Who Should Adjust your Atlas? Chiropractors, Osteopathic Physicians, Physical Therapists, Massage Therapists

The GNM Clinical Answer to Atlas Adjustment for the TMD Patient

Originally published April 2017 · Last updated May 2026

By Clayton A. Chan, D.D.S. — Founder/Director of Occlusion Connections™

The Patient’s Question

Question: Dr. Chan, do you only recommend a NUCCA type chiro for doing atlas adjustments? I have a regular chiro who says I need mine adjusted and I’m afraid it’ll mess up my jaw.

Dr. Chan’s Clinical Answer

I recognize and value any modality that assists in aligning the various mal-aligned body parts. I have worked with certified and well trained NUCCA chiropractors as well as Atlas Orthogonist (AO) chiropractors — another branch of skilled chiros who focus with objective measurements on the atlas. Osteopathic physicians are very gentle and can be effective for others with underlying distortions at various levels of the body. Even skilled massage and physical therapists who are well experienced and trained are also good.

I am not into high velocity, high force practitioners. No bone crackers, neck snappers, etc. I rather encourage my patients to seek those who are gentle and don’t need to twist or jerk you — especially if the TMD patient has a history of temporomandibular joint derangement. Gentle, light force, sometimes a skilled controlled tap is all that is required to make alterations for the better.

Beware — The Subjective-Adjustment Problem

Most chiropractors typically do not calibrate their manual manipulative adjustments in an objective measured way. Most of the adjustments are done by instinctive subjective experience and training. Many TMD patients have no real way to know if the adjustments are helping them or creating more problems — especially to their neck as it relates to their bite.

If the patient is a highly detailed proprioceptively aware person — sensitive — aggressive over-adjustments to the cervical and neck region could cause further occlusal instability, especially during the physiologically measured occlusal management stages of treatment.

Thank you for asking.

Atlas adjustment is one piece of the broader interprofessional coordination question. For the full OC clinical framework — including coordination with chiropractic, physical therapy, osteopathic and cranial therapy practitioners — see the OC interprofessional coordination hub: Interprofessional Coordination for the TMD Patient — Why Complex TMD Requires Coordinated Care →.