CardioExchange Archive

After a neck adjustment — also known as cervical manipulative therapy and typically employed by chiropractors and other healthcare providers — people are at increased risk for cervical dissections, which can lead to stroke, according to a scientific statement released by the American Heart Association/American Stroke Association. Although a cause-and-effect relationship is far from being proved, the groups say that healthcare providers should tell their patients about the association before starting the procedure.

“Most dissections involve some trauma, stretch or mechanical stress,” said José Biller, lead author of the scientific statement, in an AHA press release. “Sudden movements that can hyperextend or rotate the neck — such as whiplash, certain sports movements, or even violent coughing or vomiting — can result in CD, even if they are deemed inconsequential by the patient.”

Current knowledge about cervical dissection is limited to case-control studies and clinical reports, making it impossible to establish a cause-and-effect relationship. In some cases, an alternative explanation may be that patients in the early stage of cervical dissection may go to a chiropractor or other healthcare provider for relief of their neck pain.

“Although a cause-and-effect relationship between these therapies and CD has not been established and the risk is probably low, CD can result in serious neurological injury,” said Biller.