Expert: Dr. J. Shawn Leatherman - 11/15/2008

Question
Hi Dr Leatherman,
I am a 40-year old male. Recently, my MRI and X-ray showed I have cervical spondylosis, canal stenosis, forminal, complete loss of curvature, bulding disc and phase-2 degeneration on C4-C6. I don't not experience chronic pain on my neck but feel discomfort. I have to move my neck often to get some relieve.

I am currently seeing a chiropractor. He prescribed me with the following:
- 3x week with neck stretches/isometric exercises
- adjustments
- 2-way traction - pulling my neck forward with 10 lbs weight and pushing my forehead down with 5 lb weight (15 min each time)

I hope you can help me to the following questions:
1) How serious is my condition?
2) Is the above program sufficient to treat my condition? If not, what else do you recommend?
3) How would this program help my spondylosis, stenosis, forminal and loss of curvature?
4) Would chiropractic program help to repair the bulging and degenerative/compressed discs?
5) How much time do I need to go through the treatment before I see some results?
6) What percentage of patients (in your experience) do not respond to this treatment and why?

Thank you for your time and advice.

Answer
Dear Lee,

Here are the responses to your question.

1) How serious is my condition?  Not looking good at this point.  The degeneration will not improve and will only get worse over time without the correction of your reversed curve and improved biomechanical function.  Although this is not life threatening by any means, it will eventually lead to surgery as the degeneration gets worse.

2) Is the above program sufficient to treat my condition? If not, what else do you recommend?  The above program is sufficient, but the chiropractor will likely need to increase the traction weight a bit over time...but within your tolerance.  The doctor should have shown you your x-rays and explained how and why the traction is being targeted to improve and restore the normal curve.  It is important when applying traction to make sure that the correct segment of the spine and angle is targeted for optimum results.

3) How would this program help my spondylosis, stenosis, forminal and loss of curvature?  Restoration of the curve will take pressure off the discs and nerve roots of the spine, and limit future degenerative processes.  It will also help to slightly rehydrate the disc material.  However, it will not improve the degeneration you already have.  Once bony degneration has taken place, very little reversal will occur.  Less than 5% overall changes will occur.

4) Would chiropractic program help to repair the bulging and degenerative/compressed discs?  Yes to a certain extent...it will help the hydration of the disc, and reduce pressure on the disc which will curtail continued bulging.  Concerning actual repair of the disc, this will occur with scar tissue, but the disc will always be weaker, less elastic and prone to future degeneration.

5) How much time do I need to go through the treatment before I see some results?  The program outlined should be followed for 9 weeks if doing it four times a week, and 12 weeks when performed 3 times per week.  This (Chiropractic Biophysics)has been widely researched for efficacy and you can learn more about this type of chiropractic care at www.idealspine.com.  You can even research your chiropractic physician there to see what level of curriculum completion they have attained, and if they are certified in this technique.  Click on find a physician on the left of the main page and then click on your state and look for the clinic you are treating at.

6) What percentage of patients (in your experience) do not respond to this treatment and why?  In my clinic, over 80% of patients treated with those types of protocols get improved results on follow-up x-
ray exams.  Over 90% experience reduced pain, and improved function.

Hope this helps Lee.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net

Follow-up to your response:

Dear Lee,

This may or may not be a concern...the traction you have described will still help to regain some of the lost curve, especially if you head is forward of the chest, however, it may not be the most effective.  

By the way, was your doctor listed on the site as taking the courses...if not be careful.  Many chiropractors have started utilizing traction in their offices without proper training and are doing so without current knowledge.  Make sure your chiropractor knows exactly what they are doing!!