Friday, March 4, 2011

Multiple Sclerosis and Upper Cervical Care: Results, Discussions and Conclusions


Editor's Note: This is the last of a seven post series where I have shared five case reports on patients with MS that received upper cervical care and the results that occurred. The full article with all the reports can be read at length here.

RESULTS

At their first upper cervical chiropractic office visits, computerized thermal scans showed thermal asymmetries and cervical radiographs showed upper cervical misalignments in all five subjects. Because these exam findings indicated upper cervical injuries, all five patients consented to upper cervical chiropractic care. The five subjects underwent upper cervical care for a minimum of four months and a maximum of two years at the time of this paper's submission for publication. Before the intervention of upper cervical chiropractic care, four out of the five patients (Cases 2 through 5) showed patterns of constant, progressive MS symptoms for a minimum of six months. After upper cervical care, MS symptoms were improved or corrected, including L'hermitte's Sign, paresthesias, pain, balance, muscle weakness, bladder control, bowel control, cognitive ability, vision loss, insomnia, dizziness, and fatigue. The only case that followed the typical MS relapse-remit pattern, Case 1, had a history of MS relapses once per year for nine years. After the intervention of upper cervical care, this subject had no further relapses and remained symptom-free for two years. Therefore, results of the five cases indicated that upper cervical chiropractic care prevented the progression of MS, stopped the MS relapse pattern, and improved and/or reversed symptoms of

DISCUSSION

An important parallel in the MS patients' medical histories was their recollection of head and/or neck trauma(s) prior to the onset of MS (also mentioned in the Palmer case described in the Introduction). All five patients remembered specific incidences of trauma preceding the onset of MS symptoms such as a fall on an icy sidewalk, an auto accident, and a ski accident. In addition, all five individuals showed evidence of upper cervical injury during exams (digital infrared imaging and cervical radiographs). The body of medical literature detailing a possible trauma-induced etiology for MS, or at least a contribution, is substantial. (33-35) In fact, medical research has established a connection between spinal trauma and numerous neurological conditions besides Multiple Sclerosis, including Parkinson's Disease, Amyotrophic Lateral Sclerosis (ALS), epilepsy, migraine headaches, Attention Deficit Hyperactivity Disorder (ADHD), vertigo, and bipolar disorder, to name a few. (36-43)

While medical research has shown that trauma may lead to MS and the other neurological conditions mentioned above, no mechanism has been defined. It is the author's hypothesis that the missing link may be the injury to the upper cervical spine. While various theories have been proposed to explain the effects of chiropractic adjustments, a combination of several theories seems most likely to explain the profound changes seen in these MS patients due to upper cervical chiropractic care. After a spinal injury, central nervous system (CNS) facilitation can occur from an increase in afferent signals to the spinal cord and/or brain coming from articular mechanoreceptors. (44-48) The upper cervical spine is uniquely suited to this condition because it possesses inherently poor biomechanical stability along with the greatest concentration of spinal mechanoreceptors.

Hyperafferent activation (through CNS facilitation) of the sympathetic vasomotor center in the brainstem and/or the superior cervical ganglion may lead to changes in cerebral blood flow, including ischemia. (49-55) Because of the close association between the nervous and immune systems (the immune system recently has been reclassified as the neuroimmune system), upper cervical injuries affecting sympathetic function consequently may cause a cascade of non-favorable immune responses. (56-58) Among these are uncoordinated immune tissue responses (auto-immune responses) and the release of cortisol, which ultimately can result in decreased immune function.

It is likely that the five MS patients sustained injuries to their upper cervical spines (visualized on cervical radiographs) during spinal traumas they experienced. It is also likely that due to the injuries, through the mechanisms described previously, sympathetic malfunction occurred (measured by paraspinal digital infrared imaging), possibly causing decreases in cerebral blood flow. Consequently, because the nervous and immune systems are so closely intertwined, it is possible that CNS facilitation and cerebral ischemia could have stimulated an auto-immune response such as myelin destruction. According to the results of each of the five patients discussed in this report, it seems correction of the upper cervical injury not only stopped but also reversed the pathological processes involved in MS. However, few conclusions can be drawn from a small number of cases. Therefore, further research is recommended to study the link between trauma, the upper cervical spine, and neurological disease.

CONCLUSION

All five patients discussed in this report recalled experiencing head or neck trauma(s) prior to the onset of Multiple Sclerosis symptoms. In all five cases, evidence of upper cervical injury was found using paraspinal digital infrared imaging and upper cervical radiographs. After IUCCA upper cervical chiropractic care, all five cases reviewed revealed improvements in Multiple Sclerosis symptoms. In fact, correction of the five patients' upper cervical injuries appeared to stimulate a reversal in the progression of MS symptoms. To the author's knowledge, these are the first cases reported on this topic using thermal imaging and knee-chest adjustments since Palmer's research seventy years ago. Further investigation into upper cervical injury and resulting neuropathophysiology as a possible etiology or contributing factor to Multiple Sclerosis should be pursued.

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