Tag Archives: neck pain

Tips to Help Prevent Episodic Headaches

4 Jun

Headaches are among the most common physical ailments worldwide, with about half of
adults experiencing at least one episode each year and roughly 1 in 6 reporting a headache on
any given day. Fortunately, for most people, headaches are not a persistent issue but instead
occur episodically—that is, they arise for a short period of time and then resolve. In broad terms,
three major contributors to episodic headaches include dehydration, stress, and muscle tension.
Dehydration is a condition in which the body does not have enough fluids to support
normal physiological functions. This can lead to reduced blood volume, slowing the delivery of
oxygen to tissues and the removal of cellular waste. It can also disrupt electrolyte balance, affect
nerve signaling and muscle function, impair temperature regulation, and alter brain function.
Together, these changes can contribute to the development of a headache that may persist until
hydration is restored. To reduce the likelihood of dehydration-related headaches, drink water
consistently throughout the day and limit excessive caffeine intake. It’s also important not to rely
solely on thirst as a signal, as mild dehydration may already be present by the time thirst
develops.
Stress activates the body’s fight-or-flight response, increasing cortisol levels and causing
muscles to tighten in preparation for potential injury. While this response is helpful in short-term
emergencies, ongoing stress in daily life can lead to increased pain sensitivity and sustained
muscle tension in the shoulders, neck, and scalp. This combination can create the conditions for
tension-type headaches. Managing stress through regular physical activity, taking breaks during
the day, and practicing relaxation techniques such as controlled breathing or meditation may help
keep these headaches at bay.
Muscle tension headaches are frequently associated with poor posture, particularly
forward head posture, which places additional strain on the muscles and joints of the neck and
upper back. This is especially common among individuals who spend long periods working at
desks or using phones and tablets. Over time, this strain can lead to tightness and discomfort that
radiates into the head. Maintaining proper posture, positioning screens at eye level, and taking
regular breaks to stretch and move can help minimize this type of headache.
If these strategies do not reduce the frequency, duration, or intensity of headaches, it may
be appropriate to consult a healthcare provider, including a doctor of chiropractic. A thorough
review of medical history and current symptoms, along with a physical examination, can help
identify underlying musculoskeletal factors that may be contributing to recurring headaches.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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Whiplash Avoidance Strategies

25 May

During a whiplash event, such as a rear-end collision, the head and neck accelerate and decelerate
more rapidly than the nervous system can coordinate a protective muscular response. This can result in
sprains, strains, and microtrauma to the soft tissues of the head, neck, and upper torso, which may
manifest as neck pain, stiffness, headache, brain fog, or dizziness—collectively referred to as whiplashassociated disorders (WAD). Because many patients experience symptoms that persist for months or even
years following injury, WAD can place a significant burden on individuals, families, and society as a
whole—highlighting the importance of strategies and technologies aimed at reducing whiplash risk.
Three key technologies designed to reduce collisions are blind spot monitoring, lane departure
warning, and forward collision warning with automatic emergency braking. Blind spot monitoring
systems detect vehicles alongside the car that may not be visible to the driver and provide visual or
auditory alerts. Lane departure warning systems use cameras to identify lane markings and notify the
driver if the vehicle begins to drift out of its lane; activation of the turn signal typically overrides these
alerts. Forward collision warning systems use cameras and sensors to detect when a vehicle is
approaching another object too quickly and alert the driver. More advanced systems incorporate
automatic emergency braking, which can slow or stop the vehicle to avoid a collision or reduce its
severity.
Proper adjustment of the seat and head restraint is also important in reducing whiplash risk.
Ideally, the head should remain close to the head restraint during a collision to limit excessive backward
motion. Research suggests that a seatback angle of approximately 20–30 degrees, combined with
positioning the head within about 2 inches (5 cm) of the head restraint and ensuring the restraint is aligned
with the top of the head (not below it), may help reduce injury risk. Despite this, observational studies
have shown that a large proportion of drivers do not properly adjust their head restraints. In response,
vehicle manufacturers have introduced seat and head restraint technologies designed to reduce the relative
motion between the head and torso during rear-end impacts.
Perhaps the most important factor in reducing whiplash risk is driver attention. Distracted drivers
are less likely to recognize hazards such as rapidly approaching vehicles, unsafe lane changes by others,
or road conditions that require sudden braking. In situations where a collision appears unavoidable, some
evidence suggests that pre-contraction of the neck muscles may reduce injury severity by limiting head–
neck motion and reducing strain on cervical structures.
If a collision does occur, early management focused on maintaining activity within pain tolerance
and restoring normal movement patterns may help reduce the likelihood of persistent symptoms.
Conservative approaches, including chiropractic care, are commonly used to support recovery in patients
with whiplash-associated disorders.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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Chiropractic Care for Headache Relief

4 May

Statistically, up to 20% of adults experience frequent headaches, with approximately 1–
4% reporting headaches on more than 15 days per month. While there are many types of
headaches—and within each subtype, multiple underlying causes and triggers—research
suggests that musculoskeletal factors can contribute to certain headache presentations. What
would a doctor of chiropractic look for during the initial visits to determine whether a course of
chiropractic care could benefit the headache sufferer?
The first step is to take a patient history that explores past and present health, as well as
details specific to the chief complaint—headaches, in this case. The responses help determine
whether the headache pattern is consistent with musculoskeletal referral from the neck or
surrounding tissues. Important clues include band-like pressure around the head; pain that begins
in the neck or base of the skull and may spread to the temples, forehead, or behind the eyes;
headaches triggered by prolonged computer work, poor posture, neck movement, stress, or jaw
clenching; pain that worsens after desk work or driving; improvement with massage, stretching,
or heat; and co-occurring neck stiffness or shoulder tightness.
If the patient presents with red flags—such as a new type of headache after age 50, the
worst headache of their life, recent head trauma, signs of infection (e.g., fever), or neurological
symptoms such as weakness, numbness, or vision changes—they may be referred for urgent
medical evaluation.
The history guides the physical examination, during which the chiropractor assesses
range of motion of the cervical spine—particularly the upper cervical segments—for restrictions,
asymmetries, or reproduction of symptoms. They will also palpate soft tissues in the head and
neck, including the suboccipital muscles, upper trapezius, sternocleidomastoid, temporalis,
masseter, and levator scapulae, to identify tenderness or trigger points and determine whether
these reproduce the patient’s headache. Orthopedic testing and postural assessment further help
identify musculoskeletal contributors.
The specific treatment approach varies by patient, but generally involves conservative
therapies aimed at restoring joint mobility and reducing muscle tension. This may include spinal
manipulation or mobilization, soft tissue therapy, trigger point techniques, physiotherapy
modalities, targeted exercises, and postural education. If a musculoskeletal disorder is a primary
contributor—as is often the case in tension-type or cervicogenic headaches—patients may
experience significant improvement or resolution. For other headache types, such as migraines,
care may help reduce the frequency, intensity, and duration of episodes.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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A Role for Chiropractic in Managing Chronic Rhinosinusitis

6 Apr

Chronic rhinosinusitis is an inflammatory condition of the nasal and sinus lining that lasts
longer than twelve weeks. It’s estimated that roughly 10–12% of adults in the United States are living
with chronic rhinosinusitis at any given time, with many experiencing symptoms for years. Managing
the condition can be challenging, as it’s driven by a mix of contributing factors that may include
chronic inflammation of the sinus lining, immune dysregulation, lingering microbes, structural
factors, and environmental exposures such as air pollution and cigarette smoke. Because the
accumulation of fluid and inflammatory material in the sinuses is a key component of the disease
process, treatments that help facilitate drainage may provide symptom relief. To that extent, therapies
provided by doctors of chiropractic may have a role in caring for some patients with chronic
rhinosinusitis.
Manual therapies performed by chiropractors can help address fluid build-up both directly
and indirectly. Specific techniques such as lymphatic drainage use gentle manual pressure and
stretching to stimulate lymphatic vessels that help move excess fluid out of tissues, which may
reduce pressure and congestion. Tightness in the muscles and soft tissues that attach to the head and
neck can also restrict normal fluid movement. For this reason, myofascial release, mobilization, and
manipulative therapies aimed at restoring normal motion in the face, head, neck, and upper back may
be beneficial for some individuals.
This potential benefit is illustrated in a case series involving 14 patients with chronic
rhinosinusitis who also experienced craniofacial pain. Those who received manual therapy to address
craniofacial dysfunction over a seven-week period reported improvements in both craniofacial pain
and the severity of their sinus symptoms, while patients in a comparison group that did not receive
hands-on care reported no meaningful improvement.
Additional studies suggest that manual therapies may help improve sinus drainage, reduce
facial pain and pressure, enhance nasal airflow, and improve quality of life—particularly when
chronic rhinosinusitis is accompanied by neck muscle tension or headaches associated with cervical
spine dysfunction. Other reports indicate that some patients who have not responded to conventional
medical management, including those who have undergone sinus surgery or who wish to avoid
surgery, may experience symptom relief with conservative manual therapy treatment.
While current evidence does not support chiropractic care as a first-line treatment for chronic
rhinosinusitis, manual therapies provided by doctors of chiropractic may play a supportive role as
part of a comprehensive care plan. This may be especially relevant for patients who have difficulty
managing symptoms with usual care alone. Individuals interested in this approach should speak with
their healthcare provider to determine whether a trial of chiropractic care may be appropriate for their
situation.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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In-Office and At-Home Neck Pain Management

9 Mar

Neck pain is estimated to affect approximately 30–50% of the adult population in the
United States each year, making it second only to low back pain as a primary reason patients
seek chiropractic care. The goal of chiropractic care for neck pain is to help restore normal joint
motion and function in the cervical spine, a process that is often a collaborative effort between
care delivered during office visits and self-care performed by the patient between visits.
During office visits, neck pain patients are commonly treated with manual therapies as a
primary intervention. High-velocity, low-amplitude spinal manipulation—sometimes
accompanied by an audible pop or crack—is the technique most commonly associated with
chiropractic care. Chiropractors are also trained in lower-force approaches, including
mobilization techniques and soft tissue therapies. Treatment plans may involve more than one
type of manual therapy depending on the tissues involved, patient presentation, and clinician
judgment.
In-office care may also include cervical traction, particularly when nerve irritation is
suspected to be contributing to symptoms. To assist with short-term symptom relief, patients
may receive adjunctive therapies such as electrical stimulation (e.g., TENS), therapeutic
ultrasound, low-level laser therapy, or heat or cold therapy. In some practices, massage therapy
provided by an on-site massage therapist may also be incorporated.
Between visits, patients are encouraged to take an active role in their recovery.
Continuing to pursue normal activities within pain tolerance helps prevent muscle
deconditioning (which can increase the risk of chronic pain) and supports joint health by
promoting nutrient exchange through movement. When muscle weakness or imbalance is
identified—which is common in neck pain—patients may be instructed in specific exercises to
perform regularly as time allows. Additional guidance may include recommendations for
sleeping positions, pillow selection, and temporary work or activity modifications to support
recovery. Anti-inflammatory strategies, including dietary modifications and selected
supplements, may also be discussed when appropriate.
Once pain and functional limitations reach maximal improvement, patients are typically
released from active care. Some may be advised to schedule wellness or maintenance visits on an
as-needed or periodic basis, along with continuing neck-healthy habits in daily life. Together,
these strategies may help reduce the likelihood of future episodes or allow a subsequent neck
pain episode to be addressed earlier before it interferes with normal activities or quality of life.

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Potential Causes of Post-Surgical Neck Pain

4 Feb

Assuming patients and healthcare providers follow clinical guidelines for managing neck
pain, most neck pain sufferers can experience resolution of their pain and disability with the aid
of a conservative, multimodal treatment approach, such as those provided by chiropractors.
However, for a variety of reasons, some patients may still undergo surgical intervention, and it is
estimated that up to 40% may continue to experience persistent or disabling neck pain. Why is
this the case, and is there anything chiropractic care can do to help these patients?
The first potential cause of persistent post-surgical neck pain is an incomplete or
incorrect diagnosis. This can occur when imaging reveals positive findings—such as a disk
herniation—that are attributed to the patient’s symptoms but may not, in fact, be the underlying
cause. In some cases, a disk herniation may play a role; however, other contributing factors that
are not visible on imaging or are missed during a physical examination may also be involved.
There are also cases in which the pain generator is correctly identified and treated, but
complications from surgery result in ongoing neck pain. For example, scar tissue formation
around nerves and soft tissues can tether nerves or create a chronic inflammatory environment
that triggers pain. In addition, a decompressed nerve may continue to experience impaired
function as though it were still compressed.
Finally, a new source of neck pain may develop following an otherwise successful
surgical procedure. This can occur when spinal alignment is restored but the joints and soft
tissues are not accustomed to supporting the altered loads and forces and subsequently become
injured. Additionally, in cases of surgical fusion that restrict movement at a cervical spinal level,
the vertebrae above and below the fusion may become hypermobile to compensate, pushing them
beyond their normal range of motion and increasing the risk of injury.
With all of this in mind, how can a doctor of chiropractic help manage post-surgical neck
pain? The first step is a thorough review of the patient’s history, which guides the physical
examination. The examination not only seeks to identify potential pain generators but also helps
detect red flags that contraindicate chiropractic treatment. In addition to traditional red flags
(such as fracture, infection, tumor, severe osteoporosis, and vascular abnormalities), the
chiropractor will also assess for signs of cervical instability or incomplete healing. To help
restore normal movement and function of the cervical spine, a doctor of chiropractic will often
employ a multimodal approach that combines low-force manual therapies, gentle traction,
therapeutic exercises, and physiotherapy modalities.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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