Neck pain and some types of headaches are treated through precise cervical manipulation. Cervical manipulation, often called a neck adjustment, works to improve joint mobility in the neck, restoring range of motion and reducing muscle spasm, which helps relieve pressure and tension. Patients typically notice a reduction in pain, soreness and stiffness, along with an improved ability to move the neck. Neck manipulation is a remarkably safe procedure. While some reports have associated high-velocity upper neck manipulation with a certain kind of stroke, or vertebral artery dissection, recent evidence suggests that patients are no more likely to suffer a stroke following a chiropractic neck treatment than they are after visiting their primary care medical doctor’s office. It was also concluded that vertebrobasilar artery (VBA) stroke is a very rare event, and that this type of arterial injury often takes place spontaneously, or following everyday activities such as turning the head while driving, swimming, or having a shampoo in a hair salon.
Patients with this condition may experience neck pain and headache that leads them to seek professional care —often at the office of a doctor of chiropractic or medical doctor—but that care is not the cause of the injury. The best evidence indicates that the incidence of artery injuries associated with high-velocity upper neck manipulation is extremely rare – about 1 case in 5.85 million manipulations.
To put this risk into perspective, if you drive more than a mile to get to your chiropractic appointment, you are at greater risk of serious injury from a car accident than from your chiropractic visit.
It is important for patients to understand the risks associated with some of the most common treatments for neck and back pain—prescription nonsteroidal antiinflammatory drugs (NSAIDS)—as these options may carry risks significantly greater than those of manipulation.
According to a study from the American Journal of Gastroenterology, approximately one-third of all hospitalizations and deaths related to gastrointestinal bleeding can be attributed to the use of aspirin or NSAID painkillers like ibuprofen.
Furthermore, surgery for conditions for which manipulation may also be used carries risks many times greater than those of chiropractic treatment. Even prolonged bed rest carries some risks, including muscle atrophy, cardiopulmonary deconditioning, bone mineral loss and thromoembolism.
A comprehensive review of scientific evidence related to neck pain treatments found at least as much evidence supporting the safety and effectiveness of common chiropractic treatments, including manipulation, as for other treatments such as prescription and nonprescription drugs and surgery.
If you are visiting your doctor of chiropractic neck pain or headache, be very specific about your symptoms. This will help your doctor of chiropractic offer the safest and most effective treatment, even if it involves referral to another health care provider. If the issue of stroke concerns you, do not hesitate to discuss it with your doctor of chiropractic. Depending on your clinical condition, we can forego manipulation, and can instead recommend joint mobilization, therapeutic exercise, soft-tissue techniques, or other therapies.