NECK PAIN ANATOMY

Chiropractic Help

(Keywords: neck pain anatomy, atlanto axial joint anatomy, chiropractic HELP, atlanto occipital joint, why do we hiccup, slipped disk)

This page will help you understand the complexity of the neck. It is no simple organ. Cervical spine conditions are so common because of the extreme complexity and sensitivity of the many structures in the neck. This brief survey highlights the exquisite construction of the neck, explaining why a painful neck is so common.

The heavy skull and brain are precariously balanced on seven highly complexly engineered and exquisitely made neck bones or vertebrae, each a possible source of neck pain. The cervical spine starts just below the skull and ends just above the shoulder. It normally has a lordotic curve (a backward C-shape) which, if altered by injury, almost always is associated with chronic neck pain. The cervical spine is much more mobile than both of the other spinal regions - think about all the directions and angles you can turn your neck, normally without any painful neck.


The structure is tightly bound together by discs, ligaments and muscles, all potential sources of neck pain.

Not so tight though that it cannot move. 33 joints make the neck highly mobile, though each may be a source of the common painful neck.


Though the cervical spine is very flexible, it is also very much at risk for injury from powerful, sudden movements, such as whiplash type injuries and falls.

This high risk of harm is due to: the limited muscle support that exists in the neck, and because this part of the spine has to support the weight of the head.

This is a lot of weight for a small, thin set of bones and soft tissues to bear. Therefore, sudden, strong head movement can cause damage.

Horse riders and gymnasts, boxers and rugby players almost always have injuries in this region causing a painful neck.


Through the neck travel the most exquisitely sensitive pain structures in the body: the spinal cord and nerves emerging to supply various parts of the body, particularly the arms and scalp.

They are very prone to injury by stretching, as in whiplash, by pinching by facet joints, uncovertebral joints, disc joints and other conditions such as tumours, aneurisms etc.


The BONES, known as vertebrae

Two vertebrae in the cervical spine, the atlas and the axis, differ in their neck pain anatomy from the other vertebrae because they are designed specifically for rotation. These two vertebrae are what allow your neck to rotate in so many directions, including looking to the side. Because of their proximity to the brainstem and the spinal cord, any injury, fracture, displacement, or fixation (jamming) has the potential to cause severe neck pain, headache and a host of neurological conditions. Car accidents, falls, blows to the head commonly injure this part of the spine. The Hangman’s knot is specifically designed to fracture the axis, and rupture the spinal cord. Hence the so-called ‘Hangman’s fracture’, found in serious accidents.


The atlas is the first cervical vertebra -- the bone that sits between the skull and the rest of spine. The atlas does not have a vertebral body, being made up of a complex ring. The atlas sits on top of the second cervical vertebra -- the axis. The axis has a bony knob called the odontoid process, also known as the the dens that sticks up through the hole in the atlas. It is this special arrangement that allows the head to rotate so far from side to side. Special ligaments between these two vertebrae allow a great deal of rotation to occur between the two bones.


Seven delicate and highly complexly engineered vertebrae make up the bony structure of the neck pain anatomy, cushioned by the "inter-vertebral disc".

The black arrow shows where the so-called "hangman's fracture" occurs - through the pedical on both sides. This is also caused by the head hitting the dashboard in a headon collision. One more reason to use a safety belt. Research shows that in most suidicidal hangings there isn't sufficient drop to fracture the pedicles, and the victim dies a horrible prolonged death by asphyxiation.

Notice in this X-ray below how a short leg, giving a tilted pelvis and a scoliosis, goes all the way up into the neck. New research suggests that a heel lift to correct a leg length inequality may also help neck pain.


Joints in the neck.

There are 33 tiny joints between the bones of the neck and between the neck and the skull. The bones are separated by discs, made up of concentric circles of fibrous material with a bubble of gel in the centre, acting as shock absorbers for the all bouncing, jogging, jumping movements of the neck.



There are several different types of joints in neck pain anatomy. Disc joints, facet joints, unco vertebral joints, and some other highly specialised joints in the upper neck, but they all have one thing in common: important nerves, the most sensitive tissue in the body, travel close by.

Any injury, swelling, strain and sprain has the immediate potential to affect the nerves traveling to the neck, shoulder, arm, head and the whole body, causing pain, headache, tingling and dysfunction of the organs they supply.


TMJ ANATOMY

What's more, the sensory nucleus of the nerve to the jaw joint is located in the upper neck. Thus jaw and neck pain are often intimately related, and to be jointly and separately addressed in teh management of facial, neck, and jaw joint pain. TMJ ANATOMY ...

Why do we hiccup ? Hiccuping is a reflex contraction of the Diaphragm muscle, causing a sudden intake of breath that snaps the epiglottis closed. A hic. Irritation of the Phrenic nerve roots (C3-C4-C5), the nerve itself or one of the tissues supplied by the Phrenic nerve are the usual causes. Read more …WHY DO WE HICCUP ?


Nerves and Discs


The so-called brachial plexus is a large group of nerves that emerge from tiny foramena in the neck. They travel to and from the arms, as explained in neck pain anatomy, where they initiate muscle action (eg picking up a sandwich) and sense changes at the skin. Cold, hot, touch, vibration etc. They also tell the brain where the hand is in space for example, without your eyes having to look.


Between each pair of spinal bones is a large disc. It consists of two parts, an outer washer made of very tough fibres and an inner bubble of gel which is like a large shock absorber. whilst reading about neck pain anatomy I feel sure you have heard of the so-called slipped disk in which the gel has bulged out through the surrounding washer. it may cause for example very specific pain, numbness and tingling in fingers one and two ...

Frank pinching of these nerves may cause severe pain and disability in the arm, but even irritation of the nerve roots will cause shoulder pain, and make one prone to other conditions in the lower arm:


Ligaments

The neck is stabilised in the upright position by MANY very strong ligaments, that stretch from bone to bone maintaining the correct structure and preventing a painful neck. Some are tiny, for example the ligaments holding the ring of the atlas in position, whilst others are very large and strong. They are a very important part of neck pain anatomy.

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 these nerves 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 = Pain.

Muscles


Painful neck can originate in the muscles of the neck. The head and neck are able to move because of muscles that control and initiate the movements. Looking up at the ceiling, checking under your bed for your shoes, looking for traffic as you cross the street - all these movements are controlled by muscles. There are also stabilising muscles whose primary function to maintain the neck in the upright position.

Muscles were designed to move. Even maintaining a healthy muscle in the same position for a long period of time (eg sitting in front of a computer, driving a car, or lying on the stomach all night with the head turned) will cause fatigue and neck pain.

There are many large and tiny muscles in the neck, each a source of neck pain anatomy.

I found a page that will give you a simple test that you can do find out how strong your neck muscles are, and some really quite profound neck exercises: JULLS TEST ...


Manipulation of the neck has recently received strong condemnation from Chiropratic's critics as being highly dangerous and can cause a stroke. While this is acknowledged, it is so rare that it can largely be ignored (approximately equivalent to being struck by lightning on the golf course).

What our critics conveniently ignore is just how much more dangerous anti inflammatory drugs and analgesics are. All forms of treatment of any and every condition have potential dangers it should be candidly admitted, and in this regard chiropractic is no different.

I hope NECK PAIN ANATOMY has given you some idea of the complexity of your neck.

We haven't forgotten you, Maureen. One of those very special people. She was one of the 14,000 Americans who die every year from a bleeding ulcer, directly caused by anti inflammatory drugs. That's medicine's own research figure.


WHIPLASH CHIROPRACTIC

Any very sudden, traumatic jolt to the head and neck has the potential to injury all of these structures. That could be when the body suddenly stops, but your head keeps going (as when a car hits a tree), or when something smashes into your head.

This week it was young woman whose head was very forcibly struck by a water ski, last week a child kicked on the head and neck by a horse, every week car accidents, old and new. Falls from a horse, sport, bicycles... all need to be carefully managed, otherwise Immobilisation Arthritis and irritation of nerves almost invariably occurs.


DANGERS OF ANTI INFLAMMATORIES

Go to Kidney.org and see what drugs can do to your organs:  http://www.kidney.org/atoz/atozItem.cfm?id=145

Tip: Especially don't take medication before your consultation with your chiropractor. Deaden the pain and you may confuse him/her. It's far more difficult to diagnose and assess the problem of the drugged patient.


An apparently insoluble neck problem?


Posturite

It's not often that I rave about a commercially available product. However there is no doubt whatsoever that She-who-must-be-obeyed needs less than half the amount of chiropractic help since I bought her a Posturite, quite expensive, worth every cent.


Notice too the small 3 watt LED lamp. We are rapidly changing over to LEDs. Requiring extremely little energy, a fifteen year warranty on the globes, they will quite soon be the only globes available. Solar power generator ...



IMPORTANT CONSIDERATIONS @ Neck Pain Anatomy


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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.