The Claim: Manipulating Your Neck Could Lead to a Stroke

By ANAHAD O’CONNOR

THE FACTS
31 aug 2008--Manipulating your neck is supposed to relieve pain, not cause it. But years ago neurologists noticed a strange pattern of people suffering strokes shortly after seeing chiropractors, specifically for neck adjustments.
Their hypothesis was that a chiropractic technique called cervical spinal manipulation, involving a forceful twisting of the neck, could damage two major arteries that lead through the neck to the back of the brain. Strokes in people under age 45 are relatively rare, but these cervical arterial dissections are a leading cause of them.
Studies that followed suggested a link. One at Stanford that surveyed 177 neurologists found 55 patients who suffered strokes after seeing chiropractors. Another, published in the journal Neurologist, said young stroke patients were five times more likely to have had neck adjustments within a week of their strokes than a control group. It estimated an incidence of 1.3 cases for every 100,000 people under 45 receiving neck adjustments.
But other studies have cast doubt. One published this year examined 818 cases of stroke linked to arterial dissections at the back of the neck. Before their strokes, younger patients who saw chiropractors were more likely to have complained beforehand of head and neck pain — symptoms often preceding a stroke — suggesting they had undiagnosed dissections and had sought out chiropractors for relief, not realizing a stroke was imminent.
THE BOTTOM LINE
Forceful neck manipulation seems to carry a small risk of arterial tears.