March20, 2023

Abstract Volume: 5 Issue: 5 ISSN:

Vertebral Artery Dissection following Neck Massage

Najam Younas Butt 1*, Mohamed Al Maarawi 2, Amir S Najim Al Din 3


1. Department of Neurology, Al Ahli Hospital, Qatar

2.Department of Emergency, Al Ahli Hospital, Qatar

3. Department of Neurology, Al Ahli Hospital Qatar

Corresponding Author: Dr. Najam Younas Butt, Department of Neurology ,Al Ahli Hospital,Qatar.

Copy Right: © 2022 Dr. Najam Younas Butt, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received Date: October 15, 2022

Published Date: November 01, 2022

Vertebral Artery Dissection following Neck Massage

Learning Objectives

  • Identify the risks and side effects of massage therapy
  • Explain very severe and rare example.

Safety of Massage therapy

People think of Massage therapy as safe therapy.

Of course, it mostly is

But things can go wrong or at least a bit sour.

What is Massage Therapy?

Press, Rub, Manipulate of muscles and soft tissue

They most often use their hands and fingers

But may use forearms, elbow or feet

What are Massage Therapy Benefits?

Relieve pain

Rehabilitate sport injuries

Reduce stress, increase relaxation

Address anxiety and Depression

Aid general wellness

What are Massage Side effects?

Minor side effects are common like temporary pain, swelling, bruising

Post massage soreness and malaise PMSM

Sensitivity or Allergy to massage oil

What are Massage Therapy Risks?

Serious side effects are extremely rare if used appropriately and provided by trained massage professionals.

  • Severe headache,
  • Fracture,
  • Vertigo and Dizziness
  • Rhabdomyolysis,
  • Sensory injury from painful massage
  • Radial nerve injury by aggressive massage of inner upper arm,
  • Spinal Accessory nerve injury leaded to scapular sticking out and droopy shoulder, as a result of Trapezius muscle injury,
  • Neck arteries are a little bit fragile and some poorly trained or incompetent therapist can cause two main injuries

1- Instability of upper cervical spine

2- Stroke caused by tearing of vertebral arteries


Case Presentation:

37 Y/O Male, Philippine came to ER June 16/2019 at 9.00 AM complaining of:

  • R limbs weakness 7.15 AM
  • L side mild, dull, on/off chest pain, shoulder, L arm pain 2 days after massage,


Past Medical History: Migraine

Physical exam

R limbs strength normal

L shoulder tenderness

Muscle, L arm elevation weak

No sensory loss

Normal Reflexes

Vital Signs:

BP=134/80, P=90, T=37.4, Sat =96%, RR=19



Neurologist informed that we have a case of Transient Ischemic Attack with chest pain

Agreed for admission

Given NS 500

Paracetamol 1000 mg IV


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