Causes, Symptoms, and Chiropractic Treatment of Neck Pain

Your cervical spine, commonly referred to as your neck, is made up of seven vertebrae. Your "neck" begins at the base of your skull. The cervical spine is responsible for holding your head, which is no small feat considering your head weighs several pounds. But while your cervical spine possesses a great deal of flexibility, allowing movement in many directions, this very same flexibility renders it prone to injury and pain.

The reason for this vulnerability is attributed to the biomechanics of the cervical spine. Repetitive movements, injury, sitting for prolonged periods, or merely the natural process of aging and its attendant side-effects can affect your neck's health. Regardless of the reasons, cervical pain can present considerable discomfort.

Contributing Factors to Neck Pain
Accidents and Injury: Whiplash results from a sudden, abrupt movement of the neck or head that causes a rebound effect that may damage the tissues supporting the neck and head. The so-called "rebound" is a result of muscles reacting to strain by contracting themselves. This contraction results in muscle fatigue, stiffness, and pain. More severe cases of whiplash may be linked to intervertebral joint injury, or to damage to the discs, nerve roots, muscles, or ligaments. Whiplash is commonly associated with car accidents.

Aging: Disorders of a degenerative nature can take the form of spinal stenosis, osteoarthritis, and age-related disc ailments. They all have a direct influence on the spine.

Spinal stenosis narrows the nerve passageways in the vertebrae, making it contract and block nerve roots and thus, impair the nerves. In addition to neck pain, spinal stenosis can also affect the shoulder and arm, bringing numbness and pain to these areas.

Degenerative disc disease affects the height and elasticity of invertebral discs. Ultimately, a hernia or bulge may develop in a disc. This can cause numbness, tingling, and pain along the arm.

Osteoarthritis results in progressive degeneration of cartilage. The body's response is to create bone spurs, which in turn, affects the motion of the joints. Osteoarthritis is a common occurrence.

There are also daily habits that can aggravate the cervical spine. Obesity and poor posture, for example, alters spinal balance and forces the neck to compensate by leaning forward. Emotional strain and stress prompts muscle tightness and compression, causing stiffness and pain. The stress on the spine can result in permanent neck pain, which may also end up affecting the arms and upper back.

How Chiropractic Care Can Help
In order to determine the source of your pain, you must first locate its source. A chiropractic doctor performs exams and investigates your reported symptoms in an effort to locate the exact source of the pain. The chiropractor may ask questions regarding the amount of time you've had the discomfort, what remedies/tactics you've tried, whether other parts of your body are affected, and what, if anything, helps to alleviate the pain. Physical and neurological exams will also be conducted. The physical exam will disclose your range of motion, posture, and general physical shape while noting the kind of movements that bring pain. Your spine will be manually examined to determine its alignment and curvature, as well as establish whether there are muscle spasms. Your shoulder will also be looked at.

In the neurological exam, the emphasis will be on checking your muscle strength, reflexes, extent of pain and how far it has spread. There are cases where other tests might be needed in order to properly diagnose your condition. An X-ray, for example, helps reveal fractures, bone spurs, and a contracted disc space. An axial tomography scan, in the form of CAT or CT scan, or a magnetic resonance imaging test, known as a MRI, shows where a dilated disc may take place. In cases where nerve damage is likely the source of pain, an electromyography (EMG) might be recommended, as it can measure the responsiveness of your nerves.

Cervical Adjustments
Cervical manipulation entails, for the most part, manual adjustment of the neck joints. This type of neck adjustments effectively improves the mobility of the spine, restoring range of motion. In addition, it may also raise the amount of movement of the adjoining muscles. Patients receiving cervical adjustments report an increase in their ability to move their heads, as well as less soreness, stiffness, and overall pain.

Research findings support the use of chiropractic spinal manipulation for the treatment of patients with chronic neck pain. Comprehensive clinical trials reported significant improvement of chronic neck pain as a result of spinal manipulation. All the trial groups responded to treatment, showing improvement for weeks after treatment.

Your Personalized Chiropractic Care
Each patient receives an individualized program care that may include different types of treatment. Other recommended approaches might be the use of massage and rehabilitative exercises, and mobilization of the affected area. Contact your chiropractic doctor; it's an invaluable first step to figuring out how to care for your cervical spine.By Dr Raymond Hall

What Is Whiplash Syndrome?

Whiplash or Whiplash Syndrome is a term used to describe an event in which the cervical spine (your neck) has undergone a rapid acceleration/deceleration which causes damage to the various tissues of the cervical spine. As in a car accident, the forces involved often include an abrupt stop or change in direction. Our head has no support above it and therefore acts as a weighted pendulum, allowing for ranges of motion in our neck to exceed their normal limit.

Unfortunately, the term "whiplash" does not describe the degree or severity of the injuries sustained which may include anything from a minor strain to even death. For this reason, emergency room follow up after involvement in a car accident is the first step to rule out potentially life threatening injuries. Even at low impact speeds, there is a potential for serious injury or death and may even be accompanied by no symptoms at all.

Various structures in our neck (cervical spine) have the potential for injury in this type of accident. Strained muscles and sprained joints and ligaments are very common injuries in motor vehicle accidents. Injury to the spinal cord and/or nerve root(s) are also common features in a whiplash syndrome.

Common symptoms of whiplash may include:

• neck pain,
• neck stiffness,
• neck tightness,
• loss of range of motion,
• neck to upper shoulder soreness.

Common accompanying symptoms of whiplash may include:

• arm pain,
• numbness and/or tingling into the arm/hand/finger(s),
• headache,
• dizziness,
• fatigue.

Common signs of whiplash include:

• tenderness along the muscles of the cervical spine,
• muscle spasm (your body's natural defense response to help "guard" the injury),
• loss of range of motion,
• forward head posture,
• elevated shoulder positioning (of one or both shoulders),
• head tilted or rotated.

Once the risk of life threatening injury is ruled out for whiplash, the next step is to rule out fracture, instability and/or neurologic involvement (injury to nerves, nerve roots, discs, spinal cord). Along with orthopedic and neurologic tests, chiropractors often use x-ray, CT scan or MRI to rule out these possibilities.

By John Herner, D.C

Stress Creates Neck and Shoulder Pain

Lately I've seen patients with a lot of muscle tension in their neck and shoulders. Their shoulders are hunched up under their ears, and their necks so stiff they can barely move them. Severe neck and shoulder stiffness and pain may require physical therapy to alleviate symptoms, but I'd like to share with you the things you can do to both prevent and alleviate neck and shoulder pain.

Causes of Neck and Shoulder Pain

My patients are surprised when I tell them that most neck and shoulder stress/pain is caused by structural stress, simple things we do everyday that can cause neck and shoulder pain:

o Bad posture - Sitting, or standing, with poor posture, or slouching, causes your head to tilt forward putting continual torque on neck and shoulder muscles to prevent your head from sliding forward.

o Raising the shoulder muscles - In our daily routine, we continuously, usually unknowingly, raise the levator scapulae, the major muscles of the shoulders. This creates tension of the neck and base of skull muscles. We do this in a few ways:

1. Typing at a keyboard that is too high - and/or resting your elbows on arm rests of a too low chair while you work at a desk causes your shoulders to ride up. Spend 8 hours everyday, 5 days a week doing this and you can cause pain in your neck and shoulders.

2. Cradling a phone between your ear and shoulder - many of us do this several times a day if our jobs require talking on the phone.

3. Doing overhead work that causes you to lift your arms above your head for long periods of time, like painting ceilings, lifting heavy boxes to high shelves, etc.

4. A constant state of anxiety brought on by chronic stress. This causes us to literally "get our back up", raising and holding our shoulders in a kind of self-protective posture, much like an animal will arch their back, and put their head down perceiving an attack.

Warning Symptoms of Chronic Neck and Shoulder Pain

Most of us are familiar with that general uncomfortable feeling like a tight band is around our neck and shoulders and perhaps some very sore trigger points, areas that when touched makes us wince. In addition, we might not be able to move our head to either side without causing pain in our necks and shoulders. However, with poor repetitive structural habits, you could have symptoms of compressed nerves in your cervical spine that require a doctor:

oNumbness or tingling in hands and/or fingertips.

oBurning sensations in the muscles of the upper arms.

oWeakness lifting the arms, and/or dropping objects.

oHeadaches and/or constant tenderness in the occipital muscles, that band of muscles at the base of your head that extends from ear to ear.

A Simple Exercise To Relieve Tightness

Below is a simple stretching exercise you can do a few times a day while working to relax neck and shoulder muscles:

oBend head forward, chin on chest, then back to original position.

oHead forward, bend your head to the right, then back to original position; bend to the left, then back to original position.

oBend head slightly backward, then to the original position.

oBend head forward, chin to chest, tilt head to the right, then to the left.

Other Things You Can Do

Simple, common sense will help keep your neck and shoulder muscles healthy:

oObserve correct workspace ergonomics for your job. Adjust chair and keyboard height. Use a headset or speakerphone to avoid phone cradling.

oObserve good overhead mechanics. Take frequent stretching breaks to relax the neck and shoulder muscles. Practice correct lifting of heavy items. Most of us don't have forklifts at home or in our offices, so break down heavy boxes into more manageable sizes.

oDo aerobic exercise like walking, running, rebounding, to reduce tension.

oDrink water. Muscles and joints need adequate water to function properly. At least eight, 8 oz glasses per day, or more depending on your weight, environment (very cold, very hot needs more) and activity.

oGet a massage - acupressure massage done by a professional practitioner can work wonders on tight neck and shoulder muscles, relieving pain.

oA warm bath in Epsom salts will help remove lactic acid build up in stiff and sore muscles that can cause pain. An analgesic cream containing menthol can help relax tight muscles further.

oCalcium and magnesium supplements can also help relieve tension and pain in tight muscles.

Even though you might not be able to remove stress from your life, or completely avoid physical maneuvers that strain your neck and shoulder muscles, you can remove, or greatly alleviate, the tension in your neck and shoulders that can develop. Adhering to good neck and shoulder habits, and spending a few minutes each day doing simple stretching exercises can help you manage muscle tension so it doesn't continue to be a serious pain in your neck.

By Mark Bromson, M.D.