The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (2023)

Abstract

Chiropractic cervical manipulation is a common practice utilized around the world. Most patients are never cleared medically for manipulation, which can be devastating for those few who are at increased risk for dissections. The high velocity thrust used in cervical manipulation can produce significant strain on carotid and vertebral vessels. Once a dissection has occurred, the risk of thrombus formation, ischemic stroke, paralysis, and even death is drastically increased. In this case report, we highlight a case of a 32-year-old woman who underwent chiropractic manipulation and had vertebral artery dissection with subsequent brainstem infarct. She quickly deteriorated and passed away shortly after arrival to the hospital. Although rare, one in 48 chiropractors have experienced such an event. We utilize this case to highlight the risk associated with cervical manipulation and urge open dialogue between chiropractors and physicians. Receiving medical clearance prior to cervical manipulation in potential at risk patients would drastically reduce morbidity and mortality.

Key words

Chiropractic manipulation, Vertebral artery dissection, Brainstem infarct, Open communication, Medical clearance

Introduction

Spinal manipulation, a hallmark practice of chiropractic providers and a practice occasionally utilized by physiotherapists, osteopaths, and physicians, is often viewed as a controversial and potentially dangerous procedure without good evidence supporting its use [1]. Specifically, epidemiologic associations have been observed between chiropractic maneuvers and cervical artery dissection, although it has been difficult to prove causal relationship [2-4]. The potential consequence of cervical artery dissection is stroke, which may have a range of consequences with regards to long-term morbidity and mortality [5-7].

Herein, we report a case of vertebral artery dissection and subsequent brainstem infarction immediately following chiropractic manipulation in a young female patient. This patient experienced rapid deterioration immediately following manipulation and proceeded to undergo cardiac arrest prior to presentation to the hospital and subsequent death. This case serves to highlight the potential dangers of chiropractic manipulation and provides a thorough review of the literature relating chiropractic manipulation and stroke. Furthermore, this case presentation demonstrates a likely causal relationship although prior imaging was not available to rule out a pre-existing dissection. The case therefore satisfies many of the criteria proposed by Hill [8] and used by Tuchin [9] to refute the role of chiropractic manipulation in dissection and stroke.

Case Presentation

The patient, a 32-year-old Caucasian woman, presented to the West Virginia University Hospital Emergency Department via Emergency Medical Services. The patient had been at her usual baseline state of health with no significant past medical history prior to visiting the chiropractor for neck adjustment earlier that day for tension like soreness. The patient underwent neck manipulation after which she immediately complained of neck pain, diaphoresis, and proceeded to experience cardiac and respiratory arrest. Emergency Medical Services was called, and cardiopulmonary resuscitation was performed with one round of epinephrine administered. It was reported that the patient was pulseless and apneic for 3 minutes prior to EMS arrival. The patient was intubated on transport and her Glasgow Coma Scale score was 3T prior to arrival. Mean arterial blood pressure was 80 with palpable femoral pulses at arrival to the emergency department. Upon arrival in the emergency department, a CT stroke protocol was performed which demonstrated bilateral severe distal cervical vertebral artery dissections with acute thrombotic emboli seen in the left cervical vertebral artery (Figures 1 and 2). This was accompanied by complete occlusion of the basilar tip including the proximal posterior cervical arteries. The patient received an initial bolus of intravenous tissue plasminogen activator (IV rtPA) at this time and the decision was made to proceed with endovascular intervention given the recent onset of occlusion.

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (1)

Figure 1. CT Stroke Protocol at time of presentation. A.) 4D CTA demonstrating top of the basilar occusion and poor flow in the right vertebral artery; B.) coronal CA demonstrating dissection of verterbral arteries at the C1-C2 level, particularly prominent on the right; C.) relative blood volume; and D.) corrected relative blood volume.

(Video) The Truth About Chiropractic Adjustments

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (2)

Figure 2. CT Stroke Protocol with perfusion imaging demonstrating primary involvement of occipital lobe, cerebellum, and brainstem. Perfusion imaging reflecting rCBV, TTP, rCBF, MTT, and delay (from top-left to bottom-right).

The patient was brought to the neurovascular angiography suite and femoral access obtained. Angiography of the left vertebral artery demonstrated severe dissection involving the distal cervical vertebral artery segments at the C1-C2 level with presence of sub occlusive thrombi. There was an occlusive clot in the left Posterior Inferior Cerebellar Artery (PICA). Intracranial imaging demonstrated occlusion at the basilar apex with absent filling into the right Posterior Cerebral Artery (PCA). There was occlusion of the distal left PCA. Angiography of the right vertebral artery demonstrated severe dissection of the distal cervical vertebral artery at C1-C2 with the presence of trickle-like flow into the vertebrobasilar junction. No filling was observed in the right PICA territory (Figure 3). At this point, it was decided that the left vertebral artery offered the best access to the basilar trunk.

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (3)

Figure 3. Digital subtraction angiography at time of presentation demonstrating A.) anterior-posterior view showing basilar and PICA occlusion, B.) lateral view showing basilar and PICA occlusion, C.) left vertebral artery dissection, and D.) right vertebral artery dissection.

Subsequently, distal aspiration was begun with a Penumbra 5 Max ACE distal aspiration catheter which initially demonstrated slow flow through the suction tubing. The 5 Max ACE was withdrawn into the proximal basilar artery until flow was seen within the suction tubing. Repeat angiography at this time demonstrated recanalization of the basilar apex and proximal PCAs. TICI3 perfusion was seen in the right PCA. Occlusive clot remained in the left distal P2 segment. Given the large size of the PCA, timing of events, and patient’s age, the decision was made to attempt clot retrieval of this. At this time, the Trevo ProVue microcatheter was navigated into the left distal PCA distal to the clot. The Trevo 4 mm x 30 mm stent retriever was deployed for approximately 3 minutes. The suction canister was attached, and the stent retriever was pulled with distal aspiration. No significant recanalization was achieved with what amounted to TICI0 perfusion to the left PCA territory. No further attempts were made as it was believed that the left PCA territory had completed its infarction.

Following completion of endovascular therapy, the patient was taken for immediate MRI Brain with and without contrast for assessment of brainstem integrity and cerebrovascular status prior to transport to the intensive care unit. MRI demonstrated extensive areas of restricted diffusion accompanied by perfusion abnormalities consistent with acute infarction of the posterior circulation, specifically within the bilateral cerebellar hemispheres, right medulla, pons bilaterally, midbrain, thalami, and left occipital lobe (Figure 4). The following day, additional CT Brain imaging was acquired and demonstrated signs of elevation of intracranial pressure with hydrocephalus, worsening of cerebral edema diffusely, hemorrhagic transformation of the left occipital lobe, continued infarct evolution within the posterior circulation, and cerebellar tonsillar herniation.

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (4)

(Video) Illusion and Truth of bone cracking sound [essential test before cracking your neck!]

Figure 4. Immediate post-procedure magnetic resonance imaging demonstrating ischemic stroke within the cerebellum, brainstem, and left occipital cortex. A.) attenuated diffusion coefficient (ADC) sequence capturing left occipital stroke and B.) diffusion-weighted imaging capturing cerebellar, brainstem, and left occipital cortex stroke.

Discussion

Arterial dissection, particularly as related to the cervical arteries and risk of ischemic stroke, has become a topic of increasing interest in recent years. Many potential risk factors have been identified that include genetic disorders such as α1-antitrypsin (α1-AT) deficiency [10-12], connective tissue disease [13-15], MTHFR TT genotype [16], homocysteine concentration within the serum [16,17], history of migraine [18-20], variations in cardiac/cervical vessel anatomy [21-25], infection [10,19], oral contraceptive use [10,18,20], and trivial trauma [26-30]. A more rigorous analysis of these studies in the systematic review by Rubinstein and colleagues and additional completion of larger/more focused studies have failed to confirm that many of these variables are risk factors for dissection [31].

Cerebral and vertebral artery dissections can occur both at the chiropractor’s office and at home when practicing self-manipulation techniques [32]. Multi-artery dissection is a rare occurrence following chiropractic manipulation but can lead to extensive infarct and adverse outcomes [33]. A recent systematic review found that 901 cases of cerebral artery dissections have been reported in the literature in relation to chiropractic manipulation. In 707 of these cases, the patient went on to develop some type of stroke [34]. Notably, a study focused on malpractice data from the Canadian Chiropractic Protective Association (CCPA) showed a low incidence of neurological symptoms attributable to cervical manipulation and arterial dissection following chiropractic manipulation [35]. Specifically, data from the report suggests that a chiropractor will be aware of an arterial dissection occurring following cervical manipulation only once in 8.06 million office visits with only one in forty-eight chiropractors experiencing such an event in their entire careers [35]. Chiropractors are inexperienced in detecting the signs and symptoms of a dissection.

Diagnosing thrombosis early in these cases is critical for successful endovascular or surgical intervention [36]. For example, a recent case report showed that a patient with vertebral artery dissection and infarction following chiropractic manipulation was successfully treated with mannitol and ventriculostomy [37]. Unfortunately, despite early identification, cerebrovascular injury has resulted in at least 26 reported deaths following chiropractic spinal manipulation [38]. For our patient, clot formation was observed in the PICA, basilar apex, and distal P2 segment limiting endovascular and surgical options. Endovascular diagnosis and attempted treatment failed. The patient subsequently went on to develop hemorrhagic transformation, severe cerebral edema, and ultimately cerebellar tonsillar herniation. The key learning points for this case revolve around prevention.

Futch et al., 2015 urge chiropractic colleagues to have a high suspicion of vertebral artery dissection when patients come in for treatment with sudden neck pain and headache [39]. The use of magnetic resonance angiography in these cases may prevent the chiropractor from performing potentially dangerous manipulations in at risk individuals. Green and colleagues present modified manipulation techniques that don’t involve high velocity movements. These techniques might minimize the rotation of the neck and can potentially prevent vascular dissections [40]. In a cadaveric study, Piper and colleagues show that strain and peak angular displacement during spinal manipulation is highly variable between individuals. The peak strain often occurs at an intermediate point during the movement of the neck [41]. Therefore, even in experienced hands, a high velocity spinal manipulation may not be safe based on individual anatomical differences in patients

Based on the several reported cases of complications following spinal manipulation, we encourage increased communication between chiropractic and medical colleagues. A low threshold should exist for chiropractors to consult physicians in order to make sure the patient is cleared for manipulation. If the patient has been seen at a medical facility and MRI or CT images are suggestive of potential risks, this information needs to be communicated to the patient regarding heightened potential for adverse outcomes related to manipulation. Tarola and Phillips report a case where acute onset neck pain in a patient motivated the chiropractor to refer the patient to the emergency department before manipulation. MRA revealed vertebral artery dissection therefore preventing a potentially devastating outcome if manipulation had been performed [42]. In the future, mechanoreceptor data may be a viable option to investigate the safety of manipulation and thrust procedures on muscle spindle responses [43]. This neural based stimulation in conjunction with clinical judgment may be used to select patients at low risk for vascular injury.

Conclusion

High velocity thrust manipulation of the cervical spine places the carotid and vertebral arteries at risk of dissection. Even with early diagnosis, thrombus occlusion and subsequent infarction can lead to serious adverse outcomes. We report a case of a young woman who had bilateral vertebral artery dissections following chiropractic manipulation. The patient had thrombus occlusion that was not amenable to endovascular treatment and developed hemorrhagic transformation, cerebral edema, and cerebellar herniation. Additionally, ongoing research is necessary to determine the safety of cervical manipulation and whether the techniques should be modified in order to prevent injury.

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  37. Mikkelsen R, Dalby RB, Hjort N, Simonsen CZ, Karabegovic S (2015) Endovascular Treatment of Basilar Artery Thrombosis Secondary to Bilateral Vertebral Artery Dissection with Symptom Onset Following Cervical Spine Manipulation Therapy. Am J Case Rep 16: 868-871. [Crossref]
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Editorial Information

Editor-in-Chief

Jin-Wen Xu
Shanghai University
China

Article Type

Research article

Publication history

Received date: March 08, 2018
Accepted date: March 25, 2018
Published date: March 25, 2018

Copyright

© 2018 Turner RC. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Turner CR (2018) The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature. Biomed Res Rev 2: DOI: 10.15761/BRR.1000110

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Corresponding author

Brandon Lucke-Wold

Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

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The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (5)

Figure 1. CT Stroke Protocol at time of presentation. A.) 4D CTA demonstrating top of the basilar occusion and poor flow in the right vertebral artery; B.) coronal CA demonstrating dissection of verterbral arteries at the C1-C2 level, particularly prominent on the right; C.) relative blood volume; and D.) corrected relative blood volume.

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (6)

Figure 2. CT Stroke Protocol with perfusion imaging demonstrating primary involvement of occipital lobe, cerebellum, and brainstem. Perfusion imaging reflecting rCBV, TTP, rCBF, MTT, and delay (from top-left to bottom-right).

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (7)

Figure 3. Digital subtraction angiography at time of presentation demonstrating A.) anterior-posterior view showing basilar and PICA occlusion, B.) lateral view showing basilar and PICA occlusion, C.) left vertebral artery dissection, and D.) right vertebral artery dissection.

The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature (8)

(Video) HALL D DAY 1 SESSION 6 SURGICAL CORNEA

Figure 4. Immediate post-procedure magnetic resonance imaging demonstrating ischemic stroke within the cerebellum, brainstem, and left occipital cortex. A.) attenuated diffusion coefficient (ADC) sequence capturing left occipital stroke and B.) diffusion-weighted imaging capturing cerebellar, brainstem, and left occipital cortex stroke.

FAQs

What are the risks of chiropractic neck adjustments? ›

Serious complications associated with chiropractic adjustment are overall rare, but may include: A herniated disk or a worsening of an existing disk herniation. Compression of nerves in the lower spinal column. A certain type of stroke after neck manipulation.

Does cervical manipulative therapy cause vertebral artery dissection and stroke? ›

Conclusions: Weak to moderately strong evidence exists to support causation between CMT and VAD and associated stroke. Ultimately, the acceptable level of risk associated with a therapeutic intervention like CMT must be balanced against evidence of therapeutic efficacy.

Can chiropractic adjustments cause strokes? ›

Chiropractic adjustments causing strokes are rare, according to Haboubi. "Yeah, we do see it. It is a rare complication. It occurs in about 1 in ever 20,000 spinal manipulations.

Can chiropractic cause carotid artery dissection? ›

Patients can be at risk of carotid artery dissection and ischemic stroke after cervical chiropractic manipulation. However, such risks are rarely reported and raising awareness can increase the safety of chiropractic manipulations.

Can you get a stroke from neck adjustment? ›

If you're in the habit of having your neck adjusted by a chiropractor, Michigan Medicine neurologist Mollie McDermott, M.D., wants to share some important information: High-velocity neck manipulation can result in a vertebral artery dissection, which can lead to stroke.

Can a neck injury cause a stroke? ›

If a cervical artery in the neck becomes damaged, it can cause a dissection, which is damage to the inside of a blood vessel,” Dr. Zand explained. “This can cause abnormal blood flow and clotting – those clots can block the artery or broken off and flow north to the brain and cause a stroke.”

What type of stroke comes after neck manipulation? ›

For neurologists, there is a little doubt that chiropractic manipulation can cause vertebral artery dissection, with more than 100 reported cases of posterior circulation stroke occurring during or immediately after cervical manipulation.

Can chiropractor cause dissected artery? ›

Vertebral artery aneurysms and dissections are known complications of spinal manipulation procedures (1, 2). An estimated 1 in 20,000 spinal manipulations results in a vertebral artery aneurysm/dissection and ischemic infarct, but the exact incidence of this complication is unknown (3).

Can a chiropractor tear an artery? ›

Multi-artery dissection is a rare occurrence following chiropractic manipulation but can lead to extensive infarct and adverse outcomes [33]. A recent systematic review found that 901 cases of cerebral artery dissections have been reported in the literature in relation to chiropractic manipulation.

Can a chiropractor cracking your neck cause a stroke? ›

Neck cracking, also known as neck manipulation, can be used to help treat neck pain. In very rare cases, this has led to a stroke. This can happen if an artery in the neck tears. A blood clot can form, blocking blood flow to the brain.

What happens when your neck gets adjusted? ›

Some of the benefits of neck cracking include relief from soreness or pain, realignment of misaligned joints, feeling of lightness due to the release of pressure in the neck area, and release of endorphins.

Can a neck adjustment cause brain bleed? ›

The adjustment has been known to result in a dissection of the vertebral artery. The dissection may cause the vertebral artery wall to tear causing a flap where blood can accumulate, slowing blood flow to the brain and some times causing a clot to form at the tear of the wall.

Can you tear an artery in your neck by cracking? ›

Popping your neck can cause a small tear (dissection) in the inner lining of an artery, which leads to blood clots forming.

Can sneezing cause carotid artery dissection? ›

MRI of the head and neck with angiography showed a small right internal carotid artery dissection, 1 cm above the bifurcation, with intramural blood (figure B). A diagnosis of a spontaneous right internal carotid artery dissection was established. Sneezing was thought to be a trigger factor for the dissection.

How long does it take for a dissected carotid artery to heal? ›

Once diagnosed and treated, patients with carotid artery dissection require regular follow-up and imaging studies of both carotid arteries. Healing usually takes 3-6 months, and the incidence of contralateral dissection is higher in these patients than in the general population.

Can neck adjustments cause paralysis? ›

Phrenic nerve injury causing diaphragmatic palsy is a rare complication of cervical chiropractic manipulation. We report a case of bilateral diaphragmatic paralysis in a healthy gentleman who underwent cervical manipulation.

Can a neck injury affect your brain? ›

This is why neck injuries often lead to traumatic brain injuries. When the neck snaps around rapidly, the force can place enough stress on the brain to damage it. This often results in a concussion, the most common type of traumatic brain injury.

Can a neck injury cause brain damage? ›

Brain damage was more frequently observed in patients with upper cervical injury than in those with mid to lower cervical injury. Those patients with upper cervical injury appeared to have an elevated risk of suffering skull base fractures, traumatic subarachnoid hemorrhage, and contusional hemotoma.

What are 5 key symptoms of a neck injury? ›

Signs and Symptoms
  • Localized neck pain, which may or may not be severe.
  • Neck stiffness.
  • Pain radiating from the neck down to the shoulders and/or arms.
  • Swelling and bruising.
  • Tenderness.
  • Decrease in sensation in the arms, legs or body.
  • Muscle weakness or paralysis of the arms or legs.
  • Difficulty breathing.

What happens when a chiropractor cracks your neck? ›

When you crack your neck, the capsules around the joint will stretch. These capsules have fluid, so stretching them will allow more fluid to provide less pressure on the joint. When the pressure decreases the fluids on these joints will turn into gas. When this happens it will make a popping noise.

Can you get a blood clot from chiropractor? ›

Trauma to these arteries by a chiropractor performing manipulations may result in the formation of blood clots that travel to the brain and result in strokes. The underlying injury is a vertebral or carotid artery dissection.

When should you not use a chiropractor? ›

When Not To See A Chiropractor. Patients with herniated or slipped discs and those with arthritis may need advice from specialist physicians before seeing a chiropractor. If there is a physical abnormality or injury in your body, such as a fracture, chiropractic care may not be for you.

How do you know if you have a torn artery in your neck? ›

Some of the main symptoms of carotid artery dissection include a bad headache and pain in your face and neck. You might also have problems with your sight including losing it completely for a while, but it should come back. Other symptoms include migraine symptoms and a drooping eyelid, which can be very painful.

Can you sue a chiropractor for vertebral artery dissection? ›

ARTERIAL DISSECTION LAWSUITS & CHIROPRACTIC MALPRACTICE

If you or someone you love were diagnosed with vertebral artery dissection after a chiropractic adjustment, or if you believe medical professionals failed to diagnose a stroke, you may have grounds to pursue a medical malpractice lawsuit.

What does a stroke in the neck feel like? ›

Unusual, persistent neck pain

A vertebral artery tear may feel like something sharp is stuck in the base of your skull. If you experience such pain — especially if you also have stroke symptoms such as dizziness, double vision, jerky eye movements, unsteadiness while walking, or slurred speech — call 911 immediately.

What happens if you move your neck too much? ›

If you are constantly cracking your neck, pressure will build up in the joints. This causes the surrounding ligaments to stretch to unstable levels and the cartilage in your vertebrae to wear down. This can cause osteoarthritis, which is serious, irreversible and painful. It also causes even greater stiffness.

Is it good to get your neck adjusted? ›

Benefits of Neck Adjustments

Here are the benefits of treating neck pain with chiropractic care: Relieve chronic pain and stiffness at the source. Find relief without taking medication or undergoing surgery. Ease headaches, migraines, circulatory problems, and other issues caused by a misaligned cervical spine.

How long do neck adjustments last? ›

A typical plan might last three to six weeks, followed by a reevaluation.

Can a misaligned neck cause high blood pressure? ›

Can neck misalignment cause high blood pressure? Yes, numerous studies have shown that neck misalignment can have an effect on a person's blood pressure. Can spine problems cause high blood pressure? Spine problems or spine injuries can make your blood pressure dangerously high.

Can chiropractor cause neurological problems? ›

Neurologic complications can result from cervical spinal manipulation, such as compression or dissection injury of the vertebral artery, causing stroke.

Where is your main artery in your neck? ›

Your external carotid arteries begin at the carotid bifurcation on either side of your neck. Each external carotid artery travels upward along the side of your neck toward your ear. Near your ear, it divides into its two terminal branches: your maxillary artery and superficial temporal artery.

How serious is a torn artery in the neck? ›

A carotid dissection can cause problems with blood flow to your brain or eyes. This can cause a TIA, stroke, or one-sided blindness. All of these are medical emergencies. Call 911 if you think you might be having a stroke or TIA.

Can a tear in the carotid artery dissection heal itself? ›

There are two carotid arteries, one on each side of your neck. Dissection can occur spontaneously or after a neck injury. The condition can heal itself over time but may cause life-threatening complications, such as stroke or bleeding in the brain.

Can a dissection cause a stroke? ›

With a carotid artery dissection, the inner lining of the blood vessel tears. At the site of the tear, blood can clot. If the blood clot breaks loose, it can travel to your brain, block off blood vessels and limit blood flow, resulting in an ischemic stroke.

Can stress cause carotid artery dissection? ›

The triggers for SCAD often do not include traditional atherosclerotic risk factors. The most commonly reported triggers are extreme physical or emotional stress.

How long does it take for a carotid dissection to cause a stroke? ›

Conclusions In carotid artery dissections, completed stroke usually occurs in the first few days after the onset of the first symptoms, whether local or ischemic, but it can occur as much as 1 month later.

Can you live with a dissected carotid artery? ›

Conclusions: Most cervical carotid dissections can safely be conservatively managed, with the majority achieving anatomic and symptomatic resolution, with low rates of recurrence over long-term follow-up.

How long does it take to feel better after carotid artery surgery? ›

After surgery, most people can return to normal activities within three to four weeks. Although, many get back to their daily routines as soon as they feel up to it. During the first few weeks of your recovery, some key things to keep in mind include: You may have some soreness in your neck for about two weeks.

How long are you in the hospital for carotid artery surgery? ›

You'll usually be able to leave hospital and return home within 48 hours.

What happens when a chiropractor snaps your neck? ›

The spaces between your joints are filled with cushioning fluid, and motion can cause nitrogen bubbles to fizz and build like a soda can wanting to pop. Cracking the joint pops the bubbles and releases all the pressure.

What happens when a chiropractor pulls your neck? ›

So what happens when a chiropractor "cracks" a patient's neck? The word or term "neck cracking" refers to the manipulation applied to the cervical joints, and a person hears a 'crack' or a popping sound. This occurs because a quick motion is applied to the cervical area to loosen the neck's ligaments and joints.

Is adjusting your neck good for you? ›

By adjusting the vertebra in the neck, it improves the mobility of the cervical spine, restores range of motion, offers toxic release after a chiropractic adjustment, and increase the flexibility of the adjoining muscles.

Is it good to get neck adjustment? ›

Benefits of Neck Adjustments

Here are the benefits of treating neck pain with chiropractic care: Relieve chronic pain and stiffness at the source. Find relief without taking medication or undergoing surgery. Ease headaches, migraines, circulatory problems, and other issues caused by a misaligned cervical spine.

Why do chiropractors tell you not to crack your neck? ›

There is an abundance of blood vessels in your neck that can be damaged by continuous cracking. These vessels carry blood to, and away from your brain, so forceful and constant neck cracking can increase your risk of stroke by damaging these vessels.

Can you tell a chiropractor not to crack your neck? ›

Do Chiropractors have to Adjust your Neck? Chiropractors do not have to adjust your neck to help you heal. There are multiple chiropractic methods that do not involve any bone popping or cracking of the neck. Holistic chiropractors believe that the body has resources within itself to heal.

How long after chiropractor can you have a stroke? ›

In a review by Haldeman et al of 64 patients with cerebrovascular events after spinal manipulation, the timing of presentation ranged from 2 days to 1 month, but 63% of patients developed symptoms immediately following the manipulation (2, 4).

How long does toxic release last after chiropractic adjustment? ›

How Long Does Toxic Release Last After Chiropractic Adjustment? The length of time that toxins are released after an adjustment depends on the individual. For some people, the release may only last for a few days after the adjustment period, while others may experience a more prolonged detoxification process.

What is it called when a chiropractor pulls your head? ›

The Y-Strap adjustment works by stretching the spine pulling the head in the Y-Axis of the body. This pulling force generates a decompression in the vertebral discs. The force applied can have different speed and force patterns: From a slow and smooth stretching motion to a HVLA (High Velocity, Low Amplitude) movement.

What happens if you turn your neck too much? ›

If you are constantly cracking your neck, pressure will build up in the joints. This causes the surrounding ligaments to stretch to unstable levels and the cartilage in your vertebrae to wear down. This can cause osteoarthritis, which is serious, irreversible and painful. It also causes even greater stiffness.

What is the best position for your neck? ›

What is the best sleeping position for neck pain? Two sleeping positions are easiest on the neck: on your side or on your back. If you sleep on your back, choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head.

What can you not do after neck adjustment? ›

Avoid Prolonged Sitting. The majority of people sit for several hours each day. This wreaks havoc on our posture and can put us on the chiropractor bench in the first place. Try to avoid prolonged sitting right after an adjustment.

How many times a week can you get your neck adjusted? ›

Routine Adjustments

Some patients enjoy regular adjustments every four weeks while others find every two weeks beneficial.

When should you stop chiropractic treatment? ›

In general, it is advised to discontinue chiropractic care if any of the following is true:
  1. Increased pain. It is not uncommon to note mild discomfort after the initial manipulation treatment for the first 24 to 48 hours (similar to starting a new exercise). ...
  2. No improvement within 2 to 4 weeks. ...
  3. Symptoms have gone away.

1. Charité Clinical Journal Club (German) by Fred Luft - 06.03.2019
(Clinical Journal Club)
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