Chiropractic Emergencies

Go straight to the ER if your severe back pain comes with any of these red flags: loss of bladder or bowel control, numbness in the groin or inner thighs (saddle anesthesia), progressive weakness in both legs, fever with back pain, or pain after a serious fall or car crash. These can signal cauda equina syndrome, spinal infection, or fracture, all of which need imaging and possibly surgery within hours. For most other severe back pain, a chiropractor is a smart first stop. Muscle spasms, disc irritation, sciatica flare-ups, and locked joints are exactly what we treat every day. The American College of Physicians actually recommends spinal manipulation as a first-line treatment for acute low back pain before medication or imaging. Here is a simple rule I share with Tracy patients: if you can walk, feel your legs normally, and control your bladder, you probably do not need the ER. Call our office first. If we think you need imaging or a medical workup, we will refer you. If it is after hours and pain is severe but you have no red flags, urgent care can bridge the gap with muscle relaxers until you can see us the next business day. Car accident pain is a special case. Even if you feel okay at the scene, whiplash and disc injuries can worsen over 24 to 72 hours. If you were rear-ended on the 205 or I-580, get checked. Our [auto accident injury](/services/auto-accident-injury) team handles these cases daily, and you can read what to expect in our [first 72 hours guide](/blog/auto-accident-chiropractor-manteca-first-72-hours). For ongoing severe back pain without red flags, our [chiropractic care](/services/chiropractic-care) page explains the assessment process.

Chiropractic red flag symptoms are warning signs that your problem may not be a simple mechanical issue. Any responsible chiropractor screens for these at every visit. If you have them, we send you to the ER or your medical doctor, not the adjusting table. The main red flags include: - **Cauda equina signs**: loss of bladder or bowel control, numbness in the saddle area, or new sexual dysfunction with back pain - **Progressive neurological loss**: worsening weakness, foot drop, or numbness spreading down a limb - **Unexplained weight loss** with back pain, which can point to cancer or infection - **Fever, chills, or night sweats** paired with spine pain, suggesting infection - **Severe headache of sudden onset** (thunderclap headache), which can indicate bleeding in the brain - **Neck pain after trauma** with numbness, dizziness, or trouble speaking - **Chest pain, jaw pain, or shortness of breath**, which can be a heart attack rather than a musculoskeletal problem - **History of cancer** with new bone pain The NIH National Institute of Neurological Disorders and Stroke lists cauda equina syndrome as a surgical emergency requiring treatment within 24 to 48 hours to prevent permanent damage. One more red flag Tracy patients should know: sudden severe neck pain with dizziness, vision changes, or facial numbness after a chiropractic adjustment, sports impact, or even a hard sneeze can rarely signal a vertebral artery issue. This is why our doctors take a full history and do vascular screening before adjusting the upper neck. If you ever notice these symptoms, call 911. For context on non-emergency neck problems, see our page on [head and neck pain](/pain/head-neck) or our [Tracy neck pain guide](/blog/neck-pain-in-tracy-ca).

Valley Chiropractic Center is not a 24/7 emergency chiropractor in Tracy, and honestly, no true walk-in emergency chiropractic clinic exists in most communities. What we do offer is same-day and next-day urgent appointments during business hours across our four offices, plus a phone line where established patients can reach a doctor for advice after hours. If you are in acute pain outside our hours, here is what I recommend: 1. **Call our Tracy office and leave a message.** We check messages in the evening and can often get you in first thing the next morning at our [Tracy](/locations/tracy), [Mountain House](/locations/mountain-house), [Manteca](/locations/manteca), or [Ripon](/locations/ripon) location. 2. **Use urgent care for severe pain without red flags.** Sutter Tracy and the local urgent care clinics on Tracy Boulevard and Grant Line Road can prescribe muscle relaxers or anti-inflammatories to hold you over. They do not typically adjust the spine, but they can rule out fractures with X-rays. 3. **Go to the ER for red flag symptoms** listed in the previous question. 4. **Ice and rest at home** if pain is manageable. Twenty minutes of ice every two hours, gentle walking, and avoiding heavy lifting is the standard first aid until we can see you. One benefit of being an established patient is that we already have your history, X-rays, and treatment plan on file. When you call, we can often triage over the phone and tell you whether to head to the ER, urgent care, or wait for morning. That is one reason we encourage [preventative care](/services/preventative-care) check-ins even when you feel fine, especially for Tracy commuters spending hours in Bay Area traffic who tend to have flare-ups at the worst times.

Urgent care can help with severe back pain in specific situations, but it has real limits. It is worth the trip when you need short-term pain control, X-rays to rule out a fracture, or a medical workup for possible infection or kidney stones. It is less useful if you want lasting relief, because urgent care providers rarely address the underlying joint or disc problem. Here is what urgent care does well: - Prescribes muscle relaxers, anti-inflammatories, or short courses of stronger pain medication - Orders X-rays for suspected fractures after a fall or accident - Screens for kidney stones, urinary infections, and other non-spine causes of back pain - Provides a doctor's note if you need to miss work Here is what urgent care usually does not do: - Spinal adjustments or manual therapy - Detailed orthopedic and neurological exams of the spine - Long-term treatment plans for disc, sciatica, or joint problems - MRI referrals (usually your primary doctor handles this) Research published on PubMed and summarized by the American Chiropractic Association shows that early conservative care, including chiropractic, leads to lower opioid use, fewer imaging studies, and better long-term outcomes for acute low back pain compared to medication-first approaches. My honest advice for Tracy patients: if pain is severe and it is Sunday night, use urgent care to get through until morning. Then come see us for actual treatment. We handle [disc conditions](/services/disc-conditions), [sciatica](/services/sciatica), [pinched nerves](/services/pinched-nerves), and acute back injuries with hands-on care that pills alone will not fix. Our blog on [pain medications versus chiropractic care](/blog/pain-medications-vs-chiropractic-care-tracy) breaks down the trade-offs in more detail.

Right after a car accident, your first priority is medical safety, not chiropractic care. If anyone has head injury, chest pain, neck pain with numbness, or trouble breathing, call 911 and let paramedics assess you on scene. Do not try to drive yourself if you feel dizzy or disoriented. Once you know there is no life-threatening injury, follow these steps in order: 1. **Call the police** and get an accident report, even for minor collisions. California requires this for any crash with injury or property damage over $1,000. 2. **Exchange insurance and photograph everything**: both cars, license plates, the scene, and any visible injuries. 3. **Get evaluated at the ER or urgent care that same day** if you have any neck pain, back pain, headache, dizziness, or numbness. Adrenaline masks pain for hours or even days after a crash. 4. **Call your auto insurance** to open a medical claim. In California, your Med Pay coverage often pays for chiropractic care after an accident. 5. **Book a chiropractic evaluation within 72 hours.** Whiplash and soft tissue injuries respond much better to early treatment. The CDC reports that motor vehicle crashes are a leading cause of neck and spine injury, and delayed treatment is linked to chronic pain lasting years. Tracy sees heavy commuter traffic on I-205, I-580, and the 120, which unfortunately means our team treats a lot of rear-end whiplash cases every month. Our [whiplash treatment](/services/whiplash-treatment) and [personal injury](/services/personal-injury) pages walk through the exam and care process. For a week-by-week look at what recovery involves, read our [whiplash recovery timeline](/blog/whiplash-recovery-timeline-what-to-expect-in-weeks-1-through-12). Dr. Coykendall and the team at [our Tracy location](/locations/tracy) will document your injuries thoroughly for your insurance claim.

Yes, there are situations where an adjustment can be dangerous, and this is why a proper exam is not optional. A good chiropractor will refuse to adjust you if any of these apply, and refer you out instead. Conditions where high-velocity spinal adjustment is contraindicated or high-risk include: - **Suspected fracture** from trauma, osteoporosis, or cancer in the bone - **Cauda equina syndrome** or progressive neurological deficits - **Acute infection** of the spine or nearby tissue - **Vertebral artery dissection** or recent stroke symptoms - **Severe osteoporosis** where bone density is too low for manual force - **Certain bleeding disorders** or patients on high-dose blood thinners without medical clearance - **Unstable spinal joints** from rheumatoid arthritis or Down syndrome A 2015 review in the Journal of the American Medical Association found that serious complications from spinal manipulation are rare, especially for the low back, but the risk is not zero for the upper neck. That is why we screen carefully. If you have a personal or family history of stroke, connective tissue disorders like Ehlers-Danlos, or recent head or neck trauma, tell your chiropractor before any treatment. At Valley Chiropractic, we use a variety of [chiropractic techniques](/services/chiropractic-techniques), not just the high-velocity thrust adjustments people picture. For higher-risk patients, we may choose gentle low-force methods, instrument-assisted adjustments, or [massage therapy](/services/massage-therapy) and mobilization instead. For older adults, our [senior chiropractic care guide](/blog/senior-chiropractic-care-safe-approaches-after-age-65) covers safe options after age 65. Bottom line: an emergency is not a reason to skip the intake paperwork. Even in acute pain, we take five minutes to screen for red flags and adjust our approach. If something does not add up, we send you to the ER or your primary care doctor first. That is not overcaution, it is good medicine.