Neck pain anatomy casefile

The famous van Gogh sketch of a woman sewing displays vividly what garment workers suffer from neck pain.

Neck pain anatomy casefile anecdotes should be treated with caution. They are not scientific proof of anything.

Sometimes x-rays can be very misleading; is the patient's pain actually coming from the very visible arthritis? Perhaps not; could it be what is known as an incidental finding?

Mrs P, a 74 year old Dutch lady consulted me four months ago with a very long history of neck and right shoulder pain. There was frequent tingling in her arm, and severe headaches. She loves to sew.

The only relief she could get would be to hold her neck tightly with her left hand. Exercises given by a physiotherapist helped her shoulder but not her spine.

It all started thirty years ago when she fell at work from the top step, and cracked her head very hard against the plinth at the bottom.

Working as a telephonist aggravated the pain as she held the receiver between her shoulder and neck.

Do you recognise the artist? On the original, which I confess I don't have, you would find a simple V for Vincent.

Pinched nerve in neck is always a factor for telephonists.

Atlanto axial joint

Atlanto axial joint anatomy, grasping the details, helps clarify the muddle that a very arthritic neck can be.

Sometimes things fall happily. Murphy isn't always at his best! He must have slept in with a good Irish hangover that day; if I'd seen Mrs P's x-rays in the beginning, I would certainly not have adjusted her neck; she has the cervical spine of a woman of 90; a terrible curve, and horrible arthritis.

But, and it's a big but - her main complaint: suboccipital pain was coming from an area where there is no arthritis - but a very severe atlanto axial anatomy subluxation. It had affected the Greater Occipital nerve for thirty years giving her blinding headaches. ATLANTO AXIAL JOINT ANATOMY ...

A thorough knowledge of the neck pain anatomy casefile, and an indepth examination are essential to get to the root of problems like these.

Neck pain anatomy casefile

Neck pain anatomy casefile asks if the bad arthritis in the cervical spine actually is the cause of the symptoms?

Lateral x-ray displaying the anatomy of neck pain.
AP x-ray reveals the source of neck pain.


The acromioclavicular joint, the second most arthritis articulation in the body after the thumb, is the source of much shoulder pain.

Her shoulder complaint was coming primarily from the AC joint. When she fell down the stairs she recalls having desperately grabbed at the rail to stop herself from falling, alas without success. And gave her AcromioClavicular joint a good thump or "Klap" as we say here in Nederland. It's really a quite separate condition in this neck pain anatomy casefile.

Foot pain

Foot pain demands a diagnosis; is it coming from the ankle, one of the many little joints, or is it plantar myofasciitis or something else?

She was also suffering from one of my favourite conditions; metatarsalgia, and we were fortunate to catch it before it caused a Morton's neuroma.

Foot pain is horrible, and actually effects your longevity. Research shows that people who can't and do not walk fast, actually live a shorter lifespan. In this condition the nerves between the bones in the forefoot, the metatarsals, are irritated.

When pain or poor health strike, if it does not pass over within a few days, it is important to apply your own mind. Just taking analgesics which cover up the cause may mean that you will have this problem for life.

Should you be doing more exercise, or are you on a highly inflammatory diet? Perhaps you are sitting too long, or need to look for a different computer station.

Could it be that your shoes don't fit properly?

Pain under the foot, often a heel spur or plantar myofascitis usually responds well to Chiropractic help, just as did her neck pain.

Foot complaints can rarely be the result of neck pain leading to cervical stenosis but far more likely is this callus of metatarsalgia.

Chiropractic help

At the heart of Chiropractic help are two important facts, especially relevant in any neck pain anatomy casefile:

  • Joints that remain fixated become arthritic. The hyaline cartilage in the joints is utterly dependent on movement within the joint for its nutrition. The alternative? Immobilisation arthritis.
  • If nothing is done, waste products of from the cartilage are not cleared away and begin to irritate the nerve. Tingling in the beginning, and eventually worse, depending on the nerve. Headache, weakness in the limb, numbness ... in the foot a Mortons neuroma.

This is vital in any neck pain anatomy casefile; prevention of degenerative joint disease by keeping the joints in motion.


It was wonderful to hear the progress from Mrs P this morning: "Mijn nek is fantastisch;" my neck is fantastic. Her foot and shoulder are also much improved.

After 8 treatments she said her neck and headaches were 80 percent better over a period of a month. Now she comes for a treatment every four to six weeks; there is alas no hope of a cure.

I won't ever cure Mrs P's neck any more than I can fix her hypertension; both need occasional but regular chiropractic help and medical care.

It really is a horrible neck and frankly neither she nor I can believe how pain from thirty years can be so quickly relieved.

Miracles we do at once, but the impossible takes a little longer; every neck pain anatomy casefile is a challenge to your chiropractor. 

Does every neck respond like this? Sadly not. There are many reasons, some of them completely uncertain; stress? Computers, cars, diet? The arm pain she had was directly related to that lower neck pain anatomy arthritis.

UPDATE: It is now 6 months and she is doing great. I've allowed SOME sewing again. Not the easiest for the neck, and she is doing the stiff neck exercises faithfully.

› Neck pain anatomy casefile

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

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. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

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.

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