One of the most common concerns about the neck that is not especially worrisome: signs of “wear and tear” on the cervical spine, arthritis, and degenerative disc disease, as revealed by x-ray, CT scans, and MRI. Many people who have clear signs of arthritic degeneration in their spines will never have any symptoms, or only minor, and/or not for a long time.10 For instance, about 50% of fortysomethings have clinically silent disk bulges, and even at age 20 there’s a surprising amount of spinal arthritis. The seriousness of these signs is routinely overestimated by patients and healthcare professionals alike.11


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]


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.
Chiropractors emphasize the conservative management of the neuromusculoskeletal system without the use of medicines or surgery,[46] with special emphasis on the spine.[2] Back and neck pain are the specialties of chiropractic but many chiropractors treat ailments other than musculoskeletal issues.[4] There is a range of opinions among chiropractors: some believed that treatment should be confined to the spine, or back and neck pain; others disagreed.[53] For example, while one 2009 survey of American chiropractors had found that 73% classified themselves as "back pain/musculoskeletal specialists", the label "back and neck pain specialists" was regarded by 47% of them as a least desirable description in a 2005 international survey.[53] Chiropractic combines aspects from mainstream and alternative medicine, and there is no agreement about how to define the profession: although chiropractors have many attributes of primary care providers, chiropractic has more of the attributes of a medical specialty like dentistry or podiatry.[54] It has been proposed that chiropractors specialize in nonsurgical spine care, instead of attempting to also treat other problems,[32][54] but the more expansive view of chiropractic is still widespread.[55]
This section presents a comprehensive list of somewhat common medical problems that can cause neck pain (and might, conceivably, be confused with an “ordinary” case of neck pain). I’ll give you a quick idea of what they are and what distinguishes them. If you find anything on this list that seems awfully similar to your case, please bring the idea to your doctor like a dog with an interesting bone; and get a referral to a specialist if necessary.
The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.
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