A large study found no increased rate of cervical artery dissection after chiropractic cervical manipulation compared with an ibuprofen prescription among adults seeking care for new neck pain or headache.
Published in Chiropractic & Manual Therapies in September 2026, the study used health records and insurance claims to compare patients who received chiropractor-administered cervical spinal manipulation with patients who had an outpatient visit and received an ibuprofen prescription. Researchers matched 431,492 patients in each group and looked for a new diagnosis of cervical artery dissection within 30 days.
Dissection was diagnosed in 31 patients in the chiropractic group and 58 in the ibuprofen-prescription group. Because this was an observational study, the difference does not establish that either treatment caused or prevented a dissection. The study did not measure stroke risk.
The findings add to the evidence on this question while reinforcing the need for clinical vigilance. Neck pain or headache can sometimes be a symptom of an underlying dissection, and clinicians should pursue appropriate evaluation when one is suspected.