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Post-Concussion Syndrome

Case Study: 6 months of Post-Concussion Syndrome

Post-Concussion Syndrome

 

Read Time: [3 minutes]

Post-concussion syndrome has become a big deal with more athletes showing concern about the risks of chronic brain injury. Recovery from a concussion usually takes about 7-10 days for most people but many will have symptoms that last 30 days or more.

Our most recent case had post-concussion syndrome that lasted 6 months prior to visiting our office.

Background

A young woman was a passenger in a car that was struck from the side. The shock of the accident caused her head to whip from side to side and she lost consciousness immediately.

Although many concussions are a result of a direct blow to the head, a concussion can occur through rapid acceleration and deceleration of the head causing the brain to move and collide with the inside of the skull.

Following the concussion, the patient began having daily episodes of migraine headaches. During the migraine attacks, she would also have vertigo that led to a persistent feeling of nausea.

After being discharged from the hospital the patient was seen by an orthopedist and chiropractor. While chiropractic adjustments were helpful, she felt her symptoms come back repeatedly within hours of her treatment. The patient had an appointment with her orthopedist to receive neck injections, but was referred to our office before that to see if correcting her atlas would help.

Assessing the Neck in Concussion

The patient was put through a full examination to evaluate the  neck. In many cases of post-concussion syndrome, the neck has numerous pain-generating tissue that can be responsible for these neurological symptoms. This includes precise x-rays of the top of the neck, evaluation of neck muscle tone, structural positioning, and evaluation of head and neck control.

You can see some images of our head control laser testing below.

img_4266

Laser head positioning system

Testing head control using a maze

Testing head control using a maze

When people suffer a concussion or whiplash injury, it can cause damage to the muscles and allow us to control our head and neck movement. These injuries can lead to headaches, but they also cause problems with our sense of balance.

Once we have some baseline information on their current abilities, we can monitor how they respond and heal from the damage to their neck.

Results:

After her 2nd visit, the patient said that her headaches and nausea were almost completely non-existent.

Imagine that. Going from daily migraines, to no headaches for an entire week. All from a getting the head and neck into a better structural position.

Now that isn’t to say that life is perfect after that. There were certainly some ups and downs along the way. Overall, the patient’s headaches have improved about 80% in frequency and intensity. She has elected to skip getting injections, and is working hard everyday to get stronger.

Here’s the most important element and really the part that matters:

After the head injury, the patient was unable to do the things that made her life fun. She had trouble working out and getting motivated to exercise. Staying focused at work meant having to rely on pain killers. Taking care of a young daughter meant gritting her teeth through pain and nausea instead of being present in the moment.

That’s what all of this is about. It’s not about the pain reduction, it’s about the restoration of normal life!

For more information, you can read this patient’s testimonial below:

I’m a very active mommy that carries around the weight of a 6 year old and owning a salon full time. Work and mommy duties call for my body to be at all times ready and with it. There isn’t time for rest, much less any fatigue or achy-ness. Between playing sports when I was young, actively working out and having the burden of standing on my feet the majority of my work days, my simple adjustments just got me through. I didn’t realize that there could be a cure for my migraines, constant neck stiffness and what seemed to be a much older body that I was trapped in.

I was a back seat passenger in a car crash on New Years, where the car was deemed totaled. There were no major signs of trauma, besides the concussion and black eye I received, however, I knew something was wrong when my pain was continuing to get worse months after the accident. My routine visits to the chiropractor, became tedious weekly visits that just got me through; my pain kept coming back if I didn’t get adjusted that day. I refused to succumb to cortisone shots previously, but felt desperate. Instead of my Chiropractor sending me off the receive the possible relief from an invasive procedure, he referred me to his dear friend Dr. Chung that specializes in post concussion, migraines, fatigue and achy-ness.

Dr Chung was very thorough and did a series of X-rays and tests to see how my whole body was aligned and reviewed my MRI. He explained the symptoms and showed me what was happening to my brain and surrounding inflamed tissues. After one precise adjustment and many months of not being able to be active or myself, I felt 150%. I was scared and apprehensive as to when my pain would return. To my surprise, months later and just a few maintenance NUCCA adjustments, my pain has not returned and I was immediately able to carry on with my workouts, mommy life and my physically involved career. I was even able to hike, travel and do Cross-fit within weeks of being adjusted. My energy and range of motion has returned. I couldn’t be happier for the referral to such a dedicated, intelligent, passionate Doctor of Chiropractic. Thank you so much for your passion to treat your patients and wish you much success.
Jessica S.

Research: Correction of Anterior Head Syndrome Improves Disc Related Sciatica

Research: Correction of Anterior Head Syndrome Improves Disc Related Sciatica

Research: Correction of Anterior Head Syndrome Improves Disc Related Sciatica

 

Similar Article:

The Pain is in my back, why are you looking at my neck?

For decades, upper cervical chiropractors have looked to the neck as a primary source and cause of low back related symptoms like sciatica. While this has had many patients and other doctors skeptical of effects that a gentle neck adjustment can have on the lower back, the stories of thousands of upper cervical patients getting relief from an atlas correction can speak volumes for a low back patient.

This is often amplified by the fact that most back pain patients don’t usually see an upper cervical chiropractor as their first option. Typically they’ve seen orthopedists, acupuncturists, and more traditionally trained chiropractors, who do a great job and provide relief for the vast majority of back pain patients.

If you’ve been through these different avenues and still have pain, it’s usually because positioning of the neck has largely been ignored. After all, why would someone with back pain need to have their neck worked on?

2015 Evidence of Neck Influence on Sciatic Pain

Earlier this year, research was published in the Journal of Manipulative and Physiologic Therapeutics that addresses the effect that anterior head syndrome has on sciatic pain. Anterior head syndrome is one of the Primary Conditions we see in our office on a daily basis, because it’s tied to so many different Secondary Conditions.

What is anterior head syndrome? It’s defined by the consequences that a head that’s shifted too far forward. This includes:

  • Center of the skull displaced 40mm or greater in front of the lowest neck vertebra
  • Muscular fatigue of the posterior neck muscles
  • Abnormal postural compensation by the shoulder and pelvic girdles
  • Early onset degeneration of the cervical discs.

AHS

 

So what did these researchers find?

The Effect of adding forward head posture corrective exercises in the management of lumbosacral radiculopathy: a randomized clinical trial

The authors looked at 154 adult patients who had forward head posture (different name for anterior head syndrome) and chronic disc related sciatic pain.

  • Control Group: Patients received usual care for functional restoration including exercises for the hips and low back, cognitive behavioral therapy for pain modulation, and stress managment techniques
  • The Experimental group received the usual care for functional restoration as well as neck exercises and stretches designed to reduce forward head posture.

Both groups showed similar improved in pain scale and improvement of firing of the S1 Nerve root after 10 weeks.

However, at a 2 year follow up the group that had their anterior head syndrome corrected maintained their improvement while the control group began regressing to their previous pain levels.

 

Not Just Back Pain, But Scoliosis Too

Of course we can’t just base this type of thing on one study. In 2012, researchers studied the effect of anterior head syndrome on scoliosis. You can see that abstract below:

The role of forward head correction in management of adolescent idiopathic scoliotic patients: a randomized controlled trial.

This is not just a pain issue. When the head and neck shift forward, it has a global effect on the 3-Dimensional alignment parameters for spine as a whole.

 

Why the Neck?

Why is the head and neck so important in the management of the lower spine? We don’t have great answers on that yet, but researchers think it has to do with how the neck dictates posture for the whole body. The nerve endings that stem from the muscles and ligaments of the neck play a big role in your body’s ability to control posture.

If the neck fails to provide adequate input into the brain, then the brain fails to produce adequate input to the muscles of the spine and lower extremity. This leads to tilted or rotated pelvis, and poor angulation of the tailbone underneath the spine. It looks a little bit like this image below:

Body imbalance

 

As the neck goes back to normal, we begin to see measurements in the hips, back, and pelvis go back to normal again.

What if I can’t exercise my neck right now?

There are a lot of patients with back pain and neck pain who cringe at the idea of moving their spine, nevermind putting through an exercise regiment. For these patients, it’s important to break the cycle of pain so that we can have you looking forward to moving your body again.

Fortunately, one of the great things about an Atlas Correction procedure is that it can substantially improve Anterior head syndrome even before exercises become integrated.

We have found that a combination of Atlas Correction procedures in the neck along with corrective exercise can have a rapid and dramatic change on the correction of anterior head syndrome.

When You’re Tired of Treating Your Back, Maybe It’s Time to Look at the Neck

Pain is often times a non-linear health problem. What that means is that we can’t just think of the area that hurts to look for the cause. Sometimes we have to take a step back and look at the big picture to have a true understanding of why the body isn’t working properly.

If repeatedly treating the back over and over again has failed to produce your desired outcome, then maybe it’s time to look elsewhere. That’s the core of a holistic view point. It’s not about being a crunchy hippie, it’s about seeing the big picture, and how changing one variable effects the entire structure.

 

Case Study

Case Study – What Happens When A Current Patient Has a Head Injury – Chiropractor in Wellington

Case Study

 

Last week I had a really unique situation that I wanted to share. It really helps to clarify what my approach to patient care is when a case is not going the way that I expect.

Case Presentation:

A year ago, a woman came into the office to see me for daily headaches. The headaches had been a problem for over 40 years. They had been using over the counter medications and meditation techniques to keep the headaches under control. The worst times for the patient were the days that it rained. On rainy days, their dull headache would start to become more of a pounding type pain. In West Palm Beach where it rains most days in the summer, it’s a pretty miserable way to live.

After 2 weeks of gentle Atlas Corrections, the patient’s headache frequency dropped to 1x/week and the rain no longer had an impact on their headaches.

Within 2 months, almost all headache symptoms had resolved completely.

Enter the Concussion

The case above is a pretty standard and regular occurance in the office. Headache cases are probably the fastest responding and most successful Secondary Conditions that resolve when the Atlas is corrected. What made this case interesting is what happened about a year after she first saw me.

The patient ended up having a concussion, and as a result started showing new symptoms. There was neck pain that was never present, a new headache pattern, and a persistent abnormal tingling that wouldn’t go away.

The patient came in about a week after the concussion happened. After evaluating the patient to make sure it was safe to take care of them, I attempted to use a similar adjustment that had worked on her in the past.

While some of the post-concussion symptoms got better, the headache and the abnormal sensations didn’t budge. The patient was concerned that they might have to seek out more aggressive medical options to address the new symptoms.

Many times, an Atlas Correction is like a key to a unique lock. It rarely changes over time, but a head trauma can force that lock to break, which means you need a new key. A new and different correction becomes necessary.

I decided that I needed to re-evaluate the situation based on the NUCCA protocol for Structural Correction.

Some people think it’s uncalled for, and others think it’s excessive, but I decided to take a new set of X-rays on the patient. The radiation dosage on craniocervical X-rays are about the same as a cross-country flight, and the patient thought it was worth it.

I never want to irradiate a patient more than they need and I look to avoid X-rays if I don’t need them. I decided that the chance to help this patient recover from their post-concussion symptoms warrented a new series.

Concussion Created a New Lock, NUCCA Provides a New Key

As it turns out, the new imaging revealed a completely different angle that I needed to use for the correction. The head injury disrupted the structure of the neck so much, that it rendered the previous correction useless.

Within minutes of using the information from the new X-ray, the patient’s headache and abnormal head sensations vanished.

It’s one of the reasons I embrace the NUCCA procedure because it provides a very elegant way of troubleshooting a difficult case, especially one that had achieved such success in the past.

Some people go through and have an extremely successful run with chiropractic care, but out of nowhere it stops working.

In these moments, I encourage people not to dismiss chiropractic as a whole, but to reevaluate the APPLICATION of chiropractic to find what went wrong.