Do I Need More Chiropractic Adjustments to Correct a “Forward Thrust” In My Spine If I Feel Okay?

Samuel Homola, D.C.
December 8, 2002

I am 40 years of age, 5’5″ tall, and weigh 140 pounds. I have been seeing a chiropractor on a contract for one year, which is about to end. When I started, the chiropractor said my x-rays showed that I had a “forward thrust” of 39 mm. After a year of treatment three times a week, the forward thrust had been reduced to 24 mm (as shown with a series of x-rays taken every three months). At the rate of 2-3 mm of improvement every three months, it would take another two years to get to “perfect alignment”—which is way beyond what I can afford.

I can definitely say there has been progress. When I entered his office, I was having chronic lower back pain; now I am not. My posture has felt more vertical, and I can rotate my head forward and backward with noticeable improvement from one year ago.

My questions: What range of forward thrust or “less than perfect alignment” is considered acceptable by the chiropractic community for average functioning without pain? 5-10 mm? 10-20 mm? Can an orthopedic surgeon be able to do something that a chiropractor cannot? Given the state of my case, and considering that I am not having pain at the present time, would you recommend that I see an orthopedic surgeon?


I would advise you to forget about having a “forward thrust” misalignment in your spine. While an improvement in posture can be beneficial, there is no manipulation that will make “biostructural changes” in your bone structure. No two postures are the same, and alignment varies from one spine to another. It is neither necessary nor possible to have a “perfect alignment.” If you feel well, you don’t need treatment or a consultation with an orthopedist.

Posture improvement by exercising and “standing tall” can help relieve back pain and improve mobility. But it isn’t necessary to get regular chiropractic adjustments based on repeated x-ray exams. The x-rays taken every three months were excessive as well as unnecessary.

You should never pay for treatments in advance. Chiropractic treatment should be discontinued when you feel well. A contract for spinal adjustments to correct millimeters of “forward thrust” is a practice-building gimmick that uses scare tactics to lock a patient into a long course of treatment. Just walk away and forget about it.


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 December 8, 2002.