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Category: Case Studies

Date	21-jan-2003
Case Title	The Influence of Atlas Therapy on Tinnitus
Author	Bernd B. Kaute
Main Condition/ Disease	Hearing Disorders - Tinnitus
Source	International Tinnitus Journal 1998;4(2):165-167
Abstract	As quoted: “We present the abstract and thoughts of an outsider on the proprioceptive input of the posterior small cervical muscles to the brainstem as a source of tinnitus. After treatment of whiplash injuries and other muscular conditions with Arlen’s atlas therapy, some patients reported that their tinnitus had abated with the muscular tensions. Atlas therapy has been proven to slacken the muscles and seems to quieten to normal levels afferent impulses to the brainstem. This has been proven to apply to nystagmus. We sought to determine whether it has the same affect on some forms of tinnitus.”
Summary	In this paper Kaute describes the application of Arlen’s atlas therapy [1-3], which he states “has the clinical effect of slackening to normal…. all tense muscles in the neck and back.” He utilises a high velocity low amplitude impulse to the wing (or transverse process) of the atlas (C1) and concludes that this type of ‘therapy’ “influences the brainstem.”Kaute’s pilot study was conducted on 11 patients with 7 experiencing complete normalization of vestibular disturbances, 3 improved and one did not. His conclusions are that Arlen’s therapy had the affect of reducing tension in the cervical muscles and “lowers their afferences to the brainstem.” Further he states “Irritating these posterior cervical muscles and placing them under tension must precipitate a great afferent input to the vestibular nuclei in the brainstem.” Kaute also states “Arlen’s therapy has had no untoward incidents, as have occurred with chirotherapeutic manipulations.”Kaute presents a hypothesis for tinnitus which suggests that whiplash induced tinnitus results from an “overflow of information to the brainstem… from one or more senses” and “can lead to symptoms that mimic disorders of the neural structures, such as dizziness, nausea, vomiting, nystagmus, blurred vision, and tinnitus.”Kaute goes on to conclude that atlas therapy is helpful when tinnitus is due to muscular tensions in the neck as a result of whiplash type incidents and when the ‘therapy’ is applied quickly (within a “therapeutic window”) and administered properly.Arlen and Kaute are to be applauded for their efforts. Essentially, however I think that their work confirms the great work chiropractors have been doing for decades, especially that of B.J. Palmer and today’s upper cervical ‘specific’ chiropractors. Interestingly Kaute suggests that Arlen’s method “does not re-position the atlas, as is attempted by chiropractors”, however given my research and my own personal experiences I find this fact hard to accept. A head injury or whiplash injury will, in my well-researched opinion, in many cases result in a shift of the skull on the atlas and it is necessary to re-position the atlas in order to restore correct articulation between the occiput and atlas. This is what reduces the tension on not only the cervical muscles but also on the muscles of mastication. If Arlen’s method is not re-positioning the atlas, what is it doing? I’m certain that if Kaute was to carry them out, specific pre and post upper cervical X-rays as performed by specialist upper cervical chiropractors will confirm re-positioning of the atlas.Also, as far as I’m aware there have been no untoward incidents from the tens of thousands of cervical adjustments carried out using ‘specific’ upper cervical chiropractic techniques, which today remain overwhelmingly gentle and non-invasive. For example, Dr. Roy Sweat’s atlas orthogonal approach utilises a sound or percussion wave (impulse) in the adjustment, which is so gentle you feel absolutely nothing. Further, there have been thousands of people relieved of tinnitus through upper cervical chiropractic corrections. Many people have been relieved of tinnitus many years, and sometimes decades after the onset of tinnitus, which suggests a “therapeutic window” of opportunity is not necessarily correct.My conclusion from the reading of this paper is that Arlen and Kaute are only performing what chiropractors have been doing for many years. Further research into upper cervical chiropractic will confirm this.
References	1. Arlen A. Metameric Medicin and Atlastherapie. In JK Paterson, L Burn, Backpain, Kluwer, 212-2262. Arlen A, Godefroy GB. Reversible Veränderungen der Hirnstamm-potentiale nach Atlastherapie. Neuroothopädie Hohmann, Kϋgelgen, Liebig: Springer 1985:189-1973. Lohse-Busch H, Krämer M Atlastherapie nach Arlen (heutiger Stand). Manuelle Medizin 28:153-156, 19944. Sherrington CS. Decerebrate rigidity and reflex-coordination of movements. J Physiol 18975. Claussen CF, Kaute B, Schneider D. Neurootologische Veränderungen bei HWS Traumapatienten vor undnach Atlastherapie. Springer, 1997:189-1976. Neuhuber WL, Bankoul S. Der Halsteil des Gleichgewichtsapparats-Verbindung zervikaler Rezeptoren zu vestibulariskernen. Manuelle Medizin 30:53-57, 1992.7. Shulman A. A final common pathway for tinnitus – The medial temporal lobe system. Int Tinnitus J 1(2):115-126, 1995.
Keywords	Tinnitus, atlas, brainstem, cervical spine

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