If a chiropractor has injured you, your first priority is getting a medical evaluation to document the damage, then preserving your right to take legal action. Serious chiropractic injuries are rare, occurring in roughly 1 to 7 cases per million treatments, but when they do happen, the consequences can range from fractured ribs to stroke. Knowing what steps to take, what symptoms to watch for, and how the legal process works puts you in the strongest position to protect your health and your rights.
Get a Medical Evaluation First
Before anything else, see a physician. This serves two purposes: it protects your health and creates a medical record linking your symptoms to the chiropractic treatment. If you’re experiencing neurological symptoms like dizziness, severe headache, weakness on one side of your body, or vision changes, go to an emergency room immediately. These can signal a stroke or spinal cord injury that worsens without treatment.
For neck-related injuries, doctors typically order imaging such as an MRI or a CT scan with contrast to look for torn arteries, spinal cord swelling, or brain damage. For lower back complaints, imaging can reveal whether a disc has herniated further or whether there’s nerve compression. The specific tests depend on your symptoms, but the key point is that you need an independent medical professional, not the chiropractor who treated you, documenting what happened to your body.
Types of Injuries That Happen
The most widely recognized serious complication is a tear in one of the arteries running through the neck, called a vertebral or carotid artery dissection. During rotational neck manipulation, the artery can be overstretched, tearing its inner lining. Blood collects in the vessel wall, narrowing or blocking it, which can trigger a stroke. In adults who experience this type of arterial tear after neck manipulation, about 60% also develop bleeding around the brain. One case report described a young woman who developed headache, vomiting, double vision, dizziness, and loss of coordination after a chiropractic neck adjustment. Imaging revealed a stroke in her cerebellum and dangerous fluid buildup in her brain.
Spinal cord injuries are another category. A systematic review in the Journal of the Royal Society of Medicine documented cases of partial and complete paralysis, including patients left unable to move all four limbs. Nine cases in that review involved spinal cord damage such as weakness in multiple limbs or central cord syndrome. Six patients developed nerve root injuries causing radiating pain and numbness. Two experienced cauda equina syndrome, a compression of nerves at the base of the spine that can cause loss of bladder and bowel control.
Less catastrophic but still serious injuries include rib fractures, particularly in older women with osteoporosis. A large study of over 960,000 chiropractic sessions found that the only severe injuries were two rib fractures, both in women over 60 with bone-thinning conditions. Worsened disc herniations and increased muscle or nerve pain also occur, though milder adverse effects like temporary soreness are far more common than anything requiring emergency care.
Warning Signs That Need Emergency Attention
Certain symptoms appearing after a chiropractic adjustment are medical emergencies. The most common early sign of an arterial tear is dizziness, typically accompanied by vertigo, loss of balance, double vision, or involuntary eye movements. Up to 92% of patients with this type of injury report head or neck pain, and about 25% experience a sudden new headache unlike anything they’ve felt before. Weakness on one side of the body, difficulty speaking, trouble swallowing, or a drooping eyelid with a constricted pupil on one side (a pattern called Horner’s syndrome) all point to possible stroke.
For lower back injuries, watch for progressive numbness in the groin or inner thighs, new difficulty controlling your bladder or bowels, or rapidly worsening weakness in one or both legs. These suggest cauda equina syndrome, which requires emergency surgery to prevent permanent damage.
Who’s at Higher Risk
Certain conditions make spinal manipulation significantly more dangerous. Osteoporosis, cancer that has spread to the bones, active infections in the spine, fractures, dislocations, and narrowing of the arteries in the neck are all contraindications, meaning manipulation should not be performed. Patients with a central disc herniation in the lower back are also not candidates for forceful thrust techniques. If a chiropractor performed manipulation on you despite one of these conditions, that’s directly relevant to a negligence claim.
In some documented cases, chiropractors failed to diagnose cancer in patients and continued manipulating the spine, resulting in pathological fractures of bones weakened by tumors. A chiropractor has a legal duty to recognize when their treatment is not appropriate and to refer you elsewhere.
What the Law Requires for a Malpractice Claim
Chiropractic malpractice follows the same basic framework as medical malpractice. You need to establish four things: the chiropractor owed you a duty of care, they breached that duty by falling below the accepted standard of practice, their negligence directly caused your injury, and you suffered actual damages as a result.
Chiropractors are held to the standard of what a reasonably skilled chiropractor in the same area would do in the same situation. They are not guarantors of results. A treatment that simply doesn’t help you is not malpractice. A mere error in judgment, by itself, doesn’t create liability either. But treatment that was “unduly violent,” as courts have described it, or continuing to treat when the chiropractor knew or should have known their methods wouldn’t produce reasonable results, does create legal exposure. A chiropractor who should have referred you to a medical doctor but didn’t may also be liable.
Informed consent is another potential basis for a claim. Before performing manipulation, chiropractors are expected to disclose the material risks of the procedure. If you were never told that neck manipulation carries a small risk of stroke or arterial injury, and you then suffered that exact complication, the failure to disclose becomes part of your case. Standards around what must be disclosed vary by state, but the core principle is that you should have been given enough information to make a meaningful decision about whether to proceed.
How to File a Complaint
Every state has a chiropractic licensing board that investigates complaints against licensed chiropractors. These boards handle allegations of professional misconduct, practicing below the standard of care, and violations of state chiropractic laws. They do not handle billing disputes or insurance issues. You can typically file a complaint online through your state board’s website. Some states, like Ohio, accept anonymous complaints, though they’re harder to investigate without being able to contact you for details.
Filing a board complaint is separate from a malpractice lawsuit. The board can investigate, impose disciplinary action, suspend or revoke a license, and post that discipline to the chiropractor’s public record. But the board won’t award you money for your injuries. For financial compensation, you need a civil malpractice claim.
Building Your Case
If you’re considering legal action, several things strengthen your position. Get your medical records from both the chiropractor and the treating physician or hospital as soon as possible. Your chiropractic records should show what was done during each visit, what technique was used, and whether any screening or imaging was performed beforehand. Your medical records after the injury document the damage and create a timeline linking the treatment to the outcome.
Statutes of limitations for malpractice claims vary by state, often ranging from one to three years, so timing matters. Consulting a personal injury attorney who handles medical or chiropractic malpractice cases early gives you the best chance of meeting all deadlines. Most malpractice attorneys work on contingency, meaning you don’t pay unless you win.
Keep a written record of your symptoms, how they’ve progressed, and how the injury has affected your daily life, your ability to work, and your overall function. Damages in these cases can include medical bills, lost income, pain and suffering, and the cost of ongoing rehabilitation. In cases involving stroke, paralysis, or permanent neurological deficits, settlements and verdicts can be substantial.