What is acetaldehyde? Why might it be important? Have you ever woken up after an evening of too much wine and felt like something the cat dragged in? Outside of your complicity in overindulgence, you might blame the effect on a molecule called acetaldehyde, a breakdown product of ethanol. Acetaldehyde is potent. It’s affect on… Continue Reading »

Acute L5 Intersegmental Subluxation

Acute lower back problems due to lumbar subluxations are common in our practices. They are rarely written up in spite of their importance, challenges, and frequency. It’s important to publish them, particularly for novice chiropractors as many chiropractic colleges try to discourage them from adjusting acute back pain patients. Dr. Vance presents a case of… Continue Reading »

Acute Lower Back Pain

This is a 48 year old female patient who presented with acute low back pain. The pain began when she was making a bed (she works as a hotel maid). Upon presentation, the pain was non-radiating, midline lumbar pain. The patient denied previous episodes of lower back pain and did not have a history of… Continue Reading »

Allostasis and Allostatic Load and Chiropractic’s Role

(From the December 2008 “G”Note) The concepts of allostasis, allostatic load, and allostatic overload have become important in the understanding and quantification of wellness and health and the effect of stressors on the body. It is a foundation concept of the ICA Wellness program. What do those terms mean, and how do they fit into… Continue Reading »

Angulated Lumbosacral View

Having trouble visualizing the sacroiliac joints on your AP film? Does one or both of the sacroiliac joints appear hazy or narrow on your AP film? Do you have questions about the shape of the L5 vertebral body? Consider taking an angulated lumbosacral view. Typically, if the sacroiliac joints are in doubt, one takes left… Continue Reading »

Atlanto-Axial Articulation

In the last issue, we reviewed the atlanto-occipital articulation. The articulations of the entire upper cervical spine are highly complex as it is the meeting place of the skull, the spine and spinal cord. and the brainstem. In the Gonstead technique, the atlas misalignment is analyzed in relation to the axis, unlike in upper cervical… Continue Reading »

Base Anterior Sacrum

I have practiced Chiropractic now for 38 years. My first Gonstead Seminar was during my first year of practice. Dr. Gonstead impressed me because of his scientific way of presenting the adjustment. I knew from the first seminar with him that I wanted to learn more about his technique. One of the most notable phenomena… Continue Reading »

Childhood Obesity and the Aware Parent

Whether you’re dropping your child off at school, walking through the amusement park or mall, or just wandering down the aisle at the local grocery store, you can’t help but notice the rise in childhood obesity.  What was once rarely seen in children twenty or thirty years ago has become common in this country and… Continue Reading »

Common Pelvic Misalignment Patterns

(From The September 2008 “G”Note) A recent article by Dr. Tom Vance in the The ‘G’ Note brought up a common pattern viewed on the A-P full spine x-ray using the Gonstead analysis. The length of the ilium on the side of spinous rotation of the lumbar spine usually measures longer than the opposite ilium.… Continue Reading »

Correction of AEx Tibia

A 46-year-old male presented to our office complaining of knee and low back pain as a result of a fall at work. X-rays of the knee revealed an AEx tibia. Spinal x-rays showed a L5 PL-M. The tibia was adjusted in the seated position. L5 was adjusted prone on the HyLo table. Post-x-rays of the… Continue Reading »

Diagnostic X-Ray Risks?

The Myth of the “One Right Answer”: Diagnostic X-Ray Risks? (From the March 2006 The ‘G’ Note) A paper in the December 2005 issue of the Journal of the Canadian Chiropractic Association  by Oakley PA et al. questions the health risks of diagnostic plain film x-rays by reviewing the literature on low level radiation exposure and the… Continue Reading »

Disc Space Improvement

From the June 2008 The “G”Note This is a case of a male, aged 53 years, who demonstrated some restoration of the L3 disc space. His initial primary complaint was left lateral hip region pain and inflexibility and constriction. He said that the area felt “tight and jammed.” Thee was lower lumbar and right laeral… Continue Reading »

Disc Wedging: Is the Gonstead Model Correct? Some Thoughts

From the June 2008 The “G”Note What is the cause of the intervertebral disc wedging that we see in vertebral subluxations? Is the original mechanism described in the Gonstead Technique correct? This is an opinion based upon ongoing studies into this issue. According to the Gonstead Disc Concept that was developed in the 1950-60s and… Continue Reading »

Disc “Ingestion”

From the June 2008 The “G”Note White and Panjabi have brought forth the concept that acute, post-traumatic, lower back pain and muscle spasms may be due to a rapid ingress of fluid into the nucleus pulposus that may induce pain by irritating the outer anular fibers and thereby eliciting a pain response to the peridiscal… Continue Reading »

Doctor Relaxation Aids Adjustment Success

My adjustments are too slow. How do I speed it up? I don’t have any power to my adjustment. What can I do? When working with students on their adjusting, particularly cervical chair adjusting, two of the most common complaints are that their adjusting thrust is too slow, and/or it is ineffective or weak. When… Continue Reading »

Efficacy of Spinal Fusion?

(From the March 2007 The “G”Note) The number of spinal fusions has escalated over the years. Medicare and most workers’ compensation plans reimburse for spinal fusion. Medical journals have begun to raise questions about the procedure. Two articles in the January 2007 issue of The Backletter discuss the efficacy of spinal fusions. In this era… Continue Reading »

Enteric Nervous System: A Review

Most of us have learned that there are two primary parts of the autonomic nervous system: the sympathetic and parasympathetic nervous systems. Neuroscientists have been describing a third part of the autonomic nervous system, the Enteric Nervous System (ENS). It functions relatively autonomously, i.e., it can function with minimal extrinsic control. Gershon calls the enteric… Continue Reading »

Food and Bone Health

Can food help optimize bone health? It is said that one in three women and one in ten men over age 55 years will experience a fracture due to bone fragility as a result of osteoporosis. (Goldberg 2007) Diet is said to be a factor that can lead to or prevent osteoporosis. Many people have… Continue Reading »

Frozen Shoulder: A Review

“Doc, I can’t move my shoulder, and it hurts like !@#! when I try.” “Let me check it.” “Ouch!!! “ Hear that frequently? Me, too. Shoulder pain is a common complaint in the chiropractic office. A particularly arduous form is called “frozen shoulder.” “Frozen shoulder” covers a variety of shoulder problems whose chief features is… Continue Reading »

Gonstead Articles List

This list includes articles sponsored by GCSS as well as other articles of interest to the Gonstead chiropractor. These articles have been published in major chiropractic peer-reviewed journals. They include biographical pieces, presentations on general or specific aspects of the Gonstead technique procedures, case reports: care of various disorder using the Gonstead technique, and miscellaneous scientific articles of interest… Continue Reading »

Gonstead Disc Model: Advancing It into the 21st Century

For the Gonstead Clinical Studies Society Meeting of the Minds III Cleveland College of Chiropractic – Kansas City, Missouri October 2006 The Gonstead Disc Model is a product of the 1960s, but the model largely carries forward to today. Like all clinical sciences, it must continually incorporate current science. The technique requires it; the profession… Continue Reading »


The Gonstead System combines Visualization, Instrumentation, Motion Palpation, and X-ray analysis to form a decision on which vertebra to adjust. This is especially true with patients presenting with headaches. Headaches may come from any part of the spine for various reasons. With that said here are a few clues that may help point to the… Continue Reading »


(From the March 2011 The “G”Note) Case Report: Hemivertebrae A 22-year-old male presented to our office on January 25, 2002, with acute low back pain. He stated that he had soreness most of the time but not this “sharp pain.” The lumbar spine had restricted ROM, pain exacerbated by flexion, right and left lateral bending.… Continue Reading »

Inferior-Anterior Humerus

(From the September 2008 “G”Note) This 66-year-old male presented to our office with acute right shoulder pain. He stated that he tripped and landed on his right shoulder while playing tennis. INITIAL EXAMINATION: Upon examination, the right shoulder range of motion was limited and painful. Bruising was evident on the upper arm and shoulder. This… Continue Reading »

Instrumentation: Cervicothoracic Junction

A difficult area to analyze with a NervoScope (or Delta-T, Go-Scope, etc) is the cervicothoracic junction. I recall seeing a video of Dr. Gonstead correcting a doctor who wasn’t tilting the NervoScope properly over that region. It is important to maintain the instrument perpendicular to the spine (as seen from the side). It is not… Continue Reading »

Is Back Pain a Normal Part of Growing Up?

An article on the prevalence of pediatric lower back pain appeared in the January 2009 issue of Archives of Pediatric and Adolescent Medicine. Dr. Mark Lopes, the GCSS Research Chair, responded with a letter to the editor. The response was rejected. Was it rejected because of the D.C. behind his name? We will never know.… Continue Reading »

Jigsaw Puzzle Pelvis

(From the September 2008 “G”Note) During the February 2008 chiropractic mission to Guatemala, a 28-year-old male presented for care. He complained primarily of lower back pain in the lumbar spine and pelvis with extension into the thighs. In 1994, he was run over by the back wheels of a bus. The wheels ran over his… Continue Reading »

Lateral Lumbar Spine: Line Marking

(From December 2004 The ‘G” Note ) The Gonstead x-ray analysis of the lateral cervical spine view includes a series of endplate lines drawn from C2 to C7. These lines are used to assess the relative rotation angles in +/–X (flexion and extension) of each vertebra compared to the next one below it — i.e.,… Continue Reading »

Myth of the “One Right Answer”: Diagnostic X-Ray Risks?

(From the March 2006 The “G”Note) A paper in the December 2005 issue of the Journal of the Canadian Chiropractors’ Association by Oakley PA et al. questions the health risks of diagnostic plain film x-rays by reviewing the literature on low level radiation exposure and the “linear no-threshold” hypothesis. There is no question that there… Continue Reading »

Notes from Dr. Gonstead – 1978

These notes are from a Gonstead Advanced Session that Dr. Gonstead taught in West Palm Beach, Florida in February of 1978. The leg check is the key to S-ASIN listing in comparing the long leg that should be on the radiograph (caused by ASIN ilium to the leg check which is checked prone on the… Continue Reading »

One Doctor’s Report of Findings

There are plenty of opinions about the report of findings, commonly referred to as the ROF. The length and the content should surely be determined by you, the DC, and I encourage you to follow your intuition and refine your ROF as your career progresses. There are a few suggestions I have for you, which… Continue Reading »

Opposite Rotation of the Ilia

From the March 2008 The “G”Note When the lumbar vertebrae have a right spinous rotation, the left ilium will usually have an AS or In major, and the right ilium a PI or Ex major. When the sacrum, as view on the AP film, shows the tubercle rotated towards the right, the result is a… Continue Reading »

Pediatric Chiropractic Analysis and Technique Review

Cervical Spine AS Occiput Observation– the child has a gaze to the ceiling. History-the patient may have been in an in-Utero Constraint position (Transverse, Brow or Facial). The older child may have sustained a Brow or Facial trauma from falls. Infants, toddlers, and pre-schoolers, (rarely the pre-adolescent) may present with frontal head banging on the… Continue Reading »

Prone Hi-Lo Table Adjusting: Part 1. Sacrum

The Zenith Hy-Lo table, built to Dr. Gonstead’s specifications, is perhaps the greatest “workhorse” that the chiropractic profession has or will ever see. Its effectiveness and versatility are demonstrated by its presence in many the offices and schools throughout the world. Many associate this table with thoracic adjustments. Gonstead doctors utilize this table predominantly from… Continue Reading »

Prone Hi-Lo Table Adjusting: Part 2. Pelvis

In this article, we will explore the pelvis adjustment. It’s often said that if you could only pick one table to use for adjusting, most would choose the knee chest table. While I would agree that the knee chest table is one of Dr. Gonstead’s greatest innovations, I would have to choose the Gonstead Zenith… Continue Reading »

Sacral Fracture With Resulting Ilium Subluxation

(From The “G”Note – December 2010) Case Report A horizontal or transverse sacral fracture is the most common type of sacral fracture. It usually occurs as a result of a fall upon the buttocks or following direct trauma. The lateral radiograph is usually required to demonstrate the fracture. A 43-year-old female was presented to our… Continue Reading »

Sacroiliac Joint Pain: Sacrum or Ilium?

(From the March 2005 The ‘G’ Note) BACK TO BASICS A common dilemma for the Gonstead doctor when presented with a suspected sacroiliac subluxation is: do you adjust the sacrum or ilium when there is justification for either. In addition to the other tests used to determine not only sacroiliac involvement but also sacral or… Continue Reading »

Sciatica Patient

Sciatica is a very painful condition, and the doctor should communicate to the patient that they understand the severity of pain that is being suffered. The Three ‘S’ Rule is an easy mnemonic to remember: Sciatic Side Serious. The majority of patients with this condition should be adjusted in the side posture position as the… Continue Reading »

Scoliosis Analyses

The following study was published by the Journal of Arizona/ Nevada Academy of Science. Likelihood-Evidential Support and Bayesian Re-Analysis on a Prospective Cohort of Children and Adolescents with Mild Scoliosis and Chiropractic Management J. Michael  Menke, M.A., D.C.(1), Gregory Plaugher, D.C.(2), Christina, A. Carrari, M.A.(3), Roger R. Coleman, D.C.(4), Luca Vannetiello, M.D., D.C.(5), and Trent… Continue Reading »

Serotonin Syndrome

SSRIs (selective serotonin-reuptake inhibitor) are amongst the most prescribed drugs, the “lifestyle drugs.” Ads for those drugs cannot be avoided as they appear in magazines and on television. Are ads that show the tranquil scenes hiding something more serious, beyond the fact that every human emotion is now being considered to be a disease that… Continue Reading »

Severe Sacral Subluxation

(From the March 2007 The “G”Note) This is a case of a 49-year-old female who presented to our office with acute low back pain. She stated that she fell and did the “splits.” Initial lumbar x-rays of 9/18/06 (see image below) – sacral subluxation P-L 14 – In-Ex ilia: obturator changes (compensation) – asymmetrical pelvic… Continue Reading »


(From the December 2003 The “G”Note) Spondylolisthesis and spondylolysis are common findings in the chiropractic office. Some are symptomatic while many are incidental findings observed on physical examination and x-ray. This is a review on spondylolisthesis and spondylolysis and their chiropractic management using the Gonstead System. Terminology Spondylolisthesis: it’s Latin roots are the words spondylos… Continue Reading »

Tibia and Fibula Subluxation

(From the June 2007 The “G”Note) Editor: Extremity injuries occur frequently as most of us know in our personal lives and most of these patients benefit from chiropractic care. Early intervention can often save someone from a lifetime of chronic pain and/or joint instability or even significant disability. In the Gonstead protocol, when faced with… Continue Reading »

Torticollis: A Review

(From the December 2003 The “G”Note) Acquired torticollis is caused by contraction of the cervical musculature that results in a stiff or wry neck, and often, excruciating pain. Its Latin root words are tortus (twisted) and collum (neck). (Calliet) There are several types of torticollis. Basically, the primary categories are clonic/spasmodic or tonic. A further… Continue Reading »

Torticollis: Painless Correction Using the Gonstead Technique

(From the December 2003 The “G”Note) The doctor must know how to make the adjustment without exacerbating the patient’s pain. This requires skill as the patient is in considerable pain. Neck movements during the subluxation analysis must be kept minimal. The range of motion will determine how the adjustment should be given. With the patient… Continue Reading »

Uncinate Processes & Joints of Luschka

From The ‘G’ Note, June 2003 CLINICAL TOPIC The other day, I was asked what I knew about uncovertebral joints. Unfortunately, my knowledge was vague. I realized that, considering their importance in the cervical spine and the problems associated when they undergo degeneration, a brief review is in order. Rising superiorward on the posterolateral and… Continue Reading »

Upper Cervical Care and the Pediatric Patient

Upper cervical technique is not new to the chiropractic profession. It started with the toggle (HIO) technique, developed by Dr. B.J. Palmer, followed by other upper cervical techniques, such as Grostic, NUCCA, orthospinology and atlas orthongal. In preparing this article, I interviewed Dr. Julie Mayer Hunt, a second-generation upper cervical chiropractor who is board certified… Continue Reading »

Visibly Evident Fourth Lumbar Compensation

(From the December 2006 The “G”Note) When you see an obviously misaligned L4 on the AP x-ray, you’re probably dealing with an acute L5 subluxation. The L4 compensates to reduce pressure on the L5 disc. This results in an antalgic lumbar spine. This patient had a L5 PLI-M subluxation. Don’t be fooled into thinking that… Continue Reading »

Vitamin D

From the December 2006 The “G”Note Vitamin D has been making a splash in the news recently. There are numerous recent articles in scientific journals on the benefits of vitamin D. Below are a few of the articles and a synopsis of them. Some are readily available at your local public library or are free… Continue Reading »

Well-Balanced Child

Every parent wants to raise the perfect child: healthy, happy, loved and respected with high achievements and even higher goals.  We want our children to “have the things we didn’t have” and to achieve their dreams.  This is all well and good, unless we become so focused on our desires for our child that we… Continue Reading »

X-Ray Corner

(From the March 2006 The “G”Note) These lumbar x-rays were cropped from AP and lateral full spine x-rays taken by Dr. Randal Johnson of Monterey, California. He recently shared these at the February Monterey Bay Gonstead Clinical Studies Society meeting. This patient is a 23 year old male. 1. What pathological process do you see… Continue Reading »

X-Ray Factors & Age-Clinical Notes

Below are some tips from a radiographic technology class at the Life West SPA Day for those of us who were getting our CE hours for x-ray operators. Always store boxes of unexposed film upright. Moisture can damage film stored horizontally. It is advisable to use the same company’s film with their screens. The emulsions… Continue Reading »