Upper Cervical Therapy
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Swallowing and voice disorders

In head retraction the upper cervicals (C1/C2) bow and the lower cervical spine stretches. Thereby, throat and parapharygeal space widen .

In a complex manner, swallowing disorder (dysphagia), globus sensation (globus sensation) and voice disorder (dysphonia) are probably related with upper cervical asymmetry:

  • The vocal cord tension (-> pitch and vocal strength) and the resonant space are certainly determined by the suprahyoid muscles (the muscles above the hyoid bone). If the voice worsened without an infection (colds, etc.) being present, one must consider the involvement of exacerbated upper cervical asymmetry..
  • The most complex act of swallowing is more directly affected by the asymmetric digastric muscle conduction: The hyoid bone including the pharynx 'hanging' below, is being raised differently on each side by the digastric muscle, so that persistent dysphagia can result (Physiological effects).

But basically swallowing and voice disorders should not be considered in isolation, but as a top of an iceberg of symptoms that are all related to upper cervical asymmetry: Muscle tension in the jaw muscles, of the neck, and, finally, of the pharyngeal and laryngeal muscles (pharyngo-laryngeal tract) would therefore herald symptoms of a failing voice or swallowing disorders.

Therapeutically, it is always useful and appropriate to produce a symmetrical digastric muscle conduction, because thus a reduction of asymmetric muscle tension in the pharyngo-laryngeal tract is reached. By the rearrangement of the left posterior digastric muscle in front of the upper cervicals (C1/C2), an advantageous head retention is also created: Due to the fact that the head is carried more 'backward', this expands the pharyngeal area permanently. Mediated by the decline of the pharyngo-laryngeal muscle tone and pharyngeal expansion, a positive influence of voice and swallowing ability by the digastric muscle rearrangement is expected.

(1) patient (* 1955) was treated on 4/14/09. Medical history resulted in the following complex situation:

Almost constant pain especially in the cervical neck reported since 3 years, left-sided pulling in the head. Suddenly, three years ago, paroxysmal thoracic back pain and tingling in left side of head, discomfort in breathing. Predominantly left-sided complaints, TMJ problems, jaw muscles tightened frequently, splint at night. For 1.5 years paroxysmal speech and swallowing disorders, disturbance during half an hour to half a day, especially under stress, dizziness, nausea, vision problems left, crackling sounds in the left ear, tingling and nerve pain / dysesthesia left arm / hand, occasionally also affected left leg. These discomforts occur many times weekly to once in second week. About 20 years ago, an accident on ice with coccyx fracture (located for months).

The medical history reveals that the voice and swallowing disorder is only one of many symptoms that worsened following the accidentally (accident on ice) exacerbated upper cervical asymmetry: There are interference of concentration, dizziness, nausea, vision problems as symptoms of disorder of blood and lymph flow, as well as back pain, TMJ pains as symptoms of the twisting of the axial skeleton. Thus upper cervical asymmetry syndrome prevails, culminating in voice and swallowing disorders. After treatment, the patient wrote the following comments:

Super! Left shoulder hanging down, (...) free.

On the occasion of two follow-up appointments, the following was noted:

21/04/09 On treatment day, very light feeling. Thoracic pains were gone for 2 days, but then came back. Left in recent days increasing pain in the neck area. Since therapy automatic head rotation to the right.

5/20/09 health status improved significantly after therapy for last 2-3 days. Now again especially left-side pain.

This shows that the health situation has been improving considerably for a short time after therapy, but then again it worseened somewhat : Painful cramps had been reported .

8/5/10 Since late 2009, deterioration of the old symptoms, feeling that the left side no longer is functional. Unable to work for 2 months. Palpation of the digastric M. digastr. left posterior (possibly through yoga 11/2009).

After one year, after a period of remission of six months, everything went 'back to normal', ie the symptoms had reappeared completely. This was probably due to the left posterior digastric musclere, which had reagined its position behind the upper cervicals. Twisting exercises were at a certain time werre suspected (November 2009), however, in a long term weakened upper cervical muscles this can happen very easily under a variety of circumstances that the upper cervical asymmetry again is being established (reversibility of muscle rearrangement). After rearrangement of the digastric muscle, way to a further improvement of the health situation was opened up.

Rotation angle values ​​from 14/04/09 (top) and 5/8/10 (below). First column: horizontal rotation (L, R), second column: lateral flexion (SL, SR), third column: flexion / extension (B, S). First line: angle values ​​before digastric muscle rearrangement, second line: angle values ​​after muscle rearrangement, third line: after vibration application.

The angle values ​​speak their language: The angular values on 4/14/09 ​​show up severe limitation of rotation to the right, which dissolves after muscle rearrangement and vibrational retuning. On 5/8/10, at the start, exactly the same values ​​as before treatment on 4/14/09can be detecte , which points to the again existing upper cervical asymmetry.

(2) patient (* 1964) was treated on 11/3/10. Medical  history stated the following:

Since 4/5 months globus sensation, alternating, no dysphagia, rather cramped, no voice disorder. Occasionally tension headache, sometimes with vomiting, in phases (sometimes not for weeks). Left shoulder pain in certain movements.

On 11/18/10, the following was stated:

The posture is maintained easier and the instrument playing  (professional violin) also. Globus sensation is unchanged. Headaches did not appear recently. Shoulder pain has lessened. 

The patient suffered from a persistent globus sensation, which was combined with occasional tension headaches. There were therefore - probably occupational - tensions. The peripheral muscular phenomena did recede, however, the globus sensation did not yet recede after the short observation period.