(Keywords: SELF MANIPULATION ... tingling in arms and hands ... UncoVertebral joint ... arm pain )
Whether it's using forcible means, as in the photo below, or simply cocking your neck into hyperflexion and extension and making it pop, repeated forceful self manipulation, without distraction, is very serious.
Ask any chiropractor, and s/he will tell you that the most difficult patient in the practice is s/he who begins to manipulate their own joints. It leads inexorably to pain and tingling in arms and hands, and degenerative arthritis in tiny joints known as the Joints of Luschka, also known as the UncoVertebral Luschka joint ...
The "uncinate process" or uncus is a small piece of bone that serves to protect the nerve root from a slipped disc. It forms the delicate "uncovertebral joints".
Chiropractic manipulation uses joint distraction, something the self-manipulator cannot do, to prevent cartilage-on-cartilage trauma during the adjustment.
The tiny Joints of Luschka, aka Uncovertebral joints, are also designed to protect the nerve root, by preventing any lateral movement of the bones in the neck. They only exist in the lower cervical spine. But injury to the cartilage in these joints releases harmful chemicals that inflame the spinal nerves roots... vague, constant, and very irritating pain in the neck.
One wonders how people could possibly start popping their necks in the crazy and dangerous manner. Deaths have been recorded.
Researchers have now established beyond doubt that the hyaline cartilage in all joints is utterly dependent on movement for its proper nutrition. Immobilisation of any joint leads within a very short time, read HOURS (in white mice, anyway) to progressive, irreversible arthritic changes in the cartilage.
Immobilisation of a joint inhibits the normal flow of nutrients and oxygen to the cartilage. And removal of the toxic waste products of cartilage metabolism. Result? Immobilisation arthritis ....
Fixation of the joints is what occurs after trauma, as in the neck after whiplash such as in MVAs, diving into shallow water, or cracking your head against the bottom of the pool, a fall down the staircase, falls and collisions in various contact sports... however it can occur to any part of the spine, and the little joints in the ankle after an ankle sprain, for example. Uncorrected such injuries, and joint
the cartilage endplates of oxygen and nutrients causes an insidious
discomfort and irritation in the joint. Enter self manipulation ...
sufferers discover that turning and wriggling their heads, and sometimes manipulating
their necks brings relief from the real discomfort associated with degenerating cartilage and irritated nerves. Nothing will be seen on X-rays for five or more years, but the cartilage in the spines of mice, where fixations have been mechanically made, has under the microscope, histologically, has been seen to begin degenerating within thirteen hours.
The problem? The relief is very temporary, and within an hour sufferers need to manipulate their spines again, and again, and again.
See folk contorting and trying to pop their own necks like this? It's a sign that fixated joints are starving the cartilage of oxygen and nutrients. Specialists now acknowledge that early on there is little to be seen on X-ray in the progressive development of neck arthritis.
Manipulation by your chiropractor. Can there be too much also?
There is regrettably no research on this difficult question, but there is no doubt in my mind that too many adjustments of any single joint, simply adds to the problem rather than the solution. Just as rebound headache is actually caused by over use of analgesics, too many adjustments, in my opinion, can cause rebound cervical spine pain and ultimately radiating arm pain ...
That is simply my own opinion, based on nothing more than over thirty years in practice, that adjustment of any joint more than twenty to thirty times in a twelve month period, is probably too much manipulation. Others would disagree. I do it very occasionally in exceptionally difficult cases, but reluctantly, with the knowledge that my treatment may have become, through over-manipulation, part of the problem, rather than the solution.
Is this creating doubt in your mind? Well, just as you need to be doubtful of surgery and drugs, you need to consider just how much Chiropractic adjustment of your spine is healthy. Just as there are doctors who will give you umpteen prescriptions of anti inflammatory drugs I can promise you there are chiropractors who will happily manipulate your spine fifty, or even one hundred times in a year.
And self manipulation ten times every day? Sheer madness.
Most self manipulators seem to find themselves popping their own necks ten or more times every day. Put differently, in two to three days they manipulate their joints more than I consider healthy in a whole year. Inexorably there is injury to the cartilage lining the Uncovertebral joint Lushka and contributing to the cervical facet syndrome ... The net result is more and more neck pain, and ultimately pain and tingling in the arms and hands as the nerves are injured.
This is a difficult, vexed question. The spine has already had too much manipulation, manipulation done without distraction, injuring the hyaline cartilage that lines the bones in the joint. Yet if your chiropractor doesn't adjust your spine occasionally, and regularly, you will start manipulating it ten or more times a day again.
If you don't stop there's trouble coming, and probably BIG trouble. Complications of surgery ...
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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?
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