IS ONE CAUSE OF TRIGEMINAL NEURALGIA SUBLUXATION OF CRANIOCERVICAL POSTURE?
Main Article Content
Keywords
TRIGEMINAL NEURALGIA, CERVICAL LORDOSIS, REHABILITATION
Abstract
Objective: To describe the successful treatment of a patient with trigeminal neuralgia treated by the correction of craniocervical posture by Chiropractic Biophysics® technique methods.
Clinical Features: A 64-year-old male developed trigeminal neuralgia following a dental procedure. He had failed to get lasting relief after several prior dental treatments. Radiographic assessment revealed a lateral head translation as well as forward head posture and a military neck with notable degenerative changes between C4-C7.
Intervention and Outcome: Treatment was directed at improving the craniocervical subluxation misalignments using Chiropractic Biophysics methods. Mirror image® corrective exercises and traction techniques were used along with spinal manipulative therapy. After initial improvement in posture, symptoms improved. Unforeseen worsening of posture correlated with worsening of symptoms, and then a re-correction of posture again, dramatically improved patient symptoms. A year follow-up indicated the patient remained well.
Conclusion: This case is unique in that the correction, worsening, and re-correction of posture appeared directly related to the painful symptoms of trigeminal neuralgia. Subluxation of the craniocervical posture may be a plausible cause in some cases of this disorder. Radiographic assessment is necessary to quantify postural deformity in this disorder.
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References
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9. Moustafa IM. Does improvement towards a normal cervical configuration aid in the management of fibromyalgia. A randomized controlled trial. Bull Fac Ph Th Cairo Univ 2013;18:29-41
10. Moustafa IM, Diab AA, Taha S, Harrison DE. Addition of a sagittal cervical posture corrective orthotic device to a multimodal rehabilitation program improves short- and long-term outcomes in patients with discogenic cervical radiculopathy. Arch Phys Med Rehabil 2016;97:2034-2044
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13. Moustafa IM, Diab AAM, Taha S, Harrison DE. Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: A randomized, placebo-controlled trial. Proceedings of the 14th biennial congress of the World Federation of Chiropractic, March 15-18, 2017
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23. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther 2005;28:187–193
24. Harrison DD, Janik TJ, Harrison GR, Troyanovich S, Harrison DE, Harrison SO. Chiropractic biophysics technique: a linear algebra approach to posture in chiropractic. J Manipulative Physiol Ther 1996;19:525–535
25. Oakley PA, Harrison DD, Harrison DE, Haas JW. Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP) publications. J Can Chiropr Assoc 2005;49:270– 296
26. Harrison DE, Harrison DD, Haas JW. Structural rehabilitation of the cervical spine. Evanston, WY: Harrison CBP® Seminars, Inc., 2002
27. Harrison DE, Harrison DD, Haas JW et al. Conservative methods to correct lateral translations of the head: a non-randomized clinical control trial. J Rehab Res Devel 2004;41:631-640
28. Fortner MO, Oakley PA, Harrison DE. Non-surgical improvement of cervical lordosis is possible in advanced spinal osteoarthritis: A CBP® case report J Phys Ther Sci 2018;30:108-112
29. Lisi AJ, Salsbury SA, Hawk et al. Chiropractic integrated care pathway for low back pain in veterans: results of a delphi consensus process. J Manipulative Physiol Ther 2018 Feb;41(2):137-148.
30. Walker BF. The new chiropractic. Chiropr Man Therap 2016 Jun 30;24:26
31. Schneider M, Murphy D, Hartvigsen J. Spine care as a framework for the chiropractic identity. J Chiropr Humanit 2016 Nov 4;23(1):14-21. eCollection 2016 Dec.
32. Oakley PA, Ehsani NN, Harrison DE. Repeat radiography in monitoring structural changes in the treatment of spinal disorders in chiropractic and manual medicine practice: evidence and safety. Dose Response 2019;17(4):1559325819891043
33. Oakley PA, Cuttler JM, Harrison DE. x-ray imaging is essential for contemporary chiropractic and manual therapy spinal rehabilitation: radiography increases benefits and reduces risks. Dose Response 2018;16(2):1559325818781437
34. Oakley PA, Moustafa IM, Harrison DE. Restoration of cervical and lumbar lordosis: CBP® Methods overview. In: Bettany-Saltikov J, Kandasamy G. Spinal Deformities in Adolescents, Adults and Older Adults. IntechOpen DOI: http://dx.doi.org/10.5772/intechopen.90713.
35. Harrison DE, Moustafa IM, Oakley PA: Systematic review of Chiropractic Biophysics® (CBP®) methods employed in the rehabilitation of lumbar lordosis. Proceedings from the 14th International SOSORT meeting, San Francisco, CA, April 25–27, 2019. Poster 24, p 157
36. Harrison DE, Oakley PA. Non-operative correction of flat back syndrome using lumbar extension traction: a CBP® case series of two. J Phys Ther Sci 2018;30(8):1131-1137
37. Harrison DE, Oakley PA, Betz JW. Anterior head translation following cervical fusion-a probable cause of post-surgical pain and impairment: a CBP® case report.
J Phys Ther Sci 2018;30(2):271-276
38. Oakley PA, Harrison DE. Alleviation of pain and disability in a post-surgical C4-C7 total fusion patient after reducing a lateral head translation (side shift) posture: a CBP® case report with a 14 year follow-up. J Phys Ther Sci 2018;30(7):952-957
39. Oakley PA, Ehsani NN, Harrison DE. Non-surgical reduction of lumbar hyperlordosis, forward sagittal balance and sacral tilt to relieve low back pain by Chiropractic BioPhysics® methods: a case report. J Phys Ther Sci 2019;31(10):860-864
2. Tai AX, Nayar VV. Update on trigeminal neuralgia. Curr Treat Options Neurol 2019;21:42
3. Yadav YR, Nishtha Y, Sonjjay P, Vijay P, Shailendra R, Yatin K. Trigeminal neuralgia. Asian J Neurosurg 2017;12:585-597
4. Breig A. Biomechanics of the central nervous system. Stockholm, Sweden; Almqvist & Wiksell International, 1960
5. Breig A. Adverse mechanical tension in the central nervous system. Relief by functional neurosurgery. Stockholm, Sweden; Almqvist & Wiksell International, 1978
6. Breig A. Skull traction and cervical cord injury. A new approach to improved rehabilitation. New York, NY; Springer-Verlag, 1989
7. Harrison D, Moustafa I, Oakley P. Systematic review of Chiropractic Biophysics® (CBP®) methods employed in the rehabilitation of cervical lordosis. Proceedings from the 14th International Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) meeting, San Francisco, April 25-27, 2019:156
8. Moustafa IM, Diab AM, Ahmed A, Harrison DE. The efficacy of cervical lordosis rehabilitation for nerve root function, pain, and segmental motion in cervical spondylotic radiculopathy. PhysioTherapy 2011;97 Suppl: 846-847
9. Moustafa IM. Does improvement towards a normal cervical configuration aid in the management of fibromyalgia. A randomized controlled trial. Bull Fac Ph Th Cairo Univ 2013;18:29-41
10. Moustafa IM, Diab AA, Taha S, Harrison DE. Addition of a sagittal cervical posture corrective orthotic device to a multimodal rehabilitation program improves short- and long-term outcomes in patients with discogenic cervical radiculopathy. Arch Phys Med Rehabil 2016;97:2034-2044
11. Moustafa IM, Diab AA, Harrison DE. The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study. Eur J Phys Rehabil Med 2017;53:57-71
12. Moustafa IM, Diab AAM, Hegazy FA, Harrison DE. Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects? J Back Musculoskelet Rehabil 2017;30:937-941
13. Moustafa IM, Diab AAM, Taha S, Harrison DE. Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: A randomized, placebo-controlled trial. Proceedings of the 14th biennial congress of the World Federation of Chiropractic, March 15-18, 2017
14. Moustafa IM, Diab AA, Hegazy F, Harrison DE. Does improvement towards a normal cervical sagittal configuration aid in the management of cervical myofascial pain syndrome: A 1-year randomized controlled trial. BMC Musculoskelet Disord 2018;19(1):396
15. Moustafa IM, Diab AAM, Shima T, Harrison DE. The Effect of Normalizing the Sagittal Cervical Configuration for the Management of Cervicogenic Headaches: A 2-Year Pilot Randomized Controlled Trial. Proceedings of the 15th biennial congress of the World Federation of Chiropractic, March 20-23, 2019
16. Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 1991;14:409–415
17. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247-263
18. Harrison DE, Harrison DD, Cailliet R, Troyanovich S, Janik TJ, Holland B. Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis. Spine 2000;25:2072–2078
19. Harrison DE, Holland B, Harrison D, Janik TJ. Further reliability analysis of the Harrison radiographic line-drawing methods: crossed ICCs for lateral posterior tangents and modified Risser-Ferguson method on AP views. J Manipulative Physiol Ther 2002;25:93–98
20. Harrison DE, Harrison DD, Colloca C, Betz J, Janik TJ, Holland B. Repeatability over time of posture, radiograph positioning, and radiograph line drawing: an analysis of six control groups. J Manipulative Physiol Ther 2003;26:87–98
21. Harrison DD, Janik TJ, Troyanovich S, Holland B. Comparisons of lordotic cervical spine curvatures to a theoretical ideal model of the static sagittal cervical spine. Spine 1996;21:667–675
22. Harrison DD, Harrison DE, Janik TJ, Holland B. Modeling of the sagittal cervical spine as a method to discriminate hypolordosis: results of elliptical and circular modeling in 72 asymptomatic subjects, 52 acute neck pain subjects, and 70 chronic neck pain subjects. Spine 2004;29:2485–2492
23. McAviney J, Schulz D, Bock R, Harrison DE, Holland B. Determining the relationship between cervical lordosis and neck complaints. J Manipulative Physiol Ther 2005;28:187–193
24. Harrison DD, Janik TJ, Harrison GR, Troyanovich S, Harrison DE, Harrison SO. Chiropractic biophysics technique: a linear algebra approach to posture in chiropractic. J Manipulative Physiol Ther 1996;19:525–535
25. Oakley PA, Harrison DD, Harrison DE, Haas JW. Evidence-based protocol for structural rehabilitation of the spine and posture: review of clinical biomechanics of posture (CBP) publications. J Can Chiropr Assoc 2005;49:270– 296
26. Harrison DE, Harrison DD, Haas JW. Structural rehabilitation of the cervical spine. Evanston, WY: Harrison CBP® Seminars, Inc., 2002
27. Harrison DE, Harrison DD, Haas JW et al. Conservative methods to correct lateral translations of the head: a non-randomized clinical control trial. J Rehab Res Devel 2004;41:631-640
28. Fortner MO, Oakley PA, Harrison DE. Non-surgical improvement of cervical lordosis is possible in advanced spinal osteoarthritis: A CBP® case report J Phys Ther Sci 2018;30:108-112
29. Lisi AJ, Salsbury SA, Hawk et al. Chiropractic integrated care pathway for low back pain in veterans: results of a delphi consensus process. J Manipulative Physiol Ther 2018 Feb;41(2):137-148.
30. Walker BF. The new chiropractic. Chiropr Man Therap 2016 Jun 30;24:26
31. Schneider M, Murphy D, Hartvigsen J. Spine care as a framework for the chiropractic identity. J Chiropr Humanit 2016 Nov 4;23(1):14-21. eCollection 2016 Dec.
32. Oakley PA, Ehsani NN, Harrison DE. Repeat radiography in monitoring structural changes in the treatment of spinal disorders in chiropractic and manual medicine practice: evidence and safety. Dose Response 2019;17(4):1559325819891043
33. Oakley PA, Cuttler JM, Harrison DE. x-ray imaging is essential for contemporary chiropractic and manual therapy spinal rehabilitation: radiography increases benefits and reduces risks. Dose Response 2018;16(2):1559325818781437
34. Oakley PA, Moustafa IM, Harrison DE. Restoration of cervical and lumbar lordosis: CBP® Methods overview. In: Bettany-Saltikov J, Kandasamy G. Spinal Deformities in Adolescents, Adults and Older Adults. IntechOpen DOI: http://dx.doi.org/10.5772/intechopen.90713.
35. Harrison DE, Moustafa IM, Oakley PA: Systematic review of Chiropractic Biophysics® (CBP®) methods employed in the rehabilitation of lumbar lordosis. Proceedings from the 14th International SOSORT meeting, San Francisco, CA, April 25–27, 2019. Poster 24, p 157
36. Harrison DE, Oakley PA. Non-operative correction of flat back syndrome using lumbar extension traction: a CBP® case series of two. J Phys Ther Sci 2018;30(8):1131-1137
37. Harrison DE, Oakley PA, Betz JW. Anterior head translation following cervical fusion-a probable cause of post-surgical pain and impairment: a CBP® case report.
J Phys Ther Sci 2018;30(2):271-276
38. Oakley PA, Harrison DE. Alleviation of pain and disability in a post-surgical C4-C7 total fusion patient after reducing a lateral head translation (side shift) posture: a CBP® case report with a 14 year follow-up. J Phys Ther Sci 2018;30(7):952-957
39. Oakley PA, Ehsani NN, Harrison DE. Non-surgical reduction of lumbar hyperlordosis, forward sagittal balance and sacral tilt to relieve low back pain by Chiropractic BioPhysics® methods: a case report. J Phys Ther Sci 2019;31(10):860-864