Question
Hello:
I am a 21 year old very healthy woman. I was having migraines and my doctor noticed the tension in my neck and suggested a chiropractor. I enter with what I thought was pretty good health and leave with a shocking diagnosis. Apparently my pelvic bones are tilted, my spine is curved, a bone is displaced in my neck, and the curve in my neck is disappearing. The doctor suggests 40 visits where he will adjust my spine and this will be enough to correct my problems. The problem is my insurance only covers 20 visits and the rest of the visits would be very costly, all totaling nearly $4500! I have gotten two adjustments thus far and my neck feels ok but there is still do much muscle tension in my shoulders! I already know I need physical therapy for both shoulders because they are both slightly separated causing pain, but I can't afford both this chiropractor and physical therapy. My questions are: do you think all these problems the doctor says I have are a scheme to get money? Doesn't everyone have some kind of flaws in their spine and can't they live normal lives? Can standing in an imperfect position while getting the X-rays make is just LOOK like my neck curve is gone? Are there any studies that show years will be taken from your life if my problems aren't treated(this is what he told me)? I know I have so many questions but I really need some help.?br> Thank you,
TRH

Answer
Thanks for your question.

A recommendation by a health care provider for a certain number of visits at set fee is, in my opinion, a marketing tactic, not clinical guidance. What guarantee can this chiropractor give you that after the 40th adjustment, all of your structural problems will be corrected? In my opinion, the answer is, none.

If you have a scoliosis (an abnormal sideways curvature of the spine), at your age, you have most likely reached skeletal maturity, so unless the curvature measures greater than 20-25 degrees, it probably isn't worth worrying about.

If you have a reversed or reduced normal curvature of the neck, and lots of muscle tension, you could consider using a product such as the Posture Pro Cervical Spine Trainer (try Amazon.com) for home neck therapy, which may help restore a more normal curvature in your neck, and you could consider seeing a massage therapist for your chronic muscle aches. Before using a device like the Posture Pro, you should seek the advice of an appropriately credentialed health care provider who is familiar with your condition.

An excellent resource for learning to re-program poor posture is The Alexander Technique Workbook (2011 edition, by Richard Brennan), which can dramatically improve musculoskeletal pain. Poor posture perpetuates chronic musculoskeletal stress.

If two cervical spine manipulations have reduced your neck pain, then common sense would dictate that 38 more adjustments is probably unnecessary. It would, however, be appropriate to consider further manipulation on a symptomatic basis.  

My comments are based in part on the following commentary from a 2009 article published in the journal Chiropractic & Manual Therapies (formerly Chiropractic & Osteopathy), entitled "How to select a chiropractor for the management of athletic conditions":

"Identifying a chiropractic practitioner who uses multimodal treatment of adequate duration, who incorporates active and passive components of therapy including exercise prescription whilst using medical terminology and diagnosis without mandatory x-rays or predetermined treatment schedules or prepaid contracts of care will likely result in selection of a chiropractor with the approach and philosophy suited to appropriately managing athletic conditions. Sporting organizations and associations should consider using similar criteria as a minimum standard to allow participation in health care team selections."

( Source: http://chiromt.com/content/17/1/3)

(Disclaimer: Please understand that the comments and opinions I have given here are offered for informational purposes only, and should not be interpreted as specific medical or health care advise or diagnosis, and should not replace appropriate evaluation and treatment recommendations by a licensed health care provider, and they do not constitute the establishment of a doctor/patient relationship).

I hope that this helps to answer your questions.