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Can Chiropractic Help Spinal Stenosis?

“Is surgery my last option for spinal stenosis?”

Maybe yes … but maybe not!

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Certainly, there is a time and a place for surgery. Spinal stenosis may be one of those reasons. But doesn’t it make sense to exhaust all-non surgical options first, if possible? And ideally through natural means?

You see, when it comes to the symptoms associated with spinal stenosis, it may not actually be the canal narrowing that is the issue. Let me explain.

When it comes to spinal stenosis, there are two general categories: 1) anatomical spinal stenosis and 2) functional spinal stenosis.

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Anatomical Spinal stenosis is the type you are probably familiar with. It is there there is a physical narrowing of the space between the vertebrae in your spine and your spinal cord. Spinal stenosis can be caused by things such as arthritis, disc bulging, and certain conditions like Paget’s disease or other conditions that involve ossification of the ligaments inside the spinal canal.

So these are physical conditions that you can see on a CT scan where there is a narrowing of the spinal canal and that can be physically compressing the spinal cord, leading to nerve damage.

The hallmark when surgery is truly required due to spinal stenosis is where there is a complete loss of feeling, motor function, or even organ function.

However - if you are not experiencing this level of nerve damage or spinal stenosis - there may be more to the story.

Here is where functional spinal stenosis specifically when it involved the alignment of the bones in the top of your neck may play a significant role.

“What do the top bones in the neck have to do with functional spinal stenosis”

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The first bone in your neck at the base of your skull is called the C1 vertebra or the atlas. The second bone in your neck is the C2 vertebra or axis. All the rest of the bones are numbered: C3-C7 in the neck, T1-T12 in the middle of your back, and then L1-L5 in the bottom of your back.

The opening at the base of your skull is called the foramen magnum, which means “large hole.” 

At the level of the foramen magnum, the C1, and the C2 vertebra, there are a variety of unique properties of the spine that occur.

 

  1. Your brainstem sits at the level of the foramen magnum, C1, and C2 vertebrae. And your brainstem is the master control center for your entire body. 
  2. The C1 and C2 vertebrae are designed to allow your head to move, which means that they are flexible but also susceptible to injury. The top bones in your neck are essentially the most important but also more fragile bones in your spine.
  3. The C1 and C2 vertebrae are physically connected to your brainstem and spinal cord by a series of thick ligaments called myodural ligaments or myodural bridges that serve two purposes:
    • They maintain the integrity of your brainstem when you move your head so that it doesn’t get compressed
    • They are believed to facilitate the flow of cerebrospinal fluid, which provides circulation, insulation, and energy for your brain.

 

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This is the anatomical arrangement. So what does this have to do with spinal stenosis?

Functional spinal stenosis offices not due to physical compression on the spinal cord, but instead when something is stretching or irritating the cord, like pulling on a piece of string

Due to the relationships among the C1-C2 vertebrae, the myodural ligaments, and your spinal cord, it may be possible that a physical injury that has disrupted the normal alignment and/or movement of the bones in the top of your neck may exert a physical “pull” on the nerves at the top of your spine.

Rather than allowing things to get compressed, your body intelligently adapts to this pressure for as long as possible by changing your posture, muscle tone, etc. However, if the problem goes unresolved long enough, it may, in turn, lead to degenerative changes lower down in the body: 

 

  • Neck pain
  • Back pain
  • Hip pain
  • Knee pain, etc.

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So it is possible that the pain of spinal stenosis is not directly due to the physical compression of the spinal cord, but may instead be due to physical tension that is coming from somewhere else in your spine.

And if so - if it is possible to correct the course of this tension or irritation - it may still be possible to help the symptoms of spinal stenosis without surgery.

I repeat, there comes a point when surgery is the only option for spinal stenosis. When there is definite compression and resulting nerve damage such as a condition known as myelomalacia, surgery is indicated. 

However, if there is still a chance that the body will be able to repair - or even after surgery in order to assist with recovery - here is when you may have another option by getting the alignment of the C1 and C2 vertebrae properly repositioned relative to your head.

Spinal stenosis and the upper cervical spine 

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The C1 (atlas) and C2 (axis) vertebrae contain a large number of ligaments that prevent your brainstem of the spinal cord from injury. A large enough injury can certainly tear these ligaments, which is exceptionally dangerous and requires emergency medical care.

However, there is an infinite number of less-impactful injuries that don’t necessarily fracture or dislocate the bones in your neck but can still cause them to shift from their normal center of gravity and get stuck in an abnormal position.

The bones in your neck are constructed to move approximately 1-2cm. As small as it sounds, even a 1-2mm displacement may represent a 5-20% disruption.

Depending on where/how this displacement ends up affecting the nerves in your neck, you may end up developing headaches, migraines, neck pain, shoulder pain, dizziness, vertigo or other neurological symptoms.

However, it is also possible that you feel nothing at all … at least in the beginning!

Either way, if you have a 5-20% deviation in the normal position of the bones in the upper part of your neck - and then compound those effects like interest over a 5, 10 or 20 year period, it is possible that you may develop some pretty nasty issues down the track, including issues akin to functional spinal stenosis.

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The types of injuries I am describing are the common varieties of things that you see on YouTube that you have probably experienced in a variety of ways in your own life:

 

  • Kids falling off swings, playground equipment, trampolines,
  • Teens falling off skateboards, surfboards, or other sports hits/concussions
  • Young adults tripping over a curb, barrier or other sports-like injuries (e.g., bungee jumping)
  • Adults suffering incidental injuries including car accidents fall hits to the head, etc.

 

The potential list of injuries in infinite. And I think you will agree, that most of the things that I’m talking about sounds relatively innocent. 

What I am asking you simply to consider is the possibility that these “innocent” injuries are not so innocent. That they do have an effect, even if it is not immediate. And that something like them may also contribute towards something like functional spinal stenosis later down the track.

Something you may never have considered before.

If this makes sense and I’m sure that you will agree that it does - you may now be wondering how do you find out is something like this may be affecting your spinal stenosis.

Here is a where a unique form of healthcare known as Blair upper cervical care may be able to help you if you experience the symptoms of spinal stenosis

“How is upper cervical care different from a general chiropractor?”

Blair upper cervical care is a special division of chiropractic that was developed in the USA without the use of spinal manipulation, twisting or cracking the neck.

The principle is simple: that by correcting the alignment for the top bones in the dec - the atlas and the axis - and by reducing tension or irritation at the level of the brainstem, that is it possible to restore normal body function. In turn, this allows your body to do what it is naturally designed to do - repair and heal itself.

So rather than upper cervical care being a treatment for the effects of spinal stenosis, it is a way of restoring the normal order and empowering your own body to heal irrespective or symptoms and within limitations of time and matter.

An upper cervical chiropractic doctor has taken advanced studies in order to be certified in an approach. The procedures first begin with a specific, detailed examination of your nervous system.

These tests include posture and muscle tension tests, autonomic nerve assessments (commonly in the form of paraspinal computerized thermography), and also 3D customized x-ray series, which allow an upper cervical chiropractic doctor to identify the exact degree and direction of any misalignments between the bones in your neck.

With this information, an upper cervical chiropractic doctor is able to visualize the effect that these misalignments would be having on your brainstem and spinal cord, and then make a recommendation of care in order to reduce that tension.

One of the things that make upper cervical care different from general chiropractic is that we are not looking to adjust the bones in your neck every single time. In an upper cervical office, the fewer adjustments you need, the better you are doing!

A Blair upper cervical adjustment is also exceptionally low-force, using only the amount of force that you would use to feel your pulse. Because there is no spinal manipulation, no twisting, and no cracking noise, many people ask if the adjustment has actually done anything. That is the reason we perform the tests that we do on every office visit. 

It is to know that the adjustments you have received are having the desired effect on your body and nervous system.

“Where can I find an upper cervical chiropractor near me?”

In Australia, there are only a small number of advanced certified upper cervical chiropractic doctors. 

Our resident and principal chiropractor, Dr. Jeffrey Hannah, is an advanced certified instructor with the Blair upper cervical technique, and teaches other chiropractors in Australia, New Zealand, and elsewhere overseas this unique form of healthcare.

Our practice, Atlas Health Australia is located in North Lakes, a suburb of North Brisbane. Not only do we provide upper cervical chiropractic services for the local communities or North Lakes, Narangba, Petire, Mango Hill, Burpengary, North Harbour, Scarborough, Brighton, and Murrumba Downs, we also provide upper cervical care for the greater Brisbane area: Albany Creek, Auchenflower, Carindale, Cashmere, Chermside, The Gap, Hamilton, Everton Park, New Farm, Newstead, South Brisbane, Taringa, Teneriffe, and Toowong.

Many of our clients also travel from as far away as the Gold Coast, Ipswich, Toowoomba, and the Sunshine coast 60-90 minutes in one direction.

It is one of the reasons that we are actively looking to help other chiropractic doctors learn this work: that so upper cervical care is available in every community and just down the street around Australia.

Until that day, we do the very best that we can serve the people in our Brisbane and North Lakes chiropractic communities.

Where’ve you are, if you would like more information about spinal stenosis or upper cervical care, we would very much like to have a chat with you. You can schedule a free 15-minute over the phone consultation with our North Lakes chiropractic office at 07 3188 9329 to arrange a time with Dr. Jeffrey Hannah to discuss your individual case, spinal stenosis, and to ask any questions you may have in order to decide if care might be right for you.

You can alternatively click the Contact Us, and one of our office staff will return your email as soon as possible.

If you have any questions about spinal stenosis, how upper cervical care may be able to help you, or where you can find your nearest upper cervical chiropractor, please let us know how we can help you.

Atlas Health Australia - A passion and purpose for helping people get their lives back.

References

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Fortner MO, Oakley PA, Harrison DE. Cervical extension traction as part of a multimodal rehabilitation program relieves whiplash-associated disorders in a patient having failed previous chiropractic treatment: a CBP® case report. J Phys Ther Sci. 2018 Feb;30(2):266-270. doi: 10.1589/jpts.30.266. Epub 2018 Feb 20.

Joaquim AF, Baum G, Tan LA, et al. C1 Stenosis - An Easily Missed Cause for Cervical Myelopathy. Neurospine. 2019 Sep;16(3):456-461. doi: 10.14245/ns.1938200.100. Epub 2019 Sep 30. https://www.ncbi.nlm.nih.gov/pubmed/31607078

Kessinger RC, Boneva DV. Case Study: Acceleration/Deceleration Injury with Angular Kyphosis. J Manipulative Physiol Ther, 2000; 23(4):279-87.

McAlpine JE. Subluxation Induced Cervical Myelopathy: A Pilot Study. Chiropr Res J, 1991; 2(1):7-22.

Moustafa IM, Diab AAM, Hegazy FA, Harrison DE. Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion-extension kinematics in cervical spondylotic radiculopathy subjects? J Back Musculoskelet Rehabil. 2017;30(4):937-941. doi: 10.3233/BMR-150464.

Murphy DR, Hurwitz EL, Gregory AA. Manipulation in the presence of cervical cord compression: a case series. J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):236-44. https://www.ncbi.nlm.nih.gov/pubmed/16584950

Vallejo R, Kramer J, Benyamin R. Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature. Pain Physician. 2007 Mar;10(2):305-11. https://www.ncbi.nlm.nih.gov/pubmed/17387353

Wickstrom BM, Oakley PA, Harrison DE. Non-surgical relief of cervical radiculopathy through reduction of forwarding head posture and restoration of cervical lordosis: a case report. J Phys Ther Sci. 2017 Aug;29(8):1472-1474. doi: 10.1589/jpts.29.1472. Epub 2017 Aug 10.

Yamahata H, Niiro T, Mori M, et al. Is the atlas size associated with the pathophysiology of symptomatic spinal canal stenosis at the C1 level? J Clin Neurosci. 2018 Nov;57:58-62. doi: 10.1016/j.jocn.2018.08.036. Epub 2018 Aug 27. https://www.ncbi.nlm.nih.gov/pubmed/30166243

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