(NEW YORK) -- Spinal manipulation, a procedure that uses a flow of movement and points along the vertebrae to restore joint motion and realign the spine, is one of the most common treatments for neck pain. Previous studies suggest between 6 percent to 12 percent of Americans undergo spinal manipulation every year.
But the safety and efficacy of the technique has long been debated by medical experts.
Some evidence suggests that spinal manipulation, which is most often used by chiropractors, can offer some benefit to people who have back pain and some musculoskeletal disorders.
The technique varies in level and intensity, depending on the severity of the ailment, said Keith Overland, a chiropractor and president of the American Chiropractic Association.
However, some medical experts question whether spinal manipulation is a safe and effective technique for patients with neck pain.
Two reviews of the evidence by researchers published Thursday in the British Medical Journal add one more weight on each side for and against spinal manipulation.
In the first review, the authors conclude the technique is "unnecessary and inadvisable." The review cites studies that have suggested an association between spinal manipulation and more intense injuries, including tearing of the artery, and even stroke.
The studies "provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation," Neil O'Connell, a lecturer at the center for research in rehabilitation at Brunel University in Uxbridge, and his colleagues wrote.
According to Overland, the most common side effect from manipulation is soreness, adding that other more serious side effects are extremely rare.
The second study review suggests there are benefits to the technique, especially when used together with other pain relieving methods, such as exercise.
"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," David Cassidy, a professor in the department of epidemiology at the Dalla Lana School of Public Health at the University of Toronto, and his colleagues wrote.
According to Dr. Cain Dimon, physician director of the center for pain medicine at William Beaumont Hospitals in Royal Oak, Mich., spinal manipulation may be appropriate only after patients receive a full physical exam to detect the problem and undergo other types of treatments to relieve the pain first.
"I certainly don't dismiss chiropractic manipulation," said Dimon. "It can certainly help in some cases lower pain."
Overland said it's unlikely that a chiropractor would perform a spinal manipulation without first knowing the exact cause of pain.
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