Don’t medically investigate neck pain until it’s met at least three criteria: (1) it’s been bothering you for more than about 6 weeks; (2) it’s severe and/or not improving, or actually getting worse; and (3) there’s at least one other “red flag” (age over 55 or under 20, painful to light tapping, fever/malaise/nausea, weight loss, nasty headache, severe stiffness, very distinctive pain, and numbness and/or tingling and/or weakness anywhere else). Note that signs of arthritis are not red flags.
The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately.[46] There is not sufficient data to establish the safety of chiropractic manipulations.[13] Manipulation is regarded as relatively safe but complications can arise, and it has known adverse effects, risks and contraindications.[46] 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.[46] 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.[46] 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.[138] Indirect risks of chiropractic involve delayed or missed diagnoses through consulting a chiropractor.[4]
MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
The disk acts as a shock absorber between the bones in the neck. In cervical disk degeneration (which typically occurs in people age 40 years and older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disk space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The cervical disk may also protrude and put pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a herniated cervical disk.
Some skin problems on the neck can cause neck pain, but are usually obvious — most people will identify them as “skin problems on the neck” and not “a neck problem affecting the skin.” Herpes zoster (shingles) [CDC] causes a painful rash, cellulitis [Mayo] is extremely painful but superficial, and a carbuncle[Wikipedia] … well, it’s just a super zit, basically. If you can’t diagnose that one on your own, I can’t help you!
In 2005, the chiropractic subluxation was defined by the World Health Organization as "a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact.[46] It is essentially a functional entity, which may influence biomechanical and neural integrity."[46] This differs from the medical definition of subluxation as a significant structural displacement, which can be seen with static imaging techniques such as X-rays.[46] This exposes patients to harmful ionizing radiation for no evidentially supported reason.[47][48] The 2008 book Trick or Treatment states "X-rays can reveal neither the subluxations nor the innate intelligence associated with chiropractic philosophy, because they do not exist."[6] Attorney David Chapman-Smith, Secretary-General of the World Federation of Chiropractic, has stated that "Medical critics have asked how there can be a subluxation if it cannot be seen on X-ray. The answer is that the chiropractic subluxation is essentially a functional entity, not structural, and is therefore no more visible on static X-ray than a limp or headache or any other functional problem."[49] The General Chiropractic Council, the statutory regulatory body for chiropractors in the United Kingdom, states that the chiropractic vertebral subluxation complex "is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease."[50]
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.
The treatment plan may involve one or more manual adjustments in which the doctor manipulates the joints, using a controlled, sudden force to improve range and quality of motion. Many chiropractors also incorporate nutritional counseling and exercise/rehabilitation into the treatment plan. The goals of chiropractic care include the restoration of function and prevention of injury in addition to back pain relief.
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