Deadly twist: Neck adjustments can be risky

As Lauretti notes, almost any sudden movement of the neck can tear an artery — leaning your head back to drink a soda, for instance, doing yoga, stargazing or craning to check your blind spot as you back out of the driveway. Medical journals have reported numerous cases of women who have been seriously injured having their hair washed at a salon. According to a study from Cedars-Sinai Medical Center in Los Angeles, one-fourth of arterial dissections are caused by abnormalities that already exist in the connective tissue that make certain people particularly vulnerable to the injury. “It’s not a simple black-and-white issue that someone who visits the chiropractor and then suffers a stroke can say clearly it’s the chiropractor’s fault,” says Wouter I. Schievink, M.D., director of the vascular neurosurgery program at Cedars-Sinai. “It’s not always clear what came first, the dissection or the manipulation.”

Given the enormous amount of chiropractic visits in this country, Dr. Schievink says, the risk per visit is tiny. On the other hand, patients see chiropractors an average of 10 times during treatment. “If you take into consideration how many times they go and how many manipulations are performed, it does become a public health concern,” he says. “It’s a low risk but potentially a life-threatening one.”

‘I miss the old Christa’
It’s the late fall of 2006 and Christa Heck looks like any other professional woman walking along Manhattan’s East Side. Her light-brown hair is freshly highlighted, her dark-blue pantsuit neat and stylish. But when she steps from the street to the curb, she stumbles to the right. Certain the fumbling has gone unnoticed, she continues to chat, but her words are ever so slightly slurred.

To remember her meeting today, Heck says that she placed notes by her bed, on her bathroom door and on the microwave oven in the kitchen. “Otherwise, I might not have remembered to come,” she says, pulling medical records from a large manila envelope. She points to a 2005 neurology report that suggests she has a generalized brain injury with symptoms such as memory loss, impaired motor coordination and slower mental processing.

Heck speaks as if her true self was lost in the past — about her 3.97 grade point average in college, her plans before the stroke to go to law school and her once phenomenal ability to multitask, caring for four children while being the sole breadwinner for her family when Ed was forced onto disability. These days, her girls — ranging in age from 15 to 25, three of them stepdaughters from Ed’s previous marriage — don’t rely on her so much. “I can’t tell you how many times I’ve simply forgotten to pick up my youngest daughter from soccer practice,” she says. Nor does she see her friends as often as she used to. “I asked one of my friends if I had changed, and she said, ‘Honestly, Christa, you’ve changed a lot.’ It breaks my heart.”

Heck continued to work for two years after the stroke, her manager adjusting her assignments to help her cope. But when her company introduced a new product for her to sell, Heck resigned. “I couldn’t handle too many things at once,” she says. She has considered a job in retail, but her psychiatrist told her she might find it difficult when the store got busy and recommended she take a quiet back-office job.

Meanwhile, she spends time working with Victims of Irresponsible Chiropractic Education and Standards (VOICES), a fledgling advocacy group comprising families of 60 victims of chiropractic stroke, five of whom have died. The group is urging Congress to ban cervical manipulation. While federal action seems unlikely, another group of victims in Connecticut is supporting bills that would require that state to track chiropractic injuries and add chiropractors to a public database of physician credentials, disciplinary actions and malpractice suits. A third proposed law would require Connecticut chiropractors to obtain written consent before doing a neck adjustment, explain the risk for stroke and detail its symptoms.

“Had I known stroke was a risk, I would have recognized that something was wrong before going back a second time,” Heck says with tears in her eyes. “I miss the old Christa so much. Had I known better, I’d still have her.”

This article was originally published in the May 2007 issue of SELF.

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