Yes, Manual Therapy is low risk, and the vast majority of patients find treatment helpful. About 90% of my patients are referred through word of mouth recommendation. Adverse reactions are not uncommon however and about half of people have the following effects for a couple of days after treatment, most commonly after the first or second session.

  • A increase in pain or stiffness
  • A mild headache
  • Tiredness

Severe adverse reactions are very rare. As a Manual Therapist with a degree in Osteopathy, I am trained to screen patients to assess their suitability for treatment. I will adapt my techniques appropriately or I may decide that treatment is not suitable for the patient and in this situation will discuss other treatment options, including referring patients to other medical professionals as appropriate.

Concern is often voiced about the risk of neck manipulation causing a tear in the vertebral artery (vertebral artery dissection – a rare but serious condition that can lead to a stroke). This type of tear of the artery can be caused by serious or minor trauma and is a significant cause of strokes in patients under 45 years of age. Between 1 and 3 out of every million people who have neck manipulation are at risk of having a stroke, so the risk is real but extremely small. If you are one of the small proportion of people at risk for vertebral artery dissection, these activities also carry the same amount of risk as neck manipulation: yoga or martial arts, having your hair washed at the hairdressers, painting a ceiling, blowing your nose or turning your neck when reversing the car.

Vertebral artery dissection is also more likely if you suffer from hypertension (high blood pressure), sustain neck trauma, take oral contraceptives, suffer migraines, or as a result of other complex medical conditions. It is not always possible to identify vulnerable patients. I am trained to identify patients at high risk of a stroke and if I have any concerns, I will not perform certain neck manipulations.

If you would like to read more about possible adverse reactions to Manual Therapy, the research is published here:
Adverse Events in Manual Therapy – A Systemic Review (full report)