Your neck, also called the cervical spine, begins
at the base of the skull and contains seven small vertebrae.
Incredibly, the cervical spine supports the full weight of your head,
which is on average about 12 pounds. While the cervical spine can move
your head in nearly every direction, this flexibility makes the neck
very susceptible to pain and injury.
The neck’s susceptibility to injury is due in
part to biomechanics. Activities and events that affect cervical
biomechanics include extended sitting, repetitive movement, accidents,
falls and blows to the body or head, normal aging, and everyday wear
and tear. Neck pain can be very bothersome, and it can have a variety
of causes.
Here are some of the most typical causes of neck pain:
Injury and Accidents:
A sudden forced movement of the
head or neck in any direction and the resulting “rebound” in the
opposite direction is known as whiplash. The sudden “whipping” motion
injures the surrounding and supporting tissues of the neck and head.
Muscles react by tightening and contracting, creating muscle fatigue,
which can result in pain and stiffness. Severe whiplash can also be
associated with injury to the intervertebral joints, discs, ligaments,
muscles, and nerve roots. Car accidents are the most common cause of
whiplash.
Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.
- Osteoarthritis, a common joint
disorder, causes progressive deterioration of cartilage. The body
reacts by forming bone spurs that affect joint motion.
- Spinal
stenosis causes the small nerve passageways in the vertebrae to narrow,
compressing and trapping nerve roots. Stenosis may cause neck,
shoulder, and arm pain, as well as numbness, when these nerves are
unable to function normally.
- Degenerative
disc disease can cause reduction in the elasticity and height of
intervertebral discs. Over time, a disc may bulge or herniate, causing
tingling, numbness, and pain that runs into the arm.
Daily Life: Poor posture,
obesity, and weak abdominal muscles often disrupt spinal balance,
causing the neck to bend forward to compensate. Stress and emotional
tension can cause muscles to tighten and contract, resulting in pain
and stiffness. Postural stress can contribute to chronic neck pain with
symptoms extending into the upper back and the arms.
Chiropractic Care of Neck Pain
During your visit, I will perform exams to
locate the source of your pain and will ask you questions about your
current symptoms and remedies you may have already tried. For example:
- What have you done for your neck pain?
- Does the pain radiate or travel to other parts of your body?
- Does anything reduce the pain or make it worse?
Especially with new patients or patients with new episodes, I will do physical
and neurological exams. In the physical exam, I will observe
your posture, range of motion, and physical condition, noting movement
that causes pain. I’ll feel your spine, note its curvature
and alignment, and feel for muscle spasm. A check of your shoulder area
is also in order. During the neurological exam, I’m testing
your reflexes, muscle strength, other nerve changes, and pain spread.
In some instances, I may order
tests to help diagnose your condition. An x-ray can show narrowed disc
space, fractures, bone spurs, or arthritis. A computerized axial
tomography scan (a CT or CAT scan) or a magnetic resonance imaging test
(an MRI) can show bulging discs and herniations. If nerve damage is
suspected, I may order a special test called electromyography
(an EMG) to measure how quickly your nerves respond.
Chiropractors are conservative care doctors; our scope of practice does not include the use of drugs or surgery.
If I diagnose a condition outside of this conservative
scope, such as a neck fracture or an indication of an organic disease,
I’ll refer you to the appropriate medical physician or
specialist. I always ask for permission to inform your family
physician of the care you are receiving to ensure that your
chiropractic care and medical care are properly coordinated.
Neck Adjustments
A neck adjustment (also known as a cervical manipulation) is a precise
procedure applied to the joints of the neck, usually by hand. A neck
adjustment works to improve the mobility of the spine and to restore
range of motion; it can also increase movement of the adjoining
muscles. Patients typically notice an improved ability to turn and tilt
the head, and a reduction of pain, soreness, and stiffness.
Of course, I will develop a
program of care that may combine more than one type of treatment,
depending on your personal needs. In addition to adjustments, the
treatment plan may include muscle stim, moist heat, ultrasound, mobilization, massage or rehabilitative
exercises, or something else.
Research Supporting Chiropractic Care
One of the most recent reviews of scientific literature found evidence
that patients with chronic neck pain enrolled in clinical trials
reported significant improvement following chiropractic spinal
manipulation.
As part of the literature review, published in the March/April 2007 issue of the Journal of
Manipulative and Physiological Therapeutics,
the researchers reviewed nine previously published trials and found
“high-quality evidence” that patients with chronic neck pain showed
significant pain-level improvements following spinal manipulation. No
trial group was reported as having remained unchanged, and all groups
showed positive changes up to 12 weeks post-treatment.
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