NB below is machine translated from Swedish (not yet readable?)
Below much abbreviated text from the link below – there is much more valuable information on the link!
Cervical Instability: Causes, Symptoms, & Treatments
Diagnose cervical instability
.. symptom… many e.g. muscle spasms, neck, shoulder or jaw pain, difficulty swallowing, sensitivity to light, blurred vision, tinnitus, vertigo ..
How to test cervical instability?
Here are 4 test methods for cervical instability:
Upright MRI (AKA magnetic resonance imaging)
Supine MRI (lying on her back)
CT scan (AKA computerised tomography)
It’s worth mentioning that although MRI is the most common diagnostic test method for cervical instability, a 2012 scientific study found that MRI had ”limited diagnostic value in patients with whiplash-associated diseases” such as cervical instability.
-> Here are some measurements to diagnose cervical instability:
- Clivo-Axial Angle less than or equal to 135 degrees (https://me-pedia.org/wiki/Clivo-axial_angle)
- Grabb-Oakes measurement greater than or equal to 9 mm (https://me-pedia.org/wiki/Craniocervical_instability)
- Harris measurement greater than 12mm (https://radiopaedia.org/articles/atlanto-occipital-dissociation-injuries)
- Any spinal subluxation (https://tuckclinic.com/blog/2020/10/01/what-is-a-spinal-subluxation/)BvS-> Possibly also check https://me-pedia.org/wiki/Basilar_invaginationA lot of links below about cervical instability, refluxes, sympathykus, vagus, …
https://www.wikihow.com/Diagnose-Vagus-Nerve-DamageGoogle search https://www.google.com/search?q=gag+reflex+vagus+reflex&sxsrf=ALeKk00NuDFRN_sG8iwMrh7685Ijrwyt2Q%3A1625676096600&ei=QNnlYJ-VJOyMrgSrtrX4DQ&oq=gag+reflex+andvagus&gs_lcp=ChNtb2JpbGUtZ3dzLXdpei1zZXJwEAEYAjIECAAQDTIHCCEQChCgATIHCCEQChCgAToECAAQRzoHCCMQsAIQJzoGCAAQBxAeOgQIIxAnOgQIABBDOgUIABCRAjoFCAAQywE6BwgAEIcCEBQ6AggAOgYIABANEB46CAgAEAgQDRAeUKMmWN54YKqIAWgAcAF4AYABlAOIAcoVkgEJMy45LjMuMS4xmAEAoAEByAEIwAEB&sclient=mobile-gws-wiz-serp
(BvS) Hypothesis Diagnosis Reasoning: Above image ”Vertebrae push …” justifies the inclusion of sympathetic nervous system (SNS) dysfunctional activity that affects to increased refluxes (mostly silent but sometimes very typical symptoms) that can also behave dysfunctional – because SNS affects sphincter muscles ”conversely” = increased SNS slacker muscle. Since refluxes for many years form part of my ”symptom picture”, cervical instability can interact / affect Pharyngo esophageal function (esophageal sphincter function) = facilitates reflux behavior – a lot of info on https://www.ncbi.nlm.nih.gov/books/NBK557452/ see also below image
More reasoning based on my own experiences from actual patient position; ”While people may experience GERD (gastro-esophageal reflux disease) and back pain at the same time, gerd is more likely to be caused by something related to the existing back pain or its treatment, rather than GERD that causes back pain. Here are some possible causes of GERD and acid reflux related to back pain – and how to deal with them,” https://www.spine-health.com/blog/can-gerd-cause-back-pain
But also quiet refluxes and refluxes via ”Reciprocal Causal Relationship between Laryngopharyngeal Reflux and Eustachian Tube Obstruction”
http://medcraveonline.com/JOENTR/JOENTR-02-00046.pdf is not to be forgotten.
A symptom change (increased) observation can provide diagnoses hypotheses reasoning material? It is during the nights (the last 20 years I sleep 8-10 h excellently) but after the severe permanent rupture symptoms arose (October 2019) a pronounced increase developed, always in the last 2-3 hours, together (in parallel) with increased back pain (lumbal?) pain (has MRI data on L4-L5 foraminal stenoses and S1 herniated disks) and a two-point neck (moderate) pain. Interaction between ???
Also peculiar that reflux symptoms develop during exercise cycling but not during treadmill exercise.
About refluxes and tinnitus – https://www.betterbalanceinlife.com/the-gut-and-vertigo/ ”If you have acid reflux (or heartburn) and dizziness, I think this article might be interesting to you…. I think the author presents a very interesting idea that the ”reflux material” can aggravate the ear trumpet tubes that go from the middle ear to the neck.
I have had patients with vertigo episodes related to acid reflux.
This association is called ”sur labyrinthitis” and can result in tinnitus, dizziness and vertigo. The reflux food particles and stomach acids can irritate the ear via the ear trumpet that connects the neck to the ear.
Esophageal inflammation, or inflammation of the esophagus, is often involved due to throat irritation as well”. .. Suddenly in December, acid reflux came. I had never had it before in my life, never woke up with throat reactions/sinus/nose problems etc which may have made me suspect a silent reflux..
… I went to a gastroenterologist doctor, who basically just looked at me like I was crazy and laughed at me for asking if I was dizzy because of acid reflux!!! Dr Bell responds to the above: You may have silent reflux and/or esophageal inflammation….”
Summarizing; Cervical instability and silent refluxes can cause a number of symptoms where I focus on what are most symptoms driven by hypotheses diagnostic reasoning. Since clinical investigations are complex and cannot always clearly identify without different assessment methods, I use psychophysiological tools from the toolbox that – given the above reasoning is wrong – do not harm but are instead part of my health promotion activities I enjoy!
Synopsis; Knowledge development of the gut-brain axis really justifies open mind of system interactions, especially we will probably more generally increase our understanding of complex biopsychosocial medicine interaction (www.biopsychosocialmedicine.com)
More text below – but much more not just about cervical instability in http://carism.se/projekt-carism/a-multidisciplinary-overview-of-the-tinnitus-syndrome-fields/overview-of-some-of-the-tinnitus-syndrome-approaches/
Tinnitus, Cervical instability, and neck pain – https://www.caringmedical.com/prolotherapy-news/tinnitus/#:~:text=In%20mant%20of%20these%20patients,of%20cervical%20spine%2Fneck%20 instability.&text=%20eustachian%20tube%20is%20the,ear%20and%20the%20upper%20throat.
”People with tinnitus can benefit from many treatments. In this article, we will propose an aspect of tinnitus treatment, the relationship between tinnitus symptoms and cervical neck instability and treatments that strengthen the ligaments of the cervix. Repair of cervical necklaces in the cervix can lead to relief of tinnitus symptoms. Tinnitus can be a very complex condition to treat. Not all cases of tinnitus are caused by neck ligament damage. However, in this article we will discuss when throat ligament damage is suspected as the cause of hearing problems and as a possible reason why you have not responded to other treatments.
.. In many of these patients, their problems with tinnitus, menieres disease, dizziness, ear fullness, decreased hearing or sensitivity to sound can be traced to problems with spinal/neck instability. The Eustachian tube is the canal that connects the inner ear and upper neck”
Secondary tinnitus as a symptom of instability of the upper cervical spine: crucial management
”Abstract: Tinnitus is very often caused by instability in the craniocervical junction. It very often manifests itself as a high-altitude whistle that disappears after operative correction and stabilization of articular geometry. Prolapsed intervertebral disks, discoligamentous lesion, and even metastases as low as level C3 can cause tinnitus, which also usually disappears after surgery. Keywords: alar ligament; instability. upper cervix” See PDF printing https://pubmed.ncbi.nlm.nih.gov/14689631/
Barre-Lieou Syndrome – https://piedmontpmr.com/diagnose-treat-barre-lieou-neck-pain-blurred-vision-nausea-vertigo-tinnitus-2/
”How can a disease cause all these problems?
The answer lies in the sympathetic nervous system (part of the autonomic nervous system) that monitors and regulates various activities that occur independently of the rest of the nervous system. Examples are student accommodation for light, balance in the inner ear and breathing.
If a structure is innervated by (or monitored by) the sympathetic system is damaged, it is the task of the sympathetic system to react to that damage. In the case of Barre-Leiou, posterior Cervical Sympathetic Chain forgets to stop monitoring the site of the damage; Like a car engine like diesel, it forgets to turn it off.
When this happens, the whole system becomes too sensitive to further stimulus. Shifting barometric pressure, stress or sinus infections can worsen symptoms. Treatment should be focused on restoring normal sympathetic nerve function, improving blood flow and reducing the overall load (the total number of things that do not allow the system to heal).
Diagnosis can be difficult, especially if the attending physician is not familiar with the disease. Thermography is a specialized study that measures skin temperature. It is an ideal test to evaluate for the presence of Barre-Lieou. More traditional studies include MRI (to exclude structural problems in the head and neck) and electrodiagnostic studies (to control nerve damage).
Medications, physiotherapy and sympathetic blocks (nerve blocks directed at the sympathetic system) are all used to restore physiology to normal and relieve symptoms. People with persistent head and neck pain, e.g. after a road accident, or with persistent migraines associated with blurred vision, numbness or tinnitus, should consider Barre-Lieou when seeking help.5
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