Neck ‘cracking’ and manipulations carried out by chiropractors could trigger ‘catastrophic’ health problems such as strokes, experts warned yesterday.
Doctors claim there are serious side-effects linked to the treatment, which is used to ease neck and back pain, and it should be abandoned.
Professional bodies representing chiropractors and osteopaths should advise their members the risks are too great to justify the use of manipulation, they said.
Thousands of patients seek help each year from chiropractors, who use manipulation, massage and stretching of soft tissue to correct misalignments of the spine.
Cracking can sometimes be heard as the joint surfaces are moved apart.
The most serious potential side-effect is tearing of the lining of the vertebral artery in the neck, which may lead to a stroke.
In a medical debate on bmj.com, experts argue the technique is ‘unnecessary and inadvisable’.
Dr Neil O’Connell, of the Centre for Research in Rehabilitation at Brunel University, said studies ‘provide consistent evidence of an association between neurovascular injury [including stroke] and recent exposure to cervical manipulation’.
Estimates of the numbers of patients suffering serious complications vary – but raise ‘legitimate concerns’.
He said: ‘Most reported cases… have followed chiropractic care rather than osteopathy or physiotherapy, where manipulation is used less often.
Studies ‘provide consistent evidence of an association between neurovascular injury and recent exposure to cervical manipulation’.
‘The potential for catastrophic events and clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned.’
According to a study analysis by international medical review body Cochrane, neck manipulation as a stand-alone treatment gives only moderate short-term pain relief compared with dummy manipulations or muscle relaxant drugs.
Earlier this year British researchers suggested many side effects go unreported.
They found half of trials into chiropractic treatments failed to mention adverse effects even though there was evidence patients had suffered them.
But Professor David Cassidy, an epidemiologist from Toronto University in Canada, said there was evidence that neck manipulation benefited patients.
He also cast doubt on whether it caused strokes. He suggested neck pain and headache may be an early sign of tearing of the vertebral artery, prompting the visit to chiropractor in the first place.
As a result, a problem which is pre-existing may wrongly be attributed to manipulation, he said.
The British Chiropractic Association said the technique is at least as effective as other medical treatments and safer than drugs.
A spokesman added: ‘The term chiropractic is often mis-used for treatment carried out by non-chiropractors.
‘The cherry-picking of poor quality research needlessly raises alarm in patients.’