Dennis Woggon grew up in Onalaska, Wisconsin—a small town just outside of La Crosse—and attended Wisconsin State University in La Crosse. Dr. Fred Barge, a pioneer in chiropractic and scoliosis, was his field doctor. Dr. Woggon graduated cum laude from Palmer College of Chiropractic in 1974 and has a Bachelor of Science degree in biology. He is the founder and director of the St. Cloud Chiropractic Clinic in St. Cloud, Minnesota, where he has practiced full-time since 1974. He was certified in Videofluorscopy at Palmer College in 1992 and taught Spinal Biomechanics with his mentor, Dr. Burl Pettibon, for twenty-eight years. Dr. Woggon has written many articles and books on chiropractic and lectured nationally and internationally.
In an interview with The American Chiropractor (TAC), Dr. Woggon discusses the chiropractic approach to scoliosis care and changing people’s lives, one spine at a time.
TAC: Tell us about the services and products you offer chiropractors and how or why they are offered.
Woggon: In 2000, I established the CLEAR Institute, which stands for Chiropractic Leadership, Educational Advancement & Research. The Institute was set up to advance the profession of chiropractic and then evolved into scoliosis care. In 2004, CLEAR Institute began teaching scoliosis seminars to the chiropractic profession.
TAC: What motivated you to start working with scoliosis patients?
Woggon: My practice has always been outcome assessment based on pre and post X-ray and spinal biomechanics. Initially in practice, I saw improvement in scoliosis cases, but not consistent results. In 1990, my good friend, Dr. Gary Lawrence, brought his daughter to my Clinic for treatment of a severe scoliosis. With the assistance of Dr. Lawrence, we began to study scoliosis. We looked at the great results that we have seen in our profession and incorporated many ideas from many mentors. These included Drs. Fred Barge, Bob Mawhiney, Burl Pettibon, Don Harrison (CBP), Clarence Gonstead, Nucca, Grostic, Orthospinology, Leander Eckard, Vern Pierce, Roger Turner (Cranial Adjusting), Clayton Stitzel, with Gerry Cook of Pneumex Rehab, and many more. We really wanted to focus on what worked and what would help the scoliosis patient without getting hung up on egos.
TAC: By your assessment, how are the schools doing at providing students with the minimum basic competence to service scoliosis care?
Woggon: When I attended Palmer College in the early 70’s, I was taught that chiropractic care could not help correct scoliosis, but was beneficial in the control of the symptoms of scoliosis. I was also taught not to adjust the patient for symptoms. Fortunately, this is now changing as we understand more about scoliosis and its cause. Doctors of Chiropractic are the specialists in the neuro-muscular skeletal system. Scoliosis is a dis-ease of the neuro-muscular skeletal system. We should be the spinal experts.
Students at various chiropractic colleges, including Parker, Palmer Florida, and Logan, have expressed an interest in learning more about scoliosis treatment as part of their established curriculum, and I hope that this interest continues to grow. Scoliosis has been documented since the time of Hippocrates, and chiropractic has the potential to take the lead in the field of scoliosis rehabilitation. We really are breaking new ground, and I think today’s chiropractic student understands that demonstrating consistent, positive results with scoliosis will validate the science of what we do in the eyes of the general public, as well as our colleagues in the healthcare industry and that the benefits of promoting chiropractic care for scoliosis will extend far beyond what we do today, and impact our entire profession. It’s a very exciting time to be a chiropractor!
TAC: What is the medical approach to scoliosis treatment and how are the attitudes toward you from MD’s that recommend the medical treatment?
Woggon: The medical approach to scoliosis is to observe it from 10 to 25 degrees, brace it from 25 to 40 degrees, and then do surgery. Research has shown that bracing is ineffective and surgery is disabling. There has to be a better, more conservative approach. The MD’s who care about scoliosis patients have shown a positive interest in what we do and we receive many referrals from them. The cost of scoliosis surgery is currently about $160,000 and, frequently, the finances dictate the treatment recommendations.
TAC: What are your success rates?
Woggon: The success rate depends on patient compliance. There is no cure for scoliosis. Our goal is to allow the patient to function normally and live a good life without bracing and surgery. In the peer reviewed study in BioMed Central Results, after four to six weeks of treatment, the treatment group averaged a 17 degree reduction in their Cobb angle measurements. None of the patients’ Cobb angles increased. A total of three subjects were dismissed from the study for noncompliance relating to home care instructions, leaving nineteen subjects to be evaluated post-intervention. Conclusions: The combined use of spinal manipulation and postural therapy appeared to significantly reduce the severity of the Cobb angle in all nineteen subjects.
TAC: Is there anything you would like to add or comment on regarding hanging X-rays?
Woggon: Logan college and Robert Mawhiney, DC, did some great work with hanging traction starting in the late 1940’s. They had some positive results, but the theory was never developed until we began incorporating traction and de-rotation.
TAC: Is there any study planned for the future that will assess effectiveness?
Woggon: In the fall of 2007, we established a CLEAR Scoliosis Center on the campus of Parker College of Chiropractic. The STAR Clinic (Scoliosis Treatment and Research) is directed by Dr. Glenn Robinson and my son, Josh Woggon. This Clinic is independent of the College, but will be working together with the College for specific, unbiased research regarding scoliosis and chiropractic. This is the first time that a Chiropractic College has had a Scoliosis Clinic on campus, and it is already attracting international patients. My son Josh was so motivated by what he saw in our Clinic with scoliosis patients that he began working with CLEAR Institute in 2003, and joined the student body of Parker College of Chiropractic in 2006.
TAC: What is the biggest problem or challenge you see in the chiropractic profession today?
Woggon: The biggest challenge is to overcome apathy and ignorance. We are told we can’t do something, so we don’t even try. We need to get away from being glorified therapists who only treat back pain and focus on what chiropractic can do for spinal rehabilitation and wellness care. We need to become the spinal experts of health care. We need to be able to do scoliosis screenings on all our patients and start the necessary treatment when we first discover a scoliosis during the medical observation phase.
TAC: What kind of change is it for an office to go from traditional chiropractic, to one that specifically addresses scoliosis?
Woggon: The scoliosis spine does not follow what we would consider normal spinal biomechanics. For example, the rotation of the spinous into the concavity contradicts normal motion. The thoracic scoliosis spine exhibits a hypokyphosis, which means that P-A thoracic or adjusting the "high side of the rainbow" is contraindicated. We have noticed that when the spine loses its normal lateral curves, it adapts by developing A-P curves. In order to correct the scoliosis, the normal curves must be re-established first. In order to correct the scoliosis, the normal curves must be established. The upper cervical subluxation component has neurological ramifications with the spinocerebeller tracts of the spinal cord.
In order to change this, we utilize Mix, Fix, Set protocols. First, the spine needs to be prepared for the specific adjustment with warm-up procedures; this is the Mix step. The Fix part is specific upper cervical and spinal unit adjustments. The Set protocols involve specific spinal isometric exercises and scoliosis stretching exercises. The postural muscles and nervous system must be rehabilitated with proprioceptive neuromuscular reeducation. The average office visit for a scoliosis patient takes about two hours. The majority of the rehab is preformed by our spinal technicians with equipment we have developed. The most important change in the office is that the doctor has to think. There are scoliosis patterns, but no two scoliosis patients are the same. It isn’t easy; it is very humbling, but it is extremely rewarding. The tears in the patients’ and parents’ eyes when they find out they don’t have to be braced or have surgery is the ultimate reward.
TAC: What type of maintenance program do patients have to be placed on to maintain results?
Woggon: The scoliosis patient is a lifetime patient. They will be monitored at least twice a year and will be doing exercises for their entire life. Spinal hygiene is like dental hygiene; it is an ongoing daily process. This commitment isn’t unique to scoliosis patients, either—in my opinion, everybody should be doing exercises to maintain their spinal health. You can get a false set of teeth, but not a false spine.
TAC: How long does it take a doctor to learn how to treat scoliosis through your approach?
Woggon: CLEAR Institute offers a three-part scoliosis seminar series with the last weekend being a workshop, hands-on approach. We are currently working with on-line classes which will be ready this summer. We also offer advanced workshops at various clinics throughout the United States. These are under the direction of approximately twenty doctors who are on the Board of Advisors for CLEAR Institute. We are constantly implementing new ideas in regard to scoliosis care; these are also available on our website. Our goal is to continually provide assistance and encouragement to the doctor who decides to work with these patients. We have about three hundred doctors who have taken the seminar with clinics throughout the world, and an online support system to ensure their skills continue to develop after the seminar is finished.
TAC: Where do you see the future of chiropractic headed?
Woggon: I see chiropractic changing the world in regard to the screening and treatment of the scoliosis patient. I see the scoliosis patient being referred by the school nurse to a Doctor of Chiropractic, instead of an Orthopedic Surgeon, for conservative care for scoliosis. In the near future, society will look back and question why we would ever do spinal fusion surgery on a scoliosis patient. We will change people’s lives, one spine at a time.
TAC: Any final words for our readers?
Woggon: Albert Schweitzer said, "At that point in life where your talent meets the needs of the world, that is where God wants you to be."
You may contact Dr. Woggon at http://www.clear-institute.com/.