By Sean Burton
While chiropractic care is generally accepted as a valid form of medical treatment for a variety of conditions, there exists some controversy over the extent of its use. At the forefront of this controversy is cervical spine manipulation.
The cervical spine is the segment located in the neck. Stiff facet joints in the cervical spine, muscle tension in the neck and headaches are the main reasons people seek out cervical chiropractic care. There is a long-standing concern, both in the medical community and general public, that using manipulation techniques on the cervical spine can have harmful side effects.
The manipulation component of chiropractic care involves administering thrusts to the joints in an effort to realign them and restore normal range of motion. While this is often highly effective in other spinal areas, particularly in the lower back, many are concerned that thrusts in the neck can result in a number of complications, the worst being stroke.
The vertebrobasiliar artery runs the length of the cervical spine and is most vulnerable at the top end of the spine, where it loops into and out of the vertebra (C1). This artery provides nutrients and oxygen to parts of the brain that facilitate many functions, including vision, balance and consciousness. Many fear that the force administered during a cervical manipulation can cause this artery to rupture, resulting in possible stroke and death.
Strokes of this kind can also occur spontaneously, or when performing simple actions like coughing or turning the head. This has led some to believe that any correlation with chiropractic care is inconclusive.
What The Science Says
A study reviewing over 50,000 cases of cervical spine manipulation concluded that the risk of serious adverse effects immediately following treatment was low. Minor side effects including headache, dizziness and nerve disruption in the upper limbs were fairly common. This study can be found at http://www.ncbi.nlm.nih.gov/pubmed/17906581.
The rarity of severe side effect is not the greatest argument for cervical chiropractic care, however. Stroke cannot be ruled out as a risk of cervical manipulation. A benefit/risk analysis must be considered to determine whether this form of treatment is worth that small risk. Manipulation treatments can actually be compared to another form administered by chiropractors as well as physical therapists: mobilization. This technique entails moving joints through their ranges of motion and stretching muscles while the patient remains passive. In a study found athttp://www.ncbi.nlm.nih.gov/pubmed/20801246, both treatments are shown to be equally as effective. Since mobilization has not been associated with stroke, it is the preferable treatment.
You do not have to avoid the chiropractor if your neck is causing pain. Rather, inform yourself as to the risks and benefits associated with various techniques and decide what type of treatment you are comfortable with. Neck and back pain management should not be dangerous. There is sufficient evidence to prefer other treatments to cervical manipulation.
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Marco Abanico is a curator for DFWChiromassage Spine Blog and a chiropractor in the Dallas/Fort Worth metroplex. He is a leading authority on how to relieve spine pain easily and naturally. His clinic has helped thousands of patients put an end to their neck and back pain. If you are considering surgery for neck pain relief or if other forms of treatment have not worked, CALL US and ask us about our $40 exam and first treatment special at 513-580-4930 or logon to DFWChiroMassage Spine Blog.