^ Jump up to: a b Biller, J.; Sacco, R. L.; Albuquerque, F. C.; Demaerschalk, B. M.; Fayad, P.; Long, P. H.; Noorollah, L. D.; Panagos, P. D.; Schievink, W. I.; Schwartz, N. E.; Shuaib, A.; Thaler, D. E.; Tirschwell, D. L. (2014). "Cervical Arterial Dissections and Association With Cervical Manipulative Therapy: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association". Stroke. 45 (10): 3155–74. doi:10.1161/STR.0000000000000016. ISSN 0039-2499. PMID 25104849.


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.

Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic services are used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.
If you are in pain and want to avoid taking drugs or surgery we may be the place for you. There is never a charge for you to sit down and talk with me to find out if we can help. It’s also a bonus that most insurance plans are accepted by our office and we offer flexible payment plans. There’s no obligation. All you have to lose is the pain. Contact us today.
Your neck and shoulders contain muscles, bones, nerves, arteries, and veins, as well as many ligaments and other supporting structures. Many conditions can cause pain in the neck and shoulder area. In fact, neck pain is the third most common type of pain according to the American Pain Foundation. It is estimated that 70% of people will experience neck pain at some point in their lives.
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age,[147] but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions.[146][148] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS.[149] There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke.[15] While the biomechanical evidence is not sufficient to support the statement that CMT causes cervical artery dissection (CD), clinical reports suggest that mechanical forces have a part in a substantial number of CDs and the majority of population controlled studies found an association between CMT and VAS in young people.[150] It is strongly recommended that practitioners consider the plausibility of CD as a symptom, and people can be informed of the association between CD and CMT before administrating manipulation of the cervical spine.[150] There is controversy regarding the degree of risk of stroke from cervical manipulation.[15] Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven.[17] However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable[17] or definite.[16] There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation.[151] The incidence of internal carotid artery dissection following cervical spine manipulation is unknown.[152] The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke.[153] The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension.[154] Cervical intradural disc herniation is very rare following spinal manipulation therapy.[155]
Jump up ^ Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André (2016). "Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies". PLoS One. 11 (8): e0160037. Bibcode:2016PLoSO..1160037B. doi:10.1371/journal.pone.0160037. ISSN 1932-6203. PMC 4972425. PMID 27487116.
A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse, fraud, and quackery, which are more prevalent in chiropractic than in other health care professions, violating the social contract between patients and physicians.[32] According to a 2015 Gallup poll of U.S. adults, the perception of chiropractors is generally favourable; two-thirds of American adults agree that chiropractors have their patient's best interest in mind and more than half also agree that most chiropractors are trustworthy. Less than 10% of US adults disagreed with the statement that chiropractors were trustworthy.[193][194]
Research suggests that not just sleep position, but sleep itself, can play a role in musculoskeletal pain, including neck and shoulder pain. In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with and without sleeping problems. Sleeping problems included difficulty falling asleep, trouble staying asleep, waking early in the mornings, and non-restorative sleep. They found that people who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who reported little or no problem with sleep. One possible explanation is that sleep disturbances disrupt the muscle relaxation and healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.
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
Serious research to test chiropractic theories did not begin until the 1970s, and is continuing to be hampered by antiscientific and pseudoscientific ideas that sustained the profession in its long battle with organized medicine.[37] By the mid 1990s there was a growing scholarly interest in chiropractic, which helped efforts to improve service quality and establish clinical guidelines that recommended manual therapies for acute low back pain.[37] In recent decades chiropractic gained legitimacy and greater acceptance by medical physicians and health plans, and enjoyed a strong political base and sustained demand for services.[21] However, its future seemed uncertain: as the number of practitioners grew, evidence-based medicine insisted on treatments with demonstrated value, managed care restricted payment, and competition grew from massage therapists and other health professions.[21] The profession responded by marketing natural products and devices more aggressively, and by reaching deeper into alternative medicine and primary care.[21]
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. 
“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.
Are you looking for a Philadelphia chiropractor? Are you suffering from daily pain or have been injured in an auto accident, in sports, in your garden or at work? Dr. Paul Rubin and Philadelphia Chiropractic can help you finally put a stop to aggravated pain, so you can sleep better, feel younger and be able to participate in the activities you enjoy. Philadelphia Chiropractic is a chiropractic clinic located in downtown Philadelphia in Center City. We look forward to helping you live a more active and healthy lifestyle with gentle, personalized rehabilitation and effective, lasting pain relief. ... View Profile
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A 2012 systematic review concluded that no accurate assessment of risk-benefit exists for cervical manipulation.[15] A 2010 systematic review stated that there is no good evidence to assume that neck manipulation is an effective treatment for any medical condition and suggested a precautionary principle in healthcare for chiropractic intervention even if a causality with vertebral artery dissection after neck manipulation were merely a remote possibility.[17] The same review concluded that the risk of death from manipulations to the neck outweighs the benefits.[17] Chiropractors have criticized this conclusion, claiming that the author did not evaluate the potential benefits of spinal manipulation.[158] Edzard Ernst stated "This detail was not the subject of my review. I do, however, refer to such evaluations and should add that a report recently commissioned by the General Chiropractic Council did not support many of the outlandish claims made by many chiropractors across the world."[158]
No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors.[70] A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.[70] Two U.S. states (Washington and Arkansas) prohibit physical therapists from performing SM,[71] some states allow them to do it only if they have completed advanced training in SM, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.[72]

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.
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.
No single profession "owns" spinal manipulation and there is little consensus as to which profession should administer SM, raising concerns by chiropractors that other medical physicians could "steal" SM procedures from chiropractors.[70] A focus on evidence-based SM research has also raised concerns that the resulting practice guidelines could limit the scope of chiropractic practice to treating backs and necks.[70] Two U.S. states (Washington and Arkansas) prohibit physical therapists from performing SM,[71] some states allow them to do it only if they have completed advanced training in SM, and some states allow only chiropractors to perform SM, or only chiropractors and physicians. Bills to further prohibit non-chiropractors from performing SM are regularly introduced into state legislatures and are opposed by physical therapist organizations.[72]
Patients seeking treatment at Town Center Chiropractic with Dr. V.J. Maddio, Dr. Michael Morris, Dr. Jeffrey Fife and Dr. Sheridan Jones are assured of receiving only the finest quality care through the use of modern chiropractic equipment and technology. Dr. V.J. Maddio, Dr. Michael Morris, Dr. Jeffrey Fife, Dr. Sheridan Jones and the staff have a genuine concern for your well-being!

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.
Generally, you can expect to fill out paperwork or a questionnaire explaining your health history, reason for your visit, surgical and family history, any pain you are feeling or any previous injuries you may have. At my appointment, there was a case manager that came in to explain who I would be meeting with and how the appointment would go. This made me much more comfortable about the whole process—I actually felt at ease and excited to keep working through the next steps! Here is an example of the type of forms you will be asked to fill out.
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