Whilst such adverse effects are rare...

Whilst such adverse effects are rare, we nevertheless need to request that you sign an informed consent document and fully complete your medical intake screening form before your first appointment to indicate that you have been duly informed of any possible side effects of the therapies you may receive at this practice and to ensure we have the fullest possible picture of your current and historical health. You will receive this intake form and information pack automatically on booking your first appointment and again with your appointment reminders.


Concerning Neck Manipulations:

If you are attending for UPPER NECK pain or severe HEADACHES, please read your medical intake form fully and discuss with your Osteopath accordingly.

There have been a few occasions, following manipulation of the neck, where stroke-like symptoms and, in extremely rare cases, severe injury or death have resulted.

If a vertebral artery has already been damaged (Vertebral Artery Dissection or VAD) by a previous injury or, if it already has some inherited weakness, it can be at risk as it winds around the atlas (the top cervical vertebra, located just below the head). See: Boyle E, Cote P, Grier A. R. Examining vertebrobasilar artery stroke in two Canadian provinces. J Manipulative Physiol. Therapy 2009; 32:S194-200

During manipulation, this artery may be stretched, or tear a previously weakened lining, causing sudden, extremely severe ‘thunderclap’ headaches or neck pain. If this occurs, a thrombus (small blood clot) can then form in the injured artery wall, which may lead to a stroke or T.I.A.

Occasionally, a milder and temporary reaction, called a transient neurological adverse event can occur. It is important to note that these events can also occur in the population at large, who have never had manipulation.

There are 194 events per 1000 people who have manipulation

There are 99 events per 1000 people who have never had any manipulation

(Figures taken from Carlesso L.C., Gross A.R., Santaguida P.L., et al. Adverse events associated with the use of cervical manipulation and mobilisation for the treatment of neck pain in adults: a systematic review. Manual Therapy 2010; 15(5): 434-444)

These activities have also been known to cause a TIA or stroke:

Ceiling painting
Nose blowing
Sneezing
Coughing
Judo
Tennis
Minor neck trauma
Yoga
Visit to the hairdressers
Reversing the car
Certain medical factors can increase your chances of damaging the vertebral artery
High blood pressure
More common in females: Oral contraceptive use
Chronic headaches
Vascular pathology
Migraine
Smoking
Anticoagulants