Expert: Gerald Anzalone, D.C. - 1/4/2008

Question
OK. So I know that you have answered questions on this before, so I am going to ask you. I have been having chronic upper back pain. It constantly feels like a burning sensation. I went to the Chiropractor and had X-rays. He told me that I have a 117% loss of curve. (i guess this is hyperlordosis) He also told me that with that serious of a loss and with the pain that I am having, I should see a neurosurgeon. He told me that it causes a lot of pressure on the spinal canal and can cause brain damage if not corrected. Is my chiropractor telling me something that I should take seriously?

Answer
Kara,

Thanks for your question.

A 117-degree loss of the cervical lordosis would indicate a reversal of the lordotic curvature of the neck, called a cervical kyphosis. That's a rather significant loss of the normal curvature.

In some cases, a dramatic loss of the cervical curvature may produce pressure against the spinal cord, resulting in neurological symptoms. More commonly, such a loss of the cervical lordosis results in degenerative joint and disc changes (osteoarthritis) which in itself is painful and chronic.

Generally, surgical intervention is considered when a person has severe, unremitting pain that is unresponsive to conservative care, progressive neurological symptoms, and loss of function (in this case, of the arms and hands, since your problem is related to the neck, and the nerves and blood vessels which supply the arms and hands originate from the neck).

I also don't think that such a reversal of the cervical lordosis can be corrected by manipulation, although some proprietary chiropractic techniques would claim that they could make a difference. I'm not personally aware of any reputable studies in the medical or chiropractic literature to validate these claims, but that doesn't necessarily mean that chiropractic manipulation/adjustments couldn't help to a certain extent with reducing pain or even in making structural changes to the curvature. Physical therapy with an emphasis on spinal rehabilitation might also be helpful.

If your chiropractor is recommending a neurosurgical or orthopedic surgery consultation, you should consider seeing what recommendations the surgeon makes before deciding on your next course of action.

I hope that this response helps to answer your question.