Meniere’s disease and Upper Cervical Chiropractic

Meniere’s disease and Upper Cervical Chiropractic?

Meniere's upper cervical chiropractic neck

What is Meniere’s disease?

 

Meniere’s disease is typically diagnosed in patients suffering the following 3 symptoms:

1. Hearing loss

2. Tinnitis

3. Vertigo

These symptoms typically arise from damage to the delicate structures of the inner ear and vestibular balance mechanism.

 

 

 

Can Meniere’s disease be helped by chiropractic care?

 

Chiropractic is not a treatment for Meniere’s disease, but it can be highly beneficial for improving the spine function and hence the structures around the spine also benefit.  With that said, if you had have asked me 5 years ago, before seriously investigating and applying upper cervical specific chiropractic care I would have said no.  Now I would say it just might.

 

Is there any published evidence?  Yes.  Quite a lot actually.  See below references [1,2,3].  My favourite study on this topic was published in 2016: [3]

 

Health Outcomes Following Cervical Specific Protocol in 300 Patients with Meniere’s Followed Over Six Years,” J Upper Cervical Chiropractic Research, June 2, 2016  [3]

 

 

 

What did this study investigate?

 

300 consecutive patients with a diagnosis of Meniere’s disease began upper cervical chiropractic care.  The patients were monitored for 6 years with the primary outcome being vertigo.

 

 

 

What were the key findings?

 

-        97% of participants experienced improvements in symptoms with an average improvement of 90%.

 

-        Interestingly all 300 had a previous history of whiplash of the neck, in most cases 10-15 years before the onset of meniere’s symptoms.

 

-        Participants in the study rated their vertigo intensity on a scale of 1 – 10, with 10 being the worse vertigo imaginable. Prior to chiropractic adjustment, the mean score was 8.5.

 

-        After six weeks the mean “vertigo severity score” was 3.0

 

-        After one year, 2.0

 

-        After two years, 1.4

 

-        After three years, 0.9

 

-        At four, five and six years, 0.8

 

-        291/300 (97%) reported improvement, the average improvement being over 90% and this was maintained at 6 years after beginning chiropractic.

 

This study woke me up to the possibility, and I have now seen many patients with this as their primary health concern, and my experience has been that most of them have improved, some spectacularly.

 

 

 

What was done to the patients in this study?

 

 

Upper cervical specific chiropractic, a niche chiropractic approach was used, which is very different to regular chiropractic adjustments.  Upper Cervical Specific techniques such as Blair technique focus exclusively on the alignment of the head and the top 2 vertebrae.  The importance of this region of the spine is underappreciated and the anatomy in this region has an enormous influence on the ear’s internal anatomy and functioning.  Hence dysfunction, injury, misalignment at the base of the skull can have a detrimental impact in a variety of possible mechanisms.

 

 

 

How could the neck be related to vertigo?

 

The lead author in his discussion of the findings outlines 6 separate possible mechanisms:

 

1. Inflammation of the atlanto-Occipital (upper cervical spine) articulation (joint) with edema putting pressure on adjacent structures, i.e., the Eustachian tube.

 

 

2. Traction of Cranial nerves VII through XII, also Jacobson’s and Arnold’s nerves.  These nerves all branch off the brainstem in close proximity to the craniocervical (head/neck) junction

 

 

3. Torque of the Trigeminocervical nucleus and tract causing Eustachian tube dysfunction.

 

 

4. Irritation of the sympathetic nerves can elicit spasms within the vertebral artery, leading to a decrease in blood flow to the brainstem.

 

 

5. Chronic CSF “backjets” into the fourth ventricle due to obstruction of outflow through the foramen magnum may affect the flocculonodular lobe of the cerebellum resulting in nystagmus, vertigo and balance disorders.

 

 

6. The endolymphatic sac performs absorptive and secretory, as well as phagocytic and immunodefensive, functions. It is innervated by the superior cervical ganglion, which is located laterally adjacent to C2, axis. If irritated by an upper cervical subluxation complex it can send amplified sympathetic signals to the sac.

 

 

 

 

SUMMARY:

 

More research will shed light on the exact pathways and mechanisms, but for now it is exciting to discover that for some patients with Meniere’s the neck plays an important role and that upper cervical chiropractic care to improve the upper neck alignment and function should be considered.

 

 

 

References:

 

[1] Burcon, M (2016), “Health Outcomes Following Cervical Specific Protocol in 300 Patients with Meniere’s Followed Over Six Years,” J Upper Cervical Chiropractic Research, June 2, 2016

 

[2] Burcon M. Upper Cervical Protocol for Ten Meniere’s Patients, Upper Cervical Subluxation Complex, A Review of the Chiropractic and Medical Literature, Kirk Eriksen, Lippincott, Williams & Wilkens, Baltimore, MD, 2004, pp 284-286.

 

[3] Chung, J and O’Connell, C, (2017), “Resolution of Symptoms in a Patient Suffering From Meniere’s Disease Following Specific Upper Cervical Chiropractic Care: A Case Study and Review of Literature,” Journal Upper Cervical Chiropractic Research, January 2, 2017