Exploring the Connection Between Lumbar and Cervical Vertebrae through Sacro Occipital Technique

The relationship between different parts of the spine has long intrigued chiropractors and researchers alike. One idea that has persisted since the early 1900s is that the lumbar and cervical vertebrae may be functionally connected in a way that affects diagnosis and treatment. This concept suggests that changes or sensitivities in one region of the spine could predict or influence issues in another, distant region. Despite its clinical use, this relationship has lacked rigorous scientific study. A pilot study by Blum and Globe in 2005 aimed to explore this connection using the Sacro Occipital Technique (SOT) and orthopedic blocking, measuring patient sensitivity before and after treatment.

Understanding the Lumbar-Cervical Connection

Chiropractic care often focuses on the spine’s alignment and function. The lumbar spine (lower back) and cervical spine (neck) are distinct regions, but some practitioners have observed patterns suggesting they influence each other. This goes beyond common compensatory mechanisms seen in conditions like scoliosis, where spinal curves develop over time due to imbalance.

The idea tested in this study is that specific points of sensitivity in the cervical spine could indicate dysfunction in corresponding lumbar vertebrae. If true, this would allow chiropractors to target lumbar adjustments based on cervical findings, potentially improving treatment outcomes.

How the Study Was Conducted

The study involved 38 patients from a single chiropractic office. Participants were selected based on sensitivity at specific cervical reflex points. The researchers used the Visual Analogue Scale (VAS), a common tool to measure pain or sensitivity, to record baseline sensitivity at these cervical points.

Following the Sacro Occipital Technique R + C protocol, the lumbar vertebra related to the sensitive cervical point was adjusted. The adjustment was made in the opposite direction indicated by the cervical sensitivity. After the lumbar manipulation, the VAS measurements were taken again to assess any changes in sensitivity.

Patients were divided into two groups:

• Experimental group: 26 patients received the lumbar adjustments based on cervical sensitivity.

• Control group: 12 patients did not receive this specific lumbar adjustment.

  
  

Connection Between Lumbar and Cervical Vertebrae: Key Findings from the Pilot Study

The data showed a clear difference between the experimental and control groups. The experimental group experienced a notably larger reduction in sensitivity at the cervical points after lumbar adjustment. Statistical tests confirmed that the data were normally distributed, allowing for reliable comparison.

This suggests that adjusting the lumbar vertebra opposite to the cervical sensitivity can reduce discomfort or sensitivity in the cervical region. While this was a small pilot study, the results support the idea of a functional link between lumbar and cervical vertebrae.

Practical Implications for Chiropractic Care

This study provides preliminary evidence that chiropractors can use cervical sensitivity as a guide to adjust lumbar vertebrae effectively. Here are some practical takeaways:

• Assessment: Checking cervical reflex points for sensitivity could help identify lumbar dysfunction without direct lumbar examination.

• Treatment: Applying lumbar adjustments opposite to cervical sensitivity may improve patient outcomes by addressing underlying spinal relationships.

• Efficiency: This approach might streamline treatment by focusing on key vertebral connections rather than isolated areas.

  
  

For example, a patient complaining of neck discomfort might have a lumbar vertebra contributing to the problem. By identifying sensitive cervical points and adjusting the corresponding lumbar vertebra, a chiropractor could reduce neck sensitivity more effectively.

Limitations and Future Directions

As a pilot study, this research had a small sample size and was limited to one clinical setting. Larger studies across multiple clinics would help confirm these findings and clarify the mechanisms behind the lumbar-cervical connection.

Additionally, the study focused on sensitivity measured by VAS, which is subjective. Future research could include objective measures such as range of motion, muscle activity, or imaging to strengthen the evidence.

Summary

The pilot study by Blum and Globe offers promising evidence that the lumbar and cervical vertebrae are functionally connected in a way that can be used for chiropractic assessment and treatment. Using the Sacro Occipital Technique and orthopedic blocking, lumbar adjustments based on cervical sensitivity reduced discomfort in the neck region.

Blum CL, Globe G, R + C Factors and Sacro Occipital Technique Orthopedic Blocking: A Pilot Study Using Pre and Post VAS Assessment, Journal of Chiropractic Education Spr 2005;19(1): 45.

Introduction: Since the early 20th century, some within the chiropractic profession have posited that there is a functional relationship between the lumbar and cervical vertebra and have incorporated this concept into methods of evaluating and treatment. This concept of a systematic or predictive relationship between distant vertebral levels distinct from accumulative functional compensatory mechanisms, such as in scoliosis, is perpetuated based on observation and clinical experience without published report of any systematic study. This study seeks to investigate this relationship between the cervical and lumbar vertebra.

Methods: Patients were selected from the patient base of one office, and were limited to patients that had sensitivity at specific cervical reflex points. Using an outcome measurement, the Visual Analogue Scale (VAS) sensitivity was noted at specific points of the cervical vertebra. Then according to sacro occipital technique R + C protocol the related lumbar vertebra was adjusted opposite to the direction indicated by the cervical vertebral sensitivity. VAS measurements were recorded before lumbar vertebra manipulation and afterwards.

Results: At total of 38 patients were enrolled into this pilot study; 26 into the experimental group an 12 into the control group. Raw data from the VAS recordings were entered into SPSS, version 12.0 with a 10% check for accuracy performed. Mean change in report sensitivity as measured by VAS was notably larger for the experimental group (Table 2.0) The data was checked for normality to determine whether parametric testing would be appropriate. Both the Kolmogorov-Smirnov and Shapiro-Wilk tests indicated that the data was normally distributed. First we tested whether there was a statistically significant difference between mean VAS upon study entry. A t-test demonstrated that there was not a statistically significant difference (p=.189). This was important as we would not want a statistically significant difference between the two groups pre-test VAS measurement to be present at the outset or this might bias any interpretation of the study post-test findings. Finally we tested whether there was a statistically significant difference between pre- and post-VAS measurements and we found, using a t-test, that the notable difference in mean change in VAS scores (the experimental group mean decrease in sensitivity to palpation as reported by VAS being much greater) were statistically significantly different between the experimental and control groups (p < .001).

Treatment: R + C Factors are reflex indicators at the cervical vertebra used to identify vertebral rotation and lateral flexion inferiorities of the lumbar spine. Each lumbar vertebra is purported to have a corresponding “Lovett Brother” indicator in the cervical spine. Any manipulative form that accomplishes the “normalization” of position of the vertebra will usually cause the cervical indicator to lessen in sensitivity, which is the desired response. Sacro occipital technique has a low velocity high amplitude method of treating lumbar rotations and inferiorities using pelvic blocks for leverage while sustained pressure is applied at the lumbar vertebra.

Discussion: In an attempt to develop a biological plausibility to the R + C Factor and orthopedic block treatment phenomena found clinically some theories have been proposed. They vary from fascial and myological interrelationships, referred pain patterns facilitating tonic neck reflexes involving intersegmental spinal pathways, and visual, vestibular, proprioceptive and plantar mechanoreceptors affecting righting mechanisms for posture particularly to the cervical region.

Conclusion: Greater studies are needed to determine the relationship between the decreased sensitivity at the cervical indicators following lumbar manipulation. The findings of this study suggest further research into to cervical and lumbar vertebra interrelationships as well as orthopedic block placement and treatment may be warranted.