| Prospective Cohort Studies |
| Barrett et al, 2000 | 68 Patients; 11 chiropractors | Questionnaires given to 12 consecutive new patients | All received SMT | 53% reported an adverse event, mostly increased or radiating pain |
|
| Cagnie et al, 2004 | 465 Patients; 51 manipulating clinicians | Questionnaires given to 15 consecutive new patients | All received SMT | 283 patients (61%) reported at least 1 reaction; headache, stiffness, aggravation of complaints, and radiating discomfort accounted for two-thirds of reactions |
|
| Leboeuf-Yde et al, 1997 | 625 Patients; 66 chiropractors | Questionnaires given to 10 consecutive patients | All received SMT | Treatment reactions were common, but benign and short lasting |
|
| Rubinstein et al, 2008 | 529 Patients with neck pain; 79 chiropractors | Questionnaires completed at regularly scheduled visits | All received SMT | All patients were treated for neck pain; 56% of patients reported at least 1 adverse event; more than 70% of reported adverse events were musculoskeletal or pain |
|
| Senstad et al, 1997 | 1050 Patients; 102 chiropractors | Chiropractor asked 12 consecutive patients a set of standardized questions | All received SMT | At least 1 reaction was reported by 580 patients (55%), 53% reported reactions were local discomfort |
|
| Randomized Clinical Trials |
|
| Maiers et al, 2014 | 194 Elderly patients with neck pain | Standardized solicitation by clinicians, unsolicited reporting of patients, and qualitative interviews with patients | SMT, home exercise, or supervised rehabilitation exercise | 130 patients (67%) reported at least 1 adverse event; SMT patients reported about twice as many adverse events as patients randomized to home exercise (74 for SMT vs 40 for home exercise) |
|
| Paanalahti et al, 2014 | 767 Patients | Questionnaires at each return visit | SMT, manual therapy without SMT, and manual therapy without stretching | About 50% of patients reported an adverse event; the most common adverse event was soreness in muscles, followed by increased pain, stiffness, and tiredness; there were no differences between patients receiving SMT, manual therapy without SMT, or manual therapy without stretching |
|
| Walker et al, 2013 | 198 Patients; 12 chiropractors | Questionnaires completed within 48 h of treatment | Usual chiropractic care (96% received SMT) or a sham | 42% of usual care patients and 33% of sham care patients reported an adverse event; the most common adverse events were increased pain, muscle stiffness, headache, and radiating discomfort |
