Debunking the Myth: Chiropractic Care and Stroke

Cervical artery dissection (CAD) is a serious but rare condition that can lead to stroke, particularly in younger patients. It has been suggested that spinal adjustments may contribute to CAD, but recent research strongly refutes this claim. Understanding the science behind CAD and chiropractic care is essential to dispelling misconceptions and ensuring patients receive accurate information about their spinal health.

What is Cervical Artery Dissection (CAD)?

CAD occurs when a tear forms in the inner lining of either the internal carotid artery or vertebral artery in the neck, potentially leading to stroke. Symptoms may include neck pain, headaches, Horner’s Syndrome (eye muscle weakness), and cranial nerve palsy (Robertson & Koyfman, 2016). While the exact causes remain under investigation, studies suggest that CAD is often linked to an underlying arteriopathy—a genetic or inflammatory weakness in the arteries—rather than external mechanical forces (Robertson & Koyfman, 2016).

The Correlation vs. Causation Fallacy

Over the years, low-quality studies and case reports have attempted to establish a link between chiropractic adjustments and CAD. However, extensive research, including a meta-analysis of 253 articles, has shown that no conclusive evidence exists to support a causal relationship (Church et al., 2016). While neck pain and headaches are common symptoms of CAD, they are also frequent reasons for seeking chiropractic care, leading to a misleading correlation (Church et al., 2016). In reality, many patients experiencing early signs of CAD seek medical attention—whether from a chiropractor or a primary care physician (PCP)—before a stroke occurs, further skewing the data (Cassidy et al., 2008).

Scientific Evidence: No Link Between Chiropractic and Stroke

In a landmark study, Cassidy et al. (2008) analyzed over 110 million person-years of data to investigate whether visiting a chiropractor increased the risk of vertebrobasilar artery (VBA) stroke. Their findings were clear: there was no greater risk of VBA stroke in patients who had visited a chiropractor compared to those who had seen a primary care physician (Cassidy et al., 2008). In fact, 53% of stroke patients had visited a medical doctor within 30 days prior to their stroke, compared to only 4% who had seen a chiropractor (Cassidy et al., 2008). This suggests that neck pain, rather than chiropractic adjustments, is the more likely precursor to stroke.

The Importance of High-Quality Research

When assessing the relationship between chiropractic care and CAD, it is crucial to consider scientific rigor. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) system, used in systematic reviews, has categorized the quality of evidence on this topic as very low (Church et al., 2016). This means that many claims of an association between chiropractic adjustments and CAD lack scientific credibility and are based on incomplete data or flawed methodologies.

Understanding the True Risk Factors for CAD

Rather than external mechanical forces, research has pointed to several key risk factors for CAD, including:

• Genetic arteriopathies (underlying structural weakness in arteries)

• Connective tissue disorders (such as Ehlers-Danlos syndrome)

• Inflammatory processes

• Neck trauma (not specific to chiropractic adjustments)

A study by Robertson & Koyfman (2016) found that patients with spontaneous CAD often exhibit structural differences in their arterial walls compared to those who experience arterial trauma. This further supports the theory that CAD is more likely a result of pre-existing arterial abnormalities than any external mechanical manipulation.

Conclusion: Chiropractic Adjustments Are Safe and Effective

Despite persistent misconceptions, there is no scientific evidence linking chiropractic spinal adjustments to CAD or stroke. The research overwhelmingly suggests that CAD is more likely caused by underlying vascular conditions rather than chiropractic treatment.

At MDemetriou Chiropractic, patient safety is our top priority. We use precise, evidence-based techniques designed to improve spinal health without unnecessary risk. If you suffer from neck pain or headaches and are concerned about CAD, consult with a knowledgeable chiropractor who can address your concerns with science-backed care.

For more information or to schedule an appointment, contact us today and experience safe, effective chiropractic care designed with your well-being in mind.