When most people think of a chiropractor, they picture forceful twisting and popping sounds. Given that image, it’s completely understandable why questions about safety, particularly regarding stroke risk, come up. But what if the care you received was so gentle it felt more like having your pulse taken? At our clinic, we specialize in a precise, non-invasive technique that is fundamentally different from traditional manipulation. Before we get into the clinical studies, it’s important to know that not all chiropractic care is the same. Let’s explore the real data on stroke risk chiropractic care and how our specific approach prioritizes your safety.
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
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.
It’s completely understandable why this topic causes concern, especially when you come across alarming headlines or hear warnings from other doctors. The conversation often points back to a few key studies that have explored a potential connection. One of the most frequently cited pieces of research, published by the American Academy of Neurology, found that patients under 60 who experienced a stroke from a tear in a neck artery were six times more likely to have had a neck adjustment in the month prior. This finding, while significant, highlights an association rather than direct causation, but it’s a statistic that has understandably fueled the debate and raised important questions about the safety of traditional spinal manipulation.
This isn't the only study to examine the connection. Further research from Ontario also noted a strong link between chiropractic visits and strokes, particularly in younger adults. These findings from reputable neurological and heart associations are precisely why some medical professionals advise caution. It’s also why it’s so crucial to have an open and honest conversation about the potential risks associated with different types of chiropractic care. Understanding where the concern comes from is the first step in making an informed decision and finding a technique that feels both safe and effective for you and your body.
To get a clearer picture, it helps to look at the specific numbers. The American Academy of Neurology study reported that the chance of any type of stroke within 30 days was about 5.1 out of every 1,000 patients who saw a chiropractor, compared to 2.8 out of every 1,000 who saw a primary care doctor. What’s most telling, however, is the timeline. For patients whose stroke was linked to a neck artery tear, the event happened, on average, just 1.4 days after the adjustment. This incredibly short window supports the theory that many of these individuals were likely experiencing early stroke symptoms, like neck pain from an existing arterial tear, and were seeking care for that pain, not knowing its underlying cause.
“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).
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).
Systematic review & meta‑analysis
Concluded no convincing evidence for a causal link between neck adjustments and cervical artery dissection (CAD) (Cureus).
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).
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).
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.
When you start looking into this topic, you’ll find a lot of conflicting information, which can be incredibly frustrating. Some studies suggest a link, while others find none. The key is to look at what the highest-quality research concludes. For example, a major 2015 study by Kosloff et al. found no significant association between chiropractic visits and the type of stroke linked to neck artery tears. Interestingly, they found a stronger association between strokes and visits to a primary care provider (PCP). This doesn’t mean PCPs cause strokes; it suggests that people experiencing early symptoms of a tear, like neck pain and headaches, are rightfully seeking care from their doctor.
This finding supports the idea that the chiropractic visit isn't the cause but rather a destination for someone already in trouble. Another large-scale review by Church et al. in 2016 concluded there is no convincing evidence for a causal link between chiropractic neck adjustments and cervical artery dissection. While some researchers, like Haynes in 2012, point out that the evidence is complex, the overall picture from robust studies shows that a chiropractic adjustment is an unlikely cause of a stroke.
It’s also important to understand that cervical artery tears, while serious, can happen for many reasons—many of which are surprisingly ordinary. According to the American Academy of Neurology, these tears can be caused by injuries from car accidents or sports, but they can also result from simple, sudden movements like coughing, sneezing, or lifting something heavy. In many cases, the cause is completely unknown, and the tear occurs spontaneously. This context is crucial because it shows that the forces the neck arteries endure during everyday life can sometimes be enough to cause an issue, independent of any healthcare treatment.
This is why the findings from the Cassidy et al. study are so telling. Researchers observed that the risk of stroke after a chiropractic visit was the same as after a visit to a primary care physician's office. This strongly suggests that the patient was already experiencing symptoms of an active, in-progress artery tear and was seeking help for the resulting neck pain or headache. The healthcare visit didn't cause the event; the event caused the healthcare visit.
| Study / Source | Population & Methods | Key Conclusion |
|---|---|---|
| Kosloff et al. (2015) | US insured and Medicare Advantage adults | No significant link between chiropractic and VBA stroke |
| Cassidy et al. (2008) | Canadian case–crossover study, all ages | Elevated stroke risk only in under‑45; also after PCP visits |
| Church et al. (2016) | Systematic review / meta‑analysis | No evidence that adjustments cause CAD |
| Haynes review (2012) | Literature review | Evidence inconclusive for association or no association |
| Connecticut Board ruling (2010) | Regulatory review in CT | No demonstrated risk of stroke from neck adjustments |
It’s completely understandable to feel concerned when you hear conflicting information about your health, especially from different doctors. Let’s clear the air with what the best research tells us. High-quality studies have not shown that chiropractic visits, including neck adjustments, cause strokes. Instead, the evidence strongly suggests that any statistical link is due to patients seeking care for symptoms that are actually the early stages of a stroke, like neck pain or headaches. Think of it this way: someone with chest pain might go to their doctor and have a heart attack the next day. The visit didn't cause the heart attack; the symptoms prompted the visit. The same principle applies here, reinforcing that care from a licensed professional is not the cause.
Being informed about your body is one of the best ways to advocate for your own health. It's helpful to recognize the warning signs of a stroke, regardless of what type of care you're receiving. Key symptoms to watch for include new or unusual neck pain, blurry vision, sudden nausea, dizziness, or numbness on one side of your body. These signs can sometimes appear days or even weeks before a major vascular event, which makes them easy to dismiss as something less serious. If you ever experience a sudden onset of these symptoms, it's crucial to seek immediate medical attention to rule out any serious underlying issues, like a tear in an artery that could lead to a stroke.
It's also important to remember that not all chiropractic care is the same. The studies you'll find on this topic almost always refer to traditional chiropractic methods, which often involve high-velocity thrusts or "cracking." At Lazar Spinal Care, we use a completely different method. Our primary technique, Quantum Spinal Mechanics (QSM³), is incredibly gentle and precise. The adjustments feel more like someone is lightly taking your pulse than anything forceful or jarring. This means the care we provide is not only effective at addressing the root cause of your health challenges but is also significantly safer than the methods discussed in most clinical studies, giving you peace of mind.
The strong association found between primary care provider visits and stroke highlights a key point: people seek help when they feel pain. Many patients visit a doctor for neck pain or headaches that are actually early symptoms of a stroke in progress. Our approach is different because it starts with a foundational understanding of your body's unique structure. Instead of general manipulation, our upper cervical technique focuses on precise, gentle corrections to the top of the spine. This method avoids the forceful twisting and popping associated with traditional chiropractic, creating a safer and more comfortable experience while still achieving powerful results for your nervous system and overall health.
Your safety is our top priority, which is why our process begins long before any adjustment is made. As a new patient, you'll undergo a comprehensive NeuroBioStructural Analysis, which includes advanced diagnostics like PostureIQ™ and Insight™ neurological scans. This detailed assessment allows us to see exactly what's happening with your spine and nervous system. By identifying the precise nature of your issue, we can ensure that our care is perfectly tailored to you. This process also helps us screen for any underlying conditions that might make certain types of care inappropriate, ensuring we always proceed with the safest and most effective plan for your body.
Shifting the conversation from risk to recovery, it's interesting to see emerging research on how chiropractic care can actually support the body after a stroke. Studies suggest that because of its influence on the central nervous system, chiropractic care may help facilitate motor recovery in stroke survivors. By restoring proper alignment and function to the spine, particularly the upper cervical area, we can help improve the communication between the brain and the body. This can support the body’s natural healing processes and potentially aid in regaining function, showing that chiropractic care can be a valuable part of a comprehensive, long-term wellness plan for many different health conditions.
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.
Why did my doctor warn me about strokes if chiropractic care is safe? It's a valid question, and it often comes from a place of caution based on older or misunderstood research. Some studies have shown a statistical link between chiropractic visits and strokes, but what the highest-quality research now shows is that this is a matter of association, not causation. People experiencing the early stages of a stroke, which can include neck pain and headaches, will naturally seek care. The stroke was already in progress before the visit, but the visit gets linked to it statistically.
What makes the adjustments at Lazar Spinal Care different from traditional chiropractic methods? This is a key point. Most of the research on this topic looks at traditional high-velocity adjustments, which involve twisting and popping. Our approach is fundamentally different. We use a technique called Quantum Spinal Mechanics (QSM³), which is incredibly gentle and precise. The adjustment feels more like a light touch or someone taking your pulse. Because it avoids any forceful manipulation, it's an even safer method than the ones already deemed low-risk in major studies.
How can you be sure an adjustment is safe for me specifically? Your safety is our first priority, and our process reflects that. Before any adjustment is ever performed, we conduct a comprehensive NeuroBioStructural Analysis. This includes advanced diagnostics like PostureIQ™ and Insight™ neurological scans to get a precise picture of your spine and nervous system. This detailed assessment allows us to understand the exact cause of your issue and screen for any underlying conditions, ensuring that the care plan we design is perfectly suited and safe for you.
Are you saying there's zero risk of stroke with a neck adjustment? High-quality studies conclude that the risk of stroke following a chiropractic visit is extremely low and is no greater than the risk following a visit to your primary care doctor's office. Biomechanical research has even shown that the strain placed on the neck's arteries during an adjustment is well within the range of normal, everyday movements. The evidence strongly points to care from a licensed professional not being a cause of stroke.
If my neck pain could be an early stroke symptom, should I avoid seeing a chiropractor? Not at all. In fact, a thorough examination is the best way to figure out what's causing your pain. Our diagnostic process is designed to identify the source of your symptoms. It's also helpful for you to know the distinct warning signs of a stroke, which include sudden numbness or weakness on one side of the body, confusion, trouble seeing, or a sudden severe headache unlike any you've had before. If you experience these, you should seek emergency medical care immediately.