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Upper Cervical Protocol For Five Multiple Sclerosis Patients
TODAY'S CHIROPRACTIC , November 2000
by Erin Elster, DC.
by Erin Elster, DC.
INTRODUCTION
Multiple
Sclerosis (MS) is the foremost disabling neurological disease among
adults between 20 and 50 years of age, afflicting 250,000 people in the
United States. (1) It strikes women twice as often as men and Caucasians
more frequently than other ethnic groups. (1) The occurrence of MS is
greater in northern temperate zones. (1)The pathological process involved in MS, a demyelinating disease, is the loss of the myelin sheaths surrounding axons in the central nervous system. Demyelination is thought to result either from damage to the oligodendrocytes (white matter cells) that produce the myelin or from a direct, immunologic (auto-immune) assault on the myelin itself. (2)
Common early manifestations of MS include paresthesias (numbness/tingling in extremities), optic neuritis (vision loss), mild sensory or motor symptoms in a limb, and cerebellar incoordination (balance loss). Although the most common course of the condition is a relapsing and remitting pattern over many years, the manifestation in each patient varies. In most cases, as the disease progresses, remissions become less complete. Some patients have only a few brief episodes of disability, whereas others have a relentless downhill course over months or weeks. Although not all patients become disabled, the end stage often can include ataxia (inability to coordinate voluntary movement), incontinence, paraplegia, and mental dysfunction due to widespread cerebral and spinal cord demyelination. (2)
The MS diagnosis, primarily a clinical one, is usually rendered based on neurological history and examination. The diagnosis can be confirmed by specialized evaluation techniques including magnetic resonance imaging (MRI), evoked potentials, and cerebrospinal fluid (CSF) analysis, although none show findings pathognomonic for MS. (3-5) Traditional medical treatment for MS focuses on the use of medications to regulate the severity of symptoms such as depression, pain, bladder impairment, and sexual dysfunction. Other drugs may accelerate recovery from acute exacerbations of MS, but they neither alter the long-term course of the condition nor reverse any existing MS symptoms. (6)
B.J. Palmer, D.C., reported management of Multiple Sclerosis patients with upper cervical chiropractic care as early as 1934. (7-8) In his writings, Palmer listed improvement or correction of symptoms such as "spasticity, muscle cramps, muscle contracture, joint stiffness, fatigue, neuralgia, neuritis, loss of bladder control, paralysis, incoordination, trouble walking, numbness, pain, foot drop, inability to walk, and muscle weakness." His chiropractic care included paraspinal thermal scanning using a neurocalometer (NCM), a cervical radiographic series to analyze injury to the upper cervical spine, and a specific upper cervical adjustment performed by hand.
While few of Palmer's Research Clinic cases were published, Palmer described one case of Multiple Sclerosis in detail. (8) The patient, a 38-year-old male, went to the Palmer Research Clinic in Davenport, Iowa, in 1943, after a diagnosis of MS by the Mayo Clinic. At the time of admission into the Palmer Clinic, this subject was "…helpless; he could not feed nor take care of himself." His medical history included a head/neck trauma at age 16 in which "…he fell ten feet off a building, landing on his head." The fall rendered him unconscious for thirty minutes and he reported having a sore neck for several days. At the Palmer Clinic, upper cervical radiographs showed a misalignment of the atlas to the right. After upper cervical chiropractic care, the patient remarked, "I am happy to say that through chiropractic, I have been made almost well. Today, I have just a little numbness left in my hands. I have the full use of my hands, feet, and my whole body."
During the past several decades, research linking chiropractic and MS has been virtually nonexistent. A literature search produced only two single case reports. One patient was adjusted with an instrument, while the other was managed with thoracolumbar manual chiropractic adjusting procedures. (9-10) No other references for the chiropractic management of MS patients were found. To the author's knowledge, the MS cases discussed in this report are the first documented using specific upper cervical care (cervical radiographs, thermal imaging, and knee-chest adjustments) since Palmer's research seventy years ago.
The following five individuals suffered from Multiple Sclerosis for one to ten years, ranged from 33 to 55 years of age, and had symptoms varying from mild to severe. All patients showed lesions on MRI (MS plaques) and were diagnosed with MS by their neurologist. Some concurrently were undergoing treatment with medications. The following report discusses the upper cervical chiropractic intervention in detail and summarizes the five cases' results.
IUCCA UPPER CERVICAL CHIROPRACTIC INTERVENTION
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