Like their MD colleagues, doctors of chiropractic are subject to the boundaries established in state practice acts and are regulated by state licensing boards. Further, their education in four-year doctoral graduate school programs is nationally accredited through an agency that operates under the auspices of the U.S. Department of Education. After graduation, they must pass national board exams before obtaining a license to practice, and then must maintain their license annually by earning continuing education (CE) credits through state-approved CE programs.
A 2010 study by questionnaire presented to UK chiropractors indicated only 45% of chiropractors disclosed with patients the serious risk associated with manipulation of the cervical spine and that 46% believed there was possibility of patient would refuse treatment if risk correctly explained. However 80% acknowledged the ethical/moral responsibility to disclose risk to patient.
^ Jump up to: a b Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S (2008). "Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders". Spine. 33 (4 Suppl): S123–52. doi:10.1097/BRS.0b013e3181644b1d. PMID 18204386.
Welcome to The Joint Chiropractic - Broad Ripple! As your Indianapolis chiropractor dedicated to family chiropractic and spine health, we invite you to join the millions of Americans who have not only found relief from lower back pain, sciatica pain, and migraines, but also a pathway to wellness with chiropractic's natural, drug-free approach to healthcare.
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age, but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions. Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS. There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke. 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. 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. There is controversy regarding the degree of risk of stroke from cervical manipulation. Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven. However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable or definite. There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation. The incidence of internal carotid artery dissection following cervical spine manipulation is unknown. The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke. The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension. Cervical intradural disc herniation is very rare following spinal manipulation therapy.
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
The nerve roots stem from the spinal cord like tree branches through foramen in the vertebrae. Each nerve root transmits signals (nerve impulses) to and from the brain, shoulders, arms, and chest. A vascular system of 4 arteries and veins run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.
Five updates have been logged for this article since publication (2016). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more Like good footnotes, update logging sets PainScience.com apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages.
Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., ... Shekelle, P. G. (2017, April 11). Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. Jama, 317(14), 1451–1460. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2616395
The most worrisome causes of neck pain rarely cause severe pain, and common problems like slipped discs are usually much less serious than people fear. Sharp and stabbing pains are usually false alarms. Only about 1% of neck pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.
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."
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: 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. Chiropractic biophysics technique uses inverse functions of rotations during spinal manipulation. Koren Specific Technique (KST) may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and spinal manipulations. Insurers in the US and UK that cover other chiropractic techniques exclude KST from coverage because they consider it to be "experimental and investigational". 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.
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.
There is a wide range of ways to measure treatment outcomes. Chiropractic care, like all medical treatment, benefits from the placebo response. It is difficult to construct a trustworthy placebo for clinical trials of spinal manipulative therapy (SMT), as experts often disagree about whether a proposed placebo actually has no effect. The efficacy of maintenance care in chiropractic is unknown.
Sharp neck pain is not in itself a red flag. Believe it or not there is no common worrisome cause of neck pain that is indicated by a sharp quality. In fact, oddly, sharp pains are actually a bit reassuring, despite how they feel. In isolation — with no other obvious problem — they usually indicate that you just have a temporary, minor source of irritation in the cervical spine. Serious causes of neck pain like infections, tumours, and spinal cord problems tend grind you down with throbbing pains, not “stab” you.
One of the reasons I wanted to visit the chiropractor was to take a more active role in my overall health and wellness. I specifically chose an integrated clinic, which offered not only chiropractic care, but also physical therapy, massage therapy and nutrition consultation. We discussed the addition of multi-vitamins, fish oil and vitamin D to my wellness plan. One thing I learned through this wellness planning? Everyone’s health journey is different! Since health is personal, your approach should be tailored to your specific needs. My focus on an integrated clinic may not be right for you, but I found value in being educated about all the options available to me.