17 mars 2006]
