Pain In The Neck & Pressure Headache In The Back Of Your Head? Check For Chiari Before Getting Chiropractic Treatment
If you have neck pain and are considering seeing a chiropractor, but you also have headaches in the back of your head, you may want to consider getting an MRI to see if you have Chiari malformation, which is sometimes called Arnold-Chiari malformation. You may have never heard of Chiari malformation, but the medical community believes that Chiari malformations may be much more common than the previously estimated 1 in 1,000 births. Here's what you need to know.
Chiari Malformation & Comorbid Conditions
A Chiari malformation is a structural defect at the base of the skull and the lower part of the brain called the cerebellum. It causes the cerebellum to be below the opening for the spinal cord, which is called the foramen magnum. This can have a cork-like effect on the spinal fluid, which can cause blockages that can lead to syringomyelia and hydrocephalus, and put pressure on the brain stem. Pressure on the brain stem can lead to dysautomonia, which is the disruption of the automonic nervous system.
Symptoms of Chiari Malformation
Some people can live most of their lives without any symptoms of Chiari malformation, until something triggers the symptoms, such as a neck injury or a concussion. Sometimes, however, there may not be a definite trigger, and the symptoms will start appearing seemingly out of nowhere. Other people may have symptoms during their infancy.
Symptoms of Chiari malformation include pressure headaches in the back of the head, neck pain, dizziness, and numbness and tingling in the extremities. Typically, Chiari headaches are brought on by valsalva maneuvers, which occur when you do things like cough, sneeze, laugh, cry, shout, or force a bowel movement. Symptoms can also include problems that may seem completely unrelated, such as confusion, memory loss, trouble swallowing, stomach pain, fatigue, weakness, facial numbness, and vision problems.
Diagnosis by Imaging
Chiari malformations can be seen on CT scans, but MRIs are the best way to determine if the cerebellum is below the foramen magnum. If you have symptoms of Chiari malformation, it is important that you tell your chiropractor before getting treatment so he or she can order an MRI of your head, neck, and spine to see if you have Chiari malformation and syringomyelia.
Alternatively, your family doctor can order the MRIs. If a Chiari malformation is seen on your MRIs, you will be referred to a neurologist and a neurosurgeon for further evaluation, which should include CINE MRIs, which are movie films to determine if the malformation is causing a blockage in the flow of your cerebral spinal fluid.
Unfortunately, there is no cure for Chiari malformation, but there are treatments available. A neurologist may prescribe pain medication, and a neurosurgeon may recommend surgery to decompress the cerebellum. However, surgery should only be done if the symptoms severely interfere with your life. You will likely first be asked to consider lifestyle changes to try to alleviate your symptoms.
As was stated previously, it is crucial that your chiropractor knows that you have a Chiari malformation before he or she attempts to manipulate your spine. It's important to understand that high-velocity adjustments to the neck may cause further herniation and displacement of the Chiari malformation into the spinal cord. However, your chiropractor will be able to perform low-velocity adjustments to the region, but it's a good idea to have this cleared by your neurosurgeon and/or your neurologist.
You will be able to receive chiropractic treatment to the rest of your spine as long as care is taken to ensure that your neck is stable throughout the treatment to avoid causing disruption to the Chiari malformation's cork-like affect at the opening of the spinal cord.