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Frequently Asked Questions
Getting Started
Precision Spinal Care is a chiropractic and spine care clinic in Chesapeake, Virginia, serving the Hampton Roads area since 2002. We focus on identifying the root cause of spinal pain and injury through thorough examination, advanced diagnostic testing, and evidence-based treatment. Our services include NUCCA chiropractic, rehabilitation therapy, massage therapy, StemWave therapy, orthotic bracing, biomechanical assessments, and referral coordination with medical specialists when needed.
Dr. David Packer, DC, FSBT, is the clinic director of Precision Spinal Care and the only board-certified NUCCA chiropractor in the Hampton Roads area. He holds a Fellowship in Spinal Biomechanics and Trauma (FSBT) through SUNY Buffalo Jacobs School of Medicine, which included interdisciplinary training in orthopedic surgery, neurosurgery, neuroradiology, MRI imaging, pain management, and emergency medicine. His additional credentials include crash dynamics, medical-legal documentation, and trauma triage and treatment protocols. Dr. Packer serves on the Chesapeake Regional Hospital Foundation Board of Directors and has served as a credentialed expert witness in personal injury cases in Virginia courts. He is also a U.S. Navy veteran.
We treat a wide range of spine-related conditions, including neck pain, back pain, headaches and migraines, whiplash and auto accident injuries, disc bulges and herniations, sciatica, spinal ligament injuries, degenerative disc disease, reduced range of motion, TMJ (temporomandibular joint dysfunction), postural imbalance, vertigo and dizziness, balance issues, radiating pain into the arms or legs, and knee pain. If we determine during your exam that your condition requires a different type of care, we will refer you to the appropriate medical professional.
No. You do not need a referral from another doctor to schedule an appointment with us. You can call our office directly or book online.
Yes. We see patients of all ages. NUCCA can be particularly beneficial for older adults or anyone with a frail or sensitive body because of how gentle the procedure is. The precision of the technique and the absence of forceful manipulation make it appropriate for a wide range of patients.
Our $49 New Patient Spine Exam is designed for patients with general spine-related concerns (not auto accident or personal injury cases). It includes a health history consultation, a biomechanical, orthopedic, and neurological examination, and cervical X-rays if medically necessary at no extra charge. Dr. Packer will also review any prior imaging you bring in, such as MRIs, X-rays, or CT scans. After your exam, you will receive a separate follow-up appointment where Dr. Packer reviews your findings with you in detail and discusses your options.
Bring a photo ID, any insurance cards you may have, relevant medical records, and any prior imaging results such as X-rays, MRI, or CT scans. Dr. Packer will review any imaging you bring as part of your evaluation. If you were in an auto accident, also bring a copy of the police report and any documentation from the ER or urgent care if you were seen after the accident. You can complete your new patient intake forms online at our website before your visit. If you need to send us any records or documents ahead of time, you can email them to reception@precisionspinalcare.com.
Be as open and thorough as possible. Important details include any recent injuries, prior history of neck or back pain, previous surgeries or treatments, current medications, and how your symptoms affect your daily activities. The more information Dr. Packer has, the more accurate your evaluation will be.
New patient appointments for both general chiropractic and auto accident evaluations can last up to two hours. StemWave new patient appointments can last up to an hour and a half. We encourage all new patients to complete their intake paperwork online before their visit to save time.
Typically, no. The first visit is dedicated to a thorough evaluation so Dr. Packer can identify the root cause of your problem before recommending a course of treatment. NUCCA corrections require Dr. Packer to carefully study your X-rays and calculate a correction formula specific to your individual misalignment before any adjustment can be made. Rushing into treatment without a proper diagnosis can lead to poor outcomes. Once your exam results are reviewed, a treatment plan will be developed and discussed with you at your follow-up review of findings appointment, which is when treatment can begin.
We verify your health insurance coverage at your first visit. Because chiropractic coverage varies widely from plan to plan, our staff will review your specific benefits so you understand what is covered before treatment begins. If you have questions about your coverage ahead of time, you are welcome to call our office and we can help walk you through it.
Questions About NUCCA
NUCCA stands for National Upper Cervical Chiropractic Association. It is a chiropractic method that focuses on the alignment of the upper cervical spine (the upper neck area), specifically the relationship between the head and the top bone of the neck called the atlas. NUCCA has been practiced since 1966. Diagnosis and treatment are based on precision X-ray analysis, and each correction is mathematically calculated from your individual X-ray measurements rather than applied through generalized force. This level of accuracy is what sets NUCCA apart. The X-ray analysis allows Dr. Packer to identify the exact direction and degree of your misalignment and develop a correction formula specific to you, with over 10,000 possible combinations. No two patients receive the same adjustment.
Traditional chiropractic adjustments often involve a twisting motion and an audible pop. NUCCA is very different. There is no cracking, twisting, or popping of the neck or back. During a NUCCA correction, you will feel only a light, controlled pressure behind the ear. The correction is gentle enough that many patients don’t realize it has been performed.
Beyond the gentle approach, NUCCA differs in its clinical focus. By restoring proper alignment of the upper cervical spine, NUCCA addresses the structural foundation that influences the entire spinal column. This can lead to improvements in neck and back pain, headaches and migraines, vertigo and dizziness, balance, TMJ dysfunction, postural imbalance, and radiating pain into the arms or legs. Because the upper cervical area houses critical neurological structures, correcting misalignment there can have wide-reaching effects throughout the body.
NUCCA is also well suited for patients recovering from injuries and trauma, including car accidents. The precision of the X-ray analysis and the controlled nature of the correction make it a safe and accurate treatment option for patients whose spines have been compromised by impact or force.
The same principle that allows you to move a heavy load with a wheelbarrow: leverage. The doctor positions their body at a calculated angle specific to your individual misalignment pattern. Using the atlas vertebra and the weight of the head as a biomechanical lever, the force is transferred to the spine in a controlled and precise way. Because the correction is calculated from detailed X-ray measurements, it does not rely on force to be effective. It relies on accuracy.
This is one of the most common questions we hear. Although the NUCCA correction is performed only at the head and neck, the atlas vertebra sits at the top of the spinal column and directly influences the alignment and balance of the entire spine, all the way down to the hips.
When the atlas is misaligned, the body compensates by shifting posture to keep the head level. Over time, these compensatory shifts place abnormal stress on the muscles, joints, and discs of the mid-back, lower back, and pelvis. This can lead to muscle spasms, pelvic tilt, disc irritation, and compression of the sciatic nerve. By correcting the atlas misalignment, NUCCA restores spinal balance from the top down, which can relieve the compensatory strain that is causing lower back, sciatic, and hip pain. We treat patients with these conditions regularly.
Yes. Because NUCCA involves no twisting, cracking, or forceful manipulation of the spine, it is a well-suited option for prenatal care. Pregnancy places significant stress on the spine and pelvis, and maintaining proper spinal alignment during pregnancy can support comfort and overall function. Many of our patients continue NUCCA care throughout their pregnancy.
During your first visit, Dr. Packer will perform a thorough physical examination, review your medical history, and take X-rays if appropriate. These results will determine whether your condition is related to a biomechanical issue that NUCCA can address. If NUCCA is not the right fit, Dr. Packer will explain your condition and recommend the type of care or provider best suited to your needs.
That is completely understandable, and you are not alone. Many of our patients come to us specifically because they are uncomfortable with traditional chiropractic adjustments. NUCCA does not involve any cracking, popping, or twisting of the neck or back. The correction uses a light, controlled pressure that most patients barely feel. If you have had a bad experience with chiropractic in the past or the idea of having your neck or back “cracked” makes you uneasy, NUCCA is a fundamentally different approach. Dr. Packer will walk you through everything before any care is performed, and you will never receive treatment without understanding exactly what is being done and why.
Treatment & Recovery
This depends on the nature and severity of your condition. Some patients notice improvement early in their treatment, while others with more complex injuries require more time. Evidence-based medical science indicates that damaged spinal ligaments typically take 8 to 12 weeks to repair. Dr. Packer will set clear expectations during your consultation and reevaluate your progress at regular intervals, typically every 30 days.
The number of visits varies from patient to patient based on the type of injury, how long the problem has been present, and how your body responds to care. After your initial evaluation, Dr. Packer will outline a treatment plan that includes an estimated timeline, frequency of visits, and specific goals of care.
Treatment typically follows three phases. The first phase focuses on reducing pain and stabilizing the area of injury. The second phase, which generally spans 8 to 12 weeks, focuses on repairing damaged tissue and restoring proper spinal mechanics. Biomarkers are reevaluated every 30 days to track objective progress. The third phase, if needed, focuses on rebuilding strength and flexibility through rehabilitation therapy, massage therapy, home exercises, or periodic maintenance visits.
Our services include NUCCA chiropractic care, rehabilitation therapy, licensed massage therapy, StemWave shockwave therapy, intersegmental traction, cervical and flexion-extension X-rays, AOMSI (Alteration of Motion Segment Integrity) ligament analysis, range of motion testing, DynaROM with surface EMG (electromyography), orthopedic and neurological assessments, orthotic brace fitting through Precision DME, and the ability to order MRIs and CT scans. We also coordinate referrals to neurologists, orthopedic surgeons, neurosurgeons, pain management physicians, and primary care providers based on your exam findings.
StemWave therapy is a non-invasive treatment that uses focused electrohydraulic shockwaves to address musculoskeletal pain. It is FDA-cleared and works by stimulating your body’s natural healing response, increasing blood flow, and triggering the migration of your own stem cells to damaged tissue. StemWave can be used on knees, shoulders, hips, and other areas. During your first StemWave visit, Dr. Packer will perform a health history review and orthopedic exam, then use the device in a diagnostic mapping session to determine if you are a candidate.
Yes. We provide rehabilitation therapy, which is similar to physical therapy, and we have a licensed massage therapist (LMT) on staff. Rehabilitation therapy helps improve flexibility, strength, and stability in the muscles that support your spine. Massage therapy helps reduce muscle tension, improve circulation, and support recovery. Both services can be incorporated into your overall treatment plan.
Yes. Dr. Packer’s approach begins with conservative care, and part of his role is to determine whether your condition can be managed without surgery or whether a surgical consultation is warranted. Through his Fellowship in Spinal Biomechanics and Trauma, Dr. Packer received interdisciplinary training alongside orthopedic surgeons and neurosurgeons, which gives him the clinical foundation to recognize when a patient’s findings indicate a need for surgical evaluation. If your condition does not respond to conservative treatment, or if your exam and imaging reveal findings that require surgical intervention, Dr. Packer will refer you directly to the appropriate surgeon with thorough documentation. Proper biomechanical assessment before surgery can also help ensure the patient is in the best possible spinal alignment prior to a procedure, which can support a better surgical outcome.
Absolutely. If your exam reveals a condition outside the scope of chiropractic care, Dr. Packer will refer you directly to the appropriate medical professional. This may include neurologists, orthopedic surgeons, neurosurgeons, pain management physicians, or primary care providers. Coordinating care across providers is a core part of how we practice.
Yes. Chiropractic care is not appropriate for every condition. Issues such as spinal fractures, tumors, and certain conditions requiring surgical intervention fall outside the scope of chiropractic treatment. If Dr. Packer identifies a condition during your evaluation that requires a different type of care, he will refer you to the appropriate provider.
Orthotic Bracing
Yes. Through Precision DME (Durable Medical Equipment), our accredited supplier, we offer custom-fitted and prefabricated orthotic bracing for spine and knee conditions. We have a certified orthotic fitter on staff who will customize your brace to your specific needs.
We provide LSO (lumbar sacral orthosis) braces for lower back support, TLSO (thoracolumbar sacral orthosis) braces for mid-to-lower back support, and knee braces. All braces are selected and fitted based on your medical needs and your doctor’s prescription.
A physician’s prescription is required for orthotic bracing. If you already have a prescription, contact our office and we will coordinate the insurance approval and fitting process. If you do not yet have a prescription, reach out to us and we can help you work with your doctor to obtain one. Once approved, we will schedule a fitting appointment. Our staff also handles insurance billing and can help you understand your coverage.
Auto Accident Injuries
Yes. Through Precision DME (Durable Medical Equipment), our accredited supplier, we offer custom-fitted and prefabricated orthotic bracing for spine and knee conditions. We have a certified orthotic fitter on staff who will customize your brace to your specific needs.
The personal injury new patient exam includes a health history consultation, a biomechanical, orthopedic, and neurological examination, and cervical X-rays if medically necessary. In addition, it includes specialized testing for auto accident injuries. This includes a spinal ligament instability study using SpineCamp analysis, which evaluates whether the ligaments that hold the spinal vertebrae together have been damaged. It also includes DynaROM with surface EMG (electromyography) testing, which measures how the muscles along the spine respond during movement to detect abnormal guarding or muscle spasm patterns that may indicate injury. When indicated, Dr. Packer will order MRI through Chesapeake Regional MRI-CT Diagnostics using a specific imaging protocol designed to accurately capture auto injury findings. Personal injury patients are typically seen without upfront costs, as treatment is billed through their auto insurance or a medical lien.
Common injuries include soft tissue damage to muscles, ligaments, and tendons (including whiplash), bulging or herniated discs, spinal ligament tears, nerve compression, reduced range of motion, headaches, and radiating pain into the arms or legs. Some of these injuries may not produce symptoms for days or even weeks after the accident.
Whiplash occurs when the head and neck are rapidly forced back and forth during an impact. This motion can damage the cervical ligaments, discs, and muscles. Ligaments have a relatively poor blood supply, which means they do not heal the way muscles do. Without proper diagnosis and treatment, whiplash injuries can lead to chronic pain, instability, and long-term functional limitations.
Yes. The amount of visible damage to a vehicle is not a reliable indicator of whether the occupants were injured. Modern bumpers are engineered to absorb and release energy during impact, which means a car can sustain crashes well beyond 5 mph without showing significant exterior damage. Research has shown that occupants can sustain injuries in collisions where there is little to no visible damage to the vehicle. In fact, when a bumper absorbs and then releases energy, the forces transmitted to the occupant can actually be greater than the forces the vehicle absorbed. Neck muscle injury, ligament damage, and disc injuries have all been documented in low-speed collisions. If you were in an accident and are experiencing any symptoms, even if the damage to your vehicle appeared minor, a proper evaluation is important.
Spinal ligament injuries account for a significant portion of auto accident injuries, but they do not show up on standard X-rays, MRI, or EMG/NCV (nerve conduction) testing. Without specialized biomechanical testing, there is no way to determine whether a ligament sprain is a minor Grade I irritation, a partial Grade II tear, or a complete Grade III tear. Proper grading matters because Grade II and III injuries may result in permanent damage if left untreated. Dr. Packer uses AOMSI (Alteration of Motion Segment Integrity) ligament analysis and other biomechanical testing to identify and document these injuries.
Yes. It is never too late to have your spine properly evaluated. Many patients come to us with chronic pain that traces back to an auto accident that was never fully diagnosed or treated. While earlier intervention is always ideal, a proper evaluation and targeted treatment can still provide meaningful improvement. That said, if you are pursuing a personal injury claim, be aware that there are legal time limits that may affect your case (see the statute of limitations question below).
That is perfectly fine. We work with personal injury attorneys throughout Hampton Roads and regularly coordinate with legal teams on documentation, medical records, and case-related communication. If you have an attorney, let us know at your first visit and we will make sure they receive the appropriate records and reports. If you do not yet have an attorney but think you may need one, we can point you in the right direction.
Yes. Every state has a statute of limitations, which is a legal deadline for filing a personal injury claim. In Virginia, you generally have two years from the date of the accident to file. In North Carolina, the deadline is three years. If you miss that window, you may lose the ability to pursue compensation for your injuries. This is one reason it is important to get evaluated and begin documenting your injuries as soon as possible after an accident. If you have questions about your specific situation, consult with a personal injury attorney.
No. Our personal injury services are focused exclusively on auto accident and motor vehicle collision cases. We do not handle worker’s compensation claims. If you have a workplace injury, we recommend contacting your employer’s worker’s compensation provider to find out which medical providers are covered under your plan.
Insurance & Payment
Many insurance plans cover chiropractic treatment, and most plans allow you to schedule directly with a chiropractor without a referral. Coverage varies widely from plan to plan, so our staff will verify your benefits at your first visit and review what is covered before treatment begins.
If your insurance does not cover chiropractic care, we offer several payment options. These include Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), CareCredit, Denefits payment plans, and our discount medical plan through Chiro Health USA. Our staff will work with you to find the option that fits your situation.
A personal injury lien is a promise of payment to your healthcare provider from the settlement of your case. If your provider accepts a lien, you may not have any upfront costs during treatment. Precision Spinal Care accepts personal injury liens in most cases and will typically see auto accident patients without upfront costs as long as treatment is medically necessary and related to the accident.
MedPay is an optional coverage included in some auto insurance policies that pays for medical expenses related to motor vehicle accidents. It is no-fault, meaning it applies regardless of who caused the accident, and covers both you and passengers in your vehicle. Filing a MedPay claim does not affect your auto insurance rates. Not all auto policies include MedPay, so check with your auto insurance provider to see if you have this coverage. Precision Spinal Care follows UCC guidelines for compliance with insurance company requirements when billing MedPay.
It depends on your situation. If your insurance company is covering your medical expenses and offering a fair resolution, you may not need legal representation. However, if your insurance company is pressuring you to settle early, denying coverage, or minimizing your injuries, an attorney can help protect your interests. Attorneys typically take personal injury cases on contingency, meaning there is no fee unless they obtain a settlement.
Scheduling & Office Information
We see patients Monday from 12:00 PM to 4:00 PM, and Tuesday through Thursday from 8:00 AM to 12:00 PM and 2:00 PM to 6:00 PM. Our schedule is designed so patients can come in before or after work.
No, we are an appointment-only office. However, we can generally see new patients as early as the next business day. If you have been in an auto accident and need to be seen urgently, same-day appointments are available by request.
You can call our office at (757) 382-5555 or book online through our website. We are located at 1305 Executive Blvd, Suite 170, Chesapeake, VA 23320.