Question
can a neck curvature be changed after 70 years? I am in perfect health at the moment. Is there any danger of this.  Has there been any other deaths from chiropractic manipulation besides the one In
Canada Jan. 2004

Answer
Dear Tya Blumenthal,

Thank you for your question about neck curvature and safety issues.  Yours is similar to those I have heard from others who are investigating chiropractic.  In order to answer you properly, I'll first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation. This is not specifically the same as the findings referenced in your question, but they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without vital brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as accidental trauma, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  In addition, and quite relevant to whether any complaints ?including curvature of the neck, as you have reported - are related to vertebral subluxation, the branching of the nerve pathways is quite complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to whether the curvature you mention may be related to a vertebral subluxation.  At best, such a conclusion would be no more than a guess.  In a very real sense, the curvature that you reported is not a valid or reliable indicator of the presence of vertebral subluxation.  This type of measurement is a very poor indicator of whether a vertebral subluxation is involved or even present.  

In discussing vertebral subluxation earlier in this message, I used the word misalignment.  I am not talking here about curvature, however, and it is not interchangeable with the term subluxation.  The misalignment that I address is that of a specific segment of the spine.  Technically speaking, we have to get even a bit more advanced in what is meant by misalignment to make this clear.  The question is, Misaligned with respect to what?  It is possible to describe the body geometrically, reasoning that we are bilaterally symmetrical and concluding that there is a measurable 搈idline?or that our hips and shoulders should be 揵alanced?on a perpendicular line to this proposed 搈idline.? The problem with this thinking is that it assumes we are simply machines and ignores that we are alive, capable of movement, adaptation, growth, etc.  At any given moment, there is an optimum state for us to carry out life to our best abilities.  That optimum state will vary depending upon the circumstances, both within us and of our environment.  There are many examples to illustrate this.  If you carry something heavy with one hand, you must lean away from it, putting something of a curve into the spine, to keep yourself balanced.  Does that mean the body is failing because there is imbalance or a curve, or is it instead being quite successful in adapting you to the situation?  In another example, consider that those who argue for geometric balance or symmetry would be hard-pressed to explain why the carpenter who swings a 28-ounce hammer all day with his right arm only would have certain physical adaptations that favor his right side.  Should the carpenter have some of the tissue removed from his arm, hand and back?  Or is he merely adapted to his circumstances?  The point I'm getting at is that there is an individually determined, innately normal position for the body that cannot be described by geometry.

From the non-therapeutic standpoint, then, an adjustment is not a process that requires a series of visits; it is a procedure that is accomplished immediately.  Repeat adjustments are made if and when a subluxation is detected ?and only then.  There is no schedule of adjustments involved nor is there a specific amount of time that must pass.  It would require prophetic powers to know with any certainty when and where someone would be subluxated in the future, even though the causes are very common and, therefore, being subluxated is certainly a likely event.

In order to know if someone has a vertebral subluxation, it is necessary to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this is 揳djustment,?and can be accomplished in a variety of ways, depending upon the unique vertebral subluxation and the individual person.  

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that non-therpaeutic straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone with neck curvature better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  Please understand very clearly, though, that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above, and are not determined by the methods used.  What I can tell you must not be interpreted from the mixed viewpoint.  

Realize that the goal in a non-therapeutic straight chiropractic model is not for the purpose of straightening your spine.  This is not the type of objective that would be used in the proper delivery of non-therapeutic straight chiropractic.  This doesn't mean it is bad, it just means it is entirely different than what I would advise you on.  I will not comment, then, on the therapeutic goal of straightening any curvature in your spine or even whether it will be possible to do so.  

Something else to keep in mind is that an adjustment is effected by any of a number of techniques, but is solely and uniquely for the correction of vertebral subluxations because they, in and of themselves, are detrimental to the expression of life.  The exact technique used is not the determining factor in whether someone is providing straight or mixed chiropractic services.  In fact, because no two people are the same, many who are practicing non-therapeutic straight chiropractic and focusing solely on the correction of vertebral subluxations will rely on a variety of adjusting techniques.  They will employ the one best suited to the particular individual in the office at that particular moment.  

I'd like to comment on the portion of your question about the safety of 揷hiropractic manipulation.? You may notice that throughout this response, I have used the term adjustment to describe the methods used by a non-therapeutic straight chiropractor.  It is critical, as you research this issue, that you keep in mind that there is a significant difference between the two branches within chiropractic.  The reason I bring this up is because there will be a difference in the suitability of data depending on which branch is being addressed.  As an example, since non-therapeutic straight chiropractic does not venture outside its professional boundaries into the medical realms of diagnosis and treatment of ailments, there will be no comparison studies to show that it is safer or more effective for, say, ear infections or backaches.  Since mixing chiropractic does cross into other fields, there may be some relevance in such analyses and other sources may try to provide you with such data.  Even data pertaining to the application of and risk associated with manipulative therapy, used by some in mixing, and mentioned in your question, would not have much standing when talking about the unique and quite different matter of specific vertebral adjustment for the sole purpose of correction of vertebral subluxation.  

Occasionally, an item may appear to apply to either branch.  There are mentions, often quite sensationalized, of certain techniques used that lead to injury.  The details many times show that it was not a chiropractor, but another professional using what he termed a 揷hiropractic method,?or that it was a chiropractor actually doing something that was not within his expertise, rarely that it was the chiropractic technique that was to blame.  There is an example from case law in Missouri in which the plaintiff claimed that the chiropractor should have disclosed that there was a risk involved in undergoing chiropractic methods.  The judge acknowledged that there was a risk involved but also noted that there was a similarly miniscule risk of being struck by lightning while seated in the reception area of the chiropractic office and that if the chiropractor was negligent in not disclosing one he was also negligent in not disclosing the other.  Needless to say, the plaintiff was not successful in this matter.

The insurance industry excels in measuring risk.  These companies charge higher premiums when there is more risk or concerns over safety.  Consider that 搒afe driver?discounts are given to those who have good driving records and new licensees have some of the highest premiums because they, as a group, have the highest rate of accidents.  Well, chiropractors, in general, pay lower malpractice premiums ?much lower! - than any other profession and, when the company makes such a distinction, non-therapeutic straight chiropractors pay even less.  This may be one of the most objective and powerful statements on the safe nature of non-therapeutic straight chiropractic.

The issue of safety, then, is an individually-determined matter, consisting of a multitude of variables between the consumer and the chiropractor, quite outside the scope of this forum to determine for you.  It is also quite often more one of perception than reality.  People are typically afraid of what they don't know ?as an example, think of the fear of walking into a dark room, until the lights go on and then that fear is removed ?or of what they've been taught to fear ?for example, prejudice is an ingrained fear passed on from generation to generation without regard for the true nature of any threats or dangers.  Both are active in people's assessment of safety with chiropractic.  Consider the many 搈yths?about chiropractic that stem wholly from ignorance or preconceptions.  People are more willing to believe them if they want to justify their fears.  Out of their fear, people who don't want to go to a chiropractor have a host of reasons why they shouldn't.  They repeat the warning they've heard that if they were to go even once to a chiropractor they'd have to go for the rest of their lives, but they reject that people, after understanding the wisdom of living free of vertebral subluxation, make that choice to do so.  They cite such things as a select case where it was reported that chiropractic methods caused a fatal stroke in someone, as it may have been reported in the headlines, but fail to note that it was an unqualified neurologist who was attempting to use them.  In the case you cite, for another example, it was manipulation in question, not adjustment, as well as the chiropractor attempting to treat migraine headaches and complaints of pain, so it was clearly not involving a non-therapeutic straight chiropractor.  In addition, as I read earlier today, the ruling was that the unfortunate outcome was an accident and there is great uproar about how testimony was handled with the likelihood of some sort of follow-up action.  A number of qualified witnesses agreed that the chiropractor's actions were not responsible for the death.  This case merely illustrates how complex a question it can be and that it requires clarity in defining which segment of the profession is involved, as determined by the professional objective, and what the exact circumstances were.  

All that said, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for geometrically straightening your spine.  Remember, the two objectives are not the same.  If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  

Tya, I wish you the best in sorting out the sometimes confusing world of chiropractic.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.