Upper Cervical Therapy
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Discovery of Upper Cervical Asymmetry

Poirier, Paul (1896). Traité d'Anatomie Humaine. Representation of the suprahyoid muscles: We see the digastric muscle, as it moves in an obtuse angle above the hyoid bone.

The upper cervical asymmetry or rather the asymmetric conduction of the posterior digastric muscle around the upper cervicals (axis, atlas, occiput) has been discovered as a phenomenon, when, by means of a goniometer I did measure in many people that they very rarely had symmetrical head rotations (study). In the course of my measurements, I found that head rotations ere expanded and symmetrized after the treatment applied herein. The people treated announced a lightness of the head, feelings of relief and, in a regular manner, symptom reductions. I suspected that this was due to an entanglement of some upper hyoid muscle (suprahyoid muscles) with upper cervicals (C1, C2). 

At the beginning of 2008, a physician who lives in Kassel, Dr. Gabriele Hauenstein, and I set up a medical cooperation community aiming at explaining the observed phenomena, which was successful as a result of intensive collaboration: Anatomical findings made ​​it possible to refine the treatment, increasing clinical experience to fathom out the phenomenon more deeply. The publication is to be considered as a result of this successful collaboration.

The Centre for Anatomy of the University of Göttingen was instrumental in the investigation of the anatomical facts: Since the end of summer semester 2009, most recently in July 2012, it has been ascertained in several head-neck-preparations that the left posterior digastric muscle (Venter posterior musculi digastrici) takes its pathway, in analogy to a pulley, behind and under the apophysis of the atlas before reaching the hyoid bone. On the right side, however, the muscle goes to the hyoid bone passing in front of or next to the apophysis of the atlas (anatomical reference).

In the course of the winter semester 2009/10, a part of the medico-historical skull collection   (Blumenbach Collection)  and other skeleton collections  were examined in an exploratory manner regarding this issue. In the winter  term 2010/11, most recently in the summer term of 2012, a significant proportion (about 400 skulls) has undergone craniometrical measurement methods, in order to draw valid conclusions. After reviewing old sources, it was revealed that the phenomenon of asymmetric digastric muscle conduction had not been discovered, nor researched up until now. It is undeniably an anatomical discovery. Consequently, this chapter will have to be added to macroanatomy.

Left: View onto skull base model with atlas, mandible and sticks to illustrate the course of the digastric muscle. On the left (right on the image), the posterior digastric muscle passes behind and below the Atlas extension, on the right side, in front of or next to it. This results in a slight obliquity of the atlas in relation to the skull base. Right: Idem, in addition with axis.

Since, in clinical terms, the therapeutic rearrangement of the left posterior digastric muscle is a new discovery,  a very wide range of indications had to be checked. It was found that the upper cervical asymmetry explains a certain percentage of symptoms associated with manifold health problems. Within a disease process, one should always check whether a co-causing upper cervical asymmetry is present. The regular improvements occurring in many pathologies force to believe that there is a causal relationship between the particular symptoms and the quality of the digastric muscle conduction. The wide range of indications can be gauged by the following examples:

  • Whiplash injury causes a pulling of the left posterior digastric muscle so that the atlas remains permanently tilted, the left-hand upper cervical muscles become atrophied, because they lie like in a gypsum bed, blood circulation conditions deteriorate and become sensitive to motion: These symptoms can be treated by means of upper cervical therapy.
  • Chronic tension headache subsides after upper cervical therapy.
  • Migraine is closely associated with aggravated upper cervical asymmetry. Recent therapy experiences are encouraging. However, these symptoms require long-term follow-up.
  • At old age, this measure might be quite useful, because vertigo passes and thereby the risk of falls decreases.
  • In cluster headache, upper cervical therapy helps most likely: Because of a case with a remission confirmed by the patients and also from theoretical considerations, this is considered highly likely.

Concerning pre-existing symptoms, casuistry and the attempt at a physiological explanation has been delivered. This is to encourage the medical public to do research in the particular specialty. Years of involvement with the subject led to the realization that many people suffer more or less from upper cervical asymmetry. I feel obliged to make my discovery known to the public with all anthropological and clinical implications, so that the latter is in a position to examine the described phenomenon. In anthropological terms, the examination promises evolutionary conclusions, in clinical terms, health perspectives can be identified.