How Chiropractic Damages Your Ligaments
By Dean Moyer
Author of Rebuild Your Back
How often have you heard your chiropractor casually warn that you "may feel some discomfort" after the adjustment and your pain may even increase for a day or two… not to worry… this is normal.
Why does he do this?
What is it about spinal manipulation that causes him to issue this veiled warning?
Torn Tissue Fibers
What most chiropractors won't tell you (either because they don't know… or because they simply don't care) is that the high velocity thrust he is about to use on your spine will often cause microscopic tearing of the ligaments (including the annular ring of the intervertebral discs).
There is no doubt that the immediate feeling of release after a successful manipulation does bring about a sense of well-being. However, cracking like this is often too rough. Too many tissue fibres are broken… Microscopic scarring forms around the joint... 
Instability and Hypermobility
This constant tearing (even though on a microscopic level) of the discs and ligaments is counterproductive and can only serve to make things worse. It contributes to degenerative disk disease, hypermobility in the joints and some doctors are even starting to identify this condition as "over-manipulation syndrome."
As one former chiropractor warns:
Rotation manipulations to the upper cervical and thoracic spine can create progressive hypermobility in the capsular ligaments. Consequently, chiropractors utilizing these procedures indiscriminately without valid assessments to diagnose legitimate ligament contractures put their patients at risk for iatrogenic hypermobility… 
So we see that - instead of improving your situation - spinal manipulation does just the opposite. It actually tears tissue fibers and degrades the health of your spine. This is especially true for people over the age of 40.
All manipulation should be avoided for older individuals who are more prone to permanent ligament deformation. The most likely area to be injured is the capsular ligaments of the lower cervical spine since they have the least protection and are vulnerable to rotational thrusts. 
Degenerative Disk Disease and Increased Stiffness
The facts are clear; chiropractic manipulation is not a smart choice for treating back or neck pain. It causes -- at best -- microscopic tearing of the annular ring of the disc as well as the surrounding ligaments. This repetitive injury to the support structure of your back is going to leave you stiffer and more prone to injury the longer this abuse is allowed to continue.
As a manipulator myself, I know well the feel of a back which has been manipulated too often, The joints feel characteristically over-tough and rubbery and, even in the neck, they can be so hard to budge I feel I am wrestling a steer to the ground to get that tiny, elusive click. This is not a good way to go. 
Rotation manipulations to the upper cervical and thoracic spine can create… secondary disk degeneration, shifting of the nucleus pulposis and possibly chronic pain and tenderness. This is a major problem since it is estimated that 80% of the conditions chiropractors treat with cervical manipulation are inappropriate. 
But that's not the end of the story. For you see, if you do have any form of degenerative disk disease (and almost everyone over the age of 20 does to a certain extent) then chiropractic spinal manipulation is the worst possible thing you can do as we'll see next.
Table of Contents:
- Intro: How Chiropractic Damages Your Spine
- How Chiropractic Damages Your Ligaments
- Chiropractic Manipulation Shown To Cause Herniated Discs
- Neurological Damage and Stroke
About the Author
Rebuild Your Back
Rebuild Your Neck
The Pain Relief Manual
- Botnick A. Manipulation and Hypermobility Chirotalk May 14, 2004 (Link no longer available.)
- Padua L, Padua R, LoMonaco M, Tonali PA. Radiculomedullary complications of cervical spinal manipulation. Spinal Cord. 1996 Aug;34(8):488-92.
PubMed: Disc Prolapse Caused by Manipulation
- Malawski S, Milecki M, Nowak-Misiak M, Sokolski B, Szlapin M. Complications of vertebral disc and spinal diseases after manipulation therapy. Chir Narzadow Ruchu Ortop Pol. 1993;58(2):3-7. PubMed: Manipulation Highly Hazardous
- Li JS. Acute rupture of lumbar intervertebral disc caused by violent manipulation. Zhonghua Wai Ke Za Zhi. 1989 Aug;27(8):477-8, 509.
PubMed: Manipulation Causes Ruptured Discs
- Botnick A. Why adjustments cause neck hypermob and stroke. Chirotalk May 4, 2004 (Link no longer available.)
- Keys S. Back in Action: Straight answers to back pain and its relief. Allen and Unwin  (p. 87-99)
- Rydell N, Raf L. Spinal manipulation--treatment associated with a high risk of complications. Lakartidningen. 1999 Aug 25;96(34):3536-40.
- Coulter, et al. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA, Rand Corp, 1996
- Sanders, M. Take it from a DC: A Lot of Chiropractic is a Sham. Medical Economics Sept. 19, 1990
- Barrett S, Don't Let Chiropractors Fool You. Quackwatch Sept. 17, 1999
- Lee KP, et al. Neurologic complications following chiropractic manipulation: a survey of California neurologists. Neurology 45:1213-1215, 1995.
- Di Fabio R. Manipulation of the cervical spine: Risks and benefits. Physical Therapy 79:50-65, 1999.
- Barrett S. Chiropractic's Dirty Secret: Neck Manipulation and Strokes. Quackwatch, revised May 11, 2002.
- Gallinaro P, Cartesegna M. Three cases of lumbar disc rupture and one of cauda equina associated with spinal manipulation (chiropraxis). Lancet 1983;1:411.
- Markowitz HD, Dolce DT. Cauda equina syndrome due to sequestrated recurrent disk herniation after chiropractic manipulation. Orthopedics 1997;20:652-3.
- Saal JA. Natural history and nonoperative treatment of lumbar disc herniation. Spine 1996;21:2S-9S.
- Jagbandhansingh MP. Most common causes of chiropractic malpractice lawsuits. J Manipulative Physiol Ther 1997;20:60-4.
- Fardon DF, Millette PC. Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology.
Last updated: Sept 15, 2006