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."
All treatment is based on an accurate diagnosis of your back pain. The chiropractor should be well informed regarding your medical history, including ongoing medical conditions, current medications, traumatic/surgical history, and lifestyle factors. Although rare, there have been cases in which treatment worsened a herniated or slipped disc, or neck manipulation resulted spinal cord injury. To be safe, always check with your medical doctor to make sure your condition will benefit from chiropractic or other pain relief alternatives.
^ Jump up to: a b c d e f g h i Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558. PMID 16000175. The length, breadth, and depth of chiropractic clinical training do not support the claim of broad diagnostic competency required of a PCP. Studies of chiropractic intern clinical experience provides no evidence that chiropractors are trained to a level of a diagnostic generalist for non-musculoskeletal conditions. For chiropractors to describe themselves as PCP diagnosticians is to invite comparisons to other PC diagnosticians, i.e., family practitioners, pediatricians and internists. Such comparisons will not reflect favorably on chiropractic. PCP: primary care providers
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.
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
Chiropractic is well established in the United States, Canada, and Australia. It overlaps with other manual-therapy professions such as osteopathy and physical therapy. Most who seek chiropractic care do so for low back pain. Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues. Many chiropractors describe themselves as primary care providers, but the chiropractic clinical training does not support the requirements to be considered primary care providers, so their role on primary care is limited and disputed. Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.
As with so many things, when it comes to neck pain, an ounce of prevention may be worth a pound of cure. It's true that some causes of neck pain, such as age-related wear and tear, are not under your control. On the other hand, there are many things you can do to minimize your risk. One place to start is to look at how you sleep and what effect this may have on neck pain.
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.
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.
Some chiropractors believe that chiropractic care is the only treatment needed for any health problem. Others are committed to working with your pain management specialist as part of a comprehensive treatment plan. When looking for a chiropractor close by, it is important to decide which type of chiropractor is right for you and your pain condition. As we’ll discuss below, chiropractors will share on their website what they’re most focused on treating or what they have the most research experience with. They may also discuss their philosophies about care so you can find one that matches how you approach treating your pain.
Two sleeping positions are easiest on the neck: on your side or on your back. If you sleep on your back, choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head. This can be achieved by tucking a small neck roll into the pillowcase of a flatter, softer pillow, or by using a special pillow that has a built-in neck support with an indentation for the head to rest in. Here are some additional tips for side- and back-sleepers:
So when I work out, I overcompensate by using my lower back and hamstrings, rather than my glute muscles. As a result, I’m overworking some of the compensating muscles and my glute muscles are remaining weaker. We talked about treatment options, which included reactivating my glutes through strengthening exercises (who knew chiropractors did these?!) and prescribing weekly adjustments for the first few months.