• Dr. Norris S. Golberg

What is NUCCA?

I just got back from an amazing NUCCA Annual Conference this past weekend. What is NUCCA? It is the National Upper Cervical Chiropractic Association, and it is a collaborative of some of the brightest minds in chiropractic, with a holistic focus on clinical excellence and evidence-based practice. I learned so much, I filled a whole legal pad of notes and my head is swimming. I’m so excited to implement this knowledge and new skills in the practice.


NUCCA is a specialized form of x-ray analysis of the alignment of the Atlas bone (C1), which is the top bone in your spine, and the most important bone in your body, quite literally.

Here is why:

· C1 holds your head onto your spine.

· The Atlantooccipital Joint (C0-C1) is the only bone in the body with joints of its kind (Synovial Ellipsoidal Condylar)

· C1 is the most mobile bone in the spine with the highest ranges of motion, making it prone to injury

· C1 is unlike the rest of the spine (C2-through S1) which have a discs and two large flat (apophyseal) joints, which are actually very robust and can handle immense loads and amounts of stress without damage.

· The Atlantooccipital (C0-C1) joint is the housing of the connection point of the brain and the spinal cord, called the brain stem

· Specialized ligaments, called dentate ligaments, that suspend and protect the spinal cord anchor to the Skull, C1, and C2, as well at the end of the spine (filum terminale ligament). Misalignment of the top or bottom of your spine will put tension through these ligaments that will be then displaced on the spinal cord…NOT GOOD!

· C1 is the point where the vertebral arteries exit the spine and enter the skull, twisting of the top of the spine can distort the flow and pressure of the blood in these vital arteries to the brain. The jugular vein and carotid arteries are also sitting directly in front of the atlas bone and a big enough misalignment can also affect the flow and pressure on these vital vessels.

· The atlantooccipital junction is the area where the Cerebral Spinal Fluid (CSF) enters the skull after circulating down to the bottom of the spinal cord, misalignment at this junction will change the patterns and pressure of the flow of the CSF in and out of the skull and brain.


The initial injury or misalignment to the spine can be caused by something as natural as birth to as unnatural as an auto-accident or looking down at a phone for hours on end.


A misaligned spine makes you more susceptible to further injury because of the imbalanced and uneven stresses and instabilities that develop as compensation to the original misalignment. This is caused by what is called the Righting Reflex, our brain always tries to correct our posture when it is moved away from the normal vertical axis. Just like a sailing boat in the wind, the wind blows the sails to the side, tipping the boat, but the ballast (counterweight at the very bottom of the haul of the boat) tries to tip it back upright, and it the wind stops it will.





If your head becomes misaligned on C1 or C1 (also taking the head with it) becomes misaligned on C2 and therefor the rest of lower neck your body will try to balance your head and eyes back to normal, but this means the dropping of a shoulder or twisting of the low back and pelvis, and then over time you start to feel the effect of the imbalances in these areas.


And this is not including the neurological cascade that occurs from spinal misalignment, known as a subluxation, I could go on for days about that!


These changes can be subtle, just a few degrees in any direction, but that is enough to alter the function of the nervous system and affect the musculoskeletal structure negatively. On top of that many of the more complicated neurological symptoms, our patients come in with could be caused by many other things from a spinal misalignment. Therefore, we always conduct a thorough health history and initial exam.


X-rays are only taken after the initial exam where we confirmed if you have a spinal misalignment, if we believe you are a candidate for care, we will take x-rays. We only take the x-rays on people who we know have a spinal misalignment, who could benefit from care, and want care to be initiated. The NUCCA x-rays are one of a kind but allow the most specific and accurate measuring of the spinal anatomy and misalignment. This measurement and analysis allow a NUCCA doctor to figure out the most specific and gentle way to correct the misalignment in your upper cervical area.




Because of the unique shape and size of the atlas joint, a specialized adjustment needs to be given. Traditional twisting and cracking adjustments have been shown not to get the ideal spinal correction and the results if any are short-lasting, because the spinal was never really realigned.


The NUCCA adjustment is a very gentle pressure, and very reproducible and effective. The Doctor applies the gentle pressure along a specific vector based on the patient’s x-rays, this slides the joints back together into normal alignment, allowing optimal healing to ensue. This is how our patients get great results! Simple, yet complex.


Just like each patient’s misalignment is unique to them, so is their post-adjustment healing response. After the initial correction is confirmed with x-ray analysis the patient is monitored for alignment and stabilization. Some people hold their adjustments for months after the first adjustment, others may have a longer road with most adjustments needed to stabilize the spine and hold their adjustments for longer and longer periods, which is essential for the healing process to occur.


After the initial adjustment holding and protecting your adjustment can be as simple as keeping a positive attitude to as difficult as breaking bad habits. We give our practice members specific exercises and stretches to keep the spine healthy, mobile, and in alignment. If you’d like a copy of the videos, we give to our practice members you can grab them for free here!


NUCCA is the most technically advanced chiropractic technique out there based on the leading edge of spine and neurology research. This evidence-based approach allows me to get some of the best changes a young doc could ask for and when you look at a NUCCA do who has been practicing for decades you’ll see miracles in practice every day.


If this sounds like something you'd like to use to enhance your health or just want to learn more you can schedule a consultation here.

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