^ Jump up to: a b c McDonald WP, Durkin KF, Pfefer M, et al. (2003). How Chiropractors Think and Practice: The Survey of North American Chiropractors. Ada, OH: Institute for Social Research, Ohio Northern University. ISBN 0-9728055-5-9.[page needed] Summarized in: McDonald WP, Durkin KF, Pfefer M (2004). "How chiropractors think and practice: the survey of North American chiropractors". Semin Integr Med. 2 (3): 92–8. doi:10.1016/j.sigm.2004.07.002. Lay summary – Dyn Chiropr (2003-06-02).
^ 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.

Vertebral subluxation, a core concept of traditional chiropractic, remains unsubstantiated and largely untested, and a debate about whether to keep it in the chiropractic paradigm has been ongoing for decades.[43] In general, critics of traditional subluxation-based chiropractic (including chiropractors) are skeptical of its clinical value, dogmatic beliefs and metaphysical approach. While straight chiropractic still retains the traditional vitalistic construct espoused by the founders, evidence-based chiropractic suggests that a mechanistic view will allow chiropractic care to become integrated into the wider health care community.[43] This is still a continuing source of debate within the chiropractic profession as well, with some schools of chiropractic still teaching the traditional/straight subluxation-based chiropractic, while others have moved towards an evidence-based chiropractic that rejects metaphysical foundings and limits itself to primarily neuromusculoskeletal conditions.[44][45]
Chiropractic is a form of alternative medicine mostly concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the spine.[1][2] Proponents claim that such disorders affect general health via the nervous system,[2] through vertebral subluxation, claims which are demonstrably false. The main chiropractic treatment technique involves manual therapy, especially spinal manipulation therapy (SMT), manipulations of other joints and soft tissues.[3] Its foundation is at odds with mainstream medicine, and chiropractic is sustained by pseudoscientific ideas such as subluxation and "innate intelligence" that reject science.[4][5][6][7][8] Chiropractors are not medical doctors.[9]
Mainstream health care and governmental organizations such as the World Health Organization consider chiropractic to be complementary and alternative medicine (CAM);[1] and a 2008 study reported that 31% of surveyed chiropractors categorized chiropractic as CAM, 27% as integrated medicine, and 12% as mainstream medicine.[56] Many chiropractors believe they are primary care providers,[4][21] including US[57] and UK chiropractors,[58] but the length, breadth, and depth of chiropractic clinical training do not support the requirements to be considered primary care providers,[2] so their role on primary care is limited and disputed.[2][21]
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]
Eagle’s syndrome [Medscape] is a rare abnormal elongation of a bizarre little bit of bone at the back of the throat called the styloid process. Even a normal styloid process looks jarring when you first see one: it is so skinny and sharp that it makes one wonder how it can possibly not be stabbing something. Well, it turns out that in some cases it does “stab” you in the neck. This will cause a feeling of a lump in the throat and/or moderate intensity pains throughout the region, possibly including the side of the neck, although pain is more likely to dominate the jaw and throat.15
Utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.[1] The use of chiropractic declined from 9.9% of U.S. adults in 1997 to 7.4% in 2002; this was the largest relative decrease among CAM professions, which overall had a stable use rate.[212] As of 2007 7% of the U.S. population is being reached by chiropractic.[213] They were the third largest profession in the US in 2002, following doctors and dentists.[214] Employment of U.S. chiropractors was expected to increase 14% between 2006 and 2016, faster than the average for all occupations.[185]

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.
Rarely. Nearly all neck stiffness is minor, diffuse musculoskeletal pain: several mildly irritated structures adding up to uncomfortable, reluctant movement as opposed to physically limited movement. The most common scary neck stiffness is the “nuchal rigidity” of meningitis — which makes it very difficult and uncomfortable to tilt the head forward — but that will be accompanied by other serious warning signs, of course. Like feeling gross otherwise (flu-like malaise).
Utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.[1] The use of chiropractic declined from 9.9% of U.S. adults in 1997 to 7.4% in 2002; this was the largest relative decrease among CAM professions, which overall had a stable use rate.[212] As of 2007 7% of the U.S. population is being reached by chiropractic.[213] They were the third largest profession in the US in 2002, following doctors and dentists.[214] Employment of U.S. chiropractors was expected to increase 14% between 2006 and 2016, faster than the average for all occupations.[185]

Palmer hypothesized that vertebral joint misalignments, which he termed vertebral subluxations, interfered with the body's function and its inborn ability to heal itself.[5] D. D. Palmer repudiated his earlier theory that vertebral subluxations caused pinched nerves in the intervertebral spaces in favor of subluxations causing altered nerve vibration, either too tense or too slack, affecting the tone (health) of the end organ.[41] D. D. Palmer, using a vitalistic approach, imbued the term subluxation with a metaphysical and philosophical meaning.[41] He qualified this by noting that knowledge of innate intelligence was not essential to the competent practice of chiropractic.[41] This concept was later expanded upon by his son, B. J. Palmer, and was instrumental in providing the legal basis of differentiating chiropractic from conventional medicine. In 1910, D. D. Palmer theorized that the nervous system controlled health:


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.
Neck pain may result from abnormalities in the soft tissues—the muscles, ligaments, and nerves—as well as in bones and disks of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury (a sprain) or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.
Straight chiropractors adhere to the philosophical principles set forth by D.D. and B.J. Palmer, and retain metaphysical definitions and vitalistic qualities.[37] Straight chiropractors believe that vertebral subluxation leads to interference with an "innate intelligence" exerted via the human nervous system and is a primary underlying risk factor for many diseases.[37] Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for chiropractic treatment.[37] Thus, straight chiropractors are concerned primarily with the detection and correction of vertebral subluxation via adjustment and do not "mix" other types of therapies into their practice style.[37] Their philosophy and explanations are metaphysical in nature and they prefer to use traditional chiropractic lexicon terminology (e.g., perform spinal analysis, detect subluxation, correct with adjustment).[22] They prefer to remain separate and distinct from mainstream health care.[22] Although considered the minority group, "they have been able to transform their status as purists and heirs of the lineage into influence dramatically out of proportion to their numbers."[22]
A 2012 systematic review suggested that the use of spine manipulation in clinical practice is a cost-effective treatment when used alone or in combination with other treatment approaches.[160] A 2011 systematic review found evidence supporting the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain; the results for acute low back pain were insufficient.[11]
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Eagle’s syndrome [Medscape] is a rare abnormal elongation of a bizarre little bit of bone at the back of the throat called the styloid process. Even a normal styloid process looks jarring when you first see one: it is so skinny and sharp that it makes one wonder how it can possibly not be stabbing something. Well, it turns out that in some cases it does “stab” you in the neck. This will cause a feeling of a lump in the throat and/or moderate intensity pains throughout the region, possibly including the side of the neck, although pain is more likely to dominate the jaw and throat.15
What's to know about ulnar nerve entrapment? The ulnar nerve gives sensation to the forearm and fourth and fifth fingers. Entrapment occurs when the nerve is compressed or irritated. Arthritis, swelling, or bone spurs may be responsible. Many make a full recovery, but entrapment can lead to paralysis and loss of feeling if treatment is delayed. Learn more here. Read now
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]
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]
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. 
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]
Five to 10-minute ice massages applied to a painful area within the first 48 hours of the start of pain can help relieve pain as can heat, which relaxes the muscles. Heat should be applied for pain of duration greater than 48 hours. Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, frequently are enough to control episodes of neck pain, and muscle relaxants may help those with limited motion secondary to muscle tightness.

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.
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]
Studies have not confirmed the effectiveness of prolotherapy or sclerotherapy for pain relief, used by some chiropractors, osteopaths, and medical doctors, to treat chronic back pain, the type of pain that may come on suddenly or gradually and lasts more than three months. The therapy involves injections such as sugar water or anesthetic in hopes of strengthening the ligaments in the back.
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