Some of the findings which RAND concluded in this report has been summarized as follows:Arthur Croft, DC
Peter Curtis, MD
"In summary, there are no RCTs (randomized, controlled trial) or case series presenting data about the efficacy of cervical spine manipulation specifically for patients with acute neck pain. The limited literature available on mobilization for acute neck pain indicates that it may be beneficial for some patients, at least compared to rest and cervical collar, although instruction on mobilization and exercises may be equally beneficial."
"In summary, evidence from the literature supports the conclusion tat cervical spine manipulation and/or mobilization may provide at least short-term pain relief and range of motion enhancement for persons with subacute or chronic neck pain. The published results are insufficient to make efficacy determinations separately for patients with subacute pain and patients with chronic neck pain."
"In summary, the literature is sparse but suggests that cervical spine manipulation and/or mobilization may provide short-term relief for some patients with muscle tension (and other nonmigraine) headaches. The evidence for long-term benefit is much less conclusive."
"In summary, the literature is too limited to support or refute the use of cervical spine manipulation and/or mobilization for patients suffering from migraine headaches."
In summary, the literature described above and in previous sections on "Chronic Neck Pain’ and on "Migraine Headache" provides evidence that manipulation of the cervical spine increases range of motion and intersegmental mobility."
"Chiropractors perform about 90 percent of manipulation in the United States. Using data from a community-based study of the use of chiropractic services (Shekelle and Brook, 1991) to provide a rough estimate of the number of cervical spine manipulations delivered in the United States, and assuming that published case reports represent one-tenth of the actual complication caseload, the rate of vertebrobasilar accidents (VBA) or other complications (e.g., cord compression, fracture, hematoma, etc.) as a result of cervical spine manipulation is estimated to be 1.46 per one million manipulations. Using the same methodology, the rates of serious complications and death from cervical spine manipulation are estimated to be 6.39 per 10,000,000 manipulations and 2.68 per 10,000,000, respectively."
Coulter, I, Hurwitz E., Adams A., Meeker W., Hansen D., Mootz R., Aker P., Genovese B., Shekelle P. The appropriateness of manipulation and mobilization of the cervical spine. RAND, 1996Dynamic Chiropractic; Volume 14, Number 18, September 1, 1996.