Letting a chiropractor `crack` your neck to relieve pain could trigger stroke. I was recently presented with the Daily Telegraph article concerning neck cracking. (June 8, 2012) I was worried that anyone denied all of the details might read the article and draw the conclusion that osteopaths induce strokes in their patients. To induce a crack in someone's neck is not that difficult to achieve. Simply rotate their neck quickly beyond the normal range of motion, then behold the tell-tale click can be heard. Please do not try this at home. Clicking is not the point of the technique, rather it is a by-product.
Why would an osteopath or chiropractor perform such a technique? Hollis King PhD in, The Science and Clinical Application of Manual Therapy, 2011 discusses the modification of muscle tone, reduction in local tissue strains and to encourage better postural positions. This means tight muscles relax around the joint and tissues held in strained positions adjust. Happily osteopaths deliver these techniques with the minimum of rotation, as it is excess rotation of the neck which often causes the trauma in the vertebral artery. Osteopaths are trained to use as well as rotation, side bending, side shift, traction and compression to avoid the need to wrench the neck around!
The vertebral arteries travel up and through the little bones on the side of your neck, then a weakened artery in combination with a neck crack could occlude the artery or allow a blood clot to be dislodged and cause stroke. Doing a head stand in yoga, arching your neck over a wash basin to have your hair washed at the hair dressers, being hit in a rugby tackle or scrum incident, or other traumatic incidents could also cause such a traumatic ischemic accident. People who don't visit osteopaths also suffer strokes. perhaps a better discussion would be what percentage of the normal population suffer strokes compared to those who visit osteopaths. (20.0 strokes per 100 000 normal population.Those receiving neck cracking have a greater risk of suffering strokes. This reality makes the exhaustive screening of patients all-the-more important. At my osteopathy practice I discuss and use an up-to-date NHS VBI checklist. )
Given the extreme consequences of such a technique it would seem logical then to limit the use of this technique to only persons whom are safe to treat and where treatment is not contraindicated. Osteopaths will ask questions to illicit that the patient does not demonstrate signs of VBI, ( Vertebrobasilar insufficiency ).
Given the real improvements in patient's expressed symptoms the conservative use of these techniques once NHS clinical screening methods have been applied is safe and appropriate. The fearful views expressed in the article need to be weighed up with the counter arguments.
Daily Telegraph article.
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