This post is one doctor's account of one case, and I can't verify the details from here. The risk it describes is real, though, and it's documented. Cervical artery dissection (a tear in the wall of a neck artery, most often the vertebral arteries) is rare, but it can cause a stroke, and it has been linked to neck manipulation, especially quick rotational thrusts to the upper neck.
What the studies show and don't show:
- Case reports and case series describe strokes shortly after neck manipulation. They show that it can happen, not how often.
- Population studies are mixed. A 2008 study in the journal Spine by Cassidy and colleagues found an association between chiropractic visits and vertebrobasilar stroke, but it also raised the possibility that some early neck-artery tears cause neck pain that sends people to a chiropractor in the first place. That makes cause and effect hard to separate.
- The absolute risk is very low by most estimates, but estimates vary widely between studies.
If you want to keep your neck safe, ask any provider what technique they plan to use, and say no to fast, forceful rotation of the upper neck. Gentler options such as physical therapy, mobility work or massage exist for most neck complaints.
If you get sudden severe neck or head pain, dizziness, double vision, slurred speech, facial numbness or weakness, or trouble walking after any neck manipulation, call your local emergency number right away. Don't wait to see if it passes.
