When Chiropractic/Osteopathy May Not Be Right: Contraindications & Risks

Chiropractic care largely focuses on spinal manipulation and joint adjustments. Osteopathy, on the other hand, involves broader musculoskeletal manipulation, providing relief for musculoskeletal issues. Both Chiropractic and Osteopathic care, as a source of relief treatment, are gaining momentum. However, both carry risks of adverse effects. High-velocity thrusts, rotational maneuvers, or forceful techniques amplify these risks in vulnerable patients. Let us find out when Chiropractic/Osteopathy may not be the right option. 

I, Dr Gaurav Vaid, and at Swasthya Shastra offer a holistic approach that blends physiotherapy, osteopathy, chiropractic, and manual therapy. We evaluate whether manipulation is safe and right for you. We examine your medical condition. At Swasthya Shastra, we help you determine which specific conditions suit you and recommend the treatment accordingly. 

When Chiropractic/Osteopathy May Not Be Right?

While chiropractic and osteopathic manipulative treatments (OMT) can be effective for musculoskeletal issues, there are situations where manipulations, especially high-velocity, low-amplitude (HVLA) spinal techniques, may pose risks or be contraindicated. 

Absolute Contraindications

These are the conditions where spinal or joint manipulation should not be performed because it could cause serious harm. These conditions can be summed up under the following headings: 

1. Bone Integrity Issues

These conditions make bones weaker, fragile, or structurally unstable. It means that applying force, like during a spinal or joint manipulation, can lead to fracture, collapse, or other serious injury. 

It is important to highlight that “bone integrity” refers to how strong, healthy, and structurally sound the bone is. When bone integrity is compromised, the bone can’t safely handle the mechanical stress. 

2. Neurological or Vascular Disorders

These conditions involve the nervous system, which includes the brain, spinal cord, and nerves or blood vessels. Manipulation in such cases can worsen nerve damage, impede blood flow, or, in rare cases, trigger a stroke or paralysis. 

When these systems are already compromised, manual manipulation, especially high-velocity, low-amplitude (HVLA) thrusts, can be dangerous. In a healthy person, this injection is safe, but if nerves or arteries are already compromised, even small forces can prove fatal. 

3. Systemic or Inflammatory Conditions

Systemic or Inflammatory Conditions involve a widespread inflammation or disease affecting multiple body systems. It includes the joints, connective tissues, and immune system. Manipulations in these situations can sometimes worsen inflammation, damage unstable joints, or spread infection. 

It is always advisable to avoid high-velocity spinal manipulation, focus on gentle mobility, stretching, and posture stability. 

4. Post-surgical or Medical Instability

A person who has undergone an operation involving bones, joints, or the spine should not go for Chiropractic or osteopathic. The area may still be healing or structurally altered. Besides, a person who faces medical instability must avoid for the reason that diseases or disorders make the ligaments, connective tissues, or bone unable to maintain normal joint stability.

Relative Contraindications

These contraindications allow you to go for Chiropractic or osteopathic intervention. However, it should be approached with caution or modified. Here are some of the relative contradictions listed that allow manipulation: 

• Mild osteoporosis or osteopenia
• Acute soft tissue injury or inflammation
• Pregnancy, especially late stage. Avoid abdominal pressure or lumbar thrusts.
• Anticoagulant therapy. The risk of bleeding or bruising can’t be ruled out. 
• Hypermobility syndromes
• Psychological conditions affecting pain perception or consent

Also, read How Often Should You Visit a Chiropractor or Osteopath for Maintenance?

Potential Risks and Adverse Effects

Although most adverse events are mild. It might include temporary soreness, stiffness, and fatigue. Even though serious implications are rare but there are certain documented complications.

1. Common Risks 

These common risks are mild and short-term. They are temporary and fade after some time. Here are some of the common, mild risks: 

• Local soreness or headache. This usually lasts 24-48 hours. 
• Temporary increase in pain
• Fatigue or lightheadedness

2. Uncommon to Rare Risks

The rare risks are serious in nature. They can have lasting effects. Uncommon risks can be listed as under: 

• Vertebral artery dissection/stroke. This is linked mainly to cervical HVLA. 
• Nerve injury or radiculopathy
• Disc herniation or worsening
• Fracture in weakened bone
• Joint dislocation. This is especially for hypermobile individuals

Conclusion

So it has come to the fore that chiropractic and osteopathy are not a viable option for everyone. There is a certain section of individuals who must avoid this sort of treatment. People with absolute contradictions must refrain. This article tells you more about it. 

If you are facing any such contradiction, you must consult a physiotherapist for proper guidance and prescription. Those who are in J&K must visit Swasthya Shastra. An able team of doctors with tons of experience helps you through and guides you accordingly. 

For further queries, please reach out to Dr. Gaurav Vaid or Swasthya Shastra.