Statement of Concern to the Canadian Public from Canadian Neurologists Regarding the Debilitating and Fatal Damage Manipulation of the Neck May Cause to the Nervous System

We Canadian neurologists hereby express our strong concern and thereby issue this warning to Canadians. The public must be made aware that the neurological damage that can result subsequent to upper neck manipulation can be debilitating and fatal.

We make the following recommendations for the attention of the Canadian public, the practitioners of manipulation, the medical community, the provincial Ministries of Health and the health care professional regulatory bodies.

Our concerns are significant. Stroke and death due to neck manipulation has been reported in the scientific literature for over 50 years. New deaths, in the past few years, have been reported to the Canadian Stroke Consortium. The Canadian Stroke Consortium recently published a major prospective study. The latest data from the Stroke Consortium indicates that “more than 100 cases of dissection per year are associated with neck manipulation.” The resulting stroke and debilitation from such a large number is very significant.

A recent study by the Institute of Clinical Evaluative Sciences (ICES Ontario) indicates that patients with posterior circulation strokes under the age of 45 are 5 times more likely than controls to have visited a chiropractor within one week of the event.