NUCCA Chiropractic
What Is NUCCA Chiropractic?
NUCCA (National Upper Cervical Chiropractic Association) is a specialized chiropractic technique that focuses exclusively on the atlas (C1) and axis (C2) — the top two vertebrae of the cervical spine. Unlike traditional chiropractic manipulation, NUCCA uses precise 3D imaging to measure atlas position before any correction, and the correction itself is a gentle, calibrated contact behind the ear — no twisting, no popping, no forceful thrust. This precision-based approach makes NUCCA appropriate for patients who don’t tolerate traditional chiropractic manipulation, including those with post-traumatic injuries, migraines, craniocervical instability, or a general preference for gentle care.
The History of NUCCA
NUCCA was developed by Dr. Ralph Gregory, who dedicated his career to advancing the science of upper cervical chiropractic care. Dr. Gregory founded the National Upper Cervical Chiropractic Association in 1966 to establish standardized protocols for upper cervical work — including specific imaging methods, precise measurement calculations, and repeatable correction procedures.
The core insight behind NUCCA is that the atlas (C1) vertebra bears the entire weight of the head and sits directly beneath the brainstem. When the atlas is misaligned — even by a fraction of a degree — the body compensates throughout the postural system: head tilt, shoulder height differences, functional leg length asymmetry, and postural distortion patterns that can contribute to a wide range of symptoms. NUCCA’s premise is that precisely correcting atlas position can address these downstream compensations at their upstream source.
What distinguishes NUCCA from other upper cervical techniques is the emphasis on objective measurement. Every correction is preceded by 3D imaging that measures atlas position to a fraction of a degree, and post-correction imaging confirms the alignment change. This measurement-based approach means clinical decisions are guided by data rather than palpation alone.
How NUCCA Is Different from Traditional Chiropractic
Traditional chiropractic manipulation typically uses rotation-based, high-velocity thrusts across multiple spinal levels — the familiar “cracking” and “twisting” many people associate with chiropractic. NUCCA is fundamentally different:
- Focus is exclusively on the upper cervical spine (atlas C1 and axis C2), not the entire spine
- 3D digital imaging measures atlas position to a fraction of a degree before any correction
- The correction is a gentle, calibrated contact behind the ear — no twisting, no popping, no high-velocity thrust
- Post-correction imaging confirms the alignment change objectively
- Objective measurements are tracked at every visit — progress isn’t just how you feel, it’s what the numbers show
- Correction is followed by a rest period to allow the alignment to hold
The precision requirement is one reason NUCCA is a smaller subspecialty within chiropractic. It requires specific training, specialized imaging equipment, and ongoing certification. Dr. Justin Schallmann at Back In Balance is NUCCA Part 2 Certified — one of approximately 300 doctors worldwide trained and actively practicing this technique.
The NUCCA Correction Process
Precision imaging
3D digital imaging measures atlas position to a fraction of a degree before any correction is made.
Calculated correction
Measurements guide the exact vector, angle, and force needed for correction — nothing is guessed.
Gentle contact
A calibrated finger contact behind the ear — no twisting, popping, or high-velocity thrust.
Objective verification
Post-correction imaging confirms the alignment change so progress is documented.
Conditions NUCCA May Help With
NUCCA is best suited for conditions where upper cervical (atlas/C1) dysfunction is a significant contributor to symptoms. Common presentations that respond to NUCCA care include:
- Migraines and headaches
- Neck pain and cervicogenic pain patterns
- Vertigo and dizziness (including vestibular migraine and cervicogenic dizziness)
- TMJ and jaw pain
- Whiplash injuries and post-concussion syndrome
- Craniocervical instability (CCI)
- Trigeminal neuralgia
- Chronic pain conditions with a cervical component
- Postural distortion driven by upper cervical dysfunction
- Post-traumatic patterns following head or neck injury
We also provide complementary care for patients dealing with fibromyalgia, sciatica, disc-related conditions, and other presentations where cervical or postural factors contribute to the broader symptom picture. For every patient, we’re transparent about what NUCCA can and can’t do — no overpromising, no marketing NUCCA for conditions where the evidence doesn’t support its use.
What to Expect at Your First Visit
1. Consultation and history. We review your symptoms, any injuries, current healthcare providers, medications, and prior imaging or diagnoses. If you’ve been evaluated by specialists relevant to your condition (neurologist, orthopedist, etc.), we welcome that context.
2. Examination and imaging. Physical examination including neurological screening, postural evaluation, and 3D upper cervical imaging that measures atlas position precisely. No correction is made without this measurement.
3. First correction (if appropriate). If NUCCA is a good fit for your presentation, the first correction is delivered. Most patients describe it as light finger pressure behind the ear — no cracking, no twisting, no thrust.
4. Rest and post-correction imaging. A short rest period follows the correction to allow alignment to settle. Post-correction imaging confirms the alignment change.
5. Honest evaluation. If NUCCA isn’t likely to help your specific situation, we’ll tell you directly rather than proceed with care that isn’t a good fit.
NUCCA Training and Certification
NUCCA has a structured certification process that distinguishes it from general chiropractic training:
- NUCCA Part 1 — Introductory training in the fundamental NUCCA measurements and correction procedure
- NUCCA Part 2 Certified — Advanced certification requiring demonstrated proficiency in NUCCA analysis, measurement, and correction. This is Dr. Schallmann’s certification level
- NUCCA Board Certification (DCCJP) — The highest level of NUCCA credentialing, held by a small number of practitioners
The specialized training requirement is one reason there are only approximately 300 NUCCA-certified chiropractors worldwide. NUCCA also requires specialized 3D imaging equipment that not every chiropractic office maintains, further limiting the number of practitioners actively delivering NUCCA care.
Meet Your NUCCA Chiropractor
Dr. Justin Schallmann is a NUCCA Part 2 Certified chiropractor with over 18 years of practice experience in the Seattle Eastside. He completed a nine-month NUCCA internship with Dr. Jeffrey Scholten in Calgary, Alberta, and has been practicing NUCCA upper cervical care since 2008.
— Marcy P. in Redmond.
Frequently Asked Questions About NUCCA
What does NUCCA stand for?
NUCCA stands for National Upper Cervical Chiropractic Association. The association was founded by Dr. Ralph Gregory in 1966 to establish standardized protocols and training for upper cervical chiropractic care.
How is NUCCA different from regular chiropractic?
NUCCA focuses exclusively on the atlas (C1) and axis (C2) vertebrae, uses precise 3D imaging to measure alignment before any correction, and delivers a gentle calibrated contact behind the ear rather than high-velocity manipulation. Traditional chiropractic often uses rotation-based thrusts across multiple spinal levels (“cracking”). The precision requirement makes NUCCA a smaller subspecialty within chiropractic.
Does NUCCA hurt?
No. The NUCCA correction is gentle — most patients describe it as light finger pressure behind the ear. There’s no twisting, popping, or high-velocity thrust. This is one reason NUCCA is appropriate for patients who don’t tolerate traditional chiropractic manipulation, including those with post-traumatic injuries, migraines, or general sensitivity.
How long does a NUCCA appointment take?
Initial consultations including examination and imaging typically take 60-90 minutes. Follow-up visits are shorter — usually 15-30 minutes — since we already have your baseline measurements and just need to assess current alignment and deliver any needed correction.
How many visits will I need?
This varies significantly by condition and individual presentation. Acute conditions often respond within a few visits. Chronic conditions typically require 8-12 weeks to assess whether NUCCA is producing meaningful improvement. Complex cases like craniocervical instability may require extended care. We track objective measurements at every visit and are transparent about progress — if we’re not seeing improvement in the expected window, we’ll be direct about it.
Is NUCCA safe?
NUCCA has an excellent safety profile — one of the safest approaches in chiropractic. The gentle, calibrated nature of the correction (no twisting, no high-velocity thrust) means minimal risk of the adverse events sometimes associated with cervical manipulation. That said, NUCCA isn’t appropriate for every patient — we screen for contraindications and refer to other providers when NUCCA isn’t the right fit.
Can I get NUCCA care while pregnant?
Yes, NUCCA is generally well-tolerated during pregnancy because the correction is gentle and doesn’t involve rotation or high-velocity thrust. Many pregnant patients find NUCCA helpful for postural adaptation, headaches, and pelvic alignment. We coordinate with your obstetrician when appropriate.
Is NUCCA appropriate for children?
We evaluate children on a case-by-case basis, primarily for specific presentations where cervical involvement is likely — such as post-traumatic patterns following sports injuries, concussions, or falls. We do not market chiropractic care for general childhood conditions (colic, ear infections, developmental concerns) as the evidence doesn’t support those applications.
Does insurance cover NUCCA?
Most major insurance plans that cover chiropractic care will cover NUCCA when medically appropriate. Our office accepts most major insurance including Kaiser Permanente PPO, Anthem BCBS, Aetna, Premera, Regence, United Healthcare, Medicare, and others. We can verify your specific benefits before starting care.
What if NUCCA isn’t right for me?
If NUCCA isn’t the right approach for your specific situation, we’ll tell you directly during your initial consultation and help point you toward the appropriate provider. Honest evaluation matters more than a full schedule — we’d rather refer you to someone who can help than proceed with care that isn’t a good fit.
Ready to See if NUCCA Is Right for You?
Your initial consultation is complimentary. We’ll take a thorough history, complete appropriate assessments including 3D upper cervical imaging if warranted, and give you a direct read on whether NUCCA is likely to help your specific situation.