Reactions following a chiropractic adjustment In the course of being treated by a chiropractor for spinal derangement or subluxations, certain reactions may be experienced by the patient receiving the chiropractic treatment. The most common reaction to a chiropractic manipulation is aching or soreness in the spinal joints or muscles. This should not be alarming as it is sometimes a natural tissue response to a chiropractic adjustment. In this author’s experience, if this occurs it is usually within the first few hours post-treatment and does not last longer than 24 hours after the chiropractic session. An ice pack often reduces the symptoms more quickly. Possible complications after a chiropractic adjustment On the most extreme side of chiropractic-related problems, vascular accidents have been reported and critics of chiropractic medicine use this by recommending no spinal manipulation of the cervical spine (39). Critics of cervical manipulation emphasize the possibility of serious injury, especially to the brain stem. However, documented reports of the incidence of this are very rare.  In the hands of an experienced chiropractor, cervical manipulation usually renders beneficial results with few adverse side effects. Several authors have reported a very infrequent incidence rate of vascular accidents during chiropractic treatments that include statements such as, "there is probably less than one death of this nature out of several tens-of-millions of manipulations" (40). Cyriax states "…the risk works out to about one in ten million manipulations, and is no argument against manipulative reduction in suitable cases" (41). Similar low risk of cervical manipulation problems after a chiropractic visit is reported by others (42-44). Reactions following a chiropractic adjustment vary greatly from person to person. These may vary from a great sense of exhilaration and well being to the reactions previously described. Discussion concerning reactions to spinal manipulation from the chiropractor is encouraged between the patient and the treating chiropractor. Obtaining consent for chiropractic treatment is recommended in writing once questions are addressed by the chiropractor.