Honestly Discussing the Risks of Cervical Manipulation

Reference:Miley ML, et al Does cervical manipulative therapy cause vertebral artery dissection and stroke? Neurologist. 2008 Jan;14(1):66-73. &
Reference #2: Langworthy JM, Forrest L. Withdrawal rates as a consequence of disclosure of risk associated with manipulation of the cervical spine. Chiropr Osteopat. 2010 Oct 26;18:27

Although quite controvertial, there are rare but serious risks associated with upper and mid cervical manipulations.

A 2008 review published in the journal Neurologist, concluded, “Weak to moderately strong evidence exists to support causation between cervical manipulation and vertebral artery dissection and associated stroke.”

This UK study investigated the attitudes of British chiropractors towards informed consent and disclosure. (I have no PT study on this topic)

Most chiropractors (80%) said they believed they had a moral and ethical obligation to disclose risks associated with cervical manipulation.

However, only 45% indicated they always discuss this with patients. This low percentage may be due to the fact that 46% believed that discussing the possibility of a serious adverse reaction could raise patient fear which may increase the possibility of them refusing treatment.

Personal Comment: As health care providers we are obligated to share the potential risks of any procedure with patients. This is the reason why I hardly ever perform cervical manipulations as I would ethically require to inform the patient…

Posted on: July 05, 2011

Categories: Cervical Spine

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