Cervical Manipulation Can Cause Neurological Damage and Stroke

By Dean Moyer
Author of Rebuild Your Neck

We've seen on the previous pages that, instead of improving your health as the chiropractors like to claim, chiropractic spinal manipulation has been identified as a contributing factor in ligament damage, degenerative disc disease, nerve damage, herniated and even ruptured discs.

But that's not the most serious risk involved with spinal manipulation.

The worst risk of going to a chiropractor is that you may never make it back home.

That's right, chiropractic spinal manipulation has been conclusively linked to strokes, permanent neurological damage and even death:

In 1992, researchers at the Stanford Stroke Center asked 486 California members of the American Academy of Neurology how many patients they had seen during the previous two years who had suffered a stroke within 24 hours of neck manipulation by a chiropractor… One hundred seventy-seven neurologists reported treating 55 such patients… One patient had died, and 48 were left with permanent neurologic deficits such as slurred speech, inability to arrange words properly, and vertigo. [10]
… spinal manipulation is very risky. It can cause irreversible neurological damage or compromise the vertebral arteries supplying blood to the brain. [9]
The usual cause of the strokes was thought to be tearing of the vertebral artery walls. [10]
When manipulating for pain, rotational movements should be avoided in the upper cervical and thoracic spine. [1]
A recent review of 116 articles published between 1925 and 1997 found 177 cases of neck injury associated with neck manipulation, at least 60% of which was done by chiropractors. [10]

Chiropractic: The Surgeon's Best Friend

Not long ago I asked a family practice MD -- off the record -- why some orthopedic surgeons actually associate themselves with chiropractors... even going so far as to share a clinic with them.

He simply rolled his eyes and stated quite plainly, "They need the chiropractors to send them a steady stream of surgical candidates."

This was exactly what I already suspected, but I wanted to hear it from a qualified third party before I completely made up my mind.

It is unfortunate that some (and I believe this to be an extremely small minority) of orthopedic surgeons have chosen to turn a blind eye to what chiropractors are doing and have compromised their own integrity in this way.

Given what we've just learned from the above medical research, I don't believe any knowledgeable orthopedic surgeon would EVER recommend chiropractic treatment for a patient. And, given what we know about chiropractic in general, I don't believe any ethical medical doctor would choose to associate with them.

One Final Note

Before we wrap this up, I should point out that -- despite the obvious dangers inherent in spinal manipulation -- this does not mean that there is never a time when some form of this procedure isn't called for. Facet joints can become stuck or fixated and a gentle nudge may be required to get them moving again.

An osteopathic physician or a properly trained physical therapist should perform this procedure. They generally use a different technique that is far gentler than the one used by most chiropractors.

Going to the right doctor could save you a lot of grief… and may even save your life.

Choose wisely,

By the way, please note that I have only touched on the tip of the iceberg with this series of articles. A full bibliography is listed below that not only supports the facts presented here, but will provide you with much more information on this subject.

Also be sure to read: Medical School or Fraud Factory? An Inside Look at Chiropractic College


Table of Contents:

About the Author

Dean Moyer is the author of the books, Rebuild Your Back, Rebuild Your Neck and The Pain Relief Manual. Copies of his books are available exclusively through this website. Read more...

Rebuild Your Back
Rebuild Your Back
Second Edition
Rebuild Your Neck
Rebuild Your Neck
The Pain Relief Manual
The Pain Relief Manual


  1. Botnick A. Manipulation and Hypermobility Chirotalk May 14, 2004 (Link no longer available.)
  2. Padua L, Padua R, LoMonaco M, Tonali PA. Radiculomedullary complications of cervical spinal manipulation. Spinal Cord. 1996 Aug;34(8):488-92.
    PubMed: Disc Prolapse Caused by Manipulation
  3. Malawski S, Milecki M, Nowak-Misiak M, Sokolski B, Szlapin M. Complications of vertebral disc and spinal diseases after manipulation therapy. Chir Narzadow Ruchu Ortop Pol. 1993;58(2):3-7. PubMed: Manipulation Highly Hazardous
  4. Li JS. Acute rupture of lumbar intervertebral disc caused by violent manipulation. Zhonghua Wai Ke Za Zhi. 1989 Aug;27(8):477-8, 509.
    PubMed: Manipulation Causes Ruptured Discs
  5. Botnick A. Why adjustments cause neck hypermob and stroke. Chirotalk May 4, 2004 (Link no longer available.)
  6. Keys S. Back in Action: Straight answers to back pain and its relief. Allen and Unwin [2002] (p. 87-99)
  7. Rydell N, Raf L. Spinal manipulation--treatment associated with a high risk of complications. Lakartidningen. 1999 Aug 25;96(34):3536-40.
  8. Coulter, et al. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, CA, Rand Corp, 1996
  9. Sanders, M. Take it from a DC: A Lot of Chiropractic is a Sham. Medical Economics Sept. 19, 1990
  10. Barrett S, Don't Let Chiropractors Fool You. Quackwatch Sept. 17, 1999
  11. Lee KP, et al. Neurologic complications following chiropractic manipulation: a survey of California neurologists. Neurology 45:1213-1215, 1995.
  12. Di Fabio R. Manipulation of the cervical spine: Risks and benefits. Physical Therapy 79:50-65, 1999.
  13. Barrett S. Chiropractic's Dirty Secret: Neck Manipulation and Strokes. Quackwatch, revised May 11, 2002.
  14. Gallinaro P, Cartesegna M. Three cases of lumbar disc rupture and one of cauda equina associated with spinal manipulation (chiropraxis). Lancet 1983;1:411.
  15. Markowitz HD, Dolce DT. Cauda equina syndrome due to sequestrated recurrent disk herniation after chiropractic manipulation. Orthopedics 1997;20:652-3.
  16. Saal JA. Natural history and nonoperative treatment of lumbar disc herniation. Spine 1996;21:2S-9S.
  17. Jagbandhansingh MP. Most common causes of chiropractic malpractice lawsuits. J Manipulative Physiol Ther 1997;20:60-4.
  18. Fardon DF, Millette PC. Nomenclature and classification of lumbar disc pathology. Recommendations of the Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology.

Last updated: May 17, 2007