Answers to Questions about Chiropractic:
Can "Phase One Degeneration" in My Neck
Cause Low-Back Pain?

Samuel Homola, D.C.

Question

I have had back issues for the past 10 years or so. In the beginning, it was a work injury. It took two years to discover that I had a herniated disc at T8. After two years of therapy and fighting with my insurance company, my back still hurt. After the birth of my son two years go, my lower back and pelvis started hurting. Medication and treatment by an osteopath did not seem to do much good, so I went to a chiropractor. He did full x-rays and told me that my neck was misaligned and in "phase one degeneration." He said I would need neck traction and that prolonged care would be necessary to correct the "cause" of my symptoms and prevent further trouble.

I left the office with the same lower back pain and spasm I had when I went in. He did not treat my back. He said that he wanted to address my neck problem first. Since I am not having any neck trouble, I am concerned that I am being conned. What type of treatment should I seek when my lower back is out of alignment?

Answer

You should disregard the advice you received from this chiropractor and avoid further contact with him. There is no logical reason to believe that a neck problem would cause low-back pain, and there is no reason to suspect that you have a neck problem if have no neck pain.

It was not necessary to x-ray a person's neck ito evaluate back pain. The concept of "phases of neck degeneration" is nothing more than a gimmick used to sell long courses of unnecessary treatment. Most episodes of back pain will resolve with time, but the chiropractor's plan would enable him to treat you for a much longer period. Since there is some danger associated with neck manipulation, it should never be done without good reason and should certainly not be done as a "preventive" measure. You were justified in being suspicious of a chiropractor who wants to treat a painful back by manipulating a pain-free neck.

Donât worry about the alignment of your spine. Manipulation cannot change the position of vertebrae. I would suggest that you see an orthopedist for a definitive diagnosis of your back pain. Chances are you have some arthritis or disc degeneration. While such problems might benefit from appropriate spinal manipulation, you were misinformed by the chiropractor you are seeing. Once a diagnosis has been made, an orthopedist might recommend a good chiropractor or a physical therapist if he feels that you need spinal manipulation or mobilization. In many cases, such simple self-help measures, such as moist heat , improved sitting and sleeping postures, exercise, and so on, might speed recovery from an episode of back pain.

You might be interested in my book, The Chiropractorâs Self-Help Back and Body Book, which tells how to analyze back trouble and what to do about it.

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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 June 9, 2003