Print Posted 08/03/2017 in Category 1

Case Studies: Upper Cervical Care

Case Studies: Upper Cervical Care

Case Report #1: 
Resolution of sciatic nerve pain following upper cervical chiropractic care

Jean-Paul Bohemier, DC, Calgary, Alberta, Canada

Introduction: This case report describes the outcomes of chiropractic care using an upper cervical technique with a patient with sciatic nerve pain.  

Case Presentation: 53-year-old female presented with chronic sciatic nerve pain. The pain originated in the lumbar spine and radiated to the right foot. The patient was taking morphine every 12 hours for mild lower back pain. She had 3 discectomies with little pain relief. Upon physical examination, the patient was measured using the Postural Stress Analyzer (PSA) machine. She presented 16 degrees of postural distortion (0-5 degrees being normal) and an increase in symptomatology while lying flat or with a straight leg raise test above 45 degrees.   

Interventions and outcomes: The patient had 9 office visits over 8 weeks. She was given chiropractic adjustments (spinal manipulation) using the NUCCA technique. After her first adjustment, her posture reduced from 16 degrees to 6 degrees of postural distortion. The patient’s subjective and objective measures improved significantly. After her fourth visit, the patient was able to sleep lying on her back for the first time in 8 years.  

Discussion: The patient experienced significant improvement subjectively and objectively following chiropractic care using upper cervical technique.

Case Report #2: 

Improvement in post-concussion syndrome in a 16-year-old female under upper cervical chiropractic care

Jonathan Chung, DC, private practice, Wellington, FL

Introduction: A 16-year-old female presented to a chiropractic clinic with post-concussion syndrome. Her improvement under upper cervical care is described. 

Case Presentation: The patient was a 16-year-old female with dizziness, headache, neck pain, and brain fog. Symptoms persisted for 3 months following a concussion. Acupuncture, vestibular therapy, and management under a neurologist had shown no improvement. Patient was missing 2 school days per week, was unable to participate in competitive equestrian riding, and could not study for periods longer than 10 minutes since the injury.  

Interventions and outcomes: The patient was evaluated through the NUCCA protocol and was found to have an Atlas Subluxation Complex. Post adjustment x-ray showed reduction in atlas laterality (50%) and atlas rotation (60%). The patient was seen 14 times in 6 weeks and required 6 adjustments. She showed 60% improvement in Visual Analog Scale (VAS) scores for dizziness and concentration since beginning care. She also reported a 100% VAS improvement in headaches and cervical pain. Her mother reported the patient missing just 3 school days during the 6 weeks. The patient also resumed equestrian riding 3 weeks into care. 

Discussion: Traumatic head injury has also been associated with altered venous outflow and decreased intracranial compliance. Head injury may lead to a disruption in the mechanics of the craniocervical junction causing altered venous drainage which may result in chronic neural degeneration. Correction of the atlas subluxation complex may play a role in restoring normal cranial hemodynamics. More research is needed to determine causative role.

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