Do Chiropractors Cause Strokes?
Getting your neck adjusted or “cracked” has become a generally accepted method for both new & old neck pain, #headache & discomfort complaints. However, it is also believed by some to be the cause of a potentially dangerous medical condition known as a #stroke.
A #stroke is defined as lack of oxygen to the brain – either by an ischemic #stroke (arterial clog) or a hemorrhagic #stroke (bleeding pressures directly onto the brain). There is a fear that neck manipulation may put strain on the arteries in our neck, and may either throw or begin the formation of a blood clot that later causes an ischemic #stroke.
It’s important to know that not all #strokes are created equally, or present equally. There can be great variation between individuals & severity; some may occur within minutes, others may take several hours or even days.
The first #study to look at compared patient with Vertebrobasilar Insufficiencies (VBIs – #strokes) admitted to Ontario Hospitals over 5 years. Records were cross-referenced to determine who had visited a #chiropractor prior to. There was an association found between #chiropractor usage and #stroke occurrence in a population under the age of 45. There was no association found over the age of 45.
Right off the bat, that doesn’t necessarily look good. However, given the very low rate of VBI occurrence, yet the high volume of neck manipulations & chiropractic usage, that it would be important for further research and #study.
Our second #study compared the frequency and rate of occurrence of #stroke following both chiropractic visits & primary care physician visits (family doctors). Patient who did have a #stroke were 3x more likely to have seen either a #chiropractor, OR their medical doctor, prior to having that #stroke (if under the age of 45). If over the age of 45, this association was only present in those who visited their MD, NOT their #chiropractor.
That’s pretty interesting.
The authors concluded that this association is likely due to a patient with early-onset #stroke symptoms attempting to seek care for those symptoms specifically. That is a VERY important distinction.
A third #study, very similar to the prior one, examined #strokes occurring in a different artery (internal carotid). The same findings were made as before, however it was also found that the patients that did go on to have a #stroke, were very likely to be initially presenting with neck pain and #headache – prior to receiving ANY kind of treatment, including neck manipulation. For context, neck pain and #headache are two early presenting signs of #stroke that may show up before any other telltale symptoms might such as facial droopiness. The authors again concluded that the association is likely patients seeking care for their early #stroke symptoms, this time with more evidence.
This is the most plausible explanation for this observed relationship. Patients who undergo care and go on to have a temporal #stroke afterwards are most likely presenting with a #stroke in progress that the practitioner failed to recognize, regardless of profession. Because the signs were not caught in these patients, they would go home & proceed about their lives until the #stroke progressed in severity, landing them in the hospital.
Now that we’ve established that going to see your #chiropractor and having your neck adjusted does not “cause” #strokes any more frequently that seeing your physician does, there still may be concern over the “cracking” itself.
Another #study compared the forces on the vertebral artery during neck manipulation directly to passive range of motion testing. For those unaware, passive range of motion is when the patient turns a part of their body as far as they can, and the practitioner applies a small amount of additional pressure in order to move it further – a very commonly employed examination technique in all clinics & useful in determining affected structures & range of motion limitations. Funnily enough, the forces & stresses on the vertebral artery were ALWAYS found to be less in cervical manipulation than during passive range of motion testing.
If you’re a front sleeper, you need to turn your head to the side in order to breath. This is the equivalent of holding your neck in passive range of motion for 6-8 hours a day. As far as I know, there is no association between front sleeping & rate of #stroke occurrence. This implies that, while getting your neck adjusted could be the thing to worsen a #stroke in progress, there are many other normal activities of daily living that are just as likely or more likely to worsen a #stroke in progress.
A final #study compared the number of VBIs in Ontario hospitals that were “caused” by neck manipulation, to the estimated total number of neck manipulations performed by #chiropractors over a 10 year period.
In an estimated 134.5 million neck adjustments, 23 VBIs occurred. Some simple division gives us the percent chance of obtaining a #stroke following neck manipulation being 0.00000001%. or 1 in 5.85 million
A little more context: you have a 1 in 15,300 chance of getting struck by lightning at some point in your life. And a 1 in 340,000 chance to die in a freak firework accident.
A full neurological examination is warranted in any patient cases that may be considered “sketchy” to even further minimize this very, very, very small chance. As always, YOUR BODY, YOUR CHOCIE – if for whatever reason you are uncomfortable with neck adjustments, there are always alternative methods of care that can be explored.
Thanks for reading!
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