Some back and neck pain needs a doctor today, not a chiropractor. Some back and neck pain is not a case for a chiropractor and needs a doctor the same day. Go to an emergency room, not to us, if you have numbness in the groin or inner thighs, if you have lost control of your bladder or bowels, if a leg is becoming weak rather than just painful, if the pain followed a serious fall or a car crash, if you have a fever with back pain, if you have unexplained weight loss alongside it, if you have a history of cancer, or if a headache came on suddenly and is the worst you have ever had. We would rather you rang your doctor and never rang us at all.
Most chiropractic websites do not have this page, and the ones that do tend to have a paragraph reassuring you that everything is perfectly safe. That is not a useful answer. Everything that does anything carries some risk, and what you actually want is a straight account of what that risk is, how big it is, and what is done about it.
The short version: adjustment is generally safe, mild soreness afterwards is common and normal, serious complications are rare, and the one people ask about — a tear in a neck artery — is the subject of a genuine and unresolved scientific argument that we are not going to summarise in whichever direction happens to suit us.
The practical version matters more. We screen carefully, we will tell you when we think a neck should be left alone, and you can decline any technique at any point without giving a reason and still be treated properly by another method.
What usually happens, and what is not normal
Told to you in advance rather than discovered afterwards.
The common side effects
Soreness, stiffness, occasionally a mild headache or tiredness, for a day or two after treatment. It feels like the ache after unfamiliar exercise rather than like an injury, and it is more common after a first treatment than later ones. Keep moving gently, use heat or ice depending on which feels better, and it settles on its own.
What is not normal
Sharp pain that is worse than before and getting worse, new numbness or weakness, a severe headache, dizziness, visual disturbance, or difficulty speaking or swallowing. None of these belongs to normal recovery. Ring us the same day; if any of the last four are severe or sudden, go to an emergency room rather than waiting.
The rare serious risk
A tear in one of the arteries in the neck, which can cause a stroke. It is rare. Estimates vary widely and the research is contested — a substantial part of it argues the association exists because people with a tear already in progress seek treatment for the neck pain it causes. That argument is not settled, and we will not pretend it is.
Who should not be manipulated
Significant osteoporosis, known or suspected fracture, bone tumours, spinal infection, and progressive neurological signs all rule out thrust technique in the affected area. So does a history suggesting arterial problems. Some of these are absolute; some mean a different technique. All of them come out of the questions asked at the first visit.
How to decline something
This should not need a page and it does, because people tell us they have felt unable to say no elsewhere.
- Say it once, at any point, and it goes in your notes.
- You do not have to explain why, and nobody will ask.
- It will not be raised again at your next visit.
- Nobody will suggest you are limiting your own recovery.
- You will be offered another method that does the same job.
- You can stop a treatment while it is happening — say stop and we stop.
The risks, plainly. Adjustment is generally safe and the common side effects are mild — soreness like the day after unfamiliar exercise, a little stiffness, sometimes tiredness, usually gone within a day or two. Serious complications are rare, but they are not zero, and the one people ask about is neck manipulation. We screen for the things that make it a bad idea, we will tell you when we think the neck should be left alone, and we can treat a neck without high-velocity manipulation if you would rather we did. Ask for that and you will get it without an argument.
Questions
Risks — the questions we are asked most
Can chiropractic cause a stroke?
The complication people ask about is a tear in one of the arteries running through the neck, which can lead to a stroke. It is rare. The research is genuinely contested — a substantial part of it argues the association exists because people with a tear already in progress seek treatment for the neck pain and headache it causes, meaning the visit follows the tear rather than causing it. We are not going to pretend that argument is settled in either direction.
How do you decide whether it is safe to treat my neck?
History first, and at length. Sudden severe headache unlike your usual, neck pain unlike your usual, recent trauma, connective tissue disorders, recent infection, dizziness, visual disturbance, difficulty speaking or swallowing, or unsteadiness — any of those and the neck is not manipulated. This is a large part of why a first appointment is an hour of questions rather than ten minutes on a table.
What are the ordinary side effects?
Mild and short-lived: soreness, stiffness, occasionally a mild headache or tiredness for a day or two. Roughly what the day after unfamiliar exercise feels like. It is more common after a first treatment and it settles on its own. We tell people to expect it rather than letting them discover it and worry that something has gone wrong.
What should make me ring you afterwards?
Sharp pain that is worse than before and getting worse, new numbness or weakness, a severe headache, dizziness, visual disturbance, or difficulty speaking or swallowing. None of those is an expected part of recovery. Ring us the same day — and if any of the last four are severe or came on suddenly, go to an emergency room rather than waiting for us to call back.
Can I refuse to have my neck manipulated?
Yes, at any point, and you will not have to justify it or argue about it. Say so once and it goes in your notes; it will not be raised again at the next visit and nobody will try to talk you round. Necks are treated perfectly well with mobilisation, instrument technique, soft tissue and exercise, and for plenty of people those are the better choice regardless.
Is it safe if I take blood thinners or have osteoporosis?
Both change what is appropriate rather than ruling treatment out. Significant osteoporosis rules out thrust technique in the affected area entirely, and anticoagulants change technique selection and how firm soft-tissue work can be. Bring your full medication list — a photograph of the boxes is fine — and tell us about any bone density results, fractures or long-term steroid use.
Chiropractic care is not a substitute for medical diagnosis. Chiropractic care is not a substitute for medical diagnosis, and nothing on this website is medical advice for your particular problem. We are not physicians: we do not prescribe medication, we do not perform surgery, and we do not treat disease. What we do is examine how your spine and joints move, work on them by hand, and give you something to do between visits. If your problem turns out to be outside that, we say so and refer you — which happens often enough that you should expect it as a normal outcome rather than a failure.
We do not claim anyone else's approval. Chiropractic is a licensed health profession in New York State, and every chiropractor is registered with the State before they may practise. What we will not do is decorate this website with the name of a board, a college or an association as though somebody else vouches for us — nobody outside this clinic has reviewed it. So instead of showing you a badge, these pages tell you plainly who will see you, what they will do, what they will not do, what it costs, and what the risks are. Ask us about any of it before you book.
Ask before you book, not after
Anything on this page you want to talk through?
Ring the clinic and ask. Nobody will be impatient with you, nobody will try to book you in during the call, and a question about risk is a completely reasonable reason to telephone a clinic you have never been to.