Answers to Questions about Chiropractic:
What Is an Atlas Misalignment?

Samuel Homola, D.C.

Question

I am beginning to receive upper cervical "atlas" adjustments at Life Chiropractic College in Marietta, Georgia. I have been diagnosed with a misaligned atlas (C-2, I think?). The treatment is a machine that looks like a bench top drill press, which puts 6 PSI impact on the vertebra to push it into alignment and then see if it "holds" over time. I know this doesn't give you much info, but what should I be concerned about as I go into this therapy?

Answer

I would advise against undergoing machine treatment to correct a "misaligned" atlas.

Very often, chiropractors measure structural asymmetry on spinal x-rays and label the distortion as a "subluxation." However, the mere fact that one side of the spine looks slightly different from the other (a) does not mean that a person needs treatment; and (b) the relative positions of the neck bones cannot be changed by tapping on the vertebra with a stylus.

In rare cases where locking (fixation) of a joint in the neck causes pain and loss of mobility, a few treatments with traction, mobilization, or manipulation might restore mobility and relieve the symptoms. But tapping the neck with a machine-operated stylus may be a waste of time and money. In many cases, this type of treatment is used on symptom-free patients who are told that they have an upper cervical "subluxation" that will require a series of treatments to correct and maintain proper alignment.

Unnecessary use of neck manipulation, especially in the upper neck area where blood vessels are most vulnerable, may be harmful. People who have no symptoms do not need any treatment of this type. Futhermore, such treatment should always be discontinued when symptoms disappear.

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Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient's Guide provides an incisive look at chiropractic's history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.

This page was posted on February 2, 2002.