(Keywords: neck pain treatment, chiropractic, head neck pain, home traction unit )
Cervical spine manipulation (in Chiropractic terms, an "adjustment") per se is not usually painful with chiropractic. Let's say candidly though that really bad head neck pain is much more painful than a very sore back. A sore neck can bring you to tears. Literally.
The consultation always begins with a thorough HISTORY. Your chiropractor will ask you questions like, Where does it hurt? and When did it begin? What makes it worse, and does it run down your arm or give you headaches?
70% of the time, research shows, experienced doctors can make an a pretty shrewd diagnosis of your neck pain just from the history.
Neck pain is often caused by old injuries that caused
fixations in your neck, often unknown to you. It has now been proved
fixations slowly but surely lead to arthritis ( Chiropractic subluxation )
in the neck, causing stiffness, pain and perhaps tingling in the arm,
long after the injury has been forgotten. Why? Because they starve the
joints of vital nutrients.
Strawberries for an arthritic neck? Yes, ma'am! INTERESTING FACTS ABOUT STRAWBERRIES ...
Fish oil, freshly ground flaxseed, walnuts and pecans too are important for arthritis in the neck.
Before starting the chiropractic neck pain treatment your doctor will ask searching questions that may yield important clues.
So, scratch your head, dig deep, those little details can be very important. For example, if you get tingling or pain in the arm, do movements of your neck provoke the tingling? Which movement? Or is it constant? Which fingers? Do you get relief from the tingling in your arm by placing your arm on your head?
Alternatively, if raising your arm above your head, as in hanging the washing, increases the fatigue and tingling we usually think first of a Thoracic Outlet syndrome ...
S/he may well use this simple examination procedure to determine whether the pain in your arm is caused by a pinched nerve in the neck. Interestingly, mouse arm has now been shown to have an underlying neurogenic basis. Upper Limb Tension Test ...
FROM THE COALFACE
Mr Jones entered the consulting room with a thick scarf around his neck, even though it was midsummer. His wife was close behind him. One look at his face, and his hand clutching his neck in support, left me in no doubt where the problem was. A very sore neck. To turn his head, he turned his whole body.
'When did it start, Mr Jones?'
'Yesterday,' he said in a whisper.
'Do you have any idea what happened?''
'I was fine when I woke up,' he said. 'As I sat up I felt a sharp stab in my neck.' He had a stricken look on his face.
To cut a long story short, as I move to exam him, tears of doubt immediately filled his eyes. He didn't want anybody anywhere near his neck, let alone someone whom he thought might cause him great pain.
Mrs Jones spoke for the first time. 'Jerry was at Israeli judo yesterday. Do you think that could have anything to do with it?'
Before starting the chiropractic neck pain treatment your doctor will ask searching questions that may yield important clues. So, scratch your head, dig deep, those little details can be very important. For example, if you get tingling or pain in the arm, do movements of your neck provoke the tingling? Which movement? Or is constant? Do you get relief from the tingling in your arm by placing your arm on your head?
Looks horrific, but you'd be pleasantly surprised. Tweety didn't complain!
Neck pain treatment is always preceded by an examination which will be thorough as your doctor seeks to understand the exact nature of your condition.
It will usually start with a POSTURAL ANALYSIS. The underlying root cause of your neck pain may be a flat foot, a short leg, an imbalance in the pelvis or another seemingly unrelated problem.
RANGE OF MOTION tests of neck will follow. Which movements are restricted, which cause pain? In particular, do any movements of your neck immediately cause pain or tingling in your arm, or dizziness?
Then will follow ORTHOPAEDIC and NEUROLOGICAL tests. At the heart of chiropractic is the influence that these subluxations in your neck may have, causing not only neck pain, but influencing any of the many organs innervated by nerves that emerge from tiny openings called foramina in your neck. This following test for a frank pinched nerve you could do at home:
This will be followed by an examination of the MUSCLES in your neck and shoulders. Subluxations in your neck, as well as poor posture may cause muscular imbalances, and pain in the muscles themselves.
A MOTION PALPATION examination in the patient with neck pain is an extremely important part of chiropractic treatment. Knowing which bones in your neck to adjust, and how to adjust them, is a vital part of curing your headaches, neck pain, arm pain and in improving your general health.
While chiropractors do not make many claims about curing other 'medical' conditions, it is astonishing how many patients ask if their sinusitis, asthma, stomach pain could have been helped by the chiropractic treatment they have been receiving.
Thereafter your doctor may look for signs in the shoulder, arm, elbow and hand, as conditions such as frozen shoulder and carpal tunnel syndrome usually issue from a neck condition.
Finally, before starting your neck pain treatment, your chiropractor will do a general medical examination, checking your blood pressure, look for swollen lymph nodes, listen to your lungs, and perhaps even do a breast exam. It's always advisable to take a family member along for the first consultation. Because the nerves to the arm (the so called brachial plexus) travel close to the lungs and breast, these organs can also have an effect on your arm.
X-RAYS are not always taken before the neck pain treatment begins, but they frequently reveal important information that your doctor could not otherwise have guessed.
A picture is worth a thousand words, but because of the radiation, much as we would like to have X-rays of every neck, we only X-ray obviously difficult cases, and cases where the progress is not satisfactory.
Sitting for long periods with poor posture causes inevitably neck pain. This lady, painted by famous Dutch painter Gerard ter Borch, has pain!
Looking at the neck from the side, it has a normal curve, called the 'cervical lordosis'. Injury and even poor posture can change this curve, causing either a straight neck, a forward bending neck (called a 'cervical kyphosis') and even increase the lordosis. Changes in this normal lordosis, in my experience, are always associated with pain.
Chiropractic neck pain treatment adjustments can sometimes make dramatic changes to this pattern, but poor posture will contribute to a relapse. Expect your chiropractor to ask searching questions about your computer station and your desk. Look to the bottom of this page for a good alternative.
Data was collected directly from chiropractic neck pain treatment patients in a very large study after 28 807 neck pain treatments in order to find out whether there was worsening of symptoms, and what beneficial effect the treatment had. JMPT March 2008 abstract: http://www.jmptonline.org/article/S0161-4754(08)00030-4/abstract
What did they find?
The presenting symptoms were “neck pain,” “shoulder, arm pain,” “reduced neck, shoulder, arm movement, stiffness,” “headache,” “upper, mid back pain.” If patients had one of these symptoms, 70% responded that they experienced immediate relief after chiropractic treatment. If four of these symptoms were present, then 95% stated that they had immediate relief.
With regard to immediate worsening, 4.4% stated that they felt worse.
There were no serious side effects after any of these neck pain treatment manipulations. Any worsening was of a very temporary nature.
STIFF NECK EXERCISES FOR NECK PAIN ...
Interesting research in Spine journal (Feb 2009) shows that one can exercise the neck during neck pain treatment by raising your arm to the side . Raising your right arm to the side, what we call abduction, to 90 degrees, with a 2kg weight in your hand, causes the cervical vertebrae (all of them) in healthy people to rotate to the left.
Interestingly, raising your right arm to 120 degrees causes a counter rotation, the lower cervical vertebrae to the left and the upper vertebrae to the right.
Clinically, what we are unsure of is: should you raise one arm, and thereafter the other? Or only one arm, if you have pain on the right say? (and which arm would have the most benefit?)
And if you have upper neck pain, is the counter rotation of raising the arm to 120 degrees (to the side remember), more beneficial, or counter-productive? We just aren’t sure.
Suggestion: So, be your own researcher.
Learn to be your own researcher. Test what works best for your body. There are so many unknowns still in health care. It could be that if you have a short right leg, you should raise the right arm, but maybe the left. We just don’t know. Get to know your own body.
Ps. We would love some feedback. What did you find? What should the chiropractic scientists be researching?
Is Chiropractic treatment painful?
Research proves that neck pain treatment is usually very successful with chiropractic. 70% of patients report immediate improvement (see more below). The treatment is not usually painful, even in the patient with a very painful neck. It should be acknowledged that there are exceptions, but these will be few and far between.
Mostly there will be some loosening of the neck, mobilisation and stretching, in preparation for the manipulations. Your doctor may do some massage, may use some physiotherapeutic treatments such as dry needling, ultrasound and various electrical treatments.
The chiropractic adjustment itself may be a little frightening the first time you experience it.
Research has shown that manipulation done by an experienced chiropractor is really very safe. Far safer than the anti-inflammatories that are prescribed without undue concern. They cause thousands of deaths from bleeding ulcers every year. Literally, no exaggeration. However, like all treatments, there is an element of risk with chiropractic neck pain treatment too. Some pain may be experienced after the treatment, but this is usually after of a short lived nature. An ice pack placed (in a facecloth) on the painful parts will bring relief.
Are there any dangers associated with Chiropractic neck pain treatment? Yes, there are, but they are extremely few and far between and in comparison with the dangers associated with anti inflammatory drugs the chief danger associated with manipulation, viz Stroke Chiropractic is extremely rare at around 1/ million manipulations.
How many treatments?
It must be acknowledged that this is very dependent on your problem. Some neck pain treatment conditions respond immediately, some take months of treatment.
Broadly the neck pain treatment will fall into three parts, if the condition has been present for more than six months:
1) The TREATMENT PHASE. In this phase your doctor will be dealing with the problem, reducing your pain and stiffness by adjusting the subluxated vertebrae. This will also reduce any nerve irritation or pressure that may be present.
2) The REHABILITATION PHASE, sometimes called the STABILISATION PHASE. During this phase many exercises will be given. The intention is to strengthen your neck, to prevent a relapse, and so that you won't need to come for treatment several times a week for months and months.
3) The MAINTENANCE PHASE. It is the conviction of chiropractors that an occasional, regular treatment has much benefit in preventing relapse. In this regard you will be encouraged to have an adjustment occasionally. How occasionally? That depends on your problem. Perhaps once a month, perhaps once in six months. On average perhaps every two or three months.
A really painful neck is far more painful than a sore back
Nevertheless, neck pain treatment is not usually particularly painful.
can be a very beneficial part of back pain treatment. Much of neck pain
is simply too many hours spent at the wheel of the car, or stuck in
front of a computer. An occasional but regular massage can do wonders
for overworked muscles.
NECK PAIN TRACTION
Medical research suggests that cervical traction (on its own) has little benefit for neck pain, particularly if there is nerve entrapment.
However, in conjunction with Chiropractic Help, my experience is that traction is a useful adjunct. However, I have no research to support my belief. Alas, still so many unresearched things in Chiropractic...
Either make this HOME TRACTION UNIT ... or purchase a commercially available unit. I prefer those done lying on your back rather than sitting...
Cervical rib or first thoracic rib subluxation?
The nerve and blood supply to the arm pass through a narrow passage called the
inter scalene triangle ...
a spasm of the scalene muscles, a first thoracic rib subluxation and very rarely large
may interfere with these vital structure supplying the arm with blood and nerve supply. The condition is called a
Thoracic Outlet Syndrome ...
In short, these structures in the lower neck are the common underlying causes of the many arm pain syndromes confronting your chiropractor on a daily basis. The rotator cuff syndromes, frozen shoulders, carpal tunnel syndromes and tingling in the arms and hands. Arm pain ...
HEAD NECK PAIN
Another approach to the whole question of pain in the face, jaw, head and neck. Could your jaw joint be involved? 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 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.
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Interesting challenges of the day
1. Mr D has very severe midback back. He bent and twisted, feeding his son, and then laughed. Every breath is a nightmare. A sprung rib is every chiropractor's delight. He or she has golden hands. 30 percent better after one treatment.
2. Mrs C has a long history of severe, disabling migraine headaches since having her wisdom teeth removed. She clenches her teeth at night. After six treatments she has no migraines but some jaw joint discomfort remains; a bite plate is in the offing.
3. Mrs U has the trophy for the worst back this year. After major surgery with plates and screws two years later she still had paresis in the lower leg and severe disabling back pain. She's doing far better than expected, in no little part due to a lift in her shoe for a very short leg.
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. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment 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?
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.