Cervical manipulation, commonly known as neck manipulation, is a procedure involving adjustment of the upper seven
vertebrae
The spinal column, a defining synapomorphy shared by nearly all vertebrates,Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characteristic i ...
of the spinal column. This procedure is most often utilized by
chiropractor
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscie ...
s, as well as
osteopathic physicians
Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA) is a medical degree conferred by the 38 osteopathic medical schools in the United States. DO and Doctor of Medicine (MD) degrees are equivalent: a DO graduate may become licen ...
who practice
osteopathic manipulation
Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths.
Osteopathic manipulation is the core set of techniques in ...
. This type of manipulation may increase the risk of
stroke
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
and other issues, with studies suggesting the relationship is causative.
Location
The cervical areas is located in the upper neck region of the spine from C1 to C7 .
Methods
Many types of practitioners use various techniques to adjust the position of the cervical bones. They include
bonesetter
Traditional bone-setting is a type of a folk medicine in which practitioners engaged in joint manipulation. Before the advent of chiropractors, osteopaths and physical therapists, bone-setters were the main providers of this type of treatment. T ...
s,
physical therapist
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...
s,
chiropractor
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscie ...
s,
non-physician osteopaths, and
osteopathic physicians
Doctor of Osteopathic Medicine (DO or D.O., or in Australia DO USA) is a medical degree conferred by the 38 osteopathic medical schools in the United States. DO and Doctor of Medicine (MD) degrees are equivalent: a DO graduate may become licen ...
. The various techniques range from high velocity low amplitude thrusts to gentle positional release techniques such as Brett's Procedure.
Risks
There are associated risks that come with cervical manipulation including
spinal disc herniation
Spinal disc herniation is an injury to the cushioning and connective tissue between vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical ...
, stroke and
vertebral artery dissection
Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain. After the tear, blood enters the arterial wall and forms a blood clot, thickening t ...
. Chances of stroke may be increased due to possible tears in neck arteries, known as cervical dissection, and is among the most common causes of stroke for young and middle-aged adults.
However, it is difficult to quantify this risk, with a 2012 meta analysis of previous studies stating that a significant risk "can not be ruled out", but noted that the true risk is possibly drastically underestimated, owing to the lack of a reporting requirement for private chiropractic practitioners.
See also
*
Chiropractor
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscie ...
*
Spinal adjustment
Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence ...
References
External links
* MSNBC.com
"Deadly twist: Neck adjustments can be risky"
Manual therapy
Chiropractic treatment techniques