Cervical manipulation is a technique used by chiropractors,
osteopaths, physical therapists and others to treat neck pain and headaches.
There is an ongoing debate about whether neck manipulation is better than other
forms of treatment for neck pain or headache, and about whether neck
manipulation is in fact dangerous. The most recent “British Medical Journal” –
BMJ – has fanned the flame by debating whether cervical neck manipulation should be completely
abandoned.
This is an important discussion because there is a risk of
stroke associated with cervical manipulation, specifically the rapid thrust
used to rotate the cervical spine in order to realign cervical vertebrae. Your
vertebral arteries are vulnerable to tearing during this kind of manipulation
because of their location, around the top cervical vertebra – the
atlas. Any abrupt rotation, such as that in a chiropractic or osteopathic neck manipulation,
can stretch and tear the artery. The torn artery can become blocked depriving the brain of oxygen, or form a clot which can break loose and enter the brain. Either way, it can cause a stroke.
The incidence of stroke due to injuries suffered during
cervical manipulation is low: the medical journal “Neurologist” reports that
the best estimate is that about 1.3 persons out of every 100,000 chiropractic
patients who receive a neck adjustment suffer a stroke following the
treatment.
While this number is not high, there is still a risk, and
the consequences of stroke are heartbreaking and devastating. Since there are other treatments
that are more conservative and yet still effective – such as the use of heat,
ice, gentle stretching and over-the-counter pain medicine – you might decide that forceful cervical manipulation isn't worth the risk.
Although many chiropractors use screening tests to rule out
patients who may be susceptible to arterial damage, the medical journal “Spine”
says that stroke after cervical manipulation is so unpredictable that screening
tests are unreliable. Researchers who authored this article in “Spine” studied
as many known cases as possible to try to identify any pattern that could
predict who is most at risk for stroke from a neck manipulation, but were
unable to do so.
If you do have a cervical manipulation and feel faint, dizzy or nauseated afterward, report it to your chiropractor right away. If there is a possibility of damage to an artery, immediate treatment is necessary.
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