Neck pain is a very common complaint for which patients seek chiropractic care, though there are several possible causes…
Two common causes of neck pain are poor posture (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 (~7 kg) and when held in a forward translated position for a lengthy time frame, the muscles at the back of the neck 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 from a car accident, a slip-and-fall injury, sports injury, etc. 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 and 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 him or her clues about which tissues are injured. For example, in a motor vehicle collision, if the impact occurs from the side verses the rear end of the car, the tissues in the neck are stretched differently and the management/treatment may vary accordingly.
Neck pain can also be caused by a “slipped” or herniated disk. A herniated disk is like a jelly donut where the jelly leaks out and presses against a nerve that goes on to other parts of the body. Symptoms often include pain, numb, 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” process 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 (OA) takes years to develop and many people have a significant amount of OA but literally no pain or symptoms while others with only a little x-ray evidence of OA 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 verses 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 chiropractors sometimes need to “pre-position” the patient prior to administering an adjustment.
Other treatment considerations may include exercise instruction, physical therapy modalities (electric stim, ultrasound, etc.), the use of ice, re-adjustment of a computer monitor or workstation, and nutritional considerations.
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