Head Neck pain

Keywords; head neck pain, chiropractic help, what causes headache, arm pain, thoracic outlet syndrome.


What's needed is a classification system to determine just how bad our pain is.

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.

Here's a quote from the Kidney Foundation website. Generally, when used as directed, over the counter analgesics are reasonably safe. On the other hand, long term or heavy use of drugs, especially those that contain a mixture of painkilling medications in one capsule, have been associated with chronic kidney disease. Read the labels and beware should you see aspirin, acetaminophen and caffeine, for example, all in one pill.

Three layers of tissues, the meninges, cover the brain

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

  • Really severe pain,
  • Neck pain which radiates down the arm
  • Stiff neck and headache
  • Neck pain and a fever
  • Headache and a fever
  • Pain which you know is not getting better



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.

Make sure you tell as accurately as possible any old injuries and illnesses that you may have had. I certainly, and I presume others have too, missed that a patient has had breast cancer, for example. It's not common but every chiropractor will have had patients who have metastases from an old, and presumed quiescent, cancer. That's why a complete lifestyle change is so important after cancer. Never accept the we got it all statement; don't live in terror of cancer but do change what you eat, and don't eat. Changing to a healthy lifestyle is important for us but particularly for the cancer patient. Otherwise it just comes back, often years later.

Or a car accident that happened thirty years ago, and was presumed irrelevant. It's those old injuries that cause the chronically fixated joints that become arthritic.


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 for head neck pain

  • Grade I head neck pain:

    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.

  • Grade II cervical neck pain:
  • 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.

  • Grade III cervical neck pain:
  • 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.

  • Grade IV cervical neck pain:
  • 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.

  • Grade V neck pain: Signs or symptoms of major structural pathology, such as fracture, myelopathy, neoplasm, or systemic disease; requires prompt investigation and treatment, and probably a consultation with a specialist. Certainly if the condition is not responding within a few weeks to conservative treatment.



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 upper extremity is a subluxated first rib deep in the neck. It may cause scalene muscle spasm, together pinching the artery and nerves. The classic clinical sign is increased pain and tingling in the arms and hands when raising them above your head.

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 dripping nose. Neglect it and you will get bronchitis, then pleurisy and finally a good dose of pneumonia; now it's 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 one head neck pain can progress to grade two and three when neglected. A sure sign that it is getting worse is increasing tingling, numbness or pain in the arm, and particularly if raising the limb relieves the pain.

Avoid the gym at this time; it might help but the risk of making the condition worse is relatively high.

Here's an aside for your interest. You are a chiropractic patient. Is there anything important that you would like your chiropractor to know? Patients and their doctors often don't click. It may be that your doctor isn't listening to you. Is he always running late? He or she may be the best doctor available, technically, but if he doesn't expain things, or there are other things that irritate you, then it's best to speak frankly. Let's hear your opinion.


ADSON'S TEST

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 ...


CHIROPRACTIC COALFACE

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:

  • CHIROPRACTIC COALFACE ...


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.

  • The most usual cause is the Cervical Facet Syndrome in the upper neck. (link above) You may be interested in some of the anatomy of this area. This is a page that describes it succinctly, and simply. It's interesting, and if you are a headache sufferer, you will be especially intrigued. Read more about the Atlanto Occipital Joint ...
    ATLANTO OCCIPITAL JOINT …

  • Tension in the neck muscles , for example after long periods of studying with the neck flexed is another common cause of headaches and neck pain.
  • Another rare cause is meningitis. High temperature, stiff neck and a headache. Straight to hospital. Fortunately, brain tumours are a very rare cause of headache.
  • MENINGITIS …


REBOUND HEADACHE

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.


MIGRAINE HEADACHE

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 Chiropractic

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.



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.


STROKE

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 TMJ anatomy. And much more about what causes headache.

SHOULDER PAIN

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


Contact me directly right here.

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, and Google is now downgrading sites with poor grammar and spelling. I just won't answer.

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.

I will never give or sell your e-mail address to anyone.

PS. If you find my answer instructive, would you please ask a friend to rate the page. Many thanks.

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Interesting challenges of the day

1. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

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. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

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.