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Chiropractic therapy usually is well tolerated. Only 135 complications were reported between 1900 and 1980. Most complications are from neck manipulation. For people with serious diseases or symptoms, it is important to be evaluated and treated fully by a physician and not to substitute chiropractic medicine for conventional medicine. This is because chiropractors are not as well trained in diagnosis as physicians.

For people who pursue chiropractic therapy, one of the more common adverse effects is achy muscles, which may last for 1 to 2 days after therapy. Chiropractic treatment may also cause headaches and fatigue. One significant possible complication is stroke associated with neck manipulation. This is very rare (1 in 20,000 to 1 in approximately 3,000,000), but it also may be very serious. Bone fractures and injuries to disks are also very rare. Injuries to nerves of the lower spine as a result of lower back manipulation (cauda equina syndrome) are also extremely rare.

Chiropractic manipulation should be avoided by women who are pregnant and by people with spinal-bone fractures or dislocations, spine trauma, severe disk herniations, cancer or infection of the bone, severe osteoporosis, severe arthritis, severe diabetes, and those undergoing treatment with blood-thinning medications.

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