Is Chiropractic Care Linked to Cauda Equina Syndrome? Here's What the Research Says

Low back pain (LBP) is a common issue in active communities like South Anchorage, where outdoor recreation and physically demanding lifestyles are the norm. For many, chiropractic spinal manipulation (CSM) offers an effective and non-invasive treatment. However, concerns about its safety, particularly regarding rare conditions like cauda equina syndrome (CES), have sparked debate. Recent research provides valuable insights, reassuring patients about the safety of chiropractic care.

Cauda Equina Syndrome (CES) is a severe condition where the nerve roots in the lower portions of the spine, known as the cauda equina, become compressed due to spinal stenosis. This can cause numbness, weakness and loss of control of the bladder, bowels and legs. It necessitates immediate medical attention to avoid permanent damage and requires emergency surgery as a treatment.

CES is a serious condition involving compression of nerve roots at the base of the spine, potentially leading to symptoms like severe pain, bladder or bowel dysfunction, and numbness in the saddle area. While rare, CES can require emergency surgery to prevent permanent damage. Historically, there have been isolated reports suggesting that CSM could increase the risk of CES. However, a large-scale study comparing over 130,000 patients receiving either CSM or physical therapy (PT) for LBP found no evidence to support this claim. In fact, the study revealed a slightly lower incidence of CES in the CSM group compared to the PT group, with no meaningful difference in overall risk.

One key takeaway from the study is that the risk of CES is inherently higher in individuals with LBP, regardless of the treatment method. Both groups showed an increased risk of CES within the first two weeks of seeking care, highlighting the importance of early detection. For chiropractors, this underscores the need for thorough evaluations, attention to patient history, and prompt referral for surgical intervention if CES symptoms are present.

Male spinal column illustration.

At Backcountry Health, we prioritize patient safety by adhering to evidence-based practices and conducting comprehensive assessments before treatment. Our approach ensures that we not only alleviate pain but also monitor for rare conditions like CES, providing peace of mind for our active and health-conscious South Anchorage community. Chiropractic care remains a trusted and effective option for managing LBP and keeping you active, mobile, and ready to enjoy everything Alaska has to offer.

For more details about CES and chiropractic care, feel free to contact our team or schedule an evaluation. We’re here to help you stay strong and pain-free!

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Source:

Association between chiropractic spinal manipulation and cauda equina syndrome in adults with low back pain: Retrospective cohort study of US academic health centers. Robert J. Trager , Anthony N. Baumann, Jaime A. Perez, Jeffery A. Dusek, Romeo-Paolo T. Perfecto, Christine M. Goertz. Published: March 11, 2024

• https://doi.org/10.1371/journal.pone.0299159