Question
Hi, I'm 36yrs old, wife and mother of three. I started going to a Chiropractor in February 2010 due to right sided headaches that I was having daily. I began having neck manipulations twice a week for several months then tapering off. The headaches had improved by the summer. Mid November I had propped a pillow underneath my chest and shoulders while lying on my stomach.  I immediately felt a tingling sensation in the back of my head. I realized something wasn't right and pulled the pillow. I was out for 2-3you minutes. I could see and hear but couldn't move or speak. I finally came too but was not normal. There was constant pressure at the back of head and pain on the right upper cervical area.
I returned to the Chiropractor on Monday and explained everything. He examined me and said that my C2 had subluxated. I received an adjustment which was very painful. In pain all night. Tuesday wasnt any better. I began having intermittent nausea as well. Returned to him again on Wednesday due to the pain. This time a different Chiropractor adjusted me. By Thursday vertigo had started especially when I would turn my head.
I finally went to an urgent care which lead to an MRI/MRS of the brain and head/neck arteries. From there I was diagnosed with a right vertebral artery dissection. Doctors reasoning was the hypertension of my neck but also could not exclude the adjustments by the Chiropractor.  I was told no more neck manipulations.
Since my diagnosis I have gone from doctor to doctor.  It has been a year and I'm still dealing with the pain. I have been having pain in my right jaw and pressure and ringing in my right ear since the dissection. In April the stabs and jabs type headaches began. Not soon after that, I started having sharp shooting pains behind my eyes. In June, dysphagia started which I still deal with. I do know the rt vertebral artery has healed which wasI shown by an angiogram in January.
I've seen neurologist, neurosurgeons as well spine specialist.
I do have some medical knowledge(x-ray tech/sonographer). When I question why the C2 spinous process is right of midline and that there is tilt to the right of the upper cervical spine I get answers like "sometimes that area can be smudged" and most recently was told I have a "mild anomaly of the upper cervical area, something I was born with". Currently I've been undergoing physical therapy which I was a little reluctant. The therapists stated that my muscles in my neck especially in the occipital area were very tight. Therapy has been quite painful but I am seeing more mobility of my neck.
I'm also on diazapam(10-30mg) depending upon the pain level). I've tried indomethacin (150mg/day) which was not working. Tylenol and IB doesn't help. Also had a nerve block whi h was unsuccesful. Doctors have actually questioned me whether I'm depressed.  No...I'm in pain and know one can seem to help me. The last option my neurologist gave me was botox injections (around my forhead, occipital area, neck and shoulders). I've been putting him off because it's not getting to the root of the problem.
I was told that 50% of all neck pain is unexplained.  So do I take that as my excuse. If this helps I do remember on my initial Chiropractor xrays they explained to me that I had lost the normal lordotic curvature of my cervical spine. Now with my most recent xrays (September 2011) there is mild kyphosis at the lower level c3-c6. Also mild degenerative changes in c4-c6 which had not changed since December 2010. I've lost 40lbs part trying and partly no appetite especially with the dysphagia. Do you have any suggestions.?
So sorry for the lengthy story. I appreciate your time.
Blessings to you,
Shana

Answer
Dear Shana,

Thank you for your question.  Actually, diagnosis done over the internet is irresponsible.  Unfortunately, it is all too common these days.  That doesn抰 mean I can抰 try to give you useful information, however.  

There are many misconceptions regarding chiropractic, mainly because most people do not know there are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not revealed by a decreased lordotic curve in the cervical spine or the complaints mentioned in your question, though they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such things as being born, strenuous physical activity, sleeping posture and mattress condition, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to what may cause the complaints you describe in your question or if these may be related to a vertebral subluxation.  Even if it were possible to guess at what may be causing them, however, it is not pertinent to the matter of whether you will benefit from being free of vertebral subluxations.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this is 揳djustment,?which is not at all the equivalent of a manipulation.  

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone who has had the history you describe be better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  So, having one抯 spine checked for vertebral subluxation is tremendously important, but it抯 not for the purpose of dealing with the issues you mention.  In other words, non-therapeutic straight chiropractic can be of benefit to any spine-owner, but perhaps in ways that you may not have considered.  It抯 not that you should see a non-therapeutic straight chiropractor FOR these concerns about a straight neck and the other complaints ?you should visit one in an effort to be free of vertebral subluxations, even WITH such matters in your history.  

It sounds as if the office you抳e visited is of the mixed therapeutic chiropractic viewpoint.  In discussing vertebral subluxation earlier in this message, I used the word misalignment.  I am not talking here about spinal curving or straightness, however, and these are not interchangeable with the term vertebral subluxation.  The misalignment that I address is that of a specific segment of the spine.  Technically speaking, we have to get even a bit more advanced in what is meant by misalignment to make this clear.  The question is, Misaligned with respect to what?  It is possible to describe the body geometrically, reasoning that we are bilaterally symmetrical and concluding that there is a measurable 搈idline?or that our hips and shoulders should be 揵alanced?on a perpendicular line to this proposed 搈idline?or that the body can be presumed to take on a certain geometry in other planes as well, such as a neck curve or even in matters of alignment symmetry, as part of what you mentioned when telling me about the C2 spinous.  The problem with this thinking is that it assumes we are simply machines and ignores that we are alive, capable of movement, adaptation, growth, etc.  At any given moment, there is an optimum state for us to carry out life to our best abilities.  That optimum state will vary depending upon the circumstances, both within us and of our environment.  There are many examples to illustrate this.  If you carry something heavy with one hand, you must lean away from it, putting something of a curve into the spine, to keep yourself balanced.  Does that mean the body is failing because there is imbalance or a curve, or is it instead being quite successful in adapting you to the situation?  In another example, consider that those who argue for geometric balance or symmetry would be hard-pressed to explain why the carpenter who swings a 28-ounce hammer all day with his right arm only would have certain physical adaptations that favor his right side.  Should the carpenter have some of the tissue removed from his arm, hand and back so that it is equal to that on the left?  Or is he merely adapted to his circumstances?  The point I抦 getting at is that there is an individually determined, innately normal position for the body that cannot be described by geometry.  

From the non-therapeutic standpoint, then, the method of the non-therapeutic straight chiropractor is not for the goal of straightening a curved spine or curving a straight one.  Adjustments are made if and when a subluxation is detected ?and only then.  Geometric positioning is not within the realm of non-therapeutic straight chiropractic.  There are no procedures that are used within non-therapeutic straight chiropractic for the purpose of introducing curves or forcing other geometric arrangements into the spine, even if that may be a possible result of having proper function restored.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

Quite importantly, too, regarding your question, the issue of diagnosis deals with the limited objective of therapeutic care.  Remember, what we抳e covered here is about non-therapeutic matters and the two objectives are not the same.  Further, even though this is not a service that I would provide in my field, I would say to you that diagnosis under the best of circumstances is something of an art.  It would be irresponsible for anyone to give you a guess by e-mail or the web about your situation.  Diagnostic work and therapeutic advice are difficult enough when done properly.  It becomes a riskier proposition when done poorly.  You would be best served getting opinions from someone with first-hand knowledge about you, not a limited acquaintance through correspondence.  Anyone who is willing to speculate about your situation by e-mail is providing you little more than a guess and perhaps a dangerous one, at that!  

All that said, it would certainly be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor, even if you still elect to have therapeutic attention for your reported concerns and/or symptoms.  If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or directly at [email protected].  

Shana, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.