Uniting Atlas Subluxation and ADHD

I am sure that this post will be seen to be controversial by anyone coming from a conventional medical background who comes across this and reads it.

However iI have been on a mission of sorts to understand why my initial Atlas Profilax treatment improved my ADHD symptoms as much as it did  back in 2009, why it did not improve all symptoms, and why it was so hard to get those improvements to stick properly. I will address the third question in a second post.

The trouble is that the research that is done into the subject of ADHD (and probably any highly speculative area) is heavily biassed by previous precedent. Anyone who does any work in this area will be struck by the way in which most papers simply repeat “what we already know” even though those primary assumptions about what we already know are just that, assumptions. However these assumptions get repeated in book after book, paper after paper, internet discussion after internet discussion, until “everybody knows” that ADHD is a primarily genetic condition involving the frontal lobes, the reward centre and dopaminergic transmission.

That has never been established.
I’m convinced now that the majority of ADHD actually relates to1) Distorted and variable afferent proprioceptive input into the vestibulocerebellar system, leading to clumsiness and dysregulation of ocular coordination.

2) Compromise to the vertebrobasilar circulation secondary to high cervical malalignments- leading to hypoxia to the parts of the brainstem responsible for regulating blood flow to the rest of the body. The downstream consequence here is orthostatic intolerance and episodic cerebral hypoxia (inattention) and sympathetic overarousal– (hyperactivity and impulsivity).

3)Compromise to middle cerebral artery blood flow as a downstream consequence of rigid segments (“subluxations” ) in the upper thoracic area leading to overactivity in the sympathetic chain feeding up to the superior cervical sympathetic ganglion and through to the sympathetic innervation of the Middle Cerebral Artery.
I would suggest that the working memory deficits that have been observed in ADHD can be explained by
a) the greater burden on working memory caused by the poor co-ordination. Coordination problems will increase the amount of work required to execute even the most simple questionnaire.
b) An added burden on working memory caused by the need to restrain a hypervigilant, hypersympathetic attention and keep it on track.
c) Relative hypoxia will impair neural function and if the area involves working memory then that will be compromised. Remember here that relative blood flow impairment in the middle cerebral artery territory

We have made a number of systematic thinking errors in dealing with this problem
Just because a drug which has dopaminergic and noreadrenergic effects helps the problem does not mean that ADHD is some sort of dopamine deficiency disorder. it doesn’t even mean that the problem is primarily a neurotransmitter one at all.Interestingly here, one of the reliable effects that dexamphetamine has had on me is to shift me from a rather slouched and tired posture to a much more upright one- which is associated with midline cerebellar activation. The posture is also widely associated with alertness- especially in the context of possible threat, but also in the posture of meditation and martial art instructions.

I would speculate that the probable neurotransmitter and pathway involved here is through the locus coeruleus noradrenergic outputs- but will need to dig a little more for that. However the interesting thing is that this more upright posture will help improve neck alignment and will at least temporarily improve most of the cerebellar symptoms by normalizing and stabilizing afferent proprioceptive input.

However there is now more than enough reason to propose a completely different pathway for the causation of this problem, and also to insist that the primary modes of management should include manual therapies and neurorehabilitation.



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Neck Pain and Cerebral Perfusion

I recently became aware of the following paper – which casts some light on issues like brain fog in people with neck conditions, and also further light as to why these conditions persist.

I emphasise though that the observations here relating to this paper are probably only one mechanism causing difficulty with impaired cerebral blood flow.
I have gone into some detail here as the findings are strongly supporting some of the key tenets of chiropractic. There has been a good deal of skepticism about this from anti chiropractic lobby groups who like to pretend they are the gatekeepers of “evidence based medicine” so I am sacrificing brevity for detail.


Cerebral perfusion in patients with chronic neck and upper back pain: preliminary observations

Maxim A Bakhtadze, Howard Vernon, Anatoliy V Karalkin, Sergey P Pasha, Igor O Tomashevskiy, David Soave

Journal of Manipulative and Physiological Therapeutics 2012, 35 (2): 76-85

The study examined 45 patients with varying degrees of neck and back pain, looking at the following parameters:
1) Neck Disability Index (a self rated score of the limitation in daily life caused by the neck pain)
2) Number of “blocked segments” in the cervical spine, the thoracic spine and upper thoracic costovertebral joints, as assessed by one examiner
3) The pain score (measuring tenderness as experienced during physical examination)
4) Cerebral perfusion as measured on SPECT scan.

The following correlations were found
1) A highly significant negative correlation between the Neck Disability Index and Cerebral Perfusion- ie the more strongly positive the NDI was the the more the cerebral perfusion was impaired.

2) A slightly less significant (but still highly significant) negative correlation was found between the examiner’s findings and the cerebral perfusion.

3) The association between pain scores on the VAS  (when the back was examined)and cerebral perfusion is was significant.

4) In patients with higher NDI, the cerebral perfusion deficit occurred in frontal and parietal regions- in Middle Cerebral Artery (which receives its sympathetic innervation from the Superior Cervical Ganglion).

The paper reviewed the various theories around the interaction between pain and the ANS:


1)- central sensitisation- altered somatoautonomic reflexes

  1. sympathetic activation from spinal pain acting to stimulate the cervical ganglia, thus producing the perfusion defect.
  2. Role and response of sympathetic ganglia to somatic afferent nociceptive stimulation

93. McLachlan EM, Davies PJ, Häbler H-J, Jamieson J. On- going and reflex synaptic events in rat superior ganglion cells. J Physiol 1997;501:165-82.

Littman and Purves patterns of end-organ sympathetic reaction in the territory supplied by the superior cervical sympathetic ganglion in response to stimulation of the thoracic ventral roots (predominantly Th1-Th5). One of their findings was constriction of the arterioles of the eye and ear.

94. Lichtman JW, Purves D, Yip JW. On the purpose of selective innervation of guinea-pig superior ganglion cells. J Physiol 1979;292:69-84.

In 1980, the same investigators studied the territory of the stellate ganglion (SG), which also receives afferents from the Th1 to Th5 spinal segments.

95. Lichtman JW, Purves D, Yip JW. On the innervation of sympathetic neurons in the guinea-pig thoracic chain. J Physiol 1980;298:285-99.

Leading to point 4) That irritation of the spinal segments Th1-Th5 can produce a reflex response through the cervical sympathetic ganglia– that response including MCA constriction.

References 96-104 cover experimental proof of the role of the superior sympathetic ganglion in cerebrovascular regulation.


We report here, for the first time, a correlation in patients with chronic neck pain between scores of self-rated disability (NDI), painful spinal joint dysfunction, and brain hypoperfusion.



One noteworthy aspect of this paper is that it is nociceptive signals that activate the response to pain. Nociceptive signals can be generated below the threshold of conscious awareness of pain. Therefore it might be possible (I think very likely but don’t have enough material to prove that statement yet) that this mecahanism may operate without conscious awareness of pain, and impairing cerebral perfusion even in less severely affected patients.

The most pain sensitive structures in the spine (excluding rupture of a disc with leakage of nucleus pulposus producing an inflammatory reaction) are the facet joints, and the dura.

In any case of chronic severe neck pain, the local muscle spasm will drive tender facets together and increase pain- thus creating another feedback loop.

Also of note is another mechanism that might be driving neck dysfunction- namely orthostatic intolerance (Poor adaptation of blood flow distribution to the upright posture).. This mechanism is found in a wide range of conditions. It is a significant issue in ADHD, for instance. It can result in multiple episodes of decreased cerebral perfusion with loss of muscle tone and slumping into a posture that can drive back pain and displace vertebrae.

There appear to be a number of drivers of this dynamic and I am working on a summary of them.


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Why am I not getting better despite repeated adjustments, and why do my vertebrae keep “slipping out”?

This is a common question raised in the comments section of the blog.

Of course it is unsafe to give out individualised health advice to anyone over a blog, so the best way for me to handle this question is as a generalised post. Im notentirely happy with this post- it wanders a little too much for my liking, but this is a complex question.

I’ve been wondering myself– it has taken me 9 years to get to the point where I am now, and much of the improvement has really only consolidated in the last 2 months.

Firstly an acute injury is very different to one that has been carried since childhood.

I would guess that most acute injuries would settle back easily once corrected.


However most of us have carried the injury for a long while and there are issues with mild scoliosis, often localised arthritis and muscle spasm, and multilevel subluxations, often with flat feet and pelvic tilt. Any longstanding atlas issue will usually be accompanied by issues at the sacro-iliac joints, the feet , the thoracic spine, and often the jaw joint. The question then becomes one of how many need individual attention? Ive needed work on all but the jaw joint.

The posture chronically adopted will open some facet joints more and predispose them to go out of alignment.

Specific work to loosen up individual muscles is very helpful- and learning to self apply trigger point therapy or acupressure will save a lot of money.

I have used the Trigger Point Therapy Workbook- which is comprehensive and available as a cheap Kindle App and also an anatomy app called 3D 4 medical Muscle System Pro.

I have found that particularly valuable as it helpfully peels away the muscle layers and makes it very clear which level the problem is likely to be at.


One other comment I would make is that many of us, myself included, talk of the vertebrae “slipping out of place again”. To some extent I guess that is true— given the instability in my spine over the past 55 years there has to be some wear and tear predisposing to things slipping out of place. As a rule though I am led to understand that only usually happens when there is either loss of intervertebral disc space, or posture has become so poor that the facet joints are nearly fully open at the best of times. (That is more of an issue in the neck- where the facet joints open wider).

So in most cases the vertebrae are pulled out of place not slipping> The pull can come from tense muscles guarding other areas:A problem in one part of the spine can cause trouble elsewhere– ie for myself- pain in the right mid thoracic will cause tension in the cervicocostalis muscle, and THAT will cause reactivation of some of the subluxations in my neck ( the muscle attaches to the rear of the transverse processes of C3/4/5 and the net pull caused bowstringing of the cervical spine and a tendency to anterior subluxations at C6/7 and C7/T1).

Sometimes the pull can come from impaired orientation reflexes:  The functional neurology work I have done has demonstrated issues such as a tendency to rotate to the left- because my acoustic attention reflexes are neglected on the right. We have corrected that and it is no longer a problem.

Equally I developed a chronic pain syndrome that turned out to be purely a feedback loop within the medial pain pathways in the brain. Until that was identified it caused enormous trouble with chronic muscle spasm making everything worse, but it resolved within a couple of weeks of functional neurology treatment once it was identified 2 months ago.

These are also abnormal brain reflexes related to balance, coordination, orientation reflexes, abnormal brain reflexes related to the autonomic nervous system, often leading to low brain blood flow when upright, or to unpredictable emotional responses.

The autonomic reflexes have been a particularly tricky one to nail- and they apply as much to atlas problems as to ADHD. They cause a difficulty in regulating cerebral blood flow when transitioning from flat to upright. . This often translates to having a lower cerebral blood pressure when sitting and being on the edge of a fight or flight response (orthostatic intolerance). However,the wrong stimulus (ie getting too hot and sweaty on a humid day for instance, can trigger a collapse- where blood pressure drops and in my case, I feel a little sweaty and vague. I usually feel back pain with this-and “coathanger pain in the upper neck or back” is well known as a symptom of orthostatic intolerance.

I had had some inkling that this was going on, but the last time it happened to me (the day before I wrote this post) I happened to be starting with a back that was painfree and in good position.

This time, however, the outcome was obvious, as I had had my back nicely lined up and no pain- then the collapse re-activated all the currently troublesome subluxations and it took me 30 minutes to disentangle them.

So I do not think the vertebrae just randomly drop out of place- there has to be a trigger of some sort- and the action is driven by the muscles- which either pull the spine in the wrong direction, or fail to maintain core tone.

Other triggers that I can think of include being unfit, sitting too much in poor posture, emotional traumas and intestinal dysbiosis. (the latter is common as atlas problems interfere with normal gut contractions).

However, recovery from a significant subluxation problem takes time, patience and careful observation. My clinical training did not prepare me to do what was needed to get on top of my problems, and I have had to educate myself- relying on resources such as the ones I posted and repeatedly asking questions.

I have found functional neurology treatments extremely helpful- and also understanding the complex nature of the feedback loops which maintain the problem.

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ADHD as a model of functional disorders.

It has been known for some time that “head injuries” can produce a pattern clinically indistinguishable from ADHD. In his book “Total Concentration” the psychiatrist Harold Levinson discusses this and cites some very clear case histories. The medical profession has been slow to catch up on this- but we are now seeing some talk about head injuries and subsequent ADHD symptoms.

What is usually neglected is that head injuries are usually accompanied by injuries to the upper neck and that the upper neck houses the lower brainstem- important for vital functions and also for orienting reflexes. Equally brain injuries are often torsional and mostly involving axonal rupture in the midline structures- so not what we thought.

Upper neck injuries tend to be difficult to resolve because they scramble the proprioceptive (body position) information coming from the neck- causing each side to differ and neither side to match the other senses.
About 80% of that body position information comes from the small muscles innervated by the second cervical vertebra. The basic set of information our brain needs to construct even a crude map of the outside world is proprioception +vestibular+ vision ( see my earlier blog post titled “Upper Cervical Subluxation and the Reality Hologram).

What complicates matters further is that the scrambled proprioceptive information makes it harder to co-ordinate eye movements, and once they are a little out of sync, you get what the behavioural optometrists call “convergence insufficiency”.

The lack of convergence then creates a situation where the images from each eye do not match and that means that the brain has to suppress one for vision, and the other for balance. This maintains the loop by maintaining the eye muscle co-ordination problem.
Eventually that leads to all sorts of knock on effects in activation of other brain areas- but usually ends up with a lack of drive to the L prefrontal cortex.

Now the symptoms of convergence insufficiency and of ADHD are virtually inseparable.

We now have a significant literature that shows that oculomotor problems are usual in ADHD, and also literature that this symptom is responsive to stimulants.
That fits with reports I have had from ADHD individuals that they note an improvement in visual acuity after starting stimulants.

Now the bottom line of this is that serious brain tissue damage is relatively uncommon.
Most of these problems are what is called “functional brain disorders”- which means that they are effectively self maintaining loops of unhelpful activation patterns.

We have not had effective treatments for these problems until recently, but there is now a field growing called “functional neurology” or applied “neuroscience”. It has been pioneered by a chiropractor called Ted Carrick in the US. His major interest focus around serious head injuries, but his team are working with a wide range of disorders, getting substantial improvements in functioning in conditions clinically intractable.

This work has been gradually improving me over several years– but my situation has been complicated by decades of neglect – leading to significant spinal issues- widespread osteoarthritis and instability; severe clumsiness and oculomotor problems, episodic and unpredictable severe fatigue and a chronic pain syndrome involving my right upper back.

Now 2 weeks ago I was taught (as a practitioner) an attentional gating exercise for chronic pain. That worked so well that I was able to largely unlock my back and adopt a straighter posture, then within a week able to re-stabilise my neck, with massive improvement in visual clarity, and in co-ordination and spatial perception.– all due to that improved proprioceptive input. Strength at the gym improved enormously because of the better muscle co-ordination.

There are still a few kinks to be ironed out- but they are now manageable.

It has taken 7 years from the initial neck treatment, and a great deal of patience to source the right sort of treatment.

However, I am now juggling with a model of ADHD as a functional problem involving a series of self maintaining feedback loops- some of them operating across a number of levels:
ie neurological-musculoskeletal behavioural-interpersonal autonomic- behavioural etc.

the next step becomes one of formalising a way to systematise looking at the feedback loops.



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Sensory Mismatch and Vestibular Dysfunction

This post follows on my ” Sensory Mismatch and persistence of symptoms” post. Interestingly the authors here are looking at more dramatic symptoms that can be caused by sensory mismatch and vestibular dysfunction:


Most significantly the post mentions distorted body schema and body image, leading to de-personalisation and de-realization experiences, including out of body experiences, with associated changes in mood and loss of sense of personal agency.

It is also arguable that sensory mismatch may drive symptoms such as dystonias ( ie writers cramp or spasm in the hands of musicians who lose the  ability to play with a high level of speed and skill.

The hypothesised explanation for this one is relatively simple: – even instability in the upper neck could produce a shift in the mapping of sensory representations of the fingers on to the cerebral cortex and to deeper subcortical structures. That may be enough to produce symptoms in itself, though there may also be involvement of the vestibular  system due to the disturbed inputs caused by neck malalignment.

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Electromagnetic Radiation and Human Health, some evidence.

EMF and Blood Brain Barrier, and their relevance to atlas subluxations

There have been concerns about electromagnetic radiation for some time. While studies looking at exposure and cancer have been inconclusive this is not the best way to look at this problem.

Identifying a causal association in a population which is so saturated with EMF would be like trying to find a needle in a haystack, let alone correcting for the unknown variations in EMF exposure between individuals.

These three papers show a clear link between blood brain barrier permeability and EMFs used in wireless communication.

This permeability is not a good thing, as, as we have seen our blood often contains toxins from the metabolism of gut bacteria which should be excluded from the brain to allow efficient neurological function. This  becomes particularly relevant to the maintenance of spinal malalignment problems though, as the vestibular system, which is responsible for relating our body to our head and the whole to the environment, is one of the hardest working parts of the nervous system, and is most vulnerable to problems which impair brain efficiency. Clearly when factors such as these impair brain function, the chances of maintaining correct spinal alignment diminish rapidly.

The following 3 papers are significant and are worth reviewing. No doubt there is plenty more to be found, but I was satisfied with finding 3 papers. The “completeness freaks” amongst us are free to go hunt some more out and I would be grateful for any further papers to review.


Wireless Networks 3(1997) 455-461

Blood Brain Barrier Permeability in Rats Exposed to Electromagnetic Fields Used in Wireless Communication.

Bertil R.R. Persson, Leid G. Salford and Arne Brun


(Blood-brain barrier and electromagnetic fields: effects of scopolamine methylbromide on working memory after whole-body exposure to 2.45 GHz microwaves in rats).


Exposure to 900 MHz electromagnetic fields activates the mkp-1/ERK pathway and causes blood-brain barrier damage and cognitive impairment in rats.

The first study shows that EMFs caused slight permeability to albumin ( a protein), but the issue is that the substances that are of concern in leaky bowel (ammonia, lactic acid, tyramine, histamine, gluten, gluteomorphin and caseomorphin, and glutamate (MSG) to name a few) are much smaller and would pass through a much smaller breach in the blood brain barrier.

Since becoming aware of this information I have changed my practices around EMF substantially. Wherever possible I use speaker phone. I try and shorten phone calls, and I also look to minimise contact with sources of emissions such as screens and wiring in the walls- especially near my bedhead. I prefer to turn wifi off overnight. I also sleep on a grounded bedsheet. However more of that in a later post.






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ADHD and Suffering, the International Consensus Statement

Despite the ADHD denialaists and other fringe thinkers, ADHD is real , and it can be very troublesome:

For most of us who are classifiable as ADHD, life can be pretty hard.

The many disadvantages and harms associated with ADHD are well described and have been thoroughly researched. There is no controversy about the reality of these correlations.

In short ADHD, which causes a lack of the application of attention to moment to reality – is statistically strongly associated with suffering. ( It is associated with lots of good things too- but more about that in another post).

Now here is the tricky bit.

About 500 BC, shortly after his awakening Shakyamuni Buddha (formerly known as the prince Siddhartha Gautama said much the same thing in his four noble truths.We suffer needlessly because we do not attend carefully to the true nature of reality.

( That is a rough paraphrase- but it is good enough for this post).

A good summary of those disadvantages  can be found here:


Clin Child Fam Psychol Rev. 2002 Jun;5(2):89-111.

International consensus statement on ADHD. January 2002.

Barkley RA1.

The full text is here:


( Now there are lots of Barkley’s ideas that I think are just plain wrong– but he is often very helpful and this statement is one example. I have read most of the criticissm of this staement and they really leave me concerned about one thing more than anything else- the literacy of the authors- but that is another story).

This is Barkley’s website- it ids full of practical management tools.

All freely available

Everything is science based- but there is much science of which he is not yet aware- so don’t take what he says about genetics and so forth as gospel. It is not.

However he has been a great contributor and continues to do great good for all of us and I respect and admire him even when I disagree with him.




So yes- ADHD is strongly associated with suffering:

Here I quote heavily (  though I have tidied up some of his bad English 🙂

As attested to by the numerous scientists signing this document, there is no question among the world’s leading clinical researchers that ADHD involves a serious deficiency in a set of psychological abilities and that these deficiencies pose serious harm to most individuals possessing the disorder.

There is no doubt that ADHD leads to impairments in major life activities, including social relations, education, family functioning, occupational functioning, self-sufficiency, and adherence to social rules, norms, and laws. Evidence also indicates that those with ADHD are more prone to physical injury and accidental poisonings. This is why no professional medical, psychological, or scientific organization doubts the existence of ADHD as a legitimate disorder.

ADHD is not a benign disorder. For those it afflicts, ADHD can cause devastating problems. Follow-up studies of clinical samples suggest that sufferers are far more likely than normal people to drop out of school (32–40%), to rarely complete college (5–10%), to have few or no friends (50–70%), to underperform at work (70–80%), to engage in antisocial activities (40–50%), and to use tobacco or illicit drugs more than normal. Moreover, children grow- ing up with ADHD are more likely to experience teen pregnancy (40%) and sexually transmitted dis- eases (16%), to speed excessively and have multiple car accidents, to experience depression (20–30%) and personality disorders (18–25%) as adults, and in hundreds of other ways mismanage and endanger their lives.

Yet despite these serious consequences, studies indicate that less than half of those with the disorder are receiving treatment. The media can help substantially to improve these circumstances. It can do so by portraying ADHD and the science about it as accurately and responsibly as possible while not purveying the propaganda of some social critics and fringe doctors whose political agenda would have you and the public believe there is no real disorder here. To publish stories that ADHD is a fictitious disorder or merely a conflict between today’s Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud. ADHD should be depicted in the media as realistically and accurately as it is depicted in science—as a valid disorder having varied and substantial adverse impact on those who may suffer from it through no fault of their own or their parents and teachers.




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