Getting your neck adjusted - how worried should we be?

In response to The New York Times article "Little risk of stroke from neck adjustments" published yesterday on September 4th in "Mind Your Body", as a chiropractor, I have just something to add.

"The claim: Manipulating your neck could lead to a stroke."
Could it? There have been people who suffered a stroke after neck manipulation. It mentions forceful twisting of the neck by chiropractors. However, the forceful twisting of the neck has also been performed by barbers, bonesetters, osteopaths, manual therapists, yoga instructors ... People have also been known to have suffered a stroke after a visit to the hair salon for a hairwash. Rare incidents of strokes have been reported of people who looked at the sky or over their shoulder. Placing your neck in a vulnerable position (kind of at the sky straight up then turn your head slightly) could very well just do it even without force.

These are triggering events that led up to the unfortunate event in a person already predisposed to stroke.

Is there any sure way of ascertaining who might be more at risk from stroke after neck manipulation? No. Persons who are worried may ask their doctor if they are in the first place at risk from a stroke.

The results of a ten year study by the The Bone and Joint Decade 2000 – 2010 launched in Geneva in January 2000 during a World Health Organization (WHO) conference on “The Burden of Musculoskeletal Conditions at the Start of the New Millennium” should put some issues to rest.

There are people at higher risk of developing strokes due to lifestyle factors like smoking and drinking. They may be genetically more predisposed to suffering from a stroke, or may already suffer from high blood pressure or heart disease. The integrity of the blood vessels in their neck may be compromised and since there is no effective way to screen them, perhaps those with a medical history suggesting a higher risk of stroke should be aware that a neck adjustment has a remote chance of bringing on a stroke in these people. Having said that, people who have visited a GP for a headache or neck complaint are not less likely to suffer from a stroke thereafter (see significant findings of the Bone and Joint Decade).

With any clinical procedure, the benefits of an adjustment has to be weighed against the perceived risk. An adjustment skillfully performed, involving minimal rotation, carries very little risk to the vertebral arteries.

Ask your chiropractor about the Activator method, mobilisation, manual traction, soft tissue work, myofascial releases, which can all help with a bad neck. There are more ways than one. Chiropractors are well known for their neck adjustments called "cervical spinal manipulation". Hopefully, we can deliver similarly spectacular results using non-force techniques ... but they usually require more time.