One of the biggest fears that I hear from patients who seek Chiropractic care is that they don’t like or they  fear having their neck manipulated due to the risk of stroke. Unfortunately, there has been a lot of poor media reporting on this topic which has compounded common opinion of the safety of Chiropractic.

In regards to Chiropractic and the risk of Stroke the research is limited due to the unpredictable nature of strokes, however there are two well known studies in Chiropractic

Haldeman (2002) found after reviewing 4500 chiropractic and neurologist (medical doctors) malpractice suits in Canada, that the risk of a stroke related to Vertebral Artery Dissection is 1:400,000. This study allowed us to give patients more information on the risk and allow them to make a decision whether or not cervical manipulation is their choice of treatment. Unfortunately, there have been no studies at this point which can identify which patients are an risk of a stroke.

One of the greatest studies which looked at the risk of vertebro-basilar stroke and chiropractic care is Cassidy (2008). This study compared the incidence of patients seeking care from Chiropractors and GP’s for headache and neck pain who were later found to be having a VBA stroke. From this, they concluded firstly that ‘VBA stroke is very rare event in the population’, with increased risk associated with Chiropractic AND primary care (GP’s/ED) was equal to those who presented to their primary care provider. In a nutshell, this implies that those who had a stroke following manipulation were actually already suffering a stroke.

This means that Chiropractors have had to step up their game when it comes to assessing the patient presenting with new onset headache and neck pain. This research has given us effective tools to rule out ‘suspicious’ types of presentations and to always err on the side of caution.

Due to Niki’s background of working as an ICU/ED nurse, she uses her skills to help ascertain whether your new onset neck pain and headache is vascular in nature and requires further medical examination/investigation. Niki also does not offer Cervical Manipulation to those over the age of 60 years and/or who has a vascular history such as known coronary artery disease or peripheral vascular disease. Niki also does not offer cervical manipulation to children under the age of 12 years of age.

For those who are suitable for chiropractic care, a  great alternative to cervical manipulation is the use of the Activator Methods technique in conjunction to dry needling of the neck muscles. This type of technique is suitable for all ages from children to seniors and if you would like more information you can read their website:

One message Niki would like you to take home on this topic is don’t be scared of Chiropractic. The reason we have stayed strong in all the media hype is that we can really help some people with their pain.