One of the most common and well known therapeutic procedures performed by doctors of chiropractic is spinal manipulation (sometimes referred to as a "chiropractic adjustment"). The purpose of spinal manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for an individual. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, allowing tissues to heal.
Twenty‐six to 71% of the adult population can recall experiencing an episode of neck pain or stiffness in their lifetime. Neck pain is more common in females than in males, with rates reported as high as 77.8%. The natural history is unclear. Neck pain has a costly impact on society because of visits to healthcare providers, sick leave, disability and loss of productivity. There are a number of treatments available for neck pain, one of which is mechanical traction.

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]
Although it’s rare, once in a while neck pain may be a warning sign of cancer, infection, autoimmune disease, or some kind of structural problem like spinal cord injury or a threat to an important blood vessel. Some of these ominous situations cause hard-to-miss signs and symptoms other than pain and are likely to be diagnosed correctly and promptly — so, if it feels serious, go get checked out. Otherwise, if you are aware of the “red flags,” you can get checked out when the time is right — and avoid excessive worry until then.
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.
A personal worry example One day I became convinced that the terrible stubborn pain in my neck had to be a cancer. It was one of the lowest moments of my life. The pain had been escalating slowly for months, and eventually it got so severe and unrelenting that I lost my cool. But then, after an emergency massage appointment, I felt almost completely better…and that particular pain never bothered me again.
Licensure takes place at the state level under specific state laws. Licensing and the scope of practice may differ from state to state. Most states require that chiropractors complete the National Chiropractic Board examination before they get their license. Some states also require chiropractors to pass a state examination. All states recognize training from chiropractic schools accredited by the Council of Chiropractic Education (CCE).
Your chiropractor will ask questions about your current condition, plus any potential causes. They will then gather a complete medical history that includes not only your current status but also any previous injuries or underlying medical conditions. If your imaging is out of date or your condition has changed since your last MRI or X-ray was taken, your chiropractor may order additional imaging.
With extensive experience, our kind and caring team consistently get rave reviews from happy patients. We seek to exceed your expectations in a modern environment equipped with the latest technologies. We believe technology should enhance our ability to help you, not replace our critical thinking. No matter what challenge or concern you may have, the first step is booking a time with our doctors to evaluate your specific issues.
Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. Compared to other common treatments for pain, such as over-the-counter and prescription pain medications, chiropractic's conservative approach offers a safe and effective option.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Radiculopathy. A 2013 systematic review and meta-analysis found a statistically significant improvement in overall recovery from sciatica following SM, when compared to usual care, and suggested that SM may be considered.[101] There is moderate quality evidence to support the use of SM for the treatment of acute lumbar radiculopathy[102] and acute lumbar disc herniation with associated radiculopathy.[103] There is low or very low evidence supporting SM for chronic lumbar spine-related extremity symptoms and cervical spine-related extremity symptoms of any duration and no evidence exists for the treatment of thoracic radiculopathy.[102]
Welcome to Harrisburg Chiropractic located in Harrisburg. At Harrisburg Chiropractic we strive to give you an experience that focuses on a person’s individual needs and wants. Whether your goal is the ability to pick up your children, sit at your desk, go for a walk or play a round of golf without pain, our clinic is the place for you. You may be interested in achieving optimal health and Harrisburg chiropractor Andrew Segarra wants you to utilize us as a resource in getting there.

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The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.

I lost my insurance last month because I switched jobs and my new employer does not offer insurance. Can I just get small look at my shoulder joints that I sprained 3 years ago. For cheap please. I don’t make much. It is a 3rd degree joint sprain between my left shoulder and clavicle. It has been really painful lately I’m afraid it could be getting worse.
If you're looking for a top Cincinnati chiropractor that provides family chiropractic care we are here to help. It's also a bonus that most insurances are accepted. Today many people are searching for a “chiropractor near me”. We hope to be your first choice. Also, don’t forget to click on our New Patient Special. It’s a great way to test drive our services.
Neck pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute neck pain is abrupt, intense pain that can radiate to the head, shoulders, arms, or hands. It typically subsides within days or weeks with rest, physical therapy and other self-care measures. You play an important role in the prevention, treatment and recovery process of neck pain. However, if chronic, pain will persist despite treatment and need further evaluation.
Requirements vary between countries. In the U.S. chiropractors obtain a first professional degree in the field of chiropractic.[164] Chiropractic education in the U.S. have been criticized for failing to meet generally accepted standards of evidence-based medicine.[165] The curriculum content of North American chiropractic and medical colleges with regard to basic and clinical sciences has been more similar than not, both in the kinds of subjects offered and in the time assigned to each subject.[166] Accredited chiropractic programs in the U.S. require that applicants have 90 semester hours of undergraduate education with a grade point average of at least 3.0 on a 4.0 scale. Many programs require at least three years of undergraduate education, and more are requiring a bachelor's degree.[167] Canada requires a minimum three years of undergraduate education for applicants, and at least 4200 instructional hours (or the equivalent) of full‐time chiropractic education for matriculation through an accredited chiropractic program.[168] Graduates of the Canadian Memorial Chiropractic College (CMCC) are formally recognized to have at least 7–8 years of university level education.[169][170] The World Health Organization (WHO) guidelines suggest three major full-time educational paths culminating in either a DC, DCM, BSc, or MSc degree. Besides the full-time paths, they also suggest a conversion program for people with other health care education and limited training programs for regions where no legislation governs chiropractic.[46]
Cervical stenosis occurs when the spinal canal narrows and compresses the spinal cord and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebrae shrinks, and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken. These changes result in a narrowing of the spinal canal. In addition, the degenerative changes associated with cervical stenosis can affect the vertebrae by contributing to the growth of bone spurs that compress the nerve roots. Mild stenosis can be treated conservatively for extended periods of time as long as the symptoms are restricted to neck pain. Severe stenosis requires referral to a neurosurgeon.

There is a wide range of ways to measure treatment outcomes.[91] Chiropractic care, like all medical treatment, benefits from the placebo response.[92] It is difficult to construct a trustworthy placebo for clinical trials of spinal manipulative therapy (SMT), as experts often disagree about whether a proposed placebo actually has no effect.[93] The efficacy of maintenance care in chiropractic is unknown.[12]
“The current study provides the strongest evidence to date that chiropractic care is safe, effective, and results in high levels of patient satisfaction and perceived treatment benefit, thus strengthening our knowledge regarding this conservative nondrug option for low back pain,” Christine M. Goertz, DC, PhD, a chiropractor with the Spine Institute for Quality in Iowa, told Healthline.
Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. Compared to other common treatments for pain, such as over-the-counter and prescription pain medications, chiropractic's conservative approach offers a safe and effective option.
Dr. V.J. Maddio is a Helena native. He attended Montana Statev1173c.jpg University on a wrestling scholarship and studied five years of Associated Sciences with an emphasis in Exercise/Physiology and Sports Medicine. He graduated with his degree in chiropractic from Northwestern College of Health Sciences in Bloomington, MN. Dr. Maddio began his own practice in Helena, Montana in January of 1992. He and his wife, Maureen, have enjoyed raising their 3 children in the Helena community. He is involved in several community activities ranging from youth sports to service organizations. Dr. Maddio is certified in Active Release Technique (ART), is a Certified Impairment Evaluator in the State of Montana, currently serves on the the Board of Chiropractors for the State of Montana, and is past President of the Montana Chiropractic Association.

With extensive experience, our kind and caring team consistently get rave reviews from happy patients. We seek to exceed your expectations in a modern environment equipped with the latest technologies. We believe technology should enhance our ability to help you, not replace our critical thinking. No matter what challenge or concern you may have, the first step is booking a time with our doctors to evaluate your specific issues.
We achieve these results not with potent drugs or harmful muscle relaxers but with spinal decompression therapy that uses intermittent spinal traction to take stress off injured vertebral joints while concurrently hydrating your discs, Chiropractic Adjustments to facilitate proper motion in the joints, electrical stimulation to reduce muscular and nerve pain in localized areas and much more.

^ Jump up to: a b Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S (2008). "Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders". Spine. 33 (4 Suppl): S123–52. doi:10.1097/BRS.0b013e3181644b1d. PMID 18204386.
“When your neck muscles become weak and you try to turn your head, the joint no longer moves smoothly because it’s now out of place,” Dr. Bang says. “Often the joint catches on something, either pulling a muscle or hitting the nerve irregularly, or maybe both. Then you’ll have instant pain and your body has a protective spasm. Your body doesn’t want you to get hurt more, so it will clench, causing you to feel like you can’t even move — and leaving you wondering what you did to injure yourself.”
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We provide advanced spinal correction utilizing “state of the art” chiropractic techniques. Never in the history of chiropractic have we been able to provide the level of help and expertise that now exists. These newer correction methods are even safer, more comfortable and more effective than ever before. Our Orlando Chiropractic team has years of training and experience in spinal adjustment.
The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.
The percentage of the population that utilizes chiropractic care at any given time generally falls into a range from 6% to 12% in the U.S. and Canada,[207] with a global high of 20% in Alberta in 2006.[208] In 2008, chiropractors were reported to be the most common CAM providers for children and adolescents, consuming up to 14% of all visits to chiropractors.[209] In 2008, there were around 60,000 chiropractors practicing in North America.[4] In 2002–03, the majority of those who sought chiropractic did so for relief from back and neck pain and other neuromusculoskeletal complaints;[20] most do so specifically for low back pain.[20][207] The majority of U.S. chiropractors participate in some form of managed care.[21] Although the majority of U.S. chiropractors view themselves as specialists in neuroleptic malignant syndrome conditions, many also consider chiropractic as a type of primary care.[21] In the majority of cases, the care that chiropractors and physicians provide divides the market, however for some, their care is complementary.[21]

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 Henderson Center was founded in 1985 as The Henderson Center Chiropractic Clinic in King of Prussia, Montgomery County, Pennsylvania, but was strictly a chiropractic clinic until 1993, when Dr. M Jonathan Garzillo, a chiropractor, joined the Center. Since then, the Center has expanded beyond just chiropractic to become a multi-specialty pain management practice, incorporating massage therapies, shiatsu therapy and chiropractic care. Dr. Garzillo also brought a simple philosophy to the Henderson Center. Instead of trying to prolong care, the Center works to relieve patients of their pain in the shortest time possible. I ... View Profile
^ Jump up to: a b Palmer DD (1910). The Chiropractor's Adjuster: Text-book of the Science, Art and Philosophy of Chiropractic for Students and Practitioners. Portland, OR: Portland Printing House Co. OCLC 17205743. A subluxated vertebra ... is the cause of 95 percent of all diseases ... The other five percent is caused by displaced joints other than those of the vertebral column.
Chiropractic care (also simply “chiropractic”) is a health care discipline that emphasizes the inherent power of the body to heal itself without the use of drugs or surgery. It focuses on the relationship between the body’s structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. When appropriate, doctors of chiropractic work in cooperation with the patient’s other health care practitioners.
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.

Traditional chiropractors focus on your muscles and bones, making physical adjustments to your spine for temporary relief. At Vero Chiropractic we take a different approach to chiropractic care. We focus on your nervous system, locating issues in your body at the source and providing our patients more effective and longer lasting health outcomes. In other words, we don’t just treat your symptoms, we correct the cause of why they are occuring!


Welcome to Harrisburg Chiropractic located in Harrisburg. At Harrisburg Chiropractic we strive to give you an experience that focuses on a person’s individual needs and wants. Whether your goal is the ability to pick up your children, sit at your desk, go for a walk or play a round of golf without pain, our clinic is the place for you. You may be interested in achieving optimal health and Harrisburg chiropractor Andrew Segarra wants you to utilize us as a resource in getting there.
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
Upon graduation, there may be a requirement to pass national, state, or provincial board examinations before being licensed to practice in a particular jurisdiction.[171][172] Depending on the location, continuing education may be required to renew these licenses.[173][174] Specialty training is available through part-time postgraduate education programs such as chiropractic orthopedics and sports chiropractic, and through full-time residency programs such as radiology or orthopedics.[175]
At Whole Family Chiropractors, we strive to serve everyone in our diverse community, helping people attain their individual health, wellness and fitness goals. Mueller chiropractors Dr. Michelle Paris, Dr. Merrick Fisher and Dr. Brian Gore offer a welcoming space in which you can discuss any topics that affect your physical and mental well-being without judgment, and get answers to your questions. Our array of services include:
We integrate Chiropractic, Physical Therapy and Functional Medicine to find the cause of your problem and help remove it. Dr. Knight's unique method combines a system of traditional Chiropractic adjustments along with a customized exercise or daily activities program designed to enhance the adjustments for greater overall effectiveness. Creating for you specialized techniques to provide relief from your worst symptoms and discover the root cause of your concerns. His initial program is intensified to derive the greatest potential for improvement within the shortest amount of time. By targeting specific areas of your spine, chiropractic care h ... View Profile
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.
Some chiropractors oppose vaccination and water fluoridation, which are common public health practices.[32] Within the chiropractic community there are significant disagreements about vaccination, one of the most cost-effective public health interventions available.[221] Most chiropractic writings on vaccination focus on its negative aspects,[27] claiming that it is hazardous, ineffective, and unnecessary.[28] Some chiropractors have embraced vaccination, but a significant portion of the profession rejects it, as original chiropractic philosophy traces diseases to causes in the spine and states that vaccines interfere with healing.[28] The extent to which anti-vaccination views perpetuate the current chiropractic profession is uncertain.[27] The American Chiropractic Association and the International Chiropractors Association support individual exemptions to compulsory vaccination laws, and a 1995 survey of U.S. chiropractors found that about a third believed there was no scientific proof that immunization prevents disease.[28] The Canadian Chiropractic Association supports vaccination;[27] a survey in Alberta in 2002 found that 25% of chiropractors advised patients for, and 27% against, vaccinating themselves or their children.[222]
Most people believe that chiropractors treat back pain. That is true, but there is so much more that chiropractic care can achieve. Because chiropractors help to remove pressure from the nervous system, they can also influence many other conditions. It is common to hear chiropractic patients say that they came in for back pain and their headaches got better.
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!
Stabilization surgery is sometimes—but not always—done at the same time as a decompression surgery. In some forms of decompression surgery, the surgeon may need to remove a large portion of the vertebra or vertebrae. That results in an unstable spine, meaning that it moves in abnormal ways, and that puts you more at risk for serious neurological injury. In that case, the surgeon will restabilize the spine. Commonly, this is done with a fusion and spinal instrumentation, or implantation of an artificial disc.
Requirements vary between countries. In the U.S. chiropractors obtain a first professional degree in the field of chiropractic.[164] Chiropractic education in the U.S. have been criticized for failing to meet generally accepted standards of evidence-based medicine.[165] The curriculum content of North American chiropractic and medical colleges with regard to basic and clinical sciences has been more similar than not, both in the kinds of subjects offered and in the time assigned to each subject.[166] Accredited chiropractic programs in the U.S. require that applicants have 90 semester hours of undergraduate education with a grade point average of at least 3.0 on a 4.0 scale. Many programs require at least three years of undergraduate education, and more are requiring a bachelor's degree.[167] Canada requires a minimum three years of undergraduate education for applicants, and at least 4200 instructional hours (or the equivalent) of full‐time chiropractic education for matriculation through an accredited chiropractic program.[168] Graduates of the Canadian Memorial Chiropractic College (CMCC) are formally recognized to have at least 7–8 years of university level education.[169][170] The World Health Organization (WHO) guidelines suggest three major full-time educational paths culminating in either a DC, DCM, BSc, or MSc degree. Besides the full-time paths, they also suggest a conversion program for people with other health care education and limited training programs for regions where no legislation governs chiropractic.[46]
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com

Most people believe that chiropractors treat back pain. That is true, but there is so much more that chiropractic care can achieve. Because chiropractors help to remove pressure from the nervous system, they can also influence many other conditions. It is common to hear chiropractic patients say that they came in for back pain and their headaches got better.
If you are seeking a drug and surgery-free alternative to alleviate your back or neck pain then you’ve come to the right place. When searching for a “chiropractor near me” online, you will be happy to know that your search is over. Our highly trained and certified chiropractors have offered safe, natural, and effective chiropractic care to the people of Orlando and the surrounding areas for many years.
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.
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.
Employment of chiropractors is projected to grow 12 percent from 2016 to 2026, faster than the average for all occupations. People across all age groups are increasingly becoming interested in integrative or complementary healthcare as a way to treat pain and to improve overall wellness. Chiropractic care is appealing to patients because chiropractors use nonsurgical methods of treatment and do not prescribe drugs.
Most patients don't realize how much education chiropractors in Cincinnati have. Chiropractors are held to some of the most intense educational standards of any health field. In fact their education standards are very comparable to that of a medical doctor. After completing a strong emphasis of basic sciences in college, chiropractors attend a four year chiropractic college. This means that chiropractors are primary care physicians. 
^ Jump up to: a b Joseph C. Keating, Jr., Cleveland CS III, Menke M (2005). "Chiropractic history: a primer" (PDF). Association for the History of Chiropractic. Archived from the original (PDF) on 19 June 2013. Retrieved 2008-06-16. A significant and continuing barrier to scientific progress within chiropractic are the anti-scientific and pseudo-scientific ideas (Keating 1997b) which have sustained the profession throughout a century of intense struggle with political medicine. Chiropractors' tendency to assert the meaningfulness of various theories and methods as a counterpoint to allopathic charges of quackery has created a defensiveness which can make critical examination of chiropractic concepts difficult (Keating and Mootz 1989). One example of this conundrum is the continuing controversy about the presumptive target of DCs' adjustive interventions: subluxation (Gatterman 1995; Leach 1994).
Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results.[4] Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[4] A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition.[10] Spinal manipulation may be cost-effective for sub-acute or chronic low back pain but the results for acute low back pain were insufficient.[11] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.[12] There is not sufficient data to establish the safety of chiropractic manipulations.[13] It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.[14] There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation.[15] Several deaths have been associated with this technique[14] and it has been suggested that the relationship is causative,[16][17] a claim which is disputed by many chiropractors.[17]
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