| A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. | |
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MedLine Citation:
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PMID: 8583176 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We reviewed the literature to evaluate the risk of serious injury or death resulting from cervical manipulation and to assess the evidence that cervical manipulation is an effective treatment for mechanical neck pain. We also reviewed the literature to assess the risks and effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs), which are often used as the "conventional" first-line treatment for similar musculoskeletal conditions. DATA SOURCES: A series of Medicine literature searches were performed, and materials were reviewed from 1966-1994. Key words included: Chiropractic or Orthopedic Manipulation; Non-Steroidal Anti-Inflammatory Agents; Neck or Back Pain; Randomized Controlled Trials; Adverse Effects. STUDY SELECTION: Studies and literature reviews that provided a numerical estimate of the risk of serious adverse effects or death from cervical manipulation or NSAID use were selected. Also, randomized, controlled studies that evaluated the effectiveness of manipulation or NSAID use for neck pain were included. DATA SYNTHESIS: Although there are a small number of well-performed trials of cervical manipulation for neck pain, we were unable to locate even a single randomized, controlled trial examining NSAID use specifically for neck pain. As for comparative safety, the best available evidence indicates that NSAID use poses a significantly greater risk of serious complications and death than the use of cervical manipulation for comparable conditions. CONCLUSION: The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence tha indicates NSAID use is any more effective than cervical manipulation for neck pain. |
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Authors:
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V Dabbs; W J Lauretti |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of manipulative and physiological therapeutics Volume: 18 ISSN: 0161-4754 ISO Abbreviation: J Manipulative Physiol Ther Publication Date: 1995 Oct |
Date Detail:
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Created Date: 1996-03-20 Completed Date: 1996-03-20 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 7807107 Medline TA: J Manipulative Physiol Ther Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 530-6 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Inflammatory Agents, Non-Steroidal
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adverse effects* Cervical Vertebrae* Chiropractic / adverse effects* Death Humans Pain / drug therapy, therapy* Risk |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal |
| Comments/Corrections | |
Comment In:
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J Manipulative Physiol Ther. 1996 Mar-Apr;19(3):220-1
[PMID:
8728468
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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