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The Neck is Your Life Line

The nervous system is the master control network for your body, directing virtually every function and action, from monitoring your life needs, to precisely responding to threats to your health.

Each system, from your heart and blood vessels, to your digestive and immune systems, is directed through nerve impulses originating in your brain or spinal cord that travel through its protective bony structure: the spinal column.

The neck region is the most vulnerable region of the spine to injury. Indeed, even death can be brought through significant trauma to the neck. When the trauma is not fatal, the consequences can still be severe, such as when paralysis strikes.

Most people will not experience these severe injuries, however sprains of the delicate ligaments with subluxation (misalignment) do commonly occur. Despite the injury being smaller, their location (the neck) makes their impact more profound. Functions throughout the body can be impaired when the nerves in the upper neck are compromised.

Within chiropractic, there are specialists who focus their entire care on the uppermost two vertebrae of the spine.

Because every nerve passes through the neck, if irritation or compression is present, virtually any system of the body can be affected. The point being is that a neck disorder will not necessarily just cause neck pain or headache. Dizziness, digestive problems, fatigue, high blood pressure and generally reduced quality of life are some of the symptoms patients commonly experience.

If you have suffered a severe whiplash, you may have noticed far more than a stiff neck. Indeed, recent research suggests whiplash needs to more thought of as a whole body disorder.

We take these injuries in our office and address them in both a specific and comprehensive manner. Most patients who have suffered a neck trauma will require x-rays to analyze the posture of their spine. X-rays may also need to be taken in motion to test the stability of your ligaments and to determine precise levels of impaired movements. Without this road map, it is difficult to determine how care should be directed and factors that could influence your long-term prognosis, such as degeneration.

Neck Pain Exercise Options

Exercise for the neck is very important since weak muscles are related to many painful conditions of the neck and, can contribute to fatigue, irritability, headache, sleep loss, and more. When done correctly (perform slowly, staying within “reasonable” pain boundaries), they can increase your range of motion, reduce stiffness/tightness, and strengthen your neck muscles.

The exercises below combine range of motion (ROM) against light/partial resistance in 4 directions (forwards, backwards, and L/R side bending). To do these correctly: Similar to an arm wrestling contest: 1. Push your head into your hand while moving the head to the end of the range, “…letting the head win” (See A, C, E, G). 2. Repeat this going back in the opposite direction by “letting the hand win” (see B, D, F, H), again, moving through the entire range of motion. ALWAYS push the head into the hands, Make sure you move the head against resistance in BOTH directions, 3 times each (A-B then B-A x3; C-D then D-C x3) then, (E-F then F-E x3, and lastly, G-H then H-G, x3 reps). The trick is doing this VERY slowly (to build motor control and coordination) and to move through the entire “comfortable” range of motion. Repeat 3x slowly. If pain worsens, lighten up on the amount of pressure used or, stop the movement just prior to the sharp pain onset. If you can’t make it to the end of the movement due to pain, make a note of how many reps it took before the onset or increase of pain and how far you could move your head. Do 3 slow reps and then move to the next exercise direction.

Exercise for Neck Pain
These exercises can be performed 1 to 3x/day, according to tolerance, and will increase ROM, increase strength, and build coordination, all at the same time.

The Neck and Headache Connection

The Neck and Headache Connection

Patients with headaches also commonly complain of neck pain. This relationship is the rule, not the exception and therefore, treatment for headaches must include treatment of the neck to achieve optimum results. The term, “cervicogenic headaches” has been an accepted term because of the intimate connection between the neck and head for many years. There are many anatomical reasons why neck problems result in headaches. Some of these include:

  • The first 3 nerves exiting the spine in the upper neck go directly into the head. They penetrate the muscles at the top of the neck near the attachments to the skull and therefore, any excess pressure on these nerves by the muscles or spinal joints will result in irritation and subsequent pain.
  • The origin or nucleus of the 5th cranial nerve called the Trigeminal, innervates the sensation to the face and is located in the upper cervical region near the origin of the 2nd cervical spinal nerve, which innervates sensation to the back of the head up to the top. Therefore, problems located in the upper neck will often result in pain radiating up from the base of the skull/ upper neck over the top of the skull to the eyes and /or face.
  • The 11th cranial nerve that innervates the upper shoulders and muscles in the front of the neck arises from the top 5 to 7 spinal cord levels in the neck. Injury anywhere in the neck can result in spasm and pain in these large muscle groups.
  • Other interconnections between the 2nd cervical nerve and trigeminal/5th cranial nerve include communication with the 7th cranial / facial nerve, the 9th cranial / glossopharyngeal nerve, and the 10th cranial / vagus nerve. These connections can affect facial muscle strength/ movements, taste, tongue and throat movements, and stomach complaints such as nausea from these three cranial nerve interconnections, respectively.

When patients seek treatment for their headaches, a thorough examination of the neck, upper back, and cranial nerves is routinely performed for the above reasons. It is common to find upper cervical movement and vertebral alignment problems present in patients complaining of headaches. Tender points located between the shoulder blades, along the upper shoulders, on the sides of the neck and particularly, at the base of the skull are commonly found. Pain often radiates from the tender point over the top of the skull when pressure is applied in the upper neck/ base of the skull area. Tenderness on the sides of the head, in the temples, over the eyes, and near the jaw joint are also common. Traction or pulling the head to stretch the neck is often quite pain relieving and this is often performed as part of the chiropractic visit and can also be applied at home with the use of a home cervical traction unit. Chiropractic adjustments applied to the fixated or misaligned vertebra in the upper neck often brings very satisfying relief to the headache sufferer. Exercises that promote movement in the neck, as well as strengthening exercises are also helpful in both reducing headache pain and in preventing occurrences, especially with stress or tension headaches.

What Is This Pain in My Neck!

What Is This Pain in My Neck!

“When I woke up this morning, I couldn’t move my neck! Every time I try to move it, I feel sharp pain on the left side of the neck shooting down into the shoulder blade. It just came out of nowhere!”

Chances are, you are suffering from a common condition called torticollis, which literally means, “twisted neck” after the Latin terms of “torti” (twisted) and “collis” (neck). The common name for this is “wry neck,” and it’s basically a painful muscle spasm, like a “Charlie-horse” but located in the neck muscles. Usually, a person wakes up in the morning with this and the cause is often related to sleeping with the window being open or a fan or air conditioner blowing on you. It can also relate to a “cold settling in the muscle” after a cold or flu virus. Trauma such as falling or a car accident can also cause torticollis. However, most of the time, patients with torticollis are not sure what caused the abrupt onset of symptoms.

Usually, torticollis will gradually improve over a 2 week time frame. However, it only takes a few days to a week (at the most) if you receive chiropractic adjustments. Most importantly, without treatments, the sharp pain can last a week and can severely limit your activity, often prohibiting work as well as your desired “fun” activities. Hence, most people prefer having this treated as opposed to “waiting it out.” In some cases, it can last longer than a month and in rare cases even longer, so getting this treated is highly recommended. Also, try to get in for a treatment immediately before the muscle spasm really sets up. We find this to be the most effective approach. Here are a list of symptoms and treatment suggestions for torticollis:

Acute Torticollis Symptoms

  • Muscle spasms
  • Neck and shoulder pain
  • Neck and spine contortion (neck twisted to right or left side of body)

 

Pain Relief Treatments for Acute Torticollis

  • Chiropractic neck and spinal adjustment
  • Analgesics
  • Heat packs
  • Muscle relaxants
  • Rubs and ointments (Icy Hot, BioFreeze)
  • Massage with essential oils
  • Reiki
  • Sleep / Relax
  • Supportive cervical collar

Neck Pain – Can Chiropractic Really Help?

Neck Pain – Can Chiropractic Really Help?

Neck pain is a very common problem affecting up to 70% of the adult population at some point in life. Though there are specific causes of neck pain such as arising from a sports injury, a car accident or “sleeping crooked,” the vast majority of the time, no direct cause can be identified and thus the term nonspecific is applied. There are many symptoms associated with patients complaining of neck pain and many of these symptoms can be confused with other conditions. Wouldn’t it be nice to know what neck related symptoms are most likely to respond to chiropractic manipulation before the treatment has started? This issue has been investigated with very favorable results!

The ability to predict a favorable response to treatment has been termed, “clinical prediction rules” which in general, are usually made up of combinations of things the patient says and findings from exams. In a large study, data from about 20,000 patients receiving about 29,000 treatments, was collected and analyzed to find out what complaints responded well to chiropractic treatment. The results showed that the presence of any 4 of these 7 presenting complaints predicted an immediate improvement in 70-95% of the patients: 1. Neck pain; 2. Shoulder, arm pain; 3. Reduced neck, shoulder, arm movement; 4. Stiffness; 5. Headache; 6. Upper, mid back pain, and 7. None or one presenting symptom. Items not associated with a favorable immediate response included “numbness, tingling upper limbs,” and “fainting, dizziness and light-headedness in 4-12% of the patients. The “take-home” message here is that was far more common to see a favorable response (70-95%) of the patients compared to an unfavorable response (4-12%), supporting the observation that most patients with neck complaints will respond favorably to chiropractic treatment.

So, what do we do as chiropractors when a patient presents with neck pain? First, after gathering preliminary information such as name, address and insurance information, a history of the presenting complaint is taken. This consists of information including what started the neck complaint (if you know), when it started, what makes it worse, what makes it better, the quality of pain (aches, stiff, numb, etc.), the location and if there is radiating complaints, the severity (0-10 pain scale), timing (such as worse in the morning, evening, etc.), and if there have been prior episodes. Various questionnaires are included that are scored so improvement down the road can be tracked and a past history that includes a medication list, past injuries or illnesses, family history and a systems review are standard. The exam includes vital signs (BP, pulse, height, weight, temperature and respiration), palpation, range of motion, orthopedic and neurological examination. X-ray and/or other “special tests” may also be included, when needed. A review of all the findings are discussed and after permission to treat is granted, a chiropractic adjustment may then be rendered. A list treatment options may include:

  1. Adjustments;
  2. Soft tissue therapy (trigger point stimulation, myofascial release);
  3. Physical therapy modalities;
  4. Posture correction exercises and other exercises/home self-administered therapies;
  5. Education about job modifications;
  6. Co-management with other health care providers if/when needed.