Video Transcript
John Stenberg, DC (00:07.321)
Okay, so I get a lot of questions from folks that are searching for help online with various conditions about the difference between these two different upper cervical chiropractic techniques. The Blair Technique and then Orthospinology Technique. So today I want to differentiate these, help you understand what the pros and cons of each are, the differences and similarities, and then how to find a qualified doctor. I'm Dr. John Stenberg. I'm an upper cervical chiropractor. And in my world, there are these
procedures that we use to analyze and correct parts of the spine. So when folks have dizziness and headaches and nerve pain in different conditions, they find that often these different procedures come up as potential natural solutions, but it's not always clear what the differences are. today I want to give you a quick overview of what upper cervical chiropractic is in the first place. The similarities and differences between these different chiropractic procedures.
And then how to find a qualified doctor if you think this could be a potential solution for a health challenge that you're facing. So first and foremost, upper cervical chiropractic, as the name implies, is focused on correcting issues with the head -neck junction. So as we see the image here on the right, the upper portion of the spine where it connects to the skull is a very critical part of the spine. It's the closest to the brain and it's highly sensitive. It's a very mobile part of the spine because it allows a wide range of motion. And
There are some unique characteristics that make it a unique.
part of the spine that requires a specific approach to correct issues there. And we often find that folks that are experiencing upper cervical dysfunction have tried a lot of other therapies or strategies and have not quite find the relief that they're looking for because that structural issue that's triggering a sensitivity or
John Stenberg, DC (02:01.545)
nervous system irritation can be driving a bit of the dysfunction.
John Stenberg, DC (02:12.473)
We'll first start with what is upper cervical chiropractic? A lot of folks are familiar with the chiropractic field and when you think of chiropractic, there's a lot of different things that may come to mind. But generally most folks think of the conventional chiropractic methods where the spine is twisted, cracked, popped, generally manipulated for short -term pain relief, decreasing muscle spasm, increasing range of motion. In an upper cervical chiropractic, this is a branch of the chiropractic profession that is focused very particularly
on the upper portion of the spine where the head and neck meet. Now this junction in our structure is a very unique part of the body in that it's a very sensitive area of the spine. It's the closest to the brain and can trigger a nerve system sensitivity or reaction or lot of symptoms related to nerve system dysfunction when there is an untreated or unresolved injury to the upper part of the spine. And these injuries often happen through things like concussions or sports accidents.
motor vehicle collisions, falls, repetitive poor postures, and things like that. So when we differentiate upper cervical chiropractic from conventional chiropractic, there are some key differences to be aware of. Number one is that idea of focusing on correcting the head -neck junction almost exclusively as our target of our treatment. We use non -manipulative adjustments generally, which means that there's no twisting, cracking, or popping of this portion of the neck.
We use image guided approach, which means a detailed evaluation of the upper spine is done prior to any adjusting to understand if number one, you require an adjustment in the first place and if it's going to be effective for you, but then also what's the safest and most beneficial way to do it for each individual. And that goes beyond just what we can feel through the surface. The images, whether X -rays, MRIs, CBCTs really allow us to visually assess
the condition of the spine to make thoughtful choices about if and how we should go about our adjustments. And lastly, we are after sustainable results and this is one of the key differences. Upper cervical chiropractors want their adjustments to last as long as possible and don't want to have to redo them over and over and over. We call that holding, but a key emphasis of our treatment is to do adjustments that last so that you can sustain your relief and feel better for a longer period of time with less intervention.
John Stenberg, DC (04:33.049)
And there's actually been some research on this topic of what are the differences in these techniques and how do we understand who to see when we're in a health challenge. And the most...
The best paper on this topic is called cranios cervical chiropractic procedures, a precis of upper cervical chiropractic. And this looks at a variety of different techniques. Now, when we talk about techniques within chiropractic, these are systems that chiropractors use to analyze, treat, and care for patients in a procedural way. So there are often daily checkup assessments, there are often exam procedures and adjustment procedures that are very rigorously tested.
and follow a specified protocol in order to be reproducible and scientific. And there are a variety of techniques associated with this research paper, but I'll draw your attention to Blair and orthospinology, which are the main topics of this discussion. And we see that in the assessment category, they both use palpation, which is a hands -on feeling of the movement, the tissue tone, and the overall feel and character of the tissues around the upper portion of the spine.
Functional leg length inequality is a postural reflex test that we do lying on the chiropractic table where we look for muscular imbalances on either side of the spine, which may produce the appearance of a short leg or more muscle tension on one side of the hips and back than the other. And in the Blair technique, we do them lying face down and in the orthospinology procedure, they do them lying on your back, but it's similarly the same assessment. We both use thermography, which is an assessment of sympathetic nervous system tone.
We use an infrared instrument to measure the heat on the back of the neck and have a process for analyzing whether or not an adjustment is required based on how the nervous system is responding on that day. We both assess posture. This was not checked for Blair as it's not a daily checkup procedure, but most Blair doctors do perform a postural evaluation as a part of their assessment. And orthospinology doctors will do this on a visit by visit basis.
John Stenberg, DC (06:40.065)
in order to determine the efficacy of their adjustment and to monitor progress over time. And then lastly, radiography. And this is the use of those imaging procedures that we referenced before. In orthospinology here, you'll see that there is a pre -post indicator, which means that after your first adjustment, they will take another set of images or x -rays to immediately assess the change in alignment. Whereas, Blair chiropractors will typically perform updated
imaging procedures down the road instead of right after that first adjustment, but it does guide the adjusting process in both of these techniques. So similarities in the daily checkups or the office assessments are virtually identical with the exception of the post X -ray for orthospinology and the daily postural assessment in Blair.
The vast majority of the indicators for upper cervical dysfunction are being assessed by all of these techniques.
Now when we look at the differences in imaging modalities, we see on the top here in figure five, this is a series of x -rays that orthospinology docs would take to measure the alignment of the neck. Whereas beneath we see a series of articular x -rays, which Blair chiropractors among others would use to look at the individual segments of the spine in relation to each other and determine if and where there needs to be adjustments made. And there are typically additional x -ray procedures done along with these.
to provide a three -dimensional view of the situation. Now, in modern days, lot of Blair chiropractors and some orthospinology chiropractors use cone beam computed tomography, which is CBCT, which is this high resolution 3D imaging modality that shows us with the utmost clarity exactly what's going on beneath the surface. And again, if we need to adjust and what's going to be the most effective procedure for each
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When it comes to the adjustments, there are some key differences here. And this is the main thing when the patient is in the office for the treatment, this is the main difference that they'll experience. On the left -hand side, we see a Blair adjustment demonstrated and that's performed with the chiropractor's hand. Now the orthospinology adjustments can be performed with the hand, but are often performed with these instruments. Either the handheld instrument, which looks like this adjusting.
John Stenberg, DC (09:09.451)
instrument that he's holding here. And there's also a table mounted instrument that looks a little bit different but is similarly accomplishing the same task, which is realigning the Atlas with a low force input. And the research that's done on the force applied in both of these adjustments show that they are very similar. The Blair adjustment might use a fractional amount more force being done by hand with a drop on the table. But the orthospinology adjustment is also very light.
Most folks when they receive upper cervical adjustments in these techniques report that it doesn't really feel that aggressive. And that's on purpose. We take great care in positioning the patient for the adjustment, choosing the site that we need to adjust, and then monitoring the effects of the adjustment immediately and over time so that we can understand how to be very conservative and safe with our adjusting procedures. Ultimately, the goal is the same. You when we have these minute differences in how
procedurally check up and adjust patients, the end goal is the same, which is to take a dysfunctional cervical spine and make it more functional. And that may improve on the alignment, it may improve on the movement or some combination of those things. But ultimately the goal is an increased quality of life for the patient with
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sustainable result, meaning they don't require the same adjustment over and over and over and over endlessly, but we actually see that we make lasting changes to the position, the balance, the movement of the spine, so that the relief is sustained over time. Now the tricky part is finding qualified doctors in these procedures. And so there are a few different ways that you
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access a directory of qualified doctors and hopefully find one in your vicinity. Now the highest level of training for upper cervical chiropractors is a diplomate in chiropractic cranios cervical junction procedures. These doctors have received their doctorate of chiropractic and their 300 hour postgraduate training in all of the facets of upper cervical chiropractic and the ICA International Chiropractors Association Council on Upper Cervical Care here has a directory for
doctors specifically. I see myself there and another chiropractor here in the state of Colorado. Two for the whole state. As you can see, those are few and far between. The next would be to find chiropractors that are technique certified. So with each of these techniques, the Blair technique and the orthospinology procedures, there is a system of testing and qualifying chiropractors to be certified in the technique. And that's the next level down from the
So each of those technique organizations has their own website with a directory of doctors. So you can find orthospinology .org or blairchiropractic .com. We'll have a full list of doctors who are qualified, tested, and have passed all of the certification process for those techniques. And then the last level would be someone who's technique trained and they may not be certified, they haven't gone through the testing.
in the seminar series required for that testing, but they're familiar with the concepts. They may have an entry level understanding of the techniques or may have been practicing the technique for a period of time, but just had never pursued the certification. So there are lots of folks on those directories that might not be certified, but are well -trained and equipped to care for you in these circumstances. So hope you found that helpful. The links for these will be in the...
video description below so you can follow the links to search for a qualified doctor in your state. If you can't find someone local, please comment the name of your city or local area and I will do my best to connect you with
John Stenberg, DC (13:14.677)
well -trained and thoughtful chiropractor who can help you with these upper cervical techniques.