CHIROPRACTIC EXCELLENCE

Below is some excerpts of research into Chiropractic helping Vertigo…

Chronic Vertigo Sufferers Find Relief With Chiropractic

Many people aren’t aware of the relationship between upper cervical (neck) trauma and vertigo. With all that modern science has accomplished, there are still more unanswered questions than answered ones. This is also true in the case of vertigo research. It’s been difficult to pinpoint the exact reason(s) why certain people suffer vertigo. However, research is beginning to point toward upper cervical trauma as an underlying cause for many types of vertigo, including Meniere’s disease, Disembarkment Syndrome, and Benign Position Vertigo.

The upper cervical area of the spine refers to the two vertebrae located at the top of the spine, directly underneath the head. C1 (known as Atlas,) along with C2 (known as Axis,) are chiefly responsible for the rotation and flexibility of the head and neck. Like the rest of the vertebrae, they are extremely vulnerable to injury and trauma. In some cases, patients may recall a specific trauma to the head or neck (such as a car accident or a blow to the head.) In other cases, patients may not be able to point to a specific injury after which vertigo became a problem. This is not unusual, since it may take months or years for vertigo to develop after head trauma.

Because so many nerves transmit through the upper cervical spine (to and from the brain,) trauma to this area results in problems to other parts of the body. This is where the relationship between the upper cervical area and vertigo becomes evident. If these vertebrae become displaced, even slightly, vertigo can occur. Unless the neck injury is addressed, the symptoms persist.

Chiropractic care involves correcting the position of these injured cervical vertebrae, particularly C1 and C2. Realigning these vertebrae may reduce or eliminate many types of vertigo…

When these conditions occur as the result of irritation to the neck vertebrae caused by trauma, chiropractic care may be beneficial. Treatments are given to relieve the irritation by realigning the vertebrae back into their proper positions. Once this occurs, the vertigo may diminish or disappear entirely.

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Sixty Patients With Chronic Vertigo Undergoing Upper Cervical Chiropractic Care to Correct Vertebral Subluxation: A Retrospective Analysis

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 (misalignments of the upper cervical spine from the neural canal) and resulting neuropathophysiology. Upper cervical subluxations were found in all 60 cases. All 60 patients responded to IUCCA upper cervical care within one to six months of treatment. Forty-eight patients were symptom-free following treatment and twelve cases were improved in that the severity and/or frequency of vertigo episodes were reduced.

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Clinical Study on Manipulative Treatment of Derangement of the Atlantoaxial Joint

The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis. The clinical diagnosis of derangement consists of: dizziness, headache, prominence and tenderness on one side of the affected vertebra, deviation of the dens for 1 mm-4 mm on the open-mouth X-ray film, abnormal movement of the atlantoaxial joint on head-rotated open-mouth X-ray film. An accurate and delicate adjustment is the most effective treatment.

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Therapy of Functional Disorders of the Craniovertebral Joints in Vestibular Diseases

Cervicogenic vertigo is caused by functional disorders of the craniovertebral joints. The therapeutic effect of chiropractic treatment in 28 patients with vertigo and purely functional disorders of the upper cervical spine or with a combination of functional disorders of the upper cervical spine and the labyrinth was evaluated. In our opinion chiropractic treatment is mandatory for the therapy of patients with vestibular affections and functional disorders of the craniovertebral joints.

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Upper Cervical Protocol to Reduce Vertebral Subluxation in Ten Subjects with Menieres: A Case Series

The objective of this case series was to review the management outcome of upper-cervical protocol on ten patients diagnosed with Menieres disease. Prior to the onset of symptoms all ten cases suffered neck traumas, most from automobile accidents, resulting in undiagnosed whiplash injuries.

Chiropractic care for the reduction of subluxation was undertaken. Custom x-rays and analysis of the upper cervical vertebrae were used to determine chiropractic listings of subluxation. Thermographs of the cervical spine were utilized using a DTG-25 instrument. A Toggle adjustment was used to reduce the subluxation. The condition of Menieres, which is poorly understood, responded favorably to chiropractic care using an upper cervical approach to reduce a specific subluxation complex.

Conclusion: It is possible that the true cause of Menieres disease is not only endolymphatic hydrops as theorized, but that vertebral subluxation plays a role. Further study is recommended.

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Chiropractic Care of a Patient with Temporomandibular Disorder and Atlas Subluxation

A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which had been treated with prescription antibiotics. Her complaints were attributed to a diagnosis of temporomandibular joint syndrome and had been treated unsuccessfully by a medical doctor and dentist. High-velocity, low-amplitude adjustments were applied to findings of atlas subluxation. The patient’s symptoms improved and eventually resolved after 9 visits.

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Vertigo, Tinnitus, and Hearing Loss in the Geriatric Patient

A 75-year-old woman with a longstanding history of vertigo, tinnitus, and hearing loss experienced an intensified progression of these symptoms 5 weeks before seeking chiropractic care. The patient received upper cervical-specific chiropractic care. Through the course of care, the patient’s symptoms were alleviated, structural and functional improvements were evident through radiographic examination, and audiologic function improved. The clinical progress documented in this report suggests that upper cervical manipulation may benefit patients who have tinnitus and hearing loss.

Below is a selection of excerpts from research documenting improvements in hearing following Chiropractic Care…

Can You Hear Me Now?

Hearing loss is more than just a pain in the neck; it’s a brain thing too.

If you can’t turn up the volume on your television without waking the neighbors, consider a visit to your local chiropractor. Research suggests that mild to moderate hearing loss can be improved or restored by a single chiropractic visit. According to a study published in the journal Chiropractic & Osteopathy, 15 patients who had been diagnosed with significant hearing loss volunteered for a routine spinal adjustment. Of the 15, 6 had their hearing restored completely, 7 showed improvement, and 2 did not change.

According to Joseph Di Duro, a researcher and chiropractic neurologist at Palmer Center for Chiropractic Research in Davenport, Iowa, the biggest improvements occurred where patients needed it most – in the quieter decibel levels in everyday conversations. A year later, the researchers followed up on 3 of the study participants – all showed their hearing had remained improved and intact…

Regular visitors to the chiropractic table might be surprised to learn that the first adjustment given in 1895 wasn’t for back pain at all. It instead cured the patient’s deafness on the spot.

In another more recent case, a 36-year-old soccer player, who slammed the ball with his head and suffering severe hearing loss, had his hearing restored after a few adjustments to his spine and neck. Di Duro has been studying this intricate relationship between the nervous system, the brain, and the body…

Di Duro’s theory is based on findings from chiropractic neurology. Experts speculate that spinal manipulations spark a response back to a muscle, a joint, or the periphery, and into the central nervous system where it affects a wide range of neurological problems, including hearing deficits. Chiropractic neurology patients have reported relief from vertigo, learning disorders, pain, hyperactivity, attention deficit disorder, and other problems…

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Hearing Loss, Otalgia and Neck Pain: A Case Report on Long-Term Chiropractic Care That Helped to Improve Quality of Life

Chiropractic Journal of Australia 2002 (Dec); 32 (4): 119-130

Observation over an extended period assists in understanding the progression of chronic disorders. This patient experienced substantially reduced symptoms with chiropractic care during the 7-year observation period. Of note is the repeated exacerbation of neck pain that often precedes exacerbation in ear symptoms, along with the relief of both following adjustment and an association between improved hearing and improved cervical alignment.

Vertebrogenic Hearing Deficit, the Spine, and Spinal Manipulation Therapy (SMT): A Search to Validate the D.D. Palmer/Harvey Lillard Experience

The claim that hearing can be improved following SMT has been scoffed at as physiologically impossible, but a review of the medical and chiropractic literature suggests that hearing deficits may be associated with spinal joint motion restriction, spondyloarthrosis, irritation of the sympathetic nervous system, decreased cervico-cerebral circulation and/or decrease in tinnitus.

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Chiropractic Care of a Patient with Temporomandibular Disorder and Atlas Subluxation

A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which had been treated with prescription antibiotics. Her complaints were attributed to a diagnosis of temporomandibular joint syndrome and had been treated unsuccessfully by a medical doctor and dentist. High-velocity, low-amplitude adjustments were applied to findings of atlas subluxation. The patient’s symptoms improved and eventually resolved after 9 visits.

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Vertigo, Tinnitus, and Hearing Loss in the Geriatric Patient

A 75-year-old woman with a longstanding history of vertigo, tinnitus, and hearing loss experienced an intensified progression of these symptoms 5 weeks before seeking chiropractic care. The patient received upper cervical-specific chiropractic care. Through the course of care, the patient’s symptoms were alleviated, structural and functional improvements were evident through radiographic examination, and audiologic function improved. The clinical progress documented in this report suggests that upper cervical manipulation may benefit patients who have tinnitus and hearing loss.

Cervicogenic Hearing Loss

Findings in 62 patients suffering from vertebragenic hearing disorders are reported before and after chiropractic management. Results indicate that these hearing disorders are reversible, as demonstrated by audiometry and OAE. The therapy of choice is chiropractic manipulation of the upper cervical spine. The commoness of vertebragenic hearing disorders emphasizes their clinical and forensic importance.

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Hearing Improved With Chiropractic - Case Series

The study is significant as it looked for a scientific basis for the story behind the first chiropractic adjustment. In 1895, in Davenport Iowa, Dr. DD Palmer, a self taught healer, encountered a janitor, Harvey Lillard who was working in the building that housed the office of Dr. Palmer.  As history records, Harvey had lost most of his hearing 17 years earlier while working and bending.

Although accounts vary, it is accepted that Dr. Palmer examined Harvey and determined that a bone in his spine was out of place. He concluded that this spinal misalignment was the cause of the hearing loss that Harvey was experiencing. Dr. Palmer then proceeded to give Harvey the first intentional and purposeful chiropractic adjustment. The result was that Harvey’s hearing was restored.

In this series case study, fifteen people with various degrees of hearing loss were tested for certain frequencies to establish their degree of hearing loss. These subjects were then given only a single chiropractic adjustment and subsequently re-tested for any changes in hearing.

After just one adjustment most of the participants experienced significant hearing improvement at various tone levels. Using a standardized testing process known as the Ventry & Weinstein criteria, improvement was shown at various levels of hearing. At 40dB,  6 subjects had hearing restored, 7 subjects improved and 2 had no change. At 25dB using the Speech-frequency criteria, none of the subjects were totally restored, however, 11 had showed improvement, while 4 had no change and 3 missed a tone.

The results of this limited study add further credibility to the story of the first chiropractic adjustment. The researchers concluded, “The observations documented in this case series provide limited support to previous works indicating that, when hearing is tested immediately after a single chiropractic adjusting visit, hearing may be improved in both ears.”

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What are the secret ingredients which define a chiropractic adjustment? What are the features that separate an adjustment from other therapeutic modalities? What are the factors that differentiate a good adjustment from a bad adjustment?

Most definitions of “Adjustment” are very mechanistic in nature: “Moving the joints of the spine beyond a person’s usual physiological range of motion using a fast low-amplitude thrust”; “low-amplitude, high-velocity thrusts in which vertebrae are carried beyond the normal physiological range of movement without exceeding the boundaries of anatomic integrity”. The glaring pitfalls of such predominant definitions are that not all chiropractic adjustments carry the joints into their para-physiological range: Does this mean that SOT Blocks are not an adjustment, and that all instrument-based adjusting protocols are not chiropractic?

Perhaps it is time that we re-define the core components that describe a chiropractic adjustment?

Early chiropractic concepts spoke of universal and innate intelligence, the mental impulse, and proposed that a chiropractic adjustment doesn’t correct anything, but innate utilises the forces transmitted to the body following an adjustment to correct itself: In other words, the body is intelligent, but sometimes needs information from an external source to be able to make better perceptions, decisions and choices.

So, an adjustment is not so much an imposition of our will upon another person’s physiology; as it is the delivery of a new and enlightening piece of information which attempts to facilitate neurological change.

Torque Release Technique defines an Adjustment as “communication through touch”. What are the fundamental factors of this healing touch?

Perhaps we could define these in a physics-like formula…

A = F × CV × I2

In long-hand this translates to: Adjustment equals Force times Correctional Vector times Intent (squared).

Let’s explore this formula in greater detail:

The times signs indicate that each factor has a more significant impact on the other and on the total result than if instead the addition symbol was present; and that if all factors are present the resulting answer will be huge:

For example, in mathematical terms if each factor = 10, then A = 10 × 10 × 100 = 10,000

If the symbols had been additive the answer would be A = 10 + 10 + 100 = 120

If you minimise one of the factors then the answer is minimized:

To alter the above example slightly, if F = 1, then A = 1 × 10 × 100 = 1,000

The square symbol shows the “I” factor has the potential for greater impact: If this factor is small then the formula will not change much. Increase this factor and its impact becomes greater and greater at an exponential rate:

For example if we alter our original formula so that I = 1, then A = 10 × 10 × 1 = 100

Whereas if I = 100, then A = 10 × 10 × 10,000 = 1,000,000!!

Now let’s define the factors in more detail:

Force = Mass × Acceleration:

This is an old Newtonian formula. Every adjustment has force – an adjustment with no force at all is just a good intention. To increase force we either increase the mass or the acceleration, and if you increase both then the force greatly increases. In terms of a chiropractic adjustment, any experienced chiropractor knows the importance of speed over mass: The quicker you are the less the mass you have to use, and the more easily an adjustment is accepted. I guarantee that an adjustment will appear “heavy-handed” to a client due to excessive mass, and not due to excessive speed

Correctional Vector = Contact Point + Three-Dimensional Vector:

The force of an adjustment must have a point of contact and a direction: Specificity is what separates chiropractic adjustment from so many other therapeutic modalities, and without correctional vector I doubt that chiropractic would have attained separate and distinct status. Firstly we are more discerning in where we place our hands; for example, we don’t just stretch the lumbar spine, we adjust an L5.

Also integral in most chiropractic adjustment protocols is the direction in which we apply our force: Our predominant “listing” systems incorporate three letters to define the direction and combination of vectors in three dimensions, which we utilised in our adjustment. And we may even add a fourth letter to further define our contact point… For example: C2 PLI-S – we contacted C2 and our vector was in a direction to reduce the left and inferior vectors of the subluxation, and we used the spinous process as the contact point.

Intent = Become One + Visualisation + See Whole

R.W. Stephenson described the essential components of intent. Intent could be simply explained as what we are thinking about as we deliver an adjustment. But it can also mean much more than this as it may include our own emotional, physiological and even spiritual states.

“Become One” encompasses an almost spiritual connection that occurs when we as a practitioner enter into another’s “energy” or “intelligence” field. The insinuation is that when we come so close there is an influence between the two fields of intelligence. This has ramifications at a diagnostic level in the sense that we can potentially gather much deeper levels of information if we are perceptive to the other person’s “field”; and at a therapeutic level we potentially enter into a deep level for the transaction of information taking place.

“Visualisation” defines the need to see what we are doing: Can we imagine the structures and tissues that we are examining; can we envisage the impact that our testing and corrective vectors are having on the person’s physiology; can we see the effects of our adjustment before they actually occur?

“See whole” describes our intent: Wholeness. After our practice member is adjusted their mind/body is able to better perceive itself, the communications between mind and body are restored, and their physiology becomes more efficient and effective. Do you expect this? Do you actually SEE this occurring in your mind’s eye?

What separates an adjustment from other therapeutic modalities? The size of each factor illustrates its relative importance in the formula:

Massage = f ( m × a ) × CV × I2

Therapeutic massage is separated from relaxation massage by how deep the practitioner penetrates; that is by how much mass they use: Mass is probably the most dominant vector in the therapeutic formula. Acceleration is extremely small as most massage involves slow strokes. The vectors are usually unfocussed and very mixed, sometimes the more directions you sweep across a muscle the better. Intent is somewhat diminished due to poor visualization (most masseurs have inferior anatomical and physiological knowledge) but will have a high degree of connection and a desire to see whole.

Manipulation = f ( m × a ) × CV × I2

Manipulation is usually a mechanistic attempt to produce separation and preferably cavitation of joint surfaces: The Mass is increased and Acceleration is relatively high to achieve this end. Correctional vectors are minimised usually only involving two dimensions and are not seen as so important many times both directions/sides being manipulated to maximise the stretch effect. The intent is small, the need to become one being irrelevant, visualization being for the purpose of finding the structure to be manipulated and the outcome seen being no bigger than to cavitate a joint or to increase flexibility.

Acupuncture = f ( m × a ) × CV × I2

An acupuncture needle delivers minimal mass with no acceleration, so force is almost absent. The correctional vectors are so important, much care being taken in the location of the needles and in the precision of their insertion. The contact points are very different to a chiropractic adjustment relying on a totally different bodily system. The vitalistic intent of the acupuncturist must be considered equal to that of the principled chiropractor as they too expect great things from their therapeutic modality and it could even be argued that they are bolder in their therapeutic claims.

What differentiates a great adjustment from a bad adjustment? The adjustment with “that something extra” requires a precise combination of the secret ingredients…

Great Adjustment = f ( m × a ) × CV × I2

Bad Adjustment = f ( m × a ) × CV × I2

Keys to the adjustment with “that something extra”…

• Maximise acceleration and minimise Mass.
• Utilise a precise system to determine the most effective combination of contact point and correctional vectors.
• Maximise Intent by respecting and perceiving the connection between you and your practice member, visualizing every aspect of your analysis and correction, and having a clear picture of the intended outcomes.

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