Cervical Spine Manipulation

(🔈on) Back when @AndyOh5 and I used to play in the same church basketball league I was often tasked with the unpleasant job of guarding him, resulting in me pretty much getting crossed up and torched all the time. These days Andy mainly prefers to break ankles on the soccer field rather than the bball court when he's not traveling for work or planning for his upcoming wedding. I was happy to help him out with various issues that he's been dealing with lately, one being some uncomfortable neck pain. _ A study compared the short-term effects of spinal manipulative therapy vs. non-thrust mobilization techniques in patients with neck pain. The study's conclusion: Patients who received manipulation treatment experienced a 58% decrease in pain and a 50% decrease in disability. Patients who received non-thrust mobilization treatment had only a 13% decrease in the same categories. This suggests that in certain populations, incorporation of cervical and thoracic spinal manipulative therapy may be lead to better short-term outcomes and more quickly than non-thrust techniques. _ Every now and then a friend or patient will tell me about his/her experience with a healthcare professional who had informed them that their pain was the result of a joint or vertebral segment being out of place or alignment, and that spinal manipulation of the precise segment would restore optimal positioning and thus relieve pain. In the event that the pain would return in the future, as it often would, it would supposedly be because this misalignment recurred and could only be resolved by continual visits to get their backs cracked again. _ This mechanical "subluxation" theory of pain is unsupported by medical evidence and should discontinue to serve as a model for spinal manipulation and other rehabilitation therapies. Palpation of such minute changes with a therapist or chiropractor's hands are imprecise and highly unreliable. Correlation between pain and posture/joint position is poor. It creates an unnecessary dependency upon the practitioner and potentially creates nocebo pain. _ Sources: Bialosky et al 2009, Dunning et al 2012.

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