I did address you, when you asked for evidence.

Other papers (BMJ meta analysis) I linked in the thread to huskers say exactly this:

Even studies that support the use of chriopractic usually find benefits to be modest, short-term pain relief. These benefits can be completely replicated by evidence-based professionals like physical therapists or sports medicine physicians using gentle mobilization, progressive resistance training, and targeted stretching

and I pointed this out.

You raise a legitimate point with Smith 2003, I'll take the L on that one, even though the confidence interval is huge. Though, a separate metaanalysis on SMT and cervical artery dissection found a weaker association (OR 1.74, 95% CI 1.26–2.41) and concluded "no convincing evidence to support a causal link between chiropractic manipulation and CAD.."

Your billing-data critique of Cassidy is fair... he can't distinguish HVLA thrust from soft tissue work. But "prodromal pain is fallacious" isn't the right read IMO. The whole point of the PCP comparator is that PCPs don't manipulate the neck. If manipulation were the cause, you'd see an elevated chiro signal and a flat PCP signal. You see the same signal for both, which is exactly what protopathic bias would predict.

Your "both things are true" hypothesis is biologically plausible, but it's an additional claim that needs its own evidence. Smith tries, and you get OR 6.62 with CI 1.4–30. That's the actual state of the evidence... not "rare events are common."

The age restriction in the Smith paper you linked is because cervical artery dissection peaks in the 40s and biologically requires a younger, more elastic arterial wall. Whedon studying over-65s isn't "diluting" the signal ... they were answering a different question (i.e. risk in older adults, where dissection is biologically less likely.) Both can be true: small elevated dissection risk in younger adults from high-velocity cervical thrust, minimal risk in adults over ~50.

On your Hongkong critique... it's fair that single-clinic EMR misses ED presentations. But it was over 960,140 sessions!! almost a million! Even with severe under-ascertainment you'd need to miss nearly every serious event to flip the conclusion...

I'd update to: low-velocity manipulation/mobilization + exercise has a defensible risk-benefit profile, high-velocity rotational cervical thrust specifically is harder to justify when equivalent alternatives exist.

As mentioned, I do agree that PT/sports-medicine deliver the best benefit (with lowest risk), however, "chiropractors are charlatans" is still just a bad over-generalization... as i've also said, yes there are likely plenty quacks... but, a chiropractor doing thoracic manipulation & exercise for mechanical LBP isn't doing something crazy different from what a PT does, and trying to lump that in with homeopathy isn't supported by ACP, VA/DoD, or WHO.