Concern over spinal manipulation of the neck...

In recent months there have been some concerns raised over whether the technique of cervical spine (neck) manipulation or adjustment is advisable due to a small, potential risk of adverse reactions occuring, namely a cerebral vascular accident, or stroke.

 

In response the British Osteopathic Association (BOA) released a response (summarised later on below) that extensive research over the last 5 years has been conducted and we can confidently say that –

“The associated risk from manipulation is very low and when compared with risks associated with conventional treatments such as drugs they are equivalent or better.”

Cervical Spine manipulation is a very common form of treatment. It is one that patients often recall due to the nature of the maneuverer involving the neck and the frequently heard audible pops or clicks that occur as a result. This technique is only ever carried out when a patient has been carefully screened during extensive case history taking and a thorough examination.

This is a technique widely used by Osteopaths, Chiropractors and Physiotherapists to help with painful symptoms in the neck and often to help alleviate headaches which are caused by the cervical spine (cervicogenic).

The recent debate stems from the 7^th of June 2012 edition of the BMJ, two arguments were presented, one each for and against the use of cervical spine manipulation. This was intended to spark debate over the subject not intended to offer any conclusions on the subject.

The Press did sensationalise this with derogatory headlines. The newspapers and websites in question retracted their original headlines which were defamatory to the Osteopathic profession and the British Osteopathic Association and Professor Dawn Carnes; NCOR Chair (The National Council for Osteopathic research) responded with a press release, below is a summary of what was said:

• The BMJ published two lucid arguments for and against cervical manipulation for mechanical neck pain.
• There is no consensus about the best care or treatment that optimises pain reduction, increases function and improves quality of life with the least risk involved.   
• The BMJ published two lucid arguments for and against cervical manipulation for mechanical neck pain.
• There is no consensus about the best care or treatment that optimises pain reduction, increases function and improves quality of life with the least risk involved.
• Spinal manipulation is a very small component of the wide variety of Osteopathic techniques.
• Osteopaths pride themselves in their rigorous training standards of practice which prioritise patient safety and risk.
• Complying with these standards is a condition of an Osteopaths registration.
• The contraindications of this technique are universal to all practitioners.
• It is the patient’s choice to receive this type of treatment; many patients choose this type of care.
• There are risks involved with any type of intervention.
• NCOR have conducted extensive research over the last 5 years and can confidently say that – “The associated risk from manipulation is very low and when compared with risks associated with conventional treatments such as drugs they are equivalent or better.”
• Patients can ultimately decide fro themselves the type of treatment they feel they require or if no treatment is the preferred option.
• We need more clear evidence for patients to make these types of decision

Patients need to bear in mind...

It has been claimed that there is a small potential risk of a stroke following some manoeuvres of the neck. In terms of risk this equates to having your head backwards over the wash basin at the hairdresser or falling asleep in the cinema with your head propped backwards over the chair.

Over the years there have been millions of treatments given in the UK by osteopaths and I have not heard of single case nor have I or any of my colleagues experienced any adverse reactions in practice when administering cervical spine (neck) manipulations.

Osteopaths are trained to decide whether or not there are any risk factors involved and if the treatment is contraindicated for any reason they will not perform that certain technique.

Cervical spine manipulation is a preferred choice of many patients but there are a huge range of techniques that can be used very effectively to treat the neck if it is not safe to do so, or the patient does not wish to have this type of treatment.

More information can be ready on the Boots Web MD website:

http://www.webmd.boots.com/back-pain/news/20120608/stroke-risk-from-neck-pain-treatment?page=2