Help with Daily Headaches

Gail was referred to our office by another doctor who she had been seeing for chronic daily headaches.  Every morning Gail would wake up with a headache, and depending on how severe her head pain was she would plan her day around it.   When she came in, we identified a misalignment in her upper neck.  Her C1 vertebra, called the Atlas bone, was out of alignment and compromising the nerves at the skull base.  She was struggling with this problem for over 8 years!  After careful analysis and gentle correction, Gail is no longer waking up with headaches.   

Our favorite part is when Gail shared that she is allowing herself to look forward to her son's wedding.  She said that before care she didn't let herself look forward to his wedding because "what if she woke up with a bad headache that day".  Now she can confidently look forward to that day with her family.  

Reverse Warrior: Engage your abdominal muscles to spare your spine!

Reverse warrior posture is one of the foundation poses for many yoga practices and is one of my favorites.  It just feels so good to get that deep stretch through the side body while strengthening your legs.  Although as with all yoga poses, alignment is crucial for this posture or lower back injuries can be created or exacerbated.  There is so much going on in this posture that it can be easy to forget to engage your abdomen as you lean back and yet it is crucial to remember this to protect your lower back.    

In this posture you are not just leaning to one side but your also leaning back.  This oblique movement can be compromising to your lower back and should be avoided if you have a recent injury.  Even with the healthiest backs, remember that this movement starts and ends in your abs! 

Low Back Pain and Headaches Improved with Upper Cervical Care

We all know that pain and fear of injury can stop us from doing the things in life that we really want to do and make us feel...well...just not like ourselves. Ryan came to us experiencing low back pain, which was keeping him from exercising. Ryan was becoming frustrated because when he would exercise, his low back would flair up. He was also getting headaches two to three times a week and neck pain. Ryan’s upper cervical spine was corrected and immediately he felt the pressure off his low back. He has now had four upper cervical corrections and his low back pain, neck pain and headaches are all dramatically improved just by getting his head on straight! Is your head on straight?

WARRIOR THREE POSE FOR A STRONGER CORE AND BACK

Warrior three pose or Virabhadrasana III is a more advanced posture and requires the practitioner to have a solid foundation and balance.  This is a pose that is wonderful for strengthening: ankles, legs, back, core, and shoulders.  It is also a pose that if done incorrectly can cause some problems in the body, especially for the hip of the standing leg and for the lower back.  For the ideal benefits of this pose make sure that your foot, knee, hip, shoulders, head and arm of the raised leg are in a straight line, and that the raised leg, toes, hip points, and fronts of the shoulder all point towards the ground.  

This pose also helps with focus, concentration and invigorating the body.   

Remember that keeping a body moving is an important part of keeping a body healthy! 

Happy Practicing. 

Surgery Cancelled after beginning Upper Cervical Care

Have you ever stopped being active because of pain?  Check out Lauren's story.    Being in constant pain is draining.  Regardless of if you have had specific head or neck trauma or if you are in the category of years of pore posture, neck pain runs the gamete from annoying to debilitating.  Pain in the neck can arise from many of the various structures in this complex part of the body.  One of the most common is due to degeneration of the vertebra and joints causing bone spurs or bony growths.  Here we're going to break that process down.  When a trauma occurs and a joint in the neck is locked out of place (most commonly the 1st cervical vertebra) it then changes how that joint and the rest of the joints in the neck move.  When there is altered movement at a joint it creates inflammation and instability.  The body's response to instability is quite brilliant in fact, it's going to lay down more bone to try to stabilize that area.  This response is a natural process in the body, and like we said it's pretty brilliant because it takes DECADES for bone to degenerate to the point where it is drastically affecting function.  When the human body was evolving and our life expectancy was 40 this process was not a problem.  However if we want to stay pain free and active into our 70's-80's or even 90's we need to restore that joint motion as best we can!  This is where gentle specific upper cervical chiropractic can help your body feel better and function better.  Just ask Lauren.  

Imaging of the ligaments in the Upper Neck

Follow-Up MR Imaging of the Alar and Transverse Ligaments after Whiplash Injury:

A Prospective Controlled Study

Vetti N., Krakenes J. et al. American Journal of Neuroradiology 32: 1836-41, Nov 2011

Why do we do research? To answer questions?  Yet, how often do we seek out research that validates our paradigm?  My guess would be almost always.  Therein is the problem.  To be a true question, we must not think we already know the answer or outcome.  That was the reason that this study caught my eye.

This study was a prospective case controlled study that followed 91 symptomatic whiplash patients and 52 neck pain control patients for 1 year.  MR Imaging was done at baseline on neck pain patients and after the accident and on a 1 year follow up, results were also correlated with the neck disability index. 

The inclusion criteria for the whiplash included: MVA in the past 7 days with onset of neck pain within 48 hours.  No previous history of neck pain, and classified as WAD 1-2 (Whiplash Associated Disorders without any neurological signs, factures or dislocations).

The symptomatic control patients were included when they reported to an outpatient spine clinic with a history >3 months of neck pain with a non-traumatic onset.

The researchers concluded that the areas of high signal intensity (indicating inflammation/fibrosis/fat replacement) in the alar and transverse ligaments did not change significantly at baseline or at 1 year follow up for WAD patients.  Further the prevalence of the alar and transverse ligament high signal intensity did not differ significantly between traumatic and non-injured neck pain controls.

What the researchers concluded is that the alar and transverse ligament high signal intensity in patients with WAD1-2 observed in the first year after injury cannot be explained by the trauma.

Clinical Pearls:

“High signal intensity could theoretically be due to altered ligament function cause by neck pain.”

“Pain induced immobility causes morphologic changes in muscles, tendons and ligaments.”

“High signal intensity of the alar and transverse ligaments is also reported to be frequent in healthy non-injured persons without neck pain.”

Author’s Note: This study is a bit confounding however provides an interesting observation on neck pain related MR imaging. 

Fibromyalgia responds to upper cervical care: A Case Study

Alibhoy N. Resolution of Fibromyalgia Following Upper Cervical Chiropractic Care: A Case Study. J. Upper Cervical Chiropractic Research; June 20, 2011.

The case follows a 45 year old fibromyalgia patient with additional complaints of migraines, neck, upper back and low back pain, numbness in her fingers, bilateral sciatica, right knee pain, depression and duodenal ulcer.   She had a history of two major cervical traumas and 11 car accidents, and had seen 5 different chiropractors in 12 years.  Her activity levels were severely limited and she frequently used a wheel chair. 

Knee Chest protocol was used and the patient was seen 79 times in 17 months with 47 adjustments performed to both atlas and axis. 

At resolution of care the patient did not need the use of her wheel chair and self-reported fibromyalgia and left leg sciatica, right knee pain, chronic back pain and migraines had completely resolved.  Right leg sciatica improved 98%.  The patient was also no longer taking any of her previous routine medications. 

 Case studies are an invaluable starting point for more in-depth research.    

Will how adjusting my neck affect my hip pain?

The Effect of Upper Cervical or Sacroiliac Manipulation on Hip Flexion and Range of Motion

Pollard, DC, MS, Ward, PhD.  JMPT 1998; 21(9);611-616

Your going to adjust my neck and it will help my hip feel better?   How often have you heard this question in your office?  The following study although a few years old points to a positive correlation and gives a compelling hypothesis for the connection.

This study compared the effectiveness of an upper cervical manipulation and a manipulation of the SI joint for increasing hip range of motion in 52 subjects ages 18-34.   Testing methods where performed using a hand held digital electrogonimometer.  The patients performed a straight leg raise before and after the treatment.  The three treatment groups included just cervical manipulation, just SI joint manipulation (side posture) and the third received a sham adjustment of pressure on the mastoid process.  Range of motion was tested prior to manipulation, the patient received one treatment and then range of motion was re-tested. 

Both spinal manipulation groups demonstrated increased flexion of the hip however only the upper cervical manipulation increased hip flexion range of motion significantly. 

The potential mechanism discussed is that of the tonic neck reflex.  Changes in the muscle spindle output of the suboccipital muscles may cause reflexive proprioceptive changes to centers that control posture.   The muscles of the pelvic girdle are some of our primary posture stabilizers.  

Is your neck pain affecting your balance?

Chronic neck pain, standing balance, and suboccipital muscle atrophy--a pilot study

 McPartland JM, Brodeur RR, Hallgren RC, JMPT 1997 Jan;20(1):24-9

This study was completed at the University of Michigan and looked at 7 chronic neck pain patients and 7 controls.

The purpose of the study was to examine the relationship between chronic neck pain, standing balance and sub-occipital (the base of the skull) muscle atrophy. 

Palpation was used to determine any somatic dysfunction (misalignment) of the upper cervical spine (top of the neck), a force platform was used to measure standing balance, and MRI was used to examine fatty infiltration (evidence of injury and disfunction) of the sub-occipital muscles.

The study found that chronic neck pain patients have almost twice the amount of somatic dysfunction (tenderness, asymmetry of joint position, restriction in range of motion, and tissue texture abnormality) as compared to normal subjects. 

The greatest changes where noted at C0-C1 (where your skull meets your neck) joints and the authors concluded that this area needed the greatest amount of consideration during evaluation.  (IE upper cervical chiropractic)

Further the study showed that chronic neck pain patients demonstrated a decrease standing balance using a force plate, and MR imaging indicated that they had increased atrophy of rectus capitus posterior minor and rectus capitus posterior major. 

The authors also have a wonderful discussion with a compelling hypothesis of the far reaching implications of chronic neck pain…

“Somatic dysfunction can cause a sustained facilitation of motor neurons and reflex contraction of muscles, which may lead to impaired circulation and localized tissue ischemia, followed by atrophic changes in muscles and fatty degeneration.  Muscle atrophy and degeneration have been associated with chronic pain.  Muscles in the cervical region also contain a high density of muscle spindles… Atrophy of these muscles might reduce proprioceptive input into the dorsal horn of the spinal cord and higher centers… A reduction of proprioceptive input might result in facilitation of neural activity which is perceived by the patient as chronic pain.”

In review:  Misalignment of the upper neck causes changes in the muscles and nerves in that area that affect your standing balance!  Standing balance influences your posture, your posture contributes to breathing, hormone production, blood pressure, and more because it’s all connected! Further, the longer you have the neck pain the more negative changes develop.