Cervical Manipulation Risks

Cervical manipulation, more commonly known as neck manipulation, is a procedure where a chiropractor adjusts the upper seven vertebral bodies of the spinal column. Many chiropractors lead their patients to believe there are no risks associated with cervical manipulation.

However, for over 75 years, there have been cases that show otherwise.

Stroke: The Silent Killer

Medical literature has documented these cases, including the case of a woman who began experiencing symptoms right after a cervical manipulation she had received as a treatment for headache and neck pain.

The same day as the manipulation, she noticed ringing in her ears, heaviness on the right side of her body, and vertigo. Within hours, her headache got worse, and she experienced nausea and vomiting. Her family noticed that she had slurred speech and was drooling.

She went to the emergency room, where she was lethargic. She had palsy on the right side of her face. Her mental status became worse over the next 24 hours, and was intubated and mechanically ventilated to support her breathing. A CT scan of her head showed strokes.

Due to hydrocephalus, or fluid on the brain, she underwent emergency ventriculostomy, a neurosurgical procedure that involves creating a hole for drainage. She died shortly thereafter.

Documented Risk

Medscape documented the case and noted: Almost all forms of cervical manipulation have been implicated in these injuries… Stroke as a complication of cervical manipulation and dissection of the vertebral arteries is a rare but well-recognized and devastating problem that can occur immediately or a few days after the manipulation.

There have been medical studies that question the causal relationship between cervical manipulation, vertebral arterial dissection, and stroke, but upon further review, medical researchers discovered that “case misclassification occurred in these previous studies” leading to “an underestimation of the strength of the association.”

Tears, Hernias, Nerve Damage and More

Other injuries from cervical manipulation include:

  • Tear in the dura, or the tissue that covers the spine
  • Edema, or a buildup of fluid in the neck
  • Hematoma, or a blood pool outside of the blood vessels
  • Nerve injury
  • Disc herniation
  • Bone fracture

I believe it is crucial for patients seeking chiropractic care to be made aware of the risks prior to treatment. The risks should be clearly explained in writing and also explained thoroughly by the chiropractor.