Safety of chiropractic manipulation of the cervical spine: a prospective national survey

Training and certification of doctors of chiropractic in delivering manual cervical traction forces: Results of a longitudinal observational study

“…Participants in previous studies also have reported visual changes and vertigo or dizziness following spinal manipulation or mobilization to the neck. [50][51][52][53] DCs in clinical and educational settings should monitor their patients for adverse events and document their occurrence. Doserelated studies of spinal mobilization and manipulation should assess whether participants receiving varied doses report differences in adverse events.…”

The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow: A sub analysis of an MRI study

“…Manual therapy to the neck, in particular rotational manipulation, has rarely been associated with serious adverse events related to the craniocervical vasculature, including arterial dissection and stroke (Thiel, Bolton et al 2007). Because the majority of cases occur in relatively young, healthy people with no known cardiovascular risk factors (Thomas, Rivett et al 2011), these complications are difficult to predict.…”

Commentary

“…An example from his book Trick or Treatment 4 is the risk of stroke incorrectly attributed to chiropractic manipulation of the cervical spine. 5,6 Whereas the impressive level of benefit reported in the Bristol Homeopathic Hospital clinical outcome study, discounted by Ernst for lack of controls, will signify effectiveness to the discerning GP, whatever its limits as a demonstration of efficacy. 7,4 A regrettable consequence of Ernst's polemic is to polarise attitudes to CAM when rapprochement would be more fruitful.…”