April 24, 2019
Stroke and Neck Manipulation
Ask the Experts

Stroke and Neck Manipulation

by Berkeley Wellness  

Q: Can chiropractic neck manipulation cause a stroke?

A: Maybe. But the risk, if it exists, is very low. The concern is that neck manipulation— in which the chiropractor “aligns” the spine by abruptly rotating the head—may stretch and tear the vertebrobasilar artery in the upper neck, causing vertebral artery dissection (VAD). Untreated, VAD can block blood flow to the brain and cause a life-threatening stroke.

This has been a hot topic among doctors and chiropractors over the years. Several small studies raised concerns, and in 2002, a group of Canadian neurologists spoke out against neck manipulation.

However, there have been no large, well-designed studies showing a clear link between stroke and neck manipulation. No one knows whether the treatment can cause VAD or whether people who have a stroke following manipulation had VAD before they visited their chiropractor. VAD symptoms include neck pain, which may be a reason why people with the condition sometimes seek chiropractic care.

In addition, estimates of serious complications from neck manipulation vary wildly, ranging from one in 40,000 manipulations to one in 10 million—numbers so low as to be insignificant.

Nevertheless, we advise avoiding neck manipulation. There is no scientific evidence that it is beneficial, so even a tiny risk of a devastating stroke is unacceptable. Despite some claims, the “click” or popping sound that may occur during neck manipulation does not indicate that the procedure has corrected some problem.