Spine manipulation for neck pain ‘inadvisable’

The BBC highlights a recent report which says Spine manipulation for neck pain ‘inadvisable’

Writing in the British Medical Journal, Neil O’Connell and colleagues say that cervical spine manipulation carries a low risk of stroke, resulting from damage to the major neck arteries. They say the technique is “unnecessary and inadvisable”. But other experts believe it is a valuable addition to patient care.
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.
‘Serious complications’
Neil O’Connell, from the Centre for Research and Rehabilitation at Brunel University and colleagues argue that cervical spine manipulation “may carry the potential for serious neurovascular complications”. They also say 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.
O’Connell and colleagues refer to a Cochrane review of randomised trials of neck manipulation or mobilisation which found that as a stand-alone treatment, the technique provides only moderate short-term pain relief.
They point to other recent, high-quality trials which suggest that manipulation is no better than other treatments such as physical exercise.
In their view, the risks of using manipulation for neck pain outweigh the benefits.
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.”

You might be interested in our previous blog posts on Chiropractic medicine. No doubt, some folks experience improvement for their musculoskeletal complaints after chriopractic manipulation but it must be said the procedure in some cases may carry risks which should be considered seriously.


Malaysian physician, haematologist, blogger, web and tech enthusiast