Why get manipulated in the first place?

A few months ago in April, we wrote about the risk of VBI when getting your neck cracked, "If you like getting your neck ‘cracked’ or thinking about it, you should know about VBI", a group of researchers from the University of Sydney in collaboration with University of Queensland found that that neck manipulation is not appreciably more effective than mobilization. The use of neck manipulation therefore cannot be justified on the basis of superior effectiveness.

Project leader, Dr. Andrew Leaver from the Faculty of Health Science, University of Sydney said, "It makes us question why patients or practitioners would favour a treatment which possibly carries risk of catastrophic outcome over an equally effective one with very few reported complications despite widespread use."

So why do then patients seem lured towards neck manipulation?

While over the longer-term results from the mobilisation and manipulation approach is identical, the short-term relief that manipulation provides can be a mis-leading siren song. Patient generally immediately feel better after a crack compared to the more gentler mobilisation. But the VBI risk doesn't seem to be worth it as little is done to improve the underlying functional problem. In fact, it opens a door towards excessive frequent weekly 'cracking' session to sustain the pain relief.



  1. Controversial study suggests neck manipulation not worth the risk, University of Sydney, 9 September 2010
  2. A Randomized Controlled Trial Comparing Manipulation With Mobilization for Recent Onset Neck Pain, Archives of Physical Medicine and Rehabilitation – Volume 91, Issue 9, Pages 1313-1318 (September 2010)

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