Question
On my 4th visit to a chiropractor he wanted an xray on my neck to be completed. The findings were: There is reversal of the normal cervical lordosis. A prominent anterior marginal osteophyte at C5-6 may actually fuse this level. Mild changes of degenerative disk disease are noted at C6-7 with disk height loss and marginal osterophytosis. Mild degenerative facet change is also suggested inferiorly. The impression was mild degenerative changes and potential fusion at C5-6 involve the cervical spine.
When I went to see Chiropractor with these findings he had measured the reversal to be 60 degrees and stated this would coincide with the 2 roll over car accidents that I was in years ago. I then asked what my options were, he stated that traction 3x a week and adjustments 2x a week to start. I then asked what the fusion of C5-6 meant. He replied, where did you hear there was a fusion issue? I stated that I had received a copy of the report from the radiologists. He excused himself from the room to look at the report again. ??? When he returned he said that C5-6 could fuse together which would limit my movement. I then asked how we would know if traction & table therapy was working. His reply was that i would have good days & bad days; but I would be able to tell cause I would feel better.  Is this a normal procedure to correct my issues? Could it make my neck worse? I appreciate your time and input.

Answer
   

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Hello B.,

Two car roll-overs is fairly significant.  One of the most common causes of degeneration to a joint is a prior history of trauma several years before.  It is quite possible that even with regular treatment, your neck is predisposed to further degeneration as you age.  That is possible why the radiologist's report says there may be fusion at C5-6, especially with aging (unless it's already completely fused; I don't know since I haven't seen the x-ray myself).  Despite modern advancements in healthcare, there are still great mysteries about the body because not every patient can be defined by a textbook and not all patients respond the same way as they age.  There are just too many variabilities.  If there is not complete fusion right now, it sounds like your chiropractor is just trying to prevent it from occurring.  

From what you've written, nothing sounds too abnormal or alarming with your care.  Not everyone responds the same way to treatment, so if after a few treatments you feel worse, make sure to discuss this progress (or lack of) with your chiropractor.  Traction is a great protocol for any type of joint and disc degeneration.  This is often the gold standard for many physical therapists.  And now, many physical therapist doctors are manipulating, so your treatment is fairly similar to certain physical therapy protocols.  But like I said, not all patients respond the same way to care, so if you feel it is not helping you (you should notice some slight improvement at least after a week or two) then make sure to tell your doctor.  This is also how you may know if the treatment is making your problem worse.  Because your chiropractor is using a standard and normal treatment protocol for your neck, you are the only one who will be able to tell the doctor the treatment is making your neck worse.  And the way to know that is if you start to notice your symptoms worsening with care.  If after a month or so you begin to feel dramatically better, then it sounds like you and your doctor are doing the right thing.  Just keep communicating with your doctor about how you're feeling.

As a side note, you may ask your doctor about a good glucosamine chondroitin supplement.  The studies are conflicting, and every doctor has a different stance with this supplement since not all patients are positively affected by it, but it is a supplement for joint degeneration and many patients swear by it.  It helps to rebuild the cartilage in your neck.  You can also try MSM, but the studies are even more conflicting with this product.  Talk to your chiropractor, and if you decide to take this product, be patient because it can take a very long time to notice improvements since cartilage has a very poor blood supply.

I hope this helps you feel a little more comfortable with your treatment protocol.  Just listen to your body and talk to your doctor.  In the mean time, best of luck with your treatment!
Dr. J.R. Strecker, D.C.