Your neck, also called the cervical spine, begins at the
base of the skull and contains seven small vertebrae. Incredibly, the cervical
spine supports the full weight of your head, which is on average about 12
pounds. While the cervical spine can move your head in nearly every direction,
this flexibility makes the neck very susceptible to pain and injury.
The neck’s susceptibility to injury is due in part to
biomechanics. Activities and events that affect cervical biomechanics include
extended sitting, repetitive movement, accidents, falls and blows to the body
or head, normal aging, and every day wear and tear. Neck pain can be very
bothersome, and it can have a variety of causes.
Here are some of the most typical causes of neck pain:
Injury and Accidents: A sudden forced movement of the head
or neck in any direction and the resulting “rebound” in the opposite direction
is known as whiplash. The sudden “whipping” motion injures the surrounding and
supporting tissues of the neck and head. Muscles react by tightening and
contracting, creating muscle fatigue, which can result in pain and stiffness.
Severe whiplash can also be associated with injury to the intervertebral
joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most
common cause of whiplash.
Growing Older: Degenerative disorders such as
osteoarthritis, spinal stenosis, and degenerative disc disease directly affect
the spine.
• Osteoarthritis,
a common joint disorder, causes progressive deterioration of cartilage. The
body reacts by forming bone spurs that affect joint motion.
• Spinal
stenosis causes the small nerve passageways in the vertebrae to narrow,
compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and
arm pain, as well as numbness, when these nerves are unable to function
normally.
• Degenerative
disc disease can cause reduction in the elasticity and height of intervertebral
discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and
pain that runs into the arm.
Daily Life: Poor posture, obesity, and weak abdominal
muscles often disrupt spinal balance, causing the neck to bend forward to
compensate. Stress and emotional tension can cause muscles to tighten and
contract, resulting in pain and stiffness. Postural stress can contribute to
chronic neck pain with symptoms extending into the upper back and the arms.
Chiropractic Care of Neck Pain
During your visit, your doctor of chiropractic will perform
exams to locate the source of your pain and will ask you questions about your
current symptoms and remedies you may have already tried. For example:
• When did
the pain start?
• What have
you done for your neck pain?
• Does the
pain radiate or travel to other parts of your body?
• Does
anything reduce the pain or make it worse?
Your doctor of chiropractic will also do physical and
neurological exams. In the physical exam, your doctor will observe your
posture, range of motion, and physical condition, noting movement that causes
pain. Your doctor will feel your spine, note its curvature and alignment, and
feel for muscle spasm. A check of your shoulder area is also in order. During
the neurological exam, your doctor will test your reflexes, muscle strength,
other nerve changes, and pain spread.
In some instances, your chiropractor might order tests to
help diagnose your condition. An x-ray can show narrowed disc space, fractures,
bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT
scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and
herniations. If nerve damage is suspected, your doctor may order a special test
called electromyography (an EMG) to measure how quickly your nerves respond.
Chiropractors are conservative care doctors; their scope of
practice does not include the use of drugs or surgery. If your chiropractor
diagnoses a condition outside of this conservative scope, such as a neck
fracture or an indication of an organic disease, he or she will refer you to
the appropriate medical physician or specialist. He or she may also ask for
permission to inform your family physician of the care you are receiving to
ensure that your chiropractic care and medical care are properly coordinated.
Neck Adjustments
A neck adjustment (also known as a cervical manipulation) is
a precise procedure applied to the joints of the neck, usually by hand. A neck
adjustment works to improve the mobility of the spine and to restore range of
motion; it can also increase movement of the adjoining muscles. Patients
typically notice an improved ability to turn and tilt the head, and a reduction
of pain, soreness, and stiffness.
Of course, your chiropractor will develop a program of care
that may combine more than one type of treatment, depending on your personal
needs. In addition to manipulation, the treatment plan may include
mobilization, massage or rehabilitative exercises, or something else.
Research Supporting Chiropractic Care
One of the most recent reviews of scientific literature
found evidence that patients with chronic neck pain enrolled in clinical trials
reported significant improvement following chiropractic spinal manipulation.
As part of the literature review, published in the
March/April 2007 issue of the Journal of
Manipulative and Physiological Therapeutics, the researchers
reviewed nine previously published trials and found “high-quality evidence”
that patients with chronic neck pain showed significant pain-level improvements
following spinal manipulation. No trial group was reported as having remained
unchanged, and all groups showed positive changes up to 12 weeks
post-treatment.
Reference: American Chiropractic Association
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