aa10. Safety & Manipulation Risks

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10. Safety & Manipulation Risks

Compiled By Dr. Victor Jean Ouellette June 1999

From data supplied by the

Ontario Chiropractic Association

The following article illustrates the safety of chiropractic care to the neck. Medical treatments for the very same conditions, have hugely higher risks. In fact, a person runs about 1,000 times the risk for the use of common over the counter pain killer medications. Chiropractors' safety record is the envy of the medical profession.

Dabbs V. A

Risk Assessment of Cervical Manipulation vs. NSAIDS

for the Treatment of Neck Pain.

Journal of Manipulative and Physiological Therapeutics

Oct. 1995; 18(8):530-6.

Objective: We reviewed the literature to evaluate the risk of serious injury or death resulting from cervical manipulation and to assess the evidence that cervical manipulation is an effective treatment mechanical neck pain. We also reviewed the literature to assess the risks and effectiveness of non-steroidal anti-inflammatory drugs (NSAIDS), which are often used as the “conventional” first-line treatment for similar musculoskeletal conditions.

Data Source: A series of Medline literature searches were performed, and materials were reviewed from

1966-1994. Key words included: Chiropractic or Orthopedic Manipulation; Non-Steroidal Anti-inflammatory Agents; Neck or Back Pain; Randomized Controlled Trials; Adverse Effects.

Study Selection: Studies and literature reviews that provided a numerical estimate of the risk of serious adverse effects or death from cervical manipulation or NSAID use were selected. Also, randomized, controlled studies that evaluated the effectiveness of manipulation or NSAID use for neck pain were included.

Data Synthesis: Although there are a small number of well- performed trials of cervical manipulation for neck pain, we were unable to locate even a single randomized, controlled trial examining NSAID use specifically for neck pain. As for

comparative safety, the best available evidence indicates that NSAID use poses a significantly greater risk of serious complications and death than the use of cervical manipulation for comparative conditions.

Conclusion: The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence that indicates NSAID use is any more effective than cervical manipulation.

Dr. Victor Jean Ouellette