Playboy model Katie May died in February days after experiencing a stroke caused by a ruptured artery, and it was ruled on Wednesday that the artery was damaged during a neck manipulation by a chiropractor.
However, death caused by chiropractic manipulations is very rare. A RAND study states that the rate of serious complications caused by chiropractic adjustments are one in one million.
“With any medical care, there are risks involved,” Todd Sinett, Doctor of Chiropractic and author of Three Weeks to a Better Back, tells PEOPLE. “Chiropractic care is statistically the safest mode of treatment for any type of treatment within the neck compared to injections or even medications.”
More common risks include soreness, muscle tension, and in extreme cases, a broken rib.
May’s case is “very, very rare,” says Sinett, who explains that the adjustment impacted the arteries that go from the neck into the brain.
“In this particular case, unfortunately, her arteries got compromised so much they tore, which created a stroke and ultimately the patient died,” he said. “Statistically speaking, studies have the chances of this happening an anywhere from one in one million to one in four million.”
WATCH: Playboy Model Katie May Died After Chiropractor Ruptured an Artery in Her Neck, Coroner Says
Robert Pomahac, Doctor of Chiropractic and CEO of MaxHealth LA, says May likely had a pre-existing vascular issue.
“If a person has neck pain due to some form of trauma like a slip and fall, and their head goes into extension and rotation, this can contribute to a vascular issue,” says Pomahac. “The only way to determine if the neck pain is coming from a vascular issue is to have every person get a CT angiogram.”
Doctor of Chiropractic Dan Murphy agrees that May likely had a pre-existing issue with her artery.
“When people are having a spontaneous dissection of a vertebral artery, there are certain symptoms that if the patient has we are taught not to adjust them and send them to the ER,” says Murphy. “When this happens with a chiropractor it’s because they had some sort of underlying arterial pathology.”
However, Sinett notes May may not have been showing any signs of artery damage.
“The chiropractor could have been overly aggressive or missed some early warning signs, but she may have exhibited no risk factors, and the chiropractor could have done everything right,” says Sinett.
Jeffrey Wang, MD, co-director of the USC Spine Center, says he does not recommend chiropractic manipulations as treatment for patients with spine issues because of the risks involved.
“I don’t recommend chiropractic care for patients with spinal cord compression or nerve compression where forceful manipulation may have a great potential for problems,” he says.
Wang – who notes that May’s case is a “freak accident” – says he would prescribe physical therapy instead.
“One of the mainstays of treatments for neck disorders is doing core strengthening to strengthen the muscles around the spine,” he says. “It allows you to be supported and give more stabilization to your spine. You would not want to do any forceful manipulation because that could cause nerve damage.”