Chiropractic is a non-invasive, hands-on health care discipline that focuses on the neuro-musculoskeletal system. Chiropractors practice a manual approach. Doctors of Chiropractic are specifically trained to detect and correct problems in the spine, often before the patient is even aware they exist.
Mechanical neck pain
Pain arising from the neck! Like low back pain identifying the specific cause, whether that be a joint or muscular or commonly some combination of both, is something education, exercise, and manual therapies, such as spinal manipulation, mobilisation or various soft tissue therapies, can help. The principles with these complaints are the same as LBP, our primary goal with the case history and examination is to take anything more serious off the table, if we can do this there is a good chance that what we provide as chiropractors could help you. With this in mind, our approach to such problems may vary depending on the patient, their experience of the complaint, duration, and intensity of the complaint as well as a number of other variables.
These problems often seemingly appear from nowhere, such as waking with it, or turning your head to look at something, rather than there being some big event such as a fall which may create whiplash-type injuries. Like all complaints, they have the potential to progress from acute (short term) to chronic (long term).
Manipulation of the neck is something of a controversial topic, with some people for it and some against it, and some sitting on the fence. Harm from cervical (neck) manipulation is unknown, but estimates range from one in 20,000 to five in 10,000,000 (Gross et al, 2002) with over 30% of the participants having reactions to treatment. Increased neck pain and stiffness were the most common symptoms (Hurwitz et al, 2005) which were typically transient lasting 12-24 hours. While a study of stroke associated with GP visits and chiropractor visits found the risk was equal for patients consulting either practitioner. This suggests that cervical manipulation may not be a cause of the stroke but associated with a stroke in progress (Cassidy et al, 2009), suggesting that the symptoms which drive some to their GP or chiropractor can be symptoms of a stroke, severe headache, neck pain and stiffness. Having said this manipulation of the neck is still considered a safe and effective treatment for mechanical neck pain, but a comprehensive case history and examination are even more important in this case.
Cassidy JD, Boyle E, Cote P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ: Risk of vertebrobasilar stroke and chiropractic care. J Manipulative Physiol Ther 2009, 32:S201-S208.
Di Fabio RP: Manipulation of the cervical spine: risks and benefits. Phys Ther 1999, 79:50-65.
Gross AR, Kay TM, Kennedy C, Gasner D, Hurley L, Yardley K, Hendry L, McLaughlin L: Clinical practice guideline on the use of manipulation and mobilisation in the treatment of adults with mechanical neck disorders. Manual Therapy 2002, 7:193-205.
Hurwitz EL, Morgenstern H, Vassilaki M, Chiang M-L: Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine 2005, 30:1477-1484.
Hurwitz EL, Morgenstern H, Harber P, Kominski GF, Yu F, Adams H: A randomised trial of chiropractic manipulation and mobilisation for patients with neck pain: clinical outcomes from the UCLA neck-pain study. Am J Public Health 2002, 92:1634-1641.
