Chiropractic care is a widely practiced but controversial form of medicine. Many individuals claim that it has helped relieve musculoskeletal issues that couldn’t be resolved by traditional treatments. However, health care providers caution against seeking chiropractic treatment for neck pain. A recent tweet from an emergency medicine doctor shed light on the potential dangers of rapid neck manipulation in chiropractic care, which can lead to strokes even in young individuals without apparent risk factors.
Dr. Charles R. Wira III, an internal and emergency medicine physician at Yale Medicine, specializes in stroke and emergency critical care. He explains that there is a well-established connection between chiropractic neck manipulations and cerebrovascular dissection, which is a tear in a major artery that can trigger a stroke. While neck dissections are rare, aggressive neck manipulations should be approached with caution.
The neck contains four crucial arteries that supply blood from the heart to the brain. These arteries can be damaged during certain chiropractic adjustments, particularly ones involving high speeds and force. This can result in arterial dissection, causing a tear in the artery wall. Symptoms include severe headaches or neck pain, and they can lead to blood clot formation. These clots can travel to the brain, restrict blood flow, and cause a stroke.
Strokes related to chiropractic neck adjustments typically occur within one to four weeks after the procedure and can have devastating effects. Signs of a stroke can include facial drooping, language difficulties, dizziness, and weakness or numbness on one side of the body. Long-term complications such as paralysis, memory loss, vision problems, and speech impairments can also occur. Wira notes that larger clots cutting off blood supply to the back of the brain can have a 90% mortality rate.
It’s important to note that arterial dissections can also occur due to other factors like whiplash, roller coaster rides, severe coughing, or vomiting. While these instances are rare, any activity that puts significant stress on the neck can increase the risk of dissection.
Research suggests that chiropractic care itself may not directly cause strokes. Instead, patients seeking chiropractic treatment for headache and neck pain might already have an underlying dissection that increases their stroke risk. Individuals who are predisposed to artery dissection and strokes are more susceptible to trauma from cervical adjustments.
The overall risk of experiencing a stroke after chiropractic treatment is believed to be low, but the evidence varies. One study estimated the risk of serious adverse events, including stroke, to be between 0.05 and 1.46 per 10 million manipulations among Medicare recipients aged 66 to 99. Another report found that 1 in 48 chiropractors had a patient experience vertebral artery dissection. Previous research suggests that individuals under 45 years old who had a posterior circulation stroke were five times more likely to have recently visited a chiropractor. However, it remains unclear how common these events are after chiropractic visits.
While anyone can experience a stroke after visiting a chiropractor, certain individuals are at higher risk. This includes those with connective tissue disorders, anatomical abnormalities in the neck, recent injuries, or illnesses. In some cases, there may be no clear risk factors.
To make chiropractic care as safe as possible, it’s essential to find a chiropractor with proper training, adherence to guidelines, and awareness of potential risks. Opting for low-force techniques can also minimize risks. Communication with the chiropractor about any concerns, medical history, and preexisting conditions is crucial. Patients can discuss preferences and request a gentler approach or avoidance of neck adjustments altogether, especially if they have risk factors.
Being well-rested and hydrated before appointments is advised since dehydration and fatigue can impact blood vessel elasticity. It’s also important to keep one’s doctor informed about chiropractic visits and discuss any additional precautions that may be necessary. As long as individuals are aware of the risks and communicate with their healthcare providers, chiropractic care can be considered without unnecessary concerns.
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