How can you see Nerve Damage?

Posted in Nervous System Disorders on 11/17/2019 00:00 AM

How can you see Nerve Damage?

Can you see nerve damage in anMRI/CBCT/X-Ray?

If you have been experiencing nerve pain, problems, or nervedamage, you have probably had a whole series of tests.Unfortunately, it is not uncommon for so many of these tests tocome back as "NORMAL." 

FREE Appointment

When this happens, you may feel like you are stuck in a state oflimbo. Shock. Frustration. Confusion.

I mean, no one wants to have anything wrong with them. But ifyou know that you are experiencing nerve problems, you want yourtests to show SOMETHING because at least then you will know WHAT isgoing on, and more importantly WHAT YOU CAN DO.

This happens more commonly than you may believe. In this articlethen, I want to address the different types of imaging and some ofthe different types of conditions that do and do NOT show up witheach.

Related article

Whiplash and Concussion Treatment - Brisbane

Whiplash and Concussion Treatment - Brisbane

Oct 24, 2017

This way, I hope that I may be able to offer you some sort ofDIRECTION on what you can do next if you find yourself in thissituation. Standard disclaimer first: this article is not meant todiagnose or make any healthcare recommendations. It is forinformation purposes only.

So, let's start with what you can and can NOT see on thedifferent types of images:

IMAGES TO SEE HARD TISSUE LIKE BONE

 

  • X-Ray - shows bone and other dense materials(e.g., metal). Typically uses low-dose ionizing radiation. Can betaken lying down or upright, commonly from 2 standard angles perregion.
  • CT Scan - shows bone and bleeding inside thebody. Typically uses much higher doses of ionizing radiation tocreate a 3D image. Are taken lying down from 3 standardangles.
  • CBCT - aka Cone Beam CT Scan. Think of it as a3D x-ray, but NOT the same as a normal CT. typically uses low-doseionizing radiation. Are taken upright. (NOTE: For some very bizarrereason, these scanners are exceptionally rare in normal imagingcenters in North Lakes and North Brisbane when they are becomingincreasingly common in New Zealand, the USA, Canada, and Europe ...c'mon Queensland. Join the future!)

 

Related article

What is really a Chiari Malformation?

What is really a Chiari Malformation?

Jun 07, 2018

IMAGES TO SEE SOFT TISSUE LIKE NERVES

 

  • Ultrasound - shows water densities, muscles,and tendons. Uses sonar-the technology, but typically no clearresolution.
  • MRI - shows muscles, ligaments, and nerves inhigh definition. No known ionizing radiation or other negativeeffects. Are taken lying down from 3 standard angles (but there AREupright and open MRIs ... but again, only 2 in all Australia).

What should you not do before anMRI/CBCT/X-Ray?

Tests like MRIs, CTs, and X-Rays are not the same as bloodtests. There isn't really any prep that you need to do except toREMOVE ALL METAL ON YOUR BODY (if possible). Thatway it doesn't block what we need to see, as would be the case withx-rays.

(With MRIs, because they use magnets to produce the image, I'msure you can imagine why you don't have to have metal on or in yourbody if you need that type of image.)

Related article

Is your Sympathetic System Stressed Out?

Is your Sympathetic System Stressed Out?

Sep 19, 2016

Can you see a pinched nerve on a CT/CBCTScan/X-Ray?

So, out of all this, you may see that it is the MRI Scan thatmost clearly shows nerves directly:

  • Pinched nerves
  • Nerve damage 
  • Tumors and infections
  • Nerve fraying (such as happens with multiple sclerosis, akaMS)
  • Nerve atrophy or swelling (e.g., dementia, Parkinson's,concussion, encephalomyelitis
  • Now, if we stopped here, we would think that MRI is the onlytest necessary to consider nerves. And if there is no sign of nervedamage that everything must be fine.

NO!

It is because when we are talking about nerves, there are twotypes of nerve conditions: pathological and functional. Apathological nerve problem is one like I described before. Let'suse a computer as a metaphor. A pathological-type of nervecondition would be like a broken screen, keyboard, or some othertype of external damage that you can see.

A functional nerve condition, on the other hand, would besomething like a computer virus. It affects how the system WORKS... but you can't actually see it!

Related article

Measuring the Health of Your Nervous System

Measuring the Health of Your Nervous System

Nov 28, 2016

In my opinion, it is one of the reasons that so many nervespecialists are too-quick to diagnose chronic nerve conditions asone of the following:

 

  • A virus (because you can't see a virus on an MRI or otherscan)
  • Somatic Pain disorder (aka Fibromyalgia, because it is a"diagnosis of exclusion" that happens when they can't find what'sgoing on)
  • Stress or Psychological disorder (such as post-traumatic stressdisorder, aka PTSD)

 

You may have been told that you have one of these "conditions"because your own nerve condition remains a mystery. Now, that isNOT to exclude the possibility of something especially such asPTSD. I simply use the examples to illustrate that IF YOU AREDEALING WITH A FUNCTIONAL TYPE OF NERVE DISORDER, YOU MAY NOTACTUALLY FIND ANY SIGNS OF TRUE "PATHOLOGY" ON MRI SCANS.

And that is actually a good thing! It means that if you want tofind a solution for your condition, your efforts now need to focuson the FUNCTIONAL side of the equation.

Related article

Treatment Options for a Chiari Malformation

Treatment Options for a Chiari Malformation

Jun 07, 2018

What causes pinched nerve in the neck?

I will now use the example of a pinched nerve in the neck as aprime illustration of how you can have a nerve-type of the problembut how it does not always show up on conventional images.

First, the typical example of a pinched nerve in the neck cancome when something is physically compressing or pulling on yournerves or spinal cord. Some of the common things are bulging discs,degenerative arthritis (aka spondyloarthritis) that produces bonespurs that are like spikes that can stab the nerves if they are inthe wrong spot, narrowing or the opening between the bones in yourneck where the nerves exit.

Now, things don't just happen in your body for no reason. Thereis ALWAYS a reason (whether or not it is known). When it comes tothe above list, these processes are almost always the result of aPHYSICAL INJURY that has deteriorated over a long period of time,like wearing down a tire or the buildup of rust on a machine.

Now, if you are following me so far, let me take you to the nextlevel, which is a place that many in the medical and healthcarearena unfortunately miss! Let's consider the degree and type ofinjuries that can happen particularly to your neck. A serene enoughforce can break a bone and cause death or paralysis. A slightlyless force can cause dislocation and severe neurological issues.... But what about the next level down.

The joints in your neck each move approximately 20mm. The typesof injuries I've just described are the things that can cause grossdisplacement of 10-20mm, and they are readily seen on standardtypes of images including x-ray, CT, and MRI.

Related article

Upper Cervical Chiropractor: Do You Need It?

Upper Cervical Chiropractor: Do You Need It?

Nov 09, 2016

BUT WHAT IF THE INJURY WAS "ONLY" 1-2mm? DOES THAT MAKE IT ANYLESS SIGNIFICANT?

Consider this first. A 1mm displacement due to a physical injuryrepresents around 5% of your movement and a potential decrease infunction and irritation to your nerves like a pebble in your shoe.By itself, 5% isn't that much. BUT WHAT IF THAT PRESS AWAYNEVER GOES AWAY?

Think of it as your home mortgage or a car payment. What wouldhappen to the interest and the principle if you didn't pay that fora year? 5 years? 10 years? 20 years? 

That little thing - small as it is - can then make a bigdifference over time. Oh, and BECAUSE IT IS SO SMALL, it is oftendismissed as "insignificant" ... assuming it is seen at all!

You may have noticed in the first section that I talked about"standard types of MRI/CT/X-Ray views" and "upright" vs "lyingdown." It is because, in these different positions, you seepotentially different things about what is happening FUNCTIONALLYin your body when you are up vs. down. Moreover, it is possible toMISS something if you are just looking at things from standardfront-and-side views.

It is because humans are three-dimensional beings, and we areall different! 

So when it comes to seeing what may be causing nerve problems,it is often necessary to consider the possibility that WE NEED TOSEE THINGS FROM DIFFERENT ANGLES IN ORDER TO GET A TRUE SENSE OFWHAT IS GOING ON!

Can a cervical MRI/CBCT/X-Ray show MS?

I'll now shift to something like a diagnosis of multiplesclerosis (MS) and apply this functional nerve concept. First, thehallmark and formal diagnosis of multiple sclerosis are made ONLYif lesions are visible on the brain where there is a fraying orbreakdown of the sheath (myelin) that insulates the nerves.

Think of it like damage not the protective plastic around wires.This damage can cause nerves to misfire, and as a result, lead to astrange and complex array of symptoms.

So for a formal diagnosis of something like multiple sclerosis,you need an MRI scan. 

Can you have MS and it not show up on anMRI/CBCT/X-Ray?

The pathognomonic finding for multiple sclerosis is the brainlesions seen on an MRI. Unless those are present, you CANNOT havemultiple sclerosis.

However, might it still be possible to experience symptoms of anMS-like nerve condition without the lesions? YES.

At its root, multiple sclerosis is a condition of DISRUPTEDNERVE FUNCTION: specifically caused by demyelination. But is itpossible to INTERFERE with nerve function in other ways? YES.

Dr. Chang Ha Suh and his research team and the University ofColorado discovered in the 1970s that it takes only 15 mm Hg worthof the pressure (which is equivalent to the weight of a 5c coin) toreduce the ability of a nerve to conduct by over 50% in just 15minutes.

So what types of things could possibly produce physical pressureon a nerve?

Well, here is where we come back to the neck, those 1-2mmmisalignments, and those physical injuries that we mentionedearlier when it came to a pinched nerve in the neck. In particular,I want to draw your attention to the top bones in the neck - youratlas (C1) and axis (C2) vertebrae. These bones provide for 50% ofyour total head movement, and as a result, are particularlysusceptible to injury. 

.... And not always the big injuries that you think about likecar accidents, concussions, etc.

 

  • Sports tackles (rugby, AFL, football, etc)
  • Swimming or surfing injuries (including smashing your head intoa wave or sandbar or side of the pool)
  • Tripping over a curb, branch or another object
  • Trampolines, bungee jumping, parachuting, etc or anything elsewhere you head can snap back-and-forth suddenly
  • Childbirth (such as forceps or complicated delivery, which canexert as much as 40Kg of force on a newborn's neck

 

The point is that the C1 and C2 vertebrae are PHYSICALLYTETHERED FIRMLY onto your brainstem and spinal cord as a protectivemechanism. If either of these bones is injured - not broken ordislocated - but SHIFTED by even 1-2mm, over time they might becapable of producing an accumulative tension that can affect normalnerve function!

And because the brainstem is the master control center for theentire body's function, it is possible to develop almost any nerveor health condition you can think of.

Now, it does NOT mean that all conditions are caused by problemsin the neck. However, if you have some type of mystery nerve orhealth condition, I mention this simply so that you consider thefull spectrum of possibilities.

Including the very real possibility that your condition might becoming from a problem with the alignment of your neck!

What causes brain lesions besides MS?

Now, there are other reasons why your MRI might show brainlesions that may have nothing to do with multiple sclerosis. Let mefirst address the scary one: cancer. Most of the time, however,brain lesions are not cancer or MS.

The same with breast scans. Most lumps are not actually cancerbut are enflamed lymph nodes or masses or fibrous or connectivetissue. Still, all lumps need to be examined to be sure!

So when it comes to brain lesions, many of them are what areknown as transient ischemic attacks (TIA), which are like"mini-strokes" or microbleeds on the brain that your body was ableto heal without any apparent complications. Think of it as a burstblood vessel in your skin. If your body is able to heal, then thescar tissue may appear on an MRI like a series of "brainlesions." 

Now, it is always important to rule out the dangerous and scarythings, but this again is part of the major reason why I've spentso much of the article about nerve pain and nerve conditions suchas MS describing the significant difference between PATHOLOGICALNERVE DISORDERS and FUNCTIONAL NERVE DISORDERS.

It's relatively easy to google "nerve specialist Brisbane" or"neurologist North Lakes," where you will likely find all kinds ofinformation about PATHOLOGICAL nerve conditions. However, when itcomes to natural and FUNCTIONAL nerve conditions - including whatyou may be able to do about them naturally and without drugs orsurgery - there is far less information.

Indeed, it is ESSENTIAL that you have the proper tests - MRIs,CTs, and X-Rays - to get a clear sense of what it's going on. Then,ARMED with that information is where you may have different optionsdepending on what is going on.

And again, just because the test c comes back as "normal" doesnot mean that everything IS normal. It simply means that we aredealing with a different TYPE of nerve condition.

So at this point, if what I have been describing makes logicaland emotional sense - it just seems intuitively right for you! -and if you have been dealing with a nerve condition or some sortbut NO ONE CAN FIGURE OUT WHAT'S GOING ON, then we would like toextend you the offer to have a chat to find out if there isanything we might be able to offer DIFFERENT that may be able tohelp you.

Our focus is a special division of chiropractic known as "uppercervical care," that deals with the unique relationship betweenyour atlas (C1) and axis *(C2), and how this affects the FUNCTIONof your brain, body and nervous system.

If you would like more information, please contact us directlyvia email or at 07 3188 9329 to arrange a time to speak with one ofour North Lakes chiropractic doctors. Our doctors are allboard-certified in the Blair upper cervical procedure.

Our office is located in North Lakes, providing care not onlyfor the local communities of Narangba, Burpengary, Morayfield,North Harbour, and Mango Hill; but also providing specific atlascare for the greater Brisbane area including Aspley, Chermside,Eaton's Hill, Everton Park, Windsor, Sandgate, Shorncliffe,Redcliffe and Scarborough.

For a no-obligation, 15-minute free consultation with one of ourchiropractic doctors, please call us at 07 3188 9329. We will behappy to assist in any way that we can.

Atlas Health Australia - A purpose and passion forhelping people to live well.

 

References

Alphonsus KB, Su Y, D'Arcy C. The effect of exercise, yoga, andphysiotherapy on the quality of life of people with multiplesclerosis: Systematic review and meta-analysis. Complement TherMed. 2019 Apr;43:188-195. doi: 10.1016/j.ctim.2019.02.010. Epub2019 Feb 10. https://www.ncbi.nlm.nih.gov/pubmed/30935529

Beggs CB, Magnano C, Belov P, et al. Internal jugular veincross-sectional area and cerebrospinal fluid pulsatility in theaqueduct of sylvius: a comparative study between healthy subjectsand multiple sclerosis patients. PloS One, 2016;11(5), p.e0153960.https://www.ncbi.nlm.nih.gov/pubmed/27135831

Correale J, Gaitán MI, Ysrraelit MC, Fiol MP. Progressivemultiple sclerosis: from pathogenic mechanisms to treatment. Brain.2017 Mar 1;140(3):527-546. doi: 10.1093/brain/aww258. https://www.ncbi.nlm.nih.gov/pubmed/27794524 

Damadian RV, Chu D. The possible role of cranio-cervical traumaand abnormal CSF hydrodynamics in the genesis of multiplesclerosis. Physiol Chem Phys Med NMR. 2011;41:1-17.

DeRoeck R. The confusion about chiropractors. ImpulsePublishing; Danbury, CT: 1989 (Re: CH Suh)

Elster EL. Eighty-one patients with multiple sclerosis andParkinson's disease undergoing upper cervical chiropractic care tocorrect vertebral subluxation: a retrospective analysis. J VertebrSublux Res. 2004;2:1-9.

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

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

Ishida S, Miyati T, Ohno N, et al. MRI-based assessment of theacute effect of head-down tilt position on intracranialhemodynamics and hydrodynamics. J Magn Reson Imaging. 2018Feb;47(2):565-571. doi: 10.1002/jmri.25781. Epub 2017 Jun 3.

Hannah J. The Doctors Who Give No Medicine. International HealthPublishing. 2013. https://www.amazon.com/Doctors-Who-Give-No-Medicine/dp/0985795646 

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

Sandro Mandolesi S, Marceca G, Moser J, et al. Preliminaryresults after upper cervical chiropractic care in patients withchronic cerebrospinal venous insufficiency and multiple sclerosis.Ann. Ital. Chir., 2015 86: 192-200. pii: S0003469X15023763

Sharpless SK. Susceptibility of spinal roots to compressionblock. The Research Status of Spinal Manipulative Therapy. NINCDSmonograph 15, DHEW publication (NIH) 76-998:155, 1975.

 

Leave a comment