Edited Feb 14 2013
Symptoms
Please be aware that the following list is a list of all possible complications and their anatomical and physiological basis and that few people with this condition will have a full hand of symptoms.However, a proper understanding of anatomy and physiology of the upper cervical area and brainstem should be enough to make it clear that all of the symptoms listed below are predictable given a large enough subluxation.
The joint between the skull and the neck is designed for nodding movements, and it has been documented that the maximum rotation expected on turning well to the left or right is about 3-4 degrees.
The worst case I have seen was a rotatory subluxation of about 25 degrees demonstrated on a CT upper cervical spine. I was dismayed that the radiologist who reported it failed to note the abnormality. I would observe that this probably happened because such subluxations are not regarded as possible within allopathic medicine- and he was not looking for it. I did get the satisfaction of an amended report after conversation with the radiologist involved.
Most symptoms will be intermittent, and at least partially resolve when the patient is fit and active, so there will be great variability between patients. I have had experience with most of these symptoms being relieved in patients I have seen.
Physical and radiological examination will provide clear cut evidence of the existence of the condition.
Mechanical Symptoms
- Headaches- often involving the base of the skull, and referring to the sides of the head and around the sinuses.
- Migraines, often with marked agitation and nausea.
- Neck pains and stiffness and difficulty finding a comfortable position on the pillow at night.
- Sometimes crackling or grating noises at the base of the skull when turning the head. Often there are associated shoulder pains, especially between the shoulder blades.
- Jaw joint pains or dysfunction. Clicking jaw.
- Chest wall pain- due to the distortion of the ribcage
- Low back pain and/or disc injuries due to abnormal posture.
- Nerve root irritations at any level.
- Pains or injuries in one hip, knee or ankle, often repeated injuries to one side of the body.
- Patients may be told they have one leg shorter than the other.
Vagus nerve: Nausea, heartburn, irritable bowel, constipation, vasovagal (fainting/near fainting) episodes, probably infantile colic. Cough and voice problems
Internal Jugular Vein and venous drainage of the skull via the foramen magnum: tiredness, mental fogginess (often subtle and this may well contribute to the mental fogginess in ADHD, chronic fatigue syndrome, fibromyalgia and depression). References:
http://www.upright-health.com/
http://www.upright-health.com/vertebral-veins.html
http://www.upright-health.com/brain-cooling.html
It is of interest that current research into multiple sclerosis has raised the possibility of venous congestion of the brain having a causative role in that condition.
Dizziness- often subtle and hard to describe, and mild incoordination /clumsiness.
Note that these symptoms are likely to be related to disturbed inputs to the Vestibular/proprioceptive (balance) system caused by nerve impingements, and excess tension in some muscles and on some joints. It is likely that the actual atlas subluxation causes some brainstem injury at the time of the injury.
Tingling or burning fingers or toes- usually migratory and intermittent.
Sympathetic Nervous System:
There are multiple reasons to believe that atlas subluxations may cause sympathetic overactivation (stress response): Poor balance itself is a cause of sympathetic overactivation, also the traction on the brain stem caused by the typical head forward posture of most people with the injury activates a stress response, and there may be further impacts on sympathetic ganglia (nerve cell clusters) that lie close to the spine along the whole length of the spine.
Symptoms would include chronic anxiety and impulsiveness, fine tremor, raised heart rate
It is arguable that chronic sympathetic overactivationmay be lead to:
a)gut problems due to chronic diversion of blood flow away from the gut into the muscles which may well be contributory to peptic ulcers, food allergies ( via increased gut permeability)
b) Adrenal gland activation and chronic over production of cortisone as an expected consequence of chronic sympathetic (stress) response. Adrenal fatigue as a downstream consequence of this.
c) unstable attention- as the body is effectively being given a warning to loo for threat in the environment.
It is arguable that chronic sympathetic activation might be contributory to immune suppression, hypertension, diabetes, osteoporosis, disturbed sleep and depression.
Disturbed sleep:
This is a common complication in our experience and may be contributed to by neck discomfort at night, by sympathetic over-activation, or by a number of brain stem effects caused by alteration in balance inputs into the nervous system.. In a number of patients the neck discomfort has triggered tooth grinding which has improved after treatment.
Signs
The physical signs of atlanto- occipital subluxation are straightforward, and the diagnosis can usually be confirmed without investigations.
Posture- the head is carried forwards of the shoulders. ( In healthy posture the centre of the shoulder joint is vertically directly below the ear canals).The patient may also have a degree of hunch or a sway back.
The patient will have great difficulty straightening up to hold his head in correct position.
The front on view will often clearly indicate the problem. The head may be tilted to one side, and the neck rotated a few degrees or so off straight ahead.
The midline of the trunk may not be vertical.
One shoulder will be higher than the other.
Often the pelvis will visibly be off level as well (Usually high on the side of the low shoulder).
From the back the difference in the level of the shoulders will be more apparent, and one shoulder should be pushed out to the back. The head, shoulders, and hips may be out of alignment (viewed from above).
The neck will almost always be tender just below the ears and behind the jaw. It may be possible to feel that the neck bone is closer to the jaw on one side than the other. Postural issues, muscle spasm, or a “bull neck” can make this sign difficult to identify. However the joint between the atlas and the skull is not one at which rotation naturally occurs (beyond about 3-4 degrees at the extremes of neck rotation) so this sign is always abnormal if found.
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The spasm is involuntary muscle guarding as the muscles brace to protect the cervical spinal cord from injury.
I have been working with a chiropractor who specialises in functional neurology for some years now, and am well aware that I have had longstanding deficits of body awareness especially in the right upper quadrant. These were easily demonstrated on the more sophisticated chiropractic neurological examination that was done on me. (Us doctors have a LOT to learn).
However- due to a combination of QiGong, and some rhythm related meditation with great emphasis on balance and exact awareness of foot placement I actually tuned off the neck spasm and pain about 3 weeks ago. This is quite a remarkable result- and I now understand that the basic problem was one of my brain receiving mismatching sets of visual, proprioceptive, tactile and vestibular information– and getting very overloaded.
The other nice aspect of this is that it has completely turned off the last of my ADHD symptoms- and it happened virtually in an instant. I am now looking at a way of simplifying and operatonalising these findings to make them more widely applicable.
Which doctor did you see at kempsville? Looks like a great place. Thank you. Anja
Will your chiro adjust your C1? Not all will do this.
Good luck.
Ljdebernardi@gmail.com
LIL
Other options are to be found through the “NUCCA” website and also any practitioner of Sacro-occipital technique should be able to remedy the problem without excessive force.
I am fortunate to see one in my locale, Bloomington Minnesota. David Philips is his name.
I had already diagnosed this in myself. I backed into the diagnosis in a roundabout way, but the day I cradled my head in my hands pressing in with my thumbsjust below and behind the ears did I feel the misalignment of the atlas (the left side did not feel like the right side). I could feel a slight bony-like projection on my left side, but for the life of me no matter how much I searched find any such structure on the right side (no matter how deep I explored with my thumb). Therefore, I pressed extremely hard on the left side trying to force the bone to the right back into place. I used a hard plastic case, using the heal of my left hand to push against it while bracing the neck on the right with my right hand. I had some success but the bone would always float back to the left. Finally this morning while lying in bed I once again used the plastic case, but this time positioned it very tightly and immediately below the mastoid process on the left side. I positioned my right palm over the mastoid on the right. Pushing with the left palm on the plastic case while resisting with the right hand and at the same time trying my best to relax the neck muscles. Guess what? I can now feel the bone on the right side. The left and right sides feel the same. This has not been the case.
Now going forward I will need to maintain the ground I have taken and build on this success. I am now hoping that my sleep will improve and with it my energy level and love for life. I cannot expect this one thing to make all the difference. It will take effort on my part but I am hoping this small change will be the tipping point for me to move in a positive direction.
I am glad that the information was useful.
If you could manage to settle it yourself you were lucky- most cannot.
I certainly would not recommend that anyone try to repeat the exercise themselves!!
My blog needs major revision, as my biggest discovery has been that the original injury caused brainstem injury that left me with long term balance and co-ordination issues.
It has taken me years to get on top of these.
I am finally getting close- but I must stress that the aim is to achieve an upright, flexible posture and good eye hand co-ordination.
By “Upright” I mean SO upright that your ear canals, the centre of your shoulder joints and the centre of your hip joints lie in the one vertical plane.
This takes quite a bit of work- but the rewards in term of ability to remain calm and focussed are huge.
The reason this blog has remained anonymous has been the serious hostility I have faced from my local colleagues when I bring this matter up for public discussion.
That matter is close to being resolved, and when it is, I hope to have time to give more information on the blog.
For the meantime- it is well worth your while to go to the site psychevisual.com and look up a talk by the chiropractor Ian Niven on “visual suppression of the vestibular system”, another one by randy beck on “Clinical correlates of traumatic brain injury” and another by Matthew Holmes on “Cervical dystonia following central nervous system injury – a case study highlighting the functional neurology approach”. it costs $20 to subscribe for 1 month- but is worthwhile.
See the Biedermann book I have referenced.
I am doing specific exercises designed to correct the brainstem problem- a slow process, but progressively successful.
(Functional neurology- a new branch of chiropractic- still somewhat controversial with the conventional medical profession, but I am clear as to my improvements in reflexes, coordination and regulation of the stress response. Thankfully I have the anatomical knowledge and clinical skills to assess this- but this is an area where individuals must do their own research and make their own decisions).
100 Chiropractors over the past 20 years..but never an atlas expert.
Any suggestions for one near Santa Barbara CA.?
Thanks
Lillian
Be sure that your advisor is well informed of all sides of the argument before committing.
Your orthopedist is too ignorant to be fit to comment.
I found my major atlas subluxation was nicely fixed by one treatment with Atlas Profilax, but that correcting the rest of the spine and relearning abberant movement patterns related to my old scoliosis has been a much slower process.
Thanks! Anja
Stay tuned, there is much more information to come.
My experience is that I was badly injured by my profession’s foolish insistence that us doctors knew everything and chiropractors knew nothing.
Unfortunately to even voice that opinion in Australia is to risk the wrath of some very senior and powerful figures in the medical profession who are attempting to get chiropractic courses driven out of Australian Universities.
If I could pin this ignorance down to one individual, I would gladly sue for damages.
However I had some cervical flexion and extension xrays taken by a surgeon. He held my head in position to do them and forced my head forward and backward. He said he saw nothing to concern him whatsoever with the bone alignment and the twist and head pulling over was all down to a muscular issue. I am confused as if the muscles are in so much spasm I fail to see how the bones can be in alignment and also to how it differs to what I see from My Nucca xrays.
Who do I listen to? The Nucca doctor or the ortho guy. Do I get adjustments of massage? Any advice most welcome. Thanks so much
However,anomalous neuromuscular activity does develop and maintain this problem, and may need further work to deal with it.
Chiropractors are well trained to deal with this.
It can take some time for the adjustments to hold, your neck has become accustomed to being
in this position.
May i ask, what type of adjustment did the chiropractor do to cause your problems?
The NUCCA chiropractors do not ‘crack or ‘pop your neck or spine and would be the most
Benefical to your needs.
Hello from Minnesota USA. Medical doctors don’t seem to have answers. In regard to the Atlasprofilax, why don’t you ask my upper cervical chiropractor. Here is his e-mail.
DPPhillipsdc@gmail.com He is really nice and compassionate individual.
Teresa
Now as far as Atlas Profilax goes- my medical defence organisation has warned me that they would not insure me for any incidents involving Atlas Profilax- as the practitioners were not registered by AHPRA.I would comment though that they clearly arrived at that decision without having done due diligence on the subject and they refused to look at further information I offered to supply. My own experience of Atlas Profilax is that I have personally referred a good number of patients (about 100) all of whom did well. Another doctor I know has referred about the same number and those 200 recommended the treatment to their friends- resulting in about 200 more referrals- so I have seen a good case load.
However not all Atlas Profilax practitioners are trained enough to take people through the ongoing bodywork required to correct chronic postural issues associated with a longstanding atlas injury (these include fascial contractures, arthritic facet joints in the spine, sometimes spinal crush fractures and collapsed discs, and longstanding abberant patterns of movement. In this regard a good upper cervical or sacro-occipital proctitioner is the best option.
I would also disagree that Atlas Profilax is “the only” procedure that can correct the malalignment, and that atlas malalingments that have been corrected by Atlas Profilax always stay in place.
My own personal experience was that I had a rotatory misalignment of about 25 degrees and that the atlas profilax corrected that in a way that was uncomfortable but not painful, certainly did not seem risky, and produced an immediate result.
However- correcting my posture fully has been a big job and is taking a long while – and minor recurrent subluxations do occur. For those I have definitely found chiropractic effective and safe, and also more affordable than repeat episodes of Atlas Profilax.
What I would like to see would be more collaboration and less competition between Atlas Profilax and other manual and manipulative therapy traditions.
So- to answer your question- it really is something that you have to decide for yourself, but there is enough information there re safety.
Look especially at the atlantotec website– “their technique”- is actually virtually identical to Atlas Profilax– in fact I am told by an Atlas Profilax practitioner that they are a breakaway group from Atlas Profilax. However- they do have a study of 500 patients published on their website.
However, I have found that good chiropractors provide more comprehensive treatment than Atlas Profilax, that only fixes the one 9very important joint).
I have done enough research to be confident of sacro-occipital chiropractors and specific upper cervical chiropractors.
See http://isyourheadonstraight.com/prac2.asp?rid=1 and http://isyourheadonstraight.com/prac2.asp?rid=1 to find practitioners.
It sounds like an XRay would be in order.
As for heavy school bags- they will definitely make things worse- though the postural deformity caused by an atlas subluxation leaves one shoulder sitting up high- and people then prefer to use that shoulder to carry bags as the bag doesn’t fall off. An odd aside is that women always complain of the bra strap on the low shouler falling off and can never figure out wh until shown their posture.
My question to you is this, i have suffered for about 20 years now with a laundry list of symptoms. Many of them I am sure can be attributed to the Atlas issue and new chiro agrees. My primary issues now that making my life a living hell are allergies (which only started about 4 years ago), asthma (also started about 4 years ago), dizziness, vertigo, motion sickness, panic attacks, hear papks, etc. that come out of seemingly nowhere, etc. Chiro thinks these are probably Atlas related. However I also have suffered from chronic candida, leaky gut, digestive issues, etc, for around 20 years, viruses, bacterial infections, etc. I am 47 now, i have done the diets, anti-fungals etc., and nothing has helped. I read on another Atlas blog that the Atlas can lead to dysbiosis, due to a redirection of blood flow away from the gut. Do you feel that the Atlas can be the cause of candida and/or leaky gut in any way and do you have any suggestions on how to remedy it once snd for all? As I said, I have done the diets, probiotics, anti-fungals etc., all to no avail. I’m pretty desperate, tired of being fat and tired, and of eating such limited things. Thanks.
Look at this webpage:
http://www.dyslexiaonline.com/blog/intriguing-dyslexia-adhd-research-explains-hidden-origins-successful-treatment-phobias-announced-dr-harold-levinson/
So the issue here is that we know via the work of Heiner Biedermann and his colleagues (see Manual Therapy in Children) that the atlas problem is well and truly linked to balance/vestibular issues– and that there is a direct link between balance issues and stress/ anxiety.
The latest information is that a dysregulated stress response will lead to an imbalance between the helper and suppressor sides of the immune system (and that is putting it very crudely)– so asthma and allergies are likely to be part of the broader picture.
Re gut– the problems with chronic stress will divert blood flow away from the gut. The immune dysregulation is likely also to substantially increase the number of infections you get, and to increase your chances of being treated with antibiotics. Both impaired blood flow to the gut (via impairment of mucosal permeability and also altered gut motility and acidity), and increased antibiotics should be expected to be risk factors for intestinal dysbiosis &/or leaky gut. This problem in turn will further compromise good health and emotional regulation.
I would concur with your chiro (though still have trouble formally proving this as comprehensively as I would like).
However – with the atlas– when it is back in place– the rest of the issue is the small problem of keeping it back in place. My atlas was first corrected at age 47 by the supposedly one time Atlas Profilax- but my posture was distorted, my movement patterns were problematic and I am stuck with too much time at the computer.So- after another 4 years- I am pretty sure the problem is now fixed.I can certainly sense if it goes out and fix it very fast- and am now back in place and stable for the vast majority of the time.
Re Infections- I used to get 8 upper respiratory infections a year- (as a doctor I am in the firing line). I have had one or two in the 4+ years since the atlas was corrected by Atlas Profilax (which I regard as a good method, but not quite as good as its promotional material!)
I have found that I have got the best value from sacro-occipital chiropractic. They have a whole spine approach and gentle techniques.
I do note slow progress at the atlas area with some of my patients- and wonder if they might need one or two specific upper cervical adjustments.
These problems are complex and do not lend themselves to single treatment approaches in most cases- and any practitioner should be up front about that.
I expect my practitioners to be able to give me a good explanation of what progress they expect, and what clinical features tell them when it is time to change course.
I am happy for practitioners to offer a discount for a course of treatment versus session by session- but I would not personally be keen on paying up front for months of treatment. For a start- what if they get sick/die/go out of business?
I would guess that the adjustment left you with a sudden change in the mix of proprioceptive data being recieved by your brain- and that confusion is the cause of the problem. Persistinng with care is obviously important- but I think that the big thing we have to be looking at is ways to improve sensory integration– and that means things like qi gong, or maybe more formal sorts of dance or acrobatic type training.
Qi Gong is good because it is gentle and does not require a complex set of equipment etc to do it.
I have been looking at a new technique called “atlas balancing”- while I hve no idea at all of the efficacy of this treatment, one of its practitioners has an excellent series of vidos demonstrating the way to find the position of the atlas, and how to find a malaligned one:
http://www.atlasbalancingnow.com/practitioners.html
All 4 short videos are worth watching.
That overloaded leg will bear much more weight than the other one and be more prone to injury. Also significant is the fact that on the shortened side the knee and the hip are both thrown into external rotation and the foot pronates.
All of the above contribute to orthopedic problems at multiple levels.
To make matters even more complex- issues at the level of the foot, the sacro-iliac joints and also the temporomandibular (jaw) joint can feed back and destabilise the atlas.
While my initial Atlas Profilax treatment vastly improved my neck issues eleswhere continually destabilised it again.
In the end it has taken a year of work with a socro-occipital chiropractor to really resolve those issues, and that work has been assisted with other bodywork- initially yoga, but now specifically qi gong. It has also required expensive proprioceptive insoles. Now- after about a decade of difficulty with pain in bed at night due to multiple spinal issues- things are finally improving and I am sleeping through, and sometimes even waking with no stiffness. That has been a long time coming.
So the short answer is that the problems you describe need acomprehensive approach, and a determined persistent attitude.
As much as is possible I minimise analgesic use- and take the attitude that the pain is informing me that I am misusing my body.
That is, after all what the pain signalling mechanism is meant to do!
Anja
Have been living with vertigo for the last 20 years in the Bay Area California. Probably seen at least 30 chiro’s who claimed they could help me. Would appreciate any recommendations
for how I should approach healing. It’s been a very frustrating process. Wishing you all wellness..
Lil
he can recommend the kind of help you need in your area. My atlas was out!
ealourenco@cox.net. Blessings & good luck, Earlene
L DeBernardi 4692 Carpinteria Ave #38 Carpinteria CA 93013 925-487-6700
>
I couldn’t not leave without telling you my story and my experiences. I have recently re aligned my own atlas / c5 after doing a lot of research.
Ever since I was a kid my head was tilted, i remember closing each eye and looking at my nose with the open eye (alternating), it was like my nose was twisted but little did I know it was my head! Strange how nobody else noticed / pointed it out either.
Anyway, had pretty much all of the symptoms above apart from headaches, and wow am i impulsive (or used to be). All the way through my life (28 now) people have said I seem to lack common sense, I’ve been a moderate/ heavy social binge drinker for years and was always doing stupid things (even when sober) i thought impulsiveness was just my personality, it’s crazy!
I always thought my jaw was bigger on one side (then came the anxiety!) but it was actually underdeveloped sternocleidomastoid, levatator scapulae and trapezius on one side so yep my head was also twisted.
For years I’ve not ACTUALLY known the problem, too shy to seek prof. help, it’s not until I started working out (which I thought would cure any imbalance) that I realised the problem was a lot more serious. Basically one side of my body was developing unevenly/ slower which after research (and watching Elliott Hulse on Youtube) I realized my atlas / c5 mis alignment was sending bad signals out throught my nervous system.
Some of my personal symptoms on the effected side: (even though I was stretching like crazy) 1. could only turn my head (opposite to affected side) about 30deg, 2. Extremely tight trap – felt like it was gripping onto the ribcage when moved, 3. Deep breathe caused strange sensation (again, ribcage tightness), 4. Lower back was extremely tight (pelvis almost frozen, hardly any anterior/posterior movement), 5. Trapped nerve on trap/upper back, 6. Sharp Pain in mid back next to spine (trigger point maybe). 6. Impulsiveness, 7. Major anxiety, 8. feelings of hopelessness and depression, 9. Crunching when hitting the 30deg mark mentioned above, 10. ALMOST FORGOT – Major jaw pain (but on the opposite side)…the list goes on!
Anyway here’s what I did:
First started stretching following this video (do the affected side twice as much):
1. https://www.youtube.com/watch?v=Hxar8p0WcIM
2. Next go for a walk and focus on tensing the lower abs and the squeezing the glutes while tilting the pelvis forward (flattening your lower back) – this will release the tight pelvis muscles in your lower back. (I find walking and doing is easier – You may even feel your walking posture improve)
3.Next do these exercises to re align the c5/atlas: https://www.youtube.com/watch?v=WhflOZe4YKA
(AND LIKE HE SAYS DO THEM EVERY HOUR TRUST ME!)
I also roll out my mid back / s.blades on a foam roller.
I can’t explain how I feel now I’ve fixed mine, it’s amazing… All my symptoms have gone, my anxiety is non existent, my pelvis is free, my neck looks even and healthy, head posture is excellent and I feel so much more switched on and connected to myself and my body. I know it’s not going to be the same for everyone but after more than 10 years of having these weird cervical / alignment / imbalance problems and now after a just a few days of rehab it’s gone! got to give hope to others! I really hope this helps you :)
Also might be worth mentioning I eat a plant based diet but with protein (fish, chicken only) and also drink home made milk Kefir (the stuff is holy water!) Peace and Longevity!
thank you for your reply.
Those exercises you referred to really are excellent- and I will be referring my own patients to those links.
The emphasis on doing the scapular/cervical ones hourly really is of critical importance, as we have to de-activate an abberrant postural and muscle activation pattern that has been persisting for years- and that cannot be achieved overnight.
I personally have recently commenced Qi Gong- and find that the increased subtlety of body awareness that that gives me has vastly improved my alignment.
I have been closely inspecting the skull on which I learned anatomy- and have actually identified that it has a small defect on the base of the skull that would make the atlas much more likely to slip out of place with minimal movement.
I suspect that the individual whose skull I possess had a birth injury, and that atlas was misaligned from birth, while the bones were still remodelling. Consequently the labrum of the occipital condyle is deficient on one side- and he would have had an unstable atlas.