This week we discuss cervical examination for vascular pathology prior to cervical manipulation. In general, our biases are against cervical manipulation. However, if you choose to perform cervical manipulations, this could be a useful paper to understand to limit the risk of adverse event from the technique. The authors primarily advocate for thorough history taking, multiple clinical tests including blood pressure and cranial nerve exam, and utilizing clinical reasoning and prior knowledge of neurovascular pathology presentation and risk factors to appropriately determine safety of cervical manipulation. While we agree this is crucial to ensuring safety performing the technique, we wonder if clinicians are able/willing to spend the amount of time required to perform all the appropriate screening prior to performing a cervical manipulation? The abstract can be found here: https://www.jospt.org/doi/epdf/10.2519/jospt.2022.11147 As always, if you enjoy what you hear, be sure to follow us on your favorite podcast platform and on Instagram @readingrehabpod.  If you have any article recommendations be sure to send them our way!

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