Question
Hello, I took my son to a chiropractor today because I noticed his vertebra was bulging out on his neck, two of them. I have never noticed this before and I can't help but think this is from flipping over his bike or snowboarding accident.  The accidents were within the last month. Teenage boy!!! He has no pain, no tingling or any complaints.  I was concerned by them sticking out so far.  He was diagnosed with a reversed cervical curve and we were told that he needs 6 weeks of therapy.  My brother is a Dr. out of state and doesn't see the urgency in this if there is no pain.  He believes that my son could have been born with this. Should I leave well enough alone or have him go through therapy?? He is tall and skinny and I am concerned that I may be over reacting.

Answer
Thanks for your questions.

If your son has no symptoms (neck pain, radiating arm pain or numbness/tingling), then there is no need to treat his spine.

Radiologists have identified a "normal" range of cervical spine curvature (called the cervical lordosis) ranging somewhere between approximately 35 to 50 degrees, depending on the source.

However, there has not been a consensus of scientific opinion published in the literature to show that deviations from this range will cause problems, although some individuals feel that a loss of the normal cervical curve, or a reversal of the normal curve, will predispose an individual to earlier-onset degenerative joint disease.

Additionally, no significant health benefits have been shown when the "normal" curvature of the neck is restored. There are some chiropractic techniques which highly emphasize the restoration of "normal" spinal curvatures. These techniques have been criticized by evidence-based chiropractors for utilizing repetitive x-rays to measure "improvements" and for emphasizing long-term treatments, even for patients who are not experiencing symptoms. Proponents of the restoration of spinal curvatures sometimes liken the rationale for spinal "correction" to braces used to straighten teeth.

Loss of the normal cervical lordosis could result from genetic predisposition, or in cases, in which there are symptoms, from muscle tension or spasms.

If your son has experienced recent trauma resulting from flipping over on his bike or snowboarding, and has landed on his head or injured his neck, and if he is experiencing symptoms from such a traumatic event, x-rays would be appropriate to rule out pathology (such as fracture, instability, or ligament damage). However, in the absence of symptoms, there may be no reason to commit to a 6-week treatment plan.

There is a device that you could purchase for home use, which may be helpful in providing some correction of the neck curvature:

http://www.posturepump.com/

Use of such a device should be done only after consulting an appropriate health care provider.

I hope that this answers your question.