Should you see a Chiropractor if you have a Chiari Malformation?

Posted in Head Pain Disorders on Jan 4, 2022

One of the two most common things that people diagnosed with a Chiari Malformation are told is that a) “Drugs and surgery are your only treatment options.” or b) “You just have to live with it.” Because it is the brainstem that is involved, many people also have a degree of apprehension or fear about having anyone touch their neck, especially a chiropractor. However, what many people (including many neurologists and specialists) don’t realise is that there are many different types of chiropractors. 

Foremost, not all chiropractors twist or crack the neck. In fact, there is a special division of chiropractic known as Upper Cervical Chiropractic and the Blair Technique that focuses exclusively on the delicate relationship between the vertebrae of the upper neck and the brainstem. The Blair Technique, which was developed and researched in the USA (but is still exceptionally rare here in Australia), is a unique approach to healthcare that has a long history of helping people with complex conditions including Chiari Malformation.

The Blair Technique is a precise, natural, and specific method of chiropractic care that does not use any manipulation, twisting, or neck cracking. The procedure involves a series of customised physical, neurological and diagnostic tests that reveal the exact location, direction, and degree of misalignment in your neck. With this information, a Blair doctor of chiropractic then prescribes a personalised care recommendation, designed just for you, to help correct any underlying misalignments in your upper neck, which may thereby reduce the nerve pressure and tension associated with the Chiari Malformation. 

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If you or a loved one has recently been diagnosed with having a Chiari Malformation, the Blair technique may be a natural treatment option that doesn’t involve drugs or surgery that may be able to help improve your quality of life. 

What Causes a Chiari Malformation?

Now, you are likely wondering what the relationship is between a Chiari Malformation and misalignment of the vertebrae in your upper neck … let alone how the Blair upper cervical technique may be able to help you. A Chiari Malformation happens when a portion of the brain or brainstem bulges outside of the skull and into the upper part of the spinal canal. Also known as “cerebellar ecotopia,” a Chiari Malformation can produce a wide array of neurological symptoms:

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  • headaches 
  • migraines
  • vertigo
  • dizziness
  • chronic fatigue
  • neck pain
  • chronic body pain
  • brain fog
  • insomnia
  • dysautonomia*

(*The processing centres associated with heart, lung, and digestive function are all located in the brainstem and transmit to your organs via the vagus nerve).  The cause of Chiari Malformations is frequently a combination of genetics, osteological and neurological development. In brief, it is the shape of the base of the skull that can make people more susceptible to suffering symptoms associated with a Chiari Malformation, but then it is a combination of other factors including physical injury of the lower neck (e.g., whiplash) that can cause the underlying problem to become particularly problematic … but more on that later.

A Chiari Malformation is diagnosed from a brain MRI, which shows exactly where the brainstem is bulging outside of the cranial vault. A Type I Chiari Malformation descends into the upper cervical spinal canal by at least 5mm to the level of the C1 vertebra (aka atlas vertebra) A Type II Chiari Malformation descends into the cervical canal by at least 8mm between the level of the C1 and C2 vertebra (aka axis vertebra) A Type III Chiari Malformation descends into the spinal canal below the level of the C2 vertebra.

There is also an even more common type known as a Type Zero Chiari Malformation that is less than 5mm in size but still produces all the same types of lifer-disrupting symptoms. 

If I have pain, can I have a Chiari Malformation even when my neurologist says that everything is normal?

One thing that is important for people diagnosed with Chiari Malformations is that Chiari Malformations are measured according to size but not according to severity. For people suffering the symptoms associated with a Chiari Malformation, it is important to understand that neurologists and specialists and traditionally trained to think that it is the size and location of pathology that matter most. However, when we take a step back to actually consider the sensitivity of the nervous system, we may better appreciate that even very small problems can produce severe, life-disrupting symptoms.

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Consider the analogy of getting an eyelash or a speck of dust caught in your eye. An eyelash is approximately .15mm thick, and dust particles are even smaller. Yet, how unpleasant is it when an eyelash or dust gets caught in your eye? Quite painful actually! That is the sensitivity of your nerve system when there is an abnormal source of irritation. From the traditional perspective, a Chiari Malformation is not believed to be clinically significant until it is at least 5mm in size. And yet, if 0.15mm is more than enough to produce significant pain and nerve irritation, it is essential to appreciate that even very small problems can cause disproportionately large effects.

It also means that when people experience symptoms associated with Chiari Malformation, just because your MRI tests come back as being “normal” does not mean that things are actually normal. What it may actually mean is that you need more information and another opinion from a qualified professional, who knows to take even small problems into proper consideration.

What is the connection between an Atlas Misalignment and a Chiari Malformation?

Many people who suffer symptoms all associated with a Chiari Malformation (e.g., headaches, migraines, dizziness, vertigo, and chronic pain) have been to neurologists and specialists. However, they have not explored the possibility that the symptoms could be associated with a misalignment in the upper neck.

The missing link may be what are known as myodural ligaments. Myodural ligaments are unique slips of connection tissue found in only one place in the body: the upper cervical spine. These ligaments anchor your brainstem and spinal cord within your spinal canal so that the nerves do not get crushed when your move your head.  The atlas vertebra (C1) is responsible for approximately 50% of your total head movement: up-and-down and also side-to-side. The total amount of movement of the atlas vertebra is typically 10-20mm.

Normally, when the atlas is properly aligned and moving properly, the myodural ligaments protect the brainstem. However, if the atlas is not aligned and offset by even 0.5mm, these ligaments do not protect, but can actually exert tension on the brainstem.  Think of a Chiari Malformation like a balloon with a string. The balloon is your brain, and the string is your spinal cord. If the atlas vertebra in your neck is misaligned, it can be like pulling on the string, which in turn pulls on the balloon. If the tension is great enough, it can even produce pressure that can cause the brainstem to bulge out into the spinal canal.

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In this way, adverse mechanical tension as a result of a physical problem with the alignment of your upper neck may be one of the contributing factors that lead to the development of a Chiari Malformation. If so, the reverse may also be true: that a precise mechanical correction of the alignment of the atlas may help to reduce the pressure and relieve the symptoms associated with the Chiari Malformation

Blair Upper Cervical Chiropractic and Chiari Malformation

For people suffering from brainstem pressure, migraines, vertigo, or other symptoms associated with a Chiari Malformation, one of the most important things that can you do to improve your quality of life schedule a visit to see a Blair upper cervical specific chiropractor.

At Atlas Health, we believe that life and healing come from within. We believe that no matter who you are or what you have experienced, you can heal. Our purpose is to help people with complex health conditions including Chiari Malformation find relief so that you can enjoy the things in life that matter most to you. The way that we help people is through the power of Blair upper cervical chiropractic care, which is a unique, precise, and personalised approach to healthcare that focuses on restoring the life flow between the brain and the body.

Dr. Jeffrey Hannah is an advanced certified Blair upper cervical chiropractor. He is an international speaker, published author, and recognised leader in the special field of upper cervical-specific chiropractic care. Our practice located in North Lakes (north Brisbane) provides the highest quality in upper cervical chiropractic care for the Brisbane, Gold Coast, and Sunshine Coast communities. To find out how Blair upper cervical care may be able to help you or your loved ones back to enjoying the full quality of life that you deserve, contact our office at 07 3188 9329 or click the Contact Us link on this page, and one of our staff will return your email as soon as possible.

References

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Bidari A, Ghavidel Parsa B, Ghalehbaghi B. Challenges in fibromyalgia diagnosis: from meaning of symptoms to fibromyalgia labeling. Korean J Pain. 2018 Jul;31(3):147-154. doi: 10.3344/kjp.2018.31.3.147. Epub 2018 Jul 2. https://www.ncbi.nlm.nih.gov/pubmed/30013729

Bragée B, Michos A, Drum B, Fahlgren M, Szulkin R, Bertilson BC. Signs of Intracranial Hypertension, Hypermobility, and Craniocervical Obstructions in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front Neurol. 2020 Aug 28;11:828. doi: 10.3389/fneur.2020.00828. PMID: 32982905; PMCID: PMC7485557. https://pubmed.ncbi.nlm.nih.gov/32982905/ 

Flanagan MF. The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions. Neurol Res Int. 2015;2015:794829. doi: 10.1155/2015/794829. Epub 2015 Nov 30. PMID: 26770824; PMCID: PMC4681798. https://pubmed.ncbi.nlm.nih.gov/26770824/

Freeman MD, Rosa S, Harshfield D, Smith F, Bennett R, Centeno CJ, Kornel E, Nystrom A, Heffez D, Kohles SS. A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash). Brain Inj. 2010;24(7-8):988-94. doi: 10.3109/02699052.2010.490512. PMID: 20545453. https://pubmed.ncbi.nlm.nih.gov/20545453/

Hulens M, Rasschaert R, Vansant G, et al. The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of shared pathophysiology. J Pain Res. 2018 Dec 10;11:3129-3140. doi: 10.2147/JPR.S186878. eCollection 2018. https://www.ncbi.nlm.nih.gov/pubmed/30573989

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/

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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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