Neck Pain- Non-Surgical Treatment Options

There are many treatment options for those suffering from neck pain. There is conventional medical care where the family doctor will usually prescribe a muscle relaxant, anti-inflammatory, and/or pain killer to help patients through episodes of acute neck pain. However, many patients with neck pain have been through the process of treatments associated with medications and simply cannot tolerate the adverse side effects of stomach pain common with anti-inflammatory drugs such as ibuprofen (Advil, Nuprin, Mediprin, etc.), Aleve (Naproxen), or aspirin. Others don’t like the groggy, drunk-like feelings associated with pain killers or the sleepiness associated with muscle relaxants. Therefore, these patients often turn to complementary / alternative care.

As noted in the May, 2009 issue of Consumer’s Report for low back pain, chiropractic was the most sought after form of treatment, but there has been no extensive review of neck pain regarding evidence-based treatment approaches – at least not until February, 2008. An international “team” representing 9 countries screened over 31,000 titles of articles published between 1980 and 2006, reviewed more than 1200 articles and eventually reported on 552 studies in their final report. Their findings included the following:

•In the US, 54% utilized complementary (alternative) treatment approaches compared to 37% that obtained conventional medical care.
•Neck pain was the 2nd most common reason Americans obtained chiropractic care.
•Chiropractic was found to be the most frequently reported form of treatment for upper back or neck pain (ahead of massage therapy, relaxation therapy, acupuncture).
•Those who obtained complementary AND conventional medical care were much more likely to perceive the complementary/alternative therapy as being helpful (61% vs. 6.4% for neck conditions and 39.1% vs. 19% for headaches).
•Women more commonly obtained care than men for neck/shoulder pain (29% vs. 18% men) over a 4-6 year time frame.
•Manual therapy (mobilization, manipulation, stretching) was associated with greater pain reduction in the short-term among patients with acute whiplash when compared with usual medical care, soft collars, passive modalities, or general advice.
•For non-whiplash neck pain (without arm radiating pain), manipulation or mobilization, exercise, low level laser therapy (LLLT), and “…perhaps acupuncture…” were reported as more effective than no treatment, sham, or other alternative interventions.
•For both whiplash and non-traumatic neck pain, supervised exercise with or without manual therapy was favored over usual medical care or no care.

What does all this mean? Simple! Everyone who is suffering from neck or upper back pain should seek chiropractic care which includes manipulation, mobilization, exercise training, and activity modifying advice, as these approaches have been found to be more effective than usual medical care! Why waste time with a “wait and watch” with or without drug intervention approach when the evidence favors chiropractic related interventions. If you, a friend, or a loved one is struggling with neck or upper back pain, we will properly assess your condition and administer the appropriate care that is required. We will coordinate care with other health care services when necessary. This recommendation may represent one of most significant acts of kindness you can offer those that you truly care about.
Call us at (919)845-0200 and schedule your appointment today!

Could Neck Problems Be Affected By Your Posture?

While most of us have a look in the mirror at least once a day, few of us look at our appearance from a different angle, such as from the side. But, the view from the side can be quite revealing if you suffer from chronic neck pain.

First, note the position of your head in relation to you shoulders. Is it right above the shoulders or does it lean forward from your chest? If it does, this would be called forward head posture, and can come from a problem in your neck. Lower areas of your spine can also cause this problem. Some of us have increased our weight over the years with much of it added to our abdominal region. Because of this increased core weight, the body must counter-balance the weight gain by causing the lumbar spine to “sway- back.”

While this “sway-back” problem can create pain this the lumbar spine, it can also have far reaching effects in the posture of the neck. Usually someone with a protruding stomach and sway back will have somewhat rounded shoulders and a forward head posture. If treatment is only directed at the neck without considering how other areas may affect the stability of the neck, then the results may be less than optimum.

In an accident, many areas of the body can potentially be injured.

As a chiropractor, I not only look at your primary injuries but also how mechanically one area of the spine can affect a distant area. These more distant areas can cause neck pain by referral or they can impede complete recovery because the body is compensating for abnormal posture or movement elsewhere.

X-rays of the full spine can show this abnormal posture as can a detailed postural analysis from our office.

So do you like what you see when you view your posture from the side? If your posture leaves something to be desired, or you’re wondering whether your neck problem could be improved by changing another part of your spine, then it is important to be thoroughly checked. Just examining the neck after a whiplash may leave some injuries undiscovered. Are there tender spots in other areas of the spine? Does your overall upright posture seem lacking?

Call us at (919)845-0200 and schedule an appointment if you notice postural distortions and/or suffering with neck pain. Don’t ignore the warning signs of nerve irritation as it can be a warning of bigger issues!

After My Car Accident, Why Do I Hurt So Much?

There are many different reasons why injuries sustained in car crashes result in chronic or long term pain. First, there are several types of tissues in the neck that can give rise to pain. The most intense pain comes from the tissues with the greatest density of nerve fibers, such as the joint capsules and the ligaments holding the bones of the neck together. There are many ligaments in the neck that are vulnerable to being over-stretched and injured in a motor vehicle collision. The mechanism of a “whiplash” injury in a rear-end collision is unique. Upon impact, the vehicle rapidly accelerates forward while the head momentarily remains in its original position, resulting in an initial straightening of the neck followed by extension. At the extreme end-range of backward extension motion, the ligaments in the front of the neck are over stretched and can tear. Within milliseconds, the head is then propelled forwards into flexion which can then injure the ligaments in the back of the neck placing a significant amount of force on the joint capsules and ligaments holding the bones in close proximity. Another reason the neck is injured is the speed at which the head and neck “whip” in the backwards and forwards directions after the impact. This occurs faster than what we can voluntarily contract our neck muscles to resist–within 600 milliseconds! Therefore, even if we brace ourselves in preparation for an impact, we can’t avoid injury to the ligaments and joint capsules. Damage to the ligaments is difficult to “prove” by conventional x-ray, which is why bending views or, flexion/extension x-ray methods are needed. When there is damage to the ligaments, the vertebra will shift forwards or backwards excessively compared to neighboring vertebra. This can be measured to determine the extent of ligament laxity or damage and can help explain why neck pain can be so intense and/or chronic. Not all car accidents occur from behind. In fact, only about 1/3 occur from this direction. One study investigating which direction created greater degrees of injury reported 57% of chronic pain patient group occurred from rear-end collisions. It also found that woman sustained more ligamentous injury compared to men and that frontal and rear end collisions resulting in significantly higher levels of ligament injury compared to side impacts

Another well published reason why neck pain can “hurt so much” after a car crash is that the sensory input from the injured area to the brain can be so extreme that it leaves an “imprint” in the sensory portion of the nervous system and it becomes hypersensitive or sensitized, resulting in a lower pain threshold or being more sensitive to pain. This is similar to the “phantom limb” phenomenon that often occurs after a leg is amputated where the brain still “feels” leg pain after the limb has been removed. This has also been reported to be a reason for the significant constellation of symptoms often accompanying “whiplash” injuries. A partial list of associated symptoms with whiplash injuries includes neck pain, headache, TMJ / jaw pain, dizziness, coordination loss, memory loss, cognitive difficulty in formulating thought, communicating, losing your place during conversation, and more.

Understanding whiplash and all of its nuances regarding signs and symptoms, x-ray requirements and measurement techniques, and treatment / management strategies are well understood at this office. Chiropractors have a unique advantage over other health care providers as manual therapies, including spinal manipulation, have been shown to yield higher levels of satisfaction and faster recovery rates compared to other forms of health care. We pride ourselves in performing thorough history and physical examinations, offering high quality evidence-based therapeutic approaches and teaching necessary home-based, self-management procedures. If you, a loved one, or a friend are struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional assessment and therapeutic approach at this office.