The Power of Neck Manipulation

Are you afraid of getting your neck adjusted? For some time, it was thought that cervical
manipulation (i.e. the ‘pop’ heard when a practitioner quickly moves your head) alters blood flow
to the brain. This was believed to lead to adverse events such as stroke and even death.
However, multiple studies now support that this is simply not true.

The most recent evidence in the form of a systematic review suggests that cervical positioning
has less effect on blood flow than was previously thought. We used to think that placing the
head in extreme ranges of motion would lead to decreased blood flow to the brain from the
internal carotid and vertebral arteries. After performing multiple studies on hemodynamics in
various cervical positions, that idea no longer holds up as there were no changes in blood flow
observed.

Perhaps it is not the neck manipulation technique that leads to stroke. What could be causing
these spontaneous strokes in people with neck pain? More current evidence supports the idea
that it is the quality of the arteries to the brain that is the true risk factor for stroke.
Whedon et al performed a study on over one million of people with neck pain. One group saw
their primary care physicians and the other saw chiropractors. After 30 days, between two and
five out of every 1000 people experienced a stroke. In this small group of those that did
experience a cerebral infarction, there was not a statistically significant difference between
those who saw a chiropractor and those who saw a physician.

So, what does this mean? This shows us that it is not necessarily the manipulation that leads to
stroke, but possibly the preexisting condition of cervical artery dysfunction. Empower yourself
with knowledge and have a clear understanding of your family history and your current
lifestyle/risk factors. It also shows us that neck pain is something to be taken seriously,
especially if one experienced a recent trauma to the head. Be sure to seek out a trusted medical
professional for persistent neck pain.

We should move away from the fear of cervical manipulation causing a stroke. Neck
manipulation is incredibly effective at improving range of motion and decreasing pain when
applied to the appropriate population. Make an appointment at Repair to have a thorough
evaluation of your neck pain today!

References
1. Whedon JM, Song Y, Mackenzie TA, Phillips RB, Lukovits TG, Lurie JD. Risk of stroke
after chiropractic spinal manipulation in medicare B beneficiaries aged 66 to 99 years
with neck pain. J Manipulative Physiol Ther. 2015;38(2):93–101.
doi:10.1016/j.jmpt.2014.12.001
2. Kranenburg et al. Effects of Head and Neck Positions on Blood Flow in the Vertebral,
Internal Carotid, and Intracranial Arteries: A Systematic Review. J. of Orthopaedic &
Sports Physical Therapy. 2019.