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Introduction

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Cerebrospinal Functional Medicine

Cerebrospinal Functional Medicine (CFM) is a new medical specialty developed by Dr Young Jun Lee. Dr Lee is a Korean Medicine Doctor who was also the first doctor to receive a  Ph.D. in Integrative Medicine. Through persistent studies and research over many years he has found that balancing the TMJ (Temporomandibular joint) can recover structural distortions which leads to stablization of nerves. As a result, his findings have led to the formation of a new discipline of medicine which he termed ‘Cerebrospinal Functional Medicine (CFM)’ and he has published a number of materials within the field.

In CFM, it is viewed that many chronic and ‘intractable’ diseases are caused by structural imbalance which leads to problems in the nervous system. Therefore the treatment applied involves correcting structural imbalance thereby recovering  the nervous system and functions of organs to normality. Also, the principle within the field recognises that TMJ is the core component in controlling the function and structure of the cerebrospinal column and whole body balance.

The core theory of CFM is ‘through balance of TMJ the whole body balance is regulated’ – meaning that TMJ balance must be achieved in order to realign the upper cervical vertebrae which allows balance of the rest of body structure and stabilization of the nervous system. Based on this theory, many years of research and clinical experience has allowed Dr Lee to develop assertive and reliable methods of diagnosis, tests and treatments as a ‘holistic approach by manipulating the TMJ’. The treatment method, referred to as Functional Cerebrospinal Therapy (FCST) consists of using intraoral appliances to balance the TMJ, realignment of upper cervical vertebrae and the rest of body structure by manipulation.

For years he was ridiculed by other doctors as he emphasised importance of TMJ. However, he has also successfully collaborated with many medical doctors, including neurosurgeons, dentists and alternative medicine professions who have accepted his theory and actively supported him in advancing this new approach to cure diseases. The work is still ongoing and a growing number of people are now recognising the significance of his findings. His seminars and professional courses provided to doctors are also increasing in popularity.

What is FCST(Functional Cerebrospinal  Therapy)?

Functional Cerebrospinal Therapy (FCST) is a non-surgical treatment method currently widely applied in South Korea which normalises the nervous, hormonal and other body systems through resolving structural problems, based on CFM principles. It was developed by Dr. Lee who himself was a patient 30 years ago, suffering from paralysis in the left arm. According to Dr Lee, the cranium, spine and pelvis are core parts of our skeletal structures and distortion in any of them can affect related muscles, nervous and hormonal systems which can result in provoking a range of symptoms. FCST is a new form of treatment of 21st century which allows the core structures of our body (including cranium, spine and pelvis which can be classified as 3 points of distortion as well as TMJ) to regain balance thereby recovering normal function of nervous and other systems making it possible to cure chronic and ‘intractable’ diseases.

Conceptual Framework

In order to comprehend the full mechanism, it is important to understand the following concepts which are laid out in the ‘Framework’ drop down menu:

  • Importance of balanced body structure
  • Importance of TMJ
  • Cause of Dystonia

number of treatment casesLink to clinical cases

research of FCST

number of fcst course attendees

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number of fcst semina attendees

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Connection to TMJ, Home

Importance of TMJ

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This section explains how TMJ affects the spine structure and the nervous system. Subsequently, explanation of how FCST is unique in treating TMJ to other treatments available is provided.

i)              TMJ and structure

Movement of the TMJ is very closely related to the second cervical vertebra, C2 or also known as Axis. One might think that when the mandible opens and closes, its movement is centered around the condyle in the TMJ itself. However, this is not the case. According to the Quadrant Theorem of Guzay, the axis of rotation of the mandible lies exactly at the odontoid of C2. (The odontoid is the upward, toothlike protuberance from the second vertebra, around which the first vertebra rotates.) When the mandible moves downwards, this generates a pulling force, loosening the muscles around C2. Likewise, when moving up (i.e., when closing the mouth), it generates a pressure, which tightens the muscles around C2. This means that in an occlusion with decreased vertical dimension will aggravate muscle tension around C2 when the mouth is closed. Therefore, it is clear that distortion in TMJ will affect the position of the Axis too.

WHY TMJ

Of all 24 vertebrae in the spine (7 cervical, 12 thoracic, 5 lumbar), there is only one vertebra with an odontoid/axis, which is C2. Therefore, the Axis plays a key role in the balance of the entire spine. Together with the TMJ, C2 is the most significant variable affecting the entire spine structure.

TMJ ATLAS AXIS

So what happens next after subluxation of Axis? The rest of the spine collapses like in the domino effect even affecting position of the cranial bones and pelvis. This is explained by Lovetts reactor relationship.

LOVETT REACTOR
Source : Neurosomatic Educators INC.

According to Lovett Reactor relationship, each vertebra is coupled in motion with another vertebra and the pelvis is coupled in motion to the cranium. C1 + L5, C2 + L4 and C3 + L5 automatically move in the same direction (also known as coupling movement). The other vertebrae pairs, for example C4 + L2 move in the opposite direction. Therefore, impact on one vertebra influences other vertebrae in the spine.

Therefore, TMJ distortion causes subluxation of C2 (Axis) which leads to the collapse of the rest of the body structure.

IMPACT OF DISORDER TMJ AND AXIS
Source : http://www.upcspine.com/anatomy2.htm

collapsed structure

ii)                    TMJ and nerves

Nine of the 12 cranial nerves are found near the temporal bones from which the mandible is suspended. Particularly, the 5th cranial nerve (also known as trigeminal nerve) innervates the TMJ and are coupled to C1 and C2 (Atlas and Axis). The cranial nerves together control 136 different muscles (or 68 pairs of “dental muscles”) connecting the entire spine. According to Dr Lee, misalignment of TMJ disturbs the trigeminal nerve and it can lead to problems in the rest of the nervous system. Problems in the nervous system may cause abnormal muscle contractions and pain due to central sensitization and wider range of brain plasticity.

BLOG3

Not only this, TMJ distortion which causes subluxation of C1 and C2 can limit the space of foramen magnum (which is an opening at the base of the skull) through which the cerebrospinal fluid circulates. This can negatively impact the body-brain communication and also cause restriction of the jugular foramen, another opening in the base of the skull transmitting veins, arteries, and nerves. Restriction in these openings can mean less efficient brain respiration due to decrease in the cerebrospinal fluid circulation and can also limit proper flow of blood to the brain.

foramen magnum

The link below is a demonstration of how subluxation of upper cervical vertebrae restricts the jugular foramen. (Click slideshow in the file)

jugular foramen demo.

In conclusion, TMJ is the most important factor which contributes to collapse of spine structure and disruption of the nervous system.

STRUCTURAL CHANGES

iii)                    What causes TMJ imbalance?

Many people think that TMD (TMJ Dysfunction) is mostly caused by trauma (i.e. injury) to the jaw. However, there are many other causes of TMD including the following:

  • Chewing on one side consistently
  • Malocclusion
  • Neglect of missing tooth
  • Trauma due to complications of head and neck injury and traffic accident
  • Bad oral habits
  • Genetic or congenital problems
  • Solid foods and chewing gum
  • Mental stress
  • Teeth grinding (Bruxism)
  • Bad habits such as poor posture

When patients first experience TMJ problems, they may feel pain around the jaw area, develop headache or problems chewing. However, once TMD becomes chronic the symptoms are not only concentrated on the facial area but patients start suffering variety of symptoms including pains going down to the neck and back and psychological disorders such as depression and anxiety.

Chronic TMD symptoms_Page_1

Below is another study carried out where one TMD patient was sent to different specialists and the following were her diagnosis from each of them:

Chronic TMD symptoms_Page_2

It can be said that TMJ is the only joint in our body which causes such different symptoms between acute and chronic patients. Usually, for other joint related illnesses, the symptoms do not involve much more than pains around the affected joint area. However, studies have found that many chronic TMD sufferers not only experience pains and depression but also indigestion, allergies, chronic fatigue, dry/soar eyes, eczema, difficulties in hearing, loss of coordination, numbness in the limbs and fingers, tinnitus, asthma, cold hands and feet, apnoea, vertigo and many others. This can be explained by the impact TMJ imbalance has on the rest of our body structure and the nervous system as described above.

iv)                    How can TMJ imbalance be resolved?

There are various dental treatments, surgeries and other practices in both medical field and alternative medicine today but it may be very difficult to find treatments that are effective for all sufferers. So how is FCST different?

Dr Lee’s holistic approach is unique in that he treats TMD taking into account all of the following factors:

  • Freeway space* (see below)
  • Occlusion
  • Position of the Cranium, TMJ, Spine and Sacrum

Ultimately, this treatment aims to achieve the optimal balance (left, right, front and back) from top to bottom of our entire body. Once this optimal balance is achieved in the entire body and patients no longer experience Deflections it is viewed that patients do not require further treatment.

* Freeway space

A freeway space is the space that exists between the upper and lower articulatory members at rest. It is only when we swallow that the teeth make contact in order to create pressure.  The space varies from 1-8 mm but most people tolerate a space in the 2-3 mm region. According to Dr Lee, even 1/10 of a mm defect in the freeway space can distort the TMJ (and therefore causing problems with the nervous system). A splint made of hard material, although custom made, does not allow flexibility when there are muscular and/or structural changes in the individuals as a result of wearing the device, making it difficult to settle at the precise freeway space. Therefore, his intraoral balancing appliances are designed to fix this flaw. During treatments he uses special thin sheets of paper for optimal balance (sometimes referred to as zero point).

 

Home, Importance of balanced body structure

Importance of balanced body structure

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Our body has the ability to heal itself and maintain a healthy state. Also, our body is designed so that systems work together to sustain symmetry and balance which in turn enables normal function of systems. There are many research findings which link biological fitness and balanced body structure.  In essence, balance and control define a healthy body.

davincibalance

It can be said that all our body systems are interlinked and abnormality in one system can lead to the failure of another. This is also the case for our structure and communication function; they are closely linked. Below is a diagram of our spinal nervous system which shows how the spine, nerves, muscles and organs are connected.

Spinal Autonomic Nerves

Our central nervous system consists of the brain and the spinal cord which as the word suggests is inside the spine.

anatomical organisation of nervous system

Therefore, normal function of these nerves may be disturbed by misalignment of the vertebrae (also known as subluxation) in our spine. Below shows each vertebra and related parts as well as possible symptoms from subluxation.

spinechart
Source: http://www.drpittson.net/back.html

As the diagram above demonstrates, it can be said that problems with structure and nervous system co exist in many patients suffering from chronic conditions. Therefore, stabilization of the nervous system cannot be permanent unless the structural problem is resolved.

Before proceeding to understand the importance of TMJ and how it impacts body structure, it is useful to comprehend the role of TMJ and the following key components which Dr Lee refers to as 3 balance points in our body.

1. Cranium

In a healthy cranial structure, there is a contracting and expanding movement, called cranial rhythmic impulse (or primary respiratory mechanism). This impulse consists of a number of simultaneous motions:

  • Expansion and contraction of the cranial bones and the meninges surrounding them.
  • Pressure changes in the cerebrospinal fluid system, which moves back and forth within the central nervous system, i.e. from the cranium to sacrum and back.
  • And the cranial motion works together with a contrary motion in the sacrum.

Cranial rhythmic impulse is coupled with our diaphragmatic respiration and is vital in proper brain-body communication.

CRI

2. Pelvis (Sacrum)

The pelvis (or pelvic girdle) is a bilaterally symmetrical structure of bonus (sacrum, os coxa, and coccyx), muscles, and interconnecting tissue.

  • It supports and protects the abdomen as well as several organs in the abdomen.
  • The pelvis provides a foundation for the legs.
  • It also supports the trunk of the body via the sacrum, which is connected to the spine.

PELVIS

Understanding of our spine is also important and Dr Lee puts most emphasis on the first two vertebrae of the spine:

3. Spine

3.1 Occipito atlantoaxial joint = C1 & C2

The occipito atlantoaxial joint consists of the occiput, the Atlas (C1) and Axis (C2). In other words: the upper cervical vertebrae connecting with the cranium.

  • In the normal situation, these are neatly stacked on top of one another, in perfect symmetry, allowing unobstructed movement of the head and neck in all directions.
  • Also, in the normal situation, the brain-body communication will function perfectly via the vertebral and carotid arteries, the lymphatic system, the cerebrospinal fluid, the meningeal system and the spinal cord.

OCCIPITOATLANTOAXIAL JOINT

Especially the second vertebra C2, is a pivotal point since all muscles in head and neck are focused towards it.

AXIS 1<Picture Axis + muscles>

3.2 Rest of the spine

In a healthy body, cervical, thoracic and lumbar spine are well aligned with two typical curvatures as can seen from the side, giving the spine an S-shape.

  • The correct structure allows for flexible movement and optimal support of the entire upper body, as well as maximum shock absorption power.
  • Another very important function of the spine is protection of the spinal cord and spinal nerves.

SPINE

Temporomandibular Joint (TMJ)

There are two temporomandibular joints (TMJ), one on either side. A healthy TMJ  is mainly recognized as follows:

  • The mandible is aligned in all directions. i.e., there is no shift in the horizontal plane, and no shift in vertical direction.
  • The disk in the TMJ is in place and has not been deformed, thus allowing optimal function of the nerves, arteries and veins passing at the joint.
  • When the mandible opens and closes, the TMJ disk stays in place, allowing smooth motion, without the ball and socket of the joint touching, so that there are no clicking and/or grinding sounds.

TMJ + TMJ DISK

The following are reasons why Dr Lee puts so much importance on the joint:

1. General role of TMJ

TMJ is part of the masticatory system and is responsible for the following three functions: 1) mastication (chewing), phagia (swallowing) and speech. The masticatory system generally includes teeth, periodontal ligament, lips and tongue, cheeks, palate, TMJ and other related tissues.

2. Distinctive function of TMJ

TMJ is a joint which works 24 hours a day. Even during sleep, TMJ is the only joint which is in motion constantly. Therefore, the continuous movement of TMJ is not just a simple exercise but is necessary in maintaining life. It can be said that body organs which work persistently even during sleep are brain, heart, lungs and TMJ. Other organs such as trachea (airway), joints, spine and muscles all rest during sleep and there is a distinctive reason for why the four organs (brain, heart, lungs and TMJ) have to work throughout day and night. Firstly, the heart has to pump without a break to supply blood to the rest of the body which is essential in sustaining life. The lungs also are required to move consistently to maintain breathing. If the lungs stop and prevent breathing, the brain also stops functioning within minutes. The brain has to keep vigilant of the functions of the rest of the body even while we sleep.

So what is the reason for consistent movement of TMJ? During sleep, we swallow every minute (on average). Even though we are sleeping, the molar teeth on the upper and lower mandible are in contact every time we swallow which creates around 3.5 lb worth of biting force. This biting force is transported to the core part of the brain and supplies energy allowing normal function of the brain. Also, it is assumed that the force creates motility to sphenoid bone (located at the bottom of the brain) which is connected to the lower mandible and allows circulation of cerebrospinal fluid. The brain respires orderly only when the cerebrospinal fluid flows properly.