Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., ... Shekelle, P. G. (2017, April 11). Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. Jama, 317(14), 1451–1460. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2616395

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
Other Disease Processes: Although neck pain is commonly caused by strain, prolonged pain and/or neurologic deficit may be an indication of something more serious. These symptoms should not be ignored. Spinal infection, spinal cord compression, tumor, fracture, and other disorders can occur. If head injury has been sustained, more than likely the neck has been affected too. It is wise to seek medical attention promptly.

Attached to the back of each vertebral body is an arch of bone that forms a continuous hollow longitudinal space, which runs the whole length of the back. This space, called the spinal canal, is the area through which the spinal cord and nerve bundles pass. The spinal cord is bathed in cerebrospinal fluid (CSF) and surrounded by three protective layers called the meninges (dura, arachnoid and pia mater).


The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately.[46] There is not sufficient data to establish the safety of chiropractic manipulations.[13] Manipulation is regarded as relatively safe but complications can arise, and it has known adverse effects, risks and contraindications.[46] Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints.[46] Relative contraindications are conditions where increased risk is acceptable in some situations and where low-force and soft-tissue techniques are treatments of choice; these contraindications include osteoporosis.[46] Although most contraindications apply only to manipulation of the affected region, some neurological signs indicate referral to emergency medical services; these include sudden and severe headache or neck pain unlike that previously experienced.[138] Indirect risks of chiropractic involve delayed or missed diagnoses through consulting a chiropractor.[4]
Advanced Back & Neck Pain Center has been providing chiropractic services and treatment to the Newark, Delaware and surrounding areas since 1986. Under the guidance of founder, Dr. Richard McKay, the office has become synonymous with high level, affordable and efficient chiropractic care and pain management services that do not require the application of medications and/or surgery. Over the past five years, Dr. Richard McKay’s son, Dr. Travis McKay, has become an integral part of the practice and has taken over the role as clinical director of treatment. Together, the two Dr. McKay’s have established a treatment paradigm that ... View Profile

The treatment of neck pain depends on its precise cause. Treatment options include rest, heat or cold applications, traction, soft-collar traction, physical therapy (ultrasound, massage, manipulation), local injections of cortisone or anesthetics, topical anesthetic creams, topical pain-relief patches, muscle relaxants, analgesics, and surgical procedures. Home remedies for treatment, such as Jacuzzi treatment, neck pain relief exercises and stretches, and neck pain relief products such as neck pillows for sleep and hot pads can be very beneficial for relief of some forms of neck pain. There are many treatment options, depending on the particular neck problem and past treatment experiences. Alternative treatments that have been used for relief of chronic neck pain include acupuncture.
In diagnosing the cause of neck pain, it is important to review the history of the symptoms. In reviewing the history, the doctor will note the location, intensity, duration, and radiation of the pain. Is the pain worsened or improved with turning or repositioning of the head? Any past injury to the neck and past treatments are noted. Aggravating and/or relieving positions or motions are also recorded. The neck is examined at rest and in motion. Tenderness is detected during palpation of the neck. An examination of the nervous system is performed to determine whether or not nerve involvement is present.
DCs may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other health care providers. 
Here at Atlas Chiropractic & Wellness, we are proud to help our patients live better lives without pain. We truly believe that nobody deserves to live in pain, even as they age, and we will do everything we can to ensure that our patients are comfortable. We are proud to help people after accident or injuries and when they are uncomfortable doing their day-to-day activities.

Located at 295 Logan Street, a half mile from Del-Val College and directly across from C.B. West High School in the heart of Doylestown, Dr. Jeff McQuaite and his team at McQuaite Chiropractic Center are dedicated to exceeding your expectations and delivering a caring and affordable experience each time you visit our office. That is why our motto has always been “Old fashioned care and concern in a modern world!” Unlike conventional medicine, which focuses on attempting to treat disease once it occurs, McQuaite Chiropractic Center emphasizes improving your health in an effort to reduce the risk of pain and illness in the ... View Profile

Welcome to Rafey Chiropractic & Health Center located at 3377 Compton Road Suite 130 in Cincinnati, OH. We understand that choosing a chiropractor is a big decision. This article will help you learn the basics of chiropractic care. Please don't hesitate to contact our Cincinnati chiropractors with any further questions you have. We are here to help you achieve your goals.


Involved in a car accident? You’re not alone. Many people become injured in accidents and don’t seek the treatment needed to properly restore mobility and function. At The Good Doctor, you’ll receive comprehensive chiropractic care that will alleviate pain and symptoms resulting from your injuries. Our Los Angeles chiropractor offers a variety of treatments and methods that will get you back to a normal, healthy state. If you’re suffering from headaches, back, neck or shoulder pain, we’re ready to help.


All of our chiropractors have years of experience drawing on traditional chiropractic techniques as well as modern corrective methods to heal the mind, body, and spirit. As many of our loyal Ocoee clients can already attest to, when you come to Millenia Chiropractic, LLC we provide much more than pain relief. Our approach to chiropractic care aims to improve your posture, mobility, and overall wellbeing.
Some chiropractors believe that chiropractic care is the only treatment needed for any health problem. Others are committed to working with your pain management specialist as part of a comprehensive treatment plan. When looking for a chiropractor close by, it is important to decide which type of chiropractor is right for you and your pain condition. As we’ll discuss below, chiropractors will share on their website what they’re most focused on treating or what they have the most research experience with. They may also discuss their philosophies about care so you can find one that matches how you approach treating your pain.
Spinal manipulation is associated with frequent, mild and temporary adverse effects,[14][138] including new or worsening pain or stiffness in the affected region.[139] They have been estimated to occur in 33% to 61% of patients, and frequently occur within an hour of treatment and disappear within 24 to 48 hours;[13] adverse reactions appear to be more common following manipulation than mobilization.[140] The most frequently stated adverse effects are mild headache, soreness, and briefly elevated pain fatigue.[141] Chiropractic is correlated with a very high incidence of minor adverse effects.[4] Chiropractic are more commonly associated with serious related adverse effects than other professionals following manipulation.[17] Rarely,[46] spinal manipulation, particularly on the upper spine, can also result in complications that can lead to permanent disability or death; these can occur in adults[14] and children.[142] There is a case of a three-month-old dying following manipulation of the neck area.[137] Estimates vary widely for the incidence of these complications,[13] and the actual incidence is unknown, due to high levels of underreporting and to the difficulty of linking manipulation to adverse effects such as stroke, which is a particular concern.[14] Adverse effects are poorly reported in recent studies investigating chiropractic manipulations.[143] A 2016 systematic review concludes that the level of reporting is unsuitable and unacceptable.[144] Reports of serious adverse events have occurred, resulting from spinal manipulation therapy of the lumbopelvic region.[145] Estimates for serious adverse events vary from 5 strokes per 100,000 manipulations to 1.46 serious adverse events per 10 million manipulations and 2.68 deaths per 10 million manipulations, though it was determined that there was inadequate data to be conclusive.[13] Several case reports show temporal associations between interventions and potentially serious complications.[146] The published medical literature contains reports of 26 deaths since 1934 following chiropractic manipulations and many more seem to remain unpublished.[17]

Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www.projectionscentral.com. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.
The treatment of soft tissue neck and shoulder pain often includes the use of anti-inflammatory medication such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn). Pain relievers such as acetaminophen (Tylenol) may also be recommended. Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injections are often helpful for arthritis of the shoulder. For both neck and shoulder pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.

Chiropractic was founded in 1895 by Daniel David (D.D.) Palmer in Davenport, Iowa. Palmer, a magnetic healer, hypothesized that manual manipulation of the spine could cure disease.[215] The first chiropractic patient of D.D. Palmer was Harvey Lillard, a worker in the building where Palmer's office was located.[37] He claimed that he had severely reduced hearing for 17 years, which started soon following a "pop" in his spine.[37] A few days following his adjustment, Lillard claimed his hearing was almost completely restored.[37] Chiropractic competed with its predecessor osteopathy, another medical system based on magnetic healing and bonesetting; both systems were founded by charismatic midwesterners in opposition to the conventional medicine of the day, and both postulated that manipulation improved health.[215] Although initially keeping chiropractic a family secret, in 1898 Palmer began teaching it to a few students at his new Palmer School of Chiropractic.[23] One student, his son Bartlett Joshua (B.J.) Palmer, became committed to promoting chiropractic, took over the Palmer School in 1906, and rapidly expanded its enrollment.[23]

The best way to live with neck pain is to try to prevent it. The best things you can do to prevent neck pain are pay attention to your body, exercise, eat right, and maintain a healthy life style. In addition, do not sit at the computer for hours without getting up frequently to stretch the neck and back. Take the stress of the day out of your neck muscles and do your exercise routine. If you smoke, stop. Smoking is a predisposing factor for neck pain. If you are overweight, try to increase your activity level and eat healthier to get into shape.


Spinal stenosis is narrowing of the spinal canal that causes compression of the spinal cord (cervical myelopathy). The narrowing is caused by disc bulging, bony spurs, and thickening of spinal ligaments. The squeezing of the spinal cord may not cause neck pain in all cases but is associated with leg numbness, weakness, and loss of bladder or rectum control.

Dr. Grotzinger completed his pre-med at Drake university in Des Moines with a 4.0 GPA in 1976. He graduated from Palmer Chiropractic, Magna Cum Laude in 1981 having worked nights and fathering three children in the process. Since then he has worked both in solo practice and a number of multi-doctor clinics, gaining a wide variety of experience and proficiency. He prides himself on being an effective chiropractor who has balanced the ways of the old time chiropractors with today's emphasis on patient comfort.

A 2006 systematic cost-effectiveness review found that the reported cost-effectiveness of spinal manipulation in the United Kingdom compared favorably with other treatments for back pain, but that reports were based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to non-specific effects) remains uncertain.[161] A 2005 American systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention.[162] The cost-effectiveness of maintenance chiropractic care is unknown.[12]
Neck injuries can occur during motor vehicle accidents, other traumatic events or sports. Symptoms of these injuries include neck stiffness, shoulder or arm pain, headache, facial pain and dizziness. Pain from a motor vehicle injury may be caused by tears in muscles or injuries to the joints between vertebrae. Other causes of pain are ligament rupture or damage to a disc. Conservative treatment of these injuries includes pain medication, bed rest, reduction of physical activity and physical therapy.
A small study of just 7 patients with pain as the only symptom of spontaneous cervical artery dissection. There was disconcerting variety in presentation, but the pain was consistently severe, unfamiliar, unilateral, and mostly sudden onset. “Cervicocephalic arterial dissection should be suspected when patients complain of intense unilateral posterior cervical and occipital pain or temporal pain.”
Self care: Neck pain often resolves with rest, ice or heat, massage, pain relievers, and gentle stretches. Reduce muscle inflammation and pain using an ice pack for 20 minutes several times a day during the first 48 to 72 hours. Thereafter, a warm shower or heating pad on low setting may be added to relax the muscles. A short period of bed rest is okay, but more than a couple of days does more harm than good. If self-care treatments aren't working within the first couple of days, see your doctor.
Some skin problems on the neck can cause neck pain, but are usually obvious — most people will identify them as “skin problems on the neck” and not “a neck problem affecting the skin.” Herpes zoster (shingles) [CDC] causes a painful rash, cellulitis [Mayo] is extremely painful but superficial, and a carbuncle[Wikipedia] … well, it’s just a super zit, basically. If you can’t diagnose that one on your own, I can’t help you!
Eagle’s syndrome [Medscape] is a rare abnormal elongation of a bizarre little bit of bone at the back of the throat called the styloid process. Even a normal styloid process looks jarring when you first see one: it is so skinny and sharp that it makes one wonder how it can possibly not be stabbing something. Well, it turns out that in some cases it does “stab” you in the neck. This will cause a feeling of a lump in the throat and/or moderate intensity pains throughout the region, possibly including the side of the neck, although pain is more likely to dominate the jaw and throat.15
In the U.S., chiropractors perform over 90% of all manipulative treatments.[210] Satisfaction rates are typically higher for chiropractic care compared to medical care, with a 1998 U.S. survey reporting 83% of respondents satisfied or very satisfied with their care; quality of communication seems to be a consistent predictor of patient satisfaction with chiropractors.[211]
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So when I work out, I overcompensate by using my lower back and hamstrings, rather than my glute muscles. As a result, I’m overworking some of the compensating muscles and my glute muscles are remaining weaker. We talked about treatment options, which included reactivating my glutes through strengthening exercises (who knew chiropractors did these?!) and prescribing weekly adjustments for the first few months.
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