Head and neck pain needs a classification system to determine just how bad it is.
It still astonishes me how often I have a new patient with a cervical spine problem of several decades duration who has never consulted a chiropractor. Fifty years ago I can understand; there weren't too many DCs around in those days.
But to have been suffering all those years, 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 migraine, for example.
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 different 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.
Almost everyone will have head neck pain periodically.
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 arising from your slumbers.
Most people die in their beds.
Three layers of tissues, the meninges, cover the brain
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.
"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
Now it's time to get help. After, mm, how many days? That's 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 managed, helped, reduced, relieved, but it won't ever go
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 problem to go away completely. Better still, if you go through a short course of rehabilitation, 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 symptoms will recede completely. Don't wait too long. But don't go too soon either unless it's really severe, or you have a pinched nerve 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).
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...
Do you have vague tingling and pain in your arm?
Another cause of pain running down the upper extremity is a subluxated first rib deep in the neck; that may result in scalene muscle spasm, pinching the artery and nerves. The classic clinical sign is increased ache and tingling in the arms and hands when raising them above your head.
However, if you have a rotator cuff or frozen shoulder injury, obviously this is excepted; raising your arm will naturally increase the pain in your arm.
If it's the rib on the left side, then it may mimic a heart condition, with pain in the neck which radiates down that 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 or neck pain condition can progress when neglected. A sure indication that it is getting worse is increasing tingling, numbness or ache in the arm, and particularly if raising the limb relieves the symptoms; that's called the shoulder abduction relief sign.
Avoid the gym at this time; it might help but the risk of making the condition worse is relatively high. Don't carry heavy parcels in the outstretched arm.
Here's an aside for your interest. You are a 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 he isn't listening to you. Is he always running late? He or she may technically be the best in town, but if he doesn't explain things, or there are other factors that irritate you, then it's best to speak frankly. Let's hear your opinion.
Sleeping on your tum is a recipe for chronic head neck pain; get that left shoulder and arm under and in front of you. Worse, tum sleeping deprives the joints in the neck of normal nutrition; it's one of the causes of arthritis in the spine. If you've also had a neck injury, then you're almost certain to get degenerative joint disease in the spine.
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.
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 ...
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.
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.
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.
Ligaments are highly innervated, so that the brain will know where the neck is in space whilst the eyes are closed. Any excessive stretching of ligaments, as in whiplash, will cause nociceptors in these structures to fire off, giving pain.
If the ligaments are stretched beyond their elastic limits then important changes in the posture of the neck, and the position of the bones will occur, causing further neck pain.
In the normal neck, the curve is known as a lordosis. After a whiplash, the curve is reversed, producing a kyphosis. My take on neck pain anatomy is that Kyphosis equal Pain.
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.
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
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 surname 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.
Stop! Are you about to start typing on your smartphone? The chances are good you are wasting your time and won't get a reply. Google downgrades sites that use not-so-smart grammar.
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 ...
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