Is manipulation safe?
Is manipulation safe?
In the healthy low back, manipulation is entirely safe. Your spine is far too strong and stable, and the discs and joints too well-attached, to be damaged or disrupted by someone's efforts to manually twist your back. Manipulation can be performed in a variety of ways; quickly or slowly, gently or forcefully, over a wide range or in a limited fashion. None of these techniques can cause harm. The choice usually depends upon the practitioner's training, or perhaps upon what he or she has found helpful in the past.
Neck adjustment is a slightly different issue. There is an extremely small but clearly documented incidence of blood-vessel damage associated with neck adjustments. Vascular injury may lead to a stroke and, in very rare instances, it can be fatal. The blood vessels involved are usually the pair of arteries that run up the back of the neck and enter through the same hole in the base of the skull where the spinal cord exits. The trauma to one of these vessels occurs in an area just below the skull, where it typically follows a winding course. The proper question is not "Does damage occur?" but "How often does it happen?" No one knows for sure. Estimates range anywhere from one event in every twenty thousand adjustments (a number I do not accept) to one incident in every six million manipulations. That is an enormous range, and it reflects our lack of solid knowledge. The majority of people who have explored this issue put the incidence in the order of one vascular problem for every one- to two-million adjustments.
I was told that I need regular spinal manipulations to keep my back healthy and prevent future attacks. What do you think?
While there is evidence that manipulation can eliminate neck and back pain, there is no proof that it has any preventative value. You move the bones of your neck and back every day. Having someone else move them for you adds nothing. Having your pain-free healthy low back manipulated may feel good, and it certainly will cause no harm. Manipulating a pain-free neck may make it feel nice, but it also carries the minuscule risk of a serious complication. In both cases, you should remember that you are paying for a treatment only because it feels good and not because it possesses any legitimate therapeutic value.
*For more on back pain, pick up the September 2004 issue of Homemakers magazine.
Excerpted from A Consultation with the Back Doctor by Hamilton Hall, M.D. Text copyright 2003 by Hamilton Hall, M.D. Excerpted by permission of McLelland and Stewart Ltd. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
