Treatment Options
There are three main categories of treatment options for Chiari-1 Malformation: biochemical, mechanical, and surgical. An expert neurosurgeon can tell which approach will be best for a given patient at a given time. Therapies may be combined.
Biochemical therapies
Some doctors recommend:
Magnesium supplements to reduce or prevent headaches and improve heart and nerve function;
Calcium supplements with vitamin D, or prescription bone-building drugs, to promote the health and strength of the skull and skeleton;
Vitamin C to promote the health of blood vessels.
If the patient has too much cerebrospinal fluid inside the skull, due to overproduction or poor drainage, the Chiari expert may ask the patient to try a diuretic such as Diamox to temporarily reduce the fluid.
Pain is considered the "fifth vital sign." It means that doctors and nurses must agree to take pain reports seriously, and to offer relief if the patient needs it. When the pain of Chiari and related disorders becomes severe enough to interfere with daily function, many Chiarians take prescribed pain relievers, including sustained-release opiates.
Mechanical therapies
If a patient's Chiari symptoms are made worse by musculoskeletal tension or joint instability at the junction of the head and neck, the doctor may prescribe traction to be done at home or work a few times every day. Inexpensive home units include over-the door models with a plastic, water-filled bag. A more expensive version -- good for people who have trouble sitting -- is a floor model in which the patient lies down and slides horizontally to gently stretch the neck.
Patients also may be asked to strengthen their core. This means to do gentle exercises that improve the strength and function of the small muscles along the spine, as well as the larger muscles in the torso that are responsible for flexibility and support, so that the person can maintain good posture in various positions.
Doctors may prescribe hard or soft neck collars to stabilize a Chiarian's head-neck position and minimize the pain that comes from unstable vertebrae or weak neck muscles.Many Chiarians wear cervical collars when they travel in cars, planes, trains, etc.
Surgical therapies
If a patient's symptoms and signs warrant it, the neurosurgeon may suggest surgery to correct the problem.
For detailed, state-of-the-science information about the treatment options for Chiari Malformation and related disorders, we highly recommend that you watch The Chiari Institute's 16 hours of free, online educational videos at: www.thechiariinstitute.com (To see the video menu, which allows the viewer to choose segments on specific subjects, click on the word "videos" in the column on the left side of TCI's main page.)