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Chiari Malformations - A Natural Option?

Posted in Head Pain Disorders on Feb 14, 2021

If you have been diagnosed with a Chiari malformation of a suspect you may have a Chiari malformation, the size of the herniation may not be the most important factor!

And there may be options besides surgery!

A Chiari malformation occurs where the base of the brainstem and/or cerebellum bulges or herniates below the rim of the skull and into the upper neck.

Think of it like trying to shove a size 10 foot into a size 6 shoe. It’s not going to create pressure, and it’s not going to fit.

The typical symptoms of a Chiari malformation include headaches, migraines, vertigo, dizziness, clumsiness, muscle problems plus potentially other neurological problems.

The traditional diagnostic criteria for a Chiari malformation is 5mm, which means that your brainstem is herniating into your upper neck by 5mm. 

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However, there are many people who do not reach these diagnostic criteria with herniations only 1-3mm. This would be like trying to shove aside 10 foot into a size 8-9 shoe. 

This is a condition known as “Cerebellar Tonsillar Ectopia (CTE)” or a Type 0 Chiari Malformation.

 

Chiari malformations maybe 100-400% more common than we think

Here’s one of the first most important things you may want to know if you are experiencing these types of problems but your specialist has said that your MRI is normal:

It is that there is a big difference when diagnosing Chiari malformations in a flat vs upright posture,

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One study of over 1200 people found that the incidence of Chiari malformations was approximately 5-6% of the population experiencing neck pain.

What was most interesting was that the researchers performed two sets of MRIS: one with the patients lying flat, and the other with the patient’s sitting upright.

The difference is because when you are sitting/standing, the effects of gravity can cause the herniations to appear larger.

And that is exactly what the researchers found!

The number of Chiari malformations in people experiencing neck pain doubled (!) to 10% when taking the MRIs in an upright position for people who reported no history of a neck injury.

However, for people who reported a history of neck injuries such as a fall, whiplash, or sprain, the number of cases QUADRUPLED to almost 24%!!

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What this may mean for many people who have had standard MRIs (because sitting MRIs are exceptionally rare in Australia) is that they might have a significant brainstem or cerebellum herniation that could actually more significant than it appears!

This could well be one of the reasons why so many people experience head and neck pain problems, dizziness, or vertigo with the description that, “It feels better when I lie down but gets worse through the day.”

(It is also one of the reasons that I don’t simply read MRI reports in my own practice. I prefer to examine the actual images because these things are often NOT REPORTED!)

 

The size of the Chiari malformation may not be as important as …

Another study recently demonstrated that the size of the Chiari malformation may not always be the most significant thing when it comes to symptoms such as headaches,

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Instead, it may be a disruption or obstruction with the flow of cerebrospinal fluid (CSF) that matters most

CSF is what provides the oxygen and energy for your brain and nerve system to function properly. Disruptions with CSF flow have been associated with a wide variety of neurological issues including migraines, concussions, fibromyalgia, multiple sclerosis, and vertigo.

One research team found that 80% of people experiencing the symptoms of fibromyalgia actually showed signs of CSF obstruction in the brainstem!

Alas, CSF flow studies are almost as rare in Brisbane as upright MRIs. However, even if you did have images, you still have the even more important question, “What can you do about it?

 

The role of the upper neck in Chiari malformations

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Chiari malformations can occur during development due to an abnormal share with the skull.

However, they may also be traumatically induced (or aggravated) with certain types of injuries to your neck.

The vertebrae in your upper neck particularly - the C1 (atlas), C2 (axis), and C3 vertebrae - contain ligaments that tether onto the upper part of your spinal cord, which maintains the normal potency of your spinal canal, and may also facilitate the normal flow of CSF. 

Think of your brain and spinal cord like a balloon with a string attached to the bottom.

So, if there is ever significant trauma that affects the alignment and centre of gravity among the vertebrae in your upper neck - even if there isn’t any blood, bruising or broken bones - it could be the equivalent of pulling on that string, and as a result on the balloon.

What could that tension potentially do to your brainstem?

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Exactly! It could cause it to herniate downwards through the base of the skull and cause neurological problems,

Researchers in the USA have successfully demonstrated that precise corrections for the alignment of the vertebrae in the upper neck have been able to help people experience relief from the symptoms associated with Chiari malformations, and even improve CSF flow and reduce the size of the herniation in some instances.

Depending on the size and severity of the Chiari malformation, even if the underlying problem can not always be fully fixed, these studies reveal that there may be a viable, natural and non-surgical approach to being able to help people with symptoms associated with Chiari malformations by correcting the alignment of the vertebrae in the upper neck.

 

Blair Upper Cervical chiropractic and Chiari malformations

A special division of chiropractic that focuses on the alignment and movement through the vertebrae in the upper neck - C1 (atlas), C2 (axis), and C3 - is known as Blair upper cervical care.

Unlike forms of general spinal manipulation, there is no twisting, cracking, or popping of the neck, Instead, Blair's upper cervical care is built on precision and customisation and does NOT use spinal manipulation to correct the alignment of the vertebrae in the neck.

Every person’s bone structure is different on the outside and inside of their bodies. By understanding these differences through specialised imaging that IS available in Australia, a Blair upper cervical chiropractic doctor is able to identify the exact location, direction, and degree of misalignment in your neck. 

Then, but performing a series of precise corrections, a Blair upper cervical chiropractor works to restore normal motion for the purpose of relieving the tension on the system.

In this way, we believe that we may be able to help people experience relief from symptoms associated with Chiari malformations.

(It is actually most remarkable how COMMON we find these conditions to be … also seldom ever remarked upon on MRI. But I understand why. Many specialists do not remark on Chiari malformations until they exceed 5mm. But If I’m looking at a person with a 3mm herniation in a flat position still experiencing all the symptoms, I know that odds are that IF we took an upright MRI we would discover that they are experiencing the real deal.)

Our practice, Atlas Health, is the premier upper cervical health centre in Brisbane. We believe in the innate potential for every human being to be healthy and well.

Our mission is to help people with chronic health issues, including Chiari malformations and other conditions of the upper neck, to find relief and long-term solutions so that they can enjoy the quart of life that they desire most. 

Our principal chiropractor, Dr. Jeffrey Hannah, is an advanced certified Blair upper cervical practitioner. He is a published author, speaker, and recognised leader in the field of upper cervical chiropractic care.

If you have any questions or would like to find out if Blair upper cervical care may be able to help you, we are happy to have a chat. Our practice offers a no-obligation 15-minute over the phone consultation with Dr. Hannah to discuss your particular case so that you can decide if Blair chiropractic care may be right for you.

To schedule a complimentary consult, you can reach us through the Contact Us link on this page, or call our North Lakes (north Brisbane) office direct at 07 3188 9329.

We hope that you’ve found this article to be informative and valuable. And we hope that we may soon be able to help you.

Atlas Health Australia - “Hope, healing, and wellbeing from above-down, inside-out.”

 

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Ibrahimy A, Huang CC, Bezuidenhout AF, Allen PA, Bhadelia RA, Loth F. Association Between Resistance to Cerebrospinal Fluid Flow Near the Foramen Magnum and Cough-Associated Headache in Adult Chiari Malformation Type I. J Biomech Eng. 2021 Jan 16. doi: 10.1115/1.4049788. Epub ahead of print. PMID: 33454731.https://pubmed.ncbi.nlm.nih.gov/33454731/

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).

Van Oosterwijck J1, Nijs J, Meeus M, Paul L. Evidence for central sensitization in chronic whiplash: a systematic literature review. Eur J Pain. 2013 Mar;17(3):299-312. doi: 10.1002/j.1532-2149.2012.00193.x. Epub 2012 Sep 25. https://www.ncbi.nlm.nih.gov/pubmed/23008191

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