Abstract

Multiple chiropractors report that some patients experience symptoms of dizziness/vertigo, nausea/vomiting, neck pain, headaches, sweating, fatigue, diarrhea, and fever after spinal manipulation. These chiropractors attribute these symptoms to toxic release caused by spinal manipulation. However, a literature search of three electronic databases for research supporting this claim yielded no results. These symptoms may instead represent minor thromboembolic ischemic strokes due to cervical spine manipulation performed in the presence of undiagnosed cervical artery dissection. Cervical spine manipulation is contraindicated in the presence of cervical artery dissection. Increased education and training on cervical artery dissection and stroke is recommended for chiropractors.