A small number of neck pain patients, particularly those with arm pain or signs of spinal cord compression, require cervical spine surgery. A new option for neck surgery is an artificial disc. This device made of metal and plastic, is the correct choice for a very small number of individuals with neck pain only and no other abnormality in the cervical spine than a worn out disc.
Analysis of a clinical and cost utilization data from the years 2003 to 2005 by an integrative medicine independent physician association (IPA) which looked the chiropractic services utilization found that the clinical and cost utilization of chiropractic services based on 70,274 member-months over a 7-year period decreased patient costs associate with the following use of services by 60% for in-hospital admissions, 59% for hospital days, 62% for outpatient surgeries and procedures, and 85% for pharmaceutical costs when compared with conventional medicine (visit to a medical doctor primary care provider) IPA performance for the same health maintenance organization product in the same geography and time frame.[163]
Chiropractic overlaps with several other forms of manual therapy, including massage therapy, osteopathy, physical therapy, and sports medicine.[19][59] Chiropractic is autonomous from and competitive with mainstream medicine,[60] and osteopathy outside the US remains primarily a manual medical system;[61] physical therapists work alongside and cooperate with mainstream medicine, and osteopathic medicine in the U.S. has merged with the medical profession.[60] Practitioners may distinguish these competing approaches through claims that, compared to other therapists, chiropractors heavily emphasize spinal manipulation, tend to use firmer manipulative techniques, and promote maintenance care; that osteopaths use a wider variety of treatment procedures; and that physical therapists emphasize machinery and exercise.[19]

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]
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.
The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.
Throughout its history chiropractic has been the subject of internal and external controversy and criticism.[22][224] According to Daniel D. Palmer, the founder of chiropractic, subluxation is the sole cause of disease and manipulation is the cure for all diseases of the human race.[4][42] A 2003 profession-wide survey[38] found "most chiropractors (whether 'straights' or 'mixers') still hold views of innate Intelligence and of the cause and cure of disease (not just back pain) consistent with those of the Palmers."[225] A critical evaluation stated "Chiropractic is rooted in mystical concepts. This led to an internal conflict within the chiropractic profession, which continues today."[4] Chiropractors, including D.D. Palmer, were jailed for practicing medicine without a license.[4] For most of its existence, chiropractic has battled with mainstream medicine, sustained by antiscientific and pseudoscientific ideas such as subluxation.[37] Collectively, systematic reviews have not demonstrated that spinal manipulation, the main treatment method employed by chiropractors, is effective for any medical condition, with the possible exception of treatment for back pain.[4] Chiropractic remains controversial, though to a lesser extent than in past years.[25]
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.
As noted, ratings sites or websites with a certified list of doctors, like PainDoctor.com, can help verify a chiropractor’s license and give you an idea of their philosophy and practice areas. Each site has slightly different information to give you a better picture of your chiropractor before your first visit. Find the best chiropractor for you by looking for ones who share lots of information and knowledge, whether on their website or on social media.
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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

Beyond Chiropractic, a health and wellness center on the border of Conshohocken and Plymouth Meeting, minutes from Norristown and Lafayette Hill. The mission of Beyond Chiropractic is to provide the members of the community with highly individualized, affordable health care to promote well-being in a comfortable environment for all patients. We aim to support our patients and their families to achieve and maintain the highest quality of life. www.ConshyChiro.com ... View Profile
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.
Because the neck is so flexible and because it supports the head, it is extremely vulnerable to injury. Motor vehicle or diving accidents, contact sports, and falls may result in neck injury. The regular use of safety belts in motor vehicles can help to prevent or minimize neck injury. A "rear end" automobile collision may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond normal limits. The most common neck injuries involve the soft tissues: the muscles and ligaments. Severe neck injuries with a fracture or dislocation of the neck may damage the spinal cord and cause paralysis.
Hi Elizabeth — We’re so sorry to hear that you’re unable to find a chiropractor who worked so well for you. You may be able to contact your local chiropractic association directly and provide some more information to find him: http://www.scchiropractic.org/ or http://www.ncchiro.org/. If you’re unable to find him through either of those channels, you can look for a new one here: https://paindoctor.com/find-your-pain-doctor/. Hope that helps!
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.
At each vertebral level, a pair of spinal nerves exit through small openings called foramina (one to the left and one to the right). These nerves serve the muscles, skin and tissues of the body and thus provide sensation and movement to all parts of the body. The delicate spinal cord and nerves are further supported by strong muscles and ligaments that are attached to the vertebrae.

Mixer chiropractors "mix" diagnostic and treatment approaches from chiropractic, medical and/or osteopathic viewpoints and make up the majority of chiropractors.[22] Unlike straight chiropractors, mixers believe subluxation is one of many causes of disease, and hence they tend to be open to mainstream medicine.[22] Many of them incorporate mainstream medical diagnostics and employ conventional treatments including techniques of physical therapy such as exercise, stretching, massage, ice packs, electrical muscle stimulation, therapeutic ultrasound, and moist heat.[22] Some mixers also use techniques from alternative medicine, including nutritional supplements, acupuncture, homeopathy, herbal remedies, and biofeedback.[22]
There are several schools of chiropractic adjustive techniques, although most chiropractors mix techniques from several schools. The following adjustive procedures were received by more than 10% of patients of licensed U.S. chiropractors in a 2003 survey:[73] Diversified technique (full-spine manipulation, employing various techniques), extremity adjusting, Activator technique (which uses a spring-loaded tool to deliver precise adjustments to the spine), Thompson Technique (which relies on a drop table and detailed procedural protocols), Gonstead (which emphasizes evaluating the spine along with specific adjustment that avoids rotational vectors), Cox/flexion-distraction (a gentle, low-force adjusting procedure which mixes chiropractic with osteopathic principles and utilizes specialized adjusting tables with movable parts), adjustive instrument, Sacro-Occipital Technique (which models the spine as a torsion bar), Nimmo Receptor-Tonus Technique, applied kinesiology (which emphasises "muscle testing" as a diagnostic tool), and cranial.[76] Chiropractic biophysics technique uses inverse functions of rotations during spinal manipulation.[77] Koren Specific Technique (KST) may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and spinal manipulations.[78] Insurers in the US and UK that cover other chiropractic techniques exclude KST from coverage because they consider it to be "experimental and investigational".[78][79][80][81] Medicine-assisted manipulation, such as manipulation under anesthesia, involves sedation or local anesthetic and is done by a team that includes an anesthesiologist; a 2008 systematic review did not find enough evidence to make recommendations about its use for chronic low back pain.[82]
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.
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
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]

I am 73 yr. young, and I in so much pain and discomfort . I have a double curve of the spine and due to a loss of 3 in. since becoming elderly the pain has gotten worse. I had went to a wonderful chiropractor for years but he is no longer. My husband still works and we have United HealthCare and they don’t cover chiropractors. IS there any good chiropractors that don’t charge a high price or don’t insist on xrays which are very expensive. I also have IBS and have had 3 major bowel surgeries which causes me extreme pain

One of the most common causes of neck pain is a pillow that is too large or too flat. Make sure that the pillow you use adequately supports your neck without causing any excessive bending. In other words, if lying on your back, your neck should not be bent unduly upwards. lf lying on your side, your neck should not be bent up or down (i.e. your spine should be in a straight line). Sleeping on your stomach with your neck twisted or bent to the side can also result in neck pain.
Although mixers are the majority group, many of them retain belief in vertebral subluxation as shown in a 2003 survey of 1100 North American chiropractors, which found that 88% wanted to retain the term "vertebral subluxation complex", and that when asked to estimate the percent of disorders of internal organs (such as the heart, the lungs, or the stomach) that subluxation significantly contributes to, the mean response was 62%.[38] A 2008 survey of 6,000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions.[39] The same survey showed that most chiropractors generally believed that the majority of their clinical approach for addressing musculoskeletal/biomechanical disorders such as back pain was based on subluxation.[39] Chiropractors often offer conventional therapies such as physical therapy and lifestyle counseling, and it may for the lay person be difficult to distinguish the unscientific from the scientific.[40]
After selling his very successful practice in Boise, Idaho, Dr. Tim Dudley moved to Whitefish in 2015 to pursue his professional goals of starting a consulting business to teach other Chiropractors how to be effective and successful. He also wanted to practice what he was preaching and set out to create his dream practice from the ground up. While Whitefish has many chiropractors, there was room for Dr. Dudley’s unique and highly specialized skill set here, and it also put he and his wife much closer to where they were both raised, and to their families. Once Dr. Dudley found his ideal office space in downtown Whitefish, he opened his doors and has been helping and healing one spine at a time.
A 2016 study Goertz contributed to showed that about 14 percent of people have seen a chiropractor in the last year. Of those with significant neck or back pain, 33 percent said chiropractic care was safest compared with 12 percent who say pain medications are safer (physical therapy was perceived as safest), according to Gallup data. Also, 29 percent say chiropractic care is more effective than pain medication for those who have neck or back pain, while 22 percent preferred medication over chiropractic care.
Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment used in chiropractic care.[73] Spinal manipulation is a passive manual maneuver during which a three-joint complex is taken past the normal range of movement, but not so far as to dislocate or damage the joint.[74] Its defining factor is a dynamic thrust, which is a sudden force that causes an audible release and attempts to increase a joint's range of motion.[74] High-velocity, low-amplitude spinal manipulation (HVLA-SM) thrusts have physiological effects that signal neural discharge from paraspinal muscle tissues, depending on duration and amplitude of the thrust are factors of the degree in paraspinal muscle spindles activation.[75] Clinical skill in employing HVLA-SM thrusts depends on the ability of the practitioner to handle the duration and magnitude of the load.[75] More generally, spinal manipulative therapy (SMT) describes techniques where the hands are used to manipulate, massage, mobilize, adjust, stimulate, apply traction to, or otherwise influence the spine and related tissues.[74]

Once your history is gathered, the chiropractor may complete a physical exam, or they may begin treatment. This may be a manual spinal manipulation, or the chiropractor may use various chiropractic instruments. After your adjustment is complete, the chiropractor will recommend a schedule of follow-up visits. The number of visits will depend on your current health condition, how much pain you’re in, and what other therapies you’re using to treat your pain. Chiropractic care is always best done in addition to other pain management treatments, such as physical therapy, medication, or pain-reducing injections.
To be completely honest, I was still a little nervous before my chiropractor performed the spinal manipulation. But I really had nothing to worry about. We discussed the potential side effects, which can include mild soreness (like you might feel after a workout). If you do feel sore, you can use a cold pack to help reduce any temporary soreness you might experience.
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