No, chiropractic care is not recommended for everyone. While it helps millions of people with back pain, neck pain, and headaches, some health conditions make it unsafe or even dangerous.

This guide will help you understand when to avoid chiropractic care and what safer options you have instead. We’ll cover the most important safety concerns, warning signs to watch for, and better treatment choices for your specific situation.

Who Should Never Get Chiropractic Care

Some health conditions make chiropractic adjustments too risky. These are called absolute contraindications, meaning you should never get spinal manipulation if you have them.

Cancer in Your Spine or Bones

If you have cancer in your spine or other bones, chiropractic adjustments can be very dangerous. The cancer makes your bones weak and fragile. A spinal manipulation could cause fractures or spread the cancer to other parts of your body. According to the National Cancer Institute, cancer and its treatments can significantly weaken bones, making them more prone to fractures.

This includes:

• Bone cancer (primary or that has spread from other areas)
• Spinal tumors
• Leukemia or other blood cancers
• Recent cancer treatment that affects bone strength

If you’re currently getting cancer treatment or have a history of cancer, always talk to your doctor before seeing a chiropractor. They need to clear you for any type of manual therapy.

Severe Bone Loss (Osteoporosis)

Advanced osteoporosis makes your bones so fragile that even gentle pressure can cause breaks. The Mayo Clinic states that people with severe osteoporosis should not seek chiropractic adjustment because the risk of fracture is too high. The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that osteoporosis affects over 53 million Americans, with fractures occurring from activities as simple as coughing or bending over.

Signs you might have severe osteoporosis:

• You’ve broken bones from minor falls
• You’ve lost more than 2 inches in height
• You have a hunched back or forward posture
• You’re over 65 and have never had a bone density test

However, mild osteoporosis doesn’t always rule out chiropractic care. Some research shows that gentle techniques like the Activator method can be safely used even in patients with osteoporosis and compression fractures.

Active Spinal Infections

Any infection in your spine or surrounding tissues makes chiropractic care dangerous. The manipulation could spread the infection or worsen your condition.

Warning signs of spinal infection include:

• Fever with back pain
• Severe pain that gets worse at night
• Redness or warmth over your spine
• Unexplained weight loss with back pain

Blood Clotting Problems

If you have bleeding disorders or take blood-thinning medications, chiropractic adjustments can be risky. The manipulation might cause internal bleeding or bruising that’s hard to stop.

This includes people who:

• Take warfarin (Coumadin) or other blood thinners
• Have hemophilia or other bleeding disorders
• Take high doses of aspirin regularly
• Have low platelet counts

When Chiropractic Care Needs Special Caution

Some conditions don’t completely rule out chiropractic care, but they require extra caution and modified treatment approaches.

Recent Fractures or Spinal Surgery

If you’ve had spinal surgery or recent fractures, standard chiropractic adjustments are usually not safe. The Mayo Clinic notes that people with surgical hardware should not receive high-velocity manipulations until fully healed.

However, gentle techniques might still be possible:

• Soft tissue therapy
• Light mobilization
• Muscle work around the affected area

Always get clearance from your surgeon before starting any manual therapy.

Pregnancy Considerations

Pregnancy itself doesn’t make chiropractic care dangerous, but it requires special techniques and precautions. The Mayo Clinic recommends asking your doctor before getting adjustments during pregnancy because there hasn’t been enough research on safety.

Many chiropractors are trained in pregnancy-specific techniques that are considered safe. At HealthQuest Longevity, we offer specialized care for pregnancy-related back pain and sciatica.

Herniated Discs

Having a herniated disc doesn’t automatically rule out chiropractic care, but it requires careful evaluation. The Mayo Clinic warns that adjustments can make a herniated disc worse if not done properly.

Signs your disc problem might be too severe for chiropractic care:

• Severe leg pain or numbness
• Loss of bladder or bowel control
• Weakness in your legs
• Pain that gets much worse with movement

Arthritis and Joint Inflammation

Doctors should not perform chiropractic manipulations on actively inflamed joints. If you have rheumatoid arthritis or other inflammatory conditions, timing is important.

Chiropractic care might help between flare-ups, but should be avoided when:

• Joints are swollen or red
• You’re having an active flare-up
• Joint pain is severe

Stroke Risk and Neck Adjustments

One of the most serious risks of chiropractic care is stroke from neck adjustments. While rare, this can be life-threatening.

How Neck Adjustments Can Cause Stroke

Cervical manipulation can lead to vertebral or carotid artery dissection, where the high-velocity thrusting technique places strain on arteries that transport blood to the brain. If a tear develops, it can cause blood clots that lead to stroke. The American Heart Association explains that arterial dissection is a leading cause of stroke in people under 45 years old.

Who’s at Higher Risk

People with certain conditions have a higher risk of stroke from neck adjustments:

• Connective tissue disorders (like Ehlers-Danlos syndrome)
• Previous neck injuries
• High blood pressure
• Diabetes
• Smoking history

An estimated 1 in 20,000 spinal manipulations results in vertebral artery dissection, but the risk may be higher for certain individuals. Research published in the Journal of the American Medical Association found that vertebral artery dissection accounts for 10-25% of strokes in patients under 50 years old.

Warning Signs After Neck Adjustment

Seek emergency medical care immediately if you experience these symptoms after a neck adjustment:

• Sudden severe headache
• Dizziness or loss of balance
• Nausea and vomiting
• Vision problems
• Difficulty speaking
• Numbness or weakness in arms or legs

Age-Related Concerns

Children and Chiropractic Care

Chiropractic adjustments are considered effective for all ages, including children, but extra caution is needed for young patients. Children’s bones and joints are still developing, so gentle techniques are essential.

Elderly Patients

Treatment of the elderly with alternative medicine has increased, with 41% of seniors using complementary treatments and 20% receiving chiropractic care. However, older adults often have multiple health conditions that require careful screening. The Centers for Disease Control and Prevention notes that adults over 65 are twice as likely to visit emergency rooms due to adverse drug events, making careful medication review essential before any manual therapy.

Special considerations for elderly patients:

• Higher risk of osteoporosis
• Multiple medications
• Previous surgeries
• Slower healing times

Safe Alternatives When Chiropractic Care Isn’t Right

If chiropractic care isn’t safe for you, there are other effective treatments for pain relief.

Physical Therapy

Physical therapy uses exercises and gentle movements to improve pain and function. It’s often safer than chiropractic adjustments for people with:

• Recent injuries
• Severe arthritis
• Osteoporosis
• Previous surgeries

Massage Therapy

Massage therapy can provide pain relief through soft tissue work without the risks of spinal manipulation. It’s particularly helpful for:

• Muscle tension
• Stress-related pain
• Pregnancy discomfort
• Recovery from injuries

Medical Pain Management

Your doctor can offer various treatments including:

• Prescription medications
• Injections
• Nerve blocks
• Referrals to specialists

Lifestyle Changes

Simple changes can often provide significant pain relief:

• Regular exercise
• Weight management
• Stress reduction
• Better sleep habits
• Proper posture

How to Know If Chiropractic Care Is Safe for You

Before starting chiropractic treatment, you should have a thorough evaluation.

What to Expect in Your First Visit

A good chiropractor will:

1. Review your complete medical history
2. Perform a physical examination
3. Order imaging tests if needed
4. Discuss your symptoms and goals
5. Explain treatment options and risks

Questions to Ask Your Chiropractor

• Are you licensed and trained in my state?
• What’s your experience with my specific condition?
• What are the risks and benefits of treatment?
• What alternative treatments do you recommend?
• When should I seek medical care instead?

Red Flags to Watch For

Be cautious if a chiropractor:

• Doesn’t take a complete medical history
• Promises to cure serious diseases
• Pushes for expensive treatment packages
• Refuses to work with your other doctors
• Dismisses your concerns about safety

When to See a Doctor Instead

Some symptoms require medical attention rather than chiropractic care:

Emergency Symptoms

Call 911 or go to the emergency room if you have:

• Sudden severe back pain with fever
• Loss of bladder or bowel control
• Severe leg weakness
• Back pain after a serious injury

Serious Warning Signs

See your doctor promptly for:

• Back pain with unexplained weight loss
• Numbness or tingling in both legs
• Pain that wakes you at night
• Symptoms that keep getting worse

Making the Right Choice for Your Health

Chiropractic care can be very helpful for many people, but it’s not right for everyone. The most important thing is to make an informed decision based on your specific health situation.

Steps to Take

1. Talk to your doctor first – Especially if you have any health conditions or take medications
2. Be honest about your health – Don’t hide important medical information from your chiropractor
3. Start with gentle treatments – Conservative approaches are often safer
4. Listen to your body – Stop treatment if you feel worse
5. Consider alternatives – Other treatments might be better for your situation

Working with Your Healthcare Team

The best approach often involves multiple healthcare providers working together. Your chiropractor should be willing to:

• Communicate with your other doctors
• Refer you to medical specialists when needed
• Modify treatment based on your medical conditions
• Stop treatment if you’re not improving

Final Thoughts

While chiropractic care helps millions of people find relief from back pain, neck pain, and headaches, it’s not safe for everyone. People with cancer, severe osteoporosis, spinal infections, or bleeding disorders should avoid chiropractic adjustments.

If you’re unsure whether chiropractic care is right for you, start by talking to your doctor. They can help you understand your risks and explore safer alternatives if needed.

Remember, the goal is to find the safest and most effective treatment for your specific situation. Whether that’s chiropractic care, physical therapy, or another approach, the most important thing is getting the help you need to feel better.

At HealthQuest Longevity, we’re committed to providing safe, effective care for all our patients. If you’re dealing with back pain, chronic headaches, or other pain issues, we’ll work with you to find the best treatment approach for your unique needs.Don’t let safety concerns keep you from getting the pain relief you deserve. Contact us today to discuss whether chiropractic care is right for you, or explore our other treatment options including massage therapy and specialized programs for migraine relief.