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Neck-Cracking: Can It Increase Your Risk of Having a Stroke?

Vertebral artery dissection can lead to blood clots that cause strokes.
Published Online: Sep 19,2017
Joshua Pirestani
Many people attest that neck-cracking provides a sense of relief, which is why they self-manipulate their necks or ask their chiropractor to do it. However, if you feel the same way, you have to realize that this seemingly harmless activity can actually bring about a harmful effect. Specifically, it can increase your chances of having a stroke.

Medical experts have suspected this for years, and their suspicions were confirmed in 2012 by a team of neurosurgeons led by Dr. Felipe Albuquerque, of the Barrow Neurological Institute in Arizona. These doctors analyzed a “prospectively maintained” database of endovascular patients, which showed that some patients experienced craniocervical arterial dissections after getting chiropractic treatment.

What Is Craniocervical Arterial Dissection?
This condition—also known as a vertebral artery dissection (VAD)—refers to the tearing of the vertebral artery, which supplies the brain with oxygenated blood. Each person has two vertebral arteries, one on each side of the body.

When a vertebral artery tears, it forms a blood clot, which is the body’s natural way of repairing damaged tissues. Unfortunately, this clot partially or fully blocks the flow of blood into the brain, which means that the latter doesn’t get the right amount of oxygen that it needs. This, in turn, results into a major stroke or a series of minor strokes known as transient ischemic attacks.

Vertebral artery dissection happens whenever the neck is quickly turned or twisted. Patients with VAD usually developed this condition when they were strangled or when they got involved in a road traffic accident.

However, VAD can also happen spontaneously even without any external factors, especially in people with Ehlers–Danlos syndrome and other disorders. There are also many patients who have not been diagnosed with any disorder but have a genetic predisposition to vertebral artery dissection. These are usually the people who develop VAD while doing simple activities like laughing and lifting items.

VADs and Chiropractic Treatments
The chances of developing vertebral artery dissection increases when you go through chiropractic treatments that involve neck manipulation. These treatments are usually forceful, and the force exerted on the neck area can be enough to cause a tear in your vertebral artery.

Through their review of the endovascular database, Dr Albuquerque and his team discovered that 13 patients complained of head and neck pain and/or experienced neurological deficits—days or even hours after receiving chiropractic treatment involving neck manipulation. All of these patients had vertebral artery dissection with varying degrees of severity.

After stenting, medications, and other medical treatments, nine of the patients recovered completely. Three of them developed permanent neurological issues, and one sadly died due to a massive stroke.

It’s important to note that this study isn’t conclusive; more research still has to be done. Wade S. Smith, MD, PhD, who lead a study on VAD and chiropractic manipulation in 2003, also points out that millions of chiropractic treatments are safely carried out every year, so the risk of stroke is quite low.

Still, it’s something that everyone should think about. Before you crack your neck or go to the chiropractor, consider the increased stroke risk that it can bring.

Joshua Pirestani is the President and founder of the American Pharmacy Purchasing Alliance.