I'm sure there's other info needed to diagnosis this problem but here's what I know. The two bony processes of the #1 cervical vertebre that are normally supposed to be below the foramen magnum have slipped up into the magnum of my friends neck. As a result he has constant neck stiffness, lack of mobility, and numbness/some pain to his arm(s). I suggested that he may want to seek a DO's recommendation who uses OMM and see what they say. Anyone know whether this problem can be treated with OMM?
No harm in getting evaluated. The giving of medical advice on this site has always been sketchy and not looked upon favorably. I would comment more, but being MS-I, I know very little about diagnosis and treatment. I bet I could palpate your friend pretty good, though! Again, in all seriousness, any issue with the head and neck needs to be treated carefully. I would have him see his primary care doc and maybe get a referall to a neurologist or a DO who specializes in OMM. If you need to find one in your area, use the following link: http://directory.aoa-net.org/cfm/PublicSearch.cfm Good luck to you and I hope your friend feels better.
The two bony processes of the Atlas? The Atlas is very atypical. It does not have a body, it has a very reduced spinous process, so the only thing those two processes you are talking about could be are the two transverse processes. Those are on the lateral side of the vert. If those were to enter the foramen magnum, that would not be considered a somatic dysfunction, but rather more like a total compaction of the vertebral column; in other words, your friend would be dead. Here are the possible somatic dysfunctions at the A/O (bad naming since normal naming uses the vert on top and the one below it, here we reverse the nameing for some odd reason) are as follows: 1) Rotated left Sidebent Right Extended 2) Rotated left Sidebent Right Flexed 3) Rotated right Sidebent Left Extended 4) Rotated right Sidebent Left Flexed Basically what you are testing for is if the occiput is gliding normally on the condyles of the Atlas. Most Spinal screening is done passively, but this one is done active. With the patient supine, stand behind them with your dominant eye on the midline. Have the patient extend the neck and then observe if the head rotates and sidebends. Do the same with the patient flexing. If both condyles glide symetrically, then there is no restriction present.
Thanks for the imput. I'm sure it's difficult giving advise with such sketchy information. Whatever the exact problem was, I'd have to ask again, I'm pretty sure that those two processes slipped out of place and into the foramen. Oh well, thanks again.
I don't think he is talking about transverse processes...The atlas is very wide. I believe he is talking about the posterior tubercles of the atlas, which are two very small projections instead of a spinous process. If this were the case, I would imagine that ANY movement would be extremely painful, and that he would exhibit some neurological problems as well. Yers, Daniel MS-1 NYCOM
From what little I know, If the bony precesses of the atlas were INSIDE the f magnum, there would be major neurological complications . I cant imagine a bony protruberance entering the f magnum being a non emergent situation. It could be, however, that some of the ligaments at the atlas/axis joint have been damaged...ie slackened, and the muscular attachments at those vertabrae are causing some small deviation. ( a small deviation here can hurt a lot). Given the upper extremity pain, there could be damage lower in the C spine, via compression of the upper roots of the brachial plexus. just my humble uneducated opinion ~NYCOM MS1
Thanks for the advice. He has been to a couple of Doctors and is on a treatment plan with possible surgury in the future. I guess I was just fishing to see if anyone as heard of OMM treatments specific to his type of problem.
I wasn't trying to make a diagnosis, just reacting to a something very strange I. That's why I used language like, "I don't think...I believe...If this were the case...I would imagine..." As first year medical students, our eyes light up like it's Christmas whenever we see or hear about a real, live, patient with a real problem. It wasn't intended to be a Dx, and certainly it wasn't meant to be advice, if any was inferred. It's incredible, posterior tubercles inside the foramen magnum. I do hope that that person obtains relief from that obviously painful problem. Cheers, Daniel
Just do a little cervical HVLA. Seriously do NOT do that, that's just the answer I give for everything. Being that there is numbness and tingling I would go with the neuro consult. You should never do any OMT without first ruling out a serious problem. I mean you would try to treat an appendicitis with counterstrain!
