neck pain

Easy Improvement Through Cervical Manipulation

Chiropractor Amarillo - Dr. Jeff Williams - breaks it down for you

Let’s talk about cervical manipulation. Let us define the term ‘cervical manipulation' first. Cervical manipulation is also called ‘spinal manipulation’ and it is when you go to the chiropractor and he/she 'adjusts' your neck. It's the modality with which most chiropractors are commonly associated. 

It typically feels amazing and sometimes, if you record it, you can get 1.000,000 views on Facebook!


Patients are sometimes scared of cervical manipulation

It is extremely common for us to have new patients come to see us and be scared to death of being worked on. You would almost think we are as bad as the ones giving shots or cutting stuff off of different areas of the body. 

From the get-go, we should say that a visit to the chiropractor should be something you absolutely enjoy. It should NOT be something that you survive.

Keep that in mind. 

Now, why exactly would anyone be afraid of having a neck adjustment (aka cervical manipulation)? 

Here are some of our guesses is . This is where we get to think out loud:

  1. Rambo, Arnold Schwarzenegger, and Jon Claude Van Damme did chiropractors no favors at all when they started using the neck twist in their movies to kill their enemies silently and stealthy. These movies have literally scared millions of potential chiropractic patients half to death.
  2. There is a lot of misinformation floating around having to do with chiropractic. When that is the case, typically the patient was told by their monkey’s uncle’s pool boy that chiropractors hurt people.  Although we shouldn’t, people tend to believe hearsay and it's a fear that sits in the back of the mind for a lifetime. 
  3. The most disappointing of all reasons someone would be afraid of going to the chiropractor happens when an uninformed health care worker (doctor, nurse, etc.) tells patients that chiropractors will hurt them. The first reason this would be so concerning is that it shows these practitioners or healthcare workers simply do not keep up with the relevant literature on the topic. If they did, they would, in fact, be REFERRING you to a chiropractor for non-complicated neck pain, back pain, joint pain, or headaches and migraines. 

The body is strong

A very important point to understand is that while, yes, there are ways to easily hurt people, in general, the body is put together very strongly and a trained and licensed professional has to either be completely incompetent or they would almost have to be trying to hurt a person to do serious damage. 

Of course, there are oddities and doctors should be doing their due diligence before performing any procedure to assess for safety. Assuming the patient has non-complicated pain, cervical manipulation and chiropractic care, in general, are incredibly safe. 

What are the odds?

Here are some simple quick fun facts that I originally included in an article I wrote for (an evidence-based podcast):

  • The chances of being struck and killed by lightning is 1 in 174,426 according to the National Safety Council.
  • Awesome odds of being told to “Come on down,” on The Price Is Right stand at 1 in 36!
  • Your chances of being born with 11 fingers or toes is 1 in 500.
  • The odds of dying from a firearms assault is 1 in 113.
  • How about this one: the odds of winning an Oscar are 1 in 11,500.

Knowing this, it helps us to put into perspective that the RAND Institute estimates some sort of adverse event that (bad outcome) is the direct result of a cervical manipulation happens in about 1 out of every 1-2 million adjustments. If even that. 

What I’m trying to say is that there is an exceedingly rare chance anything bad can happen from going to the chiropractor. Much less chance than going to almost every other healthcare professional out there in the healthcare marketplace.

Malpractice Insurance Comparison

Most higher-level healthcare practitioners have to carry malpractice insurance because we’re all human. We all know that insurance carriers know exactly how much they should charge for malpractice insurance based on how many times medical or chiropractic practitioners get themselves into trouble. They HAVE to get their numbers right if they want to stay in business. 

Since we have established the fact that malpractice carriers know their numbers, let me just point out that chiropractors’ malpractice insurance is literally, on average, approximately 1/10th the cost of those in the medical field. The reason is simply that there is little to no risk in visiting a chiropractor. Chiropractors are not out there messing people up right and left. If they were, you better believe the malpractice carriers would know that and the malpractice would be much more expensive. 

When we look at the difference in malpractice costs, one would think that would drive patients to chiropractors. Especially the patients looking for safe, conservative means of pain relief. 

Doctors of Chiropractic are highly-trained professionals

Another reason there is little risk in cervical manipulation or in going to a chiropractor is that they are highly trained professionals. 

Consider this fact: Chiropractors have the EXACT SAME basic science courses as medical doctors have when they are going through medical school and, in fact, many of the professors at chiropractic colleges are medical doctors that have become professors. 

Not only do Doctors of Chiropractic have the exact same basic sciences, but are typically much more adept at reading x-rays than their medical colleagues. I have told patients for years that they would much rather a chiropractor read their x-rays than a general practitioner in the medical world. I stand by that firmly. 

Here are some of the classes chiropractors take:

  • Neurology
  • Biochemistry
  • Cell Biology
  • Histology
  • Gross Anatomy (dissection of human cadavers)
  • Microbiology
  • Systemic Anatomy
  • Physiology
  • Bone Pathology
  • Pathology
  • Differential Diagnosis
  • Nutrition
  • Embryology, etc…

In total, Doctors of Chiropractic went to college for 8 years to achieve their degree. It is certainly no weekend course or 6-month trade school. When I say chiropractors are highly trained, it’s a fact you can repeat with confidence.

In addition to their education and college hours, chiropractors must pass 4 National Board exams. These are the kinds of exams that give you hives, make your stomach sink, and cause you to stay up for days studying and studying, and….yes….studying. 

If you are smart enough to finally pass those hairy boards, then you can finally get licensed in your state as long as you stay in your lane and abide by the rules of your state licensing board. 

The life of a chiropractor is not particularly easy! 

I said all of that just to say this: it’s safe. 

Now, what conditions would make a chiropractor consider using cervical manipulation? 

The most common symptom would be simple neck pain. Sometimes we just wake up with it. Sometimes someone jerked our hand and it pulled all the way up into the neck. Now it’s a bother. Sometimes we get into car wrecks. Sometimes, it’s arthritis or degeneration. Maybe we have a degenerated disc causing pain out into the arms. 

There are several reasons for cervical manipulation being used to help patients get out of pain. 

Another one of the most common reasons for using cervical manipulation would be to treat headaches. We can’t tell you in words how effective it can be on headaches and migraines. Especially cervicogenic headaches. We have seen patients go from having headaches literally all of their lives to having none at all. It is truly profound every time we get to experience those patients.

Things like that don’t only affect the patient. They affect the chiropractor and the clinic staff as well. That’s a promise. 


Below we have picked out some of our more favorite summations from excellent research out there:

  • “Manual therapy (spinal mobilization) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner.”(Korthals-de Bos IB 2003)
  • “Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain(Hurwitz EL 2008)”
  • “There was moderate level evidence to support the immediate effectiveness of cervical spine manipulation in treating people with cervical radiculopathy(Zhu L 2015)”
  • “Chiropractic is effective in acute, subacute, and chronic low back pain, migraines, and headaches originating from the neck, for the treatment of some forms of dizziness, extremity and joint issues, as well as mid-back and acute and subacute neck pain(Bronfort G 2010).”

Alternatives to cervical manipulation

Let us assume you are not interested in cervical manipulation and want to try things in the medical field to address your neck pain or your headaches. Here are some quick facts concerning popular and common alternatives:

  • Data obtained from the U.S. Centers for Disease Control and Prevention show that more than 300 people die annually as a result of acetaminophen poisoning.
  • Beginning in 2006, according to the CDC, the number of people who died after accidentally taking too much acetaminophen surpassed the number who died from intentionally overdosing to commit suicide.
  • NSAIDs such as Ibuprofen and Acetaminophen cause at least 16,000 deaths per year and send 100,000 people to the ER in the United States every year.“Although the steroid injections for radiculopathy showed some short-term relief in pain and short-term increase in function, the benefits seen in the patients were only small and short-term only. There was no effect long-term and no affect on whether or not the person had surgery eventually. The evidence in this paper suggested there was no effectiveness at all for the treatment of spinal stenosis(Chou R 2015)”
  • “Although not approved by the Food and Drug Administration (FDA), injections are being performed with an increased frequency (160%), are typically short-acting and ineffective over the longer-term, while exposing patients to major risks/complications(Epstein N 2013)”
  • “Use of intervertebral fusion devices rose rapidly after their introduction in 1996. This increased use was associated with an increased complication risk without improving disability or reoperation rates(Maghout J 2006)”

These are just some simple thoughts and facts to help you keep information in the proper perspective and understand risk vs. benefit. Real risk. Not just something you heard from a random unreliable source. 

Our opinion is obvious: you should feel very safe and very comfortable going to a reputable and established Doctor of Chiropractic without hesitation for your neck pain or headaches. 

If you still have questions regarding cervical manipulation, please feel free to call us at Creek Stone Integrated Care at 806-355-3000 or visit our website at

You may also enjoy a different, more thorough article I authored on this topic at:



Dr. Jeff Williams, DC, FIANM is a Fellowship-trained Neuromusculoskeletal specialist and chiropractor in Amarillo, TX. As an Amarillo chiropractor, Dr. Williams treats chronic pain, disc pain, low back pain, neck pain, whiplash injuries, and more. Dr. Williams is also the host of The Chiropractic Forward Podcast. Through the podcast, Dr. Williams teaches fellow chiropractors and advocates weekly for evidence-based, patient-centered practice through current and relevant research. If you have any questions for Dr. Williams, feel free to email at [email protected]

Learn more about Dr. Williams and his practice at Dr. Williams's full-time Amarillo chiropractic practice is Creek Stone Integrated Care at 3501 SW 45th St., Ste. T, Amarillo, TX 79109

Jeff S Williams, DC, FIANM, DABFP

Jeff S Williams, DC, FIANM, DABFP


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