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.

Multiple Sclerosis and Upper Cervical Care: Case 5

Editor's Note: This is the sixth of a seven post series where I will be sharing 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.

CASE 5

History: This 43-year-old female first experienced symptoms of MS seven years ago. The symptoms included numbness in her legs, hands, and face, and lasted for two weeks. No further symptoms occurred until six years later with the onset of L'hermitte's Sign. Soon after L'hermitte's Sign began, this patient noticed loss of grip strength and a spasmodic curling of her left hand. After an MRI, she was diagnosed with MS. Because Lhermitte's Sign was present every time she nodded her head causing her pain, she began daily pain medications (neurontin). After the symptoms were constantly present for six months, she began upper cervical care.

Exam: During her initial (upper cervical) chiropractic exam, cervical flexion produced L'hermitte's Sign. Cervical extension and left rotation were reduced and painful. She reported constant tingling in her left arm, grip strength loss in her left hand, and weakness and pain in both forearms. She experienced aggravation of forearm pain while taking notes in class. As an avid martial arts participant, she expressed concern over her inability to perform push-ups in class due to exacerbation of L'hermitte's Sign. She also reported experiencing dizzy spells several times per day for many years. Cervical radiographs depicted right laterality of atlas. Computerized thermal imaging revealed thermal asymmetries of 0.5ºC.

Outcome: After the first upper cervical adjustment, this patient noted reduction in intensity of L'hermitte's Sign. By the end of two weeks of care, L'hermitte's Sign was noticeable only occasionally and no dizzy spells had occurred. After four weeks of care, this patient no longer reported experiencing any dizzy spells, arm pain, tingling, forearm weakness, or L'hermitte's Sign. Consequently, she reduced her pain medication dosage. In addition, she resumed taking notes in class and performing pushups in her martial arts class without pain or tingling.

Summary: This subject's symptoms were present constantly for six months prior to upper cervical care. With the intervention of (upper cervical) chiropractic care, symptoms were reversed either immediately or over one month's time.

Multiple Sclerosis and Upper Cervical Care: Case 4

Editor's Note: This is the fifth of a seven post series where I will be sharing 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.

CASE 4

History: This 55-year-old female was diagnosed with MS nine years ago at age 46 after an MRI confirmed active brain lesions. Her symptoms included painful paresthesia of her left arm, fatigue, mental confusion, insomnia, and lack of coordination of her right arm and leg. All symptoms progressively worsened over the nine-year period. Seven years after her diagnosis, a follow-up MRI confirmed the addition of new active lesions. Due to the fatigue, confusion, and pain, she had been on disability leave from work for several years.

Exam: During this patient's initial exam, she complained of extreme pain in her left arm, requiring multiple doses per day of pain medication (neurontin). She also took daily medication for sleeping (klonopin) and energy level (amantadine) due to her insomnia and fatigue. Her handwriting coordination (right-handed) was poor so she preferred using a computer. Cervical radiographs depicted a misalignment of her atlas to the right and posterior. Computerized thermal imaging revealed thermal asymmetries of 0.5ºC.

Outcome: During the first week of upper cervical care, this subject noticed an increase in energy level. One month later, she no longer noticed arm pain. Consequently, she consulted with her neurologist to reduce her pain medication. Her pain medication was reduced by two-thirds and she had no occurrences of arm pain. This patient also reported a continued increase in energy level and a renewed sense of mental clarity, so she considered looking for a part-time job. She felt "more alert and energized" and her "mind was clear." Four months after the start of upper cervical care her condition continued to improve without any relapses.

Summary: For the nine years prior to upper cervical care, this patient suffered from a chronic, progressive worsening of MS symptoms. Since the intervention of upper cervical care, this individual experienced improvements in MS symptoms and required less medication.

Upper Cervical Care and MS: Case 1

Editor's Note: This is the second of a seven post series where we will be sharing 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.

CASE 1

History: This 54-year-old female was diagnosed with Multiple Sclerosis at age 44 after a bout of optic neuritis, which prompted an MRI (MS plaques were visible). Over the next nine years, she experienced a minimum of one exacerbation per year lasting an average of one month. She recovered completely each time except for partial vision loss resulting from optic neuritis. The most recent flare-up occurred at age 53 when she experienced numbness that switched from side-to-side in her body. With this exacerbation, no remission occurred. Symptoms included tingling in her arms, hands, legs, and feet as well as a positive L'hermitte's Sign (pain, numbness, tingling down extremities upon cervical flexion). After these symptoms were present for three months, this subject's neurologist surmised her condition was worsening and recommended drug therapy. Due to her concerns over long-term drug use, this patient chose to undergo upper cervical chiropractic care first.

Exam: During her initial chiropractic examination, this subject showed reduced sensitivity bilaterally in her arms, hands, legs, and feet. L'hermitte's Sign was present during cervical flexion and right lateral flexion compression was positive. The subject reported experiencing these symptoms constantly for the three months prior to her chiropractic exam. Cervical ranges of motion were reduced during left lateral bending and left rotation. She reported visual loss from previous optic neuritis episodes. Computerized thermal imaging showed thermal asymmetries as high as 1.0 ºC. Analysis of cervical radiographs revealed left laterality and left anterior rotation of atlas.

Outcome: Immediately following this subject's first upper cervical adjustment, Lhermitte's Sign was no longer present. During the following week, normal sensation returned to her extremities. After two weeks of upper cervical care, cervical ranges of motion no longer produced pain and cervical compression tests were negative. At the end of week four, this patient reported improved vision in her left eye (which had been damaged by the episode of optic neuritis ten years earlier). After four weeks of upper cervical care, this subject's neurologist reexamined her and no longer recommended drug therapy. Two years after beginning upper cervical care, this subject remained symptom-free.

Summary: This patient experienced a minimum of one relapse per year for the ten years prior to upper cervical care. After upper cervical intervention, two years passed without reoccurrence of symptoms.

Multiple Sclerosis, BJ Palmer and Upper Cervical Care

Editor's Note: This is the first of a seven post series where I will be sharing 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.

B.J. Palmer, D.C., reported management of Multiple Sclerosis patients with upper cervical chiropractic care as early as 1934. In his writings, Palmer listed improvement or correction of symptoms such as "spasticity, muscle cramps, muscle contracture, joint stiffness, fatigue, neuralgia, neuritis, loss of bladder control, paralysis, incoordination, trouble walking, numbness, pain, foot drop, inability to walk, and muscle weakness." His chiropractic care included paraspinal thermal scanning using a neurocalometer (NCM), a cervical radiographic series to analyze injury to the upper cervical spine, and a specific upper cervical adjustment performed by hand.

While few of Palmer's Research Clinic cases were published, Palmer described one case of Multiple Sclerosis in detail. The patient, a 38-year-old male, went to the Palmer Research Clinic in Davenport, Iowa, in 1943, after a diagnosis of MS by the Mayo Clinic. At the time of admission into the Palmer Clinic, this subject was "…helpless; he could not feed nor take care of himself." His medical history included a head/neck trauma at age 16 in which "…he fell ten feet off a building, landing on his head." The fall rendered him unconscious for thirty minutes and he reported having a sore neck for several days. At the Palmer Clinic, upper cervical radiographs showed a misalignment of the atlas to the right. After upper cervical chiropractic care, the patient remarked, "I am happy to say that through (upper cervical) chiropractic, I have been made almost well. Today, I have just a little numbness left in my hands. I have the full use of my hands, feet, and my whole body."