Objective:

To describe one patient utilizing a handheld massage gun to relieve neck pain resulting in a traumatic vertebral artery dissection leading to a lateral medullary ischemic stroke. 

Background:

Neck pain is an ailment affecting up to 80% of people in their lifetime. Relieving neck pain in non-pharmacological ways is becoming increasingly sought after. Handheld massage guns, which utilize repetitive high-velocity percussive force, are relatively new devices and are in high demand for treating a variety of musculoskeletal pain. However, there can be serious consequences with prolonged use of percussive force on the neck. One unfortunate consequence, as seen in this case report, is a traumatic vertebral artery dissection leading to an ischemic stroke.

Design/Methods:

N/A

Results:

In 2023, a previously healthy 25-year-old woman had awoken with chronic neck pain and used her handheld massage gun for two hours angled at her right posterolateral neck.  Soon thereafter, she developed sudden dizziness, dysarthria, and right hand dysmetria. Her examination was consistent with Lateral Medullary Syndrome. She was found to have a traumatic right vertebral artery dissection causing an ischemic stroke in the right lateral medulla. Her extensive hypercoagulable and cardiac workup was negative. The severity of her symptoms required a tracheostomy tube and percutaneous endoscopic gastrostomy tube. She was eventually discharged to a skilled nursing facility.

Conclusions:

Handheld massage guns may appear to be therapeutic but should be used with caution. If not, they can be life-threatening. This young patient's life has now significantly changed due to inappropriate use of the device in the neck. The repetitive high-velocity force in the neck led to traumatic vascular injury resulting in an ischemic stroke. It is imperative to educate the appropriate use of handheld massage guns in order to prevent further injury from occurring.