Question
Hi, I have been having upper back pain for the past 4 months. It started with minor pain and increased with time, and is now much worse. Every time I move a vertebrae clicks, even sometimes when only moving my legs. I went to a chiropractor who told me my atlas was not in place due to an accident. At the moment I have been manipulated about 6 times, but the pain doesn't seem to get any better. Do you think what she is doing is right, and has identified the cause? Can this be totally cured using chiropractic manipulations?

Answer
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Hello A.,

Thanks for the question.  Your question really highlights a unique aspect of complementary and alternative therapies.  Chiropractors and many other types of practitioners have long touted the importance of treating the cause, not the symptoms.  Your painful symptoms are in your upper back, but in your chiropractor抯 opinion, the cause of your symptoms is in your neck ?your Atlas.  It would be inappropriate for me to claim your chiropractor is incorrect or correct.  However, there are many chiropractors that traditionally adjust the top of the neck only, such as the Atlas, for they believe if your upper neck is in proper alignment, everything will work itself back into alignment in the lower portions of the spine.  Keep in mind, however, that there are also other chiropractic techniques that believe just the opposite; they believe proper alignment starts with the hips, or even the knees, ankles, and legs, and after the lower spine is aligned, all vertebrae above will align better.  So, what is correct?  It depends on who you ask.  There are thousands to millions of patients who have had success from treatment by both philosophies and techniques.  

Overall, yes, it is reasonable for a chiropractor to treat an area that is not in pain and still positively affect the painful area, but I cannot directly comment on the care you are receiving with your current chiropractor.  I抦 not sure what the standards of care are in Spain, but in America, the standard of chiropractic care is for the patient to show improvement within 2-4 weeks of consistent care as prescribed by your doctor.  (Note: this does not mean complete resolution of your symptoms within 4 weeks ?merely improvement).  

The other thing to keep in mind is that you are not just the patient, but also the customer.  If you disagree with your doctor抯 recommendations or management, in a respectful and polite way, you should discuss this with your doctor.  If you have tried to discuss this with your doctor, and you still do not feel treatment is beneficial, you may want to ask your doctor for a referral for a different type of chiropractor.   Perhaps chiropractic can help your situation, but you may need to be treated with a different technique.

As mentioned, I cannot verify or deny the validity of your doctor抯 assessment or treatment, but I hope this helps clear up your treatment and options a bit.  Best of luck!

Dr. JR Strecker, DC