Having your neck adjusted by a chiropractor could be associated with an increased risk of stroke, according to a statement released by the American Heart Association.
Although, researchers cautioned that it’s not completely certain that neck manipulation causes strokes, they do want to inform people of the risks.
Neck manipulation has been associated with a risk of cervical artery dissection, a form of arterial tear that is believed to be an important cause of stroke in young and middle-aged adults.
A cervical artery dissection (CD) is a small tear in the layers of walls in the arteries in the neck. If the tear becomes dislodged into the bloodstream, it can form a clot and cause an ischemic stroke by blocking one of the blood vessels in the brain.
There are four arteries that supply blood to the brain: Two carotid arteries on each side of the neck, and the two vertebral arteries on the back of the neck. The influence of neck manipulation appears to be more important in vertebral artery dissection than in internal carotid artery dissection.
Such a tear “occurs with a sudden movement that can hyperextend or rotate the neck, such as one you may see with whiplash or sporting events, or even violent coughing or vomiting,” said statement author Dr. Jose Biller, chair of neurology at Loyola University Chicago Stritch School of Medicine. “The techniques for cervical manipulation, even though they vary among health professionals, include a rotation of the neck and sometimes a forceful thrust.”
“Although a cause-and-effect relationship between these therapies and CD has not been established and the risk is probably low, CD can result in serious neurological injury,” Biller said. “Patients should be informed of this association before undergoing neck manipulation.”
“Some symptoms, such as dizziness or vertigo, are very common and can be due to minor conditions rather than stroke,” says Biller, “but giving the information about recent neck manipulation can raise a red flag that you may have a CD rather than a less serious problem, particularly in the presence of neck pain.”
Chiropractors and osteopathic physicians should warn patients of this link, read a statement published in the Aug. 7 online edition of the journal Stroke.
“We strongly believe that patients should be informed of this association before undergoing neck manipulation,” Biller said. “Neck manipulation is associated with about one death per 1 million people due to cervical artery dissection”
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