Neck Cracking Raises Stroke Risk
Should Chiropractors Warn of Real but Small Danger?
WebMD News Archive
"If a person has any of the symptoms
of stroke, he or she should bypass the chiropractor and go directly to the
hospital," Smith says.
These red flags are:
- One side of the body becomes weak, numb, or paralyzed.
vision, blurry vision, or loss of sight.
- Trouble speaking or difficulty understanding speech.
- Loss of balance or coordination; dizziness.
- Sudden severe headache.
"Neck cracking," or cervical spinal manipulation, is the chiropractic technique that most concerns neurologists.
To make this adjustment, the practitioner often gives the neck a high velocity
twist. Chiropractors are trained to know the anatomy of the neck. Other kinds
of practitioners, Smith says, may not be so well aware of the risks. He notes
that many chiropractors already are adopting a less forceful technique for
Scott Haldeman, DC, PhD, MD, is a chiropractor as well as a
neurologist. As clinical professor of neurology at the University of
California, Irvine, he's studied many cases of arterial dissection in
Haldeman says the Smith study has a major weakness: It relies
on patients' memories of events years in the past. Also, he notes that even
though the study took place in California -- where people do more spinal
manipulations than anywhere else -- only seven cases of stroke could be linked
in any way to neck cracking.
"I think the basic information in the Smith study is very
important. It does confirm that there is a temporal relationship between stroke
and spinal manipulation that we cannot rule out," Haldeman tells WebMD. "But
their evidence that spinal manipulation is a major cause of stroke is weak. The
risk is not zero, and none of us is suggesting there isn't some risk. What we
have basically got here is a situation we have to put into perspective."
If you have neck pain, Haldeman asks, what are you supposed to
do? Taking aspirin or ibuprofen puts you at small but real risk of getting an
ulcer. No other medication is proven to work.
Surgery is unproven and has its own risks. However, Haldeman says, there is
evidence that exercise and spinal manipulation can ease neck pain in the short