by Randy Moyer, DC
I often get asked by patients how safe chiropractic care really is. I generally answer that with a quick review of the costs of chiropractic malpractic insurance rates as compared with other health care providers.
– Back surgeons generally pay about $100 – $150k in malpractice insurance per year.
– Medical doctors who do not perform surgery generally pay about $20 – $25k per year.
– My malpractice insurance is less than $1000 per year!
Why? Because chiropractors do not have malpractice claims! There is very little risk in receiving chiropractic care. In fact, a recent study published that a single aspirin is 300 times more likely to have serious side-effects than chiropractic care.
I really like the summary of chiropractic safety by the following researcher…who is also a medical doctor.
No one pays closer attention to injury statistics than Malpractice Insurance carriers.
Scott Haldeman, MD, reviewed malpractice claims records for a 10-year period between 1988 and 1997. In reviewing the outcomes following the application of 134.5 million cervical manipulations (commonly referred to as the chiropractic adjustment), the records indicated that there were 23 reported cases of stroke or vertebral artery dissection (VAD).  Of this group, 10 of the patients had the complicating factors of high blood pressure, use of oral contraceptives, or a history of smoking, all of which are associated with vascular disease. The actual incidence of stroke or VAD following cervical manipulation was found to be one per 5.85 million cervical adjustments. That means that the average chiropractor could work for 1430 years (or practice 48 full chiropractic careers!) before they might be involved with this type of litigation.
B. Non Steriodal Anti-Inflammatories (NSAIDs)
One group of patients who rely on NSAIDs for pain relief are those suffering from rheumatoid arthritis. In 1998, Dr. Singh of the Stanford University of Medicine reviewed the records of 11,000 arthritis patients at 8 participating institutions. He extrapolated that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications (internal bleeding) and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures for all NSAID users would be overwhelming, yet the scope of this problem is generally under-reported. 
Another article titled “36 Percent of Acute Liver Failures Are Linked to Acetaminophen” suggests that other organ systems are also compromised by the use of over-the-counter pain medications. 
Lauretti’s review of the literature found that The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times.
First, let’s review some history. In 1974, the Congressional Committee on Interstate and Foreign Commerce held hearings on unnecessary surgery. Their findings from the First Surgical Second Opinion Program found that 17.6% of recommendations for surgery were not confirmed. The House Subcommittee on Oversight and Investigations extrapolated these figures to estimate that, on a nationwide basis, there were 2.4 million unnecessary surgeries performed annually resulting in 11,900 deaths at an annual cost of $3.9 billion. 
With the total number of lower back surgeries having been estimated in 1995 to exceed 250,000 in the U.S. at a hospital cost of $11,000 per patient.  This would mean that the total number of unnecessary back surgeries each year in the U.S. could approach 44,000, costing as much as $484 million. 
So, the biggest risk of spinal surgery is that it may not be necessary!
Info referenced at http://www.chiro.org/LINKS/Safety.shtml