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The theory that cracking you neck may cause a stroke certainly sounds like an urban legend, specifically aimed at chiropractors, who may crack the neck and various places in the spine to help produce greater comfort. To the dismay of many people, there is some evidence that, especially among those under 60, cracking your neck can create the circumstances that can lead to stroke, though it rarely does. The matter has been studied extensively, and research done in the 2000s suggests that there is an increased risk. It is important to understand how this risk occurs and to bear in mind that the risk is still extremely low.
One study, performed by neurologist Wade S. Smith at the University of California, San Francisco, evaluated a population of 51 patients who had had a stroke. About 14% recalled having chiropractic work and neck manipulation prior to their strokes. In all, the study only linked seven cases of stroke to neck cracking, and other neurologists state the risk exists but is low. It would also be of value to follow a large group of patients who receive chiropractic care on a regular basis to see how many had a stroke after having their necks cracked. By studying only the stroke population, the actual percentage of risk can’t really be assessed.
Some strokes, especially those occurring before the age of 45, are caused by what is called cervical artery dissection. The cervical arteries intertwine through the back of the neck and head, and in some cases, they may tear. If the tearing causes bleeding, a blood clot can form, and then be passed into the brain. Of concern with cracking your neck is that the cervical arteries might tear, bleed, and develop a blood clot that would temporarily deprive the brain of oxygen. This could lead to a minor or fatal stroke, or a transient ischemic attack (TIA), sometimes called a mini-stroke.
Even if it only slightly increases the risk of cervical artery dissection, many chiropractic patients are not informed of this risk. Cracking the neck is pretty standard with a chiropractic visit, and many chiropractors and healthcare professionals believe that though the risk is minimal, patients should make an informed choice. If you do choose to have your neck cracked, you should be alert to signs of stroke in the days and weeks following a chiropractic visit.
In brief, signs of stroke include the following:
- Inability to move one half of the body
- Blurred vision or difficulty speaking
- Severe head pain that comes on suddenly
If you suspect stroke, don’t call your chiropractor — call emergency services immediately, since early treatment can minimize permanent damage a stroke may cause and lower risk of fatality. Not all strokes are due to cracking your neck, and a stroke before the age of 60 can be attributed to a number of different factors and lifestyle choices. Nevertheless, chiropractic neck manipulation slightly increases risk and should be considered as a therapy with potentially life threatening side effects.