Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2006; 11: 29–30
Two cases are reported where chiropractic treatment exposed venous spinal ballottement.
With their condition worsening in spite of treatment, one patient self-referred and the other was directly referred by the treating chiropractor for a functional neurological reassessment. Functional diagnosis is based on the patient’s neurological symmetry of cortex, cerebellum, midbrain, ponto-medullary area, spine and end-effectors. Ballottement from venous stasis and backflow can often show functional loss at different levels, e.g. absence of corneal reflexes, unevenness or loss of patellar reflexes with loss of pain and vibration sense in the legs. Loss of cortical integration (Diaschesis) produces ‘escape’ of sympathetic system (via the IML, pre-ganglionic to the sympathetic system), causing localised or multiple levels of ballottement in vertebral venous, dural and spino-medullary plexi (Kuzmichev 1971) anywhere from C1 to L1 level. This can produce a myelopathy from intermittent cord compression producing symptoms appearing at L5-S1. Reducing pain by sitting or squatting is indicative of spinal venous ballottement.
Attempting chiropractic adjustment to reduce pain may result in either cryptic or overt neural damage. Conversely, designing treatment to promote neural plasticity by epigenetic events (gene expression) in the individual patient allows integration between the higher cortical and lower vegetative centres. Venous vertebral ballottement can be reduced, corneal and patellae reflexes returned with the pain subsiding and vibration sense returning.
Chiropraxis should be diagnostically driven rather than by rigid adherence to philosophical concepts or modality-driven treatments. The chiropractor has an ethical and legal duty to refer non-responding patients.
The British Chiropractic Association.
