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“…experts debated the safety and effectiveness of spinal manipulation for neck pain in the pages of the British Medical Journal [BMJ 2012;344:e3679]. The debate featured academics, some of whom said that spinal manipulation should be abandoned as a treatment for neck pain, and some who disagreed saying that it is a valid treatment that patients like…
Given the equivalence in outcome with other forms of therapy, manipulation seems to be clinically unnecessary. The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain. In the interests of patient safety, the regulatory and professional bodies associated with professions that use manual therapy should consider adopting this as a formal policy.
Benedict M Wand, Peter J Heine, Neil E O’Connell.
Should we abandon cervical spine manipulation for mechanical neck pain? No [Full text PDF]
…when risk, benefit, and patient preference are considered, there is currently no preferred firstline therapy, and no evidence that mobilisation is safer or more effective than manipulation. Thus, the identification of safe and effective interventions for neck pain remains a high priority. We say no to abandoning manipulation and yes to more rigorous research on the benefits and harms of this and other common interventions for neck pain.
J David Cassidy, Gert Bronfort, Jan Hartvigsen.
…Both articles are based on the professional opinion of the authors, who each presented evidence supporting their viewpoints. They are not systematic reviews and it is unclear whether all evidence relevant to spinal manipulation has been considered. No firm conclusions for or against spinal manipulation can be made based on these opinions alone…People with persistent neck pain should consult their doctor and discuss the treatment options that would be appropriate for them...The debate, although loosely defined, appears to focus on spinal manipulation of the neck by chiropractors, rather than by osteopaths or both…These articles were designed to stimulate debate in a controversial area rather than to offer conclusions.”
NHS Choices review (8th June 2012)