Peter Tuchin


Case reports are often published on cervical artery dissection (CAD) with one subgroup of these being vertebral artery dissection (VAD). VAD following neck massage has been reported in literature but not summarized. Head and neck massage is sometimes delivered by inadequate or un-trained people (eg barbers/ salon people). These un-trained lay people appear to also deliver spinal manipulative therapy (SMT).

Chiropractic care often includes SMT, massage, soft tissue therapy, and other forms of therapy. However, other professions, including physiotherapy (physical therapy), osteopathy, and medical practitioners, also deliver SMT. In addition, many other “therapists” deliver SMT, with and without massage therapy. Sometimes these “therapists” do not necessarily have any formal training or qualifications. Qualified professionals such as physiotherapists (physical therapists), osteopaths, and massage therapists also deliver massage therapy. Some case reports incorrectly use the term “Chiropractic” or “Chiropractic technique” when describing a manual therapy such as massage. Clearly, massage therapy and SMT are not exclusively delivered by one profession (namely chiropractic).

This paper is a review of recent case reports on VAD following massage, and will also discuss why the term “Chiropractic” was incorrectly used. In addition, this paper discusses some evidence assessing chiropractic as a trigger for CAD. Many case reports regarding CAD continue to be lacking in detail and make significant methodological errors.


Case Reports