Reactions Following a Chiropractic Adjustment

In the course of being treated by a doctor of chiropractic for spinal derangement or subluxations, certain reactions may be experienced by the patient receiving the chiropractic adjustment.

Reactions following a chiropractic adjustment vary greatly from person to person. These may range from a great sense of exhilaration immediately following the adjustment, to a feeling of aching and soreness.

The most common reaction to spinal manipulation is aching or soreness in the spinal joints or muscles. If this aching or soreness occurs, it is usually within the first few hours post-treatment and does not last longer than 24 hours after the chiropractic adjustment. An ice pack often reduces the symptoms of this chiropractic technique more quickly.

See Chiropractic Treatments for Lower Back Pain


Possible Side Effects of a Neck Adjustment

On the most extreme side of chiropractic-related problems, vascular accidents have been reported and critics of chiropractic medicine use this by recommending no spinal manipulation of the cervical spine. One possible serious complication of chiropractic neck manipulation is a vertebrobasilar artery (VBA) stroke.1

See Chiropractic Manipulation for the Cervical Spine

The alleged association between and chiropractic visits was recently compared and contrasted with primary care physician (PCP) visits and vertebrobasilar articery stroke. According to the authors of this particular study:

  • There was "no evidence of excess risk of VBA stroke associated with chiropractic care compared to primary care."2
  • The alleged correlation more likely had to do with patients seeking chiropractic treatment of already-existing VBA symptoms (headache and neck pain) before the stroke took place.2

See What Is Causing My Neck Pain and Headache?

Critics of cervical manipulation emphasize the possibility of serious injury, especially to the brain stem. While this is a possibility, documented reports of the incidence of this are very rare.

While no studies have been done to determine the actual rate of stroke following chiropractic neck manipulation, several authors have reported a very infrequent incidence rate of vascular accidents during chiropractic adjustment treatments that include statements such as, "there is probably less than one death of this nature out of several tens-of-millions of manipulations."3 Similar low risk of cervical manipulation problems after a chiropractic visit is reported by others.4-6


In the hands of experienced chiropractors, cervical manipulation usually renders beneficial results with few adverse side effects.

With that in mind, discussion concerning reactions to spinal manipulation from the chiropractor is encouraged between the patient and the treating doctor. Obtaining consent for chiropractic adjustment is recommended in writing once questions are addressed by the chiropractor.

See How To Select The Best Chiropractor


  • 1.Terrett AGJ, Kleynhans AM. Cerebrovascular Complications of Manipulation. In:Principles and Practice of Chiropractic, 2nd ed., S. Haldeman. 1992, Appleton & Lange, Norwalk, Connecticut.
  • 2.Cassidy J D, Boyle E, Cote P et al. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. SPINE 2008; 33:S176-S183.
  • 3.Maigne, R. Orthopedic Medicine. A New Approach to Vertebral Manipulations. Springfield, IL: Thomas; 1972:155, 169.
  • 4.Hosek, RS, Schram SB, Silverman H, Myers JB. Cervical manipulation. JAMA 1981;245-922.
  • 5.Gutmann G. Verletzungen der arteria vertebralis durch manuelle therapie. Manuelle Medizi 1983;21:2-14.
  • 6.Dvorak J, Orelli F. How dangerous is manipulation of the cervical spine? Manual Med 1985:2:1-4.