A 2012 systematic review concluded that no accurate assessment of risk-benefit exists for cervical manipulation. 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. The same review concluded that the risk of death from manipulations to the neck outweighs the benefits. Chiropractors have criticized this conclusion, claiming that the author did not evaluate the potential benefits of spinal manipulation. 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."
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 2006 systematic cost-effectiveness review found that the reported cost-effectiveness of spinal manipulation in the United Kingdom compared favorably with other treatments for back pain, but that reports were based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to non-specific effects) remains uncertain. A 2005 American systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention. The cost-effectiveness of maintenance chiropractic care is unknown.
One of the most common questions that people ask is around the safety of chiropractic care. So, how safe is it? According to the American Chiropractic Association, “Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of back pain, neck pain, joint pain of the arms or legs, headaches, and other neuromusculoskeletal complaints.” While chiropractic is considered a safe complementary therapy, there can be some potential side effects, like soreness following a spinal manipulation.
Chiropractors, like other primary care providers, sometimes employ diagnostic imaging techniques such as X-rays and CT scans that rely on ionizing radiation. Although there is no clear evidence for the practice, some chiropractors may still X-ray a patient several times a year. Practice guidelines aim to reduce unnecessary radiation exposure, which increases cancer risk in proportion to the amount of radiation received. Research suggests that radiology instruction given at chiropractic schools worldwide seem to be evidence-based. Although, there seems to be a disparity between some schools and available evidence regarding the aspect of radiography for patients with acute low back pain without an indication of a serious disease, which may contribute to chiropractic overuse of radiography for low back pain.
Early opposition to water fluoridation included chiropractors, some of whom continue to oppose it as being incompatible with chiropractic philosophy and an infringement of personal freedom. Other chiropractors have actively promoted fluoridation, and several chiropractic organizations have endorsed scientific principles of public health. In addition to traditional chiropractic opposition to water fluoridation and vaccination, chiropractors' attempts to establish a positive reputation for their public health role are also compromised by their reputation for recommending repetitive lifelong chiropractic treatment.
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.
Straight chiropractors adhere to the philosophical principles set forth by D.D. and B.J. Palmer, and retain metaphysical definitions and vitalistic qualities. 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. Straights view the medical diagnosis of patient complaints (which they consider to be the "secondary effects" of subluxations) to be unnecessary for chiropractic treatment. 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. 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). They prefer to remain separate and distinct from mainstream health care. 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."
Most chiropractic medicine programs require that applicants have at least three years of undergraduate education, and an increasing number require a bachelor’s degree. In either case, your undergraduate studies must include a prescribed number of prerequisite courses, as defined by the field’s accrediting body, the Council on Chiropractic Education.
Mixer chiropractors "mix" diagnostic and treatment approaches from chiropractic, medical and/or osteopathic viewpoints and make up the majority of chiropractors. Unlike straight chiropractors, mixers believe subluxation is one of many causes of disease, and hence they tend to be open to mainstream medicine. 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. Some mixers also use techniques from alternative medicine, including nutritional supplements, acupuncture, homeopathy, herbal remedies, and biofeedback.
The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately. There is not sufficient data to establish the safety of chiropractic manipulations. Manipulation is regarded as relatively safe but complications can arise, and it has known adverse effects, risks and contraindications. Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints. Relative contraindications are conditions where increased risk is acceptable in some situations and where low-force and soft-tissue techniques are treatments of choice; these contraindications include osteoporosis. Although most contraindications apply only to manipulation of the affected region, some neurological signs indicate referral to emergency medical services; these include sudden and severe headache or neck pain unlike that previously experienced. Indirect risks of chiropractic involve delayed or missed diagnoses through consulting a chiropractor.
Finding a good, or even great, chiropractor doesn’t happen just by chance. It’s like anything else today–there are online options for finding user-generated reviews and recommendations to help you find the best chiropractor close to you. Add that to your network of family and friends, and peer-reviewed sites like PainDoctor.com, and you have the tools you need to make the best decision for you.
Jump up ^ Coulter ID, Adams AH, Sandefur R (1997). "Chiropractic training" (PDF). In Cherkin DC, Mootz RD. Chiropractic in the United States: Training, Practice, and Research (PDF). Rockville, MD: Agency for Health Care Policy and Research. pp. 17–28. OCLC 39856366. Archived from the original on 2008-06-25. Retrieved 2008-05-11. AHCPR Pub No. 98-N002.
Some of the findings from my tests were things that I could fix at home, and others could be helped with hands-on chiropractic care, like an adjustment. In my case, I didn’t have a normal c-shaped curve in my neck. This can be caused by minor whiplash, sports injuries or even sitting forward all day (I spend a lot of time at work staring at a screen). The chiropractor recommended at-home care in the way of a rolled up towel or ergonomic pillow. These can help restore the curve in your neck.