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Neck/Shoulder Pain, Neck Manipulation, & Stroke Risk Alleviation

sguptassgupta Posts: 2
edited 04/07/2015 - 8:58 PM in Neck Pain: Cervical
Hey all; hope everyone's well or on the road to it!

Over the last few years, I've had on-and-off neck and shoulder pain. Usually the pain is miserable but for a reasonably brief period (1-2 days), though for a few months I had some trouble turning my head without pain (that resolved after some physical therapy exercises). An MRI was done and there is very slight bulging at C5/C6, but it was otherwise unremarkable. The shoulder pain comes out of the blue but goes away just as quickly.

I started seeing a chiropractor recently to see if he could help, and so far (only 2 appointments in), I do think I notice a difference.

However, I came across some information about potential increased stroke risk and cervical/neck manipulation. One of the larger, more controlled studies seems to support the chiropractic position that this is an incredibly rare event, and people are no more likely to suffer a stroke after visiting a chiropractor than from visiting their primary care physician. However, other studies seem to indicate more of a relationship. I've asked a couple health care providers, including a neurologist, about this risk, and the replies I got were mixed, with the scariest coming from a neurologist who had seen a few frightening anecdotal cases in person and said he'd categorically recommend against it.

The theory is between the twisting and thrusting force applied, an artery could potentially tear, causing a stroke. This is incredibly rare, and as I said, studies are mixed, but I still have some anxiety about it.

I spoke to my chiropractor about these concerns, and as of my second appointment, we've changed techniques. No more twisting/thrusting of the neck at all - shoulders and above, he's using an "activator" (which is high velocity but low force), and he uses the standard manual thrusting/higher force technique for my upper and lower back (all below the shoulders).

For those with some expertise in this area, should staying below the neck for "standard" techniques and only using an activator above the shoulders remove any residual risk of stroke (if it exists in the first place)? I really can't see the activator (which feels like a fairly gentle tap, honestly) being too risky, and I don't think adjustment of the upper back should really be risky for the neck arteries, but I'd like to hear from someone in the know.

Thanks for any advice!


  • LizLiz Posts: 7,832
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  • SavageSavage United StatesPosts: 5,427
    edited 04/08/2015 - 11:16 PM
    Welcome! Speaking for myself.....I think I'd double check with spinal doc before others did manipulation.
    Did your primary refer you to chiropractor?
    Sometimes not all things are seen clearly with MRI and other tests can help with diagnosis and possibly other treatments.

    I started having my strokes at45 years of age. I have blood vessel...rare things going on....and family history so that probably my cause.
    Any treatment has its risks and your research is very interesting, although I know of nothing of it personally.
    You might want to talk to doctor and basically may come down to if the benefits out weigh the risks.
    Wish I could be helpful. Someone may come around and know exactly what you mean and relate.
    Ther may be information around this site on it.
    Good luck!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Thanks much for the warm welcome, and thanks, Savage! Hope you're doing well and your health is good/improving!

    Unfortunately, it's very difficult to see my primary at this point (I had an appointment last week...and it got cancelled and moved to June - since new management took over, it's been like this). That's one of the reason I like my chiropractor office - they're very accommodating and easy to get into.

    I did speak (though not in person) to a neurologist, and between him and working with my chiropractor, we settled on regular chiropractic care of the upper and lower back, but a different method (using a gentle "activator") for the shoulders/neck area (which eliminates all twisting, cracking, and most force)...this alleviated the neuro's concern while still providing treatment for me. I think my chiropractor thinks I'm nuts, but I'm just more comfortable with the gentler treatment at this time - hopefully it'll still provide some benefits.

    Thanks again for your reply!
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