Health Update: Neck Pain
Neck Pain and Chiropractic Treatment
Neck pain is a very common complaint that chiropractic has been found to be very effective in treating. There are many causes of neck pain including posture related (such as a forward head carriage) and repetitive strain (such as long static holding of awkward positions). These two causes are very similar as the head weighs approximately 15 pounds and when held in a forward translated position for a lengthy time frame, the muscles fatigue and begin to ache. This is similar to holding a baby in your arms for a long time frame. We soon find ourselves moving the baby to the other arm or against our chest due to the gradual increasing strain placed our upper quarter muscles. Hence, we must similarly change the forward head position when we are working at the computer, listening or talking (especially if the person is not directly in front of you), reading a book, cooking, and so forth.
Another cause of neck pain is trauma. This could be from a car accident, a slip-and-fall injury, sports injury, and more. These injuries are highly variable as no two injuries or accidents are the same, and there are a wide variety of neck sizes in both length and girth. Hence, the same trauma may hardly result in an injury in one person and greatly injure a smaller, more petite person. Your doctor of chiropractic will ask you about the “mechanism of injury” as that can give us clues about which tissues are injured. For example, in a motor vehicle collision, if the impact occurs from the side versus the rear end of the car, the tissues in the neck are stretched differently and the management/treatment may vary accordingly.
Other causes of neck pain include a “slipped” or herniated disk. A herniated disk is like a jelly donut where the jelly leaks out and presses against a nerve that travels down the arm. Symptoms often include pain, numbness, tingling, burning, weakness, or combinations of these sensations down the course of the nerve. When this occurs, the person is usually quite specific about where the pain is traveling such as, “…it goes down my arm to my 4th and 5th finger.”
Another cause can be related to the natural aging process involving the “wearing out” of the disk, joints, and muscle/ligament attachments. The term, “osteoarthritis” is commonly associated with these findings and is often blamed for neck pain, but this is controversial. First, osteoarthritis takes years to develop and many people have a significant amount of osteoarthritis but literally no pain or symptoms, while others with only a little x-ray evidence of osteoarthritis present with an abundance of pain.
So, how do chiropractors manage all of these causes of neck pain? A thorough history, examination, and locating the positions of pain production versus pain relief are “key” to the successful management of patients with neck pain. For one patient, traction/stretching types of manual adjustment techniques work best while for the next, this may not be tolerated at all, which is why we “pre-position” the patient prior to administering an adjustment.
Other treatment considerations may include exercise instruction, physical therapy modalities (electric stimulation, ultrasound, etc.), the use of ice, re-adjustment of a computer monitor or work set up and nutritional considerations. If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.
We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.
To schedule a FREE Consultation with Dr. Falkenroth, simply call (831) 475-8600
Health Update: Neck Pain
Is It Really Neck Pain?
A 48-year-old male had left sided neck pain with intermittent left arm tingling, numbness, and aching for 2.5 months. The pain was described as a deep nagging ache on the left side of the neck with a more intense pain in the left shoulder blade that occurred without any specific activity. Also, no particular position of the neck or head changed the symptoms in the neck or left arm. The patient described having periodic episodes of neck and left arm pain/numbness 4 or 5 times over the last 10 years, and he felt that this episode was similar to the previous episodes. He had utilized chiropractic treatment previously with good results and was considering calling for an appointment once again.
Everything "looks and sounds" like a neck condition with an associated pinched nerve causing pain and tingling radiating down the arm - but is it?
After carefully questioning, it was discovered that no specific date of onset could be tied to a trauma (specific injury), over-use activity, or any other identifiable cause. Similarly, he stated that no specific position of the head/neck or arm changed the intensity or length of time the pain lasted. This is unusual for a pinched nerve in the neck as the nerves are stretched when the arm hangs down at the side increasing the pain, and less stretched when the arm is raised over the head resulting in less arm symptoms. Another inconsistent finding was that the whole arm rather than a specific part of the arm was symptomatic. Usually, a pinched nerve follows a specific course down the arm affecting either the 4th and 5th fingers or the thumb side of the hand, but not the whole arm and hand. The physical examination was fairly typical for neck pain sufferers - limited ranges of motion of the neck, neck pain reduction with manual traction and increased with compression tests. However, there were no arm symptom changes during the neck ranges of motion tests, compression tests, or elevating the arm.
These history and examination findings pointed to a possible "organic" cause for the symptoms rather than the "pinched nerve" diagnosis. When considering a list of possible "organic" causes, heart disease must be first on the list since it has life threatening potential. In the case presentation above, the patient was indeed having a heart attack where the blood vessels to part of the heart wall were blocked and the blood carrying oxygen to the heart muscle couldn't get through, thus was causing the "referred pain" to the left side of the neck, shoulder blade and down the left arm. It is important to know that this heart related referred pain pattern never involves the right arm - only the left. Other potential symptoms can include left jaw (TMJ) pain, and the more obvious left sided chest pain, even though these were not present in this case.
The good news is that, with most neck pain, it is probably your neck and not your heart that is causing the pain. Most importantly, rest assured that we ALWAYS consider all possibilities.
If you, a friend or a family member suffers from neck pain, Pro-Adjuster treatment and a heated dry hydrotherapy massage may help relieve your pain.
To schedule a FREE Consultation with Dr. Falkenroth, simply call (831) 475-8600.
Neck and Arm Pain – The Herniated Disk?
Patients that present with neck pain along with arm numbness, pain, and/or weakness, often ask, “…what’s causing this pain down my arm?” The condition is often caused from a bulging or herniated disk pinching a nerve in the neck. The cause of this complaint can include both trauma as well as non-traumatic events. In fact, sometimes, the patient has no idea what started their condition, as they cannot tie any specific event to the onset.
The classic presentation includes neck pain that radiates into the arm in a specific area as each nerve affects different parts of the arm and hand. Describing the exact location of the arm complaint such as, “I have numbness in the arm and hand that makes my 4th and pinky fingers feel half asleep,” tells us that you have a pinched C8 nerve. This nerve can also be pinched at the elbow and make the same two fingers numb. The difference between the two different conditions is when the nerve is pinched in the neck, the pain is located from the neck down the entire arm and into digits 4 & 5 of the hand. When the nerve is pinched at the elbow, the pain/numbness is located from the elbow down to the 4th & 5th digits, but no neck or upper arm pain exists.
Examination findings usually include limitations in certain cervical (neck) ranges of motion (ROMs) – usually in the direction that increases the pinch on the nerve. Another common finding is the arm is often held over the head because there is more stretching on the nerve when the arm is hanging down and pain in the neck and arm increases. Hence, raising the arm over the head reduces the neck pain and arm pain.
To determine where the nerve is pinched, there are a number of different compression tests that can recreate or increase the symptoms. Some compression tests include placing downward pressure on the head with the head pointing straight ahead, bent or rotated to each side. Other compression tests are performed by pressing in areas where the nerve travels such as in the lower front aspect of the neck, in the front of the shoulder where the arm connects to the chest/trunk, at the elbow and at the wrist.
If there is a pinched nerve, neck pain and/or arm pain and numbness and/or tingling will be reproduced when pressure is applied to these regions. Other tests include testing reflexes and muscle strength in the arm. When a nerve is pinched, the reflexes will be sluggish or absent and certain movements in the arm are weak when compared to the opposite side.
Another very practical test is called the cervical (neck) distraction test where a traction force is applied to the neck. When neck pain or arm pain is reduced, this means there is a pinched nerve. This test is particularly useful because when neck pain and arm pain are reduced, the test supports the need for a treatment approach called cervical traction. It has been reported that the use of cervical traction when applied 3x/day for 15 minutes each, at 8-12 pounds, 78% of 81 patients reported a significant improvement in symptoms, which is very effective. Other forms of care that can be highly effective include spinal manipulation, spinal mobilization, certain exercises, physical therapy modalities, and certain medications.
To schedule a FREE Consultation with Dr. Falkenroth, simply call (831) 475-8600.
