The precipitation or aggravation of musculoskeletal pain in patients receiving spinal manipulative therapy

Complications of chiropractic adjustments or manipulations can be considered either benign or catastrophic. Although there are a number of papers on the more severe complications, the precipitation of benign and often reversible symptoms following chiropractic care has been largely ignored in the literature. This article discusses six cases where pain symptomatology was either aggravated or precipitated at a location other than the presenting complaints. Two potential causes of these complications are discussed: a) the use of long levers, which can exert force on nonsymptomatic joints in the extremities, and b) the manipulation of biomechanically dysfunctional but asymptomatic joints.