Head and Neck and Headache

CCJ is also known as an upper cervical spine. CCJ consists of an occiput, atlas and axis. This is the junction where the head becomes the neck. It is where the brain exits and continues as a spinal cord. CCJ has atlanto-occipital joint (C0/C1) and atlanto-axial joint (C1/2). C0/C1 allows the head to back and forth and C1/2 allows the head to rotate sideways. In other words, it allows a lot of degree of movement therefore it is anatomically unstable. Also does not have any disc and the CCJ structures are held together mostly by the ligaments only. Ligaments are very sensitive and susceptible to traumatic events and can lead to joint instability; excessive displacement of the bone. Most common traumatic events that could lead to the CCJ ligament issues are; 

1. Whiplash Injury

2. Car Accident (motor vehicle accidents)

3. Sports injuries (Rugby or fall from the horse)

4. Direct trauma (Contactive sports; MMA or Jiu-jitsu)

5. Traumatic birth (Involvement of the Forcep or the Suction)

To assess the integrity of the CCJ, Cone Beam Computed Tomography is used for the analysis.

CBCT is the latest technology utilised in the field of the upper cervical (CCJ) specific chiropractic world. Historically, since 1920, chiropractors utilised X-ray to analyse the spine including the upper cervical spine. Due to the single plain and left to right overlapped study, using X-ray to visualise the CCJ was very challenging. However since 2015, thanks to the advanced technology, CBCT visualises the CCJ with ease and clarity. It is basically about 600 shots of images (Multi-planar study). What about the radiation exposure? CBCT is not a conventional CT where it radiates very heavily. It uses about ⅙ or 1/10 of the total radiation exposure to the conventional CT therefore very safe. In exchange of the low radiation exposure, CBCT is only clear enough for the bone (osseous structure) study and cannot visualise any soft tissue studies (such as brain or muscles or blood vessels). 

CBCT certainly opened a new door to the upper cervical specific chiropractic world because it reveals a vast amount of information that is very useful to the CCJ correction so the upper cervical chiropractors can work on the CCJ a lot more specifically and effectively. 

Does everyone need CBCT? Of course not. Then who needs it? People with a history of traumatic events and certain neurological symptoms; such as headache, dizziness, or tinnitus.

There are 2 components that Silverdale Chiropractic focuses on. Hemodynamic and the cerebrospinal fluid of the CCJ and the cervical spine. Most of the time it is the venous drainage that is problematic, unable to drain the blood out of the brain, backflows and accumulated intracranially and results in a number of non-specific neurological symptoms but most commonly, a migraine headache. Also, the cerebrospinal fluid (CSF) circulation is vital to maintain the normal physiology of the brain. CCJ or other cervical spine subluxation can affect the space of the spinal canal and decrease the space of the CSF flow and this also can lead to a number of health issues. In Silverdale Chiropractic we have a high number of successful cases with migraine headaches particularly the chronic cases.

In Silverdale Chiropractic, we use an infrared thermography to assess the objective state of the function of the spinal cord at the level of the cervical spine. Infrared thermography is used to determine if there is any neurological interference (Increased tension of the stretched dura mater by the dentate ligaments) that the body cannot self rectify. What the imaging study such as CBCT or MRI cannot confirm is; if there is misalignment(s) or misplacement(s) does it mandate the correction? What if it is a normal anatomy to the individual? This is why infrared thermography is used to ensure that such interference is repeating over the periodic interval such as 48 hours or a week. If the same pattern is repeated, it means the same tension of the dura mater persists. Also, it gives an objective indication to either to introduce the correction or not.

CCJ Correction requires a completely different approach to the conventional spinal manipulative therapy. That means there is no twisting, cracking or popping the joint of the neck. In Silverdale Chiropractic, the very first attempt of the correction is made by the hand held tool. It is called “IQ Impulse Gun”. IQ impulse gun is an electrically working device with a very sensitive and smart sensor in it. Once it delivers the force, it calculates the repercussion and it will determine the depth and the frequency automatically and once the targeted joint is moving, and upon detecting a perpetual motion, then it stops automatically. It is the safest and reliable tool to approach such delicate structures in CCJ. Sadly for some people with very complicated anatomy and degenerative changes, IQ impulse can be limited therefore manual correction will be considered but still, no cracking and popping is involved in the process.