Comment on Steve Novella's post at Science-Based Medicine, by a practicing MD physician:
Re: neck cracking, the most recent surveys of chiropractors, as I recall, show some 2/3 or 3/4 of them using high velocity neck cracking, which is considered dangerous among ER physicians, neurologists, and neurosurgeons.
Anyone with more than a passive knowledge of the anatomy understands the vulnerability of the vertebral arteries where they exit the safety of the bone in C-2 and twist around to enter the foramen magnum. That is exactly where one would expect the artery to be torn by a sudden twist of the neck and that is exactly where the arteriograms demonstrate the artery dissection to occur.
As to [the] claims that this is done with patients on their side, all the videos I see when I Google chiropractic neck manipulation are by chiropractors with the patient either supine or seated and the practitioner above the patient. The attempt to elicit an audible “pop” when nitrogen gas exits soluble form and becomes a bubble, so the patient is impressed that something important (a bone out of place, perhaps going back into place?) has taken place, has real dangers.
As one who has spoken to the mother of a dead young girl whose neck was cracked by a chiropractor over 150 times as treatment for a tailbone pain, and who started having seizures immediately after the final manipulation while on the examining table…I understand the dangers and advise all patients to “never let them touch your neck.” I have also spoken to surviving patients in wheelchairs who were never to walk again after chiropractic neck manipulation for low back pain, and patients who needed craniotomy to treat the stroke which occurred immediately following neck cracking for shoulder pain treatment.
I know the official chiropractic position is that the neck cracking is safe, but that is not the position of the medical practitioners who deal with strokes and their sequelae.