Life-Threatening Complications of Spinal Manipulation

Spinal manipulation entails high-velocity, low-amplitude manual thrusts to spinal joints that extend slightly beyond their physiological range of motion. It is a therapeutic technique often, but not exclusively, used by chiropractors who tend to believe that it is not associated with relevant risks. This opinion is contrasted by the findings of systematic reviews,1 which summarize several hundred cases of serious complications after spinal manipulation, mostly of the upper spine. Chiropractors rightly point out that many of these instances relate to events that happened decades ago. Thus, it is relevant to ask whether life-threatening complications still occur or whether therapists have now learned how to avoid such effects.Spinal manipulation has …