“It seems to be averse-event free…no side effects and no problems.”
—George Bakris, MD University of Chicago Medical Center.

“I have referred 5,000…patients…Appropriate NUCCA corrections will resolve 85 to 95% of the symptoms.”
—Bruce M. Bell, MD Family Physician, Fox River Grove, IL

Answering questions about NUCCA and upper cervical care for other providers.

This information is intended for dentists, medical and osteopathic practitioners, physical therapists, physician’s assistants, nurse practitioners, licensed massage therapists, and other body workers.

What you can expect if you partner with us?

• Timely and detailed written reports of our findings, recommendations, and your patient/client progress, and discharge from active care.
• Recognition of your referral.
• Recognition of the dignity of your patient and the need for transparency when multiple disciplines work towards a single patient’s goals.

Why are some healthcare providers referring to NUCCA practitioners or engaging in co-management of patients?

Due to the effects upper cervical corrections can have on posture, pain patterns in the spine and extremities, TMJ disorders, and some visceral dysfunctions, NUCCA is currently under investigation in a number of research and academic venues, including by the National Institute of Health.

The most public and notable of these projects was published in the Journal of Human Hypertension, where a pilot study reveal that a NUCCA upper cervical spinal correction was associated with the reduction of systolic blood pressure in hypertensive patients.

Other projects exist focusing on the effects of the NUCCA correction on

• TMJ and jaw balance
• Blood vessel perfusion within the brain in general and the microcirculation of vasculature at the brainstem in particular
• The existence of the ‘functional short leg’ and its contribution to lower back pain

How is NUCCA different than classical manipulative techniques?

While NUCCA care is classified in the literature as a manipulative therapy, there is little in the force or manner in which the intervention is applied that is reminiscent of a traditional manipulative technique be it from osteopathy, chiropractic, or other manual therapies.

The manipulation is so gentle and precise that most patients rarely perceive it taking place.

What is the objective of NUCCA?

The goal of the upper cervical correction is to reduce the upper-cervical misalignment, thereby bringing the spinal balance, notably resting spinal muscle tone, back to equilibrium.

The resulting changes in posture takes pressure off of spinal structures, improving spinal biomechanics, relieving pain, and reducing any irritation of nerve tissue which might be present.

How do misalignments happen?

The upper cervical misalignment is created when the occipital condyles and the head’s center of mass are no longer supported by the articular pillars of the top cervical bones.

Due to a direct cervical trauma, the whole upper cervical spine, including the atlas, moves out from under the head. Or vice versa, due to a head trauma, the head moves away from the cervical spine.

What is the upper cervical misalignment according to NUCCA?

It is hypothesized that this ‘primary misalignment’ is possible due to the biomechanical disadvantage the upper cervical complex has in relation to the heavy head.

While the second through seventh cervical vertebrae are stacked liked chairs with posterior joint articulations and a strong disc, the atlas maintains its position without the benefit of posterior joints, or a disc, relying strictly on muscles and ligaments to balance the head.

While this allows movement in the frontal (side head tilt) and sagittal planes (nodding), it can create a weakness where the head loses proper juxtaposition with the cervical spine when at rest or in a neutral postural position, creating chronic postural stress.

In response to gravity the body shifts trying to balance the load of the head for reasons that have not been fully determined, where the source is reflexive, neuropathological, proprioceptive, vascular, or some combination.

There is evident spastic contracture of musculature down the back and into the pelvis. Patients present with a short leg in the supine position, and a high hip in the standing position (the functional short leg). The resting tension on the Achilles tendon may feel unbalanced with more resistance on the ‘short leg’ side. There may be an obvious tilt of the head or twist in the shoulder girdle when viewed from the font.

The misalignment and the associated postural changes are known the Atlas Subluxation Complex.

Finite element studies under the direction Dr. Vijay K. Goel (McMaster-Gardner Professor of Orthopedic Bioengineering, Co-Director Engineering Center for Orthopaedic Research Excellence (E-CORE) at the University of Toledo), undertaken by the Upper Cervical Research Foundation may tell us more in the near future.

How is the misalignment measured?

The NUCCA gold standard for measurement of the upper cervical misalignment is plain film radiography, with sagittal, frontal, and transverse projections.

Rotational (not linear) measurements are taken to measure the horizontal plane of the atlas, versus the vertical center of head and the rest of the cervical spine. Misalignments are characterized by acute angles between the atlas plane and the head greater than 3/4 of one degree.

X-ray technique and positioning are extremely specific and cannot be undertaken without a properly aligned tube.

Post x-rays are immediately taken after the correction to ensure that proper ‘line of drive’ was chosen and the upper cervical complex is moving toward a more sound position with the head and neck in a neutral position.

How does NUCCA work with other healthcare approaches?

It is not the goal of NUCCA to replace the important work of other providers.

This work is too challenging and too important to begin to interfere, let alone infringe on other disciplines!

While there may be some disagreement as the order in which solutions are sought, NUCCA provides a powerful addition to your patient care arsenal whether you are a neurologist, physical therapist, or do structural integration.

Because of the way the NUCCA approach can influence spinal postural reflexes and balance muscle tone, upper cervical chiropractic can be a wonderful way to make many health care traditions more effective in what they do. Particularly with physical therapy, neuromuscular dentistry, body work, and holistically oriented medical practitioners.

Where can I find more information?

More information is available online at the Upper Cervical Research Foundation. The NUCCA website also has digital copies of the internal research publication of the organization, known as the Upper Cervical Monograph.

Please see our links on this website.

We are always available to host you in our office to show you the protocol first hand, and answer any questions you might have.