Chiropractic Care & Stroke: Debunking the Myth (What Patients in Wellington Should Know)

The headline claim—does chiropractic “cause” stroke?

Short answer: the best available evidence does not support a causal link between chiropractic neck adjustments and stroke. The most cited population study found no excess risk of vertebrobasilar artery (VBA) stroke after a chiropractic visit compared with a GP visit—suggesting that people already developing a cervical artery dissection (CeAD) often seek care for neck pain or headache before the stroke is diagnosed. pmc.ncbi.nlm.nih.gov

In older adults (the group at highest baseline stroke risk), a large Medicare analysis reported no increased risk of stroke after chiropractic care versus evaluation by a primary care physician for neck pain. PubMed

A systematic review and meta-analysis led by neurosurgeons concluded there’s a small statistical association between cervical manipulation and CeAD, but the quality of evidence was very low and the association is most likely explained by bias and confounding—especially the fact that neck pain/headache are early CeAD symptoms that prompt care (“protopathic bias”). In other words, correlation ≠ causation. pmc.ncbi.nlm.nih.gov

The American Heart Association/American Stroke Association (AHA/ASA) agrees: the literature shows an association, not proven causation, and clinicians should be alert to CeAD warning signs during assessment. The AHA/ASA updated its scientific guidance again in 2024, reinforcing careful screening and shared decision-making. PubMedportailvasculaire.fr

How rare is cervical artery dissection—and who does it affect?

CeAD is uncommon. A 2024 population-based analysis estimated an overall incidence of around 4.7 per 100,000 people per year across carotid and vertebral arteries (with trends reflecting better detection in modern imaging). ahajournals.org

Despite being rare overall (about 2% of all ischaemic strokes), CeAD is an important cause of stroke in younger adults, contributing up to 15–25% of ischaemic strokes under 50. That’s one reason the topic draws attention disproportionate to its frequency. ahajournals.org

For local context: in Aotearoa New Zealand, over 9,000 strokes occur each year (all causes, all ages). Prevention through blood-pressure control, exercise, not smoking, and healthy nutrition still dwarfs any other strategy for reducing stroke burden. stroke.org.nz

Why the myth persists: symptoms that precede care

Many people with an undiagnosed dissection first experience neck pain or a new, unusual headache—sometimes days or weeks before neurological symptoms appear. Understandably, they seek help (from a GP, urgent care, or a chiropractor). This care-seeking creates a time link that looks like cause-and-effect when it’s actually a sign of the underlying vascular problem declaring itself. pmc.ncbi.nlm.nih.gov+1

What a Wellington chiropractic clinic should do to keep you safe

At our Wellington chiropractic clinic, safety is a system, not a slogan. Here’s how we approach it:

• Thorough history & screening: We ask targeted questions for vascular risk and “red flag” features (sudden severe neck pain or headache—especially behind one eye—neurological changes, recent minor trauma or infection, migraine history, connective tissue disorders). If we suspect a vascular issue, we don’t adjust; we arrange urgent medical assessment. portailvasculaire.fr
• Clinical reasoning over routine: Where appropriate, we use lower-force options (e.g., mobilisation, instrument-assisted methods) and avoid end-range positions—especially when you’re in acute pain.
• Informed consent: We’ll explain benefits, common short-lived reactions (like temporary soreness), rare but serious risks, and your options—so you choose what fits your goals and comfort.
• Focus on function: We target joint dysfunction/loss of proper motion and the neuromuscular patterns around it—paired with movement advice and strength-building so improvements last.

If you’re searching for a chiropractor in Wellington and want an evidence-based, safety-first approach, you’re in the right place.

When to act fast (wherever you seek care)

If you or someone with you develops face drooping, arm weakness, speech changes, sudden severe neck pain or headache, new dizziness/imbalance, or vision changes, treat it as an emergency. Call 111 immediately in New Zealand. (Remember F.A.S.T.—Face, Arm, Speech, Time.) stroke.org.nz

Bottom line

• The best evidence to date does not show chiropractic care uniquely increases stroke risk relative to visiting a GP. pmc.ncbi.nlm.nih.govPubMed
• CeAD is rare, and early symptoms often drive people to seek care—creating an association that can be mistaken for causation. pmc.ncbi.nlm.nih.gov
• AHA/ASA guidance emphasises screening and shared decision-making, which is exactly how a modern Wellington chiropractic clinic should practise. portailvasculaire.fr

References

1. Cassidy JD, et al. Spine (2008): No excess VBA stroke risk after chiropractic vs primary care. pmc.ncbi.nlm.nih.gov
2. Whedon JM, et al. J Manipulative Physiol Ther (2015): No increased stroke risk post-chiropractic in older adults. PubMed
3. Church EW, et al. Cureus (2016) Systematic review/meta-analysis: small association; very low-quality evidence; no proof of causation. pmc.ncbi.nlm.nih.gov
4. Biller J, et al. AHA/ASA Scientific Statement (2014); Jadhav AP/Yaghi S, et al. AHA/ASA Scientific Statement update (2024). PubMedportailvasculaire.fr
5. Griffin KJ, et al. Stroke (2024): CeAD incidence ~4.69 per 100,000 person-years (population data). ahajournals.org
6. Stroke Foundation New Zealand: ~9,000 strokes/year; prevention emphasis and F.A.S.T. messaging. stroke.org.nz
7. Trager RJ, et al. (2023): Neck pain/headache are common presenting symptoms among chiropractic patients later diagnosed with VAD. pmc.ncbi.nlm.nih.gov

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