Neck Popping: Stroke Risk And Real Dangers

Neck cracking, or popping, is a common phenomenon that occurs due to unnatural neck movements. While it may provide relief to some, the habit can be dangerous and has been associated with an increased risk of stroke. In rare cases, neck manipulation can cause cervical artery dissection, leading to blood clots and blockages in arteries that supply blood to the brain, resulting in an ischaemic stroke.

Stroke cases in young people

Strokes are typically associated with older people, but they can and do happen to younger people as well. In fact, according to the CDC, there has been a 15% increase in strokes in people under 65 in the US from 2011-2013 to 2020-2022. This trend is also reflected in other parts of the world. For example, in the Netherlands, the incidence of stroke in young adults increased from 14.0/100,000 person-years in 1998 to 17.2/100,000 person-years in 2010. Similarly, a French study found that the incidence of ischemic strokes in adults under 55 increased from 11.6 per 100,000 in 1985-1993 to 20.2 per 100,000 in 2003-2011.

While stroke is more common in older adults, it is important to recognize that it can occur in young people as well. Studies have shown that approximately 10% of stroke patients are under the age of 50. The risk of stroke is higher in young adults with congenital heart disease, with a nine to twelve times greater risk compared to the general population. Additionally, pediatric ischemic strokes are more common in males than females, possibly due to higher levels of physical activity in young men.

There are several risk factors that can contribute to stroke in young people. These include congenital abnormalities, blood clotting disorders, drug use, high blood pressure, obesity, diabetes, smoking, and high cholesterol. Poor lifestyle choices, such as unhealthy eating habits, lack of exercise, smoking, alcohol consumption, and drug use, can also increase the risk of stroke in younger adults.

The signs and symptoms of stroke in young people may include speech disturbances, vision or balance problems, numbness or weakness on one side of the body, and severe headaches. It is important to recognize these signs and seek medical attention immediately, as quick treatment can help reduce the risk of long-term deficits and disabilities associated with stroke.

To reduce the risk of stroke, young people should focus on maintaining a healthy lifestyle. This includes not smoking, eating a healthy diet rich in fruits and vegetables, and engaging in regular physical activity. By making these healthy choices, young people can help lower their risk of stroke and improve their overall cardiovascular health.

Risk factors for strokes in young people

Strokes in young people are occurring more often, and experts are yet to pinpoint an exact reason for this spike in cases. However, an unhealthy lifestyle, including poor diet, limited exercise, smoking, and overconsumption of alcohol, are factors leading to strokes in younger adults.

Modifiable Risk Factors

• Hypertension or high blood pressure is a leading cause of strokes. It occurs when the pressure of the blood in your arteries is too high. There are often no symptoms of high blood pressure, so it is important to get it checked regularly.
• Obesity is linked to higher "bad" cholesterol and triglyceride levels and lower "good" cholesterol levels. Obesity can also lead to high blood pressure and diabetes.
• Diabetes causes sugars to build up in the blood and prevents oxygen and nutrients from getting to the brain.
• High cholesterol can lead to a build-up of cholesterol in the arteries, including those of the brain, which can cause a blockage.
• Smoking can damage the heart and blood vessels and increase blood pressure.
• Drinking alcohol raises blood pressure levels and the risk of stroke. It also increases the levels of triglycerides, a form of fat in the blood that can harden the arteries.
• Drug use can cause blood pressure to be severely elevated.

Non-Modifiable Risk Factors

• Previous stroke or transient ischemic attack (TIA): If you have already had a stroke or a TIA, also known as a "mini-stroke," your chances of having another stroke are higher.
• Family history: Stroke risk can be higher in some families than in others due to shared genes, behaviours, lifestyles, and environments.
• Age: The older you are, the more likely you are to have a stroke. The chance of having a stroke about doubles every 10 years after age 55. However, strokes can occur at any age.
• Sex: Women of all ages are more likely than men to die from a stroke.
• Race or ethnicity: People who are non-Hispanic Black or Pacific Islander may be more likely to die from a stroke than people who are non-Hispanic White, Hispanic, American Indian or Alaska Native, or Asian. The risk of having a first stroke is nearly twice as high for Black people as for White people.
• Pregnancy and birth control pills pose unique stroke risks for women.

The cause-and-effect relationship

While it is possible to have a stroke after popping your neck, this is a very rare occurrence.

Popping your neck can cause a small tear (dissection) in the inner lining of an artery, which can lead to blood clots forming. These clots can then fly off and cause a blockage in an artery, cutting off the blood supply to the brain and resulting in an ischaemic stroke. The vertebral arteries, which supply the back of the brain with blood, are particularly vulnerable to injury during neck popping due to their location.

However, the likelihood of suffering a stroke from neck popping is very low. In the case of Josh Hader, a 28-year-old man who suffered a stroke after popping his neck, it is more likely that the tear in his artery and the resulting clot were already present before he popped his neck, and that the movement simply dislodged the clot. Hader had been experiencing neck pain for a couple of weeks prior to his stroke, which may have been an early symptom of the tear.

Strokes due to vertebral artery dissection from neck manipulation account for only 2% of ischemic strokes overall, and while they can cause paralysis, the early symptoms can be subtle and may include neck pain and headaches. The risk of spontaneous vertebral artery dissection and stroke without spinal manipulation may be higher in people with certain conditions, such as atherosclerosis or fibromuscular dysplasia.

While neck cracking can lead to stroke in rare cases, the risk is tiny, and cracking sounds during normal physical activity are not usually a cause for concern. However, it is best to avoid habitual neck cracking, as this can weaken the ligaments in the neck, leaving the arteries more vulnerable to injury.

Treatment for strokes caused by neck cracking

While neck cracking or popping can lead to strokes, they are rare. Strokes caused by neck cracking are the result of a tear in the inner lining of an artery, which can cause blood clots to form and lead to a blockage in an artery, cutting off the blood supply to the brain. This is known as an ischaemic stroke.

If you suspect that someone is having a stroke, you should call emergency services immediately. The standard treatment for strokes involves administering a fast-acting blood thinner called tPA (tissue plasminogen activator) to dissolve blood clots and improve blood flow. This treatment is most effective when given within three hours of the onset of symptoms, and can still be administered up to 4.5 hours after symptoms begin in certain cases. Low-dose aspirin is also used to reduce the long-term risk of a second stroke.

To prevent strokes caused by neck cracking, it is recommended to avoid habitual neck cracking or popping. While cracking or popping sounds in the neck during normal physical activity are usually harmless, deliberate neck manipulations can increase the risk of a stroke, even if it is a rare occurrence.

Precautions and treatments for strokes caused by neck popping

Neck cracking or popping is a common phenomenon that occurs naturally with neck movements. While it is rare, neck popping can cause strokes, especially when done regularly. However, by current knowledge, the risk of a stroke occurring due to neck popping is tiny. Here are some precautions and treatments to consider:

Precautions

• While cracking sounds in the neck during normal physical activity are usually harmless, it is best to avoid habitual neck cracking.
• If you experience neck pain or stiffness, consider gentle stretches, cold and heat therapy, massage, or over-the-counter pain relievers such as ibuprofen or acetaminophen.
• If your neck pain worsens or persists, consult a healthcare professional to determine the underlying cause.
• If you seek chiropractic care for neck pain, use a licensed and experienced chiropractor who will collaborate with your primary care doctor.

Treatments

• If you experience symptoms of a stroke, such as numbness, weakness, dizziness, vision problems, or slurred speech, call emergency services immediately.
• In the case of a stroke, the individual will receive normal stroke treatment, which includes administering a fast-acting blood thinner called tPA (tissue plasminogen activator) intravenously to dissolve blood clots and improve blood flow. This should be given within 3-4.5 hours of the onset of symptoms.
• Low-dose aspirin may also be used to reduce the long-term risks of a second stroke.

Frequently asked questions