Upper cervical chiropractic management of a patient with headaches, neck pain and a history of traumatic internal carotid artery compromise: a case report.
Mychal Beebe, Ankur Tayal
PMID 42290506WHAT IT FOUND
A patient with prior carotid artery dissection and ongoing neck pain and headaches reported lower pain and disability after light upper cervical chiropractic.
This describes a single case, not evidence the treatment works.
Key findings
01The patient reported neck pain down by 8 points and headache down by 5 points on an 11-point scale after 26 visits over 6 months.
02Neck pain disability improved by 16 points on a 50-point scale, from 23 to 7, a 32% reduction.
03The patient reported two adverse events: neck pain increased 20-50% for 7 days after the initial adjustment and 30% for 3 days after the 7th adjustment; subsequent interventions produced no further adverse events.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so it cannot show whether the treatment caused the reported improvement. The patient's carotid artery dissection had reportedly resolved on follow-up MRA before chiropractic care began, so the case does not show treatment during active dissection. Neck pain and headache can improve with time, and no control group, comparison or randomisation was used. The authors note unreported concurrent treatments, uncontrolled work or home changes, and lack of rigorous studies for the Blair protocol. Blood pressure was not taken during care outside the IFOMPT framework.
The easy way to misread this
Do not conclude that upper cervical chiropractic is safe or effective for patients with a history of cervical artery dissection. This is a single case, the dissection had reportedly resolved before treatment, and there was no control group or comparison.