Basilar Invagination - Is there a natural treatment option?

Posted in Neck Pain Disorders on Jun 13, 2022

Basilar invagination is a developmental cranial anomaly that affects the base of the skull, the upper portion of the neck, and most importantly the brainstem. 

Basilar invagination is associated with a wide array of symptoms:

  • Persistent headaches and migraines
  • Dizziness and vertigo
  • Fainting spells, brain fog, and lightheadedness
  • Muscle tremors and full-body weakness
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Certainly an array of really nasty things. The good news for many people is that a basilar invagination is NOT something that just happens to you. It is a condition that you either have or don’t, and it is something that is easily visible on x-ray, CT, or MRI. So, if you have had a series of tests because you may experience these symptoms but you do NOT have basilar invagination, you can rule that out as the cause. Now, if you DO have basilar invagination, this likely leads you to the next series of questions:

  1. What can you do about it (because surgery is usually an extremely complicated process)?)
  2. Are there any natural alternatives? (The short answer is yes, as we will discuss in this article, but not to “fix” the basilar invagination, but to give your body enough room essentially so that you are able to live and function without it impacting your daily living.

And this is actually a VERY IMPORTANT POINT for people with basilar invagination. Often, people suddenly start to experience symptoms (usually following some kind of physical injury), which prompts investigation, at which time they discover that they have basilar invagination. However, that basilar invagination would have been there years or decades prior to the onset of their symptoms.

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This means that basilar invagination by itself is not the sole causative factor, but is likely a risk factor. Therefore, it may also be possible that IF those other things can be resolved that may have caused that “dormant volcano” to wake up, it may be possible to get back to normal living. And while it is often a complex issue involving multiple approaches including what is known as upper cervical SPECIFIC chiropractic, physiotherapy, osteopathy, and certain types of dentistry (of all things), there may be a natural solution that may be able to help.

Basilar Invagination - How does it happen?

Basilar Invagination is both a combination of genetics and also bony development in how these things occur. In brief, the skull normally develops from several primary ossification centers. Among these centers are formed what is known as the sphenoid bone, which is essentially the bone behind your eyes that forms the keystone of your entire skull. In turn, the bottom of the sphenoid comes into contact and directs the position and plane of what is known as the occipital bone. The occipital bone forms the base of your skull and contains a large oval opening known as the foramen magnum which is where your spinal cord exists in your skull. Just beneath your occipital bone are two vertebrae - the atlas (C1) and the axis (C2).

The atlas is responsible for supporting the weight and centre of gravity of your skull and is involved with maintaining upright posture and balance. The axis (specifically the tip of the axis, which is known as the odontoid process, forms the pivot point which allows you to rotate your head, and also forms the anchor to the occiput so that this entire assembly does not just fall apart. Now, under normal circumstances, the pitch or vertical slope of the sphenoid and the occipital bone form in such a way so that the foramen magnum is relatively flat along the base of the skull, which means that the atlas, axis, and spinal cord exit BELOW the skull.

With basilar invagination, however, one of two things happens: either a) the pitch of the skull bones from exceptionally steep or b) they form shorter than usual. In either case, what happens is that the occipital bone forms with a steeper angle as well, which means that the foramen magnum is actually at a slight upward pitch as well. The consequence is that the odontoid process (which is like a vertical rod) can lean or tilt against the spinal cord, and thus produce pressures against the delicate neuronal centers that it otherwise should not. What this means is that people either born with a genetic predilection for OR have an acquired abnormal bony development of basilar invagination may be MORE SUSCEPTIBLE TO NEUROLOGICAL DISRUPTION if that balancing act should ever be disrupted. In other words, they have a much smaller margin of error. 

Basilar Invagination is a risk factor, but not always the cause

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This is an important point that we must raise that basilar invagination, itself, does not produce headaches, vertigo, brain fog, muscle weakness, or other symptoms. It is a RISK factor. And IF it is ever triggered, it means that the process of putting the genie back into the bottle might simply be a little more challenging.

To illustrate, we have seen many people diagnosed with a range of neurological conditions including concussion, fibromyalgia, positional orthostatic tachycardia (POTS), and also other people who suspect (based on Google searches) that they have atlanto-axial instability or Ehles Danos Syndrome (most don’t). And in many of their cases, they would have been experiencing their symptoms for a few months. Now, here’s the thing: their bone structure would have included the basilar invagination years and in most cases DECADES before the onset of their symptoms. What it turns out that these people all had in common was a relatively recent physical injury or receptive strain of some variety that was the trigger for their symptoms. 

Thus, we reiterate that basilar invagination is a risk factor, but not the sole cause of many of these neurological conditions. That being the case, we believe and find frequently that if it is possible to resolve the cause of the physical injury that triggered their symptoms, even though we cannot change their bone structure, we can get things back to a healthy balance where their own body is happy and functional again.

Natural Treatment with Basilar Invagination

There are several moving pieces that need to be taken into account for people with basilar invagination. Frequently, it is not just a matter of going to see one healthcare practitioner who is able to solve all their problems. It is a team effort with everyone working together that makes the biggest difference. Although we do not exclude anyone, there are five particular healthcare professionals (or combinations) that may be able to help people with basilar invagination:

  1. A neuromuscular dentist. The orientation of the TMJ has a profound impact on the position of the C1 and C2 vertebrae. Therefore, if a jaw injury or jaw remodeling (including braces) is part of a person’s past medical history, this factor must be considered.
  2. A musculoskeletal GP. If or when ligaments may require injections (aka prolotherapy) to strengthen, the right medical professional is often key (Note: many people who THINK they have instability issues actually don’t, so this option IMO is best reserved when other solutions may not be working quite as well as desired).
  3. An osteopath. Specifically, an osteopath who focuses on the cranial bone system to make sure that everything is moving as functional as possible may be able to reduce cranial strains of the cerebrospinal system.
  4. A physiotherapist. Rehabilitation of the neck or jaw muscles may be important as part of the overall recovery process, as also functional brain retraining if/when a concussion may be involved.
  5. A SPECIFIC upper cervical chiropractor. You do NOT want someone twisting or cracking the neck, but instead someone with proper training to address specific ligament injuries of the upper neck that need precise corrections in order to heal properly.

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It is this fourth category into which we fit. So, we hope that before even explaining what or how we may be able to help people with basilar invagination, we wanted to make it clear that our role is usually one piece of a broader team.

Upper Cervical Chiropractic with Basilar Invagination

Upper cervical specific is a special division of general chiropractic that focuses on the unique relationship between the alignment and motion of the C1 and C2 vertebrae in your neck and the function of your spinal cord and brainstem. There are many methods of upper cervical chiropractic (including the Atlas Orthogonal and NUCCA methods), and the versions that we use principally in our practice is known as the Blair Technique. The Blair Technique is unique in that it recognizes that every human being is different on both the outside and also the inside. Therefore, in order to provide the most accurate case possible, it is necessary to take these individual differences into account. 

Unlike general spinal manipulation, the Blair Technique does not perform any twisting, cracking, or stretching of the neck. Instead, we use a series of physical, neurological, and diagnostic images which show the exact location, direction, and degree of misalignment in your neck so that any treatment can be as custom-tailored, precise, and light as possible in order to produce the desired outcomes. 

Frequently, it only causes a few millimetres worth of pressure to cause many of the symptoms associated with basilar invagination. The good news though is that with a specific correction if you can take those few millimetres worth of pressure off, again, even if you can’t change the shape of your bones, can you get things back to the point where they are functional and healthy for you. Our practice, Atlas Health Australia, located in North Lakes (north Brisbane) takes care of people from around Brisbane, Queensland, and interstate with a range of head, neck, and jaw-related syndromes. To discuss your individual needs and to ask any questions you may have to decide if upper cervical care may be right for you, we offer a 15-minute complementary phone consultation. To arrange, please click the Contact Us link on this page, or call us direct at 07 3188 9329.

References

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Flanagan MF. The Downside of Upright Posture. Two Harbors Press, 2010.

Flanagan MF. The role of the craniocervical junction in craniospinal hydrodynamics and neurodegenerative conditions. Neurology Research International, 2015; Article ID 794829: http://dx.doi.org/10.1155/2015/794829. 

Rosa S, Baird JW. The craniocervical junction: observations regarding the relationship between misalignment, obstruction of cerebrospinal fluid flow, cerebellar tonsillar ectopia, and image-guided correction. Smith FW, Dworkin JS (eds): The Craniocervical Syndrome and MRI. Basel, Karger, 2015, pp 48-66 (DOI:10.1159/000365470).

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Vernon H.The cranio-cervical syndrome. London, Butterworth-Heinemann, 2001.

Jian Q, Zhang B, Jian F, Bo X, Chen Z. Basilar invagination: a tilt of the foramen magnum [published online ahead of print, 2022 May 13]. World Neurosurg. 2022;S1878-8750(22)00625-8. doi:10.1016/j.wneu.2022.05.027. https://pubmed.ncbi.nlm.nih.gov/35577208/

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