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Cracking one's neck is a common habit followed by many in order to relieve stiffness or discomfort in the neck. However, there has been debate and speculation regarding whether this seemingly innocuous act could result in serious consequences, even as serious as a stroke.

While we are at it, let's hear an expert take on it, too. Dr. Sumit Kapadia, a well-acknowledged vascular surgeon with 18 years of experience in vascular and endovascular surgery, puts things into perspective regarding the risks associated with cracking one's neck and how to stay safe.

Understanding neck cracking and its mechanism:



Neck cracking involves the voluntary or involuntary twisting or manipulation of the cervical spine to create a popping or clicking sound. This noise arises from the discharge of gas bubbles inside the synovial fluid of the joints, called cavitation. To many, the result is a pleasant feeling of relief. However, the neck contains important blood vessels, nerves, and the spinal cord, making it a sensitive and complex region.



Science says:

A study published in found that neck or spine manipulations by chiropractors and other practitioners may increase the risk of stroke, particularly if you are under 60. While it can not be fully proven, the study is the first to show a strong association between spinal manipulation and arterial dissection, even after accounting for prior neck pain. Patients experiencing increased neck or head pain after this should seek medical care. The overall risk of dissection is low, but it can lead to serious complications, including a stroke.


The risk of stroke from cracking the neck: How it happens



Dr Sumit Kapadia explains that while cracking one's neck is generally a safe activity and does not cause injury if done gently without using forces that are too extreme, there is still a rare but real chance of injury to the blood vessels that supply the brain. The main arteries that may be involved are the vertebral arteries, which course through the cervical vertebrae and supply important blood flow to the brainstem and the posterior part of the brain.

The forceful twisting or manipulation of the neck can cause a tear or dissection in the wall of these arteries, especially in cases of sudden or aggressive motion. The injury to the wall may give rise to a blood clot that can obstruct the passage of blood or embolize to the brain, resulting in a stroke; this is termed vertebral artery dissection .

Dr. Kapadia notes that this kind of vascular injury does not happen very often, but it is not impossible either. Some have predisposing conditions: the weak walls of arteries, for one, or disorders of the connective tissues. Suddenly, high-velocity neck movements-like those sometimes done during neck manipulation therapies or self-cracking-are more likely to injure the arteries than gentle ones.

Symptoms to watch out for

In the unlikely event of a stroke or arterial injury occurring as a result of neck cracking, several symptoms require immediate medical attention. These include:

• Sudden severe headache or neck pain
• Dizziness or loss of balance
• Vision disturbances like blurred or double vision
• Weakness or numbness on one side of the body
• Difficulty speaking or swallowing

Medical perspective:

Neck cracking and stroke have been thoroughly investigated in medical literature. Although many vertebral artery dissection-related strokes do indeed occur with minor trauma, including seemingly innocuous neck movements, the actual incidence remains extremely low relative to the prevalence of neck cracking in the general population.According to Dr Kapadia, most people who crack their neck never experience any harm as a result. On the other hand, it is not a risk that should be taken lightly. Physicians commonly advise against violent or forceful manipulations of the neck, especially outside controlled therapeutic environments by trained practitioners.


Safer alternatives

To minimise risk, one can do the following

Avoid forceful or repetitive neck cracking.

Instead, use gentle neck stretches and mobility exercises.

If neck manipulation by a professional is indicated, seek such care from qualified physical therapists or chiropractors.

Make sure to maintain good posture and ergonomics to reduce neck stiffness.

Stay aware of any unusual symptoms following neck movements.

Maintaining overall vascular health is very crucial as well. Hypertension, high cholesterol, and smoking may weaken blood vessels and elevate the risk of stroke. Controlling these factors will further reduce the chances of complications from neck movements.


When to seek medical care

Persistence of neck pain, stiffness, or neurological symptoms is an indication to seek medical attention. Vascular surgeons such as Dr. Kapadia assess patients for vascular abnormalities and risk factors that predispose them to arterial injuries, which also include dissections due to trauma or neck manipulations.

The condition of the neck arteries may need to be diagnosed with advanced diagnostic tools, including Doppler ultrasound, CT angiography, or MRI. These may thus provide necessary details for appropriate treatment.

Neck cracking is a common practice and is usually done for relief of tension or discomfort. Though it is not a dangerous activity, according to Dr. Sumit Kapadia, a small but significant risk exists of stroke in case neck manipulation causes any injury to the arteries supplying the brain. It has been associated with vertebral artery dissection related to forceful or sudden twisting motions. Understanding, gentle techniques, and awareness, along with timely medical attention in case of warning signs, can help prevent serious complications.