Tag Archives: pain relief

Subfailure of the Facet Joints During Whiplash Injury

22 Sep

The neck contains many structures that work together to support the head and allow
smooth movement, including muscles, ligaments, disks, nerves, and facet joints. During a
whiplash injury, the neck can experience rapid forces that stretch these tissues, contributing to
the myriad symptoms collectively known as whiplash-associated disorders (WAD). According to
a recent systematic review, injuries to the cervical facet joints—small joints located at the back
of the spine that guide movement between the vertebrae—are a common source of pain
following whiplash, even if routine imaging tests do not reveal obvious structural damage.
The review, which examined 49 studies, found that the joint capsule surrounding the
cervical facet joints can sustain what researchers call a subfailure injury. In simple terms, this
means the tissue is stretched enough to develop microscopic strains without tearing or causing
obvious structural damage. Even though these tiny injuries may not appear on imaging tests, they
can still stimulate pain-sensitive tissues, causing pain that is often aggravated by certain neck
movements or positions.
Of note, the authors also found that these small injuries may increase the sensitivity of the
nervous system, allowing pain signals to continue long after the initial injury. This could help
explain why nearly half of patients with WAD continue to experience symptoms a year after
their injury, even though the injured tissues would generally be expected to have undergone
substantial healing.
These findings highlight the importance of the physical examination when assessing a
patient after a motor vehicle collision, sports injury, head trauma, or slip-and-fall accident. By
evaluating how the neck responds to palpation, assessing range of motion, and observing which
movements reproduce the patient’s symptoms, a doctor of chiropractic can identify patterns that
may suggest involvement of one or more cervical facet joints. While no single examination
finding can definitively diagnose a facet joint injury, the physical examination helps determine
the most likely source of pain and guides appropriate treatment.
If one or more facet joints are suspected to have been injured, chiropractic care often
includes a combination of gentle spinal manipulation or mobilization, soft tissue therapy,
therapeutic exercises, and postural recommendations designed to reduce pain, restore normal
joint motion, and improve the strength and coordination of the muscles that support the neck.
Patients are generally encouraged to remain as active as their symptoms allow rather than
immobilizing the neck with a cervical collar, as prolonged use can lead to muscle
deconditioning, joint stiffness, and an increased risk of persistent symptoms.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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Wrist Mobilization May Improve Median Nerve Function

15 Sep

The median nerve provides feeling to the thumb, index finger, middle finger, and the thumb side
of the ring finger. It also controls several muscles at the base of the thumb. If pressure builds within the
carpal tunnel where the nerve passes through the wrist, the compression can impede the normal median
nerve function, resulting in the symptoms of pain, numbness, tingling, weakness, or difficulty gripping
objects associated with carpal tunnel syndrome. Because these symptoms can interfere with everyday
activities, researchers continue to investigate which conservative treatments may best improve median
nerve function.
Among the non-surgical treatments commonly used for carpal tunnel syndrome are manual
therapies designed to improve the movement of either the median nerve itself or the structures
surrounding it. One approach, known as median nerve mobilization or neural gliding, uses gentle
movements to help the nerve slide more freely through surrounding tissues. Another is carpal bone
mobilization, in which a clinician uses manual techniques to improve the movement of the small bones
that form the wrist and the carpal tunnel. Although both techniques are widely used, it has been unclear
whether either intervention can immediately improve the physiological function of the median nerve.
To investigate this question, researchers conducted a randomized controlled trial involving 74
adults with carpal tunnel syndrome. Participants were assigned to receive either median nerve
mobilization, carpal bone mobilization, or no treatment. Nerve conduction studies performed immediately
before and after treatment showed that the carpal bone mobilization group experienced significantly
greater improvements in motor nerve conduction velocity than both the neural mobilization and control
groups. Improvements in both motor and sensory conduction velocity were also observed within the
carpal bone mobilization group. By comparison, the neural mobilization group demonstrated only a
modest increase in sensory nerve amplitude.
These findings suggest that improving the mechanical environment surrounding the median nerve
may produce immediate physiological benefits. By restoring normal movement of the wrist joints, carpal
bone mobilization may temporarily reduce stress or pressure within the carpal tunnel, allowing electrical
impulses to travel more efficiently through the compressed nerve. This does not mean neural mobilization
is ineffective. Nerve-gliding techniques may improve nerve mobility, reduce mechanosensitivity, or
contribute to symptom relief over time, even if immediate improvements in nerve conduction are limited.
Chiropractors frequently manage patients with carpal tunnel syndrome using a multimodal
approach that addresses the many factors contributing to the condition. In addition to evaluating the wrist,
chiropractors may assess the elbow, shoulder, neck, and upper extremity for joint dysfunction, soft tissue
restrictions, or movement patterns that increase stress on the median nerve. Treatment may include joint
mobilization or manipulation, soft tissue therapies, nerve mobilization, therapeutic exercises, nocturnal
splinting, ergonomic recommendations, activity modification, and home stretching or strengthening
exercises. By restoring normal mechanics and reducing stress on the median nerve, conservative care may
help improve function, reduce symptoms, and support long-term recovery.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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Hands-On Care May Help Reduce Hamstring Injuries

8 Sep

Athletic performance depends on more than strength alone. Healthy movement requires
muscles, joints, and the nervous system to work together smoothly. Hamstring injuries are
among the most common in sports, especially those involving running, sprinting, and rapid
changes of direction, such as soccer. Because recovery can take weeks or even months, injury
prevention is an important goal in the sports world.
Research suggests that maintaining good joint mobility and healthy muscle function may
help the body move more efficiently. The hips and knees play a particularly important role
because they generate and absorb force during athletic activities. When movement in these joints
is limited or the muscles become fatigued, the hamstrings may be subjected to greater strain,
increasing the risk of injury.
In a November 2025 study, researchers examined these factors in a group of 66 female
soccer players. They found that athletes who received a single session of manual therapy
combined with neuromuscular exercises experienced improvements in hip and knee range of
motion as well as neuromuscular function—how effectively the brain, nerves, and muscles work
together to control movement. Improvements in these areas are thought to enhance hamstring
resilience and may contribute to a lower risk of injury, though the study did not directly measure
injury rates. While the study focused on soccer players, the findings suggest that optimizing
movement and muscle control may benefit athletes in many sports.
These findings add to a growing body of research suggesting that hands-on care and
targeted exercise may help improve the way the body moves. Better hip and knee mobility can
reduce unnecessary stress on the hamstrings, while improved neuromuscular control may help
muscles respond more effectively during demanding activities. It is important to remember that
no single treatment can prevent every injury. Training load, conditioning, previous injuries,
recovery habits, and many other factors also influence injury risk. Still, addressing movement
limitations may be one valuable component of a comprehensive injury prevention program.
While chiropractic care is most often associated with helping reduce pain and disability
following musculoskeletal injuries, many athletes also use it as part of a broader strategy to
optimize movement and function. In fact, professional teams in nearly every major sports league
include chiropractors as members of their healthcare staff. Many patients also choose to continue
receiving periodic chiropractic care after recovering from an injury so that movement restrictions
and other mechanical issues can be identified and addressed before they contribute to future
problems.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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Treating the Mid-Back May Help Relieve Neck Pain

3 Sep

Neck pain is a common condition that can make everyday activities more difficult. While
discomfort is felt in the neck, its cause may not always be limited to the cervical spine and
associated tissues because the neck does not exist in isolation. It has been theorized that because
the neck and mid-back (thoracic spine) work together during nearly every upper-body
movement, restricted motion in the thoracic spine may increase mechanical stress on the tissues
of the neck, elevating the risk of pain or injury.
Common conditions that affect the mid-back include restricted or dysfunctional thoracic
facet joints, loss of normal thoracic mobility, excessive rounding of the upper back (thoracic
kyphosis), rib joint dysfunction, muscle tightness and trigger points in the upper back and
shoulder girdle, and weakness of the muscles that stabilize the shoulder blades. Because these
problems can alter posture and reduce normal thoracic motion, they may also alter biomechanics
and place added strain on the muscles and joints of the neck. Over time, these mechanical
changes may contribute to neck pain, stiffness, and reduced range of motion.
Based on this proposed mechanical relationship, researchers have investigated whether
improving thoracic mobility can also improve neck pain and function. In one study, the authors
reviewed 17 randomized clinical trials and found that spinal manipulative therapy applied to the
thoracic spine showed evidence of reducing pain, improving function, and decreasing disability
in individuals with neck pain.
A second study reached a similar conclusion using a different therapeutic approach. The
research team found that combining manual therapy to improve thoracic mobility with exercises
to improve posture reduced neck pain and disability while increasing neck range of motion in
patients with mechanical neck pain. Together, the available evidence suggests that improving
thoracic mobility and posture may help reduce mechanical stress on the neck, decrease pain and
disability, and improve function during everyday activities.
This body of research highlights the importance of evaluating the whole person rather
than focusing only on where pain is felt. Neck pain often has multiple contributing factors, and
restrictions in nearby joints or muscles may represent one piece of the puzzle. A thorough
evaluation can help identify the factors most likely responsible for an individual’s symptoms.
Based on these findings, the chiropractor can develop a treatment plan that addresses the
potential underlying causes with the goal of reducing pain and disability, restoring function, and
potentially lowering the risk of future episodes.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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Lumbar Instability: Looking Beyond the Spine

1 Sep

While an episode of low back pain may begin after lifting, sleeping in an awkward
position, or engaging in physical activity, these events often act as triggers rather than the
underlying cause. In many cases, the factors that make the lower back vulnerable have been
present for months or even years. One such factor is lumbar instability, which occurs when agerelated changes, muscle weakness, or repetitive mechanical stress reduce the ability of the
ligaments, intervertebral disks, facet joints, and muscles to stabilize the spine. As a result, the
vertebrae may move excessively, placing greater stress on the pain-sensitive tissues in the lower
back. There is growing evidence that structures beyond the lumbar spine—particularly the
muscles that control the hips and pelvis, including the gluteal muscles and hamstrings—can also
influence lumbar stability.
The gluteal muscles and hamstrings play an important role in supporting healthy
movement and helping maintain proper control of the pelvis during everyday activities. When
these muscles are weak, the pelvis may not remain as stable during walking, bending, lifting, or
climbing stairs. This can alter the way forces are transferred through the pelvis and lower back,
increasing stress on the joints, disks, ligaments, and muscles of the lumbar spine.
The gluteal muscles, particularly the gluteus medius and gluteus maximus, are important
for controlling pelvic position and limiting excessive movement during standing and walking.
Weakness in these muscles may contribute to altered posture and movement patterns that place
greater demands on the lower back. Likewise, weak hamstrings may be less able to help control
hip motion and pelvic movement during activities such as bending, lifting, or climbing stairs.
A December 2025 study provides further support for this concept. Researchers evaluated
129 young adults, including 67 with lumbar instability, to better understand the relationship
between muscle function and low back pain. The investigators found that weaker hamstring
muscles and reduced hip mobility were associated with greater low back pain and higher levels
of disability.
These findings reinforce the notion that the body functions as an interconnected system.
Low back pain may not originate solely from the lumbar spine itself. Instead, weakness or
limited mobility in the muscles and joints surrounding the hips and pelvis can alter posture,
movement, and the way forces are distributed throughout the body. Doctors of chiropractic are
trained to evaluate musculoskeletal conditions and assess how the spine, hips, pelvis, and
surrounding muscles function together. Following a thorough examination, they can develop an
individualized, multimodal treatment plan to address contributing factors, improve function,
relieve pain, and support long-term spinal health.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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Whiplash and Occipital Neuralgia

27 Aug

Occipital neuralgia is a condition involving irritation of the occipital nerves and is often
characterized by sharp, shooting, burning, or electric-like pain that starts near the base of the skull
and radiates upward. A 2025 study of 212 patients with occipital neuralgia found that 117 reported a
prior head or neck injury, with whiplash identified as the most common cause. Let’s look at how a
history of whiplash may influence the risk of occipital neuralgia.
The greater occipital nerve originates from the second cervical spinal nerve and passes
through several layers of muscle and connective tissue before reaching the scalp. During a whiplash
injury, the rapid back-and-forth motion of the head and neck may stretch or compress the nerve,
cause microscopic injury, or trigger abnormal nerve signaling. In some individuals, these changes
may contribute to the shooting, burning, or electric-like sensations.
Whiplash commonly causes tightness in the small muscles at the base of the skull as well as
tension throughout the neck and shoulders. When these muscles remain chronically tight, they may
place pressure on nearby occipital nerves and contribute to symptoms. Trauma can also affect the
joints between the skull and first cervical vertebra as well as those between the first and second
cervical vertebrae. These structures are closely related to the nerve roots that eventually form the
occipital nerves. Joint irritation may increase local inflammation, alter nerve mechanics, and produce
pain patterns that resemble occipital neuralgia.
The healing process itself may also play a role. As injured tissues repair, scar tissue and
thickened connective tissue can develop. Because the occipital nerves pass through multiple
muscular and fascial layers, these changes may reduce the available space around the nerves and
contribute to ongoing irritation or entrapment. In some individuals, the nervous system becomes
more sensitive following injury. This process can cause normally harmless sensations to become
painful and may contribute to scalp tenderness, increased nerve sensitivity, or symptoms that persist
long after the initial injury has healed.
Occipital neuralgia is sometimes mistaken for migraines, tension headaches, or headaches
that originate from the neck. Clues that suggest occipital neuralgia include pain that begins near the
base of the skull, tenderness over the occipital nerves, scalp sensitivity, and sharp pain that radiates
toward the top of the head. Because several conditions can produce similar symptoms, a thorough
examination is important. If the examination suggests occipital neuralgia is present and the patient is
a candidate for chiropractic care, treatment may include a multimodal approach using manual
therapies, specific exercises, physiotherapy modalities, and patient education to help reduce
mechanical stress on the occipital nerves. Chiropractors are also trained to recognize when comanagement or referral to another healthcare provider may be appropriate.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

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