More than 500 people have suffered a stroke after neck manipulation, the The Guardian reports. One past study suggests neck movement can tear vertebral arteries leading to the brain, resulting in stroke. Researchers at the University of California, San Francisco, found patients younger than 60 who had strokes from vertebral artery tears were six times more likely to have had spinal manipulative therapy 30 days before.
The more recent research, published in the Journal of Neurosurgery, looked at 13 patients who suffered arterial tears within hours or days of chiropractic manipulation. Of the study’s small population sample, 31 percent ended up permanently disabled. Or died.
Larry B. Goldstein, MD, director of the Duke Stroke Center has seen cases of stroke after chiropractic manipulation, but he says it’s hard to put a number on how often it occurs. “I think you’d find that many tertiary referral centers (like Duke) see patients where this has happened,” he says. “It’s an infrequent but not impossible relationship.”
Should We All Stop Cracking Our Necks?
More than 18 million Americans seek chiropractic care, based on the 2007 National Health Interview Survey (NHIS).”My chiropractor is the best thing that ever happened to me,” a coworker chirped this morning when we talked about it.
“The number of chiropractic manipulations performed in the United States each year is in the millions,” said Wade S. Smith, MD, PhD, lead author of the UCSF study from 2003, in a release from the university. “The incidence of stroke from all causes is only 10 per 100,000, so we’re not talking about large numbers of victims.
“But rare incidences do happen, and physicians and patients should be aware of spinal manipulation therapy as a rare but potentially causal factor in stroke,” he said.
Dr. Goldstein notes certain conditions may predispose individuals for vertebral artery tears and stroke. In patients who have fibromuscular dysplasia (FMD), for example, he recommends they never have spinal neck manipulation. He’s also seen such tears happen spontaneously, when people are doing anything from lifting to laughing. “The vertebral artery goes travels through the neck. If neck is twisted, turned, extended quickly it can predispose you to having these types of tears,” he says.
Still, I think Annie and I will try to steer clear of neck-cracking as best we can. At least for now.
- Chiropractic manipulation could cause stroke, death: Study (rawstory.com)
- Roller coaster ride linked to young man’s stroke (bodyodd.msnbc.msn.com)