Objective: To document the symptomatic and functional changes in a patient with relapsing-remitting multiple sclerosis undergoing Atlas Orthogonal upper cervical and full-spine chiropractic care, and to explore proposed neurophysiological mechanisms linking craniocervical junction subluxation to multiple sclerosis pathology.
Clinical Features: A 30-year-old male with relapsing-remitting multiple sclerosis presented with dizziness, paresthesia, headaches, gait instability, and fatigue. MRI revealed supratentorial and cervical (C4–C5) demyelinating lesions. Despite initiation of disease-modifying therapy eight months prior, he reported continued progression. Radiographs demonstrated atlas subluxation and reduced cervical lordosis.
Intervention and Outcomes: Care included radiograph-guided Atlas Orthogonal upper cervical correction with adjunctive full-spine techniques, while the patient continued monthly Kesimpta. Following chiropractic intervention, patient-reported outcomes showed substantial reductions in symptom burden, fatigue, and dizziness, with a PGIC rating of “Very Much Improved.” Follow-up MRI demonstrated decreased T2 signal intensity at C4–C5 compared to prior imaging.
Conclusion: Structural correction of the craniocervical junction was temporally associated with meaningful symptomatic improvement in this patient with relapsing-remitting multiple sclerosis. This case highlights the need for further investigation into the role of upper cervical biomechanics in multiple sclerosis, particularly alongside ongoing immunomodulatory therapy.
Author Keywords: multiple sclerosis, Atlas Orthogonal, full spine, upper cervical chiropractic, vertebral subluxation, neuroinflammation
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