Pain Relief Chiropractic

Neck pain is one of the most common complaints patients have when they come to a chiropractic office for the first time, second only to low back pain. Neck pain affects all of us at some point in life, and for some, it can become a chronic, permanent problem that can interfere with many desired activities and lower their quality of life. There are many different causes, and prompt evaluation and treatment is important is some cases.

Neck pain and stiffness are the two most common symptoms that present for evaluation and treatment. This can be located in the middle of the neck and/or on either side and can extend down to the shoulders and / or chest. It can contribute to or cause tension headaches that can travel up the back of the head and sometimes behind the eyes. Pain often increases with neck movement, such as when turning the head to check traffic while driving and/or it can hurt at rest while held in static positions, such as when reading a book. Neck pain can come on gradually or quickly and often cannot be traced to a specific injury or cause making it a challenge to figure out. While neck pain is often not serious or life-threatening, there are causes that should be evaluated promptly. If you wake up with acute neck pain associated with very limited range of motion, this may be due to torticollis, or wry neck, and prompt treatment helps it resolve more quickly than “waiting it out.” Torticollis can be caused by exposure to a draft, changes in weather, trauma, or after a cold or flu. When in doubt, come in for an evaluation and treatment, as anxiety associated with the “fear of the unknown” only adds to the stress associated with neck pain and it’s ALWAYS best to be “…safe than sorry!”

Numbness or tingling may accompany neck pain and can be located in the face, arms, hands, and/or fingers. This is one of those times to come in promptly, as these symptoms may indicate the pinching of a nerve root in the neck. There are MANY chiropractic treatment approaches that effectively treat nerve root pinching, and treatment should NOT be delayed. Other common symptoms may include clicking, crunching, or grinding noises, technically called crepitus, which may or may not be benign. If the noise is accompanied by pain, especially if it radiates down to the shoulder blades or arms (either side or both), it’s time to promptly come in. Any time symptoms occur acutely or come on fast, it’s best to get evaluated as soon as possible.

Dizziness is another common symptom that can result from neck problems and is often associated with movement such as rising from laying or sitting. Certain positions of the neck can also bring on dizziness. This is sometimes caused by the “stones” in the inner ear shifting out of position and is technically called BPPV or “benign paroxysmal positional vertigo.” When this occurs, we can usually manage it very well with treatment and specific BPPV exercises. Other times, dizziness may be due to a restriction in blood flow reaching the brain. In which case, a prompt evaluation is VERY appropriate, especially if blackouts occur.

Sleep interruption or difficulty falling asleep are other good reasons to seek prompt evaluation and treatment. Sleep loss can lead to many problems such as excessive fatigue, tiredness, irritability, and just generally feeling poor! Remember, prompt care usually results in prompt resolution!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain, we would be honored to render our services.

Neck pain is a very common condition that drives many patients to seek chiropractic care. Treatment planning typically includes four primary goals: 1) Pain Management; 2) Structural Realignment; 3) Functional Restoration; and 4) Maintenance / Prevention.
1) PAIN MANAGEMENT: Getting rid of pain is the primary focus of ALL patients in the early stages of a neck injury. If we use the acronym “PRICE” (Protect, Rest, Ice, Compress, and Elevate), the first three apply when it comes to neck pain. We “protect” our neck by avoiding or changing the way we go about doing things such as our sleep position (this often prompts a “proper pillow discussion”), adjusting the outside rearview mirrors of our car (if you flair the outside mirrors outwards, it opens up the “blind spots” and may prevent a collision, especially if you cannot rotate your neck very far), and modifying other ADLs (activities of daily living). The bottom line is: if an activity creates a sharp pain sensation, it is a “warning sign” to modify or stop WHATEVER it is that you’re doing. Wearing a cervical collar for a SHORT duration of time can qualify for both “Protect” and “Rest.” Try resting your neck on a pillow when reading or watching TV, as it allows the neck muscles to rest. A cervical traction device can help reduce muscle spasm, improves flexibility (range of motion), and reduce pain. Alternating “Ice” and heat can be even more effective, as it “PUMPS” out inflammation or swelling. Heat is also a good natural muscle relaxant and ice reduces swelling (inflammation), both of which can help reduce pain. There really is no hard and fast rule as to how long you should continue using ice (days, weeks, or months) – if it helps, use it (unless you are hypersensitive and frostbite easily, in which case limit the ice time). However, heat can worsen a condition if it’s applied too soon or too long. Anti-inflammatory herbs like ginger, turmeric, boswellia, and others are very effective and actually may be BETTER than ibuprofen, Aleve, or aspirin. Recent studies indicate that there may be a delay in healing when over-the-counter pain medications are used, and the recommendation is to AVOID these drugs so healing won’t be delayed!

2) STRUCTURAL REALIGNMENT: The goal here is to improve (to the best of our ability) faulty bony misalignments that frequently exist in the neck, upper, middle back as well as the low back, as all can contribute to neck pain. This is also a great long-term goal, as it may help PREVENT future episodes of neck pain. There is a natural process of aging called osteoarthritis that none of us can avoid, but allowing faulty curves and bony misalignments to persist may actually accelerate this degenerative process! Your Chiropractor may have you lie on a tightly rolled up towel (a frozen water bottle often feels even better) placed behind the neck and when it’s comfortable, performing this on the edge of the bed is a great way to re-educate a reversed cervical curve (and, it feels GREAT!). Even a heel lift in the shoe of a short leg can help the neck! Spinal manipulation, manual mobilization techniques, and trained exercises all address this treatment goal quite effectively!

We will continue this conversation next month discussing the third and fourth topics: 3) Functional Restoration; and 4) Maintenance / Prevention, so STAY TUNED!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for neck pain, we would be honored to render our services.

“Boy, my neck is killing me! Honey, where is the ibuprofen?” Isn’t this the FIRST thing people think of when they have an ache or pain? The general public does NOT usually think, “….boy, do I need to see my chiropractor – my neck is killing me!” So, the question of the month is, which one is better, chiropractic or over-the-counter (OTC) medication? Let’s take a look.

Though this question has been discussed for years (just search: “chiropractic vs. NSAIDs”), a recent study looked specifically at this question, which will be the main focus of this Health Update. The study points out that it has been estimated that 75% of Americans will experience neck pain at some point in their life. For years, spinal manipulation has been criticized as being ineffective or providing limited benefits. Meanwhile, ads on TV, in magazines, and almost everywhere you look, show someone reaching for aspirin, ibuprofen, or even narcotics to manage their pain.

However, this new research clearly supports that seeing a chiropractor and/or engaging in light exercise can bring neck pain relief more effectively than relying on pain medications! Researchers even found that the benefits of chiropractic adjustments were still favored A YEAR LATER when comparing the differences between the spinal manipulation and medication treated groups! Moderate acute neck pain is one of the most frequent complaints prompting appointments at primary care/medical clinics and is estimated to account for millions of doctor visits per year. In some cases, pain and stiffness occurs without a known cause and there is no “standard” medical treatment. Though physical therapy, pain medication, and chiropractic have all been utilized for neck pain, until now no one had compared the benefits of each in a single study.

The study consisted of 272 neck pain subjects split up into three groups: 1) Chiropractic group (approximately 20-minute treatments an average of 15 times); 2) Pain medication group (meds included acetaminophen, and in some cases stronger prescription meds including narcotics and muscle relaxants); 3) Physical Therapy group (consisting of meeting twice and receiving advice and exercise instruction at 5-10 repetitions up to eight times a day).

At the end of three months, the chiropractic and exercise group did significantly better than those who took drugs. Approximately 57% of those receiving chiropractic management and 48% of those who did the exercises reported at least 75% reduction in pain vs. 33% of people in the medication group. A year after the treatment period ended, the numbers decreased to 53% in the chiropractic and exercise groups, compared to 38% in pain medication group. The chiropractic group received the highest scores in patient satisfaction at all time points. An interesting downside noted in the medication study group was that the subjects had to use a progressively greater amount of medication at a progressively increased frequency to manage their pain. Stomach trouble is the most common side effect of NSAIDs (leading to ulcers) as well as liver and kidney problems. Another interesting finding was that the subjects in the medication treated group felt less empowered, less active, and less in control over their own condition compared with those in the other two groups.

This study points out the benefits of two treatment approaches that chiropractors commonly utilize: spinal manipulation and exercise training/advice!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for neck pain, we would be honored to render our services.

It’s safe to say that if you haven’t had neck and/or shoulder pain, you probably will. Like low back pain, there is a statistical increase in probability that once you’ve had neck pain, the chances of having another episode are significantly increased. A recent study reported that over a 12-month period, 16-18% of the population studied complained of neck and shoulder pain and each year, medical care was obtained by 21-38% of that same group. Moreover, 13-21% lost work time because of their neck and/or shoulder pain. The study reported there was a “…strong episodic nature…” as this condition was found to frequently come and go. Neck pain can arise from a number of structures including muscles, ligaments, bone, joint capsules, and more. Typically, a patient presenting with neck pain is treated for a few weeks and is then quite satisfied with their result… until the next time. Unfortunately, there is usually, “…a next time.” So, the question is, what can we do to prevent neck pain or its reoccurrence?

When considering the many causes of neck pain and the high rate of recurrence, one common finding in those with this popular “come and go” neck/shoulder pain pattern is weakness of the deep flexors muscles located in the front of the neck. One reason for this common finding is that it is very difficult to strengthen the deep, intrinsic muscles of the neck as they are “involuntary.” That means, we cannot consciously “flex” or purposely contract our deep neck flexor muscles. Also, the larger extrinsic muscles tend to be too tight and by reflex, “turn off” or, inhibit the deep neck flexor muscles, compounding the problem.

Therefore, in order to exercise them, we must “trick” the deep muscles into contracting without contracting the larger, extrinsic muscles. This can be accomplished by doing a very specific, controlled exercise with our neck by laying on the back with a partially inflated blood pressure cuff (or, by using a special device purposely made for this test and exercise) placed behind the neck. The inflatable bag is pumped up partially to about 20mmHg and then in a VERY controlled manner, we tuck in our chin and flatten our neck pressing into the bag raising the pressure by 2mmHg and holding that steady for 3-5 seconds. This is repeated in increments by pushing down a little harder until the gauge reads 24mmHg and again, holding that for 3-5 seconds. This pattern is repeated 5x or, until you reach 30mmHg and the process is then reversed releasing the pressure in 2mmHg increments at 3-5 second holds until you reach 20mmHg again. Sound easy? Not quite!!! This exercise requires “fine motor control” to accomplish the task and most of us haven’t specifically addressed these fine moving muscles and end up only exercising the larger extrinsic muscles by doing traditional neck strengthening exercises, which further inhibits the deep neck flexors.

The first time you try this, you’ll be amazed at how challenging and tiring it is. But, after a few days of performing the exercise, you may find you feel much better!  Of course, this depends on the degree of injury one has, but often, once cervical spine stability is improved by strengthening these deep neck flexors, symptoms usually improve. So, the question is, can we achieve good deep neck flexor strength by doing a more practical, upright position exercise rather than requiring a costly apparatus that requires a laying down position?  In a recent study, a standing exercise where a similar movement called, a “neck-lengthening maneuver” was performed producing similar results as the laying down exercise (relaxation of the strong, extrinsic – outside – muscles and strengthening of the deep neck flexors). Simply tuck in the chin and stand tall, “lengthening” your neck!

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

The relationship between neck pain and our pillow is more important than most of us realize! Though we all may have at one time or another slept on a variety of surfaces, and used any number of pillows (flat, medium, bulky) made of different materials (foam, feather, air, water, or memory foam), it’s usually not until neck pain and/or headaches start to become an issue that we start to think, “…how important is my pillow?” Thankfully, the question has been addressed in a randomized peer-reviewed study. So, what did they find out?

The goal of a pillow is to support the neck more so than the head. In a study headed by Dr. Liselott Persson, MD, of the department of neurosurgery at the University of Lund in Sweden, researchers tested whether specific neck pillows have any effect on neck pain, headache and sleep quality in people suffering with chronic (>3months), non-specific neck pain. They also researched whether there was an optimum or “best” type of pillow that was preferred by their 52 patient group. They used 4 different pillows, 1 “normal” pillow and 3 of which were specially designed, each having a different shape and consistency. Over a 4-10 week time frame, the pillows were randomly distributed to the neck pain group who then graded them according to comfort, the effects on neck pain, sleep quality and headache using a questionnaire, and also described the characteristics of an “ideal pillow.” Researchers and participants concluded the “ideal pillow” (for reducing neck pain and headaches and improving quality of sleep) includes a soft pillow with good support under the neck’s curve (lordosis).

There are many styles of contoured cervical or neck pillows that vary considerably. This study supports the use of a specially designed style over a normal pillow. So what are some of the things to look for? First, consider your neck’s length and girth.  When you look in a mirror, do you have a neck that is short vs. long or, narrow vs. wide? This will direct you to a pillow that has a larger “hump” for your neck to be cradled in if it’s a long neck and, the height of the hump – taller for the slender neck or, shorter for the wide neck. Some pillows have 2 options of “hump” sizes (located on the long edges of the pillow) – one short and flat and the other side taller and wider. Others recommend lying in the middle of the pillow if you’re a back sleeper vs. lying on the edge of pillow when sleeping on your sides. A measurement taken from the neck to the point of the shoulder determines if the pillow should be a small, medium, or large. Water filled and/or air filled pillows can be varied by the amount of water or air added. The bottom line of which is “best” is based on comfort and support. Regardless of which you choose, it can take several days to get used to the new pillow, so we recommend using the pillow for at least 1 week. By then, you’ll know if you chose the right style.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.