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  • Writer's pictureJerry Kennedy

What is the difference between the Blair Technique and NUCCA?

Here at Zenith Chiropractic in Colorado Springs, we utilize the Blair Upper Cervical Technique to provide upper cervical care. We commonly field calls, emails, and inquiries asking if we practice NUCCA technique, and if not how is what we do different. The goal of this article is to answer those questions and provide a bit more information on the topic.


When it comes to upper cervical chiropractic care, there are a variety of technical approaches that are practiced by doctors. Understanding the nuances of each specific technique is beyond the scope of this article, but the goal is to distinguish a few key features that differentiate the Blair Upper Cervical Technique and NUCCA. We will start with what they have in common.


Common Ground


The Blair Upper Cervical Technique and NUCCA are similar conceptually, in that the focus of each technique is to provide a scientific and specific method of correcting upper cervical subluxation. Both techniques (as well as others not mentioned) different from conventional chiropractic in that the region of focus is on the upper neck. As the weakest and most prone to injury, the upper cervical spine is susceptible to injury. Additionally, the upper neck region is highly sensitive to the neurological system of the body, making it the epicenter of many pain conditions and health challenges for patients.

Both the Blair Upper Cervical Technique and NUCCA are systems of chiropractic analysis and adjusting procedures that can accurately diagnose and manage issues related to upper cervical subluxation.


Both approaches offer a non-manipulative adjustment, meaning no twisting, popping, or cracking. Additionally, both techniques perform upper cervical adjustments in the side lying position with a comfortable and natural spinal posture (no twisting or pulling).


When it comes to identifying what adjustment is required for each patient, both techniques utilize advanced structural analysis on imaging – often utilizing high frequency digital x-ray or Cone Beam Computed Tomography to measure spinal misalignment.


Lastly, each system utilizes a diagnostic process on each checkup to determine if an adjustment is required, when a successful adjustment has been given, and when an adjustment is not required. It is a goal of both the Blair Upper Cervical Technique and NUCCA to provide adjustments that hold for extended time periods to allow for optimal recovery.


Key Differences


In this section, we will identify some of the key differences in the techniques from an analysis and management standpoint. As a certified Blair Upper Cervical Chiropractor, I will focus on the technique approach that I am most familiar with and provide more broad comments related to NUCCA.


X-ray Analysis


NUCCA is a technique system based on a concept of head and neck orthogonality. In layman’s terms, NUCCA is designed to restore the upright posture of the head and neck while reducing tilting and rotation of the atlas (first cervical segment). In this way, the correction of the upper cervical spine has a more global perspective (alignment of head and neck).


Blair Upper Cervical Technique is built on the concept that the spine is naturally asymmetrical, and these subtle differences in bone structure in each individual should be accounted for to provide the most specific adjustment. To differ from NUCCA, Blair Technique concludes that even if the spine is not orthogonally straight, it is most healthy when the individual joints are in proper alignment and mechanical motion.


X-ray analysis from the Blair Upper Cervical perspective includes a series of measurements that evaluate each individual articulation of the entire cervical spine. Where the NUCCA approach focuses on a more global measurement of misalignment, Blair Technique seeks to pinpoint the exact structure in the spine that has misaligned. Additionally, Blair Upper Cervical Technique can measure and adjust misalignments through the cervical spine, where NUCCA technique is limited to C1 adjustments only.


Checkup Procedures


NUCCA technique utilizes a series of tools to evaluate posture deviations and imbalances in relation to head and neck positioning. This means that before and after a NUCCA adjustment, a leg length inequality (LLI) measurement is taken as well as a postural assessment. Following the NUCCA correction, these measurements are performed again to measure the amount of correction. Additionally, NUCCA doctors will take an immediate set of post-adjustment x-rays to ensure that the correct angle of adjustment was used. If the result is unsatisfactory, an additional correction and post x-ray are made to improve the result.


Blair Upper Cervical Technique utilizes a series of objective testing procedures on a visit-by-visit basis to determine the progress of the patient.


Paraspinal Thermography is used to determine the presence neurological imbalance. This sensitive testing procedure helps to determine the level of stress response in the body as it relates to structural misalignment. This test is performed after an adjustment to measure the reduction of stress in the nerve system.


The Blair Technique also measures a series of leg length inequality parameters, performed in the prone position (lying face down on a chiropractic table). The 7-way prone LLI testing performed by the Blair Upper Cervical Technique helps to identify postural imbalances, muscle coordination issues around the spine, and a pattern of dysfunction related to the cervical misalignments present. This helps the Blair Doctor to identify the adjustment or series of adjustments that need to be performed to reduce each of these parameters. This combination of tests provides a comprehensive understanding of the upper cervical subluxation each patient, which leads to less pain, improved mobility, reduction of symptoms, and with fewer adjustments.


It is worth noting that the Blair Upper Cervical Technique provides a degree of versatility in upper cervical care that NUCCA technique does not. While the NUCCA approach is extremely effective and achieves exceptional results, there are certain situations in which the Blair Technique provides the additional information required for the individual patient to receive maximum results.


Situations where Blair Upper Cervical Technique offer additional benefits include:

  • Multiple cervical misalignments

  • When an adjustment cannot be performed on the side of the spine that is misaligned (as in the case of an injured shoulder, vertigo conditions, pain and sensitivity in the area, etc.)

  • When the primary upper cervical subluxation is at the C2 level

  • Asymmetries of bone structure


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