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Study 4, Childhood Constipation: A six-year-old male presented for treatment post-motor-vehicle accident (MVA). He presented with typical neck, head, and back post-traumatic injuries. The clinical findings included unilateral erector spinae marked spasms and spinal imbalance, with a leg length discrepancy of just over ¾". Figure 19 illustrates the possible effects on the body related to subluxation of the upper cervical spine.
Palpation of the upper cervical spine revealed unilateral articular joint pain. Figure 20 shows CCJ x-rays pre (left) and post (right) adjustment with orthospinology specific analysis of the misalignment. Post upper cervical adjustment, the upper cervical misalignment is reduced and unilateral erector spinae spasm is released and the leg length discrepancy is balanced, resolving the MVA symptomology with upper cervical chiropractic care. In addition to his injuries resolving, his mother reported that his painful constipation, experienced since birth, had also resolved under care. Balancing the central nervous system with upper cervical chiropractic care allows the body to neurologically repair itself.
Trauma continues to be a major player in the disruption of the CCJ integrity. Birth trauma, falls, motor vehicle crashes, sports injuries, and other traumas affecting the head and neck relationship throughout our lives play into the ability of the CCJ to facilitate the brain/body connection. All patients deserve an appropriate evaluation of the CCJ for optimal brain health parameters and brain/body for our health. There is much more that needs to be studied and understood to optimize brain health. The upright MRI imaging is a platform that potentially could allow neurology, neuroradiology and other medical specialties to work together with board-certified chiropractic CCJ procedure specialists to benefit patients and families. Understanding the complexities of the CCJ should compel all health practitioners to study further and understand how to optimize the brain/body communication of the most critical joint region of the body.
I'd like to emphasize guidelines for practitioners who are on the front line to have high index of suspicion when they see patients with history of head or neck trauma, or autonomic symptoms involving the brain stem or cranial nerves, vertigo, brain fog, head pressure or pain of any kind, or anything from chronic constipation to cardiac arrhythmias. Autistic children should all be referred as early as possible.
Unfortunately, there is an epidemic of young infants being diagnosed with GERD by pediatricians and pediatric gastroenterologists. These infants are symptomatic, but to put a two-month-old baby, who has just been through a birth process that more than likely affected his CCJ, on Pepcid or similar acid blocking drug is not good medicine, especially if his problem can be cured with a couple of gentle movements to his upper cervical spine.
Once the brain has been decompressed and CSF flow re-established, then detoxification and healing can occur if the required nutrients are supplied. Primary to this are essential amino acids and essential fatty acids with vitamins and minerals. Neurons that have been under stress require optimal nutrition to heal. My standard approach for supplying required nutrients consists of the following:
- Paleo or Ketogenic diet,
- Supplemental amino acids in the form of Perfect Amino,
- Omega 3 supplement,
- Complete multivitamin like BodyHealth Complete that contains 5000 u Vitamin D3 and K and activated folate.
- If chemical or heavy metal toxicity is part of the picture, then Metal Free and Body Detox can be added.
In summary, it is the doctor's obligation to find the actual diagnosis that the patient has if he is to help the patient. All too often in complex cases the workup by the traditional doctor is too superficial to really do this and patients get put on symptomatic medication that has no chance of reversing the process, and a good chance that the medication will further complicate the problem. Meanwhile the actual cause has never been found.
It is my experience now that very few doctors consider that CCJ pathology could be the underlying cause and, without knowing this, never pursue this as a possible diagnosis. Dr. Hunt and her team have trained up an expanding group of doctors who know this technology and who can be consulted to help you out.
Whenever I hear on my initial interview any of the symptoms from the patient listed in Figure 5, I refer them to the upper cervical specialist for proper exam and, if needed, X-rays to confirm if there is a problem at the CCJ. This has been the most significant breakthrough in my education in many years, and it has upgraded my success results with patients tremendously. For me this has meant an upgrade in my listening skills so that when the patient mentions a key symptom(s) or answers one of my questions that my index of suspicion jumps into action and I refer them.
I know if you learn from this to listen for it and pursue it, it will do the same for you.
Drs. Minkoff and Hunt
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1. Kahn, A.N (Chief Editor), et al. Upper Cervical Spine Trauma Imaging. Medscape; Online Article 397563; 2015
2. Freeman MD, et al.; A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash); Brain Injury; July 2010; 24(7-8): 988-994
3. Illustrations courtesy of Ron Tribell; Medical Illustrator; Axis Arts; Little Rock, AR
4. Bulut MD, et. al. Decreased Vertebral Artery Hemodynamics in Patients with Loss of Cervical Lordosis. Medical Science Monitor. 2016; 22:495-500; e-ISSN 1643-3750, http://www.medscimonit.com/abstract/index/idArt/897500
5. Eriksen K. Upper Cervical Subluxation Complex: A Review of the Chiropractic and Medical Literature. Lippincott Williams & Wilkins, 2003
6. Flanagan MF. The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions. Neurology Research International. 2015;Article ID 794829.
7. Fischbein R, et al. Patient-reported Chiari malformation type I symptoms and diagnostic experiences: a report from the national Conquer Chiari Patient Registry database. Neurological Sciences. 2015;36(9):1617-24.
8. Parizel PM, et al. Magnetic Resonance Imaging of the Brain. In: Clinical MR Imaging, P.Reimer et al. (eds.); Springer-Verlag; 2010
9. Riacos R, et al. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. RadioGraphics. 2015; 35:2121-2134.
10. Flanagan MF. Craniospinal Hydrodynamics in Neurodegenerative and Neurological Disorders; Nova Science Publishers, Inc.; 2016
11. Grostic JD. Dentate Ligament – cord distortion hypothesis. Chiropractic Research Journal. 1988;1(1): 47-55.
12. Rosa S, Baird JW. The Craniocervical Junction: Observations regarding the Relationship between Misalignment, Obstruction of Cerebrospinal Fluid Flow, Cerebellar Tonsillar Ectopia, and Image-Guided Correction. In: The Craniocervical Syndrome, Smith, F.W. and Dworkin, J.S Editors; Karger; 2015; pages 48-66
13. Iliff JF, et al. A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of Interstitial Solutes, Including Amyloid β. Science Translational Medicine. 15 Aug 2012:4(147): 147.
14. Hunt JM. Observations at the Craniocervical Junction Using Upright MRI. The Chiropractic Choice (ICA digital magazine). April 2017.
Parts of this paper 'borrow' content from a paper written by Dr. Hunt for the International Chiropractors Association (ICA) digital magazine, The Chiropractic Choice, reference 14. Dr. Hunt thanks the ICA for allowing use of this content. Dr. Hunt also acknowledges the excellent illustration inputs from Ron Tribell of Axis Arts (reference 3) which help visualize the most complex joint region of the body.
Dr. David Minkoff graduated from the University of Wisconsin Medical School in 1974 and was elected to the "Phi Beta Kappa" of medical schools, the prestigious Alpha Omega Alpha Honors Medical Fraternity for very high academic achievement. He then worked for more than 20 years in the area of traditional medicine before making the switch to alternative medicine when he and his wife, Sue, founded LifeWorks Wellness Center in Clearwater, Florida. LifeWorks is now one of this country's foremost alternative health clinics, offering a wide range of cutting-edge protocols.
In 2000, Dr. Minkoff founded BodyHealth, a nutrition company which offers a unique range of dietary supplements to the public and practitioners. Dr. Minkoff is passionate about fitness and is a 42-time Ironman finisher, including eight appearances at the Ironman World Championships in Hawaii. He also writes two weekly newsletters, The Optimum Health Report and the BodyHealth Fitness Newsletter.
Dr. Julie Mayer Hunt is a second-generation upper cervical care chiropractor in Clearwater, Florida. She graduated from Life University in 1981 and started practicing with her father, Dr. David Mayer, at Mayer Chiropractic, which celebrated its 60th anniversary in February 2018. In 2000, Dr. Hunt completed her Diplomate in Clinical Chiropractic Pediatrics (DICCP), becoming the first board-certified pediatric chiropractor in Florida. In 2013, Dr. Hunt was appointed to the Florida Board of Chiropractic Medicine by the Governor and continues to serve on that board today. In 2016, Dr. Hunt was awarded her Fellow in Craniocervical Junction Procedures (FCCJP). Dr. Hunt has presented at seminars and conferences concerning upper cervical care across North America and in Europe for the ICPA, the ICA, Society of Orthospinology, The Florida Chiropractic Society, Academy of Upper Cervical Chiropractic Organizations, and many other Upper Cervical and State organizations.
Dr. Hunt has published several papers in a peer-reviewed journals and is a contributor to several chiropractic textbooks.