Like any medical treatment, chiropractic care can have side effects. Most people feel temporary soreness, stiffness, or mild discomfort after a chiropractic adjustment. Some may experience headaches or fatigue, but these effects are usually temporary.
Though rare, more serious complications can occur, such as herniated discs, pinched nerves, or stroke.
For people with AS, the risks of chiropractic care are more serious. As AS progresses, the vertebrae (the bones that make up the spine) can begin to grow together and fuse, making the spine stiff and less flexible.
These bones can develop osteoporosis, a condition that makes them weak and brittle, explains Biggee. The bones can become so fragile that they break without any obvious cause.
Even heavy massage for someone with advanced AS can cause the bones to break or slip out of place, potentially leading to nerve damage, says Biggee.
“If chiropractors are not familiar with the anatomy that goes along with the chronic changes of AS, any manipulation that’s not done carefully or even done without knowledge could really be harmful,” says Aly Cohen, MD, a rheumatologist and integrative medicine practitioner based in New Jersey, and the author of Detoxify: The Everyday Toxins Harming Your Immune System and How to Defend Against Them.
Indeed, guidelines from the American College of Rheumatology, the Spondylitis Association of America, and the Spondylitis Research and Treatment Network advise against spinal manipulation in people with spinal fusion or osteoporosis due to the risk of serious injury.
Research on chiropractic care for ankylosing spondylitis is limited. For example, a review study found that there wasn’t enough research to show whether chiropractic care is helpful for people with AS.
Because of these increased risks and the lack of clear evidence that chiropractic care is beneficial for AS, healthcare providers typically don’t recommend it, says Biggee.
If you have AS and are considering chiropractic treatment, talk with your rheumatologist first. They can make recommendations based on your condition.