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What Exercises Are Best for Neck Pain?

16 Jul

Past research has demonstrated that combining spinal manipulative therapy (SMT) with exercise yields the best long-term results for individuals with neck pain. So what exercises should we consider when neck pain rears its ugly head?

In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM).

The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!

You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.

Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.

Studies also show that weakness of the deep neck flexor muscles is very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.

Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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What Treatments Work Best for Neck Pain?

18 Jun

Experts estimate that up to 70% of people will experience an episode of neck pain in their lifetime. Though there are many potential forms of treatment available, little has been published comparing the various treatment options available to the neck pain patient.

A 2012 study that involved 272 neck pain patients compared three treatment options: chiropractic, medication, and exercise. After twelve weeks of treatment, the patients who received either chiropractic care or exercise instruction reported the greatest reduction in pain. The researchers followed up with the participants for up to a year and found that the patients in the chiropractic and exercise groups continued to report less pain than those in the medication group, and these benefits persisted until the end of the study. The researchers concluded that participants from both the chiropractic care and exercise therapy groups had more than double the likelihood of complete pain relief than with the patients in the medication group.

Quality studies on the short- and medium- term benefits of exercise and manual therapies applied to the cervical spine for patients with neck pain have been published since the 1980s. However, the benefits over the long term are not as well documented. With this in mind, a 2002 study followed 191 patients with chronic neck pain for two years comparing spinal manipulation (SM) with and without one of two types of exercises: low-tech (and low cost) rehabilitative exercise (LTEx) or high-tech MedX (machine assisted) rehabilitative exercises (HTEx).

The research team randomly assigned the 191 patients to eleven weeks of one of three treatments: SM only; SM + LTEx; or SM + HTEx. The investigators evaluated the patients at the start of the study, again after five weeks of treatment, and finally following the conclusion of the treatment phase of the study at eleven weeks. They followed-up with the patients three, six, twelve, and 24 months later as well.

The results showed that SM + LTEx and SM + HTEx were both superior to SM alone at both one- and two-year time points. Overall, the patients in the SM + LTEx group reported the greatest pain reduction and satisfaction with care. This finding is even more important, as the care delivered to the SM + LTEx group costs less than care involving specialized, more expensive equipment.

It’s clear that chiropractic care that includes spinal manipulation and/or mobilization with exercise training yields the best long-term outcomes. Add to that the use of soft tissue therapies such as myofascial release, active release technique, and various modalities, and chiropractic is CLEARLY the best choice for patients with acute or chronic neck pain.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Does Slouching Cause Neck and Shoulder Pain?

22 Mar

In a 2015 study, Swedish researchers compared the effect of a slouched vs. normal body posture with regards to performing lifting tasks.

In particular, investigators wanted a better understanding of how a slouched posture affects neck and shoulder function and muscle activity in three large muscle groups—the upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA)—during arm elevation to see if it affects range of motion, muscle activation patterns, maximal muscle activity, and total muscle work.

Study participants—non-injured, young adult males—perform maximum arm elevations in upright and slouched postures that researchers observed using a combined 3D movement and EMG (electromyography) assessment system. This measured the arm range of motion, velocity, and spine curvature simultaneously with EMG activity in the UT, LT, and SA muscles.

The research team found that participants in the slouched position experienced significantly less arm elevation and decreased movement velocity both upwards and downwards, in addition to increased peak muscle activity (that is, the muscles had to work harder) in all three muscles tested.

It appears that increased thoracic kyphosis (slouching) leads to a marked increase in physical requirements when performing simple arm movements. Over time, such changes in function could place added stress on the muscles, tissues, and joints of the neck and shoulder, leading to pain and injury. These findings add to a growing body of research regarding the detrimental long-term effects of poor posture as well as an understanding of how exactly faulty postures increase the risk of musculoskeletal disorders.

In their conclusion, the authors of the study write, “[Patients] suffering from neck-shoulder pain and disability should be investigated and treated for defective thoracic curvature issues.”

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Migraine Headaches and Nutrition?

18 Jan

According to a World Health Report, migraines are the nineteenth most common patient complaint worldwide with an 18% of women and 6% of men in the United States experiencing at least one migraine headache episode each year.

There is evidence that patients with migraines have an energy deficit disorder associated with their glucose intake. As such, adopting a strict ketogenic diet (in which ketones are the primary source of energy for the body in place of glucose) does appear to benefit patients with migraines.

A 2017 study set out to determine if it was the absence of glucose or the increase in ketone bodies that made the difference for patients. In the study, researchers provided four female migraine patients with a specially designed ten-gram beverage containing a specific type of ketone  called B-hydroxybutyrate or bHB twice a day for four weeks.

After one month, their migraine frequency rate dropped 50% to eight days/month on average without any serious side effects.  The patients also lost weight, presumably due to consuming less glucose in their diet. An additional benefit of higher levels of ketones in the body is that they have an anti-inflammatory effect.

A larger double-blind, randomized, placebo-controlled trial is now underway with a group of 90 patients that will last three months The goal of the study is to determine if this nutritional supplement is capable of reducing migraine headaches without the significant side effects and associated disabilities that are currently associated with many migraine medications.

Chiropractic care often includes nutritional counseling as an important part of caring for the whole person. In fact, there is research supported evidence that spinal manipulation alone has a very positive benefit for migraine headache patients as noted in the 2010 and 2014 UK studies regarding the effectiveness of manual therapies. Based on the outcome of this large-scale study, the use of ketone-based supplementation for migraines may become a new standard.

What Is Torticollis?

18 Dec

Torticollis, also called wry neck or loxia, represents a category of neck conditions which exhibit a twisting position of the head and neck outside of a normal neutral position. There are many potential causes for torticollis from sleeping in a faulty position to an injury to the neck, like whiplash. However, it’s commonly labeled as “idiopathic,” which basically means, “We don’t know what caused it.”

Torticollis often occurs out of the blue with no obvious cause or history such as, “When I woke up, I couldn’t turn or move my head!” It can occur at any age and may disappear on its own in a few days to weeks, but in rare cases, it can persist for months or years.

Because it can be quite alarming, most people quickly seek healthcare services, which can include visiting a doctor of chiropractic. Once the more serious causes of torticollis are ruled out (such as a severe type of infection like a retropharyngeal abscess or bacterial meningitis, fracture, neoplasm, cervical dystonia, etc.), conservative care can proceed.

If a patient has a family history of torticollis, they may have a more serious form of torticollis called cervical dystonia. This usually begins between 31-50 years of age and if left untreated, it can become permanent.

Chiropractic care often includes stretching in which manual cervical traction, spinal mobilization, and myofascial release techniques help to restore the lost range of motion and faulty posture. Once enough motion has been restored, your doctor of chiropractic may utilize spinal manipulation, which often hastens the recovery rate of torticollis. Your chiropractor may also use physical therapy modalities and or provide instruction on home-based exercises and other self-management strategies.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Care for Patients with Headaches

16 Oct

Though there are many different types of headaches, many involve both the upper cervical region (the neck) and the head. Between the muscles that attach to the head and neck, the ligaments that hold the vertebrae together, the blood vessels that allow blood to flow to and from the head, and the nerves that allow us to smell, taste, see, smile, wink, stick out our tongue, and so much more, it’s no wonder that the neck is intimately related to the head and therefore headaches.

One structure that sheds additional light on this close relationship between the neck and headaches is called the “myodural bridge” (MDB), which spans between a muscle in the back of the neck called the rectus capitus posterior minor and the protective covering of the spinal cord called the dura mater. This connection sits in close proximity to the vertebral artery, veins, and the first cervical nerve or C1 (the occipital nerve).

So how does this MDB cause headaches? Normally when we move our head and neck, the muscle contraction puts tension on the MDB, transmitting its force to tense up the dura, stabilizing the spinal cord. This prevents infolding of the dura, which can generate pain in the form of a headache.

When an injury such as whiplash occurs, cervical vertebral joint dysfunction and overly tight muscles in this area transmit abnormal tension to the dura mater via the MDB, which (like infolding) can result in headaches. If the injured muscle/s weaken or atrophy, this can further compromise the function of the MDB, leading to chronic (long-term) headaches.

A common symptom of an MDB headache is a throbbing pain, usually on one side of head near the ear/temple area and possibly behind the eye. The headache may last from several minutes to several days and the base of the head is tender to the touch. Typically, head movements intensify the pain/headache and neck pain may or may not be present.

Research shows that chiropractic manipulation, soft tissue therapy, and exercise can significantly benefit patients with headaches, regardless of the cause. But it is easy to understand that treatment directed to this region is necessary to restore function, and discovery of this MDB may play an important role as to why chiropractic care is so effective for headache patients.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.