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Volume 1, No. 1 – December 2003

A Patient’s Perspective – Greg Buchanan
Welcome to the very first edition of my newsletter. Little did I realize back in August 1997 when I first injured myself playing rugby that I would one day be heralding the benefits of chiropractic. I’d never even been to visit a chiropractor! I didn’t even know what C1 was! Neither did I think that I would resign from a company like Microsoft, that I would no longer be working in the IT industry, that the majority of my spare time would be spent reading medical papers, researching medical conditions, helping people find answers to their illnesses or spending countless hours maintaining a website. Sometimes it’s just meant to be and it seems that accidents like mine do tend to be life-changing events for a lot of people. The one thing my training and development has taught me, however, is the importance of having an open mind, to challenge the status quo and to think outside the square. Now all of this might seem to be common sense, but it is surprising the number of times you run into medical professionals who wear blinkers. Caught up in their own world, they cannot see past their noses and the opportunities, which lie beyond. The evidence ‘linking’ chiropractic, especially upper cervical chiropractic to reversal of numerous medical conditions is abundant. You can choose to open your mind and investigate it, or simply ridicule and ignore it. I’m glad I chose to investigate it, because apart from helping myself get well again, every day I help another sufferer see the light and every day I feel glad that I was chosen to be knocked out back in 1997. Well almost!

The upcspine.com giraffe logo – “Is your head on straight?”

When I first decided to build a website to try and communicate to fellow sufferers what I had discovered, I figured I needed some kind of brand which I could use throughout. I left it to Britta Hansen from Fresh Consulting britta@freshconsulting.com.au to come up with some ideas. As it turns out the very first logo she showed me and which I selected was the giraffe. As if to confirm this as a correct choice, we happened to notice in the coffee shop in which we were meeting, a giraffe hidden amongst the glasses on the counter, which seemed to be staring directly at us! And so the upcspine.com logo was born. How appropriate this was, especially since my focus is on necks. Despite its long neck, the giraffe actually has only seven cervical vertebrae, exactly the same number as humans. As it turns out the vertebra can be up to 8 or so inches long. A giraffe heart is also very large, as it needs to pump blood to and from the brain; the blood having a long way to travel through the vertebral arteries up to the brain.

Why is the neck so important? Apart from the obvious answer, if you think about the neck as a conduit from the brain (central processing unit/computer) to the body (system under control), and in that conduit travels the communication signals (nerves) which control all functions within the body, and also within that conduit is the blood supply which contains the nutrients and vital oxygen which have to be dispersed to all parts of the body, then you will have no trouble in understanding that if there was a problem in the conduit affecting the nerves and/or blood supply, then it is quite possible for any number of problems/symptoms to manifest either in the brain or in the body. So if you aren’t well and cannot find a cause, check your head out. It may not be sitting straight on top of your neck! Then think about getting yourself to see one of the ‘specific’ upper cervical chiropractors around the World. You just might be pleasantly surprised.

Research Report

Cervicogenic Hearing Loss [1]

This paper by Hülse cannot be underestimated for its importance to chiropractic. Early in my research I came across it but I only had the abstract. I purchased the paper, which was in German. It’s taken me some time to receive the translation into English and following is my summation of the paper. When you put the results of this study and a multitude of others together with the Harvey Lillard adjustment of 1895 (see Green Books this newsletter), you will soon come to appreciate that despite some medical opinions to the contrary, dysfunction of the upper cervical spine may well be one cause of an abundance of hearing disorders like tinnitus, vertigo, otlagia (ear pain), fullness, deafness, otitis media and Meniere’s disease. To dismiss the link just because it is difficult to find an anatomical link is poor investigative research. The evidence is there in one form or another. You just have to open your mind, and investigate it for yourself and you don’t have to be a medical professional to read and understand medical papers. You’ll probably need help with the medical terms used, but over time you can gain that knowledge also.

In his paper, Hülse starts by listing three points of view as to the classification of hearing disorders known as ‘cervical syndrome’. These classifications being a vascular syndrome, resulting from a narrowing of the vertebral artery(s), a neural syndrome with irritation of the sympathetic nervous system, and in the Bartschi-Rochaix syndrome, being a disturbance in the functionality of the arteries and nerves, caused by ‘myogenic or articular dysfunction’.” I think that it is very possible that all three ‘syndromes’ could be as a direct result of a vertebral subluxation C0-C1-C2 including VBI.

According to Hülse, “scientific proof does not exist for ‘neurologic cervical syndrome’”, and thus treatment protocols are non-existent, although there are cases[2] where chiropractic adjustments have improved VBI. Jensen’s article describes two such cases, where the authors examined cerebral artery flow in the twp patients, both of whom exhibited signs of vertebrobasilar ischemia prior to chiropractic treatment. The adjustments entailed non-rotary cervical adjustments and a ‘diversified’ adjustment technique to the thoracic spine. The authors postulate the adjustments had the affect of normalizing the sympathetic nervous system, allowing for change in the vasospastic cerebral vascular arteries. Improvements were measured using Doppler sonography some months post adjustments. Improvements included tremor reduction and improved peak systolic flows in common carotid and vertebral arteries.

Hülse lists symptoms as a result of cervical syndrome as being “headaches, dizziness, vision disturbances, hearing disturbances and subjective ear droning.” Anyone who has studied it knows that these symptoms are consistent with people who have suffered whiplash injury. The author goes on to discuss there being quite a deal of research which links ‘vertebrobasilar' insufficiency (VBI) or reduced blood flow through the vertebral and basilar artery system, to cochlear (inner ear) related symptoms and he goes on to state that “a forced posture with rotated head leads to dramatic decline in hearing ability”. He cites Boenninghaus (1959), Brusis[3] as explaining this hearing decline as a result of “a reduction of blood flow to the inner ear is caused by the awkward/wrong posture of the cervical spine region” and that “complete deafness has also been described.” Very interesting! Awkward or poor posture leads to a reduction in blood flow to the inner ear and as a consequence hearing disorders. (Note: regarding reduced blood flow to the inner ear, see papers[4,5] , in the www.upcspine.com research section).

According to the author “hearing disturbance can reach a mid to high level of severity” and “complete deafness has also been described”. It would seem that success via manual (chiropractic therapy) has been achieved and that “within minutes or hours of manual therapy, a significant improvement of blood flow can be achieved in the vertebral artery”. This leads Hülse to postulate that because these conditions appear to reverse after chiropractic intervention, something other than VBI is the cause of the symptoms. I think he concludes this because VBI may cause irreversible cochlear damage.

He suggests a proprioceptive influence through irritation of proprioceptors and nociceptors at the head to neck joint [cranio-cervical junction], and cites the movement segments C0/C1, C1/C2 and C2/C3 as being involved. That is the joint receptors in the upper cervical spine. A functional disturbance in these joints can lead “to a change in sensory and motor nerves and their regulatory capabilities”. He further states there are “proven connections from the neck to the core areas of the trigeminal, vestibular cochlear and vagus nerves”. Thus joint dysfunction can result in disturbance to the signals of these areas. He says that “lasting complaints” can follow “cervical trauma” and “can be explained as a functional deficiency in the cervical region. The therapy of choice with this type of neck trouble is chiropractic therapy”. Further Feldman[6] , he notes, writes, “Hearing disturbance is one of more often observed cochlear vestibular damage post whiplash trauma.”

Of the 62 patients Hülse studied 24 had low frequency (up to 1000Hz) deafness, 33 had deafness at 5-10dB, and 5 had feeling of ear pressure, and subjective deafness without verification from audiometry. Audiometric tests indicated that the non-subjective hearing loss was no longer evident following chiropractic therapy.

For example, one 43-year-old patient who was 13 weeks post whiplash from an automobile accident had “distinct proprioceptive cervical nystagmus of the left ear. After successful chiropractic treatment, not only did she not have vestibular symptoms, but her entire cochlear related symptoms had disappeared.”

Hülse also carried out retrospective examinations on 259 patients over a 5-year period. These patients had a functional deficit of the upper cervical spine, but had no primary deafness. With a battery of ENT and neuro-otological tests having been performed, and after ruling out other disturbances like VBI and more central nervous system related conditions, Hülse says, “it can be said that cochlear symptoms are linked to functional deficits in the upper cervical spine region.” Thus symptoms like deafness, tinnitus, a feeling of pressure in the ears, ear droning and otalgia are not unusual symptoms of functional deficits of the upper cervical spine.

In summary, Hülse concludes that deafness at low frequencies can be as a result of functional deficits of the upper cervical spine and …

One thing that these studies do not mention however, is exactly what chiropractic manipulative technique was used. It would seem that it would make sense to mention this and to determine if there are any correlations between a particular technique and more or less successful reversal of the condition. Either way this is a powerful paper and adds weight to what is already known throughout many chiropractic offices throughout the World, that is, some hearing disorders can be helped with well-delivered and precision upper cervical chiropractic therapy.

The Chiropractic Green Books
Pictures and copyright with permission.
The Green Books; Compiled Rob Sinnott, D.C.

In my readings about chiropractic I obviously came across references to the Harvey Lillard adjustment by D.D. Palmer. For those people who are not aware of this little piece of history I will summarise briefly that in 1895 D.D. Palmer discovered a bump in the ‘back’ (I’ll get to this shortly) of Harvey Lillard, his janitor who was deaf and had been so for 17 years or more, and proceeded to adjust ‘a displaced 4th dorsal vertebra’ back into position at which point Mr. Lillard’s hearing was reportedly restored. You will come across many references to this adjustment and quite rightly the exact causal mechanisms are being debated, for example, there are suggestions by Marsarsky[7] that a subluxation at T4 could be “responsible for preganglionic outflow to the stellate and superior cervical ganglion… and “our current understanding of the sympathetic innervation of the cochlear vasculature… seems to suggest that a probable explanation exists”. As a past sufferer of tinnitus I can tell you that on occasions when my tinnitus, fullness etc. were at their worst, both my neck and back pain were most noticeable. For me, even a bite splint provided by a dentist halted the tinnitus and ear problems in their tracks. Utilization of the jaw caused problems to start again, including back and neck pain. There are numerous muscular connections between the cervical spine, shoulder and jaw musculature. Thus any usage (eating, talking, yawning) can and does, cause spasms in the cervical and shoulder muscles to occur. Therefore I put to you that there is a connection between back problems and hearing disorders, however I also know that upper cervical adjustments correct scoliosis resulting from atlas subluxations, and therefore it stands to reason that a correction of an upper cervical subluxation can correct ‘misalignments’ below C1 and even at T4. Which vertebra was actually adjusted in Mr. Lillard’s back in 1895? If you read the Chiropractic Green Books you will note the following references to the Harvey Lillard[8] adjustment.

On page 137 of D. D. Palmer's book, THE SCIENCE, ART, AND PHILOSOPHY OF CHIROPRACTIC (1911), is a picture of Harvey Lillard. Underneath, is this statement: “The above is a likeness of Harvey Lillard, the first person who received a Chiropractic adjustment from the hands of D. D. Palmer.”

“On Sept. 18, 1895, Harvey Lillard called upon me. He was so deaf for seventeen years that he could not hear the noises on the street. Mr. Lillard informed me that he was in a cramped position and felt something give IN HIS BACK. I replaced the displaced 4TH DORSAL VERTEBRA by one move, which restored his hearing.” D.D. Palmer

Comments from B.J. Palmer:
“ My father was at all times and in all ways an honest man, not given to misrepresentations, evasions, or deceit in anything he said, wrote, or printed. He was factual in all professional statements but one - which we here now correct.

We consistently and repeatedly have said it was NOT “4th dorsal vertebra” but was AXIS that was adjusted in Harvey Lillard. Why this discrepancy, this disagreement?

In those early days, there was no mention of “vertebral subluxation” in ANY book on anatomy or orthopedic surgery. It was something NEW, even to my father. All medical books WERE FULL OF DISLOCATIONS. All medical books said that if anything happened in the backbone IT WAS A DISLOCATION, and all strenuously warned and advised against any fooling with the bones OF THE NECK particularly, because TO DO SO WOULD PRODUCE A DISLOCATION AND PRODUCE COMPLETE PARALYSIS OF THE BODY BELOW.

What had father done? Had he set a DISLOCATION? If so, it was a dangerous thing to do.
In those early days, father's idea was in stage of growing pains. He did not want ANYBODY to do ANYTHING to NECKS, for fear of consequences. He taught his earliest students, “Stay away from THE NECK because you MIGHT produce paralysis and thus destroy my new work which is just beginning to take shape. If some of you boys should fool around with necks and paralyze people, you easily could kill my new work before we get it established.”

For this reason only, my father covered up WHAT he did, WHERE he did it, to avoid dangers that COULD occur. For THIS reason ONLY, he said WHAT he did and WHERE he did it was “4th dorsal vertebra.”
Why do I say it was “the axis”? Because I was there and SAW WHAT HE DID, WHERE he did it—and it WAS the axis.

We since have learned much about cervical vertebral subluxations which are common in almost every person, which are NOT dislocations; and ADJUSTING THEM BY HAND ONLY is easy and is NOT fraught with danger when done correctly and efficiently.”

So you see according to B.J. Palmer, the adjustment given that day back in 1895 was to Harvey Lillard’s axis (C2) vertebra and not to T4 (thoracic). But does it mean that a T4 subluxation does not affect hearing? Not sure, however as most upper cervical chiropractors will know subluxations in the upper cervical spine (C1 and C2) do in fact affect the spinal column throughout, causing secondary misalignment as the skeleton realigns underneath the skull. As a result of scoliosis there could be the potential for muscular interference to structures within the vicinity of the T4 vertebra. Whilst I’m certain that the debate will continue, the important thing is to get more studies started which investigate upper cervical chiropractic so that we patients can benefit.

Further Reading – related to Newsletter Research Topic

Upcspine.com Updates and Additions

My web site has been updated in a few areas this time around.

Firstly, I have more correctly described the HIO toggle recoil technique, as Palmer specific upper cervical. I have added two new upper cervical techniques. The Cowin upper cervical orthogonal approach and the approach used by the International Upper Cervical Chiropractic Association (IUCCA), known as, Applied Upper Cervical Biomechanics (AUCB) www.pacificchiro.com.

I have added the Green Books reference above, and have dedicated a special section on the site for ‘snippets of interest’ from the Green Books. Each month or so I’ll add another little piece, however because of the shear volume of information, I think the Green Books CD is a worthwhile investment for anyone interested in chiropractic, be you a patient or a practitioner.

Upcspine.com Shop

I have added a shop for the purchase of various upcspine.com merchandise and collateral. The proceeds will be used as follows: To allocate funds towards upper cervical ‘specific’ chiropractic research. To help pay for the maintenance of the site, which involves paying my web designers to improve and update the site. Purchasing and sometimes translating research materials. Translation of papers from foreign languages can be quite expensive.

I have spent thousands of dollars investigating upper cervical chiropractic, and ‘wasted’ tens of thousands on what I call mainstream medical solutions(!), trying to get myself better. The investment in upper cervical chiropractic has been for me, from a health perspective, a worthwhile outlay of my time and money. My gift back to the profession for giving me my life back is my website and my desire to promote upper cervical chiropractic.

I have kindly been offered donations to keep my web site running and to enhance its content; however I do not wish to accept them and certainly will not be touting for them. If you wish to donate I would prefer that you donate to upper cervical chiropractic research. You choose which organization suits your objectives, philosophies and requirements.

I am absolutely certain that well directed research funds will reveal upper cervical chiropractic for what it is; a simply amazing approach to wellness which MUST be included as part of any personal wellness/health plans. Sadly this is not the case today.

I have available for purchase various T-shirts, caps, pens, notepads, mouse pads, patient brochures & cards and novel Xmas cards. All prices are quoted in Australian dollars.

Disclaimer

Disclaimer: Newsletters are based upon the opinions and conclusions of me, Greg Buchanan. They are a result of my own studies, research and personal experience. They are not intended to be a comprehensive medical opinion nor a statement of medical practice, and should not be relied upon as such. I am not a medical doctor and have no medical qualifications. I’m a patient. If readers of the material in this Newsletter require a medical opinion or advice, then you should seek that opinion on a formal professional basis from qualified medical practitioners. Further, no person should rely on any content neither in this Newsletter nor on the opinions or conclusions outlined herein without first obtaining advice from a suitably qualified professional person. The opinions, material and conclusions are provided on the understanding that the author is not responsible for the results of any actions taken on the basis of the information, opinions, material or conclusions provided in any article, publication, document or other form of communication to a person using said information and the author is not engaged in the provision of any medical, chiropractic or other professional advice. The author expressly disclaims all and any liability and responsibility to any person, in respect of anything and the consequences of anything, done or omitted to be done by any such person in reliance, whether wholly or partially, upon the whole or any part of the contents of any stories, articles, publications, documents or other material in this Newsletter or referred to in this Newsletter. In other words, research this stuff for yourself and make your own decisions.

References