Spine manipulation ‘inadvisable’
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group of chiropractors writing in the British Medical Journal have said a common chiropractic treatment for neck pain, which involves applying thrusts to the neck area of the spine, should be abandoned.
Spinal manipulation can be used to treat neck and back pain or other musculoskeletal conditions. It is a technique used by physiotherapists, osteopaths and most commonly by chiropractors. Cervical spine manipulation focuses on the neck and involves a range of high-speed manual manoeuvres that stretch, mobilise or manipulate the upper spine in order to relieve pain.
The group said cervical spine manipulation "may carry the potential for serious neurovascular complications resulting from damage to the major neck arteries”. They also said that studies "provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation".
Such injuries include tearing the lining of the vertebral artery, which is located in the neck and supplies blood to the brain, and stroke. The group said the technique is "unnecessary and inadvisable".
However other chiropractors believe it is a valuable addition to patient care. Writing in the same edition of the BMJ, another group of chiropractors said cervical spine manipulation should not be abandoned as a treatment for neck pain. They pointed to high quality evidence that "clearly suggests that manipulation benefits patients with neck pain" and raised doubt about any direct relation between manipulation and stroke.
However, they want to see more research into the pros and cons of this and other techniques with the aim of identifying safe and effective treatments.
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