Upper Cervical Chiropractic Care and the Patient with Meniere's

Guest Post by Dr. Timothy Flory

New Research Highlights Natural Relief for Meniere's Patients

Two research studies have shown the effectiveness of chiropractic management of Meniere's disease. The condition is characterized by extreme dizziness, hearing loss, and ringing in the ear. One case study on Meniere's Disease reported on the success of Upper Cervical Chiropractic in managing a patient with the disease after she underwent right vestibular nerve section that proved to be ineffective.

Dr. Tympthy L. Flory, craniocervical specialist from Atlas Spinal Care, says: "Meniere's Disease is a chronic condition that significantly reduces people's quality of life. They often suffer from recurrent vertigo and tinnitus, and some even experience hearing loss. It is known that Meniere's results from inner ear dysfunction, but evidence of the cause and effective treatment has been, unfortunately, still lacking. I have helped many people find relief, however. So it is good to see, therefore, that two significant studies have confirmed what we have believed for a long time: that chiropractic care can provide improvements in the symptoms of people suffering from this condition."

Another study investigated 300 patients, in which various improvements were noted. It was established that the primary cause of the disease in the patients was whiplash trauma, which could have been due to a blow to the head or a vehicular accident. It was found that 90 percent had atlas misalignment patterns of inferior and posterior on the other side of the affected ear. These patients, too, received Upper Cervical Chiropractic care. This study was followed over a six year period, and improvements were noted year after year. Patients reported the intensity of their vertigo using a 0 to 10 scale with 10 being most severe. The average score prior to starting treatment of the head and neck was 8.5. The intensity was down to and average of 3.0 within 6 weeks, 2.0 after the first year of care, and less than 1.0 after threes year. Interestingly, for those that maintained their atlas alignment over a period of 6 years the intensity of their vertigo remained very low, at an average of 0.8.

Both studies demonstrated that providing people with specific chiropractic care of the atlas vertebra offered benefits in terms of treating the condition. The first study concluded that this approach can be used for treating Meniere's disease by correcting the atlas subluxation complex. The second study concluded that patients who have a history of trauma and vertigo should be referred to an upper cervical specific chiropractor for evaluation.

People with Meniere's Disease have traditionally been provided with conventional medical therapy alone and not presented with other options. The new studies, however, suggest that an effective alternative exists. Upper Cervical Chiropractic care, which is a natural form of treatment, is proving to be more effective in providing long term relief.

Atlas Spinal Care is an office focused on structural correction of the head and neck, seeing many patients whose history includes trauma to the head, neck, or both. Located in Southern California, the office sees patients from around the United States seeking help with their vertigo and dizziness.

Contact Atlas Spinal Care:
Dr. Tymothy L. Flory
909-982-9100
AtlasSpinalCare@gmail.com
2335 W Foothill Blvd Suite 20, Upland, CA 91786

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(Disclaimer: Remember the objective of upper cervical care is to correct head neck misalignment that is interfering with proper brain to body communication. When this is corrected the body functions at a higher level and can often correct other problems more efficiently on its own. Please do not confuse upper cervical care as a treatment for any condition, disease or symptom.)

#UpperCervicalChiropactic Helps Some #Menieres Patients. https://t.co/UkOCaGJG8M

— Travis Robertson (@theuppercblog) December 1, 2016

Meniere’s Disease and Upper Cervical Chiropractic?

This original story appeared in the Fall 2013 NUCCA News, the quarterly newsletter of the the National Upper Cervical Chiropractic Association. It was part of one of three very different stories about healing through upper cervical care. This true-life story comes from Dr. Keith Denton in Monroe, Michigan, and was written by Dr. Zachary Ward.

Liz Hyer’s Hearing Loss and Meniere’s Disease

Liz Hyer had been managing her Meniere’s Disease symptoms well, until she began to take a turn for the worst. A chance reference to NUCCA (National Upper Cervical Chiropractic Association) on an online-support page for Meniere’s introduced her to Dr. Keith Denton. It was the first step to finally finding the full help she needed.

"Ever since I can remember," Liz Hyer told the NUCCA News, "I have had aural fullness [feeling of fullness in the ear], tinnitus [ringing in the ear], balance problems and double vision. Six years ago I was diagnosed with bi-lateral Meniere’s disease." Gradual hearing loss in both of her ears lead to the diagnosis from her medical physician.

Meniere’s is a complex and confusing disease that affects the brainstem, creating hearing and balance disturbances. Within current medical thinking, there is little that can be done for Meniere’s patients, especially the hearing loss.

Liz says that her Meniere’s episodes were mild. Though they left her tired, with ringing in her ears, and room spinning for days at a time, they only happened every few months.

Then two years ago her condition worsened. Perhaps the most noticeable change was the severe attacks of double vision. "It was to the point where I had to drive with one eye closed in order to be able to see to drive to work. It was not an ideal situation for safe driving," Liz said. Her doctor referred her to an ENT specialist who diagnosed her with another disease, known as Brown’s syndrome.

Hearing restored with upper cervical adjustment 

January 2013 was her first visit to the NUCCA doctor. "I noticed when I was having a flare up of symptoms, I would get an adjustment from my regular chiropractor and my hearing would improve somewhat," Liz said. "I did some extensive research online about Meniere’s…people were reporting that NUCCA chiropractic had helped relieve their symptoms. By the grace of God I found Dr. Keith Denton."

What happened after her first NUCCA correction? "I went home and laid down. At that point I had severe brain fog and double vision. I couldn’t think. I couldn’t see. I couldn’t hear. It felt like there was a rainforest in my head. It was like fluid running."

A week later, Liz went back to her physician, who repeated her hearing test. Liz was found to have regained her normal hearing after one adjustment. Now, nine months later, her hearing has not declined. But that was just the beginning of her healing story.

Upright MRI reveals depth of upper cervical problem 

Based on recent findings in upper cervical chiropractic research, and Liz’s symptoms, Dr. Denton thought that Liz might be experiencing something known as Arnold Chiari Malformation, where the lower portion of the brain is pulled downward into her spinal canal. He suggested Liz get an upright MRI so she would have a complete understanding of what she was facing. When she approached her neurologist, he told her that the she did not have Arnold Chiari—and that there was no such thing as an upright MRI.

Several months later, Liz tracked down an upright MRI unit in Illinois (they do exist!), and discovered that she did indeed have Arnold Chiari. "Having the hearing back, I have my confidence restored, and it gives me hope that the rest will follow with time."

Just after her interview, Liz wrote to the NUCCA News the following:

"One thing I forgot to mention during the interview was that I have had years of chronic lower back pain. This has melted away along with my hearing issue since being adjusted by Dr. Denton. I have been under regular chiropractic care since I was 18, and at least twice a month for the past 11 years, without a sign of relief for my back. In just one upper cervical adjustment, years of excruciating back pain was but a memory."

Written by Dr. Ward 

Father and dedicated upper cervical chiropractor. Find me practicing gentle upper cervical care in Oakland County, Michigan. Have a question or comment? I'm at your service. Reach me at my Auburn Hills chiropractic practice: (248) 598-4002.

(Editor's note: Remember the objective of upper cervical care is to correct head neck misalignment that is interfering with proper brain to body communication. When this is corrected the body functions at a higher level and can often correct other problems more efficiently on its own. Please do not confuse upper cervical care as a treatment for any condition, disease or symptom.)

What Has Responded To Upper Cervical Care?

For more specific stories from patients around the world click here.

(Editor's note: Remember the objective of upper cervical care is to correct head neck misalignment that is interfering with proper brain to body communication. When this is corrected the body functions at a higher level and can often correct other problems more efficiently on its own. Please do not confuse upper cervical care as a treatment for any condition, disease or symptom.)

Meniere’s Disease Breakthrough

from www.redorbit.com

Ten years of Meniere's disease research by Dr. Michael T. Burcon results in elimination of vertigo in 291 out of 300 patients.

Michael T. Burcon, DC started researching Meniere’s disease (MD) ten years ago after having three MD patients quickly recover from their vertigo under upper cervical specific chiropractic care. His papers have been published in the Journal of Vertebral Subluxation Research and the textbook, Upper Cervical Subluxation Complex, a Review of the Chiropractic and Medical Literature, by Kirk Ericksen in 2004.

The First International Symposium on Meniere’s Disease was held in Germany in 1980. Subsequent meetings were held every five years in Boston, Rome and Paris. Dr. Burcon gave his first presentation on Meniere’s to medical doctors in 2005 at the Symposium in Los Angeles. Prior to that Burcon had presented his Meniere’s research to chiropractors. He later gave two presentations to the Prosper Meniere Society in Austria and one to the Politzer Society Meeting at Cleveland Clinic.

Dr. Burcon presented his paper, “Cervical Specific Protocol and Results for 300 Meniere’s Patients,” to the Sixth International Symposium on Meniere’s Disease in Kyoto, Japan on November 16. His Session Topic was, “Novel treatment of inner ear diseases.” He also made himself available for patient consultations, technique demonstrations and interviews during his week in Japan. On Wednesday, Nov 17, he gave a demonstration at Dr. Wakagi's office in Kyoto.

Burcon has established a link between both Meniere’s disease and Trigeminal neuralgia (TN) with whiplash injuries that misalign the base of the skull with the top of the neck creating a lesion affecting the Eustachian tube and/or the Trigeminal ganglion. About half of these traumas are caused by vehicular traumas and the other half from injuries involving head trauma. Burcon believes that the correlation was not made because it takes an average of fifteen years from the time the patient was injured until the onset of symptoms.

Patients typically get diagnosed with MD or TN in middle age. Their injuries most often happened during high school or college years from a car accident, sports injury or fall on their heads. Few patients list these old injuries on their doctor’s admission paper work. In fact, they have often forgotten about them, believing they were not hurt if they were not admitted to the hospital.

Burcon Chiropractic hosted the Meniere’s Research Center’s 10th Annual Meniere’s Disease and Trigeminal Neuralgia Seminar in Grand Rapids, MI last June. Seventy doctors, patients and caregivers from five States and Canada participated. James Tomasi, author of “What Time Tuesday?” was the featured speaker. Next years seminar will be held in Ventura, CA, hosted by Dr. Jedidiah T. Smith.

Burcon has produced three Health Talk videos for GRTV. Copies of Health Talk are available free on DVD and USTREAM.

Signs and Symptoms Of An Upper Cervical Injury

These are the signs and symptoms that may indicate that you have an upper cervical spine injury, which may have gone undetected for some time. Remember these are just indicators but one should strongly consider being evaluated by an Upper Cervical Doctor if they are experiencing even just some of what is listed below. However, the posture, head tilt sign, shoulder height sign and ear symptoms will, in my opinion, make it a strong possibility that you do have such an injury.

1. Is your posture poor? Do you have rounded shoulders &/or forward head posture? Does your head feel heavy to hold?

2. Is your head tilted to one side and/or your head rotated to one side when you look in a mirror? This can be very subtle.

3. Does your nose or nasal septum deviate to one side? If so, you may find that it deviates towards the side to which your atlas has moved forward (e.g. nose deviates to the left; then atlas is forward on the left)

4. Is one of your shoulders lower than the other? Pull your shoulders back and down and look carefully for one lower than the other. Again it can be subtle.

5. Press firmly but gently with your thumb into the impression just below your skull at the top of your neck on both sides of the back of the neck. This is known as the sub-occipital area. Find the base of your skull and press the soft flesh around that area. Is this tender or painful for you?

6. Do you have some shoulder and/or neck pain/aches, which don't seem to go away?

7. Does your jaw click when you open your mouth? Further check on this; Put your pinkies (little fingers) into your ear canals and chew normally. Do you feel a bumpy dislocation like feeling? This should be a smooth action in your joints.

8. Do you have any lower back pain or mid back pain (under the shoulder blades)?

9. Can you move your head from side to side without pain or restriction? Is there a loss of Range of Motion (ROM)?

10. Do you have any sand paper, clicking or crunching sounds when moving your head from side to side in a 'NO' action?

11. Is your hearing a problem or do you have other ear symptoms (e.g. tinnitus, watery sounds, blockages, vertigo, Meniere’s Disease, otalgia, recurrent ear infections)?

12. Do you often get headaches or migraines?

13. Can you remember any trauma (even minor) to the head, neck or shoulders?

14. Was your birth difficult?

15. How’s your vision? – Sensitive to light, especially at dusk, floaters?

16. Do you experience any dizziness, vertigo or movement sensations? Does the ground seem to move away from you?

17. Do you experience any tingling and burning sensations especially in fingers and toes?

18. Do you have confirmed Scoliosis of the spine, from x-rays? Do you have one leg shorter than the other or is your pelvis higher on one side?

19. Have you had any x-rays, CT scans or MRIs taken of your neck? Do these reveal loss of normal neck curve), even a small amount?

Meniere's Disease: Discussions and Conclusions

by Michael T. Burcon, D.C.

All three Meniere's patients had a history of an automobile accident. All three showed evidence of upper cervical subluxation upon neurological examination, and all exhibited both evidence of a history of whiplash and an existing atlas subluxation in radiographs. All three had posterior and inferior left atlas listings.

It is possible that the anterior tubercle of atlas is irritating the nerve root of CN VIII as it exists from the upper lateral portion of the medulla oblongata, just anterior to the midline of the brain stem. Two patients reported that their ear problems were predominately on the right, the third case was bilateral. If atlas subluxates to the left, it could apply pressure on the right nerve root.

Medical research has established a connection between spinal trauma and numerous neurological conditions besides Meniere's disease, including Multiple Sclerosis, Parkinson's disease, Amyotrophic Lateral Sclerosis, Trigeminal neuralgia, epilepsy and migraine headaches.

Physicians often make the mistake of thoroughly examining only the area of chief complaint. When relevant, I believe it is prudent to start at the nucleus of the cranial nerve or center that supplies function to that area. For example, the brain stem, for balance disorders(CN VIII), irritable bowel syndrome (CN X, Vagus), high blood pressure (vasomotor center) and sleep disorders (reticular formation).

CONCLUSION

A case study is limited in its ability to provide conclusions. It is possible that the patients recovered through spontaneous remission or because they believed their problems had been discovered and improved, creating a placebo effect. The time span before chiropractic intervention and the long-term, clinically documented, neurophysiological improvements after initial adjustments weigh against these affects.

All patients with a history of vertigo and/or dizziness should be questioned about a history of trauma, especially whiplash from an automobile accident, contact sports injury, or serious falls, etc. Patient often forget these accidents, thinking that they were not hurt because they did not break any bones and were not bleeding. Patients with a history of both should be referred to an upper cervical specific chiropractor for examination.

Case 3: Upper Cervical Care and Meniere's Disease

CASE 3

by Michael T. Burcon, D.C.

HISTORY: Thirty five year old female presented with history of vertigo, swallowing difficulties, nausea, cervicalgia, cephalgia, double vision, occasional deafness, weakness and fatigue since 1996. She was working part-time out of her home, unable to drive or go anywhere. She reported having a minor car accident in 1991.

Diagnosed with Meniere's disease, TMJ dysfunction, rheumatoid arthritis and Arnold-Chiari malformation. Prescriptions included Duricef, Retin-A, Benzymicin and Antivert. Her father had been diagnosed with Becker's muscular dystrophy.

EXAMINATION: Leg checks demonstrated 1" right pelvic negative, 1" left cervical syndrome and positive C1 and C5 tests. Restricted range of motion with left lateral flexion. X-rays, video fluoroscopy and MRIs showed atlas to be inferior and posterior on left articulation, under lapped on the right, and inferior and posterior C5 and C6. Thermograph showed pattern of a break to the left at levels of C1 and C5.

INTERVENTION AND OUTCOME: Within 24 hours of first specific atlas adjustment, all symptoms had subsided, except dysphagia, which had gotten worse. All balance tests were negative and cervical thermograph was straighter. Full cervical range of motion was restored.

Atlas adjustment has been repeated when pattern of subluxation has returned, a total of six times in the past two years. The swallowing problem has persisted.

Case 2: Upper Cervical Care and Meniere's Disease

CASE 2

by Michael T. Burcon, D.C.

HISTORY: Fifty seven year old female diagnosed with Meniere's disease in 1991. Onset was sudden and severe. She reported being paralyzed for a short time. Following this episode, she gave up driving. She was a passenger on a bus that was in a relatively serious accident in 1975.

Symptoms were relieved for two years by endolymphatic shunt surgery. Recent test revealed 50% hearing loss in right ear. Symptoms were currently returning most mornings and lasting into the afternoon. They were relieved by diet pills, valium and bed rest. She decided to try chiropractic as an alternative to a second shunt surgery.

EXAMINATION: Patient reported dizziness, nausea and stiff neck. Leg checks demonstrated ¾" right pelvic negative, ¾" right cervical syndrome and positive C1 test. Limited range of motion of cervicals bilateraly. Cervical thermograph showed right break at level of C1. X-ray analysis revealed atlas subluxation to be posterior and inferior on the left articulation, under lapped on the right.

INTERVENTION AND OUTCOME: After specific atlas adjustment and rest, patient was post checked. She was balanced, all tests were negative and all symptoms were gone. Cervical range of motion was restored. Cervical thermograph was straight. After one year, patient is holding adjustment and symptom free.

Case 1: Upper Cervical Care and Meniere's

CASE 1

by Michael T. Burcon, D.C.

HISTORY: This 87 year-old female suffered frequent episodes of vertigo, tinnitus and nausea for 45 years. She was in a moderate car accident a few years before onset. During episodes, she walked around her home holding onto the walls, trying to keep her head level at all times. She reported numerous falls over the years, some resulting in broken bones.

She was diagnosed with Meniere's disease at University of Michigan Hospital in Ann Arbor and Memorial Hospital in Chicago. She tried a variety of medications which would help her sleep, but did not help negate her symptoms. Surgical history of colostomy and right radical mastectomy noted. Four or five years prior to the onset of symptoms, she was a passenger in a car that rear ended another stopped vehicle while traveling approximately 45 mph.

EXAMINATION: Subject reported severe dizziness, blindness in the left eye, fullness in right ear, pain and stiffness of the neck and numbness in the left thumb. She was unable to lift her left arm above her shoulder. Exhibited limited range of motion with left lateral flexion and left rotation of the head. Edema was noted below the posterior base of the skull in the area of atlas.

Leg checks showed a 1" right pelvic positive and 1" left cervical syndrome. Modified Prill check elicited positive test for C1 subluxation. Cervical x-rays revealed narrowed disc spaces at multiple levels, particularly evident at C6-7. Minimal marginal spurring and bony overgrowth of facet joint margins. Atlas was subluxated posterior and inferior on the left articulation, under lapped on the right. Fifth cervical was inferior and posterior.

INTERVENTION AND OUTCOME: Immediately following specific atlas adjustment, subject reported complete alleviation of vertigo and dizziness. When she awoke the next morning, the tinnitus was also gone. She held the adjustment and was symptom free for two years. Cervical range of motion was improved.

After suffering a minor stroke, closely followed by three compression fractures caused by osteoporosis, the subluxation returned and a second adjustment was given. That adjustment has held for six months.

Meniere's Disease and Upper Cervical Care

The basics of Meniere's and a little background.

by Michael T. Burcon, D.C.

Meniere's disease, or syndrome, is characterized by vertigo or dizziness, and some combination of four associated symptoms: nausea, inner ear pressure, low-frequency hearing loss and tinnitus. The cause of Meniere's disease is unknown, and the pathology is poorly understood. The attacks of vertigo appear suddenly, last from a few to 24 hours, and subside gradually. The attacks are associated with nausea and vomiting. The patient may have a recurrent feeling of fullness in the affected ear, and hearing in that ear tends to fluctuate, but worsens over the years. Tinnitus may be constant or intermittent.

Both the vestibular and cochlear nerves join the internal auditory meatus to form CN VIII, which enters the brain stem at the cerebellopontine angle. Meniere's is considered a common peripheral ailment, however it is often overlooked that although within the substance of the brain itself, the root entry zone of the eighth cranial nerve is considered a peripheral vestibular structure. An atlas subluxation may irritate this nerve root by compromising the size of the neural canal space. Rosenberg reported a case of cervical cord impingement observed with magnetic resonance imaging, bringing on signs and symptoms of medulla compression.

Also, dizziness related to perturbations in information received from proprioreceptors in the neck that feed into the vestibular system are not usually taken into consideration. This is a common result of even minor whiplash injuries. One theory has proposed that irritation of sympathetic nerves can elicit spasms within the vertebral artery, leading to decrease in blood flow to the brain stem.

The vertebral arteries reach the interior of the skull by ascending through the transverse foramina of the cervical vertebrae, turning medially along the upper surface of the posterior arch of atlas and then penetrating the posterior atlantooccipital membrane and the underlying dura to enter the subarachnoid space. Subluxation of atlas may diminish blood flow through the vertebral arteries and their intracranial branches, which supply the spinal cord, medulla, cerebellum and inner ear via the labyrinthine artery.

Finally, internal pressures of the body, specifically that of the cerebrospinal fluid, are rarely taken into consideration. The fluid spaces of the inner ear are connected to the CSF by the cochlear aqueduct, believed to be patent in most humans, so that pressure changes in CSF are transmitted directly to the ear.

The auditory tubes, responsible for equalizing pressure in the middle ears with the atmosphere, are controlled by the Tensor veli palatini and Salpingopharyngeus. These muscles are innervated by the Pharyngeal nerve plexuses, which have a contribution from Cranial Nerve XII. The hypoglossal canal lies under cover of about the middle of each occipital condyle, intimate to atlas.

Most normal individuals cannot appreciate the devastating impact of vertigo. The patient perceives that the world is spinning around them. Vertigo disrupts every aspect of life, since the patient loses the ability to do anything normally, especially when movement is involved. It can totally incapacitate the individual, often confining them to bed.

During my first year of practice, three patients diagnosed with Meniere's started under my upper cervical specific chiropractic care. All three improved dramatically after their first specific chiropractic adjustment of their top cervical vertebra, atlas. Two years later, they remain symptom free.

Over the next few days we will share the specifics of each case.