Pointing to the Upper Neck with Chronic Fatigue Syndrome and Fibromyalgia

Posted in Fibromyalgia on Dec 7, 2020

New Research into the Role of the Upper Neck in Chronic Fatigue Syndrome and Fibromyalgia

A recent research study looked at the underlying mechanisms in the body that could contribute towards chronic fatigue syndrome, fibromyalgia, myalgic encaphalomyelitis, and other such pain disorders.

And what the researchers essentially found was that there could be a “choke point” potentially involving the upper neck that could be part of the problem.

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The research team from Sweden studied the brain MRIs of 229 people diagnosed with myalgic encaphalomyelitis (ME) or chronic fatigue syndrome (CFS). Here are just some of their findings:


  • 56% demonstrated a Chiari Malformation, which is a herniation or bulging of the brainstem outside of the base of the skull and into the upper neck
  • A whopping 80% showed obstruction of the flow of cerebrospinal fluid (CSF), which provides oxygen and energy for the brain. Stagnation of CSF may cause fluid buildup in the brain, and lead to a condition known as “idiopathic intracranial hypertension,” which the researchers believe could be related to encephalomyelitis, aka brain swelling.
  • 50% of people exhibited hypermobility (i.e., excessive movement) between the C1 and C2 vertebrae in the upper neck*

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(*Note: the authors attributed hypermobility to “instability” or a condition known as “Ehlers Danos Syndrome (EDS). However, I would like to remark that hypermobility in the upper neck is NOT always due to Ehlers Danos, and is not always due to instability either. Hypermobility may often represent ligament compensation as the result of hypomobility (i.e., insufficient movement) of the adjacent vertebral levels.

In other words, hypermobility of C1-C2 may implicate that there is an underlying cause affecting the skull-C1 joints, or also the C2-C3 joints, and the C1-C2 problem is simply the effect.

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What does it all mean for chronic fatigue syndrome and fibromyalgia?

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Syndromes such as myalgic encephalomyelitis, chronic fatigue syndrome, and fibromyalgia are far from simple.

They are both non-linear and multifactorial. Multifactorial means that there is more than one contributing factor that appears to be related to the condition, and as a consequence, there is no single “magic cure” that fixes everything.

Non-linear means that each element contributes differently to each individual. For example, you may note that 44% of people with CFS do NOT have a Chiari Malformation. And 50% of people do NOT have C1-C2 ligament hypermobility.

Furthermore, simply because a person may have either a Chiari Malformation or Ehlers Danos Syndrome doe not guarantee that they will also experience chronic fatigue syndrome.

These are the frustrating complexities of the human body that we must appreciate when talking about things such as myalgic encephalomyelitis, chronic fatigue syndrome, and fibromyalgia.

So instead of looking for a single “cure” - because there isn’t one! - we need to consider the different elements that all may contribute and accumulate together to cause the actual problems.

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So what we may infer from this research study is that the upper neck may play a role in some way towards the development of myalgic encephalomyelitis, chronic fatigue syndrome, and fibromyalgia.


How can the upper neck be linked with ME, Fibromyalgia, or Chronic Fatigue Syndrome?

A research team from the USA has been using advanced MRI imaging to study the effects of a specific correction to the alignment of the C1 vertebra and how that influences the brain and also cerebrospinal fluid in a variety of conditions including ME and CFS.

The top vertebrae in the neck, aka the C1 (atlas) and C2 (axis) support the weight of your head, provide 50% of your total neck movement and also protect your brainstem.

These vertebrae contain unique ligaments known as myodural bridges that anchor the connective tissue around your spinal cord with the atlas and axis. In this way, it is believed that these bridges act like tethers that prevent your cord from being crushed when you move your head.

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In addition, researchers believe that these bridges also facilitate the normal flow of cerebrospinal fluids in order for your brain and nerve system to work properly.

However, these are normal conditions. What could happen if these vertebra were to misalign is another matter.

Subtle misalignments - even as tiny as 2mm - may be enough to cause a disruption in the normal balance and range of motion in the upper neck. And even though 2mm may sound tiny, that is approximately the size of a grain of sand.

And if you have ever had a grain of sand or even an eyelash gets into your eye, you know that even a very small thing can be most painful!

So, if the atlas or axis were to misalign even a few millimetres, instead of protecting the brainstem, they may exert physical tension that tugs on the cord and may also produce tiny “eddy” currents that disrupt the normal flow of cerebrospinal fluid.

Furthermore, these misalignments may, in some cases, also constrict the normal venous drainage of blood and CSF through the base of the skull., thereby producing an accumulation within the cranial vault.

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Researcher Michael Flanagan publishes in his book The Downside of Upright Posture how misalignments of the upper neck could very well be responsible for a variety of neurological conditions including neurodegeneration, myalgic encephalomyelitis, and chronic fatigue syndrome just to name a few.

Furthermore, renowned researcher Scott Rosa has demonstrated how a precise correction to the alignment of the atlas can influence a variety of things including the reduction of cerebellar ectopia (aka Chiari malformation), improvement in normal CSF flow within the brain, and even reduction of swelling association with traumatic brain injury and myalgic encephalomyelitis.

Certainly, there may be a variety of additional factors at play … especially in conditions as complex as ME, fibromyalgia, and chronic fatigue syndrome. Nevertheless, these researchers have demonstrated that there may be an important link between the alignment of the C1/C2 vertebra and the ultimate health of the brain.


C1 Treatment in Fibromyalgia and Chronic Fatigue Syndrome?

The branch of healthcare that focuses on specific alignment of the atlas and axis, and how that relates to a variety of health conditions is known as Upper Cervical Chiropractic.

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Upper Cervical is a special division of chiropractic developed and researched in the USA. Globally, it is estimated that there are 2-5% of all chiropractors who actively practise a specific upper cervical technique … but in Australia, that number is less than 1%. 

(So, if you’ve never heard about it before reading this article, I’m not surprised).

Unlike general spinal manipulation, there is no twisting or cracking of the neck.

Everything is based on precision and customisation. An upper cervical chiropractic doctor, after completing a general chiropractic degree completes a certification process in upper cervical care where they learn specialised x-ray analysis methods to determine the exact direction and degree of misalignment in the upper neck.

Again, these misalignments are often very subtle - 2mm! - which is one reason why they often go undiagnosed even on MRI images. 

Once the problem is identified, an upper cervical chiropractic doctor would then prescribe an initial course of care to correct the alignment and stabilise the underlying issue, which is believed to facilitate the normal healing process of the body.

In this way, upper cervical chiropractic believes that it is the innate mechanisms of the body itself that allow for healing. And if just given the chance-free of mechanical interference, even with complex conditions such as fibromyalgia or chronic fatigue syndrome, the body still has the potential to heal.  


Looking for chronic fatigue syndrome treatment in Brisbane?

At Atlas Health Australia, located in North Lakes (north Brisbane), we provide specific upper cervical chiropractic care for people looking for natural, long-term solutions for chronic health challenges, including for people with chronic fatigue syndrome and fibromyalgia.

Our focus is on the relationship of the upper neck as one core element to health and wellbeing. As we mentioned previously, especially with chronic fatigue syndrome and fibromyalgia there can many things happening all at once. 

In other words, there can be other stuff happening besides just your neck, which is why we always recommend an in-person assessment first to determine if we believe we may be able to help you.

Out principal chiropractor, Dr. Jeffrey Hannah is an Advanced Certified practitioner and instructor with the Blair Upper Cervical technique. He is an international author, lecturer, and recognised leader in the field of upper cervical chiropractic.

So if you have been dealing with chronic fatigue syndrome or fibromyalgia and would like further information, we are happy to offer a complementary over-the-phone consultation with Dr. Hannah to discuss your condition and to answer any questions you may have so that you can decide if care is right for you.

To accept this offer, simply click the Contact Us, or call our office direct at 07 3188 9329

It is our privilege to assist you, and we look forward to hearing from you.

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



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