Featured Research

from universities, journals, and other organizations

Should spinal manipulation for neck pain be abandoned?

Date:
June 7, 2012
Source:
BMJ-British Medical Journal
Summary:
The effectiveness of spinal manipulation divides medical opinion. Experts debate whether spinal manipulation for neck pain should be abandoned.

The effectiveness of spinal manipulation divides medical opinion. On theBritish Medical Journal website, experts debate whether spinal manipulation for neck pain should be abandoned.

Related Articles


Spinal manipulation is a technique that involves the application of various types of thrusts to the lumbar spine (lower back) or cervical spine (neck) to reduce back pain, neck pain and other musculoskeletal conditions.

Neil O'Connell and colleagues argue that cervical spine manipulation "may carry the potential for serious neurovascular complications" and that the technique is "unnecessary and inadvisable."

They say that studies "provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation." Such injuries include vertebral artery dissection (a tear to the lining of the vertebral artery, which is located in the neck and supplies blood to the brain) and stroke.

They point to a Cochrane review of randomised trials of neck manipulation or mobilisation which concluded that as a stand-alone treatment, manipulation provides only moderate short term pain relief versus controls, sham manipulation, or muscle relaxants, and is unlikely to offer meaningful long term benefit for people with neck pain.

Other recent large, high quality trials reinforce this message, suggesting that manipulation is not superior when directly compared with other physical interventions such as exercise, they add.

They argue that, given the equivalence in outcome with other forms of therapy, manipulation seems to be clinically unnecessary. "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," they conclude.

But David Cassidy and colleagues argue that cervical spine manipulation is a valuable addition to patient care and should not be abandoned.

They point to high quality evidence that "clearly suggests that manipulation benefits patients with neck pain" and raises doubt about any causal (direct) relation between manipulation and stroke.

When combined with recent randomised trial results, "this evidence supports including manipulation as a treatment option for neck pain, along with other interventions such as advice to stay active and exercise," they say.

However, they acknowledge that, when risk, benefit, and patient preference are considered, "there is currently no preferred first line therapy, and no evidence that mobilisation is safer or more effective than manipulation. Thus the identification of safe and effective interventions for neck pain remains a high priority."

They conclude: "We say no to abandoning manipulation and yes to more rigorous research on the benefits and harms of this and other common interventions for neck pain."


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal References:

  1. B. M. Wand, P. J. Heine, N. E. O'Connell. Should we abandon cervical spine manipulation for mechanical neck pain? Yes. BMJ, 2012; 344 (jun07 3): e3679 DOI: 10.1136/bmj.e3679
  2. J. D. Cassidy, G. Bronfort, J. Hartvigsen. Should we abandon cervical spine manipulation for mechanical neck pain? No. BMJ, 2012; 344 (jun07 3): e3680 DOI: 10.1136/bmj.e3680

Cite This Page:

BMJ-British Medical Journal. "Should spinal manipulation for neck pain be abandoned?." ScienceDaily. ScienceDaily, 7 June 2012. <www.sciencedaily.com/releases/2012/06/120607190827.htm>.
BMJ-British Medical Journal. (2012, June 7). Should spinal manipulation for neck pain be abandoned?. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2012/06/120607190827.htm
BMJ-British Medical Journal. "Should spinal manipulation for neck pain be abandoned?." ScienceDaily. www.sciencedaily.com/releases/2012/06/120607190827.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins