Chiropractic Neck Adjustment Risks
Chiropractic manipulation of the cervical spine, or neck, can cause dizziness, headache, vertigo and lead to stroke. Compression of the cervical arteries is a major concern and is not often disclosed to the patient before treatment in order to prevent increased anxiety levels and potential refusal of chiropractic care. When receiving neck adjustments by a chiropractor, you should always inquire about potential risks associated with the treatment.
Cervical Artery Dissection
Cervical artery dissection, or CAD, describes the separation of vessel wall layers of the carotid or vertebral arteries in the neck, or cervical spine. This condition is the most common cause of stroke in young people and is characterized by neck pain, headache and vision loss. An article in the June 2010 issue of “The Open Neurology Journal” lists major head and neck trauma due to automobile accidents and chiropractic maneuvers as the two most important risk factors for CAD. The authors further described emerging risk factors for this condition and stated that the cause of CAD is not fully understood and requires further investigation.
- Cervical artery dissection, or CAD, describes the separation of vessel wall layers of the carotid or vertebral arteries in the neck, or cervical spine.
- An article in the June 2010 issue of “The Open Neurology Journal” lists major head and neck trauma due to automobile accidents and chiropractic maneuvers as the two most important risk factors for CAD.
Vertebrobasilar Stroke
Cons of Chiropractic Care
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Vertebrobasilar, or VBA, stroke is a disorder caused by reduced blood flow through the arterial system in the neck. VBA stroke can be brought on by compression of the external wall of the carotid or vertebral arteries due to chiropractic adjustments of the neck. A study in the March 2010 issue of “Spine” investigated the correlation between chiropractic care and VBA stroke in patients admitted to an Ontario, Canada, hospital between 1993 and 2002. Researchers identified 818 VBA strokes and found that patients younger than 45 years were three times more likely to have seen a chiropractor before the onset of stroke, compared to those over 45. However, they did not find evidence of an increased risk of VBA stroke associated with chiropractic care compared to primary care by a physician.
- Vertebrobasilar, or VBA, stroke is a disorder caused by reduced blood flow through the arterial system in the neck.
- A study in the March 2010 issue of “Spine” investigated the correlation between chiropractic care and VBA stroke in patients admitted to an Ontario, Canada, hospital between 1993 and 2002.
Minor Side-Effects
According to an article in the October 2007 issue of “Spine,” the risks of adverse effects of chiropractic manipulation of the cervical spine are unknown. Researchers reviewed treatment outcomes of over 19,000 patients and found no reports of serious adverse effects. However, the study did note minor side effects including fainting, dizziness and headache in approximately 15 per 1,000 adjustments. The authors concluded that chiropractic adjustment of the cervical spine was relatively safe.
- According to an article in the October 2007 issue of “Spine,” the risks of adverse effects of chiropractic manipulation of the cervical spine are unknown.
- However, the study did note minor side effects including fainting, dizziness and headache in approximately 15 per 1,000 adjustments.
Disclosure by Chiropractors
Cervical Traction Contraindications
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A study in the October 2010 issue of “Chiropractic & Osteopathy” investigated the frequency of risk disclosure by chiropractors and consequent withdrawal from treatment as a result. Researchers distributed questionnaires to 200 chiropractors in the U.K. and found that 88 percent of the respondents considered the disclosure of treatment risk to be important when obtaining consent for treatment. However, the researchers noted that only 45 percent of the practitioners admitted that they always discuss the risks of cervical manipulation with their patients. Additionally, 46 percent of the chiropractors admitted that disclosure of possible complications would increase the anxiety levels of their patients to a point where they might refuse treatment.
- A study in the October 2010 issue of “Chiropractic & Osteopathy” investigated the frequency of risk disclosure by chiropractors and consequent withdrawal from treatment as a result.
- Researchers distributed questionnaires to 200 chiropractors in the U.K. and found that 88 percent of the respondents considered the disclosure of treatment risk to be important when obtaining consent for treatment.
Related Articles
References
- “Chiropractic & Osteopathy”; Withdrawal Rates as a Consequence of Disclosure of Risk Associated with Manipulation of the Cervical Spine; J. Langworthy; October 2010
- “Spine”; Safety of Chiropractic Manipulation of the Cervical Spine: A Prospective National Survey; H. Theil, et al.; October 2007
- “Spine”; Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study; J. Cassidy, et al.; March 2010
- “The Open Neurology Journal”; Cervical Artery Dissection: Emerging Risk Factors; S. Micheli, et al.; June 2010
- Branney J, Breen AC. Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study. Chiropr Man Therap. 2014;22:24. doi:10.1186/s12998-014-0024-9
- Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. Spine J. 2010;10(2):117-28. doi:10.1016/j.spinee.2009.09.002
- Digiorgi D. Spinal manipulation under anesthesia: a narrative review of the literature and commentary. Chiropr Man Therap. 2013;21(1):14. doi:10.1186/2045-709X-21-14
- American Chiropractic Association. American Board of Chiropractic Specialties (ABCS).
- Margach RW. Chiropractic functional neurology: An introduction. Integr Med (Encinitas). 2017;16(2):44-45.
- Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89. doi:10.1016/j.jmpt.2011.04.008
- Centers for Disease Control and Prevention. Use of yoga, meditation, and chiropractors among U.S. adults aged 18 and over.
- National Center for Complementary and Integrative Health. Chiropractic: in depth. Updated April 2019.
- National Health Statistics Report. Trends in the use of complementary health approaches among adults: United States, 2002–2012. Updated February 10, 2015.
- University of Minnesota. Taking Charge of Your Health & Wellbeing. How can I find a qualified chiropractor?
Writer Bio
Sam Lupica began scientific writing in 2007, specializing in physiology, toxicology and reproductive biology. He teaches chemistry and biology, and has published several journal articles in "Aquaculture Research" as well as informational articles in online publications. Lupica is finishing a Ph.D. in medical science and has a Master of Science in physiology and pharmacology from the University of Toledo College of Medicine.