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Patient Guide

Are Neck Adjustments Safe?

By Dr Adam Filocamo  |  BodySync Chiropractic, Stirling WA  |  July 2026

The most common concern people raise before their first neck adjustment is stroke risk. It is a fair question, and one worth answering properly. For most people, neck manipulation is safe, side effects are mild and short-lived, and serious complications are rare. Here is why the reputation does not quite match the reality.

Does Neck Manipulation Cause Stroke?

The concern most people have heard about involves a condition called cervical artery dissection, a small tear in the wall of an artery in the neck that can, in rare cases, lead to stroke. It sounds alarming, but the connection to chiropractic care is much less straightforward than it is often made out to be.

The key issue is that this condition tends to cause neck pain and headache before anything more serious develops. Those are the same symptoms that bring most people to a chiropractor. So in many cases, people are already in the early stages of a dissection when they book their appointment - they seek care because of the symptoms the condition is causing, not because of anything their chiropractor does. When this has been looked at properly, the association between chiropractic visits and this type of stroke is similar to the association seen with GP visits. That points away from manipulation being the cause.

What Side Effects Are Actually Common

The most frequently reported side effects after a neck adjustment are mild and temporary - some muscle soreness or stiffness that settles within a day or two. This is a normal response and something your chiropractor should mention before you start. Serious complications are rare. Like any manual treatment, risks exist, but the evidence does not show them occurring at a rate that would make chiropractic care an unreasonable choice for most people.

What a Good Assessment Covers

Part of a thorough initial consultation is screening for anything that changes the approach. That includes identifying risk factors that would make neck manipulation less appropriate, or ruling it out entirely in favour of other techniques. There is more than one effective way to treat neck pain, and manipulation is only used when it suits your presentation.

If You Are Unsure

Being hesitant is completely reasonable, and it is worth raising before your first appointment rather than sitting with the concern. Before any treatment is applied, we take a thorough history and assess whether neck manipulation is appropriate for you specifically.

If neck adjustments are not something you are comfortable with, there are other effective ways to address neck pain. Dry needling, soft tissue therapy, and rehabilitation exercises can all produce good results without any manipulation involved. At BodySync Chiropractic in Stirling, that conversation happens before any treatment does. If you have questions or want to talk through your options first, book online or give us a call on (08) 9274 5615.


References

  1. Cassidy JD, Boyle E, Côté P, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008;33(4 Suppl):S176-S183. doi:10.1097/BRS.0b013e3181644600
  2. Rubinstein SM, et al. Risk factors for cervical artery dissection: a systematic review with meta-analysis. Stroke and Vascular Neurology. 2025. doi:10.1136/svn-2025-004186
  3. Côté P, et al. Adverse events among older adults receiving chiropractic spinal manipulation and related treatments: an updated systematic review. Chiropractic & Manual Therapies. 2026. doi:10.1186/s12998-026-00633-3

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