I have not confirmed this “confusion” to be a direct quote from the source listed, however, it should be noted that the C8-T1 disk herniation compressing the C8 root is in error as it should be the C7-T1 disc that compresses the C8 nerve root.

Additionally, Dr. Michael Devereaux states, “The frequency of vertebrobasilar artery distribution strokes is
argued, but it is probably more common than reported. Given the risk of complications in the absence of well-documented benefit, chiropractic cervical manipulation should be avoided”. Dr. Devereaux would do well to familiarize himself with current literature. Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-Based Case-Control and Case-Crossover Study From: Spine. 33(4S) Supplement:S176-S183, February 15, 2008, clearly indicates Chiropractic manipulation does not increase stroke risk. The conclusion states, “VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care”.

It is a safe bet for many in the medical profession to underestimate the benefits and overestimate the risks associated with chiropractic care. In the U.S., for the 2008 campaign cycle, the pharmaceutical industry gave $28,801,866 to candidates. Special interest groups representing medical doctors donated $94,992,089. Almost $124 million assures this safety. The delisting of chiropractic is ensured, while an estimated 40,000 to 80,000 hospital deaths per year occur due to medical mis-diagnosis according to the March 11, 2009 issue of the Journal of the American Medical Association. This should be added to the staggering number of deaths and injuries caused by medication errors, estimated at 1.5 million!

The article states “Not surprisingly, DD is the most common condition affecting the adult spine and is the reason for over 90% of all adult spinal surgeries.” There are also multiple references to the article What is Intervertebral Disc Degeneration, and What Causes It? by Adams et al., noting a progressive structural failure. Adams notes differences between normal aging and pathological degeneration. Further noted is Rajasekaran et al suggesting that aging and degeneration are 2 separate processes.

While noting some of the indications and consequences regarding pathological and symptom producing degeneration, notwithstanding the elevated fear-avoidance beliefs, disease conviction, and other adverse biobehavioral factors exhibited in some patients, I find it obtuse to suggest “it is important that clinicians carefully communicate with patients to reassure them that disc degeneration is a normal aging process; while it certainly can be associated with episodes of pain, only in rare exceptions do these symptoms represent serious disease…”.

It should be more noted that an incidental finding of degeneration secondary to other musculoskeletal presentations, such as sprain/strain should be communicated with reassurance, however, within the progression of degeneration from the disc to the facets joints and end stage stenosis, the patient should not be falsely assured of the benign nature of age related, normal degenerative changes.

This was a very well done article and I highly recommend it!

The longus colli isotonically assists the SCM in neck flexion by stabilizing the vertebral column. It prevents an increase in the cervical lordosis with bilateral SCM contractions and stabilizes the neck in unilateral SCM contraction in neck rotation. The longus colli muscle has a similar stabilizing effect on the scalene neck muscles.

An increase in the cervical lordosis causes the longus colli muscles to lengthen while the neck extensors (scalenes, levator scapulae and upper trapezius) shorten. This is commonly noted clinically with tight neck extensors and scalenes along with weak neck flexors.

While specific craniocervical exercises are indicated for longus colli dysfunction, due to inhibition and chronic lengthening weakness, direct manual pressure into the belly of the longus colli along with perpendicular strumming can help increase play (movement) and tone (hardness). I have found the combination of exercise and direct muscle therapy to reduce longus colli dysfunction and increase neck pain relief.