Can Cracking Your Neck Cause a Stroke? The Sore Neck May Be the Warning
Most people with a torn neck artery have neck pain or a headache, so the sore neck someone gets adjusted may already be the tear.
You’ve probably seen the videos. A pair of hands turns someone’s head, there’s a loud crack, and the person on the table sighs with relief. Then there are the videos where a healthy young person tells you they had a stroke after an adjustment.
I operate on the neck, so I know where the arteries in there run. By the end of this, you’ll know the one check to do before anyone handles your neck.
What actually tears?
Two arteries on each side of your neck carry blood up to your brain. One of them, the vertebral artery, climbs through small holes in the sides of your neck bones, one bone after another.
Each of these arteries has a thin inner lining. When that lining tears, blood can seep into the artery’s wall. Most people with a torn neck artery have neck pain or a headache.
A clot can form where the lining tore, and a piece can break off and travel to the brain, where it can cause a stroke. Most of these tears happen on their own, without any injury you could point to.
So did the crack cause it?
Researchers in Ontario went through years of health records for people who’d had this kind of stroke. Beforehand, those people had seen family doctors about as often as chiropractors. Family doctors rarely adjust necks, so the researchers think many of these people were already in pain from the tear and went looking for help.
Other researchers dispute that. A smaller study in California found a stronger link between neck adjustments and torn arteries, even after accounting for neck pain. The American Heart Association says the link hasn’t been proven, but that patients should be told about it before anyone adjusts their neck.
In a big US study published this September, researchers compared adults with new neck pain who saw a chiropractor with adults whose visit ended in an ibuprofen prescription. After the adjustment, they saw no sign of a higher risk of a torn artery. They counted torn arteries instead of strokes, so the argument about strokes isn’t settled yet.
What should you do with a sore neck?
Sore necks are common, and torn neck arteries are rare. The pain I’d want you to notice is new, on one side, and unlike anything you’ve had.
Some signs can’t wait for an appointment. Call 911 right away for a drooping face, weakness or numbness in an arm, slurred speech, double vision or sudden dizziness, even if you’re young and healthy.
If you crack your own neck, the research is thin. There are a few case reports of a torn artery after people did it themselves, and no counts of how often it happens.
- The lining of a neck artery tears Most tears happen on their own, with no injury behind them.
- Blood seeps into the wall Most people with a torn neck artery have neck pain or a headache.
- A clot forms and can travel A piece can break off and block an artery in the brain.
- Get new, one-sided neck pain examined first See a doctor before anyone cracks or adjusts your neck.
The next time one of those neck-cracking videos plays, you’ll know which neck pain to get checked before anyone turns your head.
References
- Lee VH, et al. Incidence and outcome of cervical artery dissection: a population-based study. Neurology, 2006
- Arnold M, et al. Vertebral artery dissection: presenting findings and predictors of outcome. Stroke, 2006
- Cassidy JD, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine, 2008
- Smith WS, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology, 2003
- Biller J, et al. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014
- Trager RJ, et al. Association between spinal manipulative therapy and cervical artery dissection in patients with neck pain or headache: a retrospective cohort study. Chiropr Man Therap, 2026
Figure. The internal carotid and vertebral arteries, right side, Henry Vandyke Carter, Gray’s Anatomy (1918), public domain, cropped, via Wikimedia Commons.
