In the 1990s, two deaths in Canada attracted national attention when the cause of death was stroke following a chiropractic neck adjustment. This resulted in a call from neurologists to avoid cervical adjustments for neck pain. Some individuals avoid chiropractic care due to this risk or were warned never to let a chiropractor adjust their neck. However, the question that must be answered is if the stroke was truly caused by the chiropractor’s adjustment or was it just a correlation between the stroke and the adjustment. The odds of an individual having a stroke in their lifetime is about 1-in-100,000. So roughly .001%. Does going to a chiropractor increase your chances of stroke?
The main artery at risk for stroke during any head movement is the vertebra-basilar artery. The vertebra-basilar artery travels up through these small holes next to the bones of the neck. The prevailing theory is that as the artery transcends from the top of the neck into the skull, adjusting the neck with rapid rotation causes damages to the artery.
Patients with a vertebra-basilar dissection (a tear in the outside of the artery shown below) exhibit neck pain and headaches as their most common symptoms.
This dissection may lead to a stroke by the blood inside the vessel pooling around in-between the artery’s layers, causing a clot to form, which may lead to a stroke. However, these dissections occur spontaneously, from internal factors such as connective tissue disorders, hypertension, infection, or plaque buildup, rather than external forces like an adjustment.
Cassidy et al. (source population of over 100 million individuals) has done the most thorough study. In this study, they found an association between chiropractic visits and vertebral artery strokes (VBA). However, this association was no greater than a visit to your medical doctor.
A plausible explanation is that patients with head and neck pain due to vertebral artery dissection seek care from either their chiropractor or medical doctor, subsequently developing a stroke shortly after regardless of the treatment given.
In the studies mentioned above, they found “...no evidence of excess risk of VBA stroke associated with chiropractic care”.
Although there is some association with chiropractic adjustments and strokes, there are similar associations between primary care physician visits and strokes, deeming the adjustment an unlikely cause. This is phenomenal news and should put chiropractic patients at ease. However, make sure you have a chiropractor you trust that performs a thorough history and exam to decide whether you would be a good candidate for chiropractic treatment.
At Comprehensive Chiropractic, we utilize various treatments for neck pain, so if you are uneasy about going to a chiropractor because of the adjustment, do not let that stop you from finding relief. We will tailor a treatment plan customized for you and your goals to fix your pain.
Source:
Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine (Phila Pa 1976). 2008 Feb 15;33.
Dr. Caleb Gorman graduated from Logan University in Chesterfield, Missouri in 2020. He has a passion for functional movement, rehabilitation, and sports performance. Dr. Gorman has extensive knowledge of the human musculoskeletal system as he served as an anatomy and neuroanatomy tutor at Logan University’s Cadaver Lab for over two years. Caleb’s treatment and assessment certifications include Active Release Technique (ART), Dynamic Neuromuscular Stabilization (DNS), Selective Functional Movement Assessment (SFMA), and Trigger Point Dry Needling.
Comprehensive Chiropractic & Sports Performance is your Complete Wellness Center. St. Louis turns to us for chronic pain relief, injury rehabilitation, and treatment for many other conditions. We believe that our health is our greatest asset. Any effort we make towards taking care of ourselves is valuable and necessary.
Very informative. Food for thought! Thanks.