Question
I've been under chiropractic care for 3 1/2 weeks now. I did not have any major health problem. I saw my chiropractor to get a posture and help my mid-back muscles to relax a little bit. They were tense. Everything wasn't too bad.

After my 3rd treatment I woke up the next day with some numbness on the right side of the face. My vision in my right eye was a little blury. I went back to my chiro and he did some neck and back manipulation again. The numbness disappear is the next couple hours. However, after 3 weeks, my right eye is still acting weird. Some time, I can feel pressure inside my eye, my vision is sometime blurry especially in the right corner, my upper eyelid is twitching and and have a lots of tears coming from this same eye. All these symptoms are temporary and last for about 1-2 hours then go away and then come back a little bit later. I never had any problems with my vision before. No glasses, no contact lenses, perfect vision.

My chiropractor his telling me that this is normal, my body is adjusting. It's been 3 weeks and I haven't see any improvement.  My medical doctor told me that it could be a pinch nerve.

Is it really normal ? Should I continue my treatment ? What do you sugest.

Thanks for your help.

Answer
Thank you for your question.

First, the most common side-effect to manual spinal therapy/spinal manipulation iS localized soreness in the region where tissues are sensitive and possibly inflamed. In the vast majority of cases, these symptoms are mild and disappear quickly.

However, ANY vision changes or numbness in the face that a patient may experience after receiving spinal manipulation, while rare, is potentially serious. I absolutely disagree with the statement by your chiropractor that such symptoms are normal that your body is "adjusting" to the manipulative therapy.

In my opinion, all spinal manipulation of your neck should be discontinued. It is possible that a previously herniated disc may have been aggravated by the manipulation. Studies show that up to three-quarters of the general population may have herniated discs that do not produce symptoms because they are not impinging on a spinal nerve root or are not inflamed. Many radiologists now regard the finding of non-symptomatic spinal disc herniations on MRI scans as incidental. While the best information that we have on spinal manipulation suggests that manipulation may rarely aggravate a pre-existing disc herniation, it is always a possibility that one must consider.

The most serious concern for a post-manipulation complication would be a vascular accident. Again, the best available evidence suggests that vascular complications (such as a stroke) are incredibly rare post-manipulation, but they are a serious concern in individuals who are predisposed to vascular accidents.

Moreover, the literature clearly shows that in the rare cases in which a patient experiences a negative reaction to spinal manipulation, particularly with the symptoms that you have described, spinal manipulation should not be continued, and the patient should undergo medical evaluation (usually with a neurologist or a vascular specialist) to rule out an underlying medical problem, such as a vascular or neurological problem, which may contraindicate further manipulative therapy. Those patients may require additional diagnostic testing, such as an MRI scan of the head and neck, to help rule out a more serious underlying pathology.

Additionally, chiropractic education, training and practice encompasses a wide range of non-forceful, non-thrust, soft-tissue manipulation techniques which may be safely employed to address both muscular and joint-related problems. These techniques are particularly beneficial to patients who may not be appropriate candidates for traditional (i.e. thrusting-type) manipulation. Based on the training and practice style of the individual chiropractor, some chiropractors may be more skilled in these techniques than other.

In cases in which the problem is predominantly muscular, a patient may be better served by seeking the services of a licensed massage therapist.

In the interim, I strongly encourage you to seek immediate additional medical evaluation of your condition. In my opinion, you should not receive any further manipulation of the neck.

I hope that this helps to answer your question.