A 2010 study describing Belgium chiropractors and their patients found chiropractors in Belgium mostly focus on neuromusculoskeletal complaints in adult patients, with emphasis on the spine.[83] The diversified technique is the most often applied technique at 93%, followed by the Activator mechanical-assisted technique at 41%.[83] A 2009 study assessing chiropractic students giving or receiving spinal manipulations while attending a U.S. chiropractic college found Diversified, Gonstead, and upper cervical manipulations are frequently used methods.[84]

Whiplash and other neck pain. There is no consensus on the effectiveness of manual therapies for neck pain.[104] A 2013 systematic review found that the data suggests that there are minimal short- and long-term treatment differences when comparing manipulation or mobilization of the cervical spine to physical therapy or exercise for neck pain improvement.[105] A 2013 systematic review found that although there is insufficient evidence that thoracic SM is more effective than other treatments, it is a suitable intervention to treat some patients with non-specific neck pain.[106] A 2011 systematic review found that thoracic SM may offer short-term improvement for the treatment of acute or subacute mechanical neck pain; although the body of literature is still weak.[107] A 2010 Cochrane review found low quality evidence that suggests cervical manipulation may offer better short-term pain relief than a control for neck pain, and moderate evidence that cervical manipulation and mobilization produced similar effects on pain, function and patient satisfaction.[108] A 2010 systematic review found low level evidence that suggests chiropractic care improves cervical range of motion and pain in the management of whiplash.[109]
Chiropractors, especially in America, have a reputation for unnecessarily treating patients.[6] In many circumstances the focus seems to be put on economics instead of health care.[6] Sustained chiropractic care is promoted as a preventative tool, but unnecessary manipulation could possibly present a risk to patients.[4] Some chiropractors are concerned by the routine unjustified claims chiropractors have made.[4] A 2010 analysis of chiropractic websites found the majority of chiropractors and their associations made claims of effectiveness not supported by scientific evidence, while 28% of chiropractor websites advocate lower back pain care, which has some sound evidence.[197]
There are several surgical treatments available to treat cervical spine disorders. Factors that help determine the type of surgical treatment include the specifics of the disc disease and the presence or absence of pressure on the spinal cord or spinal nerve roots. Other factors include age, how long the patient has had the disorder, other medical conditions and if there has been previous cervical spine surgery.
Among people seeking back pain relief alternatives, most choose chiropractic treatment. About 22 million Americans visit chiropractors annually. Of these, 7.7 million, or 35%, are seeking relief from back pain from various causes, including accidents, sports injuries, and muscle strains. Other complaints include pain in the neck, arms, and legs, and headaches.
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