Elledge Chiropractic Blog

Women’s Magazine. January 2000.
Boulder, Colorado.
by Erin Elster, DC.

IUCCA Upper Cervical Chiropractic, a new health care technique incorporating modern computerized technology, has been effective in the treatment of vertigo syndromes, such as benign paroxysmal positional vertigo (BPPV), labyrinthitis, and Meniere’s Disease. Debbie, age 51, suffered with one to two vertigo episodes per month for an entire decade. She described her benefits from upper cervical care. “Doctors diagnosed me with labyrinthitis and prescribed decongestants and anti-nausea medications which I took for ten years,” she said. “After my first adjustment with Dr. Elster, I stopped taking the decongestants and the dizziness never returned.” One year later, Debbie remains free from vertigo symptoms and medications.

Vertigo Facts

Vertigo is a subjective sensation of environmental movement, which can range from mild, transient episodes to severe, extended attacks. Often, vertigo is associated with nausea, vomiting, malaise, hearing loss, tinnitus (ear ringing), and a feeling of ear fullness or pressure. Physicians in the United States report more than five million vertigo visits per year, making it among the 25 most common reasons Americans visit a doctor. (Vestibular Disorders Association (VEDA), 1999)

What Causes Vertigo?

Besides viral infection of the inner ear, one of the most common causes of vertigo is trauma to the head or neck. (VEDA, 1999) When a person is involved in a traumatic event such as an auto, bike, or ski accident, his/her upper neck vertebrae may misalign, remaining in a stressed position. The neck injury interferes with normal transmission of information between the spinal cord and brain, resulting in symptoms such as vertigo, ear ringing, ear congestion, and nausea. Often, a patient experiences headaches and neck pain as a result of the same injury. In many cases, months to years may pass after an accident before symptoms appear. The proper correction of the neck injury can eliminate vertigo and associated symptoms.

Vertigo Diagnosis

Diagnosis of vertigo syndromes occurs by hearing tests, examination of the middle ear, neurological evaluation, and positional testing of the head and neck. Benign paroxysmal positional vertigo is usually diagnosed when head and neck movements produce vertigo symptoms. Meniere’s and labyrinthitis, on the other hand, have involvement of hearing loss and/or ear congestion. Treatments offered by medical doctors include cervical exercises and medications for symptomatic relief of nausea and congestion.

How IUCCA Upper Cervical Chiropractic Works

IUCCA Upper Cervical Chiropractic works by correcting injuries to the upper cervical spine (upper neck), the fundamental cause of cervicogenic vertigo syndromes. Misalignments in the upper cervical vertebrae cause irritation to the nerves traveling between the brain and spinal cord resulting in vertigo symptoms. Causes of upper neck misalignments include traumas to the head, neck, or spine, such as concussion, auto accidents, whiplash, sports injuries, bike and ski falls, and poor posture. Specific correction of misaligned vertebrae in the upper neck removes irritation in the central nervous system, thereby allowing a patient’s nervous system and body to heal and resume normal function. Typical IUCCA Upper Cervical Chiropractic treatment involves an initial spinal exam, specific x-rays of the upper neck, computerized thermal spinal scans to measure neurological irritation, and specific adjustments by hand to correct the misaligned vertebrae in the upper neck. History of Trauma History of trauma is consistent with medical histories of other patients who have responded to upper cervical chiropractic care. In cases where a trauma has caused a misalignment of the upper cervical spine resulting in a wide variety of conditions months to years later, correction of the upper cervical spine has improved and/or reversed those symptoms.

Autonomic Nervous System and Chiropractic Adjustments

Arn Strasser, DC
Chiropractor
Strasser Chiropractic Center
Portland, Oregon

Chiropractic offers a treatment option for neck (cervical) pain that is utilized by millions of patients. Chiropractors are doctors who specialize in the care of non-surgical conditions of the neck with gentle, time-saving approaches that address the mechanical (how the spine moves) and neurological (nerve-related) causes of neck pain.

Chiropractors are rigorously trained to diagnosis the different types of neck conditions and to then recommend specific treatment approaches for those conditions.

Chiropractors are specialists in spinal manipulation—an active, hands-on care that returns motion to the spine. With a return of normal spinal mechanics, muscles relax and pain is resolved. Restricted spinal motion—meaning that the spine doesn’t move as easily as it should—can cause neck pain.

Chiropractic has developed a number of treatment approaches in addition to traditional spinal adjustments. These treatment approaches help chiropractors to address a wide range of neck pain conditions.

Neck conditions that respond to chiropractic care include:

• cervical sprain injuries
  spinal joint restriction syndromes
  facet joint sprain
  “whiplash” sprain injuries
  cervical disc injuries that don’t require surgery
  acute torticollis (when the neck muscles stay contracted and can actually cause the neck to stay in a twisted position) and stiff neck
  degenerative joint syndrome of the neck
  various types of chronic neck pain

Before deciding which approach or approaches to try for your pain, the chiropractor will do a thorough examination to diagnose the specific cause of your pain.

How a Chiropractor Diagnoses Neck Pain
Even if you go to the chiropractor complaining of neck pain, he or she will evaluate your spine as a whole. The chiropractor will check your neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). It’s important to examine the entire spine because even though it’s just your neck that hurts, other regions of the spine may be affected.

Your chiropractor will determine areas of restricted joint motion, disc injury, muscle spasm, and ligament injury. One way the chiropractor does that is through motion and static palpation, diagnostic techniques unique to chiropractic. Motion and static palpation is an examination by means of touch. The chiropractor will feel for tenderness, tightness, and how well each spinal joint moves. (You can read a more in-depth article on motion and static palpation here.)

The chiropractor will also analyze how you walk and look at your overall posture and spinal alignment. Those details will help your chiropractor understand your body mechanics and how well your spine is working and moving.

You’ll also go through your past medical history with the chiropractor, in addition to having a complete physical. Your chiropractor may order imaging tests (e.g., x-rays or MRIs) to help him or her diagnose the exact cause of your neck pain.

All these steps in the diagnostic process will give your chiropractor more information about your neck pain. The examination will enable your chiropractor to create an effective treatment plan.

Possible Chiropractic Treatment Approaches for Neck Pain
The exact treatment plan depends on your diagnosis. Your chiropractor may use a combination of spinal manipulation, manual techniques, and therapy instruments.

A brief note about spinal manipulation: Spinal manipulation is a safe approach to treating neck pain. A recent review of literature addressing the question of the relationship between spinal manipulation and stroke concluded that manipulation was not a significant factor in causing strokes (1).

Many people think that Chiropractic is only for your back. This misconception is easily understood; after all, chiropractors do work primarily on your back. However, chiropractic is about affecting the nervous system, and the way this is done is by adjusting the spine.

Your body is controlled by three distinct nervous systems – the central nervous system, peripheral nervous system and autonomic nervous system (which is further divided into the parasympathetic and sympathetic nervous system). All 3 parts of the nervous system must be balanced so that they can operate in unity and create a truly healthy body.

Chiropractic is great for low back and neck pain, however it works great for many ‘non back’ problems. Spinal joint fixation (subluxation) results in nerve irritation. This nervous irritation (known as facilitation) leads to exaggerated activity of the nerve, resulting in muscular tension, postural asymmetries, and limited and painful motion. Other problems include chronic hyperactivity of the sympathetic nervous system producing a variety of syndromes.

Your nervous system controls and coordinates all the functions of your body (pg. 4 -Grays Anatomy). If a subluxation causes a nerve to become irritated, then wherever that nerve goes, that part of the body will also function in an irritated and limited manner. This basic premise has made, and even the AMA admits that, Chiropractic is the number one Alternative Healthcare System in the United States.

Dr. Jonathan Donath

Period of adjustment: modern chiropractic improves flexibility and performance and reduces injuries
Men’s Fitness,  Oct, 2002  by Robert L. Pela

Foolishly ignoring the advice of my trainer, I tried to do a one-rep maximum on my own … and bench-pressed myself into an orbit of pain. The tension in the back of my neck and shoulders produced stress headaches that felt like ice picks being driven into my skull. The burning sensation between my shoulder blades made sleep damn near impossible.

Good old Dr. Johnson, my general practitioner since I was 3, offered this advice: “Take some aspirin.” I threw a 17-year-old copy of Highlights at him and stumbled to the office of a nearby chiropractor. After my first visit, my headaches disappeared. Following my second adjustment, the stiffness in my neck and shoulders was history. By my third trip, I was hooked.

HANDS-ON BENEFITS

Chiropractic, derived from the Greek word chiro-praktikos, means “effective treatment by hand.” The primary focus tends to be the spine, where the nerves are linked to all parts of the body.

“Adjusting” the spine by manipulating vertebrae that are out of whack allows the body to operate more efficiently and comfortably.

The field encompasses several areas of wellness, including joint and muscle health, and clinical nutrition. It’s this dose attention to the body’s optimal balance, Hall says, that makes chiropractic treatment beneficial to athletes and active men in the following ways:

* Improved performance Chiropractors with fitness and sports training can help improve your flexibility, range of motion, and reaction time. A report in the Journal of Chiropractic Research and Clinical Investigation found significant increases in athletic performance after only three months of chiropractic care, and the U.S. Olympic Committee assigns a chiropractor to its staffs for the Pan-American and Olympic Games.

* Injury prevention Regular visits can reduce injuries, reports John Triano, D.C., of the Texas Back Institute in Plano. Adjustments can help you maintain your full range of motion, which protects against muscle strain during workouts and reduces joint dysfunction by ensuring that your joints aren’t misaligned. “Better-coordinated movement patterns between bone and muscle create a more even distribution of weight, which prevents muscle strain during exercise,” Triano says. “And well-distributed weight prevents further misalignments and the chance of future injuries.”

* Few side effects Any residual soreness experienced the day after an adjustment is the same tenderness that results from a good workout, caused by lactic acid released by tissues that have been manipulated. The risk of injury to a patient is slim: It’s 400 times more likely that someone would be adversely affected from ingesting an Advil, says Hall.

* Fast relief “The response to a chiropractic adjustment is immediate,” Triano says. “Unlike a lot of medical care, you can tell right away if your body is responding.” That may explain why patients preferred chiropractic methods to hospital care in a three-year study on back pain published in the British Medical Journal.

Will chiropractic care work for you? If you snap your shoulder capsule playing football, direct your gurney to an orthopedic surgeon’s office. But for conditions related to muscles, joints and unbroken bones–especially chronic complaints that haven’t been resolved by traditional approaches a good chiropractor may readjust your thinking about alternative medicine.

GROWING RESPECT

According to a Gallup Poll, 10 percent of all Americans used chiropractic services within the past year. Once viewed with skepticism, doctors of chiropractic are recognized today as highly skilled professionals who work with medical doctors and physical therapists in occupational health, sports medicine and other rehabilitation practices. In fact, chiropractors–who are required to take more college hours than regular M.D.s–now represent the third-largest group of doctoral-level health providers in the United States. For advice on when and how to find a practitioner, call the American Chiropractic Association at 800-986-4636 or access www.amerchiro.org.

Chiropractic Care of Neck Pain
During your visit, your doctor of chiropractic will perform exams to locate the source of your pain and will ask you questions about your current symptoms and remedies you may have already tried. For example:

* When did the pain start?
* What have you done for your neck pain?
* Does the pain radiate or travel to other parts of your body?
* Does anything reduce the pain or make it worse?

Your doctor of chiropractic will also do physical and neurological exams. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.

In some instances, your chiropractor might order tests to help diagnose your condition. An x-ray can show narrowed disc space, fractures, bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.

Chiropractors are conservative care doctors; their scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a neck fracture or an indication of an organic disease, he or she will refer you to the appropriate medical physician or specialist. He or she may also ask for permission to inform your family physician of the care you are receiving to ensure that your chiropractic care and medical care are properly coordinated.

Neck Adjustments
A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness.

Of course, your chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.

Information taken from www.americanchiro.org

Research Supporting Chiropractic Care
One of the most recent reviews of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation.

As part of the literature review, published in the March/April 2007 issue of the Journal of
Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment

What is Chiropractic??

The basic premise of chiropractic is that alterations in spinal mechanics can lead to nerve interference, potentially leading to pain and/or ill-health. Scientists understand that an unobstructed flow of nerve impulses from the brain down through the spinal column, out the spinal nerves to every cell in the body is important to maintaining good health. Any disruption of this nerve conduction will prevent full realization of a healthy, vibrant, long life. This nerve interference is but one component of the Vertebral Subluxation Complex.

The Vertebral Subluxation Complex, or subluxation, is an often overlooked, but a very serious condition responsible for a good deal of ill-health in this country. Only chiropractors are trained to detect and correct the Vertebral Subluxation Complex. Research has shown that internal malfunctions are but one cause of vertebral subluxations. Acute trauma and chronic physical and emotional stress are other potential causes.

The Central Nevous System and Associated Stuctures

The Vertebral Subluxation Complex defined.

As we mentioned, complex means more than one part. Some scientists list seven or eight components to a subluxation; we are going to cover the five most common:

1) Spinal Kinesiopathology – improper movement or alignment of a vertebra. When this occurs your range of motion or your ability to turn, twist and move is restricted, which in turn will lead to the next four components.

2) Myopathology – muscles that connect to and move the bones can either be too long or weak, or too tight or in spasm. Either of these result in changes that are like gristle. This further restricts motion leading to further problems in the spine.

3) Neuropathology – the improper motion and function lead to irritation of the nerves. This irritation can lead to pain or can interfere with nervous system communication between the brain and the cells, tissues or organs which eventually may lead to ill-health.

4) Histopathology – when the soft tissues become irritated and inflamed from mechanical irritation or interference to the nerve the blood, lymph and other soft tissues begin to show signs of damage. Left uncorrected this can progress and lead to further demise of health.

5) Pathophysiology – left uncorrected the loss of motion leads to stiffness, creating further loss of motion. With this begins the growth of bone spurs resulting in even greater loss of motion. This is often referred to as DJD or degenerative joint disease or osteoarthritis, which is permanent and progressive.

All of this could have been avoided in the first place had proper chiropractic care been initiated to restore and maintain motion between the spinal vertebra. They were designed to move, however as we go through life, we develop subluxations as a result of trauma, repetitive action, stress or problems on the inside. This initiates a neurological reflex leading to a vertebral subluxation and its components.

The Ideas of Dr. D.D. Palmer
Taken from the Center of Natural Medicine, Winona, MN

Pregnancy and Chiropractic Care
Chiropractic care is health maintenance of the spinal column, discs, related nerves and bone geometry without drugs or surgery. It involves the art and science of adjusting misaligned joints of the body, especially of the spine, which reduces spinal nerve stress and therefore promotes health throughout the body.
Is chiropractic care safe during pregnancy?

There are no known contraindications to chiropractic care throughout pregnancy. All chiropractors are trained to work with women who are pregnant. Investing in the fertility and pregnancy wellness of women who are pregnant or trying to conceive is a routine treatment for most chiropractors.

Some chiropractors take a specific interest in prenatal and peri-natal care and seek additional training. Below represents designations of chiropractors who have taken advanced steps in working with infertility and pregnancy wellness.

• DACCP – Diplomate with ICPA reflecting highest level of advanced training
  CACCP – Certified with the ICPA reflecting advanced training
  Member of ICPA reflecting special interest
  Webster Certified – trained to specificaly work with breech positions
  Find a Chiropractor in your area

Chiropractors that have been trained to work with pregnant women may use tables that adjust for a pregnant woman’s body, and they will use techniques that avoid unneeded pressure on the abdomen.

A chiropractor who is versed in the needs of women who are pregnant will also provide you with exercises and stretches that are safe to use during pregnancy and compliment any adjustments made to your spine.
Why should I have chiropractic care during pregnancy?

During pregnancy, there are several physiological and endocrinological changes that occur in preparation for creating the environment for the developing baby. The following changes could result in a misaligned spine or joint:

• Protruding abdomen and increased back curve
  Pelvic changes
  Postural adaptations

Establishing pelvic balance and alignment is another reason to obtain chiropractic care during pregnancy. When the pelvis is misaligned it may reduce the amount of room available for the developing baby. This restriction is called intrauterine constraint. A misaligned pelvis may also make it difficult for the baby to get into the best possible position for delivery.

The nervous system is the master communication system to all the body systems including the reproductive system. Keeping the spine aligned helps the entire body work more effectively.

Pregnancy and the Spinal Association
Pregnancy and the Spinal Association

What are the benefits of chiropractic care during pregnancy?

Chiropractic care during pregnancy may provide benefits for women who are pregnant. Potential benefits of chiropractic care during pregnancy include:

• Maintaining a healthier pregnancy
  Controlling symptoms of nausea
  Reducing the time of labor and delivery
  Relieving back, neck or joint pain
  Prevent a potential cesarean section

What about chiropractic care and breech deliveries?

The late Larry Webster, D.C., Founder of the International Chiropractic Pediatric Association, developed a specific chiropractic analysis and adjustment which enables chiropractors to establish balance in the pregnant woman’s pelvis and reduce undue stress to her uterus and supporting ligaments. This balanced state in the pelvis makes it easier for a breech baby to turn naturally. The technique is known as the Webster Technique.

It is considered normal by some for a baby to present breech until the third trimester. Most birth practitioners are not concerned with breech presentations until a patient is 37 weeks along. Approximately 4% of all pregnancies result in a breech presentation.

The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issue an 82% success rate of babies turning vertex when doctors of chiropractic used the Webster Technique. Further, the results from the study suggest that it may be beneficial to perform the Webster Technique as soon as the 8th month of pregnancy when a woman has a breech presentation.

Currently, the International Chiropractic Pediatric Association recommends that women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for development throughout pregnancy. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, and the crisis and worry associated with breech and posterior presentations may be avoided altogether. Optimal baby positioning at the time of birth also eliminates the potential for dystocia (difficult labor) and therefore results in easier and safer deliveries for both the mother and baby.

http://www.americanpregnancy.org/pregnancyhealth/chiropracticcare.html

Chiropractors that specialize in the treatment of neck pain attempt to improve the function of the joints and the nervous system by adjusting vertebral subluxations. Manual spinal adjustments are the key to chiropractic treatment, and, in fact, the word “chiropractic” is derived from the two Greek words “cheiros” and “praktikos,” which together mean, “done by hand.” Chiropractic adjustments are very popular in the United States, with as many as 40 million Americans receiving regular treatments. Because there are major philosophical and theoretical differences between the ways in which chiropractors and medical doctors treat neck pain, there has always been a rift between these two groups. Recently, the chasm between chiropractors and medical doctors has started to narrow as they have begun to share information and provide each other with more insight into their respective methodologies, practices, and treatments.

Chiropractors today are more likely to refer a patient to a medical doctor when they suspect that an underlying condition may be responsible for neck pain, and some chiropractors insist that their patients have a primary care physician that they can communicate with in order to ensure that the patient is receiving the best quality care. In this sense, Chiropractors are becoming part of the broader spectrum of providers that treat neck pain.

Chiropractors frequently have different methods of making spinal adjustment, but the basic theory behind the success of chiropractic treatment is that realigning the spine relieves pressure on the spinal nerves, which can help to restore natural nerve function throughout the body. As such, chiropractors believe that a “well-aligned” body is more likely to be in a state of natural balance and the patient will experience less pain and disability. Many chiropractors today have incorporated electrical stimulation, diathermy, ultrasound, and a variety of other therapies, but the mainstay remains manual spinal manipulation or adjustment.

What should you expect when visiting a chiropractor?

When you visit a chiropractor for the first time, you will probably be asked for a general medical history and also asked to complete a questionnaire about the type of neck pain that you are experiencing. A hands-on examination typically will be performed, which involves moving your neck and limbs around to determine your limitations. Sometimes the chiropractor will take x-rays of your back to determine which vertebrae are misaligned. The diagnosis and treatment of vertebral subluxations is one of the sticking points between medical doctors and chiropractors, since there is often some disagreement between these two groups about what constitutes a spine that is out of alignment. The final treatment phase of a visit to a chiropractor typically involves manipulation of the spine in an attempt to correct subluxations and misalignments. Some chiropractors also use vitamins, massage, and electrical therapies as part of their treatment.

Taken from www.necksurgery.com

Back pain can arise from a variety of conditions. The chief among them are:

• Pinched Nerves
• Slipped Discs
• Ruptured Discs
• Scoliosis
• Arthritis
• Muscle Pain

A chiropractor can pinpoint the cause of the back pain. He or she can make the necessary spinal adjustments to relieve the problem. In some cases, a chiropractor will recommend that you seek medical attention for your situation.

The 1994 Federal Agency for Health Policy and Research (AHCPR) guidelines for low-back pain concluded that spinal manipulation, chiropractic’s primary treatment technique, is one of only three treatments whose effectiveness is substantiated by rigorous research.

According to a 1992 RAND Corp. study, patients see a chiropractor primarily for low back pain and neck pain. Because back pain is so pervasive in our society, a recent study published in the British Medical Journal pointing out that back pain doesn’t go away that easily confirmed what chiropractors have always known. Only 25 percent of low back pain sufferers had fully recovered 12 months after their first visit to a general practitioner, the study said. This low number is in conflict with the commonly-held notion that low back pain episodes go away by themselves after a month. Doctors of chiropractic have long understood the cyclic nature of low back pain.

In 1999, Blue Cross/Blue Shield of Kansas in August 1999, presented a study aimed at determining the cost and effectiveness of treating back pain with chiropractic compared with other techniques. The results showed that 38 percent of the patients chose to seek chiropractic care rather than medical care. The results showed that chiropractic was more cost-effective than anesthesiology; neurosurgery; neurology; registered physical therapy; orthopedic reconstructive surgery; physical medicine and rehabilitation; and rheumatology.  The study also showed that most of the chiropractic expenses 89%, were related directly to patient care, while only 45 percent of the medical costs were related to treatment of the condition with remainder of the costs being for diagnostic procedures. The study had excluded any costs for hospitalization, surgery, or any fees paid to orthopedists or neurosurgeons for costs associated with surgery. Without these additional costs being included in the study, the costs related to medical care were reported much lower than they actually were, and the savings from chiropractic care was actually much larger.

Chiropractors points out this study as vindication of their long-held view, “Patients suffering from back problems are in much better, and cost effective hands with chiropractic care.”

The Spinal nerves and associated systems

Satisfied Customers

A research journal, the “Journal of Manipulative and Physiological Therapeutics” published a study that showed high levels of patient satisfaction for those who went to chiropractors with what was classified as severe to moderate pain in either the back or neck.  A total of 369 patients were sampled who had gone to chiropractors with these problems.  These individuals were asked to complete surveys tracking all kinds of information from the type and severity of their problem to their level of satisfaction with care.

The results showed a very positive response from the study group in both the results they felt and their overall level of satisfaction with their care.  The results of the published study summed it up best;  “Based on the results of this survey, it seems that patients suffering from back and or neck complaints experience chiropractic care as an effective means of resolving or ameliorating pain and functional impairments.  Moreover, the patients surveyed demonstrated a high degree of satisfaction with the care they received.  Numerous other studies have demonstrated that chiropractic is as effective, if not more effective than conventional medical management of such complaints.”

Holisticonline.com