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Chiropractic Manipulation Can Lead to Stroke

Posted by Mara Calomino Jan 16 2014

Each year almost 20 million Americans who are seeking respite from back pain, neck pain, headaches and sinus problems visit the chiropractor. For many, the manipulations provide some relief. But some of these techniques, including cervical neck manipulation or “cracking the neck,” raise concerns that it may cause permanent damage.


Neck and Spinal Manipulation

Due to a lack of large scale studies, evidence to show the effectiveness of chiropractic manipulation is inconclusive. Some research shows that spinal manipulation can be helpful to relieve headaches and migraines, lower blood pressure and ease some back pain. But other studies go on to suggest that the sudden, powerful thrusts used in neck manipulations are cause for concern and could even cause tears in the carotid or vertebral artery. Tears like this can cause a blood clot that travels to the brain causing a stroke.

A 2010 study investigating deaths after spinal manipulation found 26 published and seven unpublished cases, most due to tears. And it suggested that many more cases had gone unreported. A 2013 survey of 46 studies conducted between 2001 and 2011 found 707 occurrences of stroke associated with cervical spinal manipulation, but understanding these cases was inhibited due to inadequate information.

Understand the Risk

Felipe Albuquerque, a neurosurgeon in Phoenix who has studied stroke injury after neck manipulation, determined that those who suffered neck tears in their arteries would have had a stroke regardless of their treatment, claiming it to be a coincidence.

Alan Lichter, a practicing Washington chiropractor, says “…more and more research shows that those who had strokes had a preexisting condition…there may be some risk for people who are already at risk.”

The parents of Jeremy Youngblood, a healthy, 30-year-old man, wish he would have known the risk before accepting treatment for lower back pain in 2011. It was his first visit. He died four days later from “acute cerebral infarction due to neck manipulation.”


While an association between cervical neck manipulation and stroke remains inconclusive and controversial, it is a treatment that has potentially severe side effects. Most people who are at risk of vertebral artery dissection will not be aware that a small tear is already present. It is important to discuss the potential risks with your practitioner before accepting treatment.

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