Neck pain: what upper cervical research has looked at

You were told the X-ray looks normal for your age, or that you'd have to learn to live with it. You've stretched, rested and strengthened, and it keeps coming back.

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Illustration: the atlas, the top vertebra of the neck, with a blue nerve passing through it

Neck pain is the most studied topic in upper cervical research, which still means a handful of studies rather than a library. This page gathers them, from a large multicenter cohort to single cases, so you can see what was measured and how far each result can be taken.

7 studies on this page

Designs: Randomized trial, prospective cohort study, retrospective review, retrospective case series, case report
Published: 1998 to 2026

Where these studies sit, by design and year

7 studies, published 1998 to 2026. Strongest design: controlled trial.

the studies

What each study looked at

Strongest study design first. The dots show the design, from a single case (one dot) to a controlled trial (four). How to read this library

Randomized trial2026Orthospinology, high-velocityNot indexed in PubMed

Head position sense in 72 people with neck pain, before and after one atlas correction

Who and how many: 72 patients with neck pain at one chiropractic office, randomly assigned: 51 to an atlas correction and 21 to a comparison group.
What was measured: Joint position error, a test of how accurately you can bring your head back to center, in four directions. The correction group was tested right before and right after one Orthospinology atlas correction; the comparison group on two visits before any correction.
What was found: Head repositioning accuracy improved significantly in the correction group, by roughly 42% to 52% depending on direction. The comparison group showed no significant change.
Limits: Immediate readings after one visit, unequal group sizes and no sham procedure. The correction was a quick, high-velocity Orthospinology method, a different style from ours.

Read the abstract on the journal's site → Source 1

Prospective cohort study2011Several upper cervical techniques

1,090 new patients at 83 upper cervical offices: early changes and reactions

Who and how many: 1,090 consecutive new patients at the offices of 83 upper cervical chiropractors.
What was measured: Neck disability, low back disability (Oswestry), 0 to 10 pain ratings for the neck, headache, mid back and low back, satisfaction, and any new or worse symptom within 24 hours of a visit. Measured at the start and after about two weeks: an average of 4.5 visits and 2.4 corrections over 17 days.
What was found: Neck pain and disability, headache, mid-back pain, and low back pain and disability all improved significantly, with an average satisfaction of 9.1 out of 10. About 31% of patients had a short-lived reaction (a new or worse symptom within 24 hours), and 5.1% rated it intense. No serious adverse events were reported.
Limits: No control group and about two weeks of follow-up. The authors say randomized studies are needed before risks and benefits can be weighed definitively.

Read the abstract on PubMed → Source 2

Retrospective review2026Blair upper cervicalNot indexed in PubMed

Neck X-rays over a year of Blair care

Who and how many: 45 patient files from one year of Blair upper cervical care (25 women and 20 men, average age 52). 38 had complete X-ray records.
What was measured: Disc height between the neck vertebrae, how far forward the head sits, and the neck curve on X-ray, at the start and at 3, 6 and 12 months.
What was found: Disc height increased significantly over the year. Forward head position and the neck curve did not change significantly.
Limits: A look back at files, with no comparison group, and it measured X-rays, not symptoms. It can't say how disc height would have changed without care.

Read the abstract on the journal's site → Source 3

Retrospective case series2009Orthospinology, low force by instrument

Neck pain and disability after two weeks of low-force orthogonal care

Who and how many: Consecutive patient files from one private practice over one year. The abstract does not state how many.
What was measured: The Neck Disability Index and a 0 to 10 pain rating at the first visit and two weeks later, plus X-ray measurements of atlas alignment before and after the first correction.
What was found: Neck pain and disability improved significantly over about two weeks, an average of 5.7 visits and 2.7 corrections, with no serious side effects. People whose atlas alignment moved more than 30% toward the target on the first visit had better disability scores at two weeks.
Limits: A look back at existing files, with no control group and two weeks of follow-up.

Read the abstract on PubMed → Source 4

Case report2026Blair upper cervical

Neck pain and headaches after a car accident that injured an artery in the neck

Who and how many: One man, 54, eight months after a car accident that caused a partial tear (dissection) of his left internal carotid artery. He had severe neck pain, headaches and painful, restricted neck motion.
What was measured: Exam findings, a 0 to 10 pain rating, the Neck Disability Index and the RAND-36 quality-of-life survey over six months, during which he had 5 Blair upper cervical corrections. Exam and imaging were used first to judge whether care was reasonable.
What was found: All three questionnaires showed improvement in his presenting symptoms.
Limits: One person. The authors say more study is needed on both effectiveness and safety for people with a history of artery injury. The journal published two letters to the editor in response, one of them on the report's methods.

Read the abstract on PubMed → Source 5

Case report2018Blair upper cervicalNot indexed in PubMed

A 46-year-old woman with neck pain and hand numbness

Who and how many: One woman, 46, with neck pain and hand numbness, a loss of the normal neck curve and degeneration in the neck. Her exam also found signs of dysautonomia.
What was measured: Thermography, palpation and leg-length checks at each visit, and a 0 to 10 pain rating, over four months and eight Blair corrections.
What was found: Her neck pain went from 4 to 0 out of 10. Neck pain and hand numbness improved after the first correction and resolved after two months.
Limits: One person and no comparison. The abstract doesn't report whether the dysautonomia findings changed.

Read the abstract on the journal's site → Source 6

Case report1998Grostic, by hand

A 34-year-old man with a herniated disc in his neck

Who and how many: One man, 34, with a year of severe neck, low back and arm pain after care from several medical specialists. MRI showed a disc herniation at C6-C7, and nerve testing confirmed nerve root involvement. X-rays showed the atlas and axis were misaligned.
What was measured: Re-examinations of his symptoms and findings during care with the Grostic procedure, an upper cervical method delivered by hand. X-rays were analyzed by template and by computer.
What was found: Re-examinations after about a month showed marked improvement in his symptoms and findings. At more than a year of follow-up he had not needed surgery.
Limits: One person and no comparison. A single case can't separate care from natural change over time.

Read the abstract on PubMed → Source 7

before you draw conclusions

What this research does and doesn't tell you

The randomized trial measured head position sense right after one visit, not pain. The cohort is large, but it had no comparison group and followed people for about two weeks. The Blair X-ray review measured discs, not symptoms. The file reviews looked back at existing records. The case reports describe one person each. None of these can say what would happen for you, and none followed people for years.

Published research can't predict what will happen for any one person, including you. Studies report averages and single stories; your nervous system is your own. That is why The Lazar Method^™ starts with measurement, not with a promise.

We measure first, so the answer is about you, not an average.

Before any correction we measure how your nervous system is regulating your body: heart rate variability, thermal and muscle tone scans, PostureIQ™, and digital X-ray of the upper neck. QSM3, the method used at our office, is a progression of NUCCA. Dr. Jonathan Lazar, D.C., or someone personally trained by him, will go over your scans and images with you.

If we can help, we'll tell you. If we can't, we'll help you find someone who can.

Talk it through on a 15-minute Clarity Call →

This page is educational and is not medical advice. Keep the doctors who know you in the loop.

citations

Sources

Billiris C, Becker D. 2026. Immediate Changes in Head Repositioning Accuracy Following a Precise Upper Cervical Chiropractic Adjustment: A Randomized Clinical Trial Journal of Upper Cervical Chiropractic Research August 21, 2026:18-24. Not indexed in PubMed. Article page on vertebralsubluxationresearch.com
Eriksen K, Rochester RP, Hurwitz EL. 2011. Symptomatic reactions, clinical outcomes and patient satisfaction associated with upper cervical chiropractic care: a prospective, multicenter, cohort study. BMC Musculoskelet Disord 12:219. PubMed 21974915 · DOI 10.1186/1471-2474-12-219 · free full text
Baker S, Alcantara J. 2026. Increased Cervical Intervertebral Disc Height Following Blair Upper Cervical Chiropractic Care: A Retrospective Radiographic Review Journal of Upper Cervical Chiropractic Research August 5, 2026:8-17. Not indexed in PubMed. Article page on vertebralsubluxationresearch.com
Rochester RP. 2009. Neck pain and disability outcomes following chiropractic upper cervical care: a retrospective case series. J Can Chiropr Assoc 53(3):173-85. PubMed 19714232 · free full text
Beebe M, Tayal A. 2026. Upper cervical chiropractic management of a patient with headaches, neck pain and a history of traumatic internal carotid artery compromise: a case report. J Man Manip Ther 34(5):508-514. PubMed 42290506 · DOI 10.1080/10669817.2026.2684728 · free full text
Herman C, Harris J. 2018. Resolution of Neck Pain, Upper Extremity Paresthesia & Dysautonomia in a 46-year-Old Female with Loss of Cervical Curve and Spinal Degeneration Using Blair Upper Cervical Technique: A Case Study & Review of the Literature Journal of Upper Cervical Chiropractic Research July 9, 2018:26-32. Not indexed in PubMed. Article page on vertebralsubluxationresearch.com
Eriksen K. 1998. Management of cervical disc herniation with upper cervical chiropractic care. J Manipulative Physiol Ther 21(1):51-6. PubMed 9467101

Titles are quoted exactly as published. Sources checked 2026-11-03.

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