Typically, I don’t get too personal in my blogs, but, after the past almost 3 years of the Covid debacle, I can honestly say that I’m grateful to Upper Cervical Chiropractic Care and the many patients that we, at HealthWorks, get the opportunity to help heal and become our family. I don’t believe in coincidence but believe in the Divine intervention that brings each person to our doorstep.
When I started my journey in chiropractic, I thought I was just going to get a temporary secretarial job right after high school as college at the time just didn’t seem like the path I wanted to embark upon. So, I can type 65 words per minute, can answer phones with ease and wanted a predictable work schedule—seemed like the perfect fit. I didn’t know how much it would change the entire course of my life…
Personally, chiropractic helped my chronic migraines and urinary tract problems that I had been suffering from for most of my short life (remember I was only 18 years old when I started as a chiropractic assistant). Fast forward 6 years and the day came when I witnessed what some would say is a “miracle” and once again, my life was changed.
I was working for Dr. Bart Patzer in Austin, Texas. We were getting close to closing time and a couple walks in with a little bundle in the mother’s arms, we’ll call her Baby J. They looked desperate and exhausted. I went back to get the doctor as he was packing up to leave and I guess the look in my eyes conveyed everything that needed to be said…he dropped his belongings and headed up to the front of the office.
We immediately brought the couple and Baby J down the hallway to the exam room. This tiny human came into this world with a fight on her hands. Over 24 hours in labor, got stuck in the birth canal and they were going to do an emergency c-section after pushing her up the birth canal, but apparently, she wanted to meet her parents the old-fashioned way, so they used forceps and then a vacuum to pull her out. She never let out the loud cry that all parents wait for after the baby takes it’s first breath, just a tiny whimper to know she was alive. They immediately put her on oxygen to help with her breathing and she was in the NICU for 48 hours due to apnea…she would stop breathing several times per day.
They left the hospital with her attached to an apnea monitor in hopes that it was just a precaution. But the monitor would go off so often and she didn’t seem to have even the energy to eat, they became increasingly concerned, so they were back in the pediatrician’s office within a few days. The doctor dutifully examined her and could find “nothing wrong” and could not figure out why this was occurring and gave them the gravest of outcomes with the possibility of her not making it should this situation continue.
The parents then called their family members to tell them the news. I believe Divine intervention came into play, as He does, by directing them to Dr. Patzer’s office in a “last ditch” effort to see if an upper cervical adjustment could be the answer they were looking for. You see, the family member they called is a chiropractor in South Carolina that knew that the respiratory regulating centers were in the brain stem. The atlas or C1 surrounds part of this region and if it’s out of alignment it can cause abnormal information to these regulatory respiratory centers.
The atlas sits right at the inspiratory and expiratory centers (breath in and out). If this area is compromised by a misalignment (subluxation) in this region, difficulty in breathing can occur.
(This study shows positive effect on those with one of the most common breathing problems, asthma): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829683/
We were all in the exam room, me, Dr. Patzer, his wife, Kellye and the parents along with this beautiful 12-day old tiny baby in a diaper on the exam table. He performed a thermography exam to determine what levels are compromised and what appeared was a black bar at the very top of her spine which indicated significant compromise at the upper cervical (top of the neck) region very similar to the image below:
This determined, along with her history, that an atlas alignment was indicated. Dr. Patzer proceeded to apply a tiny pressure very gently with his pinky on Baby J’s atlas in a lateral movement. In just a short period of time she took in a deep breath, turned bright pink from head to toe and let out a full lung wail along with a bowel movement! She literally exploded with life! We all started to cry along with her. Her parents had never even heard her full on cry neither at her birth or anytime after as she never got a full breath in her lungs to do so…that day was the first day of her new and full life!
She came into see Dr. Patzer several times over the next couple of weeks and after 2 weeks no longer needed the apnea monitor. Her pediatrician had no explanation for how this occurred. But we knew. Her parents knew. That’s all that mattered.
That day was the day I decided to become a chiropractor-an upper cervical chiropractor. It was no longer a fleeting thought it was a “I must do this as God has led me on this path for a reason” kind of moment. It was a feeling in the deepest most sacred part of my heart and soul and it wouldn’t let go. Almost 18 years later and as hard it has been it’s been equally as rewarding and for that I’m eternally grateful. Not only did that experience move me past my fears of being able to take on the challenge of a chiropractic education, but it gave me the appreciation for what Upper Cervical Chiropractic can do and how many lives it can affect—to bring my community back to health and lead a life of purpose and gratefulness.
The understanding of the upper cervical spine and how it affects the health of the individual is what HealthWorks is all about. We not only look at the thermography scan as we did with Baby J (nerves going to the organs and glands) but use a Surface EMG (nerves going the muscles), as well as Heart Rate Variability which determines the overall tone of the Autonomic Nervous System or how well our body deals with stress (chemical, physical and emotional stressors).
This technology allows us to objectively measure how well your nervous system is functioning and give you solid answers on how to restore optimal function so you can live to your full potential.
Here’s a great graphic to visualize the components of your nervous system exam:
The three scan together then give us your CoreScore which is based on a scale from 0- 100. The higher the number, the better the communication along those important nerves. If your score places you in the “challenged” category. This means that daily stress has become a constant habit, or your body is in a state of constant compensation. The fact that you are feeling symptoms is just another way your body is telling you that it can no longer compensate for the stresses that has been placed upon it. LISTEN TO YOUR BODY!
Heart Rate Variability is an objective measure that gives us a clear picture on how well our body is dealing with whatever stressors, known or unknown to us are affecting our overall ability to heal. A blog from Harvard Health even indicates that Heart Rate Variability is directly linked to our wellbeing.
https://www.health.harvard.edu/blog/heart-rate-variability-new-way-track-well-2017112212789
What does Heart Rate Variability have to do with being grateful? Well, if you’re consistently tired and stressed and subsequently depressed and overwhelmed about your health circumstances, how much capacity do we have for being grateful? The answer to that for most people is NOT MUCH! Heart Rate Variability is a great measure to determine whether the season you are in, is subsequently affecting your health or ability to heal.
We’ve all been there and know someone (or several someone’s) that carry the weight of the world on their shoulders and can bring the whole room down with their presence—not that they intentionally mean to, it’s just that they are stuck in this cycle and their outlook can become more grim day by day. I realize that much of this outlook on life may be due to circumstances beyond their control, however, the longer they remain in this state, the more it will affect their health including how well their neuromusculoskeletal system is functioning. This can lead to chronic pain, headaches, migraines, and other health challenges that makes being grateful or having purpose in life very difficult.
How does an atlas misalignment affect Heart Rate Variability?
If you look at the animation above, you’ll notice that the atlas misalignment, primarily the rotational component, will compress the Vagus nerve (as well as the internal jugular vein and the carotid artery). When ANY nerve is compressed, does it function well? NO! Well, the Vagus nerve, is a parasympathetic nerve (rest and digest) and is also called the “wandering nerve” as it extends from the brainstem all the way down to the large intestine! It contains both sensory and motor components and is responsible for keeping the “tone” of the autonomic nervous system. When the Vagus nerve is compressed and/or damaged, it can cause these symptoms:
Heart Rate Variability (HRV) looks at the overall balance and capacity of the Autonomic nervous system. A combination of lifestyle stressors and events constantly “sits on our shoulders” and pushes us down on us while our nervous system consistently tries to resist these stressors. Now, if the external stressors gradually overwhelm your ability to adapt, then it begins to interfere with the nervous system’s ability to compensate and that lower capacity puts the patient in a vulnerable position. They don’t have the necessary reserves to remain resilient in the face of ongoing or upcoming stressors. They have a suppressed recovery response and as the stresses accumulate or continue their health status can decline more rapidly. The statement of “getting sicker, quicker” applies here. Let’s face it, stress isn’t going anywhere. Becoming more resilient in the face of what life brings is what is needed to thrive.
So, how do I increase my Heart Rate Variability Score?
You see, gratefulness is not only a state of mind, but is greatly affected by your overall well-being. Having objective measures as well as a team of Upper Cervical Chiropractors and a wonderful staff may be the missing component to achieving optimal health.
Our promise to you
HealthWorks is dedicated to comprehensive and specific approach to taking care of spinal and nervous system needs. Let us help you, your family members, friends and co-workers find out how taking care of the most important system in the body will create optimal health that will last a lifetime! If we find we’re not the best to help, we promise to refer you to someone who is.
Many new patients get frustrated when they come to our office and they don’t get treated on the very first visit. I get that! You’re in pain and you want relief NOW! Totally understandable. However, would you like a surgeon to open you up without knowing where he needs to go or what is actually the problem? Hopefully, your answer is, NO!
Well, many times we’ve had patients come in with seemingly chiropractic issues and once we do the complete diagnostic study, we find they have something that is our of our scope of practice or that needs to be evaluated first with another physician before they start care in our office. Here are a few examples of what I’ve seen over the years. Mind you, their have only been a handful, but it was imperative that these patients get seen immediately by another physician and not our office.
X-rays are one of the most questioned by patients. We’ve been scared all our lives into thinking that X-rays are bad and we should avoid them at all costs. Although, I can understand this line of thinking, the science does not support that general spinal films, applied using a digital system, along with the filters we add, the radiation is reduced from 65-97% depending on the area imaged. https://eriksenchiropracticlaser.com/storage/app/media/xray-filters-021218.pdf
Story #1: When I was first in practice, maybe 2 years in, a gentleman came in with left shoulder and neck pain. He said that he was doing some heavy lifting and general physical activity when it became unbearable. It has been going on for about a week, ever since that day. Seems rather cut and dry. After doing the initial history, exam, and X-ray’s, I briefly looked at his films to make sure we could see all the structures that were important for evaluation, and I saw something rather suspicious. This is what I saw:
What you are seeing here, my friends, is a thoracic aneurysm! The pain upon exertion was due to this large vessel that was about to burst! This is instant death should it burst, but, can be very recoverable if found and addressed with a surgical procedure. At this point, I showed him what I found, made a copy of his films for the emergency room and told him to go directly there. This is an instance where this knowledge saved his life! I also want to say that he was under regular care by a cardiologist, who he went to first because it originally started as mild chest pain. The cardiologist did a brief exam and changed some of his medication and sent him on his way. I could have taken that information and not looked further, thinking that the cardiologist did his due diligence—I mean, it did seem very muscular and/or spinal in nature based upon the history of when the pain started. So, coming to that conclusion was definitely valid on the cardiologist’s part.
I continually go back to this example when patients are leery of taking films. Should I have adjusted this gentleman without films, the outcome may not have been a good one. Diagnostics are important not only to determine the course of care, but whether or not the problem IS a chiropractic one!
Story #2: A sweet women came in with low back pain that started about 3 months prior, really out of nowhere. It radiated down both her legs every once in a while when she bent over. This was interfering with her activities of daily living. She couldn’t take her walks anymore and even swimming seemed to aggravate it. Again, low back pain and sciatic-like pain is something chiropractors see every day. After taking films, I noticed severe bone loss in and between her L4/5 vertebrae. This is what I saw:
What you are seeing is known as discitis, or an infection of the disc which has now eaten into the vertebrae. This is an example of what is not a chiropractic case—until AFTER the infection has been taken care of by another physician. Infections of the spine and disc tissues creates a severe inflammatory condition that eventually spreads into the bone itself. This causes bones to become very prone to breaking and therefore a chiropractic adjustment, no matter how gentle, is contraindicated. I sent the films to a DACBR, a radiologist that specializes in spinal films, and they confirmed my findings. I then saw her for her report the next day and gave her all the pertinent information to her primary care physician so she could get to the appropriate caregiver. Before seeing me, she was seeing her primary care and only received pain killers and muscle relaxers—HE NEVER EVEN SUGGESTED GETTING AN X-RAY! What If we decided to do the same thing and caused further damage? Just another reason why we take our diagnostics so seriously here at HealthWorks!
Story #3: A young lady, a cheerleader and gymnast came in with neck, back and arm pain. Given how hard she pushes her body to do all the things that gymnasts do, this seemed like an obvious case to me. After all, she trains for gymnastics 6 days a week and somehow finds time for cheerleading AND school work! Made me tired just listening to her go through her day! After taking her films, I noticed something odd in her arm. A little spot that seemed not quite right. This is what I saw:
Do you see how the arm bone (humorous) looks like it has “bubbles” or part of the bone is missing? I sent it to the radiologist and as it turns out, it was a benign bone cyst. Happens mainly in children and young adults and can cause a break of the bone because the cyst decreases bone density in the region. Unfortunately, I had to tell her that she needed to refrain from her cheerleading and gymnastics and get an appointment with her pediatrician to figure out the best course of action. Once she was under care and getting the cyst taken care of, we were able to start care for the other issues associated with her neck pain—which was a chiropractic problem, and she made a full recovery in all areas. Sometimes collaboration within the healthcare field is needed for the very best outcome for patients. To me, it’s a win-win!
These are just a few examples that involve the taking of x-rays and why it’s so important to image what’s going on with the spine on the inside. Needless, to say ALL the patients were extremely thankful (ok, well maybe not the cheerleader), to get this vital information.
How about the other diagnostics that HealthWorks performs? Seeing what the structure of the spine looks like on the inside is just one of the vital tools we use to evaluate your case. Each and every patient that walks through our doors may have similar issues like headaches, neck pain, low back pain, etc., but each present vastly different and therefore getting all their information is critical to create a proper care plan.
The CoreScore
The CoreScore evaluates the function of the nervous system. The spine and spinal nerves reside in the spinal column and therefore the evaluation of this function is crucial in finding out what nerves are irritated and what nerves are functioning well. This allows us to determine the cause of the problem and not simply chase your symptoms around.
Here’s an example of a CoreScore report:
What do the numbers mean?
Think of these numbers like grades; the higher the better, with 100 being the perfect score. We use these scans not only to find out where you are when you first come in, but how you are progressing during your course of care.
What is Heart Rate Variability (HRV)?
This scan shows us how well your body is able to adapt to external stressors-chemical, physical and emotional. In other words, how much ability you have to heal and change, and what kind of initial outcome we can expect.
What is a Surface EMG scan (sEMG)?
This scan, called a Surface Electromyograph, reveal surface electricity and the variations from one level to the next. Subluxations cause changes in muscle tone that show up on this scan as changes in surface electricity. It determines how well the nerves to your muscles are functioning.
What is a Thermal Scan?
This scan measures heat along your spine. When misalignments are present, there can be a change in temperature from one side to the other (asymmetry), due to changes in blood supply. This helps us determine what nerves, that supply information to your organs and glands, may be inflamed and irritated.
Overall, the CoreScore helps us determine the overall health of your nervous system. The nervous system is very elusive and where you feel the problem, may not be the cause. This, along with correlating your other diagnostics give us a great roadmap to determine the very best course of care for you individual case.
Posture/Palpation and Leg Check
I’ve gone extensively over how posture is so important when it comes to spinal health and well-being in previous blogs, so check those out too! Essentially, posture is the “window to the spine”. It allows us to see what muscle groups are functioning properly and which ones may be compensating depending on how your present. Here’s a great example of a before and after posture change after being under care:
Palpation is when the doctor feels your spine to determine what segments are moving and which ones are “stuck”. Vertebrae should rock evenly back and forth without any inflammation or tenderness around them. We also determine what muscles are more tense and tender—this feedback from you is a very important part of your case history.
The Supine Leg Check is one of the first neurological signs that the very top bone of your spine, C1/Atlas is out of alignment. What!? What do you mean? What do my legs have to do with my spine? Well, I’ll tell ya. The atlas surrounds part of the brain stem. The brain stem controls many things like your breathing, heart function and yes, your postural muscles. When the atlas is out of alignment, it puts subtle pressure on the brain stem causing it to send aberrant information to the postural muscles, like a muscle spasm on one side of your body that torques your hip and pulls your leg up. This make it look like you have a “short leg”.
This is an example of what an atlas misalignment does to your entire body!
Raise your hands if you feel like this! Imagine, just one tiny bone at the top of your neck could cause all these symptoms AND one very precise and gentle adjustment could help you feel like your no longer tied up in knots. SIGN ME UP!
Having a thorough chiropractic exam is vital to make sure what you are experiencing is a chiropractic issue or if we need to consult another practitioner. Without this knowledge both you and your chiropractor will not be able to be fully informed on how to proceed with your care.
Our promise to you
HealthWorks is dedicated to comprehensive and specific approach to taking care of spinal and nervous system needs. Let us help you find out how taking care of the most important system in the body will create optimal health that will last a lifetime!
If we find we’re not the best to help, we promis
Headaches of all kinds are truly a day-killer and can take a toll on work and family life. 14.2% of Americans 18 or older report having some type of headache within a 3 month period and headache pain is the 4th leading cause for emergency room visits. (1) It’s a huge health problem to say the least! Wouldn’t it be great if treating a migraine didn’t mean needing to take drugs or missing productive days in your life? Upper cervical chiropractic care may be just the relief you’re looking for.
Let’s take a look at the most common types of headaches:
Tension Headaches
Notably the most common with 30-70% of the population experiencing this type of headache. (2) The stress consuming the modern world contributes to its prevalence.
Common causes:
-Emotional stress
-Computer/screen time
-Dehydration
Symptoms include:
-Stiffness and tenderness in neck muscles
-Pressure like a vice around the entire head including the back of the head
-Tension and pain in the upper shoulders
Cervicogenic Headaches
Common Causes:
-Degeneration of the cervical spine
-Poor posture, specifically forward head posture
-Strenuous activities
-History of whiplash injury
Symptoms Include:
-Dull, moderate pain in the neck and back and top of head
-Reduced range of motion and flexibility of the neck
-Blurred vision
-Pain on down arms and on top and between shoulder blades
Cervicogenic headaches affect both men and women, with women slightly more often. They tend to be mistaken for migraines, but are more moderate in nature and manifest from the neck and move upward into the head. However, they have been known to cause episodes of nausea/vomiting, dizziness and sensitivity to light and sound the longer the episode lasts.
Migraine Headaches
Typically these affect women more than men. The literature shows that migraines affect the cranial vascular system which makes these exceptionally debilitating.(3) In some cases they can last for up to 72 hours and cause significant strain on the work-life balance.
Common causes:
-Weather changes
-Hormones
-Dehydration
-Stress
-Low blood sugar
-Lack of sleep
Symptoms include:
-Nausea/vomiting
-Vision issues
-Sensitivity to light/sound
-Dizziness/vertigo
-Throbbing, unrelenting pain on one side of the head
Rebound Headaches
Also called Medication Overuse Headaches (MOH) and these typically occur with migraine sufferers. The more intense or frequent migraines become, the more medication is used and in these situations the migraine can come back with a vengeance or become a long, dull tension headache that never seems to go away no matter what you do. In these cases, finding an alternative treatment when your medication is actually causing you symptoms to become worse or longer lasting may be your answer!
Sinus Headaches
Some sinus headaches do have similar symptoms of migraines but have some distinct differences.
Common causes:
-Infection
-Common cold
-Allergies
Symptoms include:
-Fever
-Stuffy/runny nose
-Pressure/pain behind eyes
-Pain in top teeth
-Ear pain/fullness
Post-Concussion Headaches
Long after onset of initial symptoms of concussion subside, headaches can persist. In any head injury situation, the neck, especially the upper cervical region (C1/C2), is very vulnerable to damage. These types of headaches often come with other disturbing and debilitating symptoms (3).
Symptoms Include:
-Insomnia
-Concentration difficulties
-Mood changes
-Depression/anxiety
-Visual disturbances
A concussion is a head injury, so why is the upper part of the spine so important? When the atlas (C1) misaligns it impairs the brainstem’s function and alters proper communication between the brain and body.
Headaches are very common in post concussion sequela. Two studies, one with 452 and another with 212 people, they showed a headache rate of 58%. (8)
Typically we see that blood flow to the brain is hampered due to an atlas misalignment. C1 has openings on either side of the vertebrae for the vertebral artery to pass bringing oxygen-rich blood to the brain. If the atlas is misaligned, this will seriously impair this process causing many of the symptoms described.
One of the most significant observations in post concussion syndrome is reduced cerebrospinal fluid drainage. With and upper cervical misalignment, this causes a “bottleneck” reducing proper flow and drainage and can eventually cause chronic intracranial pressure not only causing severe headaches, but other chronic conditions can also eventually occur. (5)
Cluster Headaches
Common Causes:
-Mostly in men
-Smoking
-Alcohol
-Changes in sleep patterns
Symptoms Include:
-Pain, swelling and drooping in and around one eye
-Tearing of the eye
-Runny or congested nose
-Red, warm face
-Sweating
Cluster headaches cause a severe, piercing pain behind one eye and attacks can last for only 15 minutes for up to 3 hours, but can occur several times per day for many days in a row. This is one reason why this type of headache is often called the “Suicide Headache”. Suffers are often exhausted after an attack simply due to the magnitude of pain it causes.
How is it that a specific chiropractic technique can provide relief for so many different types of headaches? Well, the answer is that it is SPECFIC!
Research shows that headaches are often linked to a misaligned atlas—the top bone in the spine. A misalignment causes tension in the spinal cord and the disruption of the brains ability to communicate with the body. This affects the body’s normal functions such as the flow of blood or spinal fluid (5). The pressure associated with the misalignment can cause tension leading to the different types of headaches depending on what tissues are most affected.
Our trained upper cervical chiropractors take great care in the consultation, examination and diagnostic portion of your care before your first alignment.
What are the diagnostic tools that an upper cervical chiropractor might use? (6)
-Palpation is key in knowing what areas of the spine are moving properly and which ones are not. Muscle tension and tenderness are also key for a clear understanding on how these misalignments are affecting the entire musculoskeletal system.
-Postural assessments are used to determine asymmetry and what muscle groups are most affected when the atlas is out of alignment. The use of pre and post postural assessments can help our chiropractors decide what muscle groups need specific exercises to help strengthen and correct abnormal posture. Each patient in our office receives these exercises based on their post alignment posture assessment, so our recommendations are unique to each patient.
-Leg length inequality is checked while you are lying on your back and is one of the first neurological signs that the atlas may be out of alignment. This is typically not a true anatomical “short leg”, but a functional short leg due to the atlas misalignment. An atlas misalignment causes a drawing up and torsion of the hip causing one leg to appear shorter. Imagine walking, running, sitting and even sleeping with one side of your body completely unbalanced and your muscles working harder on one side more than the other, day in and day out.
Posture plays a significant roll in the cause of headaches and migraines, especially forward head posture. Due to the use of mobile phones and constant computer use, forward head posture has become an epidemic and coupled with an atlas misalignment, the chance of perfect storm for a headache or migraine ruining your day exponentially increases.
It’s easy to understand why poor posture can contribute to headaches and migraines, but why is the upper cervical region (Atlas/C1) so important to maintaining proper posture? Let’s nerd out for a moment…
The atlas surrounds a portion of the brainstem. Because of it’s unique connection to the brainstem via the dentate ligaments, it can stress and even deform the brainstem when the atlas or craniocervical junction misaligns. This is called the Dentate Ligament-Cord Distortion Hypothesis that was first presented by Dr. John Grostic, DC. (4)
When the atlas misaligns, due to trauma, repetitive stress or even emotional stress, this affects the part of the brainstem that controls all of your postural muscles, particularly, the spinocerebellar tracts and reticulospinal pathway arising from the lateral part of the mesopontine tegmentum and spinal locomotor network in the brainstem that contributes to this process. The figure below shows this phenomenon in detail.
-Precision films are taken which provides a specific “listing” or vectors that pertain to how your misalignment needs to be corrected. In most cases, immediately following the initial adjustment of the atlas, post films are taken to note the amount of correction. This allows our doctors to “fine tune” the adjustment and get an even more precise alignment the next time you need an atlas adjustment.
An upper cervical adjustment can be done by hand, a handheld instrument or a table mounted instrument to perform the adjustment. In our office, we use the handheld instrument. It allows us to perform not only a precision adjustment, but one that uses only a gentle tap.
Upper cervical chiropractic is gentle, yet powerful enough to relieve even the worst headache conditions and not just temporarily. Most patients have long lasting relief as long as their alignment holds, which is the goal of our upper cervical chiropractors!
References:
Momma was right! Your posture really does matter! Posture as the cause of headaches…really??
How many times did your mom yell at you to “sit up straight!”? It’s a memory that is still burned into my brain to this day. However, posture is so much more than looking good and feeling confident, it can really mess up your day should it be the cause of those nagging, production sabotaging, mood wrecker pounding headache.
In today’s world of tech, sitting now is the norm and walking has become a chore. We are chained to our desks while we toil away on our computers and then we are beholden to every buzz and ring of our cell phones—forward head posture is now the result of this necessary evil and dare I say, obsession.
There is actually a diagnosis code given to this escalating problem in which they label it “text neck” a concept conceived originally by conceived by Dr. Dean L. Fishman, D.C.. This goose-neck posture is now the dominating stance among the majority of our advanced civilization.
Does this look familiar:
A recent study shows that nearly 80% of the population between ages 18 to 44 keep cell phones with them almost every waking minute. Most estimates showing only having two hours a day without their phone in or near their hands. The stress of constantly looking down at a phone or device creates a dangerous condition known as “tech neck”. Body and spinal design do not come equipped with enduring the constant and sustained neck pressure. (1)
Whether it’s incessantly checking our phones or sitting at our desks for eight to ten hours straight, forward head posture may be a common cause of headaches.
A recent systematic review done in Hong Kong suggests that prevalence of musculoskeletal problems with mobile phone usage are high ranging from17.3% to 67.8% for neck complaints. (1)
Let’s look at the muscles that work hard everyday to keep you upright.
Honestly, just looking at this picture gives me a headache! Take a look at the bright red area on the back of the neck. Ask yourself, do your headaches typically start in the back of your neck/head and travel forward giving you the throbbing tension headache that becomes a day-wrecker? If you said a resounding “YES!”, then it’s quite possible text/tech neck or a chronic forward head posture is the bane of this miserable malady.
But, this doesn’t just end at headaches and neck pain, oh no! This issue is a literal domino effect that will eventually affect your entire spine and body. I typically refer to this effect as “The Curse of the Biped”. Why? Because, as homo sapiens we need to maintain continuous balance on all sides of our bodies to remain upright and balanced on two feet. Should an imbalance occur, we have to chronically compensate for fall down. This balancing act occurs during our entire waking day, whether we are sitting or standing—the balancing act is constantly making subtle compensations—tightening this muscle here or relaxing this muscle there to try and maintain this upright position.
When the head moves in forward extension, away from the neutral and balanced position, a heads effective weight feels as if it has doubled. “For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds.” (2). Forward head posture is becoming an epidemic with the ever growing use of technology in the form of cell phones, laptops, tablets and personal computers. Of particular importance is this syndrome in young children and adolescents has been shown to be associated with “cervical degeneration along with other developmental, medical, psychological, and social complications”. (3) This can lead to significant increases in neck and back pain in the modern world significantly affecting the overall health of both children and adults.
As a chiropractic office, we see this issue day in and day out. So, as part of a curiosity as well as a requirement to complete my studies to obtain my Diplomate of Chiropractic in Craniocervical Junction Procedures through the International Chiropractic Association Upper Cervical Council, I set out to see how the Orthospinology procedure (the upper cervical chiropractic technique utilized at HealthWorks) affected forward head posture. Much to my delight (frankly, I didn’t want to have to find another study design with a deadline lurking), the results were not only showed a positive correlation, but statistically significant as well—which is uber important in any study design!
Synopsis of the study:
Methods, Setting and Participants
A paired group study was performed which included 50 participants who were new patients from one private chiropractic clinic. Patients were ranging in age from 7 to 76, with 76% being female and 24% being male. The outcome assessed pre and post effective head weight following a specific correction of established craniocervical junction misalignment.
The human head weighs around 10 pounds and represents 8% of the total body mass as determined by researchers at the Department of Anatomy & Histology, University of Sydney. An ideal posture is when the tragus of the ear is positioned vertically above the acromion process; the head is then perfectly balanced. The PostureScreen Mobile Application uses a patient’s total body mass and determines the patient’s actual head weight using this calculation. (4)
For the purposes of this study, a lateral digital picture was taken using the PostureScreen Mobile Application with an Apple iPad. In order to account for the natural visual correction of posture (4), participants were asked to close their eyes, flex, extend and rotate their head from left to right and return to what they believed to be center without opening their eyes. Five anatomical landmarks were plotted to note lateral posture abnormalities. These landmarks included the tragus of the ear, acromion process of the shoulder, the lateral trochanter, lateral knee at the tibial tuberosity and lateral malleolus. The application then calculated the patient’s actual head weight and effective head weight due to the forward head posture presented. Effective head weight is physiologically significant because “For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds.” (2)
Intervention
Along with receiving a postural assessment on the first day of presentation, they also received a complete set of orthogonal films and analysis which “analyzes the relative positions of the occiput, atlas, and axis…demonstrating signs of a chiropractic subluxation from their evaluation” (5). The set of films included a lateral cervical neutral, nasium, and vertex views. “Radiographic examination of these structures confirms presence of misalignment allowing each adjustment to be specifically tailored using the patient’s osseous measurements”. (5) On a separate visit, the specific correction was made using Orthospinology procedures to procure the coordinates or “listing” found during the analysis. This listing determines the specific vectors needed to correct the CCJ misalignment specifically designed for each patient.
The correction was made using a KH-2 Laney, handheld adjusting instrument. A stylus was placed on the lateral neck at the transverse process of the atlas, with the patient lying on their side. The positioning of the patient and the line of drive, lateral to medial and the specific vectors used were calculated using the listing mentioned previously from the Orthospinology procedures x-ray analysis. (5)
A new postural evaluation was then made using the PostureScreen Mobile application, following the correction.
Results
Among the 50 participants, pre- to post-effective head weight decreased (mean = 30.5 lbs vs. 24.9 lbs, difference = 5.6 lbs; 95% CI 2.0, p<0.05 P(T<=t) two-tail 4.78197E-05). The result included all 50 participants, as the exclusionary measures were taken into account prior to the calculations being obtained.
Discussion
This study was not undertaken as merely a curiosity, but to determine whether a specific, gentle intervention regarding the correction of a CCJ misalignment, could possibly play a significant role in the initial treatment of forward head posture, as this postural abnormality is also associated with more than just neck, back or spinal pain, but other comorbidities like chronic posture-induced headaches that is a burden on individuals and families at home and in the workplace.
Further research and case studies regarding forward head posture and Migraines and Headaches
According to the CDC, 14.2% of adults suffer from migraine or severe headache over a 3 month timeframe. Approximately 37 million people suffer from migraines in the United States alone and it’s the 4th leading cause of an emergency room visit, with women in childbearing age being more affected than men (6).
In a case study, involving a 56 year old male, presented with “severe forward head translation of the head”, and following a course of chiropractic care and myofascial release for a period of 7 months, his headaches did not recur and he also showed improvement on x-ray in regards to the previously noted forward head posture. (7)
In another indexed study, 20 participants with unilateral migraine, along with 20 controls, migraine sufferers “showed a smaller cranio-vertebral angle than controls, thus presenting a greater forward head posture”. (8)
Conclusions
Specific correction of CCJ misalignment shows a positive initial impact on combating the epidemic of forward head posture which could lead to decreasing its noted complications in modern human health. Future studies are warranted that should include a larger cohort, multiple clinics, continued monitoring of progress while under care for a longer period of time, along with added beneficial exercises. This could further determine the significance of the postural changes and its effectiveness in decreasing the health implications associated with forward head posture.
This inter-office study is just one of the many ways HealthWorks looks deep into the cause of headaches and other Musculo-skeletal issues that can really affect the daily lives of the community. Upper cervical chiropractic care may be just the hope and help you need! Let us help you find out!
References:
1) International Journal of Community Medicine and Public Health Samani PP et al. Int J Community Med Public Health. 2018 Aug;5(8)
2) Kapadndji, A.I., The Physiology of the Joints: The Spinal Column, Pelvic Girdle and Head, Vol.3, 6th Edition, Churchill Livingstone, 2008
3) Vate-U-Lan, P., (2015). Text Neck Epidemic: a Growing Problem for Smart Phone Users in Thailand. International Journal of the Computer, the Internet and Management Vol 23 No. 3 (September-December) pp. 27-32.
Retrieved from: http://www.ijcim.th.org/SpecialEditions/v23nSP2/02_55A_Epidemic.pdf
4) Boland, D.M., Neufeld, E.V., Ruddell, J., Dolezal, B.A., Cooper, C.B., Inter- and intra- rater agreement of static posture analysis using a mobile application. J Phys Ther Sci. 2016 Dec; 28(12): 3398-3402 [Pubmed]
5) Rochester, R.P., Neck pain and disability outcomes following chiropractic upper cervical care: a restrospective case series. J Can Chiropra Assoc. (2009) Aug; 53(3): 173-185 [Pubmed].
6) Lee, W.Y., Okeson, J.P., Lindroth, J., The relationship between forward head posture and temporomandibular disorders. J Orofac Pain, (1995) Spring;9(2): 161-7. [Pubmed]
7) Gadotti, I.C., Berzin, F., Biasotto-Gonzalez, D., Preliminary rapport on head posture and muscle activity in subjects with class I and II., J Oral Rehabil. (2005) Nov;32(11): 794-9. [Pubmed]8) Burch RC1, Loder S, Loder E, Smitherman TA., The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies. Headache. 2015 Jan;55(1):21-34. [Pubmed].
What is the Atlas/C1?
The cervical spine (neck) contains 7 bones or vertebrae labeled C1 – C7. The C1 vertebra, known as the Atlas, is the first bone in the spinal column.
It's named Atlas, after the Greek Titan who was condemned to hold up the world on his shoulders (in this case your head).
More than just a foundation for support, the atlas bone itself is perhaps the most important vertebrae of the body. It’s home to a complex bundle of nerves and critical vertebral arteries, and it’s the point responsible for bearing the entire weight of the skull.
In the myth, Atlas must be careful to always hold the world still and strong, or everything would come crashing down.
He did this by balancing the world perfectly on his back.
Your Atlas/C1 vertebrae has been charged with the same task – it must hold your head strong and still, otherwise problems with balance and alignment will absolutely develop, affecting the ENTIRE spine below.
When there is a misalignment of the Atlas/C1, the communication between the brain and the rest of the body is disturbed leading to a structural and functional deficit.
These misalignments may be present from birth (even in the case of a delivery by Caesarean section) and may be worsened by traumas such as whiplash and crash collisions throughout a lifetime.
The Atlas or C1 has a direct influence on the brain stem. The brain stem controls many important systems within the body like the cardiovascular system, respiratory system and the one that upper cervical chiropractors evaluate, your postural or spinal muscles.
These muscles start at the back of your skull and all the way down your hips. They work hard for you every day and keep you upright and moving. However, when the Atlas/C1 is out of alignment, this causes tension at the brain stem. These create aberrant signals that result in what seems like a “muscle spasm” that affects one side of the body, causing unlevel shoulders and hips and even a forward head posture.
One of the first signs that we find when the atlas is misaligned is a short leg. This is the explanation from a cited article within a study called Craniocervical chiropractic procedures – a précis of upper cervical chiropractic (1): “This screening procedure does not look for an anatomic short leg but apparent asymmetry of observed leg length, describing a functional short or “contractured leg”. Presence of an apparent short leg requires further patient evaluation to determine the need for UC intervention. The proposed mechanism originates from pelvic obliquity resulting from reflexive balancing of neurologic insult created by atlas misalignment.”
In other words, one side of your body is in a big muscle spasm due to the “pressure” placed on the brain stem due to the atlas misalignment, where the postural muscles get their information on how to properly function. Our goal at HealthWorks is to precisely re-align the atlas so that this information center can function properly.
I like to think of the spinal column like a train. The atlas is the engineer of the train, the neck is the engine and the low back/sacrum is the caboose! (Bet you’ll never look at a spine the same way again!). What happens if the engineer of a train decides to take the engine off the track? What happens to the rest of the cars and the caboose? Right! The ENTIRE train goes off the track! By aligning the atlas/C1, this allows the rest of the “cars” to become better aligned, the postural muscles to become more balanced and the leg length and the hips to show even.
Another way to visualize how important atlas/C1 alignment is if the atlas/C1 is the master breaker in your breaker box that controls all the electricity in your house. What happens when you turn the master breaker off? Right! Your entire house no longer functions properly! As humans, our home for our time here on this planet is our body…which brings me to another topic, one concerning efficiency.
Many patients become upset when their atlas is out of alignment and rightfully so! Their master breaker has been “turned off”! I get it, however, the order of operations to restore normal function of your “home” must happen in order to regain balance. Would you try to use your dishwasher or blow dryer before you flipped your master breaker? No! Of course not! It simply doesn’t work that way and neither does your body.
After an atlas/C1 alignment, it takes several hours to unwind the spasmed muscles and to regain normal balance. Does it make sense to try and adjust the rest of the segments of the spinal column if the muscles are contracted like this due to an atlas/C1 misalignment?
How much proper motion and movement do you think can be achieved in a spine that needs to unwind? Understanding that the body needs to have the time to achieve this balance is sacred in the upper cervical chiropractic umbrella of techniques.
For the Nerds…yeah, you know who you are!
“The intermedius nucleus of the medulla: A potential site for the integration of cervical information and the generation of autonomic responses.” Journal of Chemical Neuroanatomy November 2009 (38) pp. 166-175.(2)
Authors: Edwards, Ian J., Deuchars, Susan A., Deuchars, Jim.
This white paper discusses the significance of the 2009 study published in the Journal of Chemical Neuroanatomy called “The intermedius nucleus of the medulla: A potential site for the integration of cervical information and the generation of autonomic responses.”
This study helps clarify why upper cervical subluxations negatively influence the autonomic nervous system and contribute to visceral and systemic dysfunction. Though the findings may seem rather elementary or non-amusing, they are quite impressive. The findings research like this help explain why upper cervical Chiropractors have seen such great results in the health of their patients over the past 120 years.
Findings were as follows:
Whew! LOTS OF IMPORTANT STUFF GOES ON AT ATLAS/C1!!
Upper cervical corrective care is a logical, effective, safe and scientifically proven procedure in the Chiropractic profession. It is designed to restore Atlas/C1 Alignment (Body Balance) to remove interference at the point where the head and neck join, in order to re-activate the body’s natural self-healing process by relieving pain and discomfort within the musculoskeletal and neuromuscular systems. Anytime our body experiences pain, this causes extreme stress within and can cascade into other inflammatory issues or can even exacerbate existing health conditions.
Chiropractic and medical experts agree that electrical and chemical messages control, monitor and maintain all body functions. These messages also direct all body healing. These messages leave the brain by way of the brainstem, pass through the top two bones in the neck (C1/C2), down the spinal cord, and throughout the entire nervous system to all parts of the body.
Atlas/C1 misalignment can cause interference at the point where the head and neck join and disrupt or distort the flow of these vital health and healing messages to any part of the body. Disrupted or distorted brain messages will allow pain and other problems to develop. At HealthWorks our objective is to restore Atlas/C1 alignment and reactivate efficient flow of neuromuscular and musculoskeletal health and healing messages to the affected part of the body so its natural self-healing process can regain and maintain optimal nervous system health.
When an Atlas/C1 misalignment is corrected and body balance is restored so healing messages can flow uninterrupted to the affected area, muscles begin to relax immediately, blood and oxygen circulation is increased, and the body’s natural self-healing process begins. When there is pain or suffering, always check for Atlas/C1 misalignment to determine if the brain is efficiently communicating with all parts of the body.
Any part of the body that cannot communicate efficiently with the brain will develop health problems. Therefore, it would be logical to say, the proper diagnosis for health problems that respond to the Upper Cervical Correction is “Head/Neck Misalignment.”
Here’s a list of common issues that respond very well to Upper Cervical Correction:
And so many, many more!
You see, an atlas/C1 adjustment is the most comprehensive and “full-body” adjustment you’ll ever receive!
Imagine, just one tiny bone at the top of your neck could cause all these symptoms AND one very precise and gentle adjustment could help you feel like you’re no longer tied up in knots. SIGN ME UP!
Having a thorough chiropractic exam is vital to make sure what you are experiencing is a chiropractic issue or if we need to consult another practitioner. Without this knowledge both you and your chiropractor will not be able to be fully informed on how to proceed with your care.
Our promise to you
HealthWorks is dedicated to comprehensive and specific approach to taking care of spinal and nervous system needs. Let us help you find out how taking care of the most important system in the body will create optimal health that will last a lifetime!
If we find we’re not the best to help with your condition, we promise to refer you to someone who is.
References:
Quality Care You Can Trust. We offer our patients all the attention and care they deserve in order to get them feeling healthy again.
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