Blog 4: Why you haven't heard of UC Specific, plus how to know if your UC doctor is doing it right
Updated: Mar 6, 2021
"Why doesn't anybody know about this"?
As I started getting well and saw other patients in the Upper Cervical Specific office doing the same, that was the question I most wanted an answer to from my chiropractor (apart from, "Why call yourself a chiropractor? Because clearly, this is different"!). If UC Specific was indeed what it seemed and alleged to be, then it had to be the greatest secret in healthcare, I thought at the time. Almost 11 years later, despite having acquired a better understanding of the inner workings of our bodies, this form of chiropractic remains no less wondrous to me. That I became a UC Specific chiropractor, after having completely disparate interests earlier in life, is testament to that. It is indeed, the greatest message I can share with another human being.
So what is the answer to that question? Broadly speaking, there are chiropractic, medical and societal reasons why people haven't heard of UC Specific. In this entry, I'll combine the latter two into one.
So let's take a look at the chiropractic reasons. UC Specific is not a fringe chiropractic technique -- at least not in terms of its history and lineage. If you imagine the history of chiropractic as a tree, with the trunk and each branch and twig and leaf representing the various chiropractic movements and techniques of the last century, then the main branch coming off the trunk would be the story of UC Specific. Why then does only 2 percent of the profession today practice it?
The first family of chiropractic is the Palmer family. Daniel David Palmer and his son Bartlett Joshua Palmer (B.J. Palmer) are know as the "founder" and "developer" of the profession, respectively. And most of the major chiropractic techniques we have today can trace their origins, some more directly than others, to their work in leading the profession from chiropractic's founding in 1895 to B.J. Palmer's death in 1961.
Perhaps no one in the profession's history has had more at stake in the results, reputation and future of chiropractic than the younger Palmer. And by the early 1920s, consternation took hold of him as self-administered field surveys sent to doctors across the country showed a troubling trend: only 35 percent of patients under chiropractic care were improving. Even more concerning for Palmer was the finding that despite the latest technological innovations of the time, which by then included x-rays, motion palpation and heat-reading instrumentation, adjustments had to be performed daily.
What separates Palmer, in my eyes at least, from other developers was that he wanted chiropractic to be reproducible and its results to be permanent. And while other developers, before, during and after Palmer's lifetime, have mostly pioneered or finessed systems of adjusting up and down the spine, Palmer's drive for a more reliable technique lead him to a very different idea. As he later wrote in his landmark tome, The Subluxation Specific, The Adjustment Specific in 1934:
"One ADJUSTMENT of specific character, at one place, rather than various diversified technique adjustments at multiple places, daily. One ADJUSTMENT, one place, having a staying-put value covering several days or weeks; rather than many "adjustments", many places, daily, few of which stay put 24 hours".
Palmer was searching for a place in the spine where he could deliver an adjustment that would essentially unlock the rest of the spine and by the late 1920s, he and another chiropractor, by the name of A.A. Wernsing, felt they had found this area in the upper cervical spine.
So now that we have some historical context, we can go through some of the reasons why despite its lineage, UC Specific is little-known today. In 1931, Palmer announced his discovery of the UC Specific principle to the profession. He said that any chiropractor who had ever gotten anyone well by adjusting below the C2 vertebra had done so by sheer luck because there could be no neurologic compromise below this segment. As you might imagine, most chiropractors were dismayed by the leader of their profession suddenly announcing that they were no longer doing chiropractic the right way. From that day onward, Palmer would take a hard-line approach to UC Specific and as a result the profession split. Most continued practicing chiropractic as they had before while others followed Palmer into UC Specific research. And that, attitude, let's say, is reason number one why this technique is not more ubiquitous today.
Palmer, the Palmer School and his research clinic in Iowa, then became the center of UC Specific research and education for 30 years. In 1951 after caring for thousands of sick people with some of the worst conditions imaginable by adjusting only the top two vertebrae, he published the results in the chiropractic Green Books and a series of pamphlets. Today the research would be considered observational and comparative despite his meticulous attempts to eliminate variables. Outcome assessment results had improved from the crisis-provoking 35 percent of the early 1920s to upwards of 90. Once the research was published, the Palmer school became an almost exclusively UC Specific school until Palmer's death in 1961. However, by then of course, there was a proliferation of chiropractic techniques and dozens of chiropractic schools across the country who had graduated thousands of chiropractors. And much like it does today, the idea of focusing on two bones, sounded preposterous to dedicated practitioners who were accustomed to adjusting up and down the back. To this day, most chiropractors to do not understand UC Specific technique and many remain ignorant of its existence altogether. And those are reasons two and three for why you haven't heard of this form of chiropractic.
The other reasons can be classified as medical and societal. In chiropractic school, we talked about the "cultural autonomy" of the medical establishment. Medicine, backed by a multi-trillion dollar industry, has bestowed upon itself the role of steward of scientific legitimacy and society has come to accept that.
As I've argued before, medical care is essential and medical discoveries and advances should be praised, especially when it comes to emergency care because that is where medicine excels. It does not excel when it comes to chronic conditions. That is why chronic conditions comprise most of this country's $3.8 trillion in annual healthcare costs. From the perspective of a chiropractor like myself, medicine has gone so far down the path of pill science that it's long forgotten that there can be a problem in the body. Considering the finances at play, there's no way back for them.
That's not to say that pill science is not valid. Of course it's valid. What makes something scientific, for me at least, is not whether a popular or influential group of people is on board but the methodology and reproducibility of the experiments and their results. And in so far as pharmaceutical companies funding an estimated 40 percent of basic research, or the initial stages of drug development, and almost all of late-stage research, thereby creating serious conflicts of interest, is valid, then the science is valid -- even if it's not necessarily sound or the best approach to many of the difficult health problems facing our population. However, in the absence of viable alternatives and in the face of a multi-billion dollar marketing machine, the public, especially in this country, has come to think of pills and other pharmaceuticals as healthcare. And that needs to change. Because while there are life-saving medications on the market, most are not. Pills are resorted to as the first or second line of defense against pain and disease when they should be way farther back.
Today, it costs more than $3 billion to oversee the development of a single drug from initial research to manufacturing and distribution. The United States market comprises more than 50 percent of the world-wide $1.25 trillion pharmaceutical profit. As of 2016, drug companies in this country spent an estimated $30 billion in advertising, about $5 billion of that going to television adds but most of it -- about $20 billion -- was targeted directly at medical doctors. An investigative article published in the Journal of the American Medical Association in 2019, found that:
Marketing to health care professionals by pharmaceutical companies accounted for most promotional spending and increased from $15.6 billion to $20.3 billion, including $5.6 billion for prescriber detailing, $13.5 billion for free samples, $979 million for direct physician payments (eg, speaking fees, meals) related to specific drugs, and $59 million for disease education. Manufacturers of FDA-approved laboratory tests paid $12.9 million to professionals in 2016. From 1997 through 2016, the number of consumer and professional drug promotional materials that companies submitted for FDA review increased from 34 182 to 97 252, while FDA violation letters for misleading drug marketing decreased from 156 to 11.
Gifts such as travel, lodging and meals appear to stimulate physicians to prescribe the promoted drug. So, more kickbacks with increasingly less oversight. By the time you watch a Lipitor commercial on tv nudging you to talk to your doctor about how the drug can help you, the drug company has already paid your doctor. Doctors, while esteemed and respected members of our communities, are not involved in the manufacturing or safety research of pharmaceutical products. They may have a basic understanding of how a drug works but that's it. Drug companies understand that physicians are their front line soldiers and as such serve as the mouthpieces for their industry.
And that plays a huge role in why people have not heard of things like UC Specific chiropractic or other powerful preventive or restorative forms of healthcare. While organizations like the National Institutes of Health do receive a small amount of funding for researching "alternative" forms of healthcare, the NIH is controlled by business interests of the pharmaceutical industry whose priority is to develop drugs not to restore function.
Lastly, this is getting to be a long entry but since I covered it on Facebook Live, I'll include it here too. If you're under care, how can you tell if you're receiving the benefits of UC Specific chiropractic?
I often talk to patients who have been under care for months. "I've been under care for a year and I don't feel any improvement" or "Every time I get adjusted I actually feel worse", they say.
My first question to them is, "How often do you get adjusted"? They answer that they get adjusted every visit or close to it. So I then ask them how often they visit and they'll usually say something like twice a month.
If you've been under UC Specific care for one year or six months or even three months and you're getting adjusted every visit, I don't care what your doctor tells you, something's not right -- something's not being addressed. And usually, it's a problem with the listing and the analysis.
The upper cervical spine demands accuracy and precision. If your doctor has incorrect or incomplete information on how, when and where you're misaligned, your adjustments won't hold and your improvement will be minimal to non-existent.
The number one thing I look for during every appointment is a change in listing. Because a patient's care is only as good as the current correct information the doctor has. As a patient, I was brought up in UC Specific with the idea that listings don't change and while listings do tend to be stable, they do change and the doctor has to be on top of it. Or, they'll adjust you incorrectly for months until they suspect something's wrong at which point they may decide to re-image you. By then, what are they even looking at? The patient's been adjusted the wrong way for months, perhaps incurred a new misalignment as a result and months of progress have been lost.
Imaging is a powerful tool. It gives us information about pathology and angles and degrees that allow us to give every patient an adjustment tailored to their anatomy. However, what good is the extra information gleaned from imaging, if the results of the analysis are incorrect or incomplete in the first place or change after a few weeks of care? As useful as imaging is, UC Specific is too beholden to the image. And while saying that is considered blasphemy in UC Specific circles, keeping a patient under care for a year and adjusting them every visit without improvement is the real problem. So if you're a patient and you've been under care for months and are getting adjusted every visit, ask questions. Know that there should be progression in your ability to hold adjustments. You should hold increasingly longer from Day 1 onwards. You shouldn't have to think about whether you're feeling better three months into care. When you're holding and clear, it is obvious in how you function and how you feel.
Professionally, it's not easy for me to write about things like this, especially as a new doctor. I don't want to step on other practitioner's toes so to speak. However, as a patient who was a challenging case for all his UC practitioners, I understand the pitfalls of our analysis and thus make sure my patients don't go through the same frustration and uncertainty of not holding during their care. And once I think of it from that side, the professional concerns aren't so important.