NUCCA-Upper Cervical Chiropractic

NUCCA is an acronym for the National Upper Cervical Chiropractic Association.  It is a technique that was designed by Dr. Ralph Gregory after many years working with Dr. Grostic (there is a Grostic technique as well, which is very similar).

The premise behind Upper Cervical work is that the head position, based on the fact that the skull holds the eyes (used heavily to determine balance) and the balance organs of the inner ear (used even more heavily than the eyes), are primarily responsible for taking in the sensory information necessary to remain upright in gravity.  If you have a truly level head, then you are much more likely to have a truly level frame (spine and pelvis) of the body.

The spine is the central column of the body and maintains our bodies upright in gravity.  Everything attaches to the spine at some level.  The muscles as well as the extremities and ribs all have a hard bony connection to the spine.  As an example, we can’t move our shoulders without having an impact on the spine’s overall position.

The spine also always moves in a compensation pattern.  What that means is that when we do any sort of positioning of the body, we are using all the different joints of the spine (including the hips) to move in a coordinated fashion to manage our body weight.  Example, if we were standing upright and someone passed us a 10 lbs bowling ball that we held in our right hand, we would naturally and without even thinking about it, shift our spinal position by leaning and twisting to be able to handle that new weight being added to our frame. This natural compensation motion is vital for being able to remain upright and is a fundamental movement the body makes anytime that we are upright.

The spine is quite stable.  It has 24 different spinal Vertebra that are stacked on top of each other on top of the hips.  Our heads sit on top of the top vertebra known as the Atlas bone or 1st Cervical (the cervical spine is the top 7 bones of the vertebral column that make up the neck).  There are many interlocking joints that allow for movement of the spine, but also keep them connected to prevent too much motion. The concept of dislocation is when a joint moves out of its locked position and is a very serious injury, not something that is handled in our office, but rather would be an Emergency Room issue.

All that being said, the upper neck is built differently in the three bones of the Upper Cervical Complex, which is the skull (1), C1/Atlas bone (2) and the 2nd Cervical bone (3) known as the Axis.  At the relationship between the Atlas (C1) and Axis (C2) we find that the angled joints that lock vertebra together throughout the spine are replaced with flat joint surfaces to promote movement.  It’s at this joint system that we get 50% or more of rotation of the head. Evolutionarily speaking, this movable joint system allows us to really turn our heads.  It allows us to turn our heads while also maintaining our body facing forward (this would be and is still important in a survival method of being able to run forwards and turn our head to look behind us without having to stop running and turning our bodies around. Think tiger chasing us…)

Unfortunately, when we assess the spine for stability (the concept of holding bones and joints in position), the Upper Cervical complex becomes a potential weak link in the overall stability of the spine.  Instead of having bone on bone joint systems that are angled to hold, we have to rely upon soft tissues such as muscles, ligaments and connective tissues to hold these bones in place. These tissues, although strong, are just not as strong as bone.

What makes misalignment occur is excessive force being applied to the body that is greater than the body’s ability to hold against it.  If the force is big enough, we know that dislocation or fracture can occur to the body. We see this all the time and it is a major injury.  When a force is introduced to the body that does not create fracture or dislocation it still has the ability to create damage and the weaker areas or weak links of the body are going to be the ones that breakdown first.

In our line of work, direct head or neck trauma and certainly whiplash type injuries put that force directly into the neck and the heavy weight of the head on top of the smaller neck is often very problematic to resist these forces.

What ultimately occurs is displacement of the bones of the head and 1st cervical vertebra.  After the trauma has occurred it is not a guarantee that displacement or misalignment will occur but if it does occur between the head and neck and IF it becomes stuck in this misaligned position, the body does not like that. What happens after the trauma is that the body immediately moves into a compensated position. Just like when the body shifts to accommodate the bowling ball in the example I mentioned above, the body will shift through the frame (spine and hips) in an attempt to level the head. Why in an attempt to level the head?  The answer is simply because of the importance of the eyes and balance centers of the inner ear. The body does not keep its spine straight and leave the head crooked, but rather it will lean, twist and turn its frame to maintain some level of balance for these vitally important sensory organs used for body balance.

This is the issue that we deal with on a daily basis.  All patients at UC Life Chiropractic Centre have a misalignment of the head and neck that is stuck in an off position and their bodies are contorted into an imbalanced position from head to toe. Since the imbalance is global to the body, we can often find symptoms in our clients that also involve the entire body.

The delicate nature of the Upper Cervical adjustment is made by understanding exactly what has happened to the upper neck joint system by taking specific x-rays and being able to measure exactly how much misalignment is present. The success of NUCCA is based upon our ability to correct this misalignment (un-stick if you will), the upper neck and allow the body to shift back into its proper naturally balanced position from head to toe.

We find that we are able to successfully influence the entire frame (spine and hips) and create a shift throughout the body no different than how the body shifts back to balance after dropping the bowling ball in the example above. The continued key to success for patients under NUCCA care is making sure that the body is then able maintain and hold this balanced position without slipping back to the misalignment that came on from the trauma.  If the body slips back, the imbalanced pressure load will return, which is why we are hopeful that after adjusting the misalignment that our patients will hold their correction and not need to be adjusted in the future.

The x-rays taken in our office, act as the map for understanding how to unlock this misalignment.  Typically, the body will misalign is 3 different directions.  Firstly, due to the weight of the head, there will be a forward motion of the skull. Secondly there will be some level of tilting between the position of the head and neck when looking at patient from the front, and thirdly, there will be a rotation component between the head and the neck (the head and the neck will not face forward in the same direction).

We are usually dealing with relatively small misalignments and they typically range between 1-5 degrees of tilt and rotation, but trust me anyone would be able to see 5 degrees of tilting of the head.  It may seem like a small number but the visible position of the tilted head would be noticeable to the naked eye.

The NUCCA adjustment is very light force and delicate.  We often say that it is only as much pressure as one would need to take a pulse on the neck and the reason that we can use such light force is based on our ability to position the patient on the table during the adjustment.  We position patients on their side to be adjusted and position them on the side that the x-rays show us is the most effective way to correct their misalignment.  We utilize gravity to help us with the correction and leverage during the adjustment so that we don’t have to use any extra force.  There is no rotation or twisting of the neck, nor will there be any high velocity adjusting done.  It’s not necessary.  The goal is to adjust the small degree of misalignment perfectly to a balanced relationship so that when the patient stands up they instinctively shift the rest of the frame to match their head and neck position.

After the first correction we will often use x-ray once again to make sure that we have successfully corrected the misalignment. If the post adjustment films show a complete reduction of the misalignment we have done our jobs. With this correction we are looking for the body begin to behave differently and also begin to heal up from any of the breakdown that the misalignment has caused.

One final important element to all of this is to also understand what else is happening at the spine and head. The vertebral column or spine is the housing for the spinal cord and the head is the housing for the brain and brainstem.  Without a doubt, the brain, brainstem and spinal cord (known as the central nervous system) is the most important organ in your body. It is the controlling organ for all body functions and is the distributing organ for communication between the brain and the body.  Without its connection things do not work.  We know this as paralysis in the muscle and organ systems and numbness in the sensory systems. With obstruction of the central nervous system we see neurological dysfunction.

When misalignment occurs at the level of the spine, there is no doubt that we are involving the neurological system. It is for this reason that although we are often looking at the body as a structural frame we are often seeing symptoms in our office of neurological dysfunction.  Often times muscle aches and pains are very annoying and impactful on someone’s life, but when you see neurological breakdown in a body it is really unsettling as it begins to effect multiple areas and is often one of the more difficult systems for health practitioners to work with.

NUCCA practitioners deal with a large spectrum of symptomatic health issues in the body.  Any physical connection to the spine such as bones, tissues and joints may be affected but so too may the neurological system that can create difficult to understand symptoms throughout the body including the organ systems.

    Typical health conditions treated by NUCCA practitioners and seen at UC Life Chiropractic Centre:
    • Migraines
    • Headaches
    • Neurological dysfunction: Multiple Sclerosis (MS), Parkinsons, Fibromyalgia
    • Chronic Neck pain and lack of range of motion (rotation of the head especially)
    • Blood flow issues: Numbness, tingling (often in extremities), high blood pressure, elevated heart rate, dizziness/nausea, blurred vision/visual disturbances
    • Balance disorders
    • Digestive disorders
    • Sleeping disorders
    • Tight muscles that won’t relax
    • Hip and knee pain
    • Postural imbalances
  • Submitted by: Dr. Matthew Kittleson, Upper Cervical Chiropractor practicing the NUCCA technique in Victoria (Downtown), British Columbia.

Specific Techniques


Select a region to view to corresponding NUCCA-Upper Cervical Chiropractic professionals operating there: