What Are Risks for Neck Pain Treatment?
Patients & Friends,
What are the risks associated with treatments for neck pain? A great amount of research regarding the safety and relative risks associated with medicines, chiropractic, injections, and surgery has been written recently.
Chiropractic treatment of neck pain may be complicated by everything from a ruptured disk with shoulder/arm/hand pain or numbness, to tumors or cancer that require urgent referral. Severe headache or arm weakness can be caused by everything from a typical mild-disk problem to a serious disease, ruptured disk, or stroke in progress. While both physicians and chiropractors are trained to know the signs and symptoms of serious problems, both medicines and chiropractic treatment itself have been associated with development of stroke in very rare cases. Also, problems can be missed and appropriate treatment delayed, regardless of which provider type you seek. The chart below suggests just how rare are some of these associations.
As many as 4 in 10 new patients have some soreness with their first chiropractic, but serious accidents are extremely rare. In fact serious complications associated with use of medicine, injections, and surgery are actually much more common than are accidents associated with use of chiropractic for neck pain. Also, modern research reveals that chiropractic may be more effective than medicines for neck pain, even providing long term improvement. So, there is growing evidence for the age old chiropractor admonition: “Chiropractic First, Medicine Second, Surgery Last!”
Robert A. Leach, DC, MS, FICC(h), CHES
Bronfert and co-workers, publishing in the Annals of Internal Medicine, reported that patients receiving 12 weeks of spinal manipulation (chiropractic) had less neck pain than patients receiving medications after 8, 12, 26 and even after 52 weeks: http://www.ncbi.nlm.nih.gov/pubmed/22213489
A study published in Spine found that seniors with chronic neck pain who were randomized to 12-weeks of spinal manipulation (chiropractic) combined with exercise fared better than seniors randomized to both supervised exercise or home exercise alone: http://www.ncbi.nlm.nih.gov/pubmed/24225010
Cassidy and co-workers published a landmark 10-year population based study covering 109 million person years of data from Ontario and reported in Spine Journal that only 34 cases of vertebral artery stroke involved patients who had been to a chiropractor within a month of their emergency room visit; among older patients it was more likely for them to have seen a medical doctor than a chiropractor in the month before going to the emergency room: http://www.ncbi.nlm.nih.gov/pubmed/18204390
Rubinstein surveyed literature on safety of chiropractic, and found most problems temporary and mild. He concluded that risks of serious adverse events after chiropractic treatment of both neck and back pain were negligible: http://www.ncbi.nlm.nih.gov/pubmed/18722202
Risks of NSAIDs like ibuprofen include gastrointestinal ulcers and even death, although new medications may help lower present risk levels: http://www.ncbi.nlm.nih.gov/pubmed/25141246
Lee and co-workers recently reviewed risks associated with neck surgery in Spine Journal in 2013; 8% had cardiac and 13% had pulmonary complications, both associated with higher rates of death within 2 years: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546141/