Interesting News for Tampa Chiropractic Patients – Could Multiple Sclerosis Be Caused By Trauma

In 1996, the British Medical Journal (Volume 313) reported a case in which a former policeman was awarded more than $820,000 in damages by a court that decided that he had developed Multiple Sclerosis (MS) after sustaining whiplash injuries from a car accident.

Within a week of the accident the 49-year-old officer started developing neurological symptoms. MRI showed that plaques had developed in his spinal cord near where he sustained his neck injury.

Several neurologists gave testimony for and against the plaintiff, but in the end the judge ruled in favor of the officer stating:

“I am satisfied that Mr. Dingley did sustain a whiplash injury… [and] that the symptoms he later displayed indicated that multiple sclerosis had developed in the very area which had been affected by the trauma. I also accepted that the historical, anecdotal and experimental evidence supported the proposition that trauma can be a causative factor in some cases and in some circumstances.

More compelling, however, was the evidence of the medical witnesses for Mr Dingley who had all themselves seen cases where they had accepted that the onset or recurrences of symptoms had been brought about by trauma, especially whiplash injury. In my opinion, these circumstances are far too strong to be put down to mere chance.” -Lord Dawson

Since this trial, there have been several studies linking MS to whiplash injuries. A study in the European Journal of Neurology found that 39 MS patients had experienced hyperextention-hyperflexion (whiplash) injuries that subsequently damaged the spinal cord in the neck.

The authors stated that these injuries may have precipitated and/or exacerbated MS.  Dr. Charles Poser of Harvard Medical School published a related article titled “Trauma to the Central Nervous System May Result in Formation or Enlargement of Multiple Sclerosis Plaques.”

He mentions that trauma to the head, neck, or upper back can act as a trigger for the appearance of new or recurrent symptoms in some patients with MS. He argues that these traumas can affect the impermeability of the blood brain barrier (BBB), an important defense system for the brain and spinal cord against foreign substances.

Could MS Show Up Years Later?

Might it be possible that patients with MS  sustained an injury in the past and do not develop symptoms until years later?

If so, what explains the often times progressive nature of this disease?  In 2011 Drs. Damadian and Chu published an article in the journal Physiological Chemistry and Physics and Medical NMR in which they discovered that eight MS patients had Cerebral Spinal Fluid (CSF) obstructions when they looked into their MRI’s.

These patients’ cerebral spinal fluid did not flow as well as normal volunteers’. In seven out of eight of these patients the obstructions were more obvious when the patients were sitting upright.

This is why it is important to have upright, weight-bearing, advanced imaging when determining the severity of a condition such as disc herniation. It was determined in this study that the obstructions were caused by structural changes of the neck due to trauma that had occurred earlier in the patient’s life.

The body produces on average 500cc of CSF a day. This fluid is important in that it protects the brain and spinal cord and nourishes the central nervous system by providing nutrients and getting rid of wastes. It is estimated that this fluid is pumped through the central nervous system at 12.47 cycles per minute in a healthy adult.

In Fonar’s Upright CINE MRI it was found that MS patients showed obstructed flow in comparison to the normal volunteers. (See Image at Right)

Damadian and Chu knew that in MS the lesions are typically concentrated adjacent to the areas in the brain CSF is produced, namely, in the ventricles.

Damadian and Chu hypothesized that when the CSF is obstructed the volume of fluid increases the pressure within the ventricles leading to leakage of CSF in the brain tissue.

Cerebral spinal fluid is full of proteins called polypeptides, and nine of these are known to be antigenic, meaning that they create an autoimmune response in which antibodies attach to these proteins.

For this reason most MS patients (90-95%)  show elevated IgG antibodies in their CSF after a spinal tap is performed. The body ends up attacking the myelin sheaths of nerve fibers creating the plaques visible in such images and on MRIs.

Myelin is important because it is electrically insulating and helps facilitate the nervous impulses necessary for sensory and movement. When there is myelin destruction the nerves don’t work as well, leading to the symptoms that MS patients experience as well as the lesions seen on MRI images.

But, what is really amazing about our bodies is that we can regenerate, hence the relapsing-remitting nature in 85% of MS patients. And what happens when the obstructions are removed? If the biomechanical obstructions are removed, would we see a decrease in these plaques and would there be fewer or no relapses?

In 2004 Dr. Erin Elster published an article in the Journal of Vertebral Subluxation Research about how removing pressure in the upper neck by adjusting the top bone can lead to improvement in patients with MS and Parkinson’s Disease.

The study found upper cervical misalignments in 81 cases, and of these cases 44 patients had MS and 37 had Parkinson’s.

These patients were under upper cervical chiropractic care for 5 years. Of the 44 MS patients 40 (91%) showed improvement with no further progression, and of the 37 Parkinson’s patients, 34 (92%) showed no further progression of the disease.

In 2015 a preliminary chiropractic study found that the link between chronic cerebro-spinal venous insufficiency (CCSVI) and MS may be due to a misalignment in the top two bones of the neck.

77 patients were evaluated with x-rays and ultrasound and experienced significant changes after an upper cervical adjustment. Figuratively speaking, poor plumbing may be causing a backup in the veins and the cerebrospinal fluid that bathes and nourishes the central nervous system.

Since we’ve started seeing patients in October we’ve had promising results with several MS patients.

We’ve seen significant decreases in pain and spasms as well as improvement in balance.

If there is a significant structural shift of the spine due to a trauma, would it not make sense that the arteries, veins and nerves that surround and pass through the spine are affected -and not just the muscles and ligaments?

Of course further research needs to be conducted, but when MRI’s and Ultrasound have shown improvements in the flow of CSF and venous drainage after an upper cervical adjustment, we believe it is time to look seriously at the connections between structural changes and serious diseases such as MS and Parkinson’s disease.

By Dr. Annie Apatiga

Mandolesi, Sandro, Giuseppe Marecca, Jon Moser, Tarcisio Niglio, Aldo D’Allessandro, Matteo Ciccone, Annapoala Zito, Dimitri Mandolesi, and Francesco Fedele. “Preliminary after Upper Cervical Chiropractic Care in Patients with Chronic Cerebro-spinal Venous Insufficiency and Multiple Sclerosis.” Annals of Italian Chiropractic 2015.86: 192-200. Print.

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