Ten years ago, I was hit by a pickup truck (as a pedestrian). The accident was severe, but I did not receive any medical checkups after being released from the emergency room. Over a period of several years, I noticed my back and shoulder becoming uneven. I asked a doctor (family medicine) about this condition five years after the accident and she diagnosed mild scoliosis. This doctor could not say whether the scoliosis has any relationship to my accident. She advised that my condition was not serious enough for surgery, but that it might worsen and cause pain as I get older.
Now, ten years after the accident, I have visited a chiropractor. While I do not currently experience any back pain, I am concerned about suffering the consequences of my accident as I grow older.
The chiropractor took x-rays and offered a treatment plan with my wife present. He told me that the good news is that I don’t have scoliosis. He diagnosed a misaligned pelvis bone and phase 1 spinal degeneration in my neck and mid-back. He says that my back has adapted to my misaligned pelvis over the years. My pelvis bone was likely misaligned in my accident. He showed me an x-ray of a 50-year-old patient who had arthritic spurs in his spine because he did not get treatment for a condition like mine.
This chiropractor claims that, by adjusting the misaligned bones, the process can be reversed over a period of months. My insurance covers 100% of the treatment, but I am concerned that the treatment can harm my back which is not hurting. His first treatment involved snapping my neck and back as well as hitting spinal disks with a small jack-hammer. The treatment was scary, but did not cause much pain.
I know you have said that chiropractic cannot straighten scoliosis, but he says that I do not have scoliosis. Is his diagnosis plausible? If so, can chiropractic straighten my back? How great are the risks that treatment could cause serious pain where none previously existed?
Scoliosis associated with an uneven pelvis is usually structural in nature and cannot be changed by manipulating the spine. An injury severe enough to cause a distortion in your pelvic bones would have been very painful, requiring hospitalization immediately following the injury. So it is not likely that your “misaligned pelvis” is the result of the accident. A leg deficiency or pelvic imbalance can cause compensatory curves in the spine, which are usually permanent in an adult. A young person with a leg deficiency greater than three-quarters of an inch can sometimes benefit from a heel lift. But chances are you have a permanent mild scoliosis, as diagnosed by your family physician. While such curvatures usually do not progress after adolescence, curvatures beyond ten degrees or so may contribute to the development of arthritic spurs in the spine with aging. But this cannot be prevented by manipulating the spine. Tapping on the spine with an Activator hammer will have little or no effect. Neck manipulation would be unnecessary and potentially dangerous. Use of the phrase “Phase 1 degeneration” is a scare tactic used to sell months and years of unnecessary treatment to prevent “progressive degeneration.” Such “preventive” treatment could very well trigger the development of symptoms that did not previously exist.
I would not worry about a mild scoliosis. Such curvatures rarely cause problems. If you do develop symptoms in the future, see an orthopedist for an evaluation.
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 28, 2004.