Thai hospital chief issues warning on risky neck cracking habits for fatigue relief

The head of the New Accident Disease Health Science Centre at Chulalongkorn Hospital issued a public warning about the dangers of the common habit of neck cracking to alleviate tiredness.

This seemingly harmless practice could lead to critical conditions such as stroke and ruptured blood vessels, especially when coupled with medication, said Teerawat Hemajutha,

Twisting, tilting, and shaking the neck could lead to stroke. This seemingly harmless routine or action to relieve tiredness or even a common method in physical therapy and bone setting, could turn perilous. If not careful, it could rupture the walls of blood vessels that feed the brain, particularly the posterior pair, leading to brain tissue death and subsequent stroke or paralysis.

Our brain is supplied by two pairs of blood vessels. The front pair, palpable at the front of the neck, feeds the forebrain, temples, and the deeper parts of the brain. The posterior pair, running through the neck bone, nourishes the cerebellum, the brain’s balance controller, and the brainstem which controls cranial nerves and limb movements. Forceful neck shaking or twisting could adversely affect these blood vessels, especially in those with existing vascular abnormalities or those who have a single posterior pair of blood vessels.

The severity of the damage depends on the speed and force of the neck movement. Even slow, repeated movements over a long period can cause harm, not just to the nerves in the neck but also to the blood vessels. This is particularly true for individuals who are already at risk due to obesity, high blood pressure, and high cholesterol, or those with a protruding bone in the neck that could compress the blood vessels.

Official reports from the American Heart and Stroke Association, supported and endorsed by the American Medical Association and the US Congress Neurological System, featured in the Stroke Journal’s October 2014 edition, highlight the risks of neck manipulation. Massage on the pressure points should also be approached with caution as the posterior blood vessel pair that feeds the brain runs through two holes at the base of the skull, reported KhaoSod.

Doctor’s advice

Teerawat suggests a safer alternative for neck fatigue.

“Keep the neck straight, face forward, and push the head against your hand in four directions — left, right, front, and back. Do this slowly, applying force for a longer duration, 10 to 20 rounds per day. This not only helps with nerve compression and bone structure adjustment but also strengthens neck muscles, eliminating the need for neck pulling at the hospital, wasting time in traffic, and crucially, avoiding pain medication, which only treats the symptom and could lead to stomach ulcers and kidney damage.

“Painkillers can also cause heart vessels to constrict. Following these evidence-based medical facts and recommendations from the American Heart Association/Stroke, being aware of the structure of blood vessels, tendons, and bones, and the dangerous postures, we can avoid problems.”