Question
QUESTION: I have postural lumbar syndrome second to kyphosis(round back) and hypolordosis. My NMRI shows mild degeneration of the lumbar discs. Pain is increased during prolonged sitting and standing and by hyperextension. I went to chiropractor for 3 times and he adjust my posture( lumbar and thoracic  spine),but he thinks that I need more adjustments until final stage (correct posture). I consider to stop with treatments cause it is painfull during manipulations and I feel uncomfortable after manipulation. He told me that is normal cause I have bad posture for a long time (I am 25 years old male) and that I need more adjustments to be painfree.
Is it safe to stop with trewatments now, before final stage and do only exercises for correction and stabilization which he gave me earlier. Is my spine unstabile now, after only 3 treatments?

ANSWER: Hi Milos,

Let's see if I can help clarify some concepts.   First, at 25, there is little chance that your posture is going to be "corrected" by anything, and it especially will not be corrected by spinal joint manipulation.  It would take a lot more to make changes to your posture, including strengthening and strecthing.   Even at that, there is no evidence to prove that these will surely correct your posture.   Also, the degeneration of your lumbar discs, if truly confirmed by MRI imaging, is likely congenital.  There are studies that demonstrate degeneration in the spine starting in the teenage years in non-symptomatic subjects.     I've never heard of "lumbar postural syndrome."   There is what's called "lower crossed syndrome" and "upper crossed syndrome."   In these, the subject has an increased lumbar lordosis, an increased thoracic kyphosis, and a forward carry to the head off of the shoulders.   The upper and lower crossed syndrome patient also has weak abdominals, weak hamstrings, short/tight hip flexors, weak back extensors and shoulder blade retractors, and short/tight and pectoral muscles.  If you've got this syndrome, it will take a lot more to correct it than spinal joint manipulation.    Being free of pain is another topic.  Being free of pain is a logical parameter for care.   IN other words, your chiropractor must consider that one of the reasons to treat you is to alleviate your pain, and not to only focus on trying to correct your posture (since that likely will not happen).   As far as pain from treatment, there is no reason to have to endure this.   It's true, that some people feel sore from joint manipulation, but there are so many ways to make it more comfortable, including doing some massage before and after the adjustment, or applying some heat, or changing the adjusting technique.   If your spine was not unstable prior to treatment, then is is not unstable because of treatment.  There is no risk of instability by not having treatment, if that's what your asking.  Instability is a pre-existing laxity to the joint, e.g. from a sprain injury.   It cannot be caused by the joint manipulation.   My suggestion is to ask the chiropractor for some logical and realistic answers to your questions.   If you cannot get simple, rational, and reasonable expanations, then you need to find a different doctor.   

'Hope this was helpful.

Dr. G

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

QUESTION: I use to have hyperkyphosis and hyperlordosis but because of pain and discomfort I flatten my lower back and now I have hypolordosis. When I try to increase lordosis I feel pressure and pain in facet joints. When I said unstabile i ment that chiropractor maybe caused hypermobility of facets and SIJ by agresive side posture adjustments. He thinks that my posture may lead to chronic discs injurie, esspecially L5-S1. Is that posture correction good for my discs (it is the most important to me)and if it isn t is there any other way to stabilized my spine and protect discs from injuries without such a painfull and agresive correction? Thanks for past answer.

Answer
Milos,

The only way we know of to protect discs from injury is to practice proper body mechanics when bending/lifting/sitting, and to avoid injurious situations (like not getting into a car crash).   Otherwise, everything else you described to me about your spine and discs and hypermobility and instability and posture is mere speculation.  All that we know for sure is that you have pain and that your side posture adjustments are painful instead of comfortable.  There is no instability caused by a few side posture joint manipulations.  Find a DC that will perform comfortable treatments and then go to the gym and strengthen all of your muscles on your own.  

Dr. G