As we have often discussed on this blog, chiropractic spinal manipulations can lead to several complications and can result in vascular injury, including traumatic dissection of the vertebral arteries with often dire consequences – see, for instance, here:


This recent paper is a most unusual addition to the list. It is a case report of a 43-year-old woman who was admitted to the emergency department after performing a self-chiropractic spinal manipulation. She experienced headache and vomiting and was unresponsive with severe hypertension at the time of hospital admission. Clinical computerized tomography angiography showed narrowing of the right vertebral artery but was inconclusive for dissection or thrombosis.

The patient died a short while later. At autopsy, subacute dissection of the right vertebral artery was identified along with cerebral edema and herniation. A small peripheral pulmonary thromboembolism in the right lung was also seen. Neuropathology consultation confirmed the presence of diffuse cerebral edema and acute hypoxic-ischemic changes, with multifocal acute subarachnoid and intraparenchymal hemorrhage of the brain and spinal cord.

The authors concluded that this case presents a unique circumstance of a fatal vertebral artery dissection after self-chiropractic manipulation that, to the best of our knowledge, has not been previously described in the medical literature.

13 Responses to A ‘Self-Chiropractic Spinal Manipulation’ that resulted in death

  • Please someone, explain to me what a ‘self chiropractic spinal manipulation’ is. At the moment I’m imagining a rope around the neck and a stool kicked away, but surely that’s too mad even for SCAM.

    • She laid on the floor and extended her neck over a stair and it’s assumed she rotated her head/neck to get the adjustment.

      Also, her health history revealed that she had some contraindications to cSMT.

  • Presumably she did more than just “click” her neck?

  • There are three main professions that use spinal manual therapy. Physical Therapists, Osteopaths and Chiropractors. Why this article is not titled “Self-Physical Therapy Manipulation”, “Self-Osteopathic Manipulation Therapy” or “Self-Manual Therapy Manipulation”, gives a true indication of the unprofessional biasness of the author of the case report.

    • why don’t you ask the original authors?

    • Giblet Giblet Giblet,
      More pointless what-aboutism from a master of it. Chiro is dangerous jiggery pokery and we all know it, erh, except for the delusional.

      There are no chiros in hospitals (a crazy few, perhaps), ambulances, AFL teams, or any serious medical establishment, only SCAM joints have them. Surely, surely, surely Giblo, that must tell you something.

      • Not meaning for this to come off in an attacking form (because that’s quite the opposite of what I’m trying to achieve here), but these statements are unfortunately quite over generalized, and factually inaccurate. Dr. Ernst literally has a red banner at the top of the website asking for you to support your comment with evidence and you have failed to do that so I’ll help you out by providing some comments backed up with evidence (because that is what we young, progressive chiropractors believe in providing)

        Before I begin I’d like to make it a point that many of us nowadays (including myself) are looking to incorporate more interprofesional collaboration amongst medical doctors, physical therapists, and chiropractors to most effectively treat our patients. I see many people here seem to have a lack of respect for the chiropractic profession and I can only wonder if you guys understand our current curriculum as we’re not the same profession we were 50 years ago. But anyways I say that to say, I hope many of you can recognize that there is a place for chiropractic in health care, we’re not all “quacks” as some of you may believe, and we are doing our best to get rid of many things some chiropractors claim that are not backed by some form of valid research (clinical guidelines, meta-analyses, RCT’s, etc.)

        Back to you Mr. Frank, starting with the hospital claim that only a “crazy few” have chiropractors on staff. Not sure what this statement was based on but there are several VA hospital’s across the country that have chiropractors on staff to help serve those who protect/protected us. While this source is more like a blog as opposed to an institutional research database, I’m using it to simply provide you a list of the cities with VA hospitals that have a chiropractor on staff. Please feel more than welcome to verify each location on

        For your ambulance claim, I would hope a chiropractor wouldn’t be on board with EMT’s as we treat neuromusculoskeletal injuries, not gross trauma or internal medicine issues. We are also extensively trained (at least at my school) to scope out red flags in treating patients who may be contraindictive to chiropractic care. I understand that chiropractors miss things and not all are made the same (just as with surgeons, MD’s, etc) but please understand that many of us do know our place in healthcare and do our best to collaborated with other medical professionals as opposed to splintering.

        AFL (assuming you mean NFL, unless you just like showing your age lol) teams actually frequently seek out chiropractic care. I speak on this not only from personal anecdotal evidence as we treat several NFL players in the office I work in, but there’s research to back up my point as well. You may be able to make a case that in the report I’ve submitted below it’s a small sample size, but being that there are only 36 teams, I feel as though the report is representative of challenging your claim (personal opinion I guess haha)

        In regards to chiropractic being “dangerous jiggery pokery”, I understand that there adverse events and risks with receiving chiropractic care (as with many other therapies), but I think labeling it as so is a bit far fetched. Many of my fellow professionals reference regarding treatment protocols to which many medical doctors highlight chiropractic care as a first avenue of treatment. Feel free to visit the website and take a look for yourself. Research supports “The likelihood that a chiropractor will be made aware of an arterial dissection following cervical manipulation is approximately 1:8.06 million office visits, 1:5.85 million cervical manipulations, 1:1430 chiropractic practice years and 1:48 chiropractic practice careers. This is significantly less than the estimates of 1:500 000–1 million cervical manipulations calculated from surveys of neurologists.” Below I’ll leave the link to that report along with a couple of other resources regarding effectiveness of chiropractic care. Feel free to ask for more as there are many and I’d love to share some knowledge with you!
        Walker, B. F., Hebert, J. J., Stomski, N. J., Losco, B., & French, S. D. (2013). Short-term usual chiropractic care for spinal pain: a randomized controlled trial. Spine, 38(24), 2071-2078.
        Passmore, S. R., Burke, J. R., Good, C., Lyons, J. L., & Dunn, A. S. (2010). Spinal manipulation impacts cervical spine movement and Fitts’ task performance: a single-blind randomized before-after trial. Journal of manipulative and physiological therapeutics, 33(3), 189-192.
        Krauss, J., Creighton, D., Ely, J. D., & Podlewska-Ely, J. (2008). The immediate effects of upper thoracic translatoric spinal manipulation on cervical pain and range of motion: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 16(2), 93-99.

        I hope that in reading these claims you can respond in a respectful manner as the post is 100% open to critique, but like I’ve provided above, please back up statements with evidence and address any bias that may exists in studies you find unless they are just cold, hard, facts (like the VA Hospital fact)

  • Prof. Erenst, you are the author of this blog. It was your job to ask those questions of the original authors of the case report. This does not reflect well upon yourself, and you could and should have done better.

  • Many pharmaceuticals including the recent investigational Covid injections have caused and are continuing to cause excess deaths and many other adverse effects.

    When are you going to research these?

  • Is it unseemly or bad manners to be amused by this stupidity?

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