Question
I am currently seeing a physical therapist who tells me that various vertebrae from the mid back to the base of the skull have been misaligned for some time. Following a successful visit whereby some of these are aligned properly, I find that they will move out of position very quickly, sometimes a few hours later (particularly the neck). I always make a conscious effort to keep my body in line etc but is there anything I can do to try and stop these problem vertebrae moving again following treatment. I even thought of buying a neckbrace but I don't know if this will work. My therapist tells me that over time the joints will stay corrected but the last 4 visits have resulted in them moving out of position after only a few hours

Answer
Chris,

There is no such thing as "misalignment" of vertebrae or vertebrae that go into or out of alignment.   This is an outdated theory.  Gordon Waddell, MD, a Scottish orthopedist who wrote a book, "The Back Pain Revolution," highlighted this flawed concept back in the 1980's.   In 1987 (I think), he stated: 揟he source of most back pain may not be gross anatomic disruption but rather a disturbance of neuromuscular function and neurophysiology.? At the same time, in chiropractic, Leonard Faye, DC, formed the "Motion Palpation Institue", and introduced a giant paradigm shift from "bone out of place" or "subluxation," to spine segmental dysfunction, or a dysfunction of the vertebra segments of the spine.  Dysfunction was a dynamic - not a static - concept.   This made a lot of sense to all of us, as we could never get a straight answer from the (frustrated) professors when we asked, "So doctor, if I adjust a rotated T4 vertebra, will I feel that it is rotated back in place? And how will I know it's in place?  And for how long?"  We'd usually get lots of mumbling and side-tracked discourse, but eventually corner the doctor (verbally) until he admitted, "Uh. I don't know."   We knew that vertebrae could appear misaligned on x-ray, but there never was any evidence that the alignment would change with treatment.   One doctor took an x-ray that showed a rotated vertebra, then had the patient turn his head left and right a few times, then retook the x-ray.  That vertebra then looked misaligned the other way.  This raised great questions for us when we were instructed to take x-rays to look for the spinal subluxation.  This was 20 years ago.  Sadly, there still are doctors taking x-rays and convincing patients that they need to get all sorts of treatment.   It is interesting that the physical therapy community has been in the same clinical quick-sand, using "misalignment" analogies that clearly are obsolete.   While it is possibly that your neck and mid back have been an issue for a long time before you had symptoms, it has nothing to do with alignment.  I would assess for joint function or ability (e.g. can you retract your neck, pinch tight your shoulder blades, or fully extend your hips and shoulders.  I would test muscular strength, and search for myofascial irritation.  Your treatment would be based on these parameters, and not misalignment.  I would have you hitting the gym if at all possible.    There are a few chiropractors in England that I know: Thomas Jeppeson, DC (who went to Beijing with me via the World Olympians Association) and also Dr Edward Rothman, DC, at the Anglo European College of Chiropractic, Bournemouth (Telephone: 01202 436200 http://www.aecc.ac.uk ).   

Regards,

Dr. G