Spinal Manipulation For Low Back Pain

Treatment Ratings


RISK: 5/5

Spinal manipulation is one of the safest forms of care available to treat low back pain. Many patients experience transient soreness, but serious complications appear to be extremely rare.

One recent review noted, “ Approximately one half of patients who undergo spinal manipulation have mild to moderate undesirable effects; these include local discomfort (occurred in 53 percent of patients in one series of 4,712 patients); headache (12 percent); tiredness (11 percent); and radiating discomfort (10 percent). Most (74 percent) of these reactions resolved within one day. Similar results were found in other series.”

Cauda Equina Syndrome ( CES) is estimated to occur in less than 1 per 1 million treatments.(Cauda equine syndrome is a serious medical condition requiring surgery. It is an extremely rare complication of manipulation.)

Other studies suggest that many patients experience transient soreness. “ Although the occurrence rate of these complications is unknown, it is probably low.”

Hebert JJ, Stomski NJ, French SD, Rubinstein SM. Serious Adverse Events and Spinal Manipulative Therapy of the Low Back Region: A Systematic Review of Cases. J Manipulative Physiol Ther. Jun 17 2013.