A leading-edge procedure that is clinically demonstrated to be effective alleviates chronic pain, enhances joint mobility, improves neuromusculoskeletal function and provides other health benefits for patients at Upper Cervical Chiropractic of New York PC.
Upper Cervical Chiropractic of New York PC Practice Founder George Gertner, DC
Practice founder George Gertner, DC, and his colleagues are among only 2,000 chiropractors in the world who practice upper cervical chiropractic, a subspecialty that focuses on the relationship between the upper cervical spine and the central nervous system and brain stem function. A frequent lecturer at respected traditional medical facilities as well as chiropractic educational institutions, Gertner belongs to a small subset of those chiropractors — 200 worldwide — who are trained in the National Upper Cervical Chiropractic Association (NUCCA) procedure, a highly specialized treatment.
Awareness of NUCCA and its benefits is growing rapidly. Upper Cervical Chiropractic of New York, which Gertner established in 2002, serves about 100 patients a day and is one of the busiest clinics of its kind. Although the primary catchment area of Gertner’s practice extends to roughly a 45-mile radius from its White Plains, New York, location, he and his colleagues see patients from around the world, including celebrities and professional athletes. They have treated approximately 10,000 patients to date.
Gertner explains the upper cervical procedure to a patient.
NUCCA: Moving Care Forward
While statistics confirm chiropractic’s growing popularity and positive public perceptions of its benefits (See “A Rapidly Expanding Field” sidebar in this article), the NUCCA procedure takes those successes to the next level. Conventional chiropractic focuses on adjusting the spine segmentally via forceful manipulations to correct the entire spine. As Gertner explains, this approach, though successful in relieving pain and improving neuromusculoskeletal function for some patients, is neither as effective nor as long-lasting as NUCCA.
“The spine is either misaligned as a whole or is in full alignment,” Gertner says. “It’s all connected, and if the top vertebra, the atlas, is misaligned, the rest of the spine is as well. That is why approaching the spine segmentally, as traditional chiropractors do, results in limited and temporary outcomes.”
In contrast, NUCCA practitioners focus solely on gently realigning the atlas, or C1, vertebra, the topmost bone in the spine, located just below the brain stem in the cervical spine. The atlas vertebra supports the weight of the head. Unlike the other 23 vertebrae in the spine, there are no disks above or below the atlas, making it highly susceptible to injury and misalignment.
“When you sustain an injury, such as from a fall or automobile accident, there is no protection at the level of the atlas, and it can misalign sometimes as much as 15 degrees,” Gertner says. “In contrast, the other vertebrae misalign only about half a degree, which are minor subluxations. An atlas misalignment is the only true subluxation, so we focus on correcting this particular vertebra. It’s really engineering the spine.”
Approaches to correcting spinal subluxations, however, are not the only difference between conventional chiropractic care and NUCCA. Many chiropractors who perform conventional techniques to treat patients often do not use diagnostic tests and X-rays before and after adjustments to evaluate patients’ spinal misalignments and assess the effectiveness of a procedure. Pre- and post-diagnostic testing and X-rays are a pillar of NUCCA care, Gertner explains.
“Proper upper cervical care requires the use of state-of-the-art diagnostic equipment with nerve scans to test the function of the organs and muscles and to locate weaknesses in the nervous system,” he says.
Path to Relief
At Upper Cervical Chiropractic of New York, patients’ initial visits entail an introductory consultation and a full evaluation that includes diagnostic testing and X-rays. Before performing the NUCCA procedure — which occurs on a patient’s second visit — Gertner uses a 3-D, high-frequency, low-radiation X-ray unit to generate ultra-clear images of the patient’s spine. The images assist Gertner in mathematically calculating the exact angles of subluxation in the atlas vertebra and spine.
Doctor of Chiropractic Trinidad performs an upper cervical correction.
Following initial X-rays, patients undergo surface electromyography (EMG) and thermography testing via the Chiropractic Leadership Alliance’s Insight Subluxation Station, a diagnostic unit that provides NUCCA practitioners reliable, quantitative, multidimensional representations of patients’ conditions, which leads to more accurate analyses of those conditions and of patients’ treatment-related progress. The EMG component of the diagnostic unit tests patients’ motor nerves connecting to their paraspinal muscles to identify areas of weakness, spasms, fatigue, numbness and pain. The thermography feature scans patients’ autonomic nervous system to pinpoint affected areas that may be causing headaches, sinus issues and allergies.
“These tests are particularly helpful in identifying where problem areas are in the nerves and helping patients understand why they’re experiencing certain symptoms,” Gertner says. “For example, headaches are often caused by pressure on the atlas, whereas arm and neck pain typically stem from pressure or subluxations in vertebrae C5 and C6.”
The final component of the initial evaluation is an orthopedic test to assess range of motion. If Gertner identifies an area of the body with limited range of motion, he conducts this exam to better grasp which positions elicit pain and which provide relief.
“Collectively, these diagnostic tests remove any guesswork and allow a high level of precision in evaluating and treating patients’ conditions,” he says.
Gertner studies the test results to develop a thorough understanding of each patient’s case and establish a personalized treatment plan. A few days after the initial consultation and evaluation, patients return for a one-on-one educational session with Gertner to learn about their spine health and recommended treatment plan, as well as to receive their first NUCCA adjustment.
A Gentle Approach
“The actual correction itself, in contrast to a conventional chiropractic adjustment, doesn’t entail forceful manipulation,” Gertner explains. “Rather, the NUCCA procedure is extremely gentle, involving a delicate touch right by the atlas, just below the ear, to align the C1 and C2 vertebrae, which subsequently causes the entire spine to align.”
“NUCCA is a safe, effective spinal correction procedure without surgery. This evidence-based technique has helped many thousands of people of all ages effectively reduce structural and neurological stress and improve overall well-being.”
— George Gertner, DC, founder of Upper Cervical Chiropractic of New York PC
The examination room at Upper Cervical Chiropractic of New York PC contains state-of-the-art technology.
The nature of the NUCCA technique makes it safe for all patients, regardless of age or health status.
“Because conventional chiropractic entails forceful manipulation, it’s often not recommended for older patients or those with fragile or brittle bones,” Gertner says. “However, even these patients are candidates for NUCCA — there aren’t any broad patient populations who wouldn’t be candidates.”
Immediately following the initial adjustment, patients undergo a second X-ray to ensure the correction’s efficacy.
When patients return for their third visit, practitioners perform another NUCCA correction, followed by a second nerve scan to evaluate whether nerves are responding to and improving with the adjustments.
Back pain is the most common form of pain reported in the United States and the No. 1 cause of disability among Americans younger than 45, according to the American Academy of Pain Medicine. It is also one of the most common reasons people seek chiropractic care. The NUCCA technique, in particular, has been shown to significantly improve back pain.
Research published in 2010 in the Journal of Pediatric, Maternal & Family Health, for example, emphasizes NUCCA’s benefits for patients living with scoliosis and life-limiting back pain. The case study followed a 15-year-old female surgical candidate with a history of lumbar pain, fairly severe scoliosis — a 44-degree Cobb angle in her mid- to lower spine — and vertigo. Using NUCCA protocols, a practitioner precisely identified the patient’s upper cervical alignment. X-ray and other diagnostic tests were used to guide the NUCCA chiropractor in adjusting the patient’s atlas vertebra. Over the course of four and a half years, the patient underwent an atlas adjustment only five times. At the end of that period, X-rays confirmed the NUCCA technique’s success: The patient’s atlas vertebra was properly aligned, the back pain and vertigo had resolved, and the 44-degree angle had been reduced to 32 degrees, averting surgery.
Similarly, the NUCCA technique has been shown to be effective in treating patients who have migraines, which affect 38 million Americans, according to the Migraine Research Foundation.
Trinidad studies X-ray films.
A 2015 study appearing in the Journal of Chiropractic Education, for instance, evaluated changes in cerebral circulation in patients with migraine headaches. The study indicated patients with migraines experience an increase in intracranial compliance index (ICCI) — the brain’s response to the inrush of blood during a heartbeat — following a NUCCA atlas intervention. A female subject who had been recruited through a neurology-based specialist referral clinic and who was examined by a neurologist prior to receiving NUCCA care underwent NUCCA care for eight weeks, with follow-up imaging at weeks four and eight. A neurologist conducted the participant’s exit interview and gathered final outcome data. The chief outcome was a 1.17 reduction in the participant’s ICCI, from 5.04 to 3.87, and the patient reported “great improvement in migraine headache symptoms,” the study notes.
In addition, a 2013 Journal of Upper Cervical Chiropractic Research case study details the improved outcome for a 16-year-old female who had experienced chronic migraines without aura since age 5. After receiving NUCCA corrections, she no longer required pain medication.
Combating Trigeminal Neuralgia
In addition to alleviating migraines, the NUCCA technique has been shown to provide relief to people experiencing trigeminal neuralgia. This condition, which affects the trigeminal or fifth cranial nerve, causes chronic pain. Gertner has been featured a number of times in Chiropractic Monthly magazine for his expertise in treating trigeminal neuralgia, as well as myofascial pain.
The Upper Cervical Chiropractic team meeting in a conference room
“Trigeminal neuralgia is known as the suicide disease because the pain is so severe and overwhelming that some people take their own lives to find relief,” Gertner says. “In a medical model, treatment typically consists of surgery, vascular decompression and/or anti-convulsion seizure medication. These methods can provide symptom relief. However, the NUCCA procedure is highly effective in treating the root cause of this condition: pressure on the trigeminal nerve. By adjusting the atlas, we are able to take the pressure off the trigeminal nerve and thus relieve pain. The vast majority of people with trigeminal neuralgia who undergo NUCCA corrections enjoy long-term relief.”
Promising Hypertension Treatment
The efficacy of the NUCCA procedure also extends to other conditions, such as hypertension. One of the top risk factors for heart disease, hypertension affects about one-third of American adults. A 2007 study published in the Journal of Human Hypertension illustrates the technique’s ability to reduce blood pressure. The study’s lead author, George Bakris, MD, Director of the University of Chicago Medicine Comprehensive Hypertension Center, told WebMD that NUCCA “has the effect of … two blood-pressure medications given in combination.”
Over an eight-week period, researchers studied 25 patients with early-stage hypertension who underwent the NUCCA technique to correct their atlas vertebra, as well as 25 similar patients who underwent a pseudo-chiropractic adjustment. None of the participants took blood pressure medication for the duration of the study.
Compared with participants undergoing sham chiropractic adjustments, participants in the NUCCA group experienced an average 14 mm Hg greater drop in systolic blood pressure and an average 8 mm Hg greater reduction in diastolic blood pressure. None of the participants experienced any adverse events or effects.
Front desk and reception area
An Effective Alternative
When conventional approaches have met with limited success, NUCCA offers a conservative, gentle, yet effective approach to healing and enhancing neuromusculoskeletal function.
“Patients who have failed to see improvements from lifestyle changes, medication therapy, and/or traditional medical or chiropractic care would greatly benefit from a diagnostic evaluation,” Gertner says. “For many, NUCCA is a potential answer to their problem.”
The team at Upper Cervical Chiropractic of New York PC
To learn more about Upper Cervical Chiropractic of New York, please visit ucc-ny.com.