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How Safe are Chiropractors?

About half of all Americans suffer from back pain, and many turn to chiropractors for help. Those who swear by chiropractic believe it helps them ease myriad complaints, from low-back pain to headaches and even digestive problems and allergies. There have been very few reputable studies, however, on the effects of chiropractic, and many Western doctors believe the potential risks far outweigh the supposed benefits.

Dem Bones, Dem Bones
Chiropractic medicine is a holistic approach to wellness that focuses on healing the body through manipulation of the musculoskeletal system, especially around the spine. Basically, chiropractors use a combination of massage, pressure, stretches, and exercises to align your vertebrae; they believe doing so will alleviate pain and balance other systems in the body. It’s meant to be a complementary form of treatment for those with chronic pain who seek a conservative alternative to drugs and surgery.  Chiropractors must pass a state licensing exam after completing two to four years of undergraduate education and four years of specialized chiropractic courses. At the end of their training, chiropractors earn a doctor of chiropractic (DC) degree.

All It’s Cracked Up to Be?
There are no systematic reviews of research proving that spinal manipulation is both safe and effective; in fact, some studies have revealed seriously adverse effects associated with the practice. Until 1987, the American Medical Association pronounced chiropractic an “unscientific cult”and urged the public to avoid it. Though the practice now has greater legitimacy among physicians and insurance companies, some reports—such as Edzard Ernst’s “Prospective investigations into the safety of spinal manipulation,” published in the 2001 issue of the Journal of Pain and Symptom Management—suggest that 50 percent of chiropractic patients experience mild negative events, like “local discomfort, headache, tiredness, and radiating discomfort.” More serious complications include “dissection of the vertebral and internal carotid artery, epidural hematoma, intracranial aneurysm, cauda equina syndrome [compression of the nerves around the spinal cord], contusion of the spinal cord, myelopathy [spinal cord injury], radiculopathy [nerve pain], and peripheral nerve palsy.” Though there’s certainly a bias in terms of where research funds are directed, we should still be alert to the potential risks of spinal manipulation.

Proceed with Caution
If you do feel want to try something new that doesn’t involve drugs or surgery, choose your practitioner wisely.  Get informed and stay involved.  Here’s what you need to know to undergo chiropractic care safely and effectively:

1.Check your DC’s credentials. Make sure he or she graduated from a school accredited by the Council on Chiropractic Education (CCE). You can find a directory of schools on the CCE’s Web site. Also, make sure the DC is licensed in your state by going to and clicking on “Chiropractic Boards.” You can also find a DC through the American Chiropractic Association’s Web site. Recommendations from a friend or doctor are great leads, but you’ll also want to do a background check through these sites.

2.Stay regular and mark your progress. Chiropractic treatment takes time and requires regular visits, often supplemented by exercises you do at home. Your DC should be taking a holistic approach to your care and helping you keep a goal in sight. This means going beyond spinal manipulation to helping you modify the behaviors that made your back hurt in the first place. For example, do you have an unsupportive desk chair or poor posture that is throwing you out of alignment? A good DC will guide you toward resolving both the causes of your discomfort and the pain itself. Remember that the goal of treatment is to prevent you from having problems in the future, not to keep you coming back every week.

3.Always walk around a little after each adjustment. You want your joints and muscles to get used to the proper alignment, instead of getting back into their old, painful grooves. The right chiropractor will show you stretches and exercises to do on your own to reinforce the effects of spinal manipulation.

Many people feel that chiropractic really helps them with a wide variety of problems, and you, too, may find it successful. All new treatment regimens, however, should be approached with caution in order to reap the maximum results with the minimum risks.

A Delicate Balance
If you have back pain or other issues that haven’t been fully addressed by your traditional doctor and are looking for alternative therapies, acupuncture, massage therapy, and yoga may give you the help you need without subjecting you to the risks associated with spinal manipulation. But if you’re one of those for whom chiropractic medicine has eased pain and alleviated symptoms, feeling good may be the only proof you need of its benefits.

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