Neck Pain Patient Decision Aid: Step 3: Difference between revisions

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| Increased neck pain26
| Increased neck pain<ref name="Carnes 2010">Carnes D et al. Adverse events and manual therapy: A systematic review. Man Ther 2010; 15:355–63</ref>
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| [[Image:NeckPainPatientAid_OrangeSmiley_Frown.png|25px]][[Image:NeckPainPatientAid_OrangeSmiley_Frown.png|25px]][[Image:NeckPainPatientAid_OrangeSmiley_Frown.png|25px]][[Image:NeckPainPatientAid_YellowSmiley_Frown.png|25px]]<br>
| [[Image:NeckPainPatientAid OrangeSmiley Frown.png|25px]][[Image:NeckPainPatientAid OrangeSmiley Frown.png|25px]][[Image:NeckPainPatientAid OrangeSmiley Frown.png|25px]][[Image:NeckPainPatientAid YellowSmiley Frown.png|25px]]<br>
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| (29 out of every 100 patients will experience a short-term increase in neck pain)
| (29 out of every 100 patients will experience a short-term increase in neck pain)
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<br>
==== Neck mobilizations ====


<br> <br><br>
Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible.<br>


Neck mobilizations<br>• Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible.<br>Increased neck pain24,25<br> <br>(22 out of every 100 people will experience a short-term increase in neck pain)  
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| Increased neck pain<ref name="Carlesso 2010">Carlesso LC et al. Adverse events associated with the use of cervical manipulation and mobilization for the treatment of neck pain in adults: A systematic review. Man Ther 2010; 15: 434-444.</ref><ref name="Hurwitz 2005">Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30(13):1477-84.</ref>
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| (22 out of every 100 people will experience a short-term increase in neck pain)
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| Increased neurological symptoms<ref name="Carlesso 2010" /><ref name="Hurwitz 2005" />
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(10 out of 100 people will experience some short-term neurological symptoms [pins and needles sensation, weakness, or numbness])
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==== Neck manipulations ====


Increased neurological symptoms24,25<br> <br>(10 out of 100 people will experience some short-term neurological symptoms [pins and needles sensation, weakness, or numbness])
*Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible


Neck manipulations<br>• Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible <br>Increased neck pain24-26<br> <br>(22 to 41 out of 100 people experience a short-term increase in neck pain)  
{| width="600" border="0" align="center" cellpadding="1" cellspacing="1"
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| Increased neck pain<ref name="Carlesso 2010" /><ref name="Hurwitz 2005" /><ref name="Carnes 2010">Carnes D et al. Adverse events and manual therapy: A systematic review. Man Ther 2010;15:355–63</ref>
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|
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| (22 to 41 out of 100 people experience a short-term increase in neck pain)
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Increased neurological symptoms24,25<br> <br> (19 out of every 100 people experience short-term neurological symptoms)


• Very rare, but serious or catastrophic side effects such as unbearable symptoms or stroke have also been reported. <br>o Unbearable symptoms26<br>(Approximately 1 out of every 10 000 experience ‘unbearably severe side effects’)<br>o Stroke or death24,26<br>(It is difficult to determine the frequency of these adverse event due to the small number of participants in each study, but it is likely much less than 1/10 000)


 <br>Upper back manipulations<br>• Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible <br>Increased pain24<br> <br>(21 out of every 100 patients experience a short-term increase in pain) <br>
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| Increased neurological symptoms<ref name="Carlesso 2010" /><ref name="Hurwitz 2005" />
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| (19 out of every 100 people experience short-term neurological symptoms)
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*Very rare, but serious or catastrophic side effects such as unbearable symptoms or stroke have also been reported.&nbsp;
*Unbearable symptoms<ref name="Carnes 2010" /><br>(Approximately 1 out of every 10 000 experience ‘unbearably severe side effects’)
*Stroke or death<ref name="Carlesso 2010" /><ref name="Carnes 2010" /><br>(It is difficult to determine the frequency of these adverse event due to the small number of participants in each study, but it is likely much less than 1/10 000) 
 
==== Upper back manipulations ====
 
*Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible
 
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| Increased pain<ref name="Carlesso 2010" />
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(21 out of every 100 patients experience a short-term increase in pain)  
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Revision as of 18:30, 27 April 2012

This page is part of the 'Should I receive manual therapy and exercise for my neck pain?: A patient decision aid' resource for patients. Please see the main project page for further information, or proceed to Step 3 below to recognize the risks.

NeckPainPatientAid Step3 Logo.png

Each treatment option has potential side effects:

Exercise[edit | edit source]

  • Mild and infrequent side effects such as short-term increases in neck, arm, head or back pain, muscle soreness, and dizziness have been reported.
Increased neck pain[1]
NeckPainPatientAid OrangeSmiley Frown.pngNeckPainPatientAid OrangeSmiley Frown.pngNeckPainPatientAid OrangeSmiley Frown.pngNeckPainPatientAid YellowSmiley Frown.png
(29 out of every 100 patients will experience a short-term increase in neck pain)

Neck mobilizations[edit | edit source]

Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible.

Increased neck pain[2][3]
(22 out of every 100 people will experience a short-term increase in neck pain)


(10 out of 100 people will experience some short-term neurological symptoms [pins and needles sensation, weakness, or numbness])
Increased neurological symptoms[2][3]

Neck manipulations[edit | edit source]

  • Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible
Increased neck pain[2][3][1]
(22 to 41 out of 100 people experience a short-term increase in neck pain)


Increased neurological symptoms[2][3]
(19 out of every 100 people experience short-term neurological symptoms)


  • Very rare, but serious or catastrophic side effects such as unbearable symptoms or stroke have also been reported. 
  • Unbearable symptoms[1]
    (Approximately 1 out of every 10 000 experience ‘unbearably severe side effects’)
  • Stroke or death[2][1]
    (It is difficult to determine the frequency of these adverse event due to the small number of participants in each study, but it is likely much less than 1/10 000) 

Upper back manipulations[edit | edit source]

  • Mild and infrequent side effects including short-term increases in neck, arm, head, or back pain and dizziness are possible
(21 out of every 100 patients experience a short-term increase in pain)
Increased pain[2]


  1. ↑ 1.0 1.1 1.2 1.3 Carnes D et al. Adverse events and manual therapy: A systematic review. Man Ther 2010; 15:355–63 Cite error: Invalid <ref> tag; name "Carnes 2010" defined multiple times with different content
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Carlesso LC et al. Adverse events associated with the use of cervical manipulation and mobilization for the treatment of neck pain in adults: A systematic review. Man Ther 2010; 15: 434-444.
  3. ↑ 3.0 3.1 3.2 3.3 Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30(13):1477-84.
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