In rare cases, manipulation of the neck or “neck cracking” has caused a stroke.

Manipulation is a high-speed twisting or turning movement that often causes a popping or clicking sound in the area.

These types of manipulations are often done to treat neck pain. They can be performed at home or clinically by a massage therapist, a chiropractor, or an osteopath.

The stroke itself occurs due to a condition called cervical artery dissection, which is more commonly referred to as vertebral artery dissection.

Medical emergency

Call 911 or local emergency services if you or someone around you experience:

This is when an artery in your neck tears. When this happens, blood begins to leak into the wall of the torn blood vessel, between the thin layers that make up the blood vessel wall.

As blood leaks, the space inside the blood vessel through which blood normally flows becomes narrow or even completely blocked.

Eventually, the blood from the torn artery can clot. This blocks the artery, reducing or cutting off blood flow to an area of the brain. The regions of the brain normally supplied by the damaged blood vessels can experience diminished blood flow, which results in a stroke.

Strokes due to vertebral artery dissection are rare. They account for only 2% of ischemic strokes overall but are a notable cause of stroke in younger people.

Strokes due to vertebral artery dissection from neck manipulation can cause paralysis. In some cases, the early symptoms can be subtle and may include neck pain and a headache

The risk of spontaneous vertebral artery dissection and stroke without spinal manipulation may be higher in people who have:

Case studies have documented vertebral artery dissection following both self-manipulation and manipulation by a chiropractor.

There has been debate over neck manipulation and whether it should be used to treat neck pain. This debate centers on whether the benefits of neck manipulation outweigh the potential health risks.

The National Center for Complementary and Integrative Health says spinal manipulation by a properly trained and licensed professional is relatively safe.

However, the center notes that people who opt for neck manipulation should be aware of the associated risks.

If you seek chiropractic care for neck pain, use a licensed chiropractor who will work collaboratively with you and a primary care doctor. Try to find a chiropractor who has experience addressing neck pain.

If you have a sore or stiff neck, the following self-care options may help ease your discomfort:

  • Stretches: Performing some gentle stretches may help ease tension or pain in your neck.
  • Using cold and heat: Applying a cold compress for the first few days may help reduce pain and inflammation. After a few days, use a heat source such as a heating pad to boost circulation in your neck muscles.
  • Massage: A gentle massage of the affected area may help relieve pain and tension in your neck.
  • Over-the-counter (OTC) pain relievers: Some examples include ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol).

If neck pain worsens, persists, or interferes with daily activities despite self-care, make an appointment with a healthcare professional. They can help determine what may be causing your pain.

Neck cracking, known as neck manipulation, can help treat neck pain. When performed by a qualified professional, neck manipulation is generally safe.

If you do choose neck manipulation as a therapy, be sure to see a licensed, trained provider and be aware of the potential risks.

In very rare cases, neck manipulation has led to a stroke. If an artery in the neck tears, a blood clot can form, blocking blood flow to the brain.