Alternatives to "Neck Cracking"
Dear Editor:
As chiropractors, we seem to be taught manipulation / grade V mobilization without learning the other grades of mobilization that can be equally effective. Grade IV mobilization is basically taking the joint to its passive end range and oscillating with a passive overpressure. I commonly employ this technique, which I learned via McKenzie technique seminars, for patients who have contraindications to HVLA or patients who don't like cracking.
Chiropractors do learn this to a degree when we learn to perform motion palpation, but we don't appreciate that the motion palpation is a treatment as well as a test. Very often we want to jump right to the HVLA because that's what we love to do, but mobilizations can work great as well, and involve less force and less risk. Thanks again for the thought-provoking article [Dr. James Lehman's "'Don't Crack My Neck': What Do You Do Next?" September 2018 issue].
Joshua Lederman, DC, MS, CCSP, Cert. MDT
Schaumburg, Ill.
Dry Needling for the Neck
Dear Editor:
I am a chiropractor (PCCW 1995 graduate) practicing in Israel. I work two days a week at the Institute for Pain Medicine at Rambam Hospital (one of the largest hospitals in Israel). Fortunately, my boss, Dr. Vulfsons, is one of the pioneers in Israel in teaching and practicing dry needling. I got my dry needling training in 2010 and then joined the team of instructors, training mostly family practitioners, army doctors, physical therapists, osteopaths and chiropractors.
As a chiropractor, I integrate dry needling as part of my standard care for most of my patients. It is a great diagnostic and treatment tool, and luckily it is allowed under the scope of practice. So yes, there is another safe and effective way to treat a neck without "cracking" and with quick results.
Michael Moshe Danoff, DC
Kibbutz Gesher Haziv, Israel
