A CLASSIFICATION SYSTEM - how bad is my pain?
Keywords: head neck pain, chiropractic help, what causes headache, arm pain, home traction unit, migraine headache, thoracic outlet syndrome
It still astonishes me how often I have a new patient with neck
pain of twenty years duration. Fifty years I can understand - there
weren't too many chiropractors around in those days.
But to have been suffering with head neck pain, gulping down prodigious quantities of pills that are known to poison the kidneys, or just suffering in misery, makes absolutely no sense when science proves so conclusively what causes headache.
A quote from the Kidney Foundation website: "Generally, when used according to directions, over-the-counter analgesics are safe. However, heavy or long-term use of these medicines, especially those that contain a mixture of painkilling ingredients--such as aspirin, acetaminophen and caffeine--in one pill, have been linked to chronic kidney disease."
Almost everyone will have head neck pain periodically.
NECK PAIN ...
Why? For many reasons, but not least that there are few of us who have not had a car accident, fallen down the stairs or taken a tumble from a horse or bicycle. Getting out of bed in the morning is dangerous but there's only one thing more dangerous. Not getting out of bed! Most people die in their beds! But seriously, just when is the right time to go to your doctor or chiropractor, (sorry, got that wrong: your chiropractor, or your doctor) with neck pain and headaches? Yes, we really do know what causes headache.
Preferably before your brain requires this sort of examination! Recognise the Dutch artist? Rembrandt van Rijn who lived about 400 years ago. This is what it might look like when a surgeon has to peel the meninges off the brain! But you won't let the headaches get that bad, will you? Look for a good chiro in your neck of the woods.
Neck pain treatment
"How bad is my head neck pain?" is a question you may have been asking yourself. "Am I being a baby with a low pain threshold, or do I actually have a problem?"
A few thoughts. Just because you have a pain in the neck, or elsewhere, does not mean you must rush off to the chiropractor or your doctor. But then when should you go?
These are my golden tips. If you have
then it's better to get help. After, mm, how many days? Difficult to say, it's best to use your own intuition. But recognise that if you arrive at the chiropractor with a pain you have had for three months or more, the definition of chronic, then you will certainly need more than a few treatments.
What's more research shows that if you've had neck pain for over six months then, no matter what treatment you have, it's with you for life. It can be treated, helped, reduced, relieved, but it won't ever go away completely.
For an acute problem that has only begun in the last few days or
weeks, as a rule, after a short course of chiropractic neck pain
treatment one may expect the pain to go away completely. Better still,
if you go through a short course of rehab, there's a good chance that it
won't return for a long time.
But if you've had head neck pain for months or years, it is more difficult for your chiropractor to give you an assurance that your pain will recede completely. Don't wait too long. But don't go too soon either! Unless your head neck pain is really severe or you have a pinched nerve in neck that radiates down your arm. Then you really shouldn't wait; arm pain probably won't go away on its own.
If you're handy you can make a home traction unit that is very effective against head neck pain particularly if it radiates to the arm; make it yourself for a fraction of the cost of a commercial unit.
One of the great things about the chiropractic adjustment is that it's rarely painful. Artfully done, even with severe neck pain, and you're terrifiied that he or she is going to hurt you, or make it worse, it's rare that the cervical adjustment is painful.
Just this week, a lady with very severe neck pain; just one adjustment, no pain from the treatment, and she's eighty percent better; it's not always like that, especially if there's also arm pain.
In the interim, a good massage from your spouse may relieve your head neck pain, particularly for back of head headaches, use some alternating ice and heat, do a few simple exercises, and don't go playing silly twits! This is not the time for a game of rugby, or lifting pianos. Avoid carrying heavy groceries on the affected side.
A strong recommendation ...
Research indicates that if you have neck pain for six months, then YOU WILL PROBABLY HAVE IT FOR THE REST OF YOUR LIFE. Once you know it's not going to get better of its own accord, then do something -- or spend the rest of your life suffering from head neck pain.
Why is that? Frankly, we're not totally certain but what we do
know is that the hyaline cartilage in the little bones in your neck is
very sensitive to subluxations - it's now proven that the cartilage
begins to degenerate within 13 hours (in white mice anyway).
A simple classification system:
No signs or symptoms suggestive of major structural pathology (ie no severe pain, no radiation, no recent trauma) and no interference with activities of daily living. This will likely respond to those simple things suggested above; it does not usually require intensive investigations or ongoing treatment.
No severe pain or radiation, but now begins to interference with activities of daily living. You wake in the night with pain. You can't turn your head, and driving the car is thus dangerous. After a week or ten days, you have to acknowledge that it's not really improving. Then we suggest it's time to make an appointment with your chiropractor (or even your doctor first, if that is your first choice). A good examination is in order, and perhaps some early intervention aimed at preventing long-term disability.
with the onset of neurological symptoms. Headache, radiation pain or tingling down the arm, or into the midback. Now it's definitely time to get help, particularly if it has lasted for more than a few days.
Still no signs or symptoms of major structural pathology, but presence of neurologic signs such as decreased deep tendon reflexes, weakness, and/or sensory deficits. In my opinion it is now definitely time for x-rays, perhaps even a scan. The pain of a pinched nerve in neck is often severe, the ache in your arm something you cannot escape, no matter how you change your position. It's often worst at night. This head neck pain should no longer be ignored.
Slipped disc in neck
Undoubtedly one of the most difficult conditions at the Chiropractic
Coalface is severe neck pain radiating down the arm, especially if there
is wasting of the muscles. The classic sign is RELIEF of arm pain when raising the arm.
Slipped disc in neck casefile...
ARM PAIN OR TINGLING?
THORACIC OUTLET SYNDROME
Another cause of pain running down the arm is a subluxated
first rib deep in the neck. It may cause scalene muscle spasm, together pinching the artery and nerves to the arm. The classic clinical sign is INCREASED pain and tingling in the arms and hands when raising the arms.
If it's the rib on the left side, then it may mimic a heart condition, with pain in the neck which radiates down the left arm.
What I always remind my patients is that before you get pneumonia, it all starts with a cold. Neglected and you will get bronchitis, then pleurisy and finally a good dose of pneumonia. Life threatening. An ounce of prevention when you are at the cold and flu stage makes good sense.
It's frightening how quickly a grade I head neck pain can progress to grade II and III when neglected. A sure sign that it is getting worse is increasing tingling, numbness or pain in the arm, and particularly if placing your hand on your head relieves the pain in your arm.
Avoid the gym at this time; it might help but the risk of making the condition worse is relatively high.
An aside. You are a chiropractic patient. Is there anything important that you would like your chiropractor to know?
A Mr S. consulted me about six weeks ago with head neck pain that turned out to be a Thoracic Outlet Syndrome. It started a year earlier whilst on holiday in Italy, perhaps after playing tennis which he hadn't done for some years. In the left arm, possibly from throwing the ball up to serve. This action requires use of the neck muscles, raising the arm, collar bone and first rib.
Severe pain in the chest, neck and left arm began in the middle of the night and, assuming the worst, they rushed off to the nearest hospital. A nightmare - they were on holiday in Florence.
Extensive heart tests, both that night, and after he returned to
Holland revealed nothing amiss with his heart. Unfortunately, nobody
considered a musculo-skeletal cause of the pain, or whether Adsons Test,
the classic orthopaedic test for TOS could be positive.
ADSONS TEST ... video.
The pinched nerve in neck pain continued to plague him on and off, particularly with tingling in the arm at night, which would waken him. Twice more his wife rushed him off to the hospital in the middle of the night. A stent was mooted even though nothing specifically wrong with his heart could be found.
Why chest pain? The ribs attach posteriorally to the spine, but
in the front they articulate with the breast bone. A dysfunctional rib
may also cause pain in the front of the chest. Nevertheless obviously it
is important to rule out at heart attack first. Do you know the classic
signs of a
HEART ATTACK ...
For more interesting cases from the Chiropractic Coalface, follow the link below. Yesterday, for example, after only five treatments a patient was bemoaning the fact that he had suffered from this condition for over a year, yet chiropractic had fixed it so quickly. In fact, after the first treatment it was already 80% better. Miracles we do at once, the impossible takes a little longer! "Don't tell me. Tell you doctor! And your neighbour too!"
Some understanding of the anatomy of the cervical spine - the atlanto axial joint anatomy, at the top of your neck - may be of interest to you. If not, skip the link:
CERVICAL FACET SYNDROME and STIFF NECK EXERCISES
Astonishingly, TEN YEARS AFTER a whiplash injury, only 12% of the victims have absolutely no symptoms.
For the remaining 88% ... research by a group of orthopaedic
surgeons states that a majority are suffering from a cervical facet
syndrome. That would confirm my experience as a chiropractor ... worse,
unless carefully managed, leads inexorably to arthritis of the neck.
CERVICAL FACET SYNDROME ... Read more …
Neglected, the lower neck syndromes almost inevitably lead to NECK ARM PAIN ... tingling in the fingers, carpal tunnel syndrome, frozen shoulder, and the like. One solution is STIFF NECK EXERCISES FOR NECK PAIN ...
HEADACHE and the ATLANTO OCCIPITAL JOINT
Some 80% of headaches are reckoned to be 'tension headache'. This is not from stress / tension, but tension of the meninges surrounding the neck and brain.
If you are taking more than half a dozen analgesics per week
then it is definitely time to consider chiropractic treatment. Remember
that Rebound headache is CAUSED by over-dosing with painkillers. It's
also what causes headache.
The pills you are taking may actually be CAUSING your headaches! Probably 10-20% of my day is taken up with patients suffering from headaches.
Getting them off the anti inflammatory drugs, or at least greatly reducing them is usually not a problem. What is particularly destructive is dual antiinflammatory drugs.
In the practice one often finds that migraine has been misdiagnosed: Any severe headache is called a migraine. Not so. What makes true migraine headache difficult is that there are a number of causes. Food allergies, a problematic tooth or jaw joint, an eye problem, a neck condition. Read more ...
Whiplash is pooh poohed in many medical and insurance circles, but after nearly thirty years in practice, I have come to the conclusion that not many people escape completely unscathed from a car accident. I am personally one of the lucky ones. I was hit from the side, which is often the worst, because of damage to the uncovertebral joints of Luschka, some twenty years ago, and I have absolutely no problems. Perhaps because I was treated promptly by a colleague, and so didn't develop the dreaded immobilisation arthritis.
I treat many, many people with neck pain and headaches. On questioning, we realise that most can trace the condition back to a whiplash that apparently, mysteriously, caused no injury. But down the road you realise otherwise.
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Meantime, use the search function near the top of the left column to find more information about subject material mentioned on the page, where links have probably been removed.
It remains pure mystery how a whiplash that caused no obvious injury could years later prove to be the source of your stiff neck and headache.
That was until research proved that immobilisation arthritis was the spoke in the wheel. When a joint isn't moving normally, the hyaline cartilage is starved of normal nutrition and oxygen, waste products build up, and slowly, slowly, undetected, arthritis.
It's now been proved beyond all doubt: FIXATIONS CAUSE ARTHRITIS.
Chiropractic periodically gets bad press when a patient has a stroke after treatment. A case 3-4 years ago occured 17 days after the treatment! Another that gained wide negative publicity, on investigation, proved that the chiropractor treated only the patient's foot! But the newspaper headline: CHIROPRACTOR STROKES PATIENT had already done its damaged.
People have strokes, and just because they consulted a chiropractor in the last month, that does not mean that was the cause. In fact, research proves that people who had strokes were equally likely to have consulted their medical doctor in the last weeks as their chiropractor. The stroke was developing and had nothing to do with what the medical doctor, or chiropractor, were doing.
The chiropractic adjustment is probably the safest medical
procedure in the treatment of head neck pain. There are one in two
million manipulations serious mishaps after neck adjustments. We as a
profession are not in denial; and we do our best to identify those at
higher risk. Statistically you are more likely to be struck by lightning
on the golfcourse than have a stroke after a chiropractic adjustment.
Read what the latest research on stroke proves.
Popular story teller, chiropractor Bernard Preston, daily confronted with patients suffering from head neck pain, tells of his brush with STROKE ...
HEAD NECK PAIN: TEMPORO-MANDIBULAR-JOINT pain. TMJ anatomy
The jaw joint is a major cause of head neck pain and facial pain. It's a very complex joint, so this next very interesting, but perhaps difficult page will certainly give you some insights, if you think you may have this problem. Clicking sounds in the jaw and pain just in front of the ear and the muscles around the jaw are the cardinal signs. For more info about the TMJ, follow the link.
Meantime you might be interested in these little exercises if you
suspect your head neck pain is coming from your jaw, or if you are
experiencing jaw joint pain.
The TMJ is a common cause of head neck pain and especially one
sided headache just ABOVE the ear. Where you'll find the Temporalis
muscle, a great big jaw muscle. Sorry, but you will have to learn some
And much more about what causes headache.
HEAD NECK PAIN and the Rotator Cuff are intimately connected,
not only because they share muscles and bones, but because the nerves
that innervate the shoulder come from the neck. For more about shoulder
pain, click here:
ROTATOR CUFF ...
WHY DO WE HICCUP ?
Hiccuping is a complex subject, but at the heart of the problem is a large muscle called the Diaphragm. It separates the chest cavity from the abdomen. The Diaphragm is ennervated by the Phrenic muscle that comes from the neck, C3-4-5 nerve roots. It's a common complaint in infants, the hic often responds readily when treated with Colic Chiropractic. COLIC CHIROPRACTIC ...
LINKS @ HEAD NECK PAIN
Go from HEAD NECK PAIN to CHIROPRACTIC NECK PAIN TREATMENT ...
Go from Head Neck Pain to CHIROPRACTIC HELP home page …
Olives and Olive Oil contain an anti-arthritic substance. Olive Pate ...so easy to make.
I receive many questions at Chiropractic Help. It might be help for a spinal condition, but it could also be about a failed Carpal Tunnel operation, or some such thing.
I will do that by answering your questions personally, but it will be converted to a Web Page so others can benefit from your questions. Omit your name if you like...
However, do understand that, in the main, I'm going to be directing you (should it be pertinent) to a Chiropractor in your neck of the woods. I'll respond to all reasonable inquiries, but please be specific, and give some details: which fingers, what increases the pain, and relieves it, injuries, do xrays show anything, does placing your arm on your head relieve or increase tingling in the arm... without these sort of details, I'm unable to give a sensible answer.
Please also don't write from your blackberry or iphone. Many many people will be reading what you write, and I don't want gobbledygook at chiropractic help. It lowers the tone of the whole site.
There is no charge for this service, however if you find my answer useful, you might like to consider purchasing my latest book, Stones in my Clog. Gems, both funny and healthful, from the life and work of a Chiropractor. It's only $2.99. Stones in my Clog ...
Pose Me A Question! Pretty please, in decent grammar and spelling.
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Interesting challenges of the day
1. Mr B has the trophy for the most acute neck in February. He has quite advanced lower neck arthritis for a forty year old, thanks to a severe fall on the head from a trampoline. But this is upper cervical pain. Right rotation is simply impossible. Luckily he is improving rapidly, eighty percent better he says after three treatments. See cervical facet syndrome.
2. Mrs C is a new patient with a long history of lower back pain, hip pain and pain in both feet. We'll see how we get on, Rome wasn't built in a day.
3. Miss U sprained her ankle two months ago, wearing high heels. She still has severe mid foot pain. Xrays and perhaps a CT scan.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of foot. It started after a long drive in the car. Update, she's forty percent less painful after four treatments, but the leg is still numb. Update two; she 60% better, but it's slow and is going to take the full 6 weeks to heal. Further update; a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. Mrs Y, a 70 year old woman is on maintenance care fo a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection in the shoulder. After 4 operations he is incapacitated and going rapidly down hill.
8. Mrs Z, an 78 year old woman is doing remarkably well with a bad sciatica. But at over 200 lbs she is not losing weight, in fact gaining despite my suggestions. She's high risk for a stroke. Referral to a dietician to crack the whip.
9. Mr A, a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. Reassured him it's not hip arthritis.
10. Mrs B, a 64 year old woman has had Scheuermanns disease; it's left with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment, provides she come every six weeks or so for treatment.
11. Mr C, a young engineer fell off his mountain bike injuring his cervical spine and pelvis. Luckily both responded very quickly to a few chiropractic adjustments. Update: his neck is sore again. It all goes back to a whiplash injury ten years ago when he was rammed by a fully laden truck carrying a load of stone. Time for Xrays.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes. Chiropractors shouldn't be treating the elderly? Bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional
response which turned out to be exactly correct. I now consult a local chiropractor.
You write a superb newsletter, too.
Your own unresolved problem. Pose a question
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.