Is An Atlas Adjustment Needed to Relieve Headache or Neck Pain?

Samuel Homola, D.C.
May 11, 2009

I just read a comment you made about atlas adjustments for lower back pain. You indicated that lower back pain cannot be caused from a misaligned atlas. I am currently seeing a Chiropractor that uses this technique for headaches and other neck problems. My question is: Do you believe in the technique of adjusting the Atlas for headaches or other upper neck problems? If not, Why?


General neck manipulation can be of value in relieving tension headache and in restoring loss of mobility caused by certain mechanical-type neck problems. Specific manipulation of the atlas might occasionally be of value when there is an upper cervical problem. But I don’t know of any credible evidence to indicate that the atlas should be routinely adjusted for headache or neck pain or as a treatment for a variety of health problems. Ongoing manipulation of the atlas or upper cervical area is never necessary and places the patient at risk of injury to vertebrobasilar arteries (stroke).

When manipulation of the atlas is needed to restore mobility to the neck area, only a few manipulations would be needed. The danger is greatest when head rotation is used to force neck rotation beyond 45 or 50 degrees. 

Some chiropractors believe that atlas misalignment causes a myriad of health problems by placing pressure on the brain stem. There is no credible evidence to support this belief. When the atlas is freely movable, its resting place cannot be changed. A measured “misalignment” may indicate nothing more than structural asymmetry (irregular or uneven bone structure).

Because of the risk associated with neck manipulation, you should get such treatment only as needed to relieve symptoms or to restore mobility in the neck area. If you have doubts about the treatment you are getting, or if your neck pain persists, see an orthopedist for a definitive diagnosis. 


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 article was posted on May 11, 2009.