Dr. Davis here from Vista CA…Here is a follow-up to our recent post…a little a long and a little technical but very informative…
Upper Cervical Chiropractic has been demonstrated in the medical journals to be a very effective approach to restoring proper neurological and structural integrity to the body after a whiplash injury. In fact The Journal of Whiplash and Related Disorders, a peer-reviewed publication, documents the effectiveness of upper cervical chiropractic care in the care of post whiplash patients. The entire research article is available as a pdf file.
Whiplash Facts*:
- There are 7-8 million motor vehicle crashes (MVC) in the U.S. per year
- 3 million of those involve whiplash injury
- 42,000 are killed each year
- 50% of those injured have long-term symptoms
- 10% of those injured become disabled
- 45% of chronic neck pain sufferers attribute the problem to past Motor Vehicle Crashes
*Statistics come from the Spine Research Institute of San Diego, an internationally recognized organization committed to preventing crashes and reducing its burden as an epidemic.
Following a head or neck trauma such as a whiplash type injury one area that is commonly damaged is the proprioceptive system of the neck. Proprioception is your body’s ability to perceive your position is space. The upper cervical spine has the most dense collection of proprioceptors in the body. When these proprioceptors are damaged people tend to have an increase sensitivity to pain stimuli which can lead to chronic pain. An Upper Cervical Corrective Procedure is designed to correct this underlying cause in order to restore proper neurology and physiology to the body. This underlying proprioceptive imbalance could be the reason why Upper Cervical Care is so effective in helping those with whiplash injuries.
A study done in June 2005, that was published in Spine demonstrated some key points regarding a small muscle in the upper neck called the rectus capitis posterior minor (a major proprioceptive muscle) and how chronic neck pain and headaches can follow Whiplash type injuries:
KEY POINTS FROM THE AUTHORS OF THE STUDY:
1) The rectus capitis posterior minor tendon fuses with the spinal dura.
2) The rectus capitis posterior minor tendinous fibers, fascia and the perivascular sheathes form the posterior atlanto-occipital membrane.
3) The posterior atlanto-occipital membrane fuses with the spinal dura.
4) The nuchal ligament does not attach to the spinal dura.
KEY POINTS FROM DR. DAN MURPHY, D.C.:
1) Connections between the spinal dura and muscles / ligaments in the posterior atlanto-occipital interspace may transmit forces from cervical spine joints to the pain-sensitive dura, generating cervicogenic headaches.
2) The tendinous fibers of the rectus capitis posterior minor muscle fuse with the spinal dura via the posterior atlanto-occipital interspace.
3) This study clearly demonstrates that the rectus capitis posterior minor tendon fibers are directly continuous with the spinal dura via the posterior atlanto-occipital interspace and become a part of the spinal dura.
4) The direct continuity of the rectus capitis posterior minor muscle to the spinal dura prevents dural enfolding and injury during extension of the head and neck.
5) When the rectus capitis posterior minor muscle extends the cranio-cervical junction, a small portion of its muscular fibers simultaneously contract to pull the spinal dura posteriorly, preventing dural enfolding and dural injury.
6) Static strain and/or trauma to the rectus capitis posterior minor muscle may stimulate the pain-sensitive dura, generating a cervicogenic headache.
7) The rectus capitis posterior minor fascia is the main connective tissue structure in the posterior atlanto-occipital interspace, and that the rectus capitis posterior minor fascia and muscle are the main contributors to posterior cranio-cervical stability.
CLINICAL APPLICATION FROM DAN MURPHY:
[Hack GD, Koritzer RT, Robinson WL, et al. Anatomic relation between the rectus capitis posterior minor muscle and the dura mater. Spine 1995;20:2484-6.]
The original study by Hack (above) documenting a connection between the rectus capitis posterior minor muscle and the spinal dura mater through a connective tissue bridge was published in 1995, and at that time I proposed the following:
1) The spinal dura is innervated with pain afferents.
2) Contraction of the rectus capitis posterior minor pulls the spinal dura into a safe position so that is does not enfold into the spinal cord causing cord injury or injury to the dura itself.
3) Whiplash extension injuries occur so quickly (taking less than .1 seconds) that the rectus capitis posterior minor muscle does not have enough time (requiring about .2 seconds) to contract and pull the spinal dura to safety.
4) The resulting injury to the pain sensitive dura could be a cause of post whiplash headache.
This study supports the contention that chronic upper neck postural stress and distortions can cause chronic stress on the spinal dura mater. Only an Upper Cervical Corrective Procedure such as NUCCA is effective at correcting this underlying problem. Find out more at www.nuccawellness.com or call the office for an evaluation today to see if NUCCA could help you….760-945-1345.
References:
Journal of Whiplash & Related Disorders, Vol. 5(1) 2006
Available online at http://www.haworthpress.com/web/JWRD
Configuration of the Connective Tissue in the Posterior Atlanto-Occipital Interspace Spine Volume 30(12) June 15, 2005 pp 1359-1366 Nash, Lance MSc; Nicholson, Helen MB, PhD; Lee, Antonio S. J. MSc; Johnson, Gillian M. PhD; Zhang, Ming MB, MMed, PhD
Dr. Davis, This article cites the Atlas Orthogonal technique. Do you practice AO?
Thank you for your reply.
Dr. Fiorini,
I practice NUCCA primarily and I use the Orthospinology instrument in some cases. Are you an AO practitioner?
Dr. Davis
http://dennisfiorini.wordpress.com/
Yes. We practice Atlas Orthogonal as taught by Dr. Roy Sweat the developer. I am also president of the R.W.Sweat Foundation for Chiropractic Research. I was one of the contributing doctors for the study you cited.
Fantastic. Keep up the good work!