The American Heart Association has published a statement which says there may be an association between stroke and therapy involving neck manipulation, though they were not able to confirm whether a neck manipulation causes stroke or not.

Neck manipulation has been linked with a risk of cervical artery dissection, a form of arterial tear that is believed to be a cause of stroke in young and middle-aged adults.

This new statement from the American Heart Association has been published in their journal Stroke, and they believe patients should be aware of this potential risk prior to receiving neck manipulation therapy.

A cervical artery dissection (CD) is a small tear in the layers of walls in the arteries in the neck. If the tear becomes dislodged into the bloodstream, it can form a clot and cause an ischemic stroke by blocking one of the blood vessels in the brain.

Dr. Jose Biller, lead author of the statement said, “Most dissections involve some trauma, stretch, or mechanical stress. Sudden movement that can hyperextend or rotate the neck – such as whiplash, certain sports movements, or even violent coughing – can result in CD, even if they are deemed inconsequential by the patient.”

Some of the techniques used within neck manipulation therapy can bring on these sudden movements, by extending and rotating the neck, and at times forcefully.

“Although a cause-and-effect relationship between these therapies and CD has not been established and the risk is probably low, CD can result in serious neurological injury,” said Dr. Biller. “Patients should be informed of this association before undergoing neck manipulation.”   8/8/14


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