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Should we abandon cervical spine manipulation for mechanical neck pain? Yes

updated

Tags: treatment, chiropractic, spinal adjustment, neck, manual therapy, controversy, debunkery, spine, head/neck

One article on PainSci cites Wand 2012: The Chiropractic Controversies

PainSci notes on Wand 2012:

Extremely well-written position paper this tired old controversy.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Cervical spine manipulation (a high velocity, low amplitude, end range thrust manoeuvre) is a common treatment option for mechanical neck pain yet may carry the potential for serious neurovascular complications, specifically vertebral artery dissection and subsequent vertebrobasilar stroke. The non-superiority of manipulation to alternative treatments, coupled with concerns regarding safety, renders cervical spine manipulation unnecessary and inadvisable.

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Specifically regarding Wand 2012:

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