Chiropractic - Safety and regulation of chiropractic

There is statutory regulation of chiropractic in the UK.

Chiropractic is one of two complementary and alternative medicines (CAMs) that operate under statutory regulation. The other is osteopathy.

Regulation

Statutory regulation of chiropractic works in the same way as regulation for conventional medical doctors.

This means it is illegal to practise as a chiropractor or call yourself a chiropractor unless you are registered with the General Chiropractic Council (GCC).

The GCC only accepts registration from practitioners who have certain qualifications in chiropractic and who agree to comply with its code of practice (see below).

Regulation aims to protect patient safety, by setting and monitoring standards of training, practice and conduct. This doesn't mean there is scientific evidence that the treatment provided is effective, however.

Chiropractors in the UK must adhere to standards of practice laid down by the GCC. If you use a chiropractor and they do not adhere to this standard of practice, you can complain to the GCC, which has a duty to investigate the complaint.

You can read more about the qualifications required of chiropractors on the General Chiropractic Council website. You can also use this website to find a registered practitioner.

Never use an unregistered practitioner.

Code of Practice

The GCC has developed a Code of Practice which says that treatment provided by chiropractors should:

respect patients' dignity, individuality and privacy
respect patients' rights to be involved in decisions about their treatment and healthcare
justify public trust and confidence by being honest and trustworthy
provide a good standard of practice and care
protect patients and colleagues from risk of harm
cooperate with colleagues from their own and other professions

Read the full General Chiropractic Council's Code of Practice and Standard of Proficiency (PDF, 368kb).

Safety

Around 50% of patients report experiencing adverse effects after spinal manipulation. The most commonly reported adverse effects are:

mild headache
stiffness or soreness
temporarily increased pain
fatigue

These effects are usually minor or moderate, develop within four hours of a session and typically resolve themselves within one or two days.

Serious complications that have been linked to spinal manipulation include:

tearing of an artery wall, leading to stroke
injury to the spinal column, leading to paralysis
build-up of blood between the skull and the outer layers of the brain, which can result in coma or death

These events usually occurred after spinal manipulation involving the neck. Some may have occurred due to a pre-existing health condition, and not the spinal manipulation itself.

These more serious complications of spinal manipulation are probably rare. Estimates of the rates of serious complications range widely, from one in tens of thousands to one in millions of treatments.

Special precautions

The use of manual treatments as practised by chiropractors is not recommended in cases where there is an increased risk of damage to the spine or other bones, or the nerves.

This means that people with certain health conditions may not be able to have chiropractic. They include people with:

severe osteoporosis
primary cancer of the bone or a secondary cancer that has spread to the bone
poorly controlled arthritis or gout
poorly controlled diabetic neuropathy
fractures
compression of the nerves in the spinal cord

Chiropractic treatment is also not recommended if you are taking anticoagulants, such as warfarin.

In some cases, where manipulation of bones, joints and soft tissue is not recommended, a chiropractor may be able to offer other treatments, along with diet, exercise and lifestyle advice.

If you have any of these health conditions, or you are unsure whether chiropractic is safe for you, speak to your GP first.