Neck Cracking: Stroke Risk And Prevention

Neck cracking, also known as neck popping or cervical spinal manipulative therapy, is a common phenomenon that happens due to unnatural neck movements. While it is rare, cracking your neck can cause a stroke. This happens when a tear forms in the inner lining of an artery, leading to blood clots that can cause blockages in arteries downstream, cutting off blood supply to the brain. This is known as an ischemic stroke.

Cracking your neck can tear an artery

Cracking your neck can, in rare cases, cause a stroke by tearing the inner lining of an artery. This is known as cervical artery dissection, or more commonly, vertebral artery dissection. When this happens, blood begins to leak into the torn blood vessel, causing the space inside the vessel through which blood normally flows to narrow or become completely blocked. This can lead to the formation of blood clots, which may break free and travel to the brain, causing an ischemic stroke.

The two vertebral arteries, which are major arteries in the neck, join to form the basilar artery that supplies blood to the back of the brain. These arteries are vulnerable to injury by rotation and bending of the neck as they pass through bony canals in the vertebrae.

While cracking your neck can lead to a stroke, the risk is very small. The cause-and-effect relationship is also uncertain. In the case of Josh Hader, a 28-year-old man who suffered a stroke after cracking his neck, it is more likely that the tear in his artery and the resulting blood clot were already present before he cracked his neck. The cracking movement may have simply dislodged the clot.

Strokes due to vertebral artery dissection from neck manipulation can cause paralysis, and in some cases, the early symptoms can be subtle, including neck pain and a headache. If you experience any of the following symptoms after cracking your neck, call emergency services immediately:

• Numbness or weakness, particularly if it impacts one side of the body or face
• Dizziness or loss of balance
• Problems with vision
• Slurred speech or difficulty talking

This can lead to blood clots

Neck cracking can lead to a stroke, although this is a rare occurrence. The speedy twisting of the neck can cause a small dissection in the inner artery lining, which in turn causes the formation of blood clots. These clots can dissolve without causing harm or displaying any symptoms. However, they can also break free and travel to the brain, blocking an artery and causing an ischemic stroke. This blockage cuts off the blood supply to part of the brain.

The two vertebral arteries in the neck join to form the basilar artery, which supplies blood to the back of the brain. These arteries are vulnerable to injury by rotation and bending of the neck as they pass through bony canals in the vertebrae. When the neck is turned, these arteries are stretched.

Habitual neck cracking can weaken the ligaments that hold together the joints between the vertebrae, allowing for more extensive neck movement and increasing the vulnerability of the arteries to injury. This can lead to a tear in the artery, known as vertebral artery dissection, which is one of the most common causes of stroke in people under 45.

While the risk of a stroke from neck cracking is small, it is best to avoid habitual neck cracking to reduce the chances of this rare but serious complication.

Blood clots can cause an ischaemic stroke

Blood clots can cause an ischemic stroke, which occurs when a vessel supplying blood to the brain is blocked. This blockage can be caused by a blood clot, preventing blood from reaching the brain. This is a medical emergency and can be fatal.

There are two types of ischemic strokes: thrombotic and embolic. Thrombotic strokes occur when a blood clot forms in the brain, while embolic strokes happen when a clot forms elsewhere in the body and travels to the brain, becoming stuck in a blood vessel.

The main cause of ischemic strokes is atherosclerosis, or fatty deposits (plaques) that line the vessel walls. These fatty deposits can cause two types of obstructions: cerebral thrombosis and cerebral embolism. Cerebral thrombosis is when a blood clot develops at the site of a fatty plaque within a blood vessel supplying blood to the brain. Cerebral embolism is when a blood clot forms in the heart or large arteries of the upper chest or neck and then travels to the brain, becoming lodged in the smaller blood vessels.

In rare cases, neck cracking or manipulation can lead to a stroke. This occurs when the speedy twisting of the neck causes a small dissection in the inner artery lining, leading to the formation of blood clots. These clots can block the artery, reducing or cutting off blood flow to the brain and resulting in a stroke. However, this is an uncommon phenomenon, and the likelihood of it causing a stroke is pretty low.

Vertebral artery dissection is a common cause of strokes in under-45s

Vertebral artery dissection (VAD) is a rare cause of stroke in the general population, but it is one of the more common causes of stroke in patients younger than 45. It is estimated that VAD is responsible for at least 20% of ischemic strokes in young people and up to 25% of stroke cases in this age group are due to VAD. The condition can be challenging to diagnose as its signs and symptoms can be vague.

VAD occurs when there is a tear in one or more of the three tissue layers that make up the vertebral artery. This can affect blood flow and lead to life-threatening complications such as stroke. The vertebral artery supplies oxygen-rich blood to the brain and spine, so a disruption in blood flow can have serious consequences.

The risk factors for VAD include spinal manipulation, vertebral artery hypoplasia, hypertension, oral contraceptive use, chronic headache syndromes/migraines, intrinsic vascular pathology, fibromuscular dysplasia, cystic medial necrosis, and recent infection. Activities such as chiropractic adjustment, deep tissue neck massage, yoga with neck hyperextension, painting a ceiling, and heavy weight lifting can also lead to VAD.

The typical patient with VAD is a young person who experiences severe occipital headache and posterior nuchal pain following a head or neck injury. They may subsequently develop focal neurological signs attributable to ischemia of the brainstem or cerebellum. In some cases, the early symptoms can be subtle and may include neck pain and a headache.

The treatment options for VAD include anticoagulation therapy, thrombolytic therapy, endovascular treatments, and surgical procedures. Most patients with VAD have a good prognosis and can achieve a full recovery. However, it is important to closely monitor neurological deficits and provide appropriate rehabilitation therapy if necessary.

The risk of stroke from neck cracking is tiny

Neck cracking, also known as neck popping or cervical spinal manipulative therapy (cSMT), is a common phenomenon that occurs due to unnatural neck movements. While it can be performed at home, it is also often done by professionals like chiropractors and osteopaths to treat neck pain.

Neck cracking can, in rare cases, cause a stroke. This happens when a small tear, or dissection, occurs in the inner lining of an artery, leading to blood clots that can cause blockages in arteries downstream. This is known as an ischemic stroke, where the blood supply to the brain is cut off. The risk of this happening is increased when the ligaments that hold together the joints between the vertebrae are weakened, allowing for more extensive neck movement and leaving the arteries more vulnerable to injury.

However, the risk of stroke from neck cracking is tiny. While there are reports of individuals suffering strokes after cracking their necks, these cases are rare. Estimates for the incidence of arterial tears after chiropractic treatment range from 1 in 20,000 to 1 in 250,000 treatments. The number of people who crack their necks is unknown but is probably large, further suggesting a low risk.

Additionally, the cause-and-effect relationship between neck cracking and stroke is not always clear. In some cases, the tear in the artery and the resulting blood clot may already be present before the neck is cracked, with the movement simply dislodging the clot. Furthermore, stroke is a common condition with various risk factors, including high cholesterol, irregular heart rate, and high blood pressure.

While the risk of stroke from neck cracking is small, it is still important to be cautious. If you experience any pain, numbness, dizziness, or other unusual symptoms after cracking your neck, seek medical advice. For those with spine conditions or weak connective tissues, it is recommended to avoid neck cracking altogether.

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