Introduction

Earlier this year, Dr. Danielle Belardo, a cardiologist from Precision Preventive Cardiology in Los Angeles, treated a young stroke patient whose arrival took her by surprise. The young woman had been healthy with no underlying medical conditions, but she had recently visited a chiropractor for a neck adjustment. This seemingly benign visit would soon lead to a life-altering event.

A Shocking Diagnosis

The diagnosis? A grade II dissection of the vertebral artery, which occurred on the chiropractor's table during the adjustment, resulting in a stroke. This severe arterial tear disrupted blood flow to her brain, manifesting in immediate vision changes, walking difficulties, and weakness on one side. Fortunately, the patient survived, but she now faces a long recovery, including medication to prevent further clots.

Professional Concerns

Dr. Belardo's experience with this patient was particularly poignant, as it wasn't the first occurrence of strokes due to neck manipulations she had encountered in her practice. Feeling a sense of responsibility, she shared the story on social media platforms, sparking widespread attention and discussions among medical professionals and the public. Her post highlighted the lack of evidence supporting the safety and effectiveness of neck adjustments and questioned why such a procedure remains legal despite its potentially life-threatening risks.

Understanding Neck Manipulation

Neck manipulation, or cervical manipulation, is a common chiropractic practice intended to relieve pain and discomfort in the neck and upper back. This technique often involves a swift thrust of the neck, producing a popping sound that many find satisfying, but it can carry severe consequences.

The Controversial Debate

While advocates from the American Chiropractic Association claim that this technique is safe and effective, many physicians dispute this, arguing that any potential benefits do not outweigh the risks, particularly when alternatives like physical therapy exist. While strokes attributed to neck manipulation are considered rare, the doctors quoted in the article have frequently observed these cases and confirm their potential severity.

Real-Life Cases

Dr. Ayesha Sherzai, a neurologist and co-founder of the Brain Health Institute, estimates that she has encountered several cases of strokes linked to neck adjustments. She remembers two distressing cases vividly: a mother who collapsed after a manipulation and another individual who succumbed to a stroke that left half of her brain affected. Her observations, alongside those of Dr. Belardo, highlight a troubling pattern.

Understanding the Risks

Experts explain that the vertebral arteries, which are essential for supplying blood to the brain, can be fragile. A manipulation can cause damage, leading to tears or dissections that could trigger a stroke—potentially immediately or weeks later. Such incidents lead to devastating outcomes, often with life-changing repercussions.

The Chiropractic Response

Despite the testimonials from various medical professionals, the chiropractic community maintains that extensive research has found no direct link between neck manipulation and strokes. Chiropractors often suggest that individuals who suffer strokes following adjustments were already experiencing issues that could lead to dissections. However, many, including Dr. Sherzai, vehemently challenge this rationale, asserting that pain from dissections is typically not present in the weeks prior to manipulation.

Call for a Registry

Given the lack of concrete data on the risks involved, Dr. Belardo and Dr. Sherzai are advocating for the establishment of a registry to systematically track neck manipulation-related injuries. They are calling upon fellow medical professionals to contribute to this initiative, similar to registries for conditions such as spontaneous coronary artery dissection, which primarily affects healthy women.

The Importance of Data

Such data is crucial for making informed medical recommendations and establishing guidelines. The absence of a registry means that the actual risk of stroke post-manipulation remains uncertain—potentially anywhere from 1 in 1,000 to 1 in 100,000.

Patient Awareness

As these discussions evolve, it is vital for individuals considering chiropractic care to engage in open conversations with their practitioners regarding the risks associated with neck adjustments. Informed consent allows patients to make educated decisions about treatments. Healthcare professionals like Dr. Sareh Rajaee emphasize the importance of understanding these risks, advocating for patient autonomy in making health choices.

Conclusion