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]
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.
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.
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.
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).

Among people seeking back pain relief alternatives, most choose chiropractic treatment. About 22 million Americans visit chiropractors annually. Of these, 7.7 million, or 35%, are seeking relief from back pain from various causes, including accidents, sports injuries, and muscle strains. Other complaints include pain in the neck, arms, and legs, and headaches.
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