Specific chiropractic upper cervical adjustments can be effective in the care and correction of Chiari-malformations, chronic cerebrospinal venous insufficiency (CCSVI),and normal pressure hydrocephalus(NPH).

Chiari malformations cause the brainstem, typically the cerebellum, to become lodged in the foramen magnum in the base of the skull. Chiari malformations can compress the brainstem causing potentially catastrophic consequences. CCSVI causes sluggish venous blood circulation inside the cranial vault. NPH is due to sluggish circulation of cerebrospinal fluid (CSF). CSF flows into the venous drainage system of the brain. Consequently, venous drainage problems can affect CSF flow.

For the most part the brain floats freely inside the cranial vault. Some researchers, however, have suggested that the dentate ligament attaches the brainstem to the rim of the foramen magnum. Other than that, the remainder of the brain and cord is unattached except at the filum terminale. The filum terminale is the tail end of the cord that attaches to the tailbone. The tailbone is called the coccyx and is located at the bottom of the sacrum which is part of the pelvis.

Upper cervical subluxations alter the normal relationship and position of the brainstem within the cranial vault and foramen magnum as it passes through to the spinal cord. Disruption of their normal relationship can lead to compression of the brainstem and functional disturbances. It can also affect blood and CSF flow in the brain and cord. Lastly, it can trap the brainstem in an abnormal position.

Chiropractic Upper Cervical Adjustment

The above is an old picture of a knee chest toggle recoil adjustment. It is the original chiropractic upper cervical method of treatment developed and taught by B.J. Palmer. He referred to the procedure as a “Hole in One” or HIO adjustment because the goal was to realign the foramen magnum with the spinal canal in the upper cervical spine. The purpose for aligning the canal was to free communication of the nervous system between the brain and body.

Palmer’s procedure used a special device called a neurocalometer (NCM) to help determine the presence of misalignments and determine when to adjust, as well as monitor a patient’s progress. The device measured temperature differentials along the left and right side of the spine. Consistent patterns of temperature differentials suggested stress in the spine and nervous system. Palmer patented his device.

In addition to his procedure, Palmer developed a personal philosophy on life to go along with it. He then proclaimed that the only place true subluxations could occur was in the atlas or axis vertebra. Furthermore, anyone who used any other method or adjusted segments below the second cervical vertebra was not practicing chiropractic upper cervical. Those who did practice his method were required to purchase an NCM, which Palmer patented and profited from.

Palmer’s egocentric proclamation enraged the vast majority of the profession and caused a rift that almost destoyed it. The rift continues today. There are those who practice strictly specific chiropractic upper cervical and don’t include any other procedures. The vast majority of chiropractors, on the other hand, work on the full spine, as well as extremities and other related problems. Very few full spine chiropractors, however, offer specific chiropractic upper cervical care. This is unfortunate for patients with neurodegenerative diseases who could benefit from both.

Nonetheless, despite his short comings, B.J. Palmer’s contribution to chiropractic and science was monumental. Among other things, specific upper cervical chiropractic care may provide an important missing piece in the puzzle of neurodegenerative diseases such as Azlheimer’s, Parkinson’s and multiple sclerosis. More patients with neurodegenerative diseases would benefit if more chiropractors offered upper cervical care. It may also help with prevention of some of these devastating diseases.

In the knee chest toggle recoil procedure the patient is in a kneeling positon with their chest supported on an adjustable table. Typically, but not always, the head is turned in the direction of the strain or misalignment. In other words, using the picture above as an example, if one of the upper cervical vertebra are misaligned to the left, the head is turned to the left. The doctor then stands on the left side of the table and and makes contact with his left wrist bone on the left side of the patient’s misaligned vertebra.

The doctor’s stance was bent over at the waist parallel to the floor with the arms hanging straight down. The thyroid notch at the bottom of the doctors throat was directly over the intended contact point. The contact was made with the small point of the pisaform bone on the outside edge of the wrist. The left hand in this case was then laid on top of the contact hand with its pisaform bone precisely positioned in the anatomical snuff box of the contact hand below. This created a tight and more accurate mechanical link.

The arms were held nearly staight with just a slight bend in the elbows. When the setup was complete, the arms were quickly snapped with a flick of the tricep and pectoralis muscles in the arms and chest respectively. The thrust was shallow and finished with a slight torque of the hand in either direction depending on the strain. As the soon as the thrust reached its peak stroke and velocity the doctor was trained to let his upper body collapse as the arms recoiled. This was done to protect the patient. It also allowed the elastic components of the vertebral segments to respond without resistance from the doctors hands.

Long before working on other students, student doctors use specific exercises to train their tricep and pectoral muscles to flick quickly. They also work on devices to develop touch. At symposiums students and doctors would have contests to see who could “adjust” on a practice device, known as a speeder, with an egg placed on top of it. It was a tough challenge indeed that resulted in many cracked eggs despite the highly skilled hands of doctors who trained specifically in their procedure as much as any surgeon.

The original method of chiropractic upper cervical developed by B.J. Palmer is still taught today, but for the most part has also gone through many modifications and improvements. The goal of all chiropractic upper cervical techniques, however, is to realign the upper cervical spine. Realigning the upper cervical spine can be effective in the correction of Chiari malformations, CCSVI and NPH.

Palmer’s method and its modern counterparts is close to one hundred years old now. Because of deliberate medical misinformation and propaganda, as well as prejudice within the chiropractic profession, it has almost been completely ignored. Hopefully, it will catch on within the profession and continue to improve as brain scans provide the evidence to support its effectiveness. Specific chiropractic upper cervical care needs to be included as a serious consideration for intervention in neurodegenerative diseases, as well as prevention. It blends well with the theory and practice of CCSVI and decompression surgical intervention options.