Arete Chiropractic

Innovative treatment relief for migraines and headaches with Upper Cervical Care

Nearly everyone has had headache pain, and most of us have had it many times. In fact, headaches and migraines affect 38 million people in the United States and is a leading cause of disability. The disease can be managed, but there is no cure, and many medications used to treat migraine have disabling side effects. Patients often prefer to avoid daily medication and seek nonpharmacologic options, including complementary and integrative therapies. Although migraine is a disease with multivariate symptoms that vary by patient, over 75% of migraine patients report associated neck pain, and many note musculoskeletal complaints, such as neck stiffness, muscle tension, or problems with jaw function. Most common triggers include:

  • Genetics: When studies are done on twins, there is as much as a 51 percent likelihood that they will both develop migraines. This is more likely in those with aura than those without. 

  • Triggers: Migraines often begin with triggers. Things like food, exhaustion, and weather have been known to trigger headaches. In fact, the majority of people who have migraines report having triggers as well. The trigger can occur as many as 24 hours before the migraine hits.

  • Physiological characteristics: Psychological stress has been reported to be a trigger for migraines in as many as 80 percent of the cases. Other things associated with migraines are PTSD (post-traumatic stress disorder), abuse, menstruation, oral contraceptive use, pregnancy, perimenopause, and menopause.

  • Dietary considerations: As many as 60 percent of people say they have food triggers. Some report such things as aged cheeses, red wine, chocolate, alcohol, MSG, too much or too little caffeine, and aspartame as possible triggers. However, no substantial evidence exists to prove this. 

  • Environmental features: Such things as changes in weather, barometric pressure, allergies, bright sunlight, lightning, and indoor air quality are potential triggers for some migraine sufferers.

It is most likely that migraines start with a neurovascular disorder that begins in the brain and spreads to the blood vessels. The central nervous system is definitely a contributing factor, along with brainstem malfunction. Can anything be done to alleviate migraine pain? An innovative treatment using The Blair Upper Cervical Care method focuses on treating the underlying problem that causes migraines and headaches. 

Migraine Graph.png

The missing factor: The Upper Neck 

Chronic Migraine headaches are caused by many different factors. An important factor is the relationship between chronic migraine headaches and the upper neck. Specifically how the base of your skull connects to the top couple of vertebrae in the cervical spine. C1 and C2, or Atlas and Axis, as they are called, are the most freely moving vertebra in the entire spine. This gives us a great range of motion in our neck but also means that when the body has trauma, it is an area that is likely to mis-align. A misalignment at the skull base interferes with nerve pathways, blood flow, and cerebrospinal fluid flow. Compromise to any of these systems can result in the symptoms of migraine headaches. At Areté Chiropractic we are experts in evaluating the alignment of the head and neck and how that affects spinal health and body balance. If a misalignment in the C1-C2 vertebra is a contributing factor to migraine headache, then reducing or correcting that misalignment will make a significant difference in how your body functions. We can often help people's bodies function better with less symptoms, or even recover completely.

A Study Gives Hope for Migraine Relief

In 2012, the Journal of Chiropractic Medicine relayed the findings of a study that involved a woman suffering from migraines and tremors. They were observing how the Blair technique, a specific type of upper cervical adjustment given by upper cervical chiropractors, would impact her health.

The woman was 39 years old and was having a migraine as many as 2 or 3 times a week. She had a history of having migraines since she was 10 years old. Her family doctor prescribed various medications —  acetaminophen, sumatriptan, Isometheptene, dichloralphenazone, propranolol, and numerous other over-the-counter pain medications — to no avail. While they gave her some relief, it was only temporary at best. 

She agreed to give upper cervical chiropractic care a try. She received specific adjustments to her upper cervical spine, specifically the C1 (atlas) and C2 (axis) bones of the upper neck. After her very first adjustment, she noticed that her migraines and tremors were both improved! She continued seeing good results over the next four months. 

The headache disability scale was used in her evaluation. This is a scale using 1 – 100 points (52 for emotional and 48 for functional disability) to indicate how much damage the headache being endured is causing in one’s life. The higher the score, the greater the disability. These were her results before having her adjustment by the chiropractor:

  • Total: 68/100

  • Emotional: 28/52

  • Functional: 32/48

After four months of care, she was re-evaluated and these were her new scores:

  • Total: 14/100

  • Emotional: 4/52

  • Functional: 10/48

This is truly good news if you suffer from migraines!

Upper Cervical Chiropractic | Cranio Cervical Syndrome

What is Upper Cervical Chiropractic Care? 

Upper Cervical Chiropractic spinal corrections provide relief to millions of migraine sufferers by releasing pressure and stress from the spine and nervous system. Research from 2015 showed that people who received upper cervical manual adjustments reduced their drug consumption by 80%, lowered days of migraines per month by 97%, and experienced an amazing decrease in pain and functional disability associated with migraines by 100%. 

Nutrition, stress, hormones, and other lifestyle factors also play a role in the intensity and extent of migraines. The core of all of these factors connects to the role of the central nervous system. The brain and nervous system direct the control and function of the entire body. Chiropractors assess and address specific areas of function in the nervous system through appropriate care of the spine. Every Upper Cervical Chiropractic adjustment helps improve communication between the brain and the body, reducing stress from the central nervous system. 

Five lifestyle tips to address the cause of migraine headaches:

1) Chiropractic adjustments to correct spinal alignment and pressure in the upper neck

2) Remove dietary neurotoxins (artificial colors, sweeteners, and preservatives)

3) Increase water intake

4) Increase high quality sleep

5) Engage in regular body movement through exercise and increased heart rate

WHY MEDICATION IS OFTEN INEFFECTIVE FOR CHRONIC MIGRAINES

While medication may temporarily help with the symptoms of a migraine, there is no miracle pill that will stop the next migraine from occurring. Plus, many medications can produce more headaches when taken frequently and for long periods of time. The result is a cycle where one medication is taken to deal with migraine headache pain until it begins causing them and then the medication is switched, and the process starts again.

Other treatments involve dangerous Botox injections or a journal in which you record foods, activities, etc. to determine potential migraine triggers and avoid them. Are you tired of the run-around, the trial and error, and the side effects?

Portsmouth best chiropractor

UPPER CERVICAL CARE FOR MIGRAINES

Using the Blair technique, we locate and correct very specific misalignments of the upper neck. Such misalignments can result in reduced blood and cerebrospinal fluid flow to the brain. They can also affect communication in the body by placing pressure on the brainstem, as well as creating muscle tension and joint dysfunction. Once these issues are relieved through an adjustment, healing can begin.

So, if you or someone you know suffers from migraines, Upper Cervical Chiropractic care may be a very helpful tool to regain quality of life and function. Call our office today to find out more or to schedule an Initial Consultation today. 

603-380-9184






Living Pain-free without medication

Raya is a photographer and was suffering with pain in her left shoulder and through her rib cage, especially when she was working a long or stressful photo shoot. As you can imagine, this continuous problem was beginning to take a toll her body and get in the way of her ability to function while doing her job. 

After getting her spine checked and "getting her head on straight", Raya's body balance has been restored, relieving her nagging pain. She has been holding her alignment (meaning she does not need to be adjusted) for three months. She is able to power through those long photo shoots and stressful situations without resorting to medications and is out there sharing her passion with the world!

Protect your lower back in standing forehead to knee Pose

Standing poses are fantastic for improving balance and as an added benefit, this pose stretches those often too tight hamstrings.  Yet the standing forehead to knee pose is one that I see done incorrectly the most.  The chiropractor in me winces because I know how easy it is to compromise the lower back when this one is done incorrectly.  

If you are holding up that outstretched leg with your arms, and you know who you are, then you are at risk for straining your lower back.  With the weight of the leg in the arms and your lower back folded over, you're putting a lot of pressure on your spine, and the muscles in the lower back.  The group of muscles at risk is called your erector spinae muscles.  In an ideal world, the leg should actually be held up by its own strength and supported with the abdomen. 

Test yourself to see if you can stand on one leg and extend the other out without using your hands for support.  If you can, you're ready for this pose.  If not, then back off a bit: standing up right with the leg outstretched just at a lower angle or even with the knee bent.  In these modified versions you will still get the benefit of improved balance and increase muscle strength, all while your lower back is being protected! 

Vertigo, TMJ, and neck pain helped with Upper Cervical Care

Jeremy came in 6 months ago with severe bouts of vertigo. He had a concussion during a hockey game 3 years prior and had been struggling with vertigo for the last two years. The symptoms had progressed to the point where he wouldn’t be able to get off the floor or leave the house for days because he was too dizzy and nausea and couldn’t trust his balance. Jeremy experienced constant whooshing in his ears with temporomandibular joint (TMJ) pain and dysfunction (TMD). He also had neck and low back pain and stiffness.

Jeremy has been under upper cervical chiropractic care now for six months. He has not had any bouts of vertigo since starting care and his neck pain, jaw pain, whooshing in his ears and his low back pain are all much improved. Jeremy is back outdoors hiking and doing the things he loves again!

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?

Whiplash Relief with Upper Cervical Care

Craig was in a bad head-on motor vehicle accident about five years ago, which had suffered from bad whiplash.  When he first came in about eight months ago, he felt unstable in his spine, he had left arm pain, numbness and tingling, as well as low back and neck pain.  Also after the accident, he found that he couldn't work out with being in pain or injuring himself. After the first four weeks of corrections, Craig was reporting dramatic improvements and was able to get back in the gym. Now he has been holding his alignment for about six months - meaning he hasn’t needed to be adjusted! He has his confidence back and is feeling strong!

MIGRAINE AND BACK PAIN RELIEF AFTER CAR ACCIDENT WITH UPPER CERVICAL CARE

Car accidents can be traumatic and life changing. They can leave you with chronic headaches, neck and back pain, and rob you of your ability to concentrate and complete day to day tasks. Janelle was in a car accident and suffered with those symptoms for over a year before finally finding relief with Upper Cervical Care.

One of the most common injuries car accident victims experience is whiplash, which occurs when the tissues supporting the head and neck are damaged and the bones in the neck are forced out of alignment. No one wants their neck cracked or twisted after getting whiplash, but the technique we use involves gentle adjustments that cause no additional trauma to the neck and give the body time to heal.

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. 

Grip Strength in Athletes improve with Cervical Adjusting

The Effects of Cervical Spine Manipulation on Judo Athlete’s Grip Strength

Botelho, M.B., DC, Andrade B. B. MD, PhD. JMPT, November 2011

 

This article is straight forward and provides an excellent reference for those Upper Cervical chiropractors interested in athletics.  The test population didn’t suffer from any particular condition, in fact they were male and female athletes from a nationally competitive judo team and cervical spinal manipulative therapy (or adjustments to the chiropractic community) made a statistically significant difference in their grip strength! 

 

The study includes 18 athletes randomly assigned to either a treatment group or a sham adjustment group.  The subjects where given 3 SMT within 3 weeks with a minimum of 36 hours between treatments.  Grip strength was tested using a hydraulic dynamometer immediately before and after treatment.   Grip strength improved in each hand pre and post intervention each time, the level of improvement was statistically significant, while no statistically significant difference was noted in the sham treatment group. 

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.  

Trigeminal neuralgia and migraine pain: One patient's response

Trigeminal neuralgia and migraine pain: One patient's response

Trigeminal Neuralgia and Chronic Migraine: One Patient's response to Blair Upper Cervical Care

Is your Back Pain shrinking your Brain?

Chronic Back Pain is Associated with Decreased Prefrontal and Thalamic Grey Matter Density

Apkarian V.A., et al.  Journal of Neuroscience, Nov 2004, 24(46):10410-10415

This research was out of Northwestern University in Chicago Illinois in 2004.  It was the first study to correlate chronic back pain (CBP) with decreased grey matter in the brain.  As we work with patients every day, people who have chronic unremitting back pain for 1 year or more have an accelerated neurodegenerative process underway in their brain.  If we are able to help them we are playing an active role in slowing that process!

The researchers studied 26 people with chronic back pain (unrelenting pain localized around lumbosacral area for greater than 1 year) and 26 control patients.  They performed 2 different types of analysis for estimating global grey matter in the brain and adjusted statistics for age, gender, and type of pain (musculoskeletal and neurogenic/radicular). 

Clinical Pearls:

Normal whole brain grey matter atrophy is 0.5% per year.

Atrophy caused by CBP was measured at 5-11% per year, the equivalent of 10-20 years of aging.

The reduction in grey matter was localized to the dorsolateral prefrontal cortex (DLPFC) and the thalamus.  The DLPFC is responsible for inhibition of the orbitofrontal activity of the brain.  The orbitofrontal area is responsible for perception of pain.  The researchers then extrapolated that with loss of inhibition of the orbitofrontal areas of the brain, chronic pain suffers perceive increased pain.

Patients with neuropathic pain showed a greater loss of cortical grey matter.

Is one leg shorter than the other?

Is one leg shorter than the other?

“approximately 90% of the population have anatomical difference in leg length, averaging 5.4mm(~3/16in)…whereas a difference of more than 20mm(~3/4in) is considered clinically significant in contributing to various musculoskeletal pathologies.”