A common chiropractic treatment for neck pain, which involves applying thrusts to the neck area of the spine, should be abandoned, say experts.
Writing in the British Medical Journal, Neil O'Connell and colleagues say that cervical spine manipulation carries a low risk of stroke, resulting from damage to the major neck arteries. They say the technique is "unnecessary and inadvisable".
But other experts believe it is a valuable addition to patient care.
Spinal manipulation is used to treat neck and back pain or other musculoskeletal conditions by physiotherapists, osteopaths and most commonly by chiropractors.
Researchers said injuries include tearing the lining of the vertebral artery, which is located in the neck and supplies blood to the brain, and stroke.
However, not all experts agree. Writing in the same edition of the BMJ, Professor David Cassidy, from the University of Toronto, and colleagues argue that cervical spine manipulation should not be abandoned as a treatment for neck pain.
They point to high quality evidence that "clearly suggests that manipulation benefits patients with neck pain" and raises doubt about any direct relation between manipulation and stroke.
But they want to see more research into the pros and cons of this and other techniques with the aim of identifying safe and effective treatments.
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