Neck Cracking Raises Stroke Risk
Should Chiropractors Warn of Real but Small Danger?
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
"At the end of last week I was having neck pain," Haldeman
says. "I know very well there is a risk of complication, but I didn't want to
go through the weekend with my neck hurting. So on Saturday, I had an
adjustment on my neck."