doctor touching man's bare back and neck in medical office

Not My Neck

Chronic Headaches and Neck Pain

Every now and then a patient comes to me with chronic headaches and neck pain that was referred to me by their primary care provider for evaluation with one stipulation – no cervical manipulation. The patient also reiterates that they do not want their neck to be cracked or popped. 

The Fear of Chiropractic Manipulation of the Neck

I get it when movies portray the twisting motion of the head that eventually breaks the neck, but that is a mere impossibility when it comes to chiropractic manipulation of the neck. The cracking sound has nothing to do with breaking bones, and the last I checked, everyone is walking out of the clinic on their own accord. This fear factor is why only 8 to 11 percent of the population utilizes chiropractic care. 

After a thorough history and examination, all signs called for chiropractic manipulation of the patient’s neck that came in with specific instructions of no neck adjusting. Here is where the ethical side of me as a physician comes in and the super ego goes out. As opposed to a doctor-centered behavior, I must change to a patient-centered behavior. Although there is no physical contraindication to the manipulation, caring for the patients must be meaningful and valuable. 

Atlantic Wellness Center of New Smyrna Beach

We at Atlantic Wellness Center are respectful of individual patient preferences and will not adjust anyone’s neck that is not comfortable with the procedure. There are other methods that we as chiropractors use to get the same result. 

Recently, and as far back as 60 years ago, chiropractors were finger-pointed for the cause of carotid artery dissection. This condition is characterized as an intrusion of blood between the layers of the artery wall due to the tearing of those layers. When blood collects within the layers, narrowing of the channel within the artery can restrict blood flow to the brain. Neck trauma, or something as simple as blowing one’s nose can cause this. Risk factors, such as hypertension, migraines, oral contraception and smoking, allow patients to be more susceptible to arterial dissection. Approximately 90 percent of the blockages do resolve on their own without any medical intervention needed.

A new study published in the journal, Spine, explained that there is no increased risk of arterial dissection and stroke with chiropractic neck manipulation. The findings also suggested that patients seeking medical or chiropractic care for neck pain have already damaged the vertebral artery. 

Unfortunately, sometimes a stroke did occur following a medical or chiropractic visit, but the damage that caused the stroke was already present at that time. 

To yours in better health! 

Dr. Shawn Snow author biography

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