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Saturday 24th August 2019

'Neck cracking' not advisable

8th June 2012

A new debate has flared over the value of cervical spine manipulation for neck pain.

Consulting Room

Experts writing in the British Medical Journal have suggested that the common chiropractic treatment for neck pain, which involves applying thrusts to the neck area of the spine, should be abandoned and is "unnecessary and unadvisable".

But other experts disagree and they maintain that the technique is a valuable addition patient care.

Neil O’Connell and colleagues from the Centre for Research and Rehabilitation at Brunel University have suggested the technique carries the potential for serious neurovascular complications with a low risk of stroke, resulting from damage to the major neck arteries.

Spinal manipulation is used by physiotherapists, osteopaths and chiropractors and involves a range of high-speed manual manoeuvres that stretch, mobilise or manipulate the upper spine in order to relieve pain.

They conclude: “The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain.”

But Professor David Cassidy from the University of Toronto, who was also writing in the BMJ, challenged a direct link between manipulation and stroke and said that manipulation benefits patients with neck pain.

However, there have been calls for more research into this and other techniques to help identify safe and effective treatments.

The British Chiropractic Association said chiropractors were highly trained in spine care and that “the cherry-picking of poor quality research” needlessly raised alarm among patients.


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