Thursday, October 22, 2009

Upper Cervical Care Reviewed

This is one person's overview of NUCCA care. I thought it was very well done and worth sharing as it covers many of the basics of Upper Cervical Care.

By Lennard Zinn

The top, or Cl vertebra (C is for "cervical," i.e., "neck") is also called the "atlas" vertebra. Cl is concave on top to accept the convex base of the skull, and it is convex on the bottom to fit into the concave top of the next vertebra. Central to the vertebrae runs the spinal cord, carrying body control messages from the brain. Between each pair of vertebrae are 31 pairs of nerves extending out to organs and muscles.

Misaligned (or "subluxated") vertebrae can impinge on the nerves and hamper body function. Chiropractors apply force to parts of the spine with the intent of returning vertebrae to their normal positions. Cracking sounds usually accompany the adjustment. Upper Cervical Technique is distinct in that the adjustment is only performed on the Cl vertebra and the adjustment normally makes no sound. Furthermore, the direction of the application of force to perform the adjustment is not based simply on palpation (the chiropractors "feel") but rather on detailed analysis of X-rays. From the X-rays, a three-dimensional force vector is calculated and then applied to Cl to correct its position.

A misaligned atlas throws off leg length and distorts the entire body. The skull and the other vertebrae rotate and tip to compensate for rotation and tip in C1. The head weighs between 8 and 14 pounds. If it is not sitting straight on top of the spine, the muscles of the body must do something to counteract this bowling ball hanging off to the side. If the muscles on one side of the spine are tighter than those on the other, then the pelvis is pulled up on that side, thus "shortening" that leg.

I went to Farmington, New Mexico, a town of 40,000 near the four comers area, to view this procedure, as there are no practitioners of it within hundreds of miles of my Boulder, Colorado, home. Lloyd Pond, D.C., who practices with his son, Lonnie, is recognized among those who follow the subject as one of the leading practitioners of upper cervical technique.

Diagnostic Methods

The Ponds use a complex diagnostic machine with a digital printout called an "Anatometer" to quantify body distortion. It measures the degree of vertical pelvic tilt, pelvic rotation in a horizontal plane, the lean of the spinal column at the shoulder level, and the amount of weight the patient carries on each foot.

Patients first lie flat on a table to have leg length differences measured.

Patients said that they only feel a very slight pressure and the warmth of the hand on their neck. There was no deflection of the patient's head or neck during the procedure, nor was there an audible sound.

A heat-sensing probe is passed up the spine on the back of the neck. The probe has a temperature sensor on either side, of the spine hooked up to a machine that graphs the temperature readings as a function of position. The graph shows large surface-temperature variations on either side of the spine, indicating interrupted nerve supply.

The adjustment direction is based on X-rays, which one of the Ponds takes to ensure accuracy. Patient position and distance to the lens is precisely set in each of three different X-ray angles.

On a light board, lines are drawn on the X-rays through a series of bone points. The precise relative angles of Cl, the head, and the spine are measured in three planes. Once the exact misalignment of the atlas is determined, a vector direction in three dimensions is determined, precisely opposing the misalignment.

Adjustment procedure

The chiropractor applies a force directly along the determined vector direction to return the atlas to its proper position. The force must be applied with enough pressure to overcome the body's internal resistance to the adjustment without going too far.

The patient lies on his or her side on a low inclined bed with a head support. The adjustment is performed with the side of the heel of one hand on a comer of the Cl vertebra located just behind the patients ear lobe. Lloyd or Lonnie Pond takes a number of measurements with the tape measure to determine where to stand and how to orient his sternum relative to the patient, a different position is used with every patient.

He clasps one hand about the wrist of the other hand, sets the heel of the lower hand on the bone and aligns his arms and the top of his sternum directly down the force vector determined from the X-ray. He does not push by straightening the arms, nor does he push by rocking his back or body forward. With either of those motions, the heel of the hand does not move along a line connecting the top of the sternum and the heel of the hand. Instead, the chiropractor locks his body in place, and the force comes from the shoulders by contracting the head of the triceps muscle. To call it subtle would be an understatement.

I observed the procedure being performed on a number of patients, and interviewed them before and after. They were long-term patients of the Ponds (some on the order of 15-20 years; Lloyd Pond has been doing this work in Farmington for 40 years). Several of the leg-length discrepancies were originally around an inch. Most Patients were coming in for a semi-annual or annual checkup, although one had been involved in an automobile accident dent three days earlier.

Patients said that they only feel a very slight pressure and the warmth of the hand on their neck. There was no deflection of the patient's head or neck during the procedure, nor was there an audible sound.

Afterward, the leg lengths were even, and the thermographs showed consistent temperatures on both sides of the spine.

Patients' comments

The patients reported feeling immediate relief. The reduced strain in the face of the auto accident victim was obvious.

Patients commented that while many joke about "having magic words said over them... half the people in town come to the Ponds." One woman, noted that Pond's rates have gone up from $11 a visit when she first started seeing him 20 years ago to the current $30 per visit but quickly added that she "would pay any amount for it" Patients told me of not only a reduction in the symptoms of body aches, but generally improved overall health.

Lloyd Pond claims only to correct the position of Cl, and he acknowledges that it can improve overall health by improving delivery of nerve impulses and instructions from the brain, helping the body combat disease processes. Due to Cl's close proximity to the brain stem, it simultaneously affects the brain and the entire spinal cord, and thus the entire body.

Lloyd Pond comments that his method is simply the application of physics to the human body. The adjustments can hold for years, unlike most chiropractic adjustments. After the initial series of treatments, visits are separated by many months, and Pond says if alignment is not off, "we don't touch 'em".

When asked why less than 1 percent of chiropractors specialize in this technique, Lonnie Pond says that chiropractors are pulled in many different directions toward various chiropractic specialties, and, he added, "it is easier to crack backs."

John Dunn, D.C., a cyclist, and upper cervical chiropractor from Tallahassee, Florida, says that it takes a certain type of person to practice the technique. It is an exacting method and a real-life application of vector analysis, and therefore, attracts "the pocket-protractor types who drive used cars."

Dunn notes that the work-up is time consuming, the adjustment is sublime, and the follow-up visits are less frequent so there isn't much motivation for a chiropractor to pursue the approach.

"It also takes balls to tickle someone behind the ear and tell them they are going to be just fine," joked Dunn.

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