Expert: Gerald Anzalone, D.C. - 8/2/2007

Question
I went to see the chiropractor a couple of weeks ago because of some pain in my back and my a twitch in my thumb. I also had numbness and pain in my hands and arms. When they took the X-rays I was diagnosed with military neck. I really don't understand it. Could you explain it to me? I have never had any trauma to my neck so how did I get it? If I wouldn't of gotten treatment could I be paralyzed? Should I get a second opinion? Thank you.

Answer
Courtney,

"Military neck" is a general layman's term to describe the loss of the normal curvature of the cervical spine (neck), called the lordosis (a backwards c-shaped curvature). The moniker is derived from the rigid stance of attention that military cadets or soldiers are forced to assume which resembles the appearance of the cervical spine on radiographs. The correct term to describe the loss of the lordosis is called a hypolordosis.

Some spine experts feel that a hypolordosis pre-disposes an individual to premature arthritic (i.e. degenerative) changes of the facets, or joints, of the neck. Others feel that there is no significant association between hypolordosis and neck pain or degenerative changes. My opinion is that it depends... a reversal of the cervical curvature (called a cervical kyphosis) tends to be more associated with symptoms due to the complete alteration of the normal mechanics of the joints, but in theory, a hypolordosis can produce altered weightbearing forces and abnormal mechanics of the joints of the neck. The causes may be due to trauma, genetics (like a scoliosis), or "other"... meaning that we're not quite sure.

I also have a hypolordosis, but most of my neck pain tends to be muscular, rather than joint related.

My one word of caution would be to avoid a chiropractor who tries to sell you on a certain number of visits to "correct" this problem or repetitive x-rays to measure "improvement" with treatments. There is no evidence to show that any specific number of adjustments or manipulations will correct a hypolordosis, and repetitive x-rays are clinically unnecessary and increase exposure to ionizing radiation. Many chiropractors and other spine specialists simply consider a hypolordosis an incidental finding, especially if no symptoms are present.

No, there is no evidence to show any correlation between the presence of hypolordosis and paralysis, with or without treatment.

I hope this answer is of help to you.