Manipulative neck therapy was found to have association with cervical artery dissection (CD) that can bring about stroke, but it wasn’t certain if neck manipulation per se causes stroke, the American Heart Association said in a statement issued Thursday, Aug. 7.
CD is described by the AHA as “small tear in the layers of artery walls in the neck.” When there’s blood clot following a minor or major neck trauma and later blood vessel blockage in the brain, it can lead to ischemic stroke. It is also said to be a significant cause of strokes in both the young and the middle-aged people.
José Biller, M.D., a lead author of the statement as well as neurology chair and professor at Loyola University Chicago Stritch School of Medicine, said in a statement that most dissections include some kind of stretch, mechanical stress or trauma.
Techniques used on cervical manipulative therapies vary, according to the researchers, yet health practitioners use some maneuvers for therapy that rotate and extend the neck, that even involve forceful thrust sometimes.
Biller added that sudden movements, hyperextending or rotating the neck can bring about CD, although these are regarded inconsequential by a patient. Movements may be violent vomiting or coughing, some sports activities and whiplash, among other things.
“Although a cause-and-effect relationship between these therapies and CD has not been established and the risk is probably low, CD can result in serious neurological injury,” said Biller, adding that patients need be abreast of such association prior to going through neck manipulation.
A connection between CD and neck manipulation is said to be hard to evaluate by health professionals because patients starting to have CD may pursue treatment for the relief of neck pain. Neck pain is a usual symptom of CD that can lead to stroke symptoms in several days.
The researchers said that people who experience neurological symptoms following a trauma or neck manipulation should seek medical help at once. Symptoms include pain in the head or back of the neck, vertigo or dizziness, unsteadiness in walking, double vision, slurred speech, vomiting, nausea and jerky movements of the eye.
“Some symptoms, such as dizziness or vertigo, are very common and can be due to minor conditions rather than stroke, but giving the information about recent neck manipulation can raise a red flag that you may have a CD rather than a less serious problem, particularly in the presence of neck pain,” Biller said.
The scientific statement on neck manipulation and cervical artery dissection was published by Stroke journal of the AHA.
