Concussion from Impact to Chest Journal Review

“Concussion with primary impact to the chest and the potential role of neck tension.”

Journal of Open Sport and Exercise Medicine 2018

Most research papers on Concussion have focused on direct blows to the head. There have been a handful of papers that linked stretching of the soft tissue in the brainstem in the Craniocervical Junction (CCJ) to concussion. The paper we are looking at today studies impact to the chest, and estimates the strain put on the CCJ. The CCJ or Upper Cervical Spine can be a major component of Concussion and why Post Concussion Syndrome (PCS) symptoms don’t seem to resolve. If you had a concussion over 30 days ago and are still experiencing Concussion like symptoms, that is called PCS. This is a sign that the CCJ or upper cervical spine might be involved. Upper Cervical Chiropractors focus directly on analyzing and correcting the misalignment of the Atlas and Axis, or C1 and C2 vertebra, to bring proper fluid flow, nervous system balance, as well as structural balance back to the head, neck, and whole body. Gentle, vectored correction to the upper cervical spine might be what’s holding you back from health. Call an upper cervical specialist today to find out more.

In this study, impact testing was done to the chest of a helmeted and unhelmeted Anthropomorphic Testing Device (ATD), which is basically a test dummy. They also reconstructed two National Football League (NFL) collisions which resulted in concussions of the players from live footage. Lastly, they tested a Finite Element (FE) model to estimate the stretching of the cervical spine under tensile and flexion loading conditions. They found that the helmeted ATD had a 40% increase in neck tensile force and an 8% increase in neck flexion angle compared to the unhelmeted ATD. From this data the researchers concluded that strain in the upper cervical spine and the upper cervical spinal cord from neck tension is a factor in concussion. So, if you have been struggling with health problems like brain fog, fatigue, head pain, dizziness, and neck pain since a concussion incident; whether it was from a hit to the head, whiplash, or a hit to another part of the body, getting your Upper Cervical Spine assessed by an upper cervical specialist might be the next step to regaining your health. Call today at 603.380.9184 to find out more.

Upper Cervical Chiropractic Care and Bed Wetting

Chiropractic management of primary nocturnal enuresis. JMPT 1994

In this paper linked above, a chiropractic study was done at the Palmer Chiropractic Institute in Davenport Iowa on the management of 46 children with Primary Nocturnal Enuresis for 10 weeks. Primary Nocturnal Enuresis means children with consistent bed wetting incidents more than 2 times per week after the age of five that has never gone away. Secondary Enuresis would be if it came on and then went away for 6 months and then came on again. In the 10 week study, 25% of the children achieved a 50% or greater reduction in bed wetting incidents. Statistics say that approximately 5-7 million children suffer from chronic bed wetting. At age 5, it’s approximately 10-15% of the population, by age 8 that number goes down to 6-8%, and by age 15 years old it goes down to 1-2% of the children. It tends to affect boys more than girls. So if your child is suffering from this problem Chiropractic care can be a gentle and safe treatment option to give children their lives back. Give us a CALL TODAY to set up an initial evaluation.

You may be wondering what chiropractic care has to do with bed wetting. Chiropractic is a safe gentle means to balance the Nervous System. The Nervous system can be broken down into two parts: #1 the CENTRAL NERVOUS SYSTEM or CNS, which is the brain and spinal cord; and #2 the PERIPHERAL NERVOUS SYSTEM or PNS, which is the rest of the nerves that come off the CNS and go to EVERY SINGLE ORGAN TISSUE AND CELL IN THE BODY. The PNS can be broken down into more parts. One of them is the Autonomic Nervous System or ANS, which consists of the PARASYMPATHETIC and SYMPATHETIC nervous system (also called the fight or flight), and the rest and digestive systems. The ANS is what regulates and controls homeostasis and normal organ function in the body like: DIGESTION, BLADDER CONTROL, REPRODUCTIVE SYSTEM CONTROL, HEART RATE, LUNG CAPACITY, BREATHING, and many more systems.

So how can chiropractic help? The centers for the sympathetic system are located along the spinal cord in the mid spine and the parasympathetic centers are located in the brainstem and sacral plexus of nerves in the low back and pelvis. So if a child has had spinal misalignment from a very early age, it can create abnormal nerve flow which can cause dysfunction of the balance and control of organs like the bladder. These spinal misalignments might be from a traumatic birth process, stress in the womb, or through accidents that may have happened while learning to walk and crawl. Chiropractic is a gentle and safe way to realign the spine to balance the nervous systems of children. To see if your child is a good candidate for care CALL US today.

What are the other treatment options for chronic bed wetting? The paper titled Management of Primary Nocturnal Enuresis ( Pediatric Child Health 2005) talks about medications, behavioral therapy, and bed wetting alarms as the main treatment options. What the paper briefly mentions are the side effects of the medications which include things like headaches, constipation, and decline in mental health in children. All of those side effects are things all parents would want to avoid. There are some positive responses with the behavioral therapy along with the bed wetting alarm. Interestingly, chiropractic is not mentioned at all in the paper above, even though we see significant changes in bed wetting patterns in children quite often within the chiropractic profession. So if this is something your family is struggling with, give us a call at 603.380.9184 to find out more about how chiropractic can help.

Reflex control of the spine and posture

Reflex control of the spine and posture: a review of the literature from a chiropractic perspective. Journal of Chiropractic and Osteopathy, 2015

This paper is a review of the literature on the interactions of postural reflexes and how they influence the balance of the body from a chiropractic perspective. Chiropractic was founded on the idea that the nervous system controls and regulates all of the systems of the body, so if the nervous system’s ability to function is interrupted then the systems of the body start to lose function. Most of the literature in chiropractic discusses this direct nervous system, brain to body, connection to health. The objective of this paper is to define how posture plays an important role in maintaining the health of the body via direct reflexive control systems that rarely get talked about in the chiropractic profession. This set of direct postural reflexes control the alignment of the body in the earth’s gravity environment all day long and are constantly running in the background. What chiropractors tend to find is that when the posture goes into an abnormal state with one shoulder higher than the other, head tilt to one side, and hips rotated and higher than another with a functional short leg the physiology of the human body is greatly affected. Once this abnormal posture sets in, the nervous system breaks down and dysfunction begins to show up in the body. This is what Upper Cervical chiropractors work to fix. If you are noticing that your posture is taking a turn for the worst an initial evaluation with an upper cervical chiropractor will be able to tell you if you are a good candidate for care. You can call to set up an initial evaluation here.

9.8 m/sec^2, the force of gravity, is a constant force down upon the human body from the day we are born until we leave the earth. This resistance is pivotal to the growth and development of the human frame. We develop spinal curve in the womb; as we start to grow our spines take on a C shaped curve. Then when we are born we start to develop a curve in the cervical spine when we lift and hold our heads up, then we develop our lumbar curve when we learn to crawl and walk. These curves and the shape of the human spine gives structure to our bodies to resist gravity but that’s only half the story. Our nervous system has to then hold our structure up in gravity by constantly having checks and balances that tell us how to move and how to react to a dynamic environment to maintain a constant postural state and erect posture. These checks and balances include three major systems: the Vestibular (or inner ear) system, the Visual system, and the Mechanoreceoptive system in the; muscles, ligaments, tendons, and facet joints. These systems also talk to each other through the Vestibulo-ocular, vestibulo-cervical, occulo-cervical, and cervico-collic reflexes. All of these checks and balances are constantly sending afferent information to the brain about where your head is in space, how your head movement has changed the position of your trunk and how your trunk movement has changed the position of the head. What’s really fascinating is that they all work independently of each other but they also all need each other to keep the body truly balanced in a dynamic, gravity environment. So when someone is struggling with a multitude of chronic health issues whether it is a digestive issue or an issue with Migraines they could have a similar origin in the postural control center of the body. Getting your upper cervical spine checked by an Upper Cervical Chiropractor is the first step to correcting posture. Call us today.

Lastly the Upper Cervical Spine is the most dense area of postural reflexive control of the whole system. The first reason is that the vestibulocular, and spinocerebellar tracts of nerves in the spinal cord have direct connections to the upper cervical spine so when it is out of place it can affect the whole body’s posture. The second reason is that the upper Cervical spine has the the largest density of proprioceptors in the spine; meaning the largest amount of tiny gps muscle receptors that tell the brain how the body is balanced above the neck and below. If your Upper Cervical Spine is out of alignment, it could be shifting more than just bones. It could be setting up negative postural reflex patterns that wear and tear on your body’s joints, and your nervous system’s ability to communicate between the brain and the body. Don’t hesitate to call your local Upper Cervical Chiropractor if you are noticing that you are begin to develop poor posture and your spine seems out of alignment. Call us today for a thorough neurologic exam, and chiropractic assessment to get your posture back on track and your health on point. 603.380.9184

Trigeminal Neuralgia and Chiropractic Care: A Case Report

Trigeminal Neuralgia and Chiropractic Care: A Case Report.

The paper above is a case report of a chiropractor who treated a patient who suffered from Trigeminal Neuralgia (TN) for 7 and ½ years. She treated off and on with the chiropractor for 18 months and while under chiropractic care, reported a decrease in overall symptoms and at times a near resolution of symptoms while she was following the Chiropractors treatment protocol. This patient was a 68 year old female and had reported to the Chiropractor that it was her last straw and that she was all out of options, having treated with Acupuncture, Physical Therapy, pain medications, and anti-seizure medications for pain control. The sensation she was having ranged anywhere from electrical shocks on one side of her face, hot burning water, to bugs crawling across her skin. She did not obtain long term relief with any of these treatment options other than the chiropractic manipulation. If you are experiencing Trigeminal Neuralgia pain, chiropractic care may be able to help. An initial evaluation with a Chiropractor may be able to uncover some Upper Cervical problems that may be contributing to or directly causing Trigeminal Neuralgia. Call to set up an evaluation today.

Trigeminal Neuralgia (TN) has been termed the “Suicide Pain”. As stated by the patient in this study, it brings people to their knees by its sharp, sudden, severe, but brief stabbing, recurrent pain. The pain is in the distribution of the fifth cranial nerve. The risk of developing the problem (known as prevalence) for TN is 1/1000 for men and 2/1000 for women. The Incidence of TN is 4/1000 for men and 6.5/1000 for women. TN is approximately twice as common in females as males. Primary care physicians will encounter TN 4 times in a 35-year career and chiropractors even less, as stated by this paper. Upper Cervical Chiropractors who specialize in correcting misalignment in the C1 and C2 vertebra tend to see it more than what was reported here because of the chiropractic speciality. TN pain can be activated by a sensitization of the Trigeminal Nucleus, found just behind the Temporomandibular Joint in the skull. Patients that visit Upper Cervical Chiropractors often report more problems with their Upper Cervical Spine and craniocervical junction (which includes the bas of the skull). Therefore, TN comes up more frequently. The nucleus of the Trigmeninal nerve can get activated via the Trigeminocervical nucleus found in the Upper Cervical Spine, which has a direct nerve connection to the spinal nerves that arise at C1, C2, and C3 in the Upper Cervical Spine. Upper Cervical Chiropractors gently assess and realign C1 and C2 under the skull, to decrease the stimulus into the Trigeminocervical nucleus which fires up into the nerves in the face. If there has been trauma to the Upper Cervical spine via head and neck injuries, or repetitive poor posture from sitting at a desk for years, it can be a contributing factor or a causative factor of TN. So if this sounds like you, call an upper cervical specialist to be checked for Upper Cervical misalignment.

The treatment options for TN include Physical Therapy, medications like carbamazepine, gabapentin, pregabalin, and tricyclic antidepressants for pain. If these treatments don’t work to reduce the pain, usually the next step is decompression or compression of the nerve via surgery, or radiofrequency ablation of the nerve by burning it. This paper showed good success when treatment was consistent with manual manipulation of the Upper Cervical spine. So why not try a specialist in the Upper Cervical spine? Call us today! 603-380-9184

Review of Article on Malformations of the Craniocervical Junction

Review of research article titled “Malformations of the Craniocervical Junction Chiari Type 1 and Syringomyelia: (Classification, Diganosis, and Treatment.)” published in 2009 in the Journal of Muskuloskeletal Disorders.

Chiari syndrome was first described in 1883 by Cleland and was given its present day description by Chiari in 1891. By the mid 1970’s the term Chiari began to be used by the medical field to describe the condition.

The genetic component of Chiari Syndrome is understood to be a malformation of the Craniocervical junction (CCJ) or the Upper Cervical spine in which the developmental tissue doesn’t form properly. In most cases the Cerbellum has tonsils that descend down through the hole at the base of the skull called the Foramen Magnum (FM). In the worst cases some of the brain stem descend as well into the FM and it is accompanied by Hydrocephaluas, and Syringomyelia. Patients experience recurring head pain, cervical pain, and spasticity of the lower limbs. These are all symptoms that patients see results with every day in Upper Cervical Chiropractic Offices. If you are experiencing these symptoms it can help to have an upper cervical specialist examine you.

Chiari type 1 is noteworthy because it is the most common type and can be very life threatening. Syringomyelia, which accompanies the Cerebellar Tonsilar Ectopia (CTE) of a Chiari type 1 means REED or FLUTE like spinal cord. This is slightly more prevalent in females and can be found in children at birth all the way up to 60 years of age, but not often over people of 65 years. The average diagnosis age is between 25-45 years old. So if you have been diagnosed recently and you haven’t had your upper cervical spine checked call us.

Treatment is broken down into surgical and non surgical. Surgical treatment includes removal of the bone of the occiput base of the skull or the back of C1 vertebra to remove pressure off the spinal cord and brainstem. 83% of patients see relief with this surgery of some sort. However there is a 2% mortality rate associated with this as the brainstem controls breathing and heart rate and a whole host of internal functions. When the bone that supports the brain is removed it does have the potential to create a lot of problems for the body. Non surgical treatment included electrical stimulation to override the pain sensations in the nerves, but there was little evidence to support this. There was more evidence to support pain medication to relieve the headaches, neck pain, and other symptoms, however they are not that effective and can have side effects. The last options the paper discussed were things like Occupational Therapy and Physical therapy to help regain movement in the body, as well as Craniosacral Osteopathy. This is where an Upper Cervical specialist could step in as well and assess the area of the Chiari symptoms for misalignment. At Arete Chiropractic, we hold advanced certifications in evaluation and treatment of the craniocervical junction. If the upper Cervical spine is out of alignment it can compress the soft tissue even more. If you are experiencing any of these symptoms or feel that Upper Cervical Chiropractic Care could be a solution for you, Call today 603-380-9184

Head Trauma Recovery with Blair Upper Cervical Chiropractic Care

6 months ago Bob came into see us and was suffering from headaches, neck pain, midback pain, low back pain, numbness and tingling in his hands and ringing in the ears or tinnitus. We partner with the Craniocervical Foundation (CCF) to provide subsidized Upper Cervical Chiropractic Care for active military, veterans, or those in financial need. The CCF was perfect for Bob because he had a bad head trauma when he was working construction a few years ago. This injury not only impacted his work, but also his social life and hobbies. While hiking, he would have a hard time keeping his pack on his back comfortably. At work his arms would go numb. He also reported that his tinnitus would increase with stress.

Bob didn't want the neck pain, back pain and headaches to be his new normal, so he checked out the CCF. Under the CCF Bob was able to make a near full recovery in less than 6 months. Now he can carry his pack comfortably on long hikes and not even think about it. The numbness and tingling in his hands is much better, the ringing in his ears is nearly gone, and his headaches, neck pain, and back pain are a thing of the past!

If you are dealing with any of these conditions and you would like to see if we can help reach out today!


Recovery from Whiplash Injury with Upper Cervical Chiropractic Care

Post-traumatic upper cervical subluxation visualized by MRI: a case report

Journal of Chiropratic and Osteopathy. 2007 Dec 19;15:20.

In this paper we follow a 21-year-old female that was in a head-on collision where a truck traveling at 55mph struck the front left corner of her car while she was going 45 mph. The female patient was knocked unconscious as the speeds of the collision are added together and come out to roughly a 100mph accident! That energy travels directly through the car and into your body. This is why an Upper Cervical Chiropractic specialist should be consulted directly after a patient is cleared for fractures and serious soft tissue injury.

Paramedics rushed her to the Emergency Room where they proceeded to take x-rays of her neck (2D of bone) and a CT of her neck (3D of bone). The reports came back negative. She didn’t have any fractures or large tears or bleeds that they could see so they gave her a referral for a neurologist whom she saw quickly and sent her home with migraine medication.

Two days after the car accident, she rates her head and neck pain 9 on a scale of 1-10, and she is suffering from dizziness and incredible restriction in her neck. The chiropractor checks her spine by checking range of motion and doing orthopedic exams, which find a positive Valsalva test and some positive neurologic findings. The chiropractor noticed that the muscles in the patient’s neck were very stiff and that something wasn’t quite adding up. The Chiropractor took flexion/extension x-rays to look for soft tissue injuries in the cervical spine and those came back negative. So next he referred her out for an MRI of the Cervical spine and found a Syrinx (central spinal cord injury) from C2-C7, a left alar ligament with a left lateral translation of C1 vertebra under the occiput (Because the Alar ligament checks lateral movement of C1), and a Myodural bridge injury between the sub occipital muscle called the Rectus Capitus Posterior Minor (RCPMi) and the spinal cord (because RCPMi) was in spasm. Sometimes it takes a great investigator to get to the bottom of what’s happening in a cervical whiplash injury. Upper Cervical chiropractors are great at getting to the bottom of these types of problems!

Immediately the Chiropractor gently corrected the position of C1 and put the patient on a care plan of three visits per week for six weeks. At the end of six weeks the patient had a 75% reduction in symptoms. After six months under conservative Chiropractic care the patient had a complete resolution of symptoms! So if you have been struggling with symptoms like headaches, dizziness, neck pain, or low back pain after a whiplash accident, reach out to the closest Upper Cervical Chiropractor to you!

Arete Chiropractic: (603) 380-9184

Helpful Information About Whiplash and Upper Cervical Chiropractic Care

Today we are reviewing a paper that was published in 2008 titled “Whiplash: Diagnosis, treatment, and associated injuries.” in the journal Current Reviews in Musculoskeletal Medicine. This study is a review of 485 articles on Whiplash and Whiplash associated disorders. These injuries are from acceleration and deceleration in the cervical spine.

In the united states whiplash is the most common injury associated with car accidents. It affects up to 83% of the population and costs patients $3.9 billion annually in medical bills. However, if you total the litigation fees, it totals up to $29 billion.

In 1995 The Quebec Task Force met and created a grading and classification system to Whiplash injuries:

Grade 0: No complaint about the neck. No physical signs of injury.

Grade 1: Neck complaint of pain stiffness or tenderness only. No physical signs.

Grade 2: Neck complaint and Musculoskeletal signs including decreased range of motion and pain or tenderness.

Grade 3: Neck complaint and neurological signs including decreased or absent Deep Tendon Reflex’s weakness and sensory deficits.

Grade 4: Neck complaint and fracture or dislocation.

Controversies exist in how to diagnose, treat, and give a prognosis for whiplash injuries. There is a wide variety in the way patients report their injuries as well, and in many cases it can be hard to find diagnostic criteria to prove the problem. The diagnosis of whiplash associated disorders is grounded in the clinical findings of Headache, Neck pain or stiffness, arm pain and numbness or tingling, TMJ pain, Visual disturbances, memory and concentration problems and psychological distress. Patients may also experience Psychosocial symptoms like depression, fear, anger, hypochondriasis, and anxiety.

Commonly there will be radiographic findings that accompany whiplash injuries like Preexisting degenerative disc or joint disease in the cervical spine or a loss of the normal cervical curve, known as the lordotic curve. Some studies even suggest that part of the problem with whiplash is the joints in the cervical spine are actually misaligned and become hypomobile or stuck out of place and that early mobilization or correction of the alignment can improve motion and speed recovery.

Some of the studies suggest that symptoms persist in 25-40% of patients after one year. Another study showed that 7 years post injury, 40% of patients were still suffering from Whiplash Associated Disorder symptoms.

The paper described factors that may delay recovery like age, sex, and preexisting cervical spine conditions. We see that whiplash associated disorders appear more in patients that are older in age, more females than men (due to the physical size of the neck and the structures in it), and the proper curve, or lack thereof, before the accident.

Click the link below to see the paper discussed here. And feel free to watch Dr. Evans Facebook live video, too!

If you or someone you know are suffering from some of the whiplash associated disorders symptoms like: neck pain, headache, numbness or tingling, loss of range of motion in the neck and jaw pain, Upper Cervical chiropractic care may be an option to help them recover. To learn more, come and join us at our Dinner with Don on Whiplash coming up on September 27 at 6:30. Dinner is on us at the Atlantic Grill in Rye, NH. Check out the EVENT on Facebook or call 603.380.9184 to reserve your seat today!

Meniere's Disease Relief with Upper Cervical Chiropractic Care

George, a 75-year-old male, came into our office in February with neck pain, throbbing headaches in the back of the head, decreased range of motion in the neck, left foot numbness, and left arm weakness. Some of these symptoms were a result of a stroke in 1993. George also said his head felt heavy and that he had a hard time holding it up. In January of 2017 George had started to develop what are known as "drop attacks" while traveling and flying on a plane. Drop attacks are episodes that can include: vertigo, dizziness, nausea, and vomiting. These left him exhausted with little to no energy and hearing loss in both ears. When we met George, he was having drop attacks every three or four days. He had been told that he may have Meniere's disease and was given a medication called meclizine to help with the drop attacks. They were occurring more and more frequently and the effect of the meclizine was wearing off faster and faster. 

George's condition had gotten to the point that George couldn’t go out any more because of the unpredictability and frequency of his debilitating drop attacks. His daughters did some research online and found that Blair Upper Cervical Chiropractic care has helped with some Meniere's cases. George and his daughters decided it was time to try something different. When they came in for the initial evaluation, we measured George's posture, range of motion in his neck, balance, arm strength, and spinal misalignment in his upper cervical spine. By analyzing these tests and exams, we came up with best way to balance George's upper neck gently and carefully with a vectored correction. After his first correction we noticed that his energy increased, his balance improved, he had no more nausea, his neck pain decreased and his hearing started to return. George's gate was even better when he walked and stood.

After six months of upper cervical chiropractic care, George has only received four upper cervical corrections. We are happy to note that George is back to enjoying gardening, he has been able to return to work, has stopped taking his meclizine, his walking gate is more balanced, his energy is back, and he just got back from a vacation with his daughters where he flew on a plane without drop attacks or issues! You can even see that over time, he was able to stand with his feet closer together (see image below showing the difference between his initial posture picture in February and his latest posture picture taken in August).

If you know of someone suffering from Meniere's disease, vertigo nausea, vomiting, headaches or neck pain, an upper cervical specialist may be able help!

George Tsang.jpg

Research Study on Whiplash Associated Disorders

Whiplash is the most commonly reported injury from motor vehicle accidents, and are on the rise. Today we will review the current literature on rear-end motor vehicle whiplash accidents and the associated disorders and injuries.

In 2016 a study was published in The Journal of Orthopaedic and Sports Physical Therapy titled "Whiplash associated disorders: occupant kinematics and neck morphology" (see link below). This paper is the culmination of thirty years of research and attempts to prevent whiplash injuries. 

While whiplash is commonly reported, the term is often actually misused. This study states that it has been confused with the description of the symptomatology, when it’s actually the description of the type of injury. So when someone complains of whiplash, it’s actually whiplash associated disorders or WAD. 

So how do whiplash injuries occur? In the initial phase, the head and upper neck move backward and flex downward, hyper-extending the lower neck and pushing the torso forward. This creates an unnatural S curve shape of the cervical spine which can injury the ligaments, tendons, muscles, joints, bones, and nerves. In second phase, the head moves backwards behind the torso and the cervical spine, decelerating in cervical extension to the point that the joints in the cervical spine are generally taken to their end ranges of motion and often slightly beyond. Finally, the head returns to what will now be its new normal positioning over the cervical spine as the momentum and force has left the body (See Figure 1 below). Whiplash is more common in females, or people with smaller neck bones and muscles because the size and thickness of the structures can actually stave off some of the injury components.

Preexisting conditions of the cervical curve (or lack thereof) can be somewhat of a predictor for injury during an accident. A "lordotic" or C-shaped cervical curve is important in dealing with stresses and traumas in the body as it acts like a shock absorber. However, if someone has a preexisting misaligned spine with either a straightening of the cervical curve or a kyphotic (backwards) curve, a whiplash type injury can create instability from the forces being displaced in a pathological pattern during the moment of the accident (see Figure 2 below).

This paper gives a great synopsis of whiplash associated disorders.  If you or someone you know has recently been in a rear-end whiplash type accident, they could benefit from an assessment by an Upper Cervical Chiropractor. Want to learn more? Come to our Dinner with Doc on Whiplash event September 27 at the Atlantic Grill in Rye, NH! A complimentary dinner is included. Reserve your seat today by calling the office at 603-380-9184 or my visiting our Facebook event page:

Figure 1

Figure 1

Figure 2

Figure 2

Herniated Cervical Disk Neck and Back Pain Helped with Upper Cervical Chiropractic Care

We're at it again! Clearly we love research studies and finding case reports about Upper Cervical Care. As medical professionals it's so important to stay informed, which helps us be better chiropractors and healthcare providers for you! Today we're looking at an article titled "Management of Cervical Disc Herniation with Upper Cervical Chiropractic Care" that was published in 1998 in the Journal of Manipulative and Physiological Therapeutics by Dr. Krik Eriksen.

This case report follows a 34-year-old male with severe neck and lower back pain due to a cervical disc herniation. Up to this point this was the first paper that tracked the progression of a patient with a Cervical Disc Herniation of the Nucleus Pulposus and chiropractic care. The diagnosis was confirmed with use of both an MRI and a Needle EMG.

When the patient began care with an upper cervical chiropractor, his pain was as bad as it gets. It was rated a 10 out of 10 (on a scale of 1-10, 10 being the worst). The pain was also rated at 76% on the Neck Pain Disability Index Questionnaire. The scale is designed to show how the neck pain has affected the patient's ability to manage their everyday activities, 0% being no issues with daily function and 100% being complete inability to function. The patient had been under medical care for one year, including Physical Therapy. 

After the first upper cervical correction, his pain was substantially lower. After one month of care, he reported only a 2 out of 10 on the pain scale as well as a 26% on the neck pain disability index questionnaire, which was a significant improvement. Also he had a needle EMG that reported his neurologic findings had resolved. One year later, he had only needed to be adjusted two times and his symptoms were still all clear and confirmed from another Needle EMG by the medical doctor.

This may only be one case report, given that his results were so statistically significant and that his neck and lower back pain were drastically reduced through Upper Cervical Chiropractic Care, this shows that there may be some link between upper cervical spinal instability and lower cervical spine instability and that this relationship should be investigated further. 

You can watch the Facebook live video Dr. Evans posted on the subject here:

Are you interested in research like us?  You can read the case study here:

Upper Cervical Care and Parkinson’s Disease: a case report

Dr. Erin Elster is an Upper Cervical Chiropractor that has produced many peer reviewed articles on Upper Cervical Chiropractic and conditions like Multiple Sclerosis and Parkinson’s Disease such as, "Upper cervical chiropractic management of a patient with Parkinson's disease: a case report".

This week Dr. Evans posted a Facebook live video reviewing this paper, published in the Journal of Manipulative and Physiological Therapeutics in 2000, is a case report she produced on the successful management of Parkinson’s Disease in a 60-year-old male with Upper Cervical Chiropractic Care.

The patient in Dr. Elster's paper was a male that was diagnosed with Parkinson's disease at age 53 after a twitch developed in his left fifth finger. “He later developed rigidity in his left leg, body tremor, slurring of speech, and memory loss among other findings”.

Parkinson’s Disease affects the central nervous system, by destroying the substantia nigra. The substantia nigra sends messages to secrete dopamine in the brain. It is possible that this lack of dopamine allows the brain to send continuous excitatory signals. This constant signal induces Parkinson's symptoms such as rigidity and tremors. It is hypothesized that Parkinson’s Disease symptoms begin to appear after 80% of the dopamine producing cells in the substantia nigra are destroyed.

Parkinson’s Disease symptoms present as a tremor of the hand on one side of the body and over time, resting tremors develop and can be accompanied by slowness, stiffness, and lack of arm swing on the affected side.

The use of the Unified Parkinson's Disease Rating Scale (UPDRS) was used to monitor the progress of the patient by a movement specialist. The UPDRS entrance symptoms of the patient were tremor, rigidity, and depression as well as a dragging left foot. “According to a comparison between beginning and final UPDRS evaluations, this patient showed an overall improvement of 43% after the third month of care”.

An important piece of this paper is a recognition that the patient had a previous history of traumatic head and neck injuries. An association is drawn by Dr. Elster that head and neck injuries may precede the onset of some chronic neurodegenerative diseases like Parkinson’s disease. Dr. Elster points out that this patient had a history of six prior head and neck injuries that were from concussions in football and motor vehicle accidents.

Within the medical literature there is a large amount of evidence that supports a trauma induced etiology for Parkinson’s Disease. However, the medical literature does not define the mechanism for the onset of Parkinson’s Disease. In this paper Dr. Elster proposes a mechanism of onset that has to do with an injury to the Upper Cervical spine. That then sends poor messages to the brain about what’s going on with the body, this is called mechanoreception. Mechanoreceptors are sensors within the body that sense pressure and distortions in position of the joints in the spine.

This paper shows successful outcomes of a patient with Parkinson’s Disease treated with upper cervical chiropractic care. At the time it was written, this was the first case report involving chiropractic and Parkinson’s disease in the medical literature. Further investigation into traumatic injury of the upper cervical spine as a possible etiology of Parkinson's disease should be pursued.

Here is a link to the paper:


Clinical Improvements for Multiple Sclerosis Patients Using Upper Cervical Chiropractic Care

This week Dr. Evans highlighted a study titled "Preliminary results after Upper Cervical Chiropractic Care in patients with chronic cerebrospinal venous insufficiency (CCSVI) and Multiple Sclerosis (MS)." A link to the paper on the study is below.

The purpose of the study was to evaluate the impact of Upper Cervical Care on patients with CCSVI and MS by looking at clinical and x-ray results. 

Multiple Sclerosis or MS is a neurological autoimmune disease that attacks the fat cells of the Central nervous system. This results in a loss of nerve function and body function.

Chronic Cerebrospinal venous insufficiency or CCSVI is a theory that was developed by an Italian doctor who posed that a deficiency in the venous outflow of blood from the skull and neck can actually cause a backup of fluid in the brain. He theorized that this causes a whole list of problems and the that answer was to put a stent in the Jugular vein to open the vein and allow for the blood to properly flow.

The study looked at 77 patients before and after receiving about 4 months of Upper Cervical Chiropractic care using x-rays and evaluation of clinical symptoms. What they found was a statistically significant clinical improvement following treatment.

This is a preliminary study and the results were very positive. It would seem that Upper Cervical Chiropractic care may be a conservative and non-invasive approach to balancing the fluid flow away from the brain, which in turn allows the central nervous system to function better.

Upper Cervical Care Helps with Migraines and Post Concussion Syndrome

Meet Jen.  Jen came into our office in April with Post Concussion Symptoms of fatigue, brain fog, daily headaches, migraines, dizziness, memory loss, neck pain, low back pain and sciatica. Post concussion syndrome (or PCS) is diagnosed when a concussion's symptoms linger for longer than 30 days.

Jen had been dealing with migraines since she was in first grade, and chronic daily headaches nearly every day. She also suffered a concussion in February while playing soccer and had a couple of concussions prior to that, so the head and neck problems were starting to pile up. After careful analysis and a gentle correction to align her upper neck, her body is coming back to balance. 

Post concussion syndrome can last for months or even years so when Jen's body started to heal after the very first correction she knew she was in the right place. 

After being under care for eight weeks, Jen's migraines and headaches that she's had since first grade have mostly resolved . She has more energy and is able to get through a full work week without calling out and feels more clear when she is at work. Post concussion symptoms, headaches and migraines aren't ruling her life anymore!

Upper Cervical Chiropractic Care Patient Satisfaction and Experience

A paper titled "Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study"; was published in the Journal of Musculoskeletal Disorders in 2011 (see link below).

Study Methods:

A Total of 1,090 consecutive new patients from 83 chiropractors nationwide were recruited for this practice-based study. There were 3 Upper Cervical Chiropractors that were involved in the study with 5 Clinical Outcome Assessments:

1) Neck Pain Disability Index (0-100)

2) Oswestry Back pain Index (0-100)

3) Numerical Rating Score (0-10) for neck pain, headache, midback pain, and low back pain

4) Treatment satisfaction

5) Symptomatic Reactions

Data was collected at baseline and after 2 weeks of care.

Subclinical status for pain and disability was defined as <3 on Numerical rating scale and <10% respectively.

Symptomatic reaction was defined as a new complaint or a worsening of the complaint >30 % on a Numerical rating scale of 0-10 and was less than 24 hours after an upper cervical correction.

Study Results:

There were 4,920 total office visits for those 1,090 patients, which is 4.5 office visits per patient over approximately two weeks.

There were a total of 2,653 corrections (2.4 per patient) over 17 days. So, patients only needed to have an adjustment at about half of their visits, which means when they weren't being adjusted they were holding their alignment.

31 % of the 1,090 patients (383 patients) had a symptomatic reaction and 5.1% of the total patients (56 patients) had an intense symptomatic reaction.

Outcome assessments were significantly improved for neck pain and disability, headache, midback pain and low back pain. Following care, patients also reported a high level of patient satisfaction with a mean of 9.1/10.

The 83 Upper Cervical chiropractors used in the study had administered over 5 million corrections over their careers with out a reported incidence of a serious adverse event.

Study Conclusions:

Upper cervical chiropractic care may have a fairly common occurrence of mild intensity symptomatic reaction for a short period of time less than 24 hours following an upper cervical correction. However, outcome assessments were significantly improved with just less than 3 weeks of care with a high level of patient satisfaction. The preliminary data from this study shows that the benefits of upper cervical chiropractic care outweigh the risks!


Upper Cervical Spine, Migraines, and Balance

Most of us have relied on the GPS in our smartphone or vehicle to tell us where we are and where we’re going. GPS has become standard equipment in our devices and vehicles. But that isn’t unique to smartphones and cars. Our bodies come equipped with GPS, too! There are sensory receptors called proprioceptors in your joints, skin and muscles that give you awareness of where your body is in space, which is called proprioception. This is what allows you to close your eyes and be able to touch your finger to your nose without looking in a mirror, and it is crucial for your body’s ability to balance.

These receptors are all throughout the body, but there are more proprioceptors in the top of your neck, at the base of your skull, than most other places in your body. They tell your neck how to hold your head to keep your head (and eyes) level. 

In 2018 there was a paper published in the Journal of Oral & Facial Pain and Headache titled “Impaired Standing Balance in Individuals with Cervicogenic Headache and Migraine”. The study tested three groups of participants for standing balance and sway: 24 people with cervicogenic headaches (a neck problem that turns into a headache), 24 with Migraines, and 24 that had no symptoms. The participants were tested on either a firm or soft surface, with their eyes open or closed, and in a wide stance (feet shoulder width apart) or a narrow stance (feet together). The results showed that the migraine and cervicogenic headache groups had a much larger sway pattern than the group without symptoms.  This shows a possible relationship or link between Cervicogenic headaches and migraines, and balance. This could mean that the neck proprioception is off in the people with head and neck pain, which can create problems with standing balance and coordinating movement.

Chiropractors call the head and neck the upper cervical spine. For some people, cervicogenic headaches, migraines, balance issues, and proprioception problems, might all be connected in the upper cervical spine. At Arete Chiropractic, we are Upper Cervical Chiropractic specialists who work with the top two cervical vertebra gently and with a specific correction to bring balance between the head and the neck.

Check out this live Facebook video by Dr. Evans where he discusses the above paper as well as a 2014 paper published in Frontiers in Human Neuroscience titled "Neck Proprioception Shapes Body Orientation and Perception of Motion".

Is your head on straight?

body balance.jpg

Chronic Migraines Helped with Upper Cervical Chiropractic Care

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 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 cerebral spinal 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.

Just ask Courtney! Courtney had been struggling with chronic headaches since she was about 12 years old. For the weeks prior to starting care at Areté she was struggling with DAILY migraine headaches. It made it difficult for her to live her life. She was also experiencing TMJ pain, constant neck, upper back, and lower back pain, and she would notice about once a day that her hands would fall asleep. You may be wondering what her headaches have to do with her hands. Nerves from the neck go into the shoulder, arm, and hand. So it was a pretty safe bet that Courtney's neck was a big piece of the pie as to why her body was expressing all these symptoms.

She has been under care for over six months now and has much less spinal pain, no numbness in the hands, and she only gets a migraine when her upper neck goes out of alignment!

Upper Cervical Care and Stress, Pain and the Immune System

You've probably heard the phrase "it's all in your head".  Since the brain is the master control center for all the functions of the body, there is a lot of truth to that statement! Research studies show that the way we think and feel about pain impacts the way our brains make us feel pain.  Over time, stress and pain make changes in the brain and body, and alter your immune system. This can slow down the body's ability to heal, and cause inflammation, depression, and even more stress and pain! 

So what can you do? Fortunately there are a lot of measures you can take to help. Staying positive, meditation, moving more, sleeping well, and eating better can all help overcome the vicious cycle of stress and pain. Upper Cervical chiropractic care is also a piece of the pie. Not only can it help with migraines, back pain, and neck pain, it also helps your brain know more accurately what is going on in and around your body.

Want to learn more about how this works? check out the video below! 

For more information about Upper Cervical chiropractic care or to schedule an initial evaluation, call 603.380.9184.


Craniocervical Foundation Provides Access to Upper Cervical Chiropractic Care with the help of Annie's Angels Donation

Arete Chiropractic is proud to be a partner of the Craniocervical Foundation, which provides access for people with head and neck injury or related conditions who would not normally be able to afford or access upper cervical chiropractic care, including active duty military and veterans.

This past Monday, Annie's Angels donated funds to the Craniocervical Foundation that would cover 25 visits to Arete Chiropractic through the foundation.  Annie's Angels ( is a local organization, founded by Bill and Diane DaGiau, whose primary mission is to help local families struggling financially through a life threatening disease, illness or disability.  We are honored and thrilled to have found allies in health in Annie's Angels, and to be able to provide upper cervical chiropractic care using these funds to impact the health and lives of those in need in our community. 

If you are interested in the Craniocervical Foundation or would like to give the gift of health with a donation, call 802-441-5223 or email INFO@CRANIOCERVICALFOUNDATION.ORG


Dinner with Doc on Meniere's

Vertigo, Dizziness, Ringing in the ears?

These are common symptoms of Meniere's Disease, a condition of the inner ear that can be significantly related to the neck. Join the doctors of Areté Chiropractic as they discuss the anatomy and disease process of this condition, as well as tips and tools to help you recover and get your life back.

Areté Chiropractic is an upper cervical chiropractic office in Portsmouth NH that provides gentle, specific, and effective treatment for head and neck conditions. Utilizing state of the art 3-D imaging, the doctors help many people recover from chronic conditions like: headaches, neck pain, migraines, vertigo, whiplash, and concussion. Join them at the Atlantic Grill to see if upper cervical care could be a solution for you.

May 24, 2018, 6:30-8:30pm

Atlantic Grill, 5 Pioneer Rd, Rye, NH 03870

Call the office at 603.380.9184 or click the button below to reserve your seat today!