Manipulation for Neck Pain

Treatment Ratings

R

RISK: 5/5

5_Hearts_Treatment_Rating

Manipulation of the neck is a remarkably safe procedure, particularly in comparison to other treatments used for neck pain and related conditions. Some M.D.’s have cautioned that there might be an increased risk of stroke and even death associated with neck manipulation, but even the more conservative estimates put that risk at less than one in 100,000. So how rare are these events? A study by a major chiropractic malpractice carrier in Canada found that VAD will occur in 1 in 8 million chiropractic office visits, 1 in 5.85 million cervical adjustments, and once in nearly 50 chiropractic careers.

By comparison, the risk of bleeding to death from NSAIDs is 2-3 per 100,000.

Some M.D.s have cautioned patients not to have their necks manipulated, but that recommendation is not supported by widely accepted current scientific evidence.

Hawk C. The Praeger Handbook of Chiropractic Health Care. Santa Barabara CA: ABC-CLIO; 2017.

Haldeman S, Carey P, Townsend M, Papadopoulos C. Arterial dissections following cervical manipulation: the chiropractic experience. CMAJ: Canadian Medical Association Journal. 2001;165(7):905-906

Cassidy JD, Boyle E, Côté P, et al. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study. European Spine Journal. 2008;17(Suppl 1):176-183.

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