Are neck adjustments safe?
Neck adjustment, particularly of the top two vertebrae of the spine, has on rare occasions been associated with stroke and stroke-like symptoms. This risk is considerably lower than those serious adverse events associated with many common health treatments such as long-term use of non-prescription pain relievers or birth control pills. While estimates vary, a range of one to two events per million neck adjustments is the ratio generally accepted by the research community.
An extensive commentary on chiropractic care, published in the February 2002 issue of the Annals of Internal Medicine, which is the journal of the American College of Physicians, reviewed more than 160 reports and studies on chiropractic. It states the following with regard to the safety of neck adjustment: "The apparent rarity of these accidental events has made it difficult to assess the magnitude of the complication risk. No serious complication has been noted in more than 73 controlled clinical trials or in any prospectively evaluated case series to date."
A Canadian study, published in 2001 in the medical journal Stroke, also concluded that stroke associated with neck adjustment is so rare that it is difficult to calculate an accurate risk ratio. The study was conducted by the Institute for Clinical Evaluative Sciences (ICES) and the authors have stated: "The evidence to date indicates that the risk associated with chiropractic manipulation of the neck is both small and inaccurately estimated. The estimated level of risk is smaller than that associated with many commonly used diagnostic tests or prescription drugs."
The most recent research into the association between neck adjustment and stroke is biomechanical studies to assess what strain, if any, neck adjustment may place on the vertebral arteries. The preliminary findings of this ongoing work indicate that neck adjustment is done well within the normal range of motion and that neck adjustment is "very unlikely to mechanically disrupt the VA [vertebral artery]."
An extensive commentary on chiropractic care, published in the February 2002 issue of the Annals of Internal Medicine, which is the journal of the American College of Physicians, reviewed more than 160 reports and studies on chiropractic. It states the following with regard to the safety of neck adjustment: "The apparent rarity of these accidental events has made it difficult to assess the magnitude of the complication risk. No serious complication has been noted in more than 73 controlled clinical trials or in any prospectively evaluated case series to date."
A Canadian study, published in 2001 in the medical journal Stroke, also concluded that stroke associated with neck adjustment is so rare that it is difficult to calculate an accurate risk ratio. The study was conducted by the Institute for Clinical Evaluative Sciences (ICES) and the authors have stated: "The evidence to date indicates that the risk associated with chiropractic manipulation of the neck is both small and inaccurately estimated. The estimated level of risk is smaller than that associated with many commonly used diagnostic tests or prescription drugs."
The most recent research into the association between neck adjustment and stroke is biomechanical studies to assess what strain, if any, neck adjustment may place on the vertebral arteries. The preliminary findings of this ongoing work indicate that neck adjustment is done well within the normal range of motion and that neck adjustment is "very unlikely to mechanically disrupt the VA [vertebral artery]."
