Answers to Questions about Chiropractic:
Can Atlas Adjustments Relieve My Back Pain?

Samuel Homola, D.C.

Question

Thanks for putting together this website, it's been very helpful.

I have been suffering from lower back pain for about 4 years now, and it has gotten to the point where my tolerance for NSAIDs has become too high and my back pain has gotten worse.

I went to a chiropractor after seeing a rheumatologist (under the thought that I had ankylosing spondylitis) and an orthopedic surgeon (gave me NSAIDs and told me to follow up if I had any pain). I am now about to be on my third visit with a chiropractor.

The chiropractor told me that my atlas is misaligned and that, over time, my body had adjusted to this problem by making the right side of my back stronger, which has created more tension, etc. This was found using some of the methods you describe. I was told that my right leg was functionally shorter than my left, that I had weight imbalance, and that my right shoulder is much lower than my left (this is true). Additionally, he took x-rays of the atlas and one other test that showed the strain on the right side of my back vs. the left side. Finally, he said that the answer to this is neck manipulation. Is this something you could elaborate on?

What type of doctor should I see regarding my back pain?

It is correct that my right shoulder is pretty significantly lower than my left. The pain is most acute after sleeping or lying down for 4-5+ hours. It is acute enough to wake me up from sleep and not allow me to go back to sleep. It mediates during most of the day and is not bothersome. Sleep is really the most problematic.

I cannot thank you enough for your response. Fixing this problem would greatly ameliorate my quality of life.

Answer

It's very unlikely that you have a misaligned atlas or that a neck problem has anything to do with your lower back problem. If you are not having neck pain, you should not have neck manipulation.

See: http://www.sciencebasedmedicine.org/the-problem-with-chiropractic-nucca/
and http://www.sciencebasedmedicine.org/neck-manipulation-risk-vs-benefit/

It's important to get an accurate, definitive diagnosis that will offer a plausible explanation for your back pain. One shoulder being higher than the other is an indication of scoliosis but is not usually significant unless the scoliosis exceeds 25 or 30 degrees. A visit to an orthopedic department associated with a university hospital may be the best way to obtain a correct diagnosis plus guidance for treatment from (a) an orthopedist who specializes in spinal problems, (b) a physiatrist (MD who specializes in physical medicine) or (c) a good chiropractor who does not subscribe to such nonsense as "atlas misalignment" or "subluxation of a vertebra." There may also be useful self-help measures, such as exercise and an appropriate mattress.

_________________

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 September 12, 2014.