Misalignments of the craniocervical junction (CCJ) can be particularly devastating due to the intimate relationship of this region with the brainstem. One area that is particularly affected by structural stress in this region is the reticular formation located in the caudal brainstem; the reticular formation controls posture and other autonomic functions. One sign that there may be a problem at the CCJ is a breakdown in posture.
Things to look for in your patients to see if they may have an upper cervical misalignment are:
- Head tilt
- Unleveled shoulders
- A short leg
- Persistent muscle tension that does not respond to treatment
Due to the complexity of the biomechanics at the CCJ, a specialized approach is required to address issues arising in this region. The NUCCA procedure allows for an in-depth analysis of the joint articulations at the CCJ and calculation of a specific adjusting vector that is used to realign the head and neck and reduce stress on the nervous system.
Vertebral Subluxation Complex (VSC)
The core principles of chiropractic focus on the vertebral subluxation complex (VSC) and its relationship to health. VSC is a spinal bone misalignment or malfunction that may cause interference with the nervous system. Nervous system interference reduces a person's ability to function properly and adapt to the environment; it can lower resistance and may ultimately lead to various symptoms or disease.
VSC involves multiple components:
Malfunction of the spine means that the normal motion and position of the spinal bones (vertebrae) have been altered. As a result, some areas of the spine become "fixed," and other areas become overly "mobile." Postural signs such as scoliosis, head tilt, shoulder imbalance, hip rotation, or one leg being shorter than the other often accompany this first component of VSC. This stage of VSC is the precursor to other more serious components. Science calls this kinesiopathology.
Nerve interference may be the most important component to VSC. Misalignments can cause nerve interference by creating pressure or traction on the nerves or their coverings as they pass through the small passageways between vertebral bones. In addition to altered joint function, interference can also be caused by localized inflammation or toxicity. Whatever the mechanism, nerve interference can affect all areas of the body including muscle, bone, skin, blood vessels, glands, internal organs, and even our thought processes. Science calls this neuropathology.
Muscle imbalance is a common component of VSC. The body acts to protect the nervous system and spine through the muscular process of "guarding." Misalignment may cause patterns of muscle spasm and/or weakness that can further compromise the nervous system. Science calls this myopathology.
Soft tissue dysfunction and local damage to the ligaments, discs, and other supportive tissues can occur around the spine. The lack of proper joint function, either from long-standing misalignments or traumatic injury, may cause local malnutrition, scar tissue development, and changes in the joint position. This can lead to disc degeneration, joint disease, and the compromise of nervous tissue. Science calls this histopathology.
Bone and body changes may occur in the later stages of VSC. In an effort to stabilize an injured or malfunctioning joint, the body may form calcium deposits (bone) or spurs. Ultimately spinal joints may begin to fuse, reducing your chiropractor's ability to help you restore normal function to your spine. Science calls this pathophysiology.
Practice Based Research
NUCCA & Migraines
Research has indicated a possible hydrodynamic mechanism that may contribute to the onset of a headache, in particular, a migraine headache. The central nervous system is housed inside the protective boney shield of the skull and vertebral column. Specialized venous drainage systems help to control fluid pressure (created by blood and cerebral spinal fluid) inside this closed system. Head and neck injuries can impair this drainage system and lead to alterations in intracranial compliance factors and autonomic dysregulation. This pilot study examines how an atlas misalignment correction in migraine patients effects intracranial compliance and demonstrated an improvement in the quality of life of the participants, with a reduction in headache-related disability.
NUCCA & Occlusion
In a 2016 study the relationship between a malocclusion and a misalignment of the craniocervical junction was examined. The craniocervical junction consists of the joints between the skull, atlas (C1) and axis (C2). Misalignments in this region can alter how the skull is balanced on top of the neck. In addition to creating strain in the muscles and ligaments of the neck, this malposition can also influence the function of the temporomandibular joint. In turn, this can result in stressed bite patterns (more commonly referred to as a malocclusion). The findings of this study suggest a possible link between head posture and occlusion and suggest that appropriate co-management of temporomandibular joint disorders between chiropractors and dentists may be warranted.
NUCCA and High Blood Pressure
A 2007 pilot study conducted by Drs. Bakris and Dickholtz demonstrated a reduction in blood pressure following an upper cervical adjustment. The degree of reduction varied among participants with the mean reduction being equivalent to taking two blood pressure medications. In addition, participants blood pressure remained reduced eight weeks later. Though more research is required, this provides exciting insight into a possible mechanical mechanism underlying high blood pressure and offers a gentle, non-invasive approach to treating it.