Insta-Evidence "Cervical Adjustments?" #9

Are Chiropractic Cervical Adjustments Safe?

A chiropractic adjustment or is a specific high velocity, low amplitude thrust. A type of manual therapy that has been implemented by chiropractors for over 100 years; with plenty of research showing that it’s a viable method and treatment for chronic pain (Cassidy, Lopes & Yong-Hing, 1992) (Haneline & Cooperstein, 2009), increasing ROM (Millan et al., 2012), improving healing outcomes (Salehi et al., 2015) and increasing proprioception awareness (Lelic et al., 2016). 

Soooo...Does it work? Yes. 

Is it safe? Well, there have some literature reviews & case studies published that suggest a correlation between cervical artery dissections (causing strokes) and cervical manipulations or adjustments (Turner et al., 2018). While we have to acknowledge that this link is there, it’s also important to note that these studies failed to prove any actual causation between cervical adjustments and strokes. Furthermore, a study in 2008 concluded the correlation is likely caused by patients seeking chiropractic care while already experiencing the symptoms of a stroke - such as headaches, migraines or neck pain; all symptoms that chiropractors are highly associated with treating (Cassidy et al., 2008). 

A 2002 study showed that a single high velocity, low amplitude thrust only represents 1/9th of the strain it would take to reach mechanical failure of a vertebral artery (Symons, Leonard & Herzog, 2002). Furthermore, a population, case-control, case-crossover study looked at a population of 100 million and concluded there to be no evidence of ANY excess risk of vertebral artery dissection or stroke associated with chiropractic care compared to primary care (Cassidy et al., 2008). 

Key takeaway here is the importance of a thorough history and quality, detailed spinal examination prior to any treatment; to screen for patients who may be experiencing the early stages of a stroke. 

Hope this helps! Peace