Answers to Questions about Chiropractic:
Why Am I Having More Pain
from Having My Spine Realigned?

Samuel Homola, D.C.

Question

In a four-month period, I have received 35 adjustments by a single chiropractor. As a result I am experiencing considerable neck, head, collar bone, right arm and shoulder pain, along with lower back pain. I have complained of headaches, an episode of vertigo, and numbness and tingling in areas of my body which were previously nonexistent. His standard response is that I have messed up his work and to keep coming for more adjustments. He took x-rays, and based on those, began a series of adjustments to realign my spine. He was operating on the theory that the improper curves in one's spine could be realigned. I have pain where I have never had it before, feel that this chiropractor is a fraud, am concerned that he has caused permanent damage and wonder what recourse I have. Can you explain what happened? What is the best course of action now?

Answer

While spinal manipulation can be beneficial in the treatment of some types of neck and back pain of mechanical origin, such treatment should be approached cautiously when there is arm or leg pain and other symptoms indicating involvement of a nerve root. It's important to rule out disc herniation and other problems that might be aggravated by spinal manipulation before beginning chiropractic treatment.

Whatever the diagnosis, spinal manipulation should not be continued if symptoms worsen after one week of treatment or if there is no improvement after two weeks. Treatment should be applied only in the area where symptoms originate and should be discontinued when the symptoms disappear. Unfortunately, some chiropractors manipulate the entire spine—from the neck to the tailbone—in an attempt to "realign" the vertebrae and straighten spinal curvatures. In an adult, spinal curvatures are usually permanent structural adaptations and cannot be changed or corrected. Prolonged use of spinal manipulation in an effort to "correct" such curvatures is futile and may cause trouble by disturbing joints, ligaments, and muscles that are aligned into a curvature that compensates for an imbalance that cannot be corrected. The result of such unnecessary and forceful treatment can be pain and other symptoms in areas that were previously symptom-free. Usually these symptoms will subside when the treatment is discontinued.

When a chiropractor recommends more and more "adjustments" for new and unrelieved pain over a period of four months, there is good reason to complain and to seek a medical opinion, usually from an orthopedist. Persistent radiation of pain down an arm or a leg, or the development of headache, vertigo and other symptoms following unnecessary use of neck manipulation, should be brought to the attention of a neurologist.

I usually offer this advice to patients seeking chiropractic care:

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was revised on February 12, 2002.