Safety concerns have been raised in relation to manipulative techniques used by some osteopaths. 'Neck cracking', i.e. cervical high-velocity low-amplitude thrusting, has received particular attention in the popular media due to a possible risk of arterial occlusion and consequently of stroke. Although the existing data cannot provide a conclusive estimate of the cervical artery dissection risk researchers have stated that a stroke risk of about 1.3 per 100 000 chiropractic visits for individuals aged under 45 years ...