The Gentleness of Upper Cervical Care

The NUCCA Procedure is a Gentle Correction

A gentle touch and controlled contact on the first vertebrae in the neck is designed to restore balance to the spine. Even though the primary focus is the neck, the effects of the correction influences the whole spine and all body systems. This is because the NUCCA procedure influences one of the highest control centers over body balance, the brain stem and central nervous system. The C-1 vertebrae, also known as the Atlas, is a small donut-like bone located at the top of the spine and the base of the skull that surrounds the brain stem. When the spine is subjected to stress it can become misaligned. This head/neck misalignment is also known as the Atlas Subluxation Complex or ASC .

The Balancing Act

The nerves in our spinal column are very sensitive to pressure and stress. When the spine becomes misaligned sufficiently it stresses the nerves, compromises their normal impulses, and changes function throughout the body. Nerves are responsible for four primary functions:

    Control and regulate all vital functions including circulation, breathing and digestion.

    Activate muscles allowing us to move.

    Allow us to sense, perceive and feel.

    Relate us to the world outside ourselves including learning, experiencing and behavior.

                               

Evaluation, Evaluation, Evaluation

Once you have decided to be examined for a spinal misalignment, an extensive evaluation process begins. The process begins by looking at your detailed health history including any past traumas, motor vehicle accidents, surgeries, other treatment programs and other diagnostic tests including other x-rays. Your chief complaints, including location, onset, and duration must all be evaluated and assessed. After concluding this initial process, the doctor will begin the steps necessary to determine if you are a candidate for NUCCA care.

Finding the Problem

The NUCCA Doctor will focus attention on the relationship of the head to the neck. The top bone of the neck, known as the atlas, must be in line with the head, as well as the vertebrae below. Spinal injury or damage can misalign these structures resulting in:

    Postural imbalance.

    Pelvic distortion.

    Leg length disparity also known as the "short leg" phenomenon.

As you lay on your back, measurement of the leg length equality will be made. Additional evaluation of posture may include shoulder height, hip height and deviation of the head to either side. Ranges of motion may also be measured. Specific instrumentation may also be used to evaluate body weight distribution, pelvic rotation and normal nerve function. If a spinal misalignment is indicated by history and examination, a series of x-rays are taken. It is important to know you would only be accepted as a patient if the consultation and exam results indicate that you could benefit from NUCCA care. The X-rays are only taken if care is to be initiated. 

Table Time 

Each correction is determined from x-ray measurement. Patients lay on their right or left side on the upper cervical table. By gently contacting the side of your neck, the doctor will direct your head and neck back toward a balanced, healthy position.

Precise, Accurate and Small  Corrections

The upper cervical correction depends upon precise mathematical calculations, physics, and biomechanics. X-rays are a critical part of ensuring the spinal correction is accurate and successful. The doctor will take pre-correction x-rays from different angles focusing on the atlas. These x-rays determine the direction and degree of spinal misalignment and how to properly restore the spine to normal.

Continuous Monitoring

Because each correction experience and healing response is unique to the individual, you will be monitored closely for any changes that you might experience which are linked to the healing process. We have stressed the importance of receiving the best possible correction during the first visit. The doctor will take x-rays after your correction to confirm results. This is typically done only after the initial correction. What we know is "The better the correction, the better the chance of recovery."

Concussion, Headache, Vertigo?... Upper Cervical Care?

(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 concussion, headaches, vertigo or any other condition, disease or symptom. This is also a more in depth post of one that I posted previously. Thanks to Dr. Bill Davis for this more in depth look.)

Adapted from: Do concussions cause chronic headaches and vertigo?

by Dr. Bill Davis

For years I have been asking my patients if they have a history of head and neck injuries including, car accidents, falls, times where they have been knocked unconscious, had a concussion or stitches to their head.

Why?

When accidents and injuries tear loose the connective tissue that holds the spine in place it creates a weakness, which can cause the spine to break down and lock into a stressed position.

The area of the body that is the most vulnerable to injury and has the most far reaching effects is the upper neck. The top bone in the spine, the atlas sits right underneath the skull and when the tissues around it become stretched and damaged the weight of the head can be shifted from center.

Once the position of the head is altered the position of the eyes and ears is altered as well. The brain will initiate a reflex called the righting reflex in order to balance the eyes and the semicircular canals in the ears with the horizon.

The problem is now the head is slightly off center and the spine must adapt to that position by often twisting and turning the remaining structure of the spine. This can lead to tilting of the shoulders, the hips and imbalance all the way down to the legs leading to an unequal distribution of weight.

Body imbalance can lead to a variety of different health problems, but frequently has the same root cause…

The original head or neck injury created a misalignment of the Atlas bone at the base of the skull which led to the subsequent problems with the structure of the body, nerve and blood flow from the brain to the body.

Here is a great example from a recent research article published in the Journal of Upper Cervical Chiropractic Research ~ January 6, 2011

A 23-year-old female patient presented for upper cervical care five months after a slip and fall that resulted in a concussion. The patient presented with symptoms of vertigo and headaches consistent with post concussion syndrome. The patient had a longstanding history of headaches that were exacerbated by the concussion and a new complaint of positional vertigo that occurred immediately following the trauma. Significant body imbalances were noted including a leg length difference. Specific Upper Cervical X-rays demonstrated an upper cervical misalignment.

She began to receive Upper Cervical Specific Chiropractic care and the headache and vertigo was gone immediately following the first adjustment. Post X-Ray evaluation showed a significant improvement in the alignment of the head and neck. The follow up examination the following day revealed a significant decrease in muscles spasm in the neck and the legs were balanced.

The patient’s fourth visit was two weeks following the first adjustment and at that time the patient reported a slight nagging headache had begun earlier that day, rated at 2/10, but she did not have any symptoms of vertigo. The patient’s care was continued on a frequency of twice per month for evaluations and progress monitoring. She was evaluated with Atlas Orthogonal protocol for necessity of adjustment and her symptoms were monitored at every evaluation. She continued to report a complete resolution of vertigo and intermittent headaches rated as 2/10 that occurred at an average of two hours/day.

Who do you know that has had a concussion? Do they have a chronic health problem? Is there head/neck misalignment and interference in brain to body communication limiting the ability for you to heal?

Only an upper cervical doctor could tell you.

Upper Cervical Care Reviewed

This is one person's overview of NUCCA care. I thought it was very well done and worth sharing as it covers many of the basics of Upper Cervical Care.

By Lennard Zinn

The top, or Cl vertebra (C is for "cervical," i.e., "neck") is also called the "atlas" vertebra. Cl is concave on top to accept the convex base of the skull, and it is convex on the bottom to fit into the concave top of the next vertebra. Central to the vertebrae runs the spinal cord, carrying body control messages from the brain. Between each pair of vertebrae are 31 pairs of nerves extending out to organs and muscles.

Misaligned (or "subluxated") vertebrae can impinge on the nerves and hamper body function. Chiropractors apply force to parts of the spine with the intent of returning vertebrae to their normal positions. Cracking sounds usually accompany the adjustment. Upper Cervical Technique is distinct in that the adjustment is only performed on the Cl vertebra and the adjustment normally makes no sound. Furthermore, the direction of the application of force to perform the adjustment is not based simply on palpation (the chiropractors "feel") but rather on detailed analysis of X-rays. From the X-rays, a three-dimensional force vector is calculated and then applied to Cl to correct its position.

A misaligned atlas throws off leg length and distorts the entire body. The skull and the other vertebrae rotate and tip to compensate for rotation and tip in C1. The head weighs between 8 and 14 pounds. If it is not sitting straight on top of the spine, the muscles of the body must do something to counteract this bowling ball hanging off to the side. If the muscles on one side of the spine are tighter than those on the other, then the pelvis is pulled up on that side, thus "shortening" that leg.

I went to Farmington, New Mexico, a town of 40,000 near the four comers area, to view this procedure, as there are no practitioners of it within hundreds of miles of my Boulder, Colorado, home. Lloyd Pond, D.C., who practices with his son, Lonnie, is recognized among those who follow the subject as one of the leading practitioners of upper cervical technique.

Diagnostic Methods

The Ponds use a complex diagnostic machine with a digital printout called an "Anatometer" to quantify body distortion. It measures the degree of vertical pelvic tilt, pelvic rotation in a horizontal plane, the lean of the spinal column at the shoulder level, and the amount of weight the patient carries on each foot.

Patients first lie flat on a table to have leg length differences measured.

Patients said that they only feel a very slight pressure and the warmth of the hand on their neck. There was no deflection of the patient's head or neck during the procedure, nor was there an audible sound.

A heat-sensing probe is passed up the spine on the back of the neck. The probe has a temperature sensor on either side, of the spine hooked up to a machine that graphs the temperature readings as a function of position. The graph shows large surface-temperature variations on either side of the spine, indicating interrupted nerve supply.

The adjustment direction is based on X-rays, which one of the Ponds takes to ensure accuracy. Patient position and distance to the lens is precisely set in each of three different X-ray angles.

On a light board, lines are drawn on the X-rays through a series of bone points. The precise relative angles of Cl, the head, and the spine are measured in three planes. Once the exact misalignment of the atlas is determined, a vector direction in three dimensions is determined, precisely opposing the misalignment.

Adjustment procedure

The chiropractor applies a force directly along the determined vector direction to return the atlas to its proper position. The force must be applied with enough pressure to overcome the body's internal resistance to the adjustment without going too far.

The patient lies on his or her side on a low inclined bed with a head support. The adjustment is performed with the side of the heel of one hand on a comer of the Cl vertebra located just behind the patients ear lobe. Lloyd or Lonnie Pond takes a number of measurements with the tape measure to determine where to stand and how to orient his sternum relative to the patient, a different position is used with every patient.

He clasps one hand about the wrist of the other hand, sets the heel of the lower hand on the bone and aligns his arms and the top of his sternum directly down the force vector determined from the X-ray. He does not push by straightening the arms, nor does he push by rocking his back or body forward. With either of those motions, the heel of the hand does not move along a line connecting the top of the sternum and the heel of the hand. Instead, the chiropractor locks his body in place, and the force comes from the shoulders by contracting the head of the triceps muscle. To call it subtle would be an understatement.

I observed the procedure being performed on a number of patients, and interviewed them before and after. They were long-term patients of the Ponds (some on the order of 15-20 years; Lloyd Pond has been doing this work in Farmington for 40 years). Several of the leg-length discrepancies were originally around an inch. Most Patients were coming in for a semi-annual or annual checkup, although one had been involved in an automobile accident dent three days earlier.

Patients said that they only feel a very slight pressure and the warmth of the hand on their neck. There was no deflection of the patient's head or neck during the procedure, nor was there an audible sound.

Afterward, the leg lengths were even, and the thermographs showed consistent temperatures on both sides of the spine.

Patients' comments

The patients reported feeling immediate relief. The reduced strain in the face of the auto accident victim was obvious.

Patients commented that while many joke about "having magic words said over them... half the people in town come to the Ponds." One woman, noted that Pond's rates have gone up from $11 a visit when she first started seeing him 20 years ago to the current $30 per visit but quickly added that she "would pay any amount for it" Patients told me of not only a reduction in the symptoms of body aches, but generally improved overall health.

Lloyd Pond claims only to correct the position of Cl, and he acknowledges that it can improve overall health by improving delivery of nerve impulses and instructions from the brain, helping the body combat disease processes. Due to Cl's close proximity to the brain stem, it simultaneously affects the brain and the entire spinal cord, and thus the entire body.

Lloyd Pond comments that his method is simply the application of physics to the human body. The adjustments can hold for years, unlike most chiropractic adjustments. After the initial series of treatments, visits are separated by many months, and Pond says if alignment is not off, "we don't touch 'em".

When asked why less than 1 percent of chiropractors specialize in this technique, Lonnie Pond says that chiropractors are pulled in many different directions toward various chiropractic specialties, and, he added, "it is easier to crack backs."

John Dunn, D.C., a cyclist, and upper cervical chiropractor from Tallahassee, Florida, says that it takes a certain type of person to practice the technique. It is an exacting method and a real-life application of vector analysis, and therefore, attracts "the pocket-protractor types who drive used cars."

Dunn notes that the work-up is time consuming, the adjustment is sublime, and the follow-up visits are less frequent so there isn't much motivation for a chiropractor to pursue the approach.

"It also takes balls to tickle someone behind the ear and tell them they are going to be just fine," joked Dunn.

What does Head/Neck Misalignment do to your muscles?

There is anatomical terminology in this one hope the basics make sense to everyone though.

Atlas Subluxation Affects on Muscles

From Dr Marshall Dickholtz, D.C. and NUCCA

A stressor has been defined as a condition in the body produced by an injurious factor and manifested by a syndrome (H.Selye). A subluxated C1 distorts the spine and the pelvis because it causes spastic contracture of the extensor (antigravity) muscle of the spinal column. Spinal and bodily distortion result. A subluxated C1- therefore, is acting as an injurious factor, manifesting itself as a syndrome, which is verifiable by measurement and can be correlated to the C1 subluxation. The patient with a subluxated C1 has a subluxated spinal column, an over-innervation of the motor neurons of the spinal cord, neuromuscular imbalance, loss of muscular synergism, distortion of the spinal column from the true axis of the body, and leg disparity. This is the C1 subluxation complex syndrome, and is correctable solely from a precise and predetermined C1 adjustment.

If disequalibrium and cervical spine displacement do not cause a state of subluxation until C1 moves laterally on the occipital condyles, what constitutes a normal lateral range of motion for C1? Vertebrae can be shown to displace and not cause detriment or insult to the nervous structure. If a vertebrae does displace and thereby causes insult to the nervous structure, it is logical to assume that it has abnormally moved, or moved beyond its normal range of motion. Because C1 cannot misalign laterally more than one half of a degree from its alignment to the occipital condyles (about the thickness of a sharp pencil mark), without imbalancing the neurological inhibitory mechanism of the reticular formation at the caudal end of the brain stem. C1 has practically no normal lateral range of motion.

This phenomenon has been observed and tested on over 10,900 cases over a period of many years. The C1 distortion syndrome has always manifested itself whenever C1 has moved laterally three-quarters of one degree or beyond on the occipital condyles when the vertebra was moving from its normal position toward the abnormal position.

The type of neurological detriment that is caused by the lateral displacement of C1 on the occipital condyles appears to be a mechanical tractionization of the caudal end of the brain stem. It has been noted in medical literature that pathological and traumatic situations affecting the brain stem can produce impairment or loss of the inhibitory control over the body's extensor musculature. National Upper Cervical Chiropractic Research Association (NUCCA) research on the effects of a subluxated C1 on the caudal end of the brain stem confirms the medical hypothesis.