“Exploration leads to knowledge and understanding so the world can become a more mindful place.”
Written By: Jared E. Katz
Reviewed By: Paul Zeltzer, MD
Introduction Welcome to our first Control Chiari Exploration! At the end of every other month, our ship sets out on an information journey in hopes to deliver more resources to a community that deserves them. A Control Chiari Exploration is a hybrid of a research article and a blog with a mission to educate patients about pain management options that they might not regularly be accustomed to. With a stronger knowledge base, a patient can be empowered to investigate whether this method is best suited to improve their quality of life as they discuss with their healthcare professional.
What is Chiari Malformation (CM)? Chiari malformation is a congenital abnormality of the brain in which part of the cerebellum (responsible for controlling body movements and coordination) herniates through an opening in the skull base, and moves into the spinal cord. Congenital Chiari malformation occurs in nearly 1 out of every 1,000 births.
Acquired Chiari malformation may also take place secondary to head trauma, or any iatrogenic (surgery-related) injury, although it is much less prevalent than the former.
Does Chiari cause pain? Does Cookie Monster love cookies? YES! Body aches constitute the most predominant symptom of Chiari, likely resulting from improper nerve and muscle function. A persistent headache can often lead to severe debilitation of the quality of life where a person fails to function optimally. This makes it essential to seek treatment for the chronic pain symptoms associated with Chiari malformation. Chronic and severe headaches may also affect the cervical (neck) muscles, joints, and subsequent kinetic chain of the body.
What is Control Chiari? Control Chiari is a pain management awareness movement developed by The Chiari Project, a 501(c)3 non profit organization based in Santa Monica, CA. The focus is to educate the Chiari community on a variety of pain management options that can be applied to the debilitating symptoms of Chiari Malformation, as well as its comorbidities. Some examples of these therapeutic modalities include the following:
Each of the above options represents categories to Control Chiari. We will continue to explore scientific evidence that highlights the usefulness of our highlighted form of pain management. The first category of Control Chiari that we hone in on is Manipulative and Body Based Methods, which typically focuses on the impact of body movement with pain alleviation and release of tension on the body. Without further adieu, our first exploration begins with the Graston Technique, a modern method used for controlling chronic pain by affecting the body’s soft tissue.
What is the Graston Technique? Graston technique is a novel instrument-assisted method which allows an efficient mobilization of those soft tissues that have undergone scarring due to some form of trauma inflicted upon them. Keeping this in mind, physical therapists and chiropractors can utilize this method to mitigate the severity of a multitude of painful neuromuscular conditions. Many medical studies have endorsed the genuine role played by Graston technique in pain relief. In one trial conducted by a research team from South Korea, Graston technique achieved a significant control of chronic low backache in a cohort of 15 patients, while it also led to an improved range of motion in the lower back. In another study, this intervention was successfully used for relieving chronic heel pain. Moreover, small-scale studies have also been conducted where researchers believe that Graston’s technique could also be a potential treatment for fibromyalgia (a musculoskeletal disorder). As the clinical manifestations of Chiari and fibromyalgia are often overlapping, such a therapeutic tool could hypothetically prove to be equally useful for the chronic pain associated with the former. Graston technique has not been extensively subjected to clinical trials and is only a suggestion.
 Lee JH, Lee DK, Oh JS. The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. Journal of physical therapy science. 2016;28(6):1852-5.
 Looney B, Srokose T, Fernández-de-las-Peñas C, Cleland JA. Graston instrument soft tissue mobilization and home stretching for the management of plantar heel pain: a case series. Journal of manipulative and physiological therapeutics. 2011 Feb 1;34(2):138-42.
 Kim MK, Kim HJ, Kim HS, Jeong JG, Jeon JH. The Effect of Graston Technique and Chuna manual therapy combined with Korean Medical Treatment for fibromyalgia: A Case Report. The Acupuncture. 2017 Aug 20;34(3):121-30.
The Chiarian Experience! As we travel through unfamiliar territory analyzing a new pain management option, we gather more intel from a member of our beautiful Chiari community.
NEXT STOP; CHIARIAN EXPERIENCE!
Our Control Chiari Exploration touches down in Texas, the Lone Star state and visits Jaci, who explains, “I have chronic nerve pain and muscle pain on my right side. I tend to get a lot of knots in my back as well as muscle pain and tension in my neck, back, and hips.
When the chiropractor conducts the Graston technique through fascia work, it helps get my body back in balance. Pinpointing and working specific muscles and tendons has really saved me. It helps control my chiari and allows me to function. It is important for other Chiarians to know that Graston can be very painful, but it’s a good pain. A good pain means that you know you’ll feel better afterwards. My mobility and pain are much better afterwards which makes this technique extremely valuable to my management routine!”
Jaci Bumpus currently lives in Lampasas, TX where she is still able to work, do CrossFit, and stay active while continuing to manage her Chiari Malformation.
NEXT STOP; SPECIALIST EXPERIENCE!
Our Control Chiari Exploration touches down right nearby Los Angeles’ upscale shopping street of Rodeo Drive and visits Dr. Javid who says, “In my experience of helping Chiari and Syringomyelia patients, I have found Graston to be beneficial. Some of the muscles that seem to contribute to patients symptoms are the semispinalis capitis, proximal trapezius, and the splenius capitis. These muscles appear to be, in part, muscles that when treated effectively, may reduce the patients symptoms.”
Dr. Amin Javid is a nationally published author in the field of Human Biomechanics and Functional Movement currently practicing in Beverly Hills, California. Dr. Javid’s Whole-Body approach successfully identifies and addresses the root cause of neuro-musculo-skeletal disorders and has placed him amongst the most sought after authorities in the area.
Conclusion! Let’s face it, living with Chiari is a day to day struggle, but it is critical for more pain management research to be established because it will provide useful data for our community searching for answers. Intervention trials for Graston technique which specifically target the Chiari population, are non-existent at this stage. However, if deemed useful for Chiari patients, such trials could be designed in the future for determining its efficacy as a potential therapeutic measure for chronic pain. To reiterate, always remember that this pain management option is only a suggestion and may not be suited for you, but it is always worth investigating first. For further information regarding Graston technique, please visit the following websites:
3… 2… 1… Liftoff!
Please join us on our next Control Chiari Exploration.
ABOUT THE WRITER
Jared E. Katz is a writer, researcher, Traumatic Brain Injury (TBI) consultant, and brain health coach/advocate. Jared is not only a TBI and Chiari Malformation thriver, he is a motivator of the mind and the body where he constantly stresses human improvement. Jared currently serves as Executive Director and Founder of The Chiari Project, a 501(c)3 non profit organization that operates exclusively for educational, scientific, and charitable purposes. Also, Jared serves as Founder and CEO of PainLes, a health technology company.