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Chiropractors/What would you think of this Xray?

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Neck
Neck  
QUESTION: I'm a 29yr female and I went to see a Chiropractor for pain between my left shoulder  blade  and spine (felt like something needed to pop and couldn't). I have also had 2 children and knew  that I was probably really due for some general adjustments. My ex rays came back with various findings including this lovely neck. What would your thoughts be?

ANSWER: I would say that it is not proven to be a big deal.  In fact, if you simply stood up a little more straight, tipped your head up a little (you are not positioned properly in this x-ray and the first horizontal line needs to be touching the base of your skull, not through it), and had someone else draw those lines, it would be more normal.  The reverse curve is very common and as far as we know it is not always a source of pain or impairment.  It is purely theoretical that it leads to degeneration of the joints at the curve angle.  Also, there is no gurantee that one particular method will correct it.  Some chiropractors make a big deal about it, likely because they can scare you into extended courses of care ($$$).    This is an outdated, dogmatic procedure.  You could get the same or better treatment results with a thorough hands-on examination and good quality manual therapy, including adjustments, and without exposing yourself to x-ray.  I am a newspaper columnist and your timing is good, because the upcoming article will be about whether one needs x-rays (Metrowest Daily News, Framingham, MA).   Lorraine, if after two treatment sessions all your pain is gone and you have full and pain-free range of motion of your neck and shoulders, and full strength of your neck, upper back, arms, and you are sleeping well and doing all your activities well, then what does it matter what your curve angles are?   Try strengthening your upper back muscles and then see about your neck curve.  In other words, don't get sucked into extended or unnecessary care over this.

'Hope this was helpful,

Dr. G'

---------- FOLLOW-UP ----------

QUESTION: Thank you Dr G for you response :) I also looked up your article written you mentioned (http://m.metrowestdailynews.com/article/20140408/ENTERTAINMENTLIFE/140406593/200) and it was well written, thank you for that as well. So are you bottom line saying that the curvature of your neck and or spine doesn't technically matter if there is no pain or limited mobility involved?
Doesn't the spine house the spinal cord - which communicates to the body (sending messages) via the brain? - so if the path was not "properly" curved couldn't signals not reach or be impeded in some way? My arms go numb when I lift them in the air.  I have extremely cold hands and feet and overall lower body temperature - my thyroid checks out normal though. Could having a reversed curve in my neck (and other areas of my spine) by a reason?
My chiropractor is wonderful and seems very knowledgeable he has done adjustments and given me a Denneroll pillow to lie over 20mins a day. I can understand not wanting to expose myself to X-rays often, makes sense. How would you evaluate improvement in someone of my case? My muscles on the side of my neck and always tight and sore, but I thought that was just from my busy mommy and athlete life.
I actually went in for a pain between my left shoulder blade and spine (like something needed to pop but couldn't) / that pain is still there. I also have a winged scapula on the left, with no pain. -- all derived from my neck? I practice good posture, I am fit and eat well.

Answer
Lorraine,

Yes, the vertebrae house the spinal cord, and the spinal cord communicates with the brain.  The altered curve in your neck does not affect this.  The line drawings and angles of your bones do not impede the nerve like it was a garden hose being stepped on.   I believe it is very good to go to the chiropractor and obtain spinal joint manipulation and, even better, with the addition of soft tissue work.  I belive it is a healthy thing to do for our joints. That is my belief, based on scraps of data, and based on observation and personal experience.   The data does not support the concept that the subtle alterations in your spine's vertebral alignment affect your nerves in any way. If your bone has a spur, or a disc bulges, or some other structure in the spine dents into the nerve, then that's another story, and the alteration in nerve function becomes obvious.   Lorraine, chiropractors have been discussing and researching this very topic for decades.  It was back in the 1980's, when more DC's were abandoning the "bone out of place" idea, that Len Faye formed the Motion Palpation Institute, creating a paradigm shift.  More DC's began to think and research, and not just do whatever some self-proclaimed guru espoused.  Your DC knows full well that there is no viable research to prove that your altered neck curve is the cause of your problems.  It is merely a hypothesis that the altered curve can lead to degeneration in the lower cervical vertebra, but it's not known for sure or known if degeneration would have occured anyway (e.g. your genetics), and it is not proven at all that your curve can be reversed, or if it was reversed if you would feel or function any better.  As for your winging scapula, that can be caused by many things, including the use of crutches or from pregnancy, none of which has anything to do with your neck curve...  

Hope this was helpful,

Dr. G'

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Scott F. Gillman, DC, DACBSP

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21 Years in practice: I can answer any question regarding chiropractic and sports medicine treatment. Mostly, I can help the unknowing public understand what is safe, valid, reasonable and evidence-based, and what kinds of unscrupulous chiropractors and fraudulent methods to stay away from. I have an advanced specialty degree in Chiropractic Sports Medicine. I have experience treating elite and Olympic athletes.

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