Expert: Scott F. Gillman, DC, DACBSP - 2/11/2009

Question
I am curious about what types of conditions a chiropractor can really correct.  I had a two level cervical foraminectomy without fusion about seven years ago with good results. All nerve symptoms resolved.  Lately my neck has been tight which could be due to stress also. I recently saw a chiropractor who took x ray.  He said that my neck is curved, but in the wrong direction, placing stress on areas not designed to handle stresses.  How can adjustments really "correct" the curve? I was suprised that he didnt set me up with a home stretching program. Another red flag I had is that I told him that my husband just had his mri which showed two levels where the spine was flattened and bowed due to extreme bone spur formation. My husband has been having a lot of nerve pain in his shoulder and down his arm pretty much constantly.  We just heard from a neurosurgeon who feels he is a candidate for a foraminectomy without fusion.  The chiropractor asked me to bring the MRI in. From what I know, it would be dangerous to adjust a neck with issues as severe as my husbands. I am starting to have real reservations about this chiropractor.  My L5 had ruptured years ago and according to a spinal surgeon, only ten percent of the space is left and there is mainly a powdery substance in the disc space.  I never had surgery there,  The chiropractor is telling me that by adjusting that area,the disc can rehydrate to some extent.  What is your opinion about what he is saying?

Answer
Amy,

Find a chiropractor that is more clinically astute and evidence-based.  He cannot make any significant change to your neck curve, and even if after 4x/week for 6 months he did, there is no guarantee that you will feel better.   Yes, distracting the spine will allow the disc to decompress a bit and it can hydrate.  That's one explanation as to why we are taller in the morning and shorter in the evening.  Again, there is no evidence that distracting and hydrating the disc will prove a cure to back pain.  The methods of distractive manipulation have been around for decades, and they are helpful for lots of people with arthritic lower backs, stenosis pain, or sciatica, but all the reasons why there is benefit are under speculation.  As for your neck, home stretching may not help much, but you have to find the right mix of stretching and strengthening exercises to help you out.  

'Hope this helps.  

Dr. G