Controversial Chiropractic Neck Adjustment Technique Raises Concerns of Stroke Risk, Say Doctors

Chiropractic neck adjustment Controversial Chiropractic Neck Adjustment Technique Raises Concerns of Stroke Risk, Say Doctors
Controversial Chiropractic Neck Adjustment Technique Raises Concerns of Stroke Risk, Say Doctors

Controversial Chiropractic Neck Adjustment Technique Raises Concerns of Stroke Risk, Say Doctors


Chiropractic care is a popular alternative treatment method for various musculoskeletal conditions. One of the most common techniques used by chiropractors is the neck adjustment, also known as cervical manipulation. This technique involves applying a high-velocity, low-amplitude force to the neck joints with the aim of improving mobility and reducing pain. However, recent concerns raised by doctors regarding the potential risk of stroke associated with chiropractic neck adjustments have sparked a heated debate within the medical community.

The Controversy

Understanding Chiropractic Neck Adjustments

Chiropractic neck adjustments are performed to correct subluxations, or misalignments, in the cervical spine. The chiropractor applies a quick thrust to the neck joints, often accompanied by a cracking sound, which is believed to release pressure, improve joint mobility, and alleviate pain. While many patients report positive outcomes and relief from their symptoms, the safety of this technique has come under scrutiny.

The Risk of Stroke

Doctors have expressed concerns that chiropractic neck adjustments may increase the risk of stroke, specifically a type called vertebral artery dissection (VAD). The vertebral arteries are located in the neck and supply blood to the brain. Manipulation of the neck may potentially cause a tear in the wall of these arteries, leading to blood clot formation and subsequent stroke. Although the risk of stroke associated with chiropractic care is relatively low, the potential consequences are serious, and it is crucial to consider this risk when deciding on treatment options.

Evidence and Research

The Association Between Neck Adjustments and Stroke

Several studies have investigated the link between chiropractic neck adjustments and stroke. A systematic review published in the journal Spine in 2014 analyzed the available research and found a small association between chiropractic neck manipulation and vertebral artery dissection. However, it is important to note that the reported association does not imply direct causation, and the overall risk remains relatively low.

Identifying Patients at Risk

In order to minimize the potential risk of stroke, doctors emphasize the importance of proper patient selection. Those with a history of certain medical conditions, such as connective tissue disorders, previous neck injuries, high blood pressure, or a predisposition to blood clotting, may be at higher risk for complications from neck adjustments. It is crucial for chiropractors to conduct thorough evaluations and assess the individual risk factors before proceeding with any manipulation techniques.

Appropriate Assessment and Regulation

Improving Communication and Informed Consent

To address concerns regarding the safety of chiropractic neck adjustments, doctors and chiropractors alike stress the need for open and transparent communication with patients. It is vital for chiropractors to inform patients about the potential risks, benefits, and alternatives to neck adjustments before proceeding with treatment. Informed consent should be obtained, allowing patients to make educated decisions about their own healthcare.

Standardization of Training and Techniques

Regulatory bodies acknowledge the need for standardized training and techniques in the chiropractic profession to ensure patient safety. By establishing clear guidelines and protocols, chiropractors can enhance their skills and knowledge to minimize the potential risks associated with neck adjustments. Continuous professional development and adherence to evidence-based practices are essential for maintaining the highest standard of care.

The Importance of Shared Decision-Making

Empowering Patients in their Healthcare

Shared decision-making between patients and healthcare providers is crucial in ensuring the best possible outcomes. By actively involving patients in the decision-making process, healthcare professionals can inform and educate them about the potential risks and benefits of various treatment options. This collaborative approach enables patients to make informed decisions that align with their values, preferences, and individual risk factors.


While chiropractic neck adjustments have been widely used for the management of musculoskeletal conditions, concerns regarding the potential risk of stroke have raised important questions. Although the exact association between neck manipulation and stroke remains under debate, doctors emphasize the need for appropriate patient selection, improved communication, standardized training, and shared decision-making to ensure the safety and efficacy of chiropractic care. It is crucial for patients to consult with their healthcare providers, weigh the potential risks and benefits, and make informed decisions about their own well-being.

Frequently Asked Questions

1. Are chiropractic neck adjustments safe?

Chiropractic neck adjustments carry a small risk of stroke, specifically vertebral artery dissection. While this risk is relatively low, it is important for patients to discuss their individual risk factors with a healthcare provider before undergoing any neck manipulation techniques.

2. How can I ensure the safety of chiropractic care?

To ensure the safety of chiropractic care, it is crucial to choose a qualified and licensed chiropractor who adheres to evidence-based practices. Open communication, informed consent, and thorough evaluations are essential components of safe chiropractic treatment.

3. Are there alternative treatment options for neck pain?

Yes, there are alternative treatment options for neck pain, including physical therapy, massage, acupuncture, and pain medications. It is important to consult with a healthcare provider to determine the most suitable approach based on individual needs and preferences.[3]

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