Strokes Due to Chiropractic Cervical Manipulation:
Cervical Manipulation

Cervical Manipulation

The location of the subluxation is the determining factor in deciding where to manipulate. Thus, a chiropractor may well manipulate the cervical spine for low back pain, claiming to have located a subluxation in the cervical spine even though the neck is asymptomatic.

Cervical manipulation is one of the most common chiropractic procedures. This has an historical basis. B.J. Palmer, D.D. Palmer's son and a great popularizer of chiropractic, invented the "hole in one" idea: the most important subluxations occurred in the upper cervical vertebrae, thus manipulation of the these vertebrae could have the greatest effect on the nervous system and consequent health. The National Upper Cervical Chiropractic Association is one organization which still supports this view.

As a treatment for neck pain, a recent study made the following conclusion regarding cervical manipulation: From the standpoint of health policy, and when the objective is to maximize life expectancy and quality-adjusted life expectance, there is no single treatment among NSAID, exercise, and manual therapies [of which cervical manipulation is one] that is clearly better for neck pain. Therefore, a practitioner's decision about the best treatment to provide to an individual patient should be based on the patient's informed treatment preferences and attitudes toward risk. G van der Velde, et al., "Identifying the Best Treatment Among Common Nonsurgical Neck Pain Treatments," Spine 35, no. 45 (2008), S184-191, at 5189. (Emphasis added.)

It is doubtful a physical therapist, osteopath or physiatrist would use cervical manipulation for neck pain, as therapies equally effective but carrying less risk exist, such as mobilization, a much gentler procedure. Cervical manipulation for the reduction of subluxations, whether for a specific condition such as asthma or allergies, or for health "maintenance," or "wellness care" is never a legitimate therapy from an evidence-based or scientific standpoint, although, unfortunately, perfectly legal under the state chiropractic practice acts.

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© 2009 Jann Johnson Bellamy, J.D., (jbellamy@alternativemedsafety.org), Campaign for Alternative Medicine Consumer Safety. Reprinted by The Abelson Law Firm with permission. Further reproduction prohibited without permission of the author.