Spinal Manipulation Should Not Be Routinely Used, New Study Warns

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Main Category: Bones / Orthopaedics
Also Included In: Complementary Medicine / Alternative Medicine;  Sports Medicine / Fitness;  Pain / Anesthetics
Article Date: 02 Jul 2007 - 0:00 PDT

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According to a study published in the Journal of the Royal Society of Medicine, spinal manipulation should not be used routinely. Routine use of spinal manipulation on the upper spine could result in serious complications, such as stroke, and even death.

Lead researcher Edzard Ernst, Professor of Complementary Medicine at Peninsular Medical School, Universities of Exeter and Plymouth, said "Even allowing for an extraordinarily high level of under-reporting, spinal manipulation has been associated with about 600 serious adverse events. In addition, it causes non-serious adverse effects in about 50 percent of all patients who use it. If any drug were linked to such rates of harm, I somehow doubt that it would still be on the market."

Case reports, retrospective case series, prospective case series, case-controlled studies and surveys were reviewed by the Prof. Ernst. Clear evidence was found of adverse events, from low level pain to disc herniation, bone fractures, spinal cord injury and stroke.

Several studies identified a link between routine spinal manipulation when the cervical vertebrae are involved and risk of adverse effects. Prof. Ernst believes patients may not be receiving enough information regarding the risks associated with spinal manipulation that would allow them to give informed consent. It is not uncommon for serious adverse effects not to be reported in the medical literature.

Professor Ernst said "The very high level of under-reporting in this area suggests that the adverse effects that have been identified are just the tiny tip of a very large iceberg".

Dr. Kamram Abbasi, editor of the Journal of the Royal Society of Medicine said "Evaluation of non-drug interventions is a thorny issue, particularly those used in complementary therapies. The central issue here is ensuring that sufficient high-quality evidence is available for patients so that they can make an informed decision before beginning any therapy. We spend a great deal of time minutely scrutinising certain interventions, while many others offered by the health service are relatively unstudied."

What is Spinal Manipulation?

Spinal manipulation/adjustment is a manual treatment where a vertebral joint is passively moved between the normal range of motion and the limits of its normal integrity, though a universally accepted definition does not seem to exist. It is occasionally used by osteopaths, physiotherapists and physicians, and it is the hallmark treatment of chiropractors.

"Adverse effects of spinal manipulation: A systematic review"
Professor Edzard Ernst
Journal of the Royal Society of Medicine
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Written by: Christian Nordqvist
Editor: Medical News Today
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