Soon after the discovery of the X-ray, chiropractors began using this tool in the examination and care of the spine.
Besides revealing the presence or absence of proper spinal curves,
side views of the spine can more easily show the long-term effects of
neglected spinal trauma.
Think of it as Spinal Decay
This process in the spine has similarities to tooth decay in that it
shows up usually because of neglect. Also, like tooth decay, it can
happen to anyone, regardless of age.
Because it is often seen in older people, many believe it’s merely
the normal aging process. However, it appears that this progressively
worsening, degenerative condition is the result of uncorrected spinal
misalignment. It's one of the ways your body deals with the stress of
gravity.
Three Phase Process
Spinal decay is a process. Whether you take three snapshots of the
process or twenty-three snapshots, it’s a process. We use the
three-phase model based on the book Managing Low Back Pain, by W. H. Kirkaldly-Willis and Thomas Bernard, Jr., plus Anatomico-Roentgenographic Studies of the Spine,
by Lee A. Hadley, M.D. We find that it makes the differences between
each phase great enough so our patients can appreciate what they’re
seeing.
Text Book Normal
While this process can occur anywhere in the spine, it’s easiest to
see in the cervical (neck) spine. This is what the side view of the neck
should look like. From the side, the neck should have a graceful
forward curve. The edges of each bone are well defined. There should be
equal disc spacing between each bone and the openings for nerve roots
should be clear and unobstructed.
In Phase One there is a loss of curve and a reduced ability to turn
and bend. In some cases, the disc space between adjacent vertebrae may
be reduced. Or, discs can become wedge-shaped, inviting more serious
soft tissue damage. Depending upon your body’s adaptive capacity, pain
or other obvious symptoms may not be present. Even the resulting reduced
range of motion may be too subtle for many to notice.
If neglected, in Phase Two, joint surfaces lose their clearly defined
edges as the early signs of bone spurs become visible on X-ray views.
Some believe that the body senses the accompanying inflammation as the
sign of a broken bone. It begins the process of depositing calcium
salts. Without being in a cast to prevent movement, fusion doesn’t
occur.
If still left uncorrected, the problem worsens in Phase
Three. Amazingly, pain or other obvious symptoms may not yet show up.
But finally, the body successfully “mends the broken bone.”
This process can take years. Its presence calls into question the
claim that many patients make that they were “…fine until last week when
I bent over to tie my shoes.” That’s not what the X-rays tell us!
The Prognosis
Some patients who begin chiropractic care in Phase One discover a
restoration of their spinal curves and improved range of motion. Success
with Phase Two patients is less predictable and depends on many
factors. While we can do little after decades of neglect with Phase
Three cases, we instead turn our attention to those areas of the spine
that have not yet been lost to the process.
It’s impossible to predict what effect, if any, chiropractic care
will have on slowing, stopping or reversing this process. Nor can a
particular phase be used to predict how much care will be needed.
