Question
QUESTION: I am a 46 year old athletic female. I suffered from neck pain for several months until I could no longer turn my head without shooting pain down my back. I went to see my physician who noted that my OA (occipital-atlanto) and AA(atlas-axis) joints were jammed on the right side. He tried to relieve them in the office but it was just too painful for me. I subsequently went home and after about 2 hours I was lifting my head up from reading and I heard a loud pop.  I definitely felt relief, but the pain persisted. Several days ago I went to a chiropractor who took full spinal X-rays. One of the problems is that I have no curvature in my neck and even a slight reverse curve starting at C5-C6.  There are bone spurs on both of these vertebrae and the disc is abnormally compressed. My chiropractor suggested cervical traction for 36 wks.  Can you please tell me if it's possible to get curvature back in your neck, especially at my age? Are there exercises one can do to counteract this?  Is it imperative to use the traction device in his office or can I use the Dennerol device at home with the same results?  And lastly, there are several misaligned cervical vertebrae which we are addressing.  Are these a result of the lack of curvature in my neck or unrelated?
Thank for your time in answering my questions.

ANSWER: Gina,

Get the heck out of that chiropractor's office.   Full spine x-rays simply because you have a sore neck is a blatant disregard of all current evidence-based guidelines and it also is a public health threat.  THere is no logical reason to have full-spine x-rays.  This was done decades ago to look for misalignment and then to attempt to fix the misalignment.   As it turns out: you cannot determine where there really is misalignment, even if think you see misalignment there is no proof that it is abnormal, and even if you believe there is a misaligmnent that is abnormal, there is no proof that manual procedures or traction or exercise will change it.  Lots of people have lost or reversed curves.   It is possible that the reversed curve can lead to greater degenerative changes in the lower neck, but it is also likely that degenerative changes can occur with a normal curve (since degenerative changes often are genetic) and that the reversed curve can remain free of degeneration.   There is no good evidence that aggressive tractioning will change this any more than just getting regular manual therapy.  If you want to do traction, you can do it at home with a head harness (often rigged up by DC's or PT's for that purpose).   Keep in mind that prolonged or aggressive traction can cause adverse effects and leave you worse than when you began.  Go ahead an search the Q&A's on this site where I've addressed the "lost curve" topic.   Frankly, anyone that exposes a patient to full-spine radiation when the patient only has neck pain should be reported to the state's licensing board.   

'Best,

Dr. G

---------- FOLLOW-UP ----------

QUESTION: So when you state "even if you believe there is a misalignment that is abnormal, there is no proof that manual procedures or traction or exercise will change it," are you referring specifically to curvature of the neck?  Because obviously misalignment of the spine is why we go to chiropractors in the first place.  I asked this chiropractor how many in his profession typically take full spinal x-rays and he responded "about 85%." I have only been to one other chiropractor years ago from a skiing accident and he did not take any x-rays nor did he do any manual adjusting. All adjustment was by activator. This chiropractor is also telling me he wants to adjust me every day.  Is this normal?
Thank you for your time Dr. G

Answer
Gina,

Misalingment of the spine is NOT the reason people go to chiropractors.  People go to chiropractors (initially, at least) because they have pain, usually neck pain or back pain.   It's the chiropractor that sells them on the flawed concept of misaligned bones that need aligning in order to prevent a disease.   Don't get me wrong.  Getting manual therapy in the form of skilled joint manipulation and soft tissue therapy and targeted exercises can be very beneficial in many ways.  It helps many people feel good and perform at their best.  But it is not because they got their bones put back in a straight line.   That's not how it works...   Getting adjusted every day is fine, but only if it's for a few days for mild cases or a few weeks if you were severely bad off.   Not because the doctor thinks you have a misaligned curve.  That's erroneous.  You are being treated by someone that is not an evidence-based or outcomes based provider.   You really need to look elsewhere.

Dr. G