Regulation

 

Like Doctors and Dentists, Chiropractors are governed by a statutory Regulatory Body, the General Chiropractic Council, which has the power to suspend or strike off members of the profession who are guilty of unacceptable professional conduct or negligence.

The GCC sets the minimum standards for clinical practice and for training of undergraduate chiropractors and implements qualifying standards for chiropractors entering the UK from abroad.

Chiropractic has undoubtedly been made safer since the GCC opened its register in 1999; before then, anyone could claim to be a chiropractor, even if they had no training, now it is a criminal offence to style yourself as a chiropractor unless you are registered with the GCC and meet its annual registration criteria.

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Risks

 

The Royal College of Chiropractors (RCC) has undertaken a review of the research literature on the safety and risk of manual treatment of the spine.

Experiencing mild or moderate adverse effects (known as benign adverse events) is relatively common after chiropractic care, affecting 30-50% of patients. However, these effects are not unique to chiropractic care and may also be experienced at similar frequency with other forms of manual therapy, including that delivered by physiotherapists and osteopaths. Note that these effects:

• are short-lived (usually resolve within 24 hours);

• may include musculoskeletal pain, stiffness and/or headache;

• may also include dizziness, tiredness, feeling faint/lightheaded and/or tingling in the arms following neck treatment.

The evidence suggests that it is difficult to predict which patients are more likely to experience adverse events. Patients with higher levels of neck pain may have a greater chance of experiencing symptoms from the nerves in the arms (i.e. tingling or discomfort). However, although benign adverse events may be a problem for neck-pain patients in the short-term, they do not seem to affect results in the longer term.

There are rare reported cases of serious spinal or neurological problems, including strokes, following chiropractic care. Because of their rarity, it is unclear what the level of risk is, but it has been estimated at between 1 in tens of thousands and 1 in millions of treatments. Since serious adverse events may result from pre-existing underlying conditions, screening for potential risk factors, signs or symptoms is a routine element of a visit to a chiropractor.

There appears to be an association between chiropractor visits and stroke associated with arteries in the neck; however, the level of risk appears to be similar to that for medical practitioner visits. This suggests the treatment may not be related to the stroke, but that the early symptoms of stroke, such as neck pain, led the patient to visit the practitioner. Thus, screening for known neck artery stroke risk factors, or signs or symptoms that there may be a problem, is routinely undertaken by chiropractors.

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