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Understanding Upper Cervical Chiropractic Treatment With Dr. Josh Grey

2 years ago

Have you been experiencing headaches every day that seems to have no cure? Listen to today's guest, Dr. Josh Grey, as he talks about the wonderful benefits of chiropractic treatment. His mom's relief of headaches with the help of a chiropractor introduced him to this practice, and he eventually went back to school to pursue a degree in chiropractic even after pursuing a business degree. Dr. Josh feels sad to know most people rely on medicines and make them worse, so he wanted more people to know about the importance of chiropractic and the benefits it can give to your life. 


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Understanding Upper Cervical Chiropractic Treatment With Dr. Josh Grey

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We have a very special guest. He is one of my favorite upper cervical doctors, Dr. Josh Grey. He is an upper cervical doctor in the greater San Francisco Bay Area in Pleasanton, California. A great doctor, knowledgeable, and extremely passionate about the Blair upper cervical work. We have a great episode for you, and I hope you enjoyed it as much as I did. Please welcome, Dr. Josh Grey.


We have a phenomenal episode ready for you. We have Dr. Josh Grey. He is a phenomenal upper cervical doctor in Pleasanton, California, and it’s an honor to have him on the show. Dr. Josh, how are you?

I’m good. I can't complain. It's great to be here. Thanks for having me on.

Dr. Josh, I love asking people, first of all, where you are from and second of all, how you’ve got into upper cervical chiropractic because not many people do, and it's a phenomenal profession to be in. Josh, where are you from originally?

Most people don't know that I was originally born in Groton, Connecticut. My dad was in the Navy and then got us stationed in South Georgia. That's where I grew up, and most people associate with me growing up in Georgia. That is how I’ve got involved in chiropractic. We are a chiropractic family. I grew up with a lot of allergies, always sick, and on a lot of antibiotics.

My mom started having these headaches. Finally, someone said to her, “There is this chiropractor you should go see.” She made an appointment. She started seeing him and she was like, “I don't understand it.” She was getting relieved. She got better. That's how I was introduced to chiropractic. It wouldn't be until 8 or 10 years later that I would go to chiropractic school, and then the rest is history.

I love the domino effect chiropractic has, not only the patient but the entire family. Your mom was probably suffering for a while with headaches. You’ve got your mom back, and it changed the whole dynamic of the family and made the whole family healthier. It puts you on the path you are on. Who would have thought?

It's funny because I can remember, being a kid and a teenager, I can see, even now, people's headache eyes where they are out over their daily lives and have headache eyes. It's one of those things that you always hope that they find chiropractic and upper cervical because there is a lot of relief there.

It's interesting too when people come into the office with those headache eyes. Their eyes are shut. It's gloomy. You deliver a nice, specific adjustment. You rest and they come back. It's open. The light’s back in their eyes. It's such a phenomenal thing to see. Dr. Josh, I did some research on you. Before chiropractic school, you were in another profession, right?

Yes. I have done a lot of things. I did my undergrad in business, and then I had worked abroad for six months.

Where at?

In Qatar.

I couldn't even point to that on the map. Where is that?

It's in the Middle East, next to Saudi Arabia.

How did you end up there?

I was open to the opportunity, which it's one of those things that when folks are not born into chiropractic, they can fall into it based on being a patient or my mom being a patient and family and whatnot. When I came back to the US, I didn't want to live in the South, so I moved to California. I worked in tech and then healthcare tech.

I had a friend that had a healthcare crisis. That's when I finally stepped back. I was like, “I want to do more in healthcare than be on the tech side of things.” That's when I went back to school. It was super convenient that Life West was in my backyard to go to, so I don’t have to relocate again. The cruel irony is that my undergrad was next door to Life University. It was always there waiting on me. I just had to be there.

Josh, there are several different avenues you can jump in when you get to chiropractic school. What made you land on the upper cervical and become an upper cervical doctor?

I was a little biased knowing that my mom had gotten success from an upper cervical doc.

That was upper cervical in Georgia.

I believe it was Grostic. I went in being like, “That's all I'm going to do.” Throughout my time in school, I practiced all of the electives for the upper cervical. I put myself under the care of all the various techniques and sought something that resonated with me that made sense to me so that it wasn't working. It didn't like I had to fight it to make sense or fight to figure it out. Once it clicked and I found Blair, and I was under Blair Care, then I was like, “This is what's for me for sure.”

Dr. Josh, you published an interesting research paper.

It was in 2018 or 2019.

It's a very cool study. It's the Reduction of Symptoms of Meniere’s Disease & Trigeminal Neuralgia. If you read the paper, one of the most beautiful things about it is there was one Blair adjustment that was delivered throughout the care with a support work with Thompson Technique. That's a beautiful thing. I don't know any other adjustment or technique that could put somebody back into alignment once and the body continues to heal. That is such a beautiful thing. That’s what's so beautiful about the upper cervical work.

What's phenomenal is that we were using Blair and supportive care for that patient in that case but what Blair focuses on is how different everyone's anatomy is. Everybody's system is unique to them. That worked amazing for that patient, and we hope to replicate it. That's why we take the X-rays in Blair. There are some people that even as light as the Blair adjustment is, it may be too much for their system. That's why we leveraged the upper cervical network of chiropractors to say, “What other techniques are even lighter than Blair?” We get NUCCA. Maybe a patient can get relief from that. It's about finding what works for them, and that patient did have phenomenal results.

I have a couple of patients that sometimes the drop headpiece can be a little bit too much. Sometimes we will have to use the TRT instrument with the light that's got the little torque in it that clears them out well. For other upper cervical docs, you’ve got to find something to help all your patients. Sometimes people need something a little bit different.

One of the things that Dr. Forest taught me was some patients, where the drop of the table is a little bit too much. There are little pediatric speeder boards that patients can be on.

He puts grown adults on the pediatric piece.

Depending on their anatomy, systems. One of those things that makes research and the different upper cervical societies so important is that they can investigate that and then standardize it across it being something that you figure out and test. Again, that's why those that volunteer for the Blair Upper Cervical Society and that published research allows people to figure out like, “What can work for my patients when they are not getting results?” Whether they do that directly or refer to an upper cervical chiropractor, the patient's results are the most important.

Josh mentioned Dr. Tom Forest, who is considered pretty much the godfather of the Blair technique. He is amazing. Josh gets to work with him daily. Josh, what have you picked up from Dr. Forest, and how has he made you a better upper cervical doctor?

The thing that I would highlight to folks is he taught me how important patient education is. I shadowed his office as a student. Anyone that's shadowed him knows that they go and do the markups on the X-rays, and it's all about the X-rays because if the X-rays are wrong, your adjustment is probably not that accurate.

You can do a beautiful adjustment, and if it's the wrong segment or way, that person is not going to feel too good.

After all of that, I had finished my clinic responsibilities in school, and I had the opportunity to be under a preceptor. I asked him, and he said yes. I was super static about that. In that preceptorship, I never adjusted. I was a 130-pound shadow, and I would be in the room with him when he was talking to patients. A lot of my peers were like, “You are not adjusting. How is that and everything?” I was like, “It's fine by me because I learned.”

The goal is that we adjust them once or very few times and they hold. Everything after that and what keeps them coming back to get checked and understanding what's happening in their bodies, and then how they can communicate that to others, so they can get that results as well is education. Above everything, and that's why Dr. Forest continues to teach, so anyone that's lucky enough to be in an elective, reset an elective and do the training, just keep soaking it up.

It's huge that patients need to be continually educated about the healing process because every now and then, you will adjust somebody. They feel great. They are like, “I'm good.” They disappear for a little bit. It's like, “We are so glad you are feeling great but we want that to continue. You miss the point that there are ebbs and flows through the healing process. You do a lot of good healing 3, 6, 9 months in, so we want to continue to monitor you.” That must have been amazing being able to watch Dr. Tom Forest educate patients. I'm sure you pick up a lot of great things on the adjustments, the X-ray readings, and difficult cases that in upper cervical care we all see.

That's one of the things of being with someone that's also so experienced in some of the cases that being a new doc you are super nervous about, you are like, “I don't know how to approach it.” He's like, “I have seen this before. I have seen some variation.” You are like, “This is what we are going to do.” That goes back to the speeder board or the modifications and leg checks when people have different issues going on. It's amazing.

For newer docs, especially people that are newer to upper cervical, sometimes the nervous thing is like, “The patient is going to be upset that I'm not adjusting them.” I will confess that sometimes I get that nervous still. I'm like, “They are going to be upset.” It always amazes me when people are excited. They celebrate. One, they understand. We are doing our jobs. It's something that newer docs need to realize people will get there. You have to be dedicated to the education aspect.

What Dr. Josh is talking about with upper cervical, as he stated before, our goal is to do as few amount of adjustments as possible. When somebody comes in, their scan looks good, legs are balanced and we say, “They are holding.” It's a very good thing. It means their body is healing, and we don't want to interrupt the nerve flow that's already there. I have had a couple of patients they had been holding, their scan looks good.

At the end of the visit like, “Do I still have to pay?” I did my job. You are holding, everything is looking good. Dr. Forest even says like, “I should charge you twice because you are holding or I should charge you double because you are holding.” That's the main goal. Holding is healing. If you are balanced, you don't need adjustment, that's the biggest win in upper cervical.

The more folks get educated and understand that they are happy to pay. They are happy to be holding. The other thing that we highlight is, this goes back to education. In that visit, they are not being told like, “You are holding. Bye. Have a nice day.” It’s like, “Are you doing your head and neck exercises?” Maybe they are holding, and there are other recommendations based on how they are presenting that we want to give them. They are walking away with that information as well as our expertise and saying, “You don't need an adjustment. You are good to go.”

We see a ton of people that have upwards of twenty neurological symptoms. They base their life around doctor's appointments. The upper cervical puts the power back in their hands to heal themselves. Once everything is in alignment and the interference is removed, you don't need anybody moving things around. You become your own doctor. Your body is healing by itself.

What's so beautiful about upper cervical is that people have been told they are going to have to live with their condition or symptoms for the rest of their life. Once they start holding, they can go on a maintenance schedule for 2 or 3 weeks, and that adjustment will continue to work long after we give it. That's a beautiful thing.

It's unfortunate that more folks don't get to hear about upper cervical. On the front end, they are suffering from the issues that they are dealing with. That's why it's so great, like your show and all of the different resources that are out there for folks. I, myself, have had people come in and they were like, “I heard about this on the internet.” They have tried 10,000 other things. We are always happy to give them hope. The title of your show, Expect Miracles.

Dr. Josh, is there a condition, element or symptom that gets you fired up that you like to treat most in the upper cervical?

The label of fibromyalgia. One, I have known family and friends that have had it, and I know how difficult that is. To lessen their symptoms, improve their quality of life, get them as close to living optimally as possible, that's what always gets me fired up. It fires me up because those are the folks that oftentimes lose the most hope because people push them away. Sometimes they get pushed on medications that make them feel worse. As you said, we are not treating symptoms, we are not curing folks but I can try to get you holding and getting you as close to your 100% as possible.

I would have to agree with fibromyalgia. People that walk in our door with fibromyalgia are in the most excruciating pain I have ever seen any human in. The wind blows too hard, it's too much on their face. Some people can't even wear the masks because of that sensation of them touching their face, sharp electric shock, shooting pain, they can't eat solid food. It's an unbearable condition. When somebody gets their life back through adjusting their upper neck, they start breaking down and crying tears of joy. I know you have seen it. That is one of the most beautiful things with upper cervical. I would have to agree with you on that.

One of the funniest stories was when I was working up in Spokane with Dr. Rachae Bell and Becky Ellis, there was this lady who must have been in her 60s. She had fibromyalgia for probably 40 years. She had been adjusted and been doing well. She comes in, and you are always like, “How are you doing,” gauging things. She's like, “I feel terrible.” She had been holding for so long. “I feel so good I'm overdoing it.” If you are going to feel bad, it's because you overdid it like your hobbies or getting to enjoy life, not because you feel bad. That one always ends up to me as one of those where sometimes I feel bad, and then you are like, “That's a good reason but let's not overdo it.”

When some people are not holding as well as we would like to see them, sometimes we forget to take into account what they are doing outside the office. Are there any restrictions you put on patients a day or two aftercare, or maybe a couple of weeks, a month or two in care to hold their adjustments?

It always depends on where they are at. The requirements also shift and change like someone's care and how frequently they get seen. It depends, if you come in with a triple whiplash history, it's going to be a lot harder to hold. Some folks get excited, no vacuuming, heavy lifting, and working with cast iron. For others, when they are asymptomatic, healthy, and they are kids and teenagers, their body has a lot more resilience. What would make you or I go out of adjustment? They are unfazed.

That's why you do a thorough history and exam to figure out, “Here are our recommendations.” Again, checking in on that visit to say, “How have you been doing? What have you been doing? Are you holding or not?” For those that aren't holding, you have to dig into, “What activities of daily living are you doing? What is your exercise like? Are you doing our head and neck exercise recommendations, etc.?” It's like you are a chiropractor and Sherlock Holmes trying to figure out what's making you go out.

I remember when I first started care, I felt like I needed to strengthen my neck right away. I didn't tell Dr. Hall. I was doing isometric exercises and chin tucks, and I was coming back. I was like, “I don't know why I'm out. I'm not doing anything.” They are like, “You are not doing anything? What are you doing outside the office?” I’m like, “I’m doing chin tucks.” They are like, “Some people can get away with that. Others, including yourself with a big trauma history, your muscles and ligaments are trying to mold around your adjustment. When you are doing stuff like that in the very beginning, it's going to have a tendency to go back where it has been for 15, 20 years.”

It's one of those things I talked to folks about. It's like slouching if you are out and feel better. You have to engage your muscles, and you are working at it. Sometimes it gets tired, and it's hard work but that's the ideal. That's what you should be doing. When you slouch, you are like, “I get that relief.” It’s temporary and damaging in a way. It's one of those things that because you are feeling better, it doesn't guarantee that you are in adjustment.

When your patients would you say, “Reach a maintenance type of care,” where you start to space them out, and they are doing well. It's probably different than everybody but is there a 3-month, 6-month mark where you graduate stages of Care?

You are looking at it during the exam process. When they are up for re-exams, that's when you are evaluating like, “How far can we stretch you out?” You have to have good records so that you can say, “Over the time that we have seen you since your last exam, how have you been holding?” For someone that has been adjusted once since their last exam, you are going to approach that a lot differently than you have to get adjusted twice every week. It's unfortunate when you have those tough cases where they have to be adjusted so often. There is a case that those exist. Our modern life is tough on us.

The other thing that makes me think of is you asked about recommendations, and so you are like, “You can't lift over 10 or 20 pounds.” They say, “I have dogs to walk or I have kids that I have to take care of.” These are our recommendations and the ideal state of getting you to hold. Life happens but that's also why you get checked. If you go out, we will get you back in.

What do you do on your re-exams? What are you reevaluating?

We are going through all of their positives like the range of motion, grip strength, and the standard to check them for an adjustment as well. Depending on if we have had to add any special exams based on their conditions or how they present, we are doing that as well.

Do you work with any other practitioners in the area to help facilitate healing, whether it be massage therapists or acupuncturists? Anything that might help the healing or the holding process in your patients?

One thousand percent, and that's one of the things where you see people get to hold more is when they do adjunct therapies, and they are taking care of themselves. We are not curing any conditions. We are not treating symptoms. The more diagnostics people can get, the more they can understand their bodies and see what's going on, the better.

It's phenomenal the network that Dr. Forest has built, not just within upper cervical but full spine chiropractic and all different kinds of practitioners. We talk about that subluxation is toxins, thoughts and traumas. There are other people that know a lot about troubled thoughts, toxins. Whenever you start leveraging, especially for those tougher cases, that's when people are able to hold better and longer.

Do you work with any nutritionists by any chance?

I haven't referred anyone to a nutritionist directly.

It's a huge part of people's everyday life. I wonder how that would play into effect. I'm sure it would do nothing but be beneficial.

The other thing is that it's super beneficial because as everybody's body is unique, their misalignments and anatomy, so are diets. I have had patients ask me, “What do you do to workout and diet?” I'm like, “What works for me in my body could be completely different for you.” Having a good nutritionist to refer to or even a network where they specialize in nutrition pathology, keto or whatever it is, that’s beneficial to have.

I'm starting to notice too, at a certain point, it's going to be hugely beneficial for the patient to start getting moving and exercising. The people that I feel sometimes don't do well or the people that are not doing anything are sitting at the desk all day, in traffic, going home, and sitting on the couch. There is no movement. There is no disc hydration or imbibition going on to keep that spine nice and healthy. That is a daily life factor that is playing us all. At some point, the movement has to be put into the treatment plan and talked about.

Movement is life. I talked to folks because some people under upper cervical care have dizziness or can't be active. That level should be a spectrum. What you are hinting at is if people overdo it, they don't hold. They are outside of their spectrum. They underdo it if they are not being active, even a little bit, what may seem like minuscule to others, that's the perfect amount for them. When they are in that spectrum for them, they hold well. When that habit and routine goes out the door, they were like, “I stopped my gym routine, and I have been busy with work.” They have stopped the movement. They have increased their stress, and they aren't holding as well.

You’ve got things like sleep. Sleep is huge. A lot of people are not getting enough sleep, and it's very easy to dismiss these days, and that will throw everything off if you are not sleeping well.

I have seen your prior episode, and you talked about the sympathetic nervous system when they are misaligned. One of those things that I realized about myself is I'm always, “Go, go, go.” I'm always willing to sacrifice sleep, even though I know what all the research says and how important it is. What I did was I was like, “I will look at data, and I will believe that.” I started wearing this Oura ring. It gives me metrics on how well I slept and my HRV is doing. When that number starts ticking down, I'm like, “I’ve got to relax. I'm going to skip the gym.” I'm going to sacrifice the movement so that I can rest and recover.

That ring is hooked up to an app on your phone where you can monitor. Technology is a beautiful thing sometimes.

What I would like to see is people wear an Oura ring again, talking about light research or whatever. A group of people starts wearing Oura rings, make no lifestyle changes and get some metrics, and then start upper cervical care and see how their vitals change. How much their sleep scores are and things like that. Being able to quantify in addition to qualifying our results is what it's going to take to get it more widespread because there are people that feeling better makes sense to them but whenever they say, “I feel bad but my metrics are good.” How many other things in health do we talk about with metrics? Blood levels, BMI, weight, and all of that. There are a number people can ascribe to.

I already have patients doing that. They will have either that thing that goes the whoop strap or a ring, and they will come in, and they were like, “My REM sleep has been off, and my resting heart rate is up. I know I'm out.” You are like, “Relax. We will see what's going on.” Sure enough, their scan is off. There are people that are getting very in tune with that, which is a very cool thing.

It goes back to the sympathetics and parasympathetics. There are some people that, whether it's their symptoms, you can see a constellation come up than being out. I always say like, “Look at your parasympathetics. If your stomach is upset and you didn't eat anything weird, if you are not sleeping well many days in a row, that should be a red flag to get checked because you are either on the way going out or you are already out.”

There are a lot of things to pay attention to. Some people disappear for 6, 8 months in care, and their symptoms start to come back, and they forget about upper cervical. They resurfaced a year later and they were like, “I don't know what's going on.” You haven't been checked in a year. You were good before that. You are probably out of alignment. Sure enough, they get back on track.

Everyone's journey is different. Sometimes people can't be seen as often as they need to or should because they are off to college. There are so many different reasons and things going on in people's lives that we have to meet them where they are. That's where it goes back to the expectation, and I have told patients, I’m like, “We need to see you on Monday.” They were like, “I can't.” “That's okay, but you have to understand, we may not get the results that you want to see if you go out, and then we see you on Wednesday, Thursday,” whenever. It's being real with the expectations, and when they can accept that and understand it, they respect us more for when they try to hold us accountable for when they are not holding.

It goes back to touching on what you said is everybody's got their own treatment plan and little spectrums in care. When I first started, I had everybody, “I'm going to see you this.” You have to make modifications for different patients. If you tell your patients you want to see them, then most people are compliant, and they want to get better and will do it.

Sometimes, I was afraid. I was like, “I want to see you next week, a little sooner than expected because I want to make sure you are holding.” Sometimes I would not say that because I didn't want to see what their reaction was, but now it's like, “This is going to be best for you. Let's check you next week. I want to make sure you are holding and feeling better.”

Sometimes people will be like, I will say, “We are going to schedule for Wednesday.” They were like, “I want to come in on Monday.” It's one of those things that, compared to some docs, we know we are both fairly new in practice. When they get it and start feeling better, they are like, “I want to be sure I'm holding.” When they are eager to come in and get checked and not adjusted and pay, the light has gone off in their way.

If you think about it too, we are still seeing people way less. I'm a huge fan of anybody doing chiropractic but some treatment plans are 3 or 4 times a week for six months. That's not our goal. We are not trying to see people three times a week at all. When you do ask your patient, “We are going to see you sooner rather than later.” You’ve got to think, “We are not seeing you that much, to begin with, too.” It's not that big of a burden to put on the patient because it's minimal visits over a long time anyway.

That's what I tell folks when I ask to see them sooner. When patients had been under care for 10 or 20 years, they forgot that when they started care, they were seeing a couple more times a week than they were now. It's like, “Based on how you are presenting, let's get it checked.” It's like a plane taking off. If you keep that momentum and holding, it's much easier to keep it than if you are like, “I went out and I'm going to wait a month for my appointment.” No. Get seen sooner. Get checked. Get it corrected, so you can keep that altitude.

There are people that hold for months and maybe even years at a time. Sometimes we hit these little speed bumps where you get extra stress, you are not sleeping well, and something is going on at home. “We saw you maybe 6, 8 times last year but I want to see you once or twice over the next couple of weeks to make sure you are back on track.” If you are seeing a person once a month and you are adjusting them every time, you’ve got to wonder how much holding is going on. That's the most important thing.

The thing in school that made me aware of that as they were saying, “Accountants hold less during tax season,” a light bulb went off of like, “They are more stressed. They are working more.” That’s the analogy I use to say, “If your work has increased demands, you have to take better care of yourself.” They are like, “I guess I'm putting more demand on my body.”

Dr. Josh, where can people find you online, websites, social media or anything like that if they want to schedule an appointment with you?

They would go through Forest Chiropractic in Pleasanton, and they would look us up, give us a call, and get scheduled for a new patient appointment.

Dr. Josh, at the end of each episode, I would like to ask all my guests, what is one piece of advice that has resonated with you over the years that you would like to give the audience? It could be anything.

The best piece of advice I have ever been given is if it scares you, you have to do it. It's that nervousness, and that's the growth opportunity. That's one of the things that I have been scared of in so many times. Sometimes I forget that advice. Once I have committed and done it, even if it's a failure or tough, after the fact, the learning and growth make it completely worth it.

Sometimes, that feeling or sensation can eat away at your soul. You get so scared that every time you think about it, you do it. That feeling goes away, and you feel so much better about yourself. Josh, thank you so much for coming on. I would love to have you back at any time. Ladies and gentlemen, Dr. Josh Grey, a phenomenal upper cervical chiropractor in California. Please go see him if you are in the San Francisco area, you will be in good hands.

Thank you so much for having me.

Thank you, Josh.

About Dr. Josh Grey

Dr. Josh Grey has always been fascinated by chiropractic. Growing up in Georgia, his family received care from a second-generation chiropractor vastly improving their quality of life. Dr. Gray didn’t get care because he thought he was healthy. He went off to school to pursue a business degree while working as a pharmacy technician. During that time, he interned in the medical reporting department of CNN.

Dr. Grey’s first chiropractic adjustment came while working in San Francisco’s startup culture placing increased demands on his body. It also happened to be a Blair technique adjustment. Dr. Grey would then come to find out that Blair was a more modernized version of the care his family had been receiving in Georgia. It was then, with a passion for healthcare, Dr. Grey went back to school to pursue a degree in chiropractic.

At Life West Chiropractic College West, Dr. Grey excelled at his standard studies and incorporated additional training in upper cervical chiropractic care, public health, and patient education. Since graduating, Dr. Grey has worked in Spokane, Washington, San Francisco, and now in Pleasanton at Forest Chiropractic. He continues to educate the public and other chiropractors by publishing patient case reports and studies.

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