Previously, we have explored rare cases where individuals experienced severe complications following chiropractic adjustments. For instance, Joanna Kowalczyk passed away in 2021 after several chiropractic manipulations, with coroner reports highlighting a stroke resulting from vertebral artery tears likely initiated during personal training and worsened by cervical manipulation. Similarly, former Playboy model Katie May passed away after seeking care for neck pain, which the coroner attributed to a neck adjustment performed by her chiropractor.
When discussing risks of this magnitude, the most important question for anyone seeking spinal care is simple: Is chiropractic care safe?
1. No Reported Deaths from Chiropractic Treatment in Singapore
To the best of our knowledge, there has never been a publicly recorded death resulting from chiropractic treatment in Singapore, and no formal statistics suggest anyone has suffered a stroke locally from seeing a chiropractor.
The closest high-profile incident occurred in Indonesia back in 2015, which prompted authorities to shut down Chiropractic First clinic at Pondok Indah Mall, South Jakarta. The treating chiropractor in that case was American practitioner Randall Cafferty. Reports indicate that Cafferty had previously faced disciplinary action regarding his licence from the California Board of Chiropractic Examiners, and he remains wanted by Indonesian authorities.
2. The Regulation of Chiropractors in Singapore
The lack of formal statutory regulation for chiropractors in Singapore can sometimes confuse consumers. The Singapore Medical Council has clarified that chiropractors are not registered medical doctors. Formal regulation would help the government better define the scope of practice and establish clear professional standards.
Despite not being classified as allied health professionals or medical doctors, chiropractors are legally permitted to practise in Singapore. As former Minister for Health Khaw Boon Wan noted in parliament, chiropractors retain their right to operate independently.
3. What Are the Risks of Chiropractic Neck Adjustments?
While extreme complications like stroke are exceptionally rare, accounting for zero publicly reported fatalities in Singapore’s decades-long history of chiropractic care, they are serious and must be acknowledged. Millions of adjustments are likely performed across the country, but risks do exist.
Common, minor side effects include:
- Post-adjustment soreness: Typically mild and resolving within a couple of days, particularly common for first-time patients.
- Muscle strain or joint sprain: Temporary discomfort that usually heals naturally within days to two weeks.
4. Are All Neck Manipulations Created Equal?
The short answer is no. Certain techniques carry significantly higher theoretical risks than others:
A. Y-Strap Adjustments
Anatomically speaking, high-force Y-strap adjustments make little sense. They place high stress on the cervical facet joints and elevate the potential for vertebral artery strain. Given the limited clinical benefit and disproportionate risk, they are best avoided entirely.
B. HVLA (High-Velocity Low-Amplitude) Techniques
HVLA techniques are generally considered safer for the cervical spine. The thrust is fast, but the actual physical movement range is minimal, allowing for a satisfying cavitation sound without excessive strain on local blood vessels.
C. Preferring Minimal Rotation and Flexion
When receiving neck care, it is ideal to seek practitioners who work with the spine close to a neutral or slightly flexed position. Avoid practitioners who push the neck into extreme rotation or extension at the end range of motion, as these positions place unnecessary stress on the vertebral arteries.
5. Risks Exist in All Treatments and Daily Activities
It is worth noting that risks are not exclusive to chiropractic care, they are a part of everyday life and standard medical procedures alike:
- Physical and athletic activities: Unforeseen medical emergencies can happen during routine athletic events, marathons, or heavy lifting like squatting (such as the cases involving Justyn Vicky or Yashtika Acharya).
- Medical procedures: Conventional medical interventions also carry inherent risks, whether through medication, or localised injections like standard steroid treatments, or surgery.
6. Are Chiropractic Neck Adjustments Right For You?
No physical treatment comes with a zero-risk profile. While minor muscle soreness is common after spinal adjustments, rare complications like vertebral artery dissection remain a serious consideration, particularly because early stroke symptoms can easily mimic ordinary neck pain.
At Square One Active Recovery, we choose not to perform spinal manipulations because their clinical benefits are often temporary, and we prefer to avoid unnecessary risks to the cervical spine. When in doubt regarding your neck and shoulder aches, always choose to err on the side of caution and consult an evidence-based healthcare professional.
Looking for safer, evidence-based alternatives for managing neck pain and stiffness? Book a clinical assessment with Square One Active Recovery today.
Key Takeaways
Keep these fundamental concepts in mind regarding neck adjustments and safety:
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Safety record in Singapore: There are no reported deaths or formal statistics confirming stroke from chiropractic adjustments locally, though rare international incidents highlight the importance of safety.
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Not all manipulations are equal: High-risk maneuvers like Y-strap adjustments lack anatomical justification and should be avoided in favour of safer, minimal-rotation techniques.
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Evidence-based alternatives: Clinics like Square One Active Recovery bypass high-risk spinal manipulations entirely, focusing instead on active recovery and functional rehabilitation.
