Evidence On Safety And Stroke Risk From Chiropractic Adjustments - A Literature Review

A Note From Dr. Lazar

Hi, Friends —

I wrote this post in response to a young woman whose cardiologist recently advised her to stop seeing my team—or any chiropractor—because she might “end up having strokes.”

I’ll refrain from editorializing (as best I can), but here’s what she messaged us:

“I went to a cardiologist today who said I should stop seeing you guys because I could end up having strokes from seeking treatment through a chiropractor. I am very lost and confused on what I should be doing because these doctors haven't even been a help for me, and I don't even know if I believe them. Is it true that I could end up having a stroke? I'm upset with not really having any answer from this other doctor, but you have been very helpful and seem to be giving me answers and relief I haven't seen in years with my pain. I also feel like either way, I could be at a loss and end up disabled.”

When I spoke with her directly, here’s what she shared with me:

• She no longer trusts that cardiologist and asked if I could recommend someone else.

• She’s concerned that her worsening symptoms are being unfairly blamed on our care.

• After just a few weeks under our care, she’s able to mop and clean without needing to stop and rest—something she hasn't been able to do for years.

• She’s hopeful and excited about the progress she’s already made and where she’s headed next.

This kind of situation is heartbreaking. No one should be made to feel afraid, confused, or stuck—especially when they’re finally seeing real progress. That’s why I decided to send her some clinical research articles to help set her mind at ease. And then I thought, “Why not make this available to everyone?”

Below, you’ll find peer-reviewed studies that explore the safety of chiropractic care—particularly regarding stroke risk. And here’s something especially important: these articles refer to traditional chiropractic techniques, which involve high-velocity, low-amplitude thrusts.

At Lazar Spinal Care, we take it even further. Our technique, QSM³, uses gentle, precise adjustments that feel more like having your pulse taken than anything forceful. That means the care we provide through The Lazar Method is not only effective—but it’s even safer than the methods discussed in these studies.

Thanks for taking the time to read and explore. I hope this information empowers you to make confident, informed decisions about your care.

— Dr. Lazar

Quick Summary

Chiropractic care, especially cervical spine manipulation performed by licensed professionals, has not been demonstrated to cause stroke or arterial dissection in the general population. Most associations seen between visits and stroke are likely due to patients seeking care for early symptoms of dissection (e.g. neck pain) rather than the adjustment itself being causal.

Key Studies & Reviews

1. Kosloff et al. (2015) (Click here to download)

“Chiropractic care and the risk of vertebrobasilar stroke: results of a case‑control study in U.S. commercial and Medicare Advantage populations.”

• Used data from ~1,829 VBA stroke cases.

• Found no significant association between chiropractic visits and vertebrobasilar stroke in both commercial and Medicare Advantage populations (all age groups) (PubMed).

• Chiropractic care is an unlikely cause of VBA stroke; Primary Care Provider (PCP) visits had a stronger association, likely because patients with dissection symptoms seek medical attention first (PubMed).

2. Cassidy et al. (2008) (Click here to download)

Population-based case–crossover study in Canada (reported in Rothwell & Côté et al.)

• Showed elevated risk only in people under 45, and also observed the same increased risk after PCP visits—suggesting pre-stroke symptoms prompt care, not adjustment causing stroke (Wikipedia).

3. Church et al. (2016) (Click here to download)

Systematic review & meta‑analysis

• Concluded no convincing evidence for a causal link between neck adjustments and cervical artery dissection (CAD) (Cureus).

4. Haynes (2012) (Click here to download)

Review on risk of stroke from neck adjustments

• Emphasized that evidence is inconclusive for both a strong association or a complete absence thereof, highlighting observational limitations (PMC).

5. Connecticut Chiropractic Board (2010 ruling)

• Declared that evidence is insufficient to conclude that stroke or CAD is a risk or side effect of chiropractic cervical adjustments. Stroke likelihood after chiropractic care is no greater than after PCP care (journal.parker.edu).

Additional Evidence & Context

• ClinicalCompass (2021): notes the Kosloff case-control study and biomechanical research showing no abnormal strain on arteries during adjustment, reinforcing safety perspectives (The Clinical Compass).

• Biomechanical studies demonstrate that cervical adjustments typically imparts strains well within safe ranges seen in normal neck movements (The Clinical Compass).

Chiropractic visits—including neck adjustments—have NOT been shown to cause strokes or arterial dissections in high-quality studies. Research indicates any statistical association is likely due to patients seeking care for symptoms that precede strokes. Most evidence finds no increased risk compared to routine visits to primary care providers.

At‑a‑Glance Comparison Table

Key Takeaways

• Stroke risk after chiropractic care is extremely low and comparable to medical visits.

• Apparent associations are likely due to symptom-driven care, not causation.

• Evidence for causal links is absent or weak, particularly in older patients.

• Licensed chiropractors perform cervical adjustments within safe biomechanical limits.

Disclaimer:
This document is intended for educational purposes only and does not replace personal medical advice, diagnosis, or treatment. Patients are encouraged to make healthcare decisions in collaboration with qualified providers they trust. If you've received conflicting recommendations—especially ones that cause fear or confusion—it may be wise to seek a second opinion and review current evidence before making decisions about your care. The information and research presented here are provided to clarify common misconceptions about chiropractic care and stroke risk, based on peer-reviewed scientific literature. This document is not intended as legal or medical advice.