Expert: Dr. Victor Dolan, DC, DACBSP - 5/31/2008

Question
I had gone to a chiropractor 2 days ago, my complaint was mid back and chest pain. I have an anterior disc replacement with a fusion in c5-c6 of my cervical  spine. My pain in referred. I told him not to adjust my neck, had it done one other time and I had a headache for 2 weeks. He said he did not adjust my neck, but he did the T1 of my thoracic spine. I didn't want anything done but my midback. I am so mad, I now have such a headache that has ruined my weekend! I have occipital neuralgia, which he has caused to act up again. I had no head pain till he did that to me! Why do chiro's always want to adjust my neck? Could he of hurt my fusion? It has been 2 years since I had the surgery.

Answer
Hello Karen,

Neck pain, herniated disc, headache, occipital neuralgia, fusion.

This Staten Island Chiropractor treats very conservatively.  Most of the family Doctors of Chiropractic that I know are very conservative in treatment.  "Why do chiro's always want to adjust my neck?" , , ,
hmmmmmmm I do not know.  How many doctors have you been to that want to osseously adjust your neck?  

I agree with you.  Depending upon the maneuver utilized to adjust T1, there could be some irritation above that into the cervical region.

Chiropractic, like medicine or surgery, has many different approaches, many treatments for the same conditions in different patients, or for the same condition in one patient - but at different times with different concurrent conditions.

The Doctor of Chiropractic who treated you before the surgical fusion saw that osseous adjustment techniques, soft tissue techniques, low force techniques had progressed as far as possible in your condition.  Once the conservative approach had been exhausted, the 'big guns', the last resort, the 'atom bomb' had to be dropped- invasive surgery.

Surgery, the last resort, permanently changes the 'geography and geology' of the area.  Once surgery has taken place it certainly limits what a Doctor of Chiropractic, Physical Therapist, Massage Therapist can do to you.  There are limitations, but there are many options ( as stated above- soft tissue, low force, no force techniques).  Many patients complain when they go to the Doctor and do not receive a vigorous adjustment, but this Staten Island Chiropractor- in practice 25 years at the same place, starts slow, and depending upon the patient and condition,,, may never osseously adjust (even though that is my preferred method!).

Sacro-Occipital Technique (SOT) is very gentle upon the cervical spine and entire spine, Activator technique is very soft and gentle, osteopathic type stretching and mobilisation is soft, gentle and effective.

Fusion.  Fusion with bone?, Plates and screws?, regardless,,, if the surgery was performed long enough ago, say a year or more, your new boney segment should be as stable and strong as the individual vertebrae were prior to surgery.  Some people with fusion do tolerate osseous maneuvers, but that would not be the starting point in therapy.  It is not probable that the T1 maneuver damaged the fusion, but depending upon the vigor of the manipulation, irritation and inflammation could certainly have happened.

I do not know what area you live in, but I know that in Staten Island Chiropractic offices you would not be vigorously osseously adjusted by any of the family Doctors of Chiropractic that I am familiar with.

After a conservative regimen of care, starting slowly, monitoring response, changing treatment as indicated, ultimately you may never be osseously adjusted in the C-spine; but that does not mean that other more conservative Chiropractic techniques could not be utilized.

I would go to a Doctor that utilizes applied kinesiology, SOT, activator, nimmo, other 'low force', soft tissue approaches.  Often doctors do advertise their techniques in the chiropractic yellow pages.  Look for those soft tissue techniques which may be more suited to you.

I wish you good luck, and agree with you.

As always, this article is for discussion purposes only.  Conversation to elicit information, education and not prescriptive recommendation. Specific evaluation, DX, RX, TX, PX can only be given in person by a treating health professional.

Wishing you Good Health Naturally.

Dr. Victor Dolan, DC, DACBSP. CCN
http://www.GoodHealthNaturally.info
http://www.DocDolan.net
http://drvictordolan.chiroweb.com  (email newsletter)