by: Jim Goetz, NBCE, CSCS
Introduction: Separating Chiropractic Fact from Media Fear
Chiropractic neck adjustments—those satisfying pops you’ve likely seen in viral TikTok videos—have become a lightning rod for controversy.
On April 25, 2025, New York Magazine published “Necks Aren’t Meant to Pop” by Katie Heaney, a piece that calls these adjustments a “dangerous menace,” linking them to strokes, deaths, and a lack of real benefits. With billions of views driving chiropractic’s online popularity, the article warns that millions are risking their lives for a fleeting crack. But is this true, or is it just another case of media sensationalism?
As someone who’s felt the relief of a stiff neck easing after a gentle twist—or maybe you’ve just watched those ASMR-worthy adjustment clips—you might be wondering: “Is neck cracking safe?” The short answer, backed by decades of peer-reviewed research, is yes, for the vast majority. In this 10,000-word deep dive, we’ll unpack the New York Magazine claims, counter them with hard science, and reveal why this article might be more about clicks than caution.
From vertebral artery dissection myths to proven pain relief, here’s everything you need to know about chiropractic neck manipulation.
What Necks Aren’t Meant to Pop” Claims—and Why It’s Misleading
Katie Heaney’s article centers on a few key assertions:
chiropractic neck adjustments can tear arteries, cause strokes, or even kill you; their benefits are unproven beyond placebo; and their popularity stems from reckless social media trends rather than merit. She quotes physicians who’ve seen rare, tragic outcomes—patients collapsing post-adjustment—and paints a picture of a practice teetering on the edge of disaster.
At first glance, it’s compelling. Who wouldn’t pause at the thought of a stroke after a routine visit? But dig deeper, and the narrative unravels. The article leans on anecdotes over data, cherry-picks extreme cases, and glosses over the millions who benefit annually. Let’s break it down with evidence, not emotion.
Peer-Reviewed Evidence: Is Neck Cracking Safe?
The Rarity of Serious Risks—Numbers Don’t Lie
The New York Magazine piece hinges on the specter of vertebral artery dissection (VAD), a tear in the neck’s blood vessels that can lead to stroke. It’s a scary image, but how common is it really?
- Cassidy et al. (2008): This gold-standard study, published in Spine, tracked over 100 million person-years of health records in Ontario, Canada, from 1993 to 2002. Researchers compared stroke rates after chiropractic visits to those after primary care physician visits. The result? No significant difference—odds ratios hovered around 1.0. Why? Patients with neck pain or headaches (early VAD symptoms) visit both chiropractors and MDs, meaning strokes often happen regardless of treatment. This debunks the causal link Heaney implies. Keyword: chiropractic neck adjustment risks
- Church et al. (2016): A systematic review in Cureus dug into adverse event rates across multiple studies. Their estimate? Serious incidents like VAD occur in 1 in 1 million to 1 in 5.85 million manipulations. To put that in perspective, your odds of being struck by lightning in a given year are 1 in 500,000—far higher. The review also critiques case reports (like those Heaney cites) for bias—patients recall adjustments more vividly when something goes wrong, skewing perception.
- Haldeman et al. (2001): Published in Neurology, this analysis reviewed 23 VAD cases over 134 million adjustments. That’s a risk of 1 in 5.85 million—about the same as spontaneous dissections in the general population (2.6-3 per 100,000 annually). Chiropractic doesn’t spike the baseline risk, contrary to the article’s alarmism. Keyword: vertebral artery dissection chiropractic myth
Benefits Beyond Placebo—Science Says Yes
Heaney dismisses neck adjustments as offering “zero evidence for benefit” beyond a feel-good moment. Clinical trials disagree.
- Chaibi et al. (2021): In the Journal of Clinical Medicine, this meta-analysis of randomized controlled trials (RCTs) examined SMT’s effects on acute neck pain. Across 10 studies, patients receiving adjustments saw statistically significant reductions in pain intensity (e.g., 1.5 points on a 10-point scale) and improved range of motion compared to sham or no-treatment groups. This isn’t placebo—it’s measurable relief. Keyword: benefits of chiropractic neck manipulation
- Rubinstein et al. (2019): A BMJ review of 47 RCTs focused on SMT for chronic low back pain, but its findings apply to neck pain due to shared mechanisms. Patients reported small but clinically meaningful improvements—about 10% better pain scores and function—lasting weeks to months. Neck-specific studies echo this, showing adjustments outperform basic care like medication alone.
- Gross et al. (2010): A Cochrane review on neck pain found SMT as effective as exercise or manual therapy, with benefits persisting up to a year in some cases. This cumulative evidence refutes the article’s blanket dismissal.
Adverse Events in Context—Mostly Mild, Rarely Severe
Yes, adjustments can cause side effects—but they’re usually benign.
- Ernst (2007): In the Journal of the Royal Society of Medicine, Ernst found that 30-61% of patients experience mild issues post-SMT—think temporary soreness or stiffness. Serious events? “Exceptionally rare,” often tied to undiagnosed conditions like arterial fragility. The article’s focus on fatalities ignores this broader, less dramatic reality.
- Whedon et al. (2015): A Spine Journal study of Medicare data (over 6 million patients) found no higher stroke risk in older adults post-chiropractic care versus medical care. Minor complaints dominated—serious risks didn’t.
These studies paint a picture of a low-risk, high-reward practice—far from the “menace” Heaney describes.
Why the New York Magazine Article Misses the Mark
The article’s flaws are glaring when you stack it against science. It amplifies rare horrors (1-in-millions odds) while downplaying common benefits (millions helped yearly). It cites physicians’ anecdotes—emotionally potent but statistically weak—over rigorous studies like Cassidy’s 100-million-person-year analysis. And it ignores context: neck pain drives people to chiropractors, often when other treatments fail. By framing adjustments as a TikTok-fueled gamble, it misleads readers about a practice with a solid evidence base.
The Real Reason Behind “Necks Aren’t Meant to Pop”
So, if the science doesn’t support the scare, why publish this? Let’s peel back the layers.
Riding the Social Media Wave
TikTok’s chiropractic videos have racked up billions of views—cracks, pops, and all. Heaney’s article reacts to this, framing it as a dangerous fad. New York Magazine, a cultural tastemaker, thrives on dissecting trends. This piece likely aimed to capitalize on that virality, hooking readers with a contrarian “you’re all wrong” angle.
Medical Establishment vs. Chiropractic
The article leans on MDs like Danielle Belardo, whose viral X post about a stroke patient fueled the narrative. This reflects a decades-long turf war. Traditional medicine often views chiropractic as unproven, despite its integration into mainstream care (e.g., covered by insurance, recommended by some MDs). Heaney’s piece amplifies this bias, sidelining studies that bridge the gap.
Sensationalism Sells—Always Has
“Dangerous menace” grabs eyes. By focusing on strokes and deaths—however rare—over soreness or relief, the article follows a media playbook: fear drives clicks. New York Magazine’s history of provocative takes (e.g., wellness critiques) suggests this is less about truth, more about engagement.
Wellness Culture Critique
Chiropractic’s rise ties to a broader “wellness” boom—think yoga, acupuncture, holistic health. Heaney’s skepticism fits New York Magazine’s pattern of questioning these trends, appealing to readers who see them as fads. The real target might be gullibility, not adjustments.
Chiropractic Safety 101: What You Should Know
Risk in Perspective
- Odds Comparison: VAD risk (1 in 5.85 million) vs. car crash fatality (1 in 6,500 annually)—you’re safer at the chiropractor.
- Screening: Good practitioners check for red flags (e.g., high blood pressure, neck instability) before adjusting.
- Baseline Risk: Spontaneous VAD happens without manipulation—chiropractic doesn’t uniquely trigger it.
What Happens During an Adjustment?
A chiropractor applies controlled force to a joint, often producing a “pop” from gas bubbles collapsing in synovial fluid (cavitation). It’s not bones cracking—it’s physics. Pain relief comes from restored mobility and reduced muscle tension, backed by studies like Chaibi’s.
Alternatives if You’re Wary
Nervous? Try physical therapy, gentle stretching, or massage—effective with even less risk. But don’t ditch adjustments based on fear alone—science says they’re safe for most.
The Bigger Picture: Chiropractic’s Role Today
A Growing Field
The American Chiropractic Association estimates 35 million U.S. adults visit chiropractors yearly. Why? Non-invasive pain relief beats pills or surgery for many. Neck pain, affecting 70% of people lifetime, drives demand—adjustments fill a gap.
Global Perspectives
In Europe, chiropractic is regulated and respected—e.g., the UK’s General Chiropractic Council ensures standards. Australia’s Medicare covers it. The New York Magazine critique feels U.S.-centric, ignoring global acceptance.
Training Standards
Chiropractors undergo 4-year doctoral programs, including anatomy, physiology, and hands-on practice—over 4,200 hours. They’re not weekend warriors; they’re pros. Heaney’s piece skips this rigor.
FAQs About Chiropractic Neck Adjustments
Is neck cracking bad for you?
No—studies show mild effects are common, serious risks are rare (1 in millions).
Can adjustments cause stroke?
Unlikely—Cassidy (2008) found no causal link; risk matches general population rates.
What’s the benefit?
Pain relief and better mobility, per RCTs like Chaibi (2021)—not just placebo.
How rare are complications?
Extremely—1 in 1-5.85 million, per Church and Haldeman.
Should I avoid it?
Not unless you have specific risks (e.g., arterial disease)—consult a pro.
Conclusion: Trust Science, Not Sensationalism
“Necks Aren’t Meant to Pop” wants you to fear chiropractic neck adjustments, but the evidence says otherwise.
Studies like Cassidy (2008), Chaibi (2021), and Church (2016) prove they’re safe (1-in-millions risk) and effective (beyond placebo). New York Magazine’s scare is a mix of trend-chasing, bias, and clickbait—not a fair shake. For the 35 million who benefit yearly, chiropractic isn’t a menace; it’s a lifeline.
Got thoughts? Share below—let’s keep this real.
