Question
I met a chiropractor at company's health fair, they provide evaluation on spine for only $30. I went to this chiropractor's office and had some x-rays. I don't remember how were the positions while the x-rays were taken. Anyway, he showed me that my neck curve is -2 degree, compare to 45 degree normal curve I have 110% of neck curve loss. He said my case is in phase 2 (pretty serious), my health is in jeopardy and I should start the treatment right away.

Interesting enough, the second day I had x-rays with at chiropractor's office. I also visited my family doctor because of very bad pain on my neck and shoulder area. Family doctor prescribed x-ray on my neck with radiology center and the result from this x-ray says my neck x-ray is very healthy and normal! So, it may be the stress from work or sitting position causing the muscle pain.

Please help me understand: -2 degree neck curve means neck is tilting forward or backward? Is it necessary to have neck curve adjusted? Or is it even possible to correct it? Is there any exercise I can do try to correct it myself?

Thank you very much for your attention!

Answer
Monique,

First, if you don't have any neck symptoms, you shouldn't be exposed to this much ionizing radiation in the form of radiographs.

Second, even in the presence of neck symptoms, x-rays are not always required. Current radiology guidelines suggest the use of x-rays when a fever is present in conjunction with spinal pain, in the case of trauma, or in other cases in which an underlying pathology is suspected.

Third, regarding cervical curvatures, depending upon the source, the average measurements for a normal cervical curvature, called the cervical lordosis, will vary somewhat.

A negative 2 degree curve suggests that you have a reversal of the normal cervical lordosis (called a cervical kyphosis), which may be implicated with early joint and disc degeneration and the later onset of joint and disc-related pain.

However, a 2005 study in the Journal of Manipulative and Physiological Therapeutics ("Determining the Relationship Between Cervical Lordosis and Neck Complaints") found that patients with lordosis of 20?or less were more likely to have cervicogenic symptoms (that is, pain arising from dysfunction of the joints of the neck).

The study also found that people who had a 0?or less (meaning a reversal of the normal curvature of the neck) had significantly increased incidences of pain. The odds that a patient with cervical pain had a lordosis of 0?or less was 18 times greater over all age ranges. Males were found to have greater incidences of cervical lordosis loss than females, especially in the 40- to 49-year-old age range.

The researches also found a statistically significant association between cervical pain and lordosis less than 20?and a 揷linically normal?range for cervical lordosis of 31?to 40? They concluded that maintenance of a lordosis in the range of 31?to 40?could be a clinical goal for chiropractic treatment.

Some reports in the literature assert that restoration of the cervical lordosis is possible through various proprietary chiropractic techniques.

As far as I am aware, however, these techniques are not part of standard chiropractic education and training, and the clinical utility of these techniques has not been clearly established in the research.

Additionally, as far as I am aware, there is nothing in the existing research to suggest that the loss of the normal cervical lordosis seriously jeopardizes an indvidual's healty, and the causes for loss of the cervical lordosis have not been clearly identified.

I am also not familiar with anything in the literature to suggest that once your cervical curvature is restored to a certain range that it will remain there.

I support the concept of patient self-care (meaning rehabilitative exercise or ergonomic and postural modifications, which the research substantiates), but I am skeptical about any technique that requires an aggressive commitment to repetitive chiropractic treatments. Most evidence-based practitioners consider this tactic to be a marketing strategy rather than a clinical strategy based on the best available evidence.

In my opinion, based upon the research consensus to date, treatment of a spinal region that is not causing symptoms is unnecessary. Additionally, medical physicians generally use spinal x-rays to screen for medical pathology and generally don't take abnormal biomechanics into consideration in their anaylysis.

I hope that this answers your question.