EIGHTY-ONE PATIENTS WITH MULTIPLE SCLEROSIS AND PARKINSON’S DISEASE UNDERGOING UPPER CERVICAL CHIROPRACTIC CARE TO CORRECT VERTEBRAL SUBLUXATION: A RETROSPECTIVE ANALYSIS
 
   

Eighty-One Patients with Multiple Sclerosis and
Parkinson’s Disease Undergoing Upper Cervical
Chiropractic Care to Correct Vertebral Subluxation:
A Retrospective Analysis

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:
   Frankp@chiro.org
 
   

FROM:   J Vertebral Subluxation Research 2004 (Aug);   23 (8):   1–9 ~ FULL TEXT

Erin L. Elster, D.C.

Private Practice
Boulder, Colorado
erin@erinelster.com


Objective:   The objective of this article is threefold: to examine the role of head and neck trauma as a contributing factor to the onset of Multiple Sclerosis (MS) and Parkinson’s disease (PD); to explore the diagnosis and treatment of trauma-induced injury to the upper cervical spine through the use of protocol developed by the International Upper Cervical Chiropractic Association (IUCCA); and to investigate the potential for improving and arresting MS and PD through the correction of traumainduced upper cervical injury. Data from 81 MS and PD patients who recalled prior trauma, presented with upper cervical injuries, and received care according to the above protocol are reviewed.

Clinical Features:   Each patient was examined and cared for in the author’s private practice in an uncontrolled, non-randomized environment over a five-year period. Of the 81 MS and PD patients, 78 recalled that they had experienced at least one head or neck trauma prior to the onset of the disease. In order of frequency, patients reported that they were involved in auto accidents (39 patients); sporting accidents, such as skiing, horseback riding, cycling, and football (29 patients); or falls on icy sidewalks or down stairs (16 patients). The duration between the traumatic event and disease onset varied from two months to 30 years.

Intervention and Outcome:   Two diagnostic tests, paraspinal digital infrared imaging and laser-aligned radiography, were performed according to IUCCA protocol. These tests objectively identify trauma-induced upper cervical subluxations (misalignment of the upper cervical spine from the neural canal) and resulting neuropathophysiology. Upper cervical subluxations were found in all 81 cases. After administering treatment to correct their upper cervical injuries, 40 of 44 (91%) MS cases and 34 of 37 (92%) PD cases showed symptomatic improvement and no further disease progression during the care period.

Conclusion:   A causal link between trauma-induced upper cervical injury and disease onset for both MS and PD appears to exist. Correcting the injury to the upper cervical spine through the use of IUCCA protocol may arrest and reverse the progression of both MS and PD. Further study in a controlled, experimental environment with a larger sample size is recommended.



From the Full-Text Article:

Introduction:

While the link between head trauma and the later development of Parkinson’s disease (PD) or Multiple Sclerosis (MS) remains controversial, many PD and MS researchers have confirmed the connection. [1-12] Several researchers have reported a strong association between head trauma and the subsequent development of PD in retrospective case-controlled studies and have found this association to be stronger than that of other environmental agents long suspected as risk factors for PD. [1-5] On average, these studies found that head trauma occurred two to three decades prior to PD onset. [1, 2, 5] One recently published study, performed at the Mayo Clinic and headed by Dr. J.H. Bower, investigated the association between head trauma and PD in more detail. [1] By reviewing the complete medical records of both cases and controls, the study team was able to objectively determine prior occurrence of head trauma without introducing recall bias. Study results suggest that head trauma is associated with the later development of PD, even when study limitations were taken into consideration.

In a discussion regarding the possible role of trauma in the development of MS, Dr. Charles Poser [9-11] notes that “in some patients with MS, certain kinds of trauma (to the brain and/or spinal cord, including whiplash injuries) may act as a trigger at some time for the appearance of new or recurrent symptoms.” Poser goes on to suggest that trauma to the central nervous system may alter the blood-brain-barrier (BBB), which many researchers consider to be a critical step in the formation of MS lesions. He cites research conducted on monkeys demonstrating that mild trauma inflicted on the central nervous system, including whiplash injury, results in a breakdown of the BBB. He also cites several researchers who observed the correlation between trauma and the formation or exacerbation of MS lesions. He further notes that the “relationship (between cervical spondylosis and MS) has been well documented by MRI in many patients with MS, revealing a close anatomical correspondence between compression of the cervical spinal cord by spondylosis or herniated discs … and intraspinal plaques at the same level.”

In 1996, a British court awarded damages to a plaintiff based on the rapid onset of MS closely following a motor vehicle accident. [12] The presiding judge stated that he was “satisfied that (the plaintiff) did sustain a whiplash injury... and that the symptoms he later displayed indicated that MS had developed in the very area which had been affected by the trauma.” Experts testified that hundreds of MS cases diagnosed subsequent to auto accidents existed; too many, they claimed, to be caused by chance.

While links between trauma and the later development of MS and PD have been established, researchers have yet to define an exact mechanism to explain the onset of MS and PD following trauma, nor have they isolated an objective method for measuring and/or diagnosing the kind of trauma-induced injuries that appear to precipitate MS and PD. This paper serves to address the above issues through the summary of case histories, diagnostic test results, and treatment responses of 81 MS and PD patients, 78 of whom recalled head or neck trauma prior to disease onset. These patients were examined and cared for in the author’s private practice over a five-year period in a nonexperimental environment without control subjects. This paper does not purport to be a controlled research study, but rather serves to provide a foundation for future research. Case reports of two of the 81 cases (1 MS case and 1 PD case) were published in indexed, peer-reviewed journals. [13-14] Other reports documenting successful treatment of patients with similar diagnoses using upper cervical chiropractic care are limited primarily to Palmer’s upper cervical research conducted seventy years ago, which was never published in a peer-reviewed, indexed fashion. [15-16] Patients with other neurological conditions such as Migraine headaches and Tourette Syndrome also responded favorably to IUCCA upper cervical chiropractic intervention. [17-18] In both cases, patients reported substantial traumas to the head or neck prior to the onset of symptoms and diagnoses.

      Clinical Features

Of 81 total cases of Multiple Sclerosis (MS) and Parkinson’s disease (PD), 44 individuals with MS and 37 with PD consented to examination and treatment in the author’s private practice. Patients began treatment at various intervals over a five-year period. Treatment duration varied from one to five years depending on the individual. Patient data for the 44 MS patients and for the 37 PD patients were compiled and listed in Tables 1 and 2 respectively.

MS patients ranged in age from 21 to 66 years old and presented with a one to thirty year history of MS, as diagnosed by their neurologists. PD patients ranged in age between 34 and 77 years and presented with a one to twenty year history of PD, as diagnosed by their neurologists. Most patients reported that they “had tried everything” to relieve their symptoms including prescription medications, chiropractic adjustments, osteopathic manipulation, physical therapy, massage therapy, rolfing, acupuncture, herbs, Chinese medicine, chelation, special diets, supplements, and removal of dental amalgams.

Patients were questioned as to whether they recalled a history of trauma (blow to the head, concussion, whiplash, accident, fall, etc.) prior to the onset of MS or PD. Of the 44 MS patients, 43 (98 %) recalled a history of trauma. (Table 1) Of the 37 PD patients, 35 (95%) recalled a history of trauma. (Table 2) Of the 78 patients who recalled traumas (many recalled more than one), 39 (21 PD patients and 18 MS patients) reported experiencing one or more auto accidents (many were minor rearend collisions); 29 reported multiple blows to the head and/or neck during sporting activities including skiing, cycling, horse back riding, football, gymnastics, etc.; and 16 reported falls on icy sidewalks or down stairs. In other lesser-reported incidences, one man reported being kicked in the head by a cow; another man reported blows to the head as a result of heavy machinery accidents; and two female patients reported concussions from domestic abuse. The duration between the traumatic event and disease onset varied from two months to 30 years. It should be noted that sixteen additional MS patients and seven additional PD patients were examined and accepted for care during the same period but chose to discontinue care during the early treatment weeks. Data from these patients were not included in this report.

      Intervention

Each patient was examined and cared for utilizing protocol developed by the International Upper Cervical Chiropractic Association (IUCCA), including the use of paraspinal digital infrared imaging, laser-aligned upper cervical radiography, kneechest adjusting posture, and post-adjustment recuperation. [19] The care, described in detail in previous publications, [13-18] is based on the original upper cervical chiropractic research performed by Palmer seventy years ago. [15, 16]

To diagnose spinal injury, a paraspinal thermal analysis was performed using the Tytron C-3000 (Titronics Research and Development) according to thermographic protocols. [20-23] (Figure 1) In all 81 cases, paraspinal scans contained static thermal asymmetry of 0.5şC or higher, which indicates neuropathophysiology originating from the upper cervical spine. [24-27] (Figure 2) (Table 1)

Based on the results of the thermal scans, a cervical x-ray series (lateral, anterior-to-posterior, open mouth, and base posterior) was taken utilizing a specially designed machine (American X-ray Corp.) that incorporates a laser-aligned frame, a laser mounted to the x-ray tube (Titronics Research and Development), a positioning chair, and head clamps. [28] (Figure 3) This configuration is designed to ensure accuracy when measuring the deviation of the upper cervical spine from the neural canal. Analysis of the upper cervical radiographs revealed deviation of the upper cervical spine from the neural canal, or upper cervical subluxations, in all 81 cases. On average, each patient’s atlas and axis deviated from the foramen magnum (occiput) laterally (to the left or right) five millimeters or less and rotationally (anterior or posterior) five degrees or less. In Tables 1 and 2, atlas listings are depicted with laterality of left (L) or right (R) and rotation of anterior (A) or posterior (P). The lateral movement of axis is listed to the left (ESL) or right (ESR).

Because upper cervical subluxations were discovered in all 81 cases, it was recommended that these patients receive care to correct their cervical injuries. Before initiating care, patients were cautioned to continue medical treatment including medications unless otherwise advised by their physicians. After consent was obtained, care was administered according to IUCCA protocol to correct the lateral and rotational deviation of each patient’s upper cervical spine. To administer the adjustment, each patient was placed on a knee-chest table with his or her head turned to the side of laterality (either left or right). (Figure 4) Using the posterior arch of atlas or lamina of axis as the contact point, an adjusting force was introduced by hand. [29]

Following the adjustment, the patient was placed in a postadjustment recuperation room for fifteen minutes as per thermographic protocol. [20-23] After the recuperation period, a postadjustment thermal scan was performed to ensure restoration of normal neurophysiology. (Figure 5)

All subsequent office visits began with a thermal scan. An adjustment was administered only when the patient’s presenting thermal asymmetry returned. If an adjustment was given, a second scan was performed after a recuperation period to determine whether restoration of normal thermal symmetry had occurred. On average, patients were seen two times per week during the first two weeks of care, one time per week during the following four weeks, two times per month during the following month, one time per month for the following three months, and once per quarter thereafter.

      Outcome

Outcomes of the 44 Multiple Sclerosis (MS) patients and 37 Parkinson’s disease (PD) patients are illustrated in Tables 3 and 4 respectively. The tables list gender, age, years since diagnosis, initial symptoms, improved symptoms, and category of improvement (minor, moderate, substantial or no change). If the patient’s condition remained the same during the care period, “no change” was listed. Patients reporting improvement with, or absence of, less than half of their symptoms were indicated as showing “minor” improvement. Patients reported reporting improvement with, or absence of, half of their symptoms were identified as having “moderate” improvement. If patients showed improvement or with, or absence of, the majority of their symptoms, they were categorized as having “substantial” improvement.

Of the 44 MS cases, 40 (91%) reported improvement. Of these, 28 showed “substantial” improvement; 8 showed “moderate” improvement; and 5 showed “minor” improvement. No further progression of MS was noted in the improved cases during the care period, which ranged from one to five years depending on the patient. Four cases reported “no change” in their condition.

Of the 37 PD cases, 34 (92%) reported improvement. Of these, 16 showed “substantial” improvement; 8 showed “moderate” improvement; and 11 showed “minor” improvement. No further progression of PD was noted in the improved cases during the care period, which ranged from one to five years depending on the patient. Three cases reported “no change” in their condition.

      Hypotheses

Seventy-eight of the 81 Multiple Sclerosis (MS) and Parkinson’s disease (PD) patients recalled head or neck trauma prior to the onset of the disease, including blows to the head, whiplash, or concussion sustained as a result of motor vehicle, sporting, or other accidents. These findings are consistent with published retrospective studies conducted with MS and PD patients regarding head trauma sustained prior to disease onset. In this case, patients were examined to confirm trauma-induced spinal injuries. Two diagnostic tests - paraspinal digital infrared imaging and laser-aligned upper cervical radiography - were administered according to the protocol of the International Upper Cervical Chiropractic Association (IUCCA). In all 81 cases, trauma-induced upper cervical subluxations were discovered.

After administering IUCCA upper cervical chiropractic care, 91% of the MS patients and 92% of the PD patients improved, and no further progression of MS or PD was noted in the improved patients during the care period. Seventy percent of the improved MS patients and 47% of the improved PD patients showed “substantial” improvement, reporting the absence or significant improvement with the majority of symptoms.

Hypotheses:   MS and PD both can be induced as a result of head and neck trauma and the resultant injury to the upper cervical spine. Further, this injury can be diagnosed and corrected through the administration of IUCCA upper cervical chiropractic care. Finally, it is the correction of this injury that may arrest and reverse the disease processes involved in MS and PD.



Conclusion

Eighty-one patients with either Multiple Sclerosis (MS) or Parkinson’s disease (PD) were evaluated and cared for using protocol developed by the International Upper Cervical Chiropractic Association (IUCCA). Histories of trauma to the head and/or neck were recalled in 78 cases; upper cervical subluxations were found in all 81 cases; and 91% of the cases responded to care, with symptoms improved and/or reversed and no further progression of either MS or PD detected. These results indicate a causal link between trauma, upper cervical injury, and disease onset for both MS and PD. Correcting the injury to the upper cervical spine through the use of IUCCA protocol may arrest and reverse the progression of both MS and PD. Further study in a controlled environment with a larger sample size is recommended.


Acknowledgements

The author gratefully acknowledges Drs. William Amalu and Louis Tiscareno of the International Upper Cervical Chiropractic Association (IUCCA) for their Applied Upper Cervical Biomechanics Course and the Titronics Corporation for the Tytron C-3000 Paraspinal Digital Thermal scanner.



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