Increase Disc Height & Reduce Neck Pain? New Study Says Yes | #535

Hello and welcome to The Evidence-Based Chiropractor. I am your host, Dr. Jeff Langmaid. On today's episode, we are talking cervical spine. We have not done that in a little while. We're going to talk about cervical spine disc height decreasing neck pain and disability following improvements in cervical lordosis and posture. Talk about a story that ties into what we do each and every day in our practices. That's what we're gonna highlight on today's episode. Before we get started, big shout out to two partners. Leander Tables, they're gonna hook you up with $1,000 off their Series 950 just by being a listener to this podcast. Click on down below, connect with their team, or you can use the code EBC2026 online. Additionally, Shockwave Centers of America. I saw Dr. Dan out at Parker Seminars just a couple weeks back. We were talking about all the great things that they're doing and some of the new products they brought to market. They're gonna hook you up with $500 off and a free cart for a Shockwave unit in your practice. I love Shockwave and their company is fantastic. Click on down below and connect with their team. $1,500 in savings just right there by being a listener of this podcast. But as I said at the top, today's episode, all about the research. Another brand new study, 2026. The title, Increased cervical disc height and decreased neck pain and disability following improvement In cervical lordosis and posture utilizing chiropractic biophysics. I'll drop a link down to the study down below. And while this study was produced and highlights chiropractic biophysics, I think there's a lot we can learn whether you use CBP in your practice or not, just around lordosis, around posture, around how that can actually make material improvements. So we're gonna dive into that on today's episode. Each and every day, I am sure you have people walking into your practice with neck pain, with headaches, with cervical spine stiffness. And often we see the same thing. You can go out to lunch or dinner tonight and you're gonna look around and you're gonna see a lot of forward head posture. You're gonna see a lot, if you take x-rays, of a loss of cervical curve and of course degenerative changes on imaging. So globally, neck pain is one of the leading causes of disability. We talk about low back a lot, but don't forget about the cervical spine and the neck. It affects hundreds of millions of people worldwide. You wanna talk about market opportunity? Hundreds of millions of people and costs the US healthcare system alone over $130 billion, billion dollars annually. So this is not a small problem. And often just like the low back, medications, injections, surgery, these things are often discussed. But the reality is most patients are searching for non-invasive solutions. So the question that the researchers asked specifically in this study was, if cervical degenerative changes are linked to posture and spinal alignment, can improving alignment and posture actually improve the symptomatology and potentially even influence disc health? And that is what this study explored. So this was a case series. It had 64 patients with cervical disc degeneration. And they were trying to basically evaluate how structural changes impact neck pain, disability, alignment, and potentially even any, uh, disc changes on imaging. So with this study, they were really focusing on the degenerative changes to the cervical disc, one of the most common factors in chronic neck pain, because when the cervical discs degenerate, there's a lot of things that happen, many of which you are very familiar with. There can be a loss of cervical lordosis, there can be reduced disc height, could be inflammatory changes, of course, modic changes, right? Nerve, uh, ingrowth into the disc, that invagination of the nerves over time causing discogenic pain, big issue. And then structural instability ultimately as well. So all of these factors can contribute in combination or in isolation to both pain and dysfunction. So the researchers point out something really, really important, which are degenerative changes in the cervical spine they're often associated with abnormal posture and abnormal spinal alignment. So don't get hung up on the language here. So, you know, let's go through this, and, uh, you know, you can put this into the language that you utilize, but I'm using the language they utilize in the study, right? So that alignment, as they would say, included things like forward head posture, cervical lordosis, abnormal spinal biomechanics. So in other words, how the spine is positioned and loaded over time may influence disc health. So the researchers ask a really logical question: if posture and alignment contribute to degenerative changes, could correcting that alignment actually improve patient outcomes? So to look— to explore this, they looked at patients undergoing CBP protocols, which included spinal adjustments, probably what you do every day, you know, therapeutic exercises, probably some of what you do, spinal traction, probably do some of that, as well as postural correction. Now, this was under the CBP protocols, But a lot of this stuff you probably do in your practice to some degree, whether you are CBP-focused or not. So their goal was to evaluate whether this structural approach could improve symptoms, disability, and, and/or measure a difference in spinal alignment. So this was a retrospective case series, 64 patients in, in chiropractic-specific practices. All of them had neck pain, all of them had abnormal cervical posture. All of them had reduced neck mobility, and all of them had cervical disc degeneration that was confirmed on imaging. So most of the patients in this study had actually tried other treatments before entering the program. So that included medical care, physical therapy, some had even visited other chiropractors, but their symptoms had not improved prior to enrolling in this program. So the treatment program was not one or two visits. On average, the patient was there about a little bit under 40 visits. So 38-visit average, 20 weeks of care. So the treatment included a combination of a variety of different things, corrective exercise, adjustments, traction, postural correction again. And the researchers compared things before and after. So they took a baseline and they took an after. So before, the average neck pain score was 6.66 out of 10, which is a moderate amount of pain. That's not nothing. Like that's a strong moderate, right? The average Neck Disability Index was about 40%, which indicates moderate disability effect that actually affects daily activity. So these patients weren't just like uncomfortable, they had significant functional limitations. Now, after the program, both neck pain and disability improved pretty significantly. The study reports significant, statistically, excuse me, statistically significant reductions in both pain and disability following treatment. And importantly, the improvements exceeded the minimum clinically important difference, meaning they weren't just statistically significant, they were actually clinically significant for the patients, which is the most important thing. You don't want to just change a number on a page and have somebody still not feeling well. Your goal is to help them live their best life. And that is clinical— meaningful clinical improvement. So the really fascinating part was that they also did imaging. Whether you do imaging or not, separate story in your practice. But they did in this study. So they measured spinal alignment and disc height. They found over time that the lordosis improved, that the forward head posture decreased, that the disc height increased, and that these changes did seem to correlate with reductions in pain and disability. So simply put, as the alignment improved on the imaging, the symptoms also did improve. And as the disc height increased, the pain and disability decreased. So it's a pretty powerful relationship. And the researchers in this study did also— they performed a correlation analysis between several variables. Samples. They looked at some of the things we've just— we've discussed, like the curvature, the translation, the disc height, the pain levels, disability, and they found pretty strong correlations. When cervical disc lordosis improved and forward head posture decreased, pain scores decreased as well.

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Another example: as disc height improved, pain and disability scores seemed to drop. So The authors described this relationship as both direct correlations and inverse correlations. So direct correlation was between posture correction and symptom improvement. Inverse correlations were between disc degeneration markers and patient outcomes. So the structural improvements in this study were able to be linked to clinical improvements, which is really, really impactful. Many of us, uh, I think all of us, whether you're using a CBP protocol, whether you're using SFMA, whether you're using the— whatever system you use from an analysis perspective, Posture Screen, whatever it is. Many of us do look at posture. We know it matters. The alignment of things does matter. Now there's wiggle room. Not everything needs to be quote unquote picture perfect. I think that's where often docs that want to throw something out, they throw the baby out with the bathwater, so to speak. And often the truth is in the gray area, meaning our bodies can tolerate a lot. We are dynamic. Not everything needs to be perfect to be perfectly functional. But as we move away from perfection, often we see that there's a decrease in functional ability and potentially an increase in pain. And of course, if you take this to an extreme, there could be organ issues. You think about extreme scoliosis cases, right? That becomes not just about the spine. It becomes about the heart, the lungs, et cetera. That's an extreme case with extreme thoracic scoliosis. But it emphasizes the point that while small, small changes might not manifest in terms of deep functional deficits, ultimately you got to pay the piper. And as there are challenges and as there are injuries and as there are stress and as decades go on and as injuries mount up and as you get older, these things do become impactful over time. So structural rehab may influence not just symptoms, but also biomechanics and, and disc health. And you can approach this— this is a CBP-focused study, but you can approach that in a variety of ways in your practice. You know, there are many options out there— injections, um, you know, that really reduce pain temporarily at best. But when you're taking a structural approach through exercise, through adjustments, through potentially traction, whatever's right for that patient, you're really starting to change the underlying biomechanics and mechanics of the spine. And this study, I, I think reinforces the role that we play in addressing chronic spinal degenerative changes without drugs or surgery. And that's a message people want to hear. So helping people understand that neck pain is often related to posture and spinal issues. And when we can improve how things are moving, we can reduce the stress on discs and joints. Simple message, simply said, people can get that. Helping people understand your spine is designed to have natural curves, and when those curves are lost, the discs and the muscles have to work harder. That is a true statement that's easy to say, that people can understand, that it just starts to build that bridge of knowledge from you to your patient. That communication is critical. Otherwise, people drop off care too early. They don't understand what you're doing. And, you know, I hate to be the bearer of bad news, that's a lot of people. I'm gonna— I would venture to say That's a majority of people in a majority of chiropractic practices. Really don't know why they're there. They're there, they think they're there to get rid of pain. And that's why they leave as soon as they're out of pain. Why? Because their problem is solved, quote unquote, in their mind. That doesn't mean they need to stay on for 75 years being seen every single day, obviously. But it does mean that there was a missed opportunity. If somebody's coming in 50 years old, they have all sorts of issues, and they leave after 3 visits, that's a chiropractic aspirin. You haven't changed biomechanics, you haven't changed habit, you haven't really helped them on their journey to better health. You helped them get out of pain temporarily. Sometimes that's okay if that's their health goal, but you have to— they have to even know that more is possible, and many people don't. So applying research like this in your patient education, your report of findings, a lot of the same places we talk about each and every week, in your marketing and content, in your reactivation campaigns. Really, really important. So the big takeaways from this study were there's a— there are patients with cervical disc degeneration, they underwent cervical spine rehab, and after care they experienced a few things. And all 4 of these are really nice: significant reductions in neck pain, meaningful improvements in disability, improvements in cervical alignment, and increases in disc height. And the structural improvements in spinal alignment, quote unquote, they're actually correlated with improvements in symptomatology. So as the spine moved towards an improved posture— I'll say a more balanced posture is the way I like to put it— um, and, you know, patients felt and functioned better. Big win for everybody. So it reinforces a really powerful concept in spine care: spine is not just a stack of bones, right? This is a dynamic structure influenced by a variety of factors, including posture, mechanics, movement, all of these things. And when we improve how the spine functions and moves, we often see, no surprise, meaningful improvements in pain and quality of life. So use this information, get out there, tell that story, and help as many people as possible, 'cause there are a lot of people struggling with exactly these issues in your town, literally today. Before we wrap up, big shout out to NovoPulse and Diabetes Reversal Group. Diabetes Reversal Group, massive success, wicked easy to implement. They do all the heavy lifting. Click on down below in the show notes, just watch their video, learn about it. You got people with diabetes type 2 coming into your practice each and every day, there's no doubt about it. Are you even offering them the option for a solution? Diabetes Resource Group might be a really easy way to bring that into your practice. NovoPulse OA Recovery Program. NovoPulse is not just a device, it's a program. They give you the device and the marketing and the clinical and the CEs and the training, and the product's awesome. So NovoPulse Osteoarthritis OA Recovery Program, click the link down below, connect with their team, have a conversation. And if you have not left a rating or review for this podcast, I would love it if you would take a moment and do so. Scroll on down, tap how many stars, leave a line or two of feedback. That would be awesome. It helps more and more docs find out about this podcast. Whether it's your first time listening or you've been listening for all 510 years, 500 episodes, thank you so much. Thank you for tuning in. Deeply appreciate it. Thank you for being a chiropractor. Have a fantastic week in practice, and I will talk to you soon.

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