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Chiropractic Manipulation of Neck: Stroke Risk?

American Heart Association releases statement saying risk may be increased if artery wall is torn

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"We are concerned that a statement like this can possibly create a fear in a patient, preventing them from making a choice of treatments that may in fact turn out to be the safest choice of all for their neck pain or headache," he said.

In a statement released Thursday, the American Osteopathic Association had this to say about the new statement: "U.S.-trained osteopathic physicians [DOs] use osteopathic manipulative therapy to diagnose, treat and even prevent illness or injury. DOs are taught to conduct thorough evaluations using standard neurological and orthopedic examinations."

The statement noted that osteopaths should not be grouped with chiropractors and physical therapists, who are not physicians and use different techniques for cervical manipulative therapy.

Biller noted that the association between neck adjustments and stroke is difficult to evaluate. People who already have suffered an artery tear may seek treatment to relieve neck pain, which is a common symptom of cervical artery dissection that can precede a stroke by several days.

Because of this, all medical professionals -- including chiropractors and osteopaths -- should be on the lookout for any stroke risk factors occurring in patients seeking help for neck pain or chronic headache, he said.

Overland agreed, adding that chiropractors should discuss the potential stroke risk of neck manipulation with any patient who has other risk factors for stroke, such as cardiovascular disease, family history of stroke or severe headaches.

By the same token, chiropractors shouldn't necessarily discuss stroke risk with someone with no other risk factors, he added.

"If someone came in from playing basketball and they have a pulled muscle in their neck, but are otherwise perfectly healthy, we don't see a relationship or risk there," Overland said. "The discussion should be based on a thorough examination."

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