Neck Pain

Neck pain is a common problem that I see in practice every day.

There are many causes but 3 of the most common are:

1. Mechanical
2. Arthritic and
3. Disc

Mechanical Causes

Mechanical causes of pain include joint and muscle strain.  They are the most common cause and often arise from poor movement/lack of movement and poor posture.  And there is  often a combination of factors  aggravating the condition.

For example, sitting at the computer for hours often means a lack of movement and poor posture.  Throw in turning the head to a second screen on one side and trying to hold the phone between the ear and shoulder, no wonder strain builds in the neck every time we sit at the desk.  Other examples are sitting long periods in a car/on a couch.  Another example often overlooked is sleeping on your belly, sleeping with the wrong type or size pillow.

Signs and symptoms this might be an issue are:

1. stiffness and aching in the neck, upper back and shoulder muscles (especially the trapezius muscle)
2. tenderness in the neck and shoulder muscles to touch
3. reduced range of motion especially the ability to turn the head or look up
4. headaches from the base of the skull and around to forehead and temples
5. pain and headaches typically worse at the end of the day
6. pain and restriction aggravated by maintaining a single position or repeating a particular activity.

Strategies to help reduce this type of issue would include postural changes especially when sitting and using a computer/at a desk.  Movement breaks to avoid the prolonged positions are a great help.  Set a timer to remind you to get away from the computer or job you are doing.   Another good tactic is to build in movement to your day.  For example, stand and walk around the room when you take a phone call.  Or have the printer located a the other end of the building.

When tension builds in the neck and shoulders, the Neck Side Stretch is a good way to relieve it.  Often though once the tension has built up, “the damage has been done”.  This is where the preventative exercises like the No Money Exercise and the Foam Roller are most effective.

Arthritic Causes

Above: left normal with smooth even joint surfaces and an even curve.
Right: mild to moderate arthritic change with decreased space, roughened joint surfaces and a reduced curve.

If the neck is under mechanical strain for long enough, degenerative changes or osteoarthritis can develop.  It may also result from an injury that damages or weakens the joints, causing them to deteriorate rapidly.

Signs your neck is being effected by arthritic pain:

1. the neck will feel stiff after being in one position for a while
2. pain can increase after activity and reduce with rest
3. it’s gradually getting harder to turn your head around
4. you may hear crack, pop or grind when you move your neck

Strategies to help manage these issues include all the above.  A more focused stretch for the neck is the neck roll.  Some people will need to do this in addition to the foam roller, others it makes an excellent substitute.

Disc Causes

Discs are the flexible spacers between every vertebra in your spine.  Direct injury/trauma like whiplash or progressive wear’n’tear due to postural problems or poor movement patterns can damage the discs.

When the discs are damaged they can move into spaces between the vertebra where the nerves are and can compress and irritate them.

Neck pain caused by disc problems can be debilitating.

Signs and symptoms your neck pain may be coming from a disc problem include:

1. Pain can be severe and spread to the top corner of the shoulder blade and travel down the arm.
2. There can be pins and needles, numbness and weakness in the arm and hands.
3. Pain can severely limit neck movement.  Looking up can aggravate the issue.  Turning and bending to the side can also be aggravating.
4. Lying flat in bed can limit sleep due to pain.  Many people with these problems find they can get some sleep in a recliner.
5. An unusual thing that can happen is the patient can cradle the arm or rest the forearm over the top of the head to relieve pain in the arm.
6. Sudden “jolts” like hitting a pothole while driving, coughing or sneezing can reproduce the pain in many cases also.

Strategies to help in this situation may vary form patient to patient.  Spaces between the vertebrae can be opened up by using different Chiropractic techniques.  There is usually inflammation present and things like ice and heat, rest or gentle exercise may be recommended to help start recovery.

Common Factors

From what I’ve just shared with you, it would be logical to conclude that each type of problem would have a different approach to getting relief.  But the truth of it is that one issue often leads to the next and can be overlapping.

For example, mechanical neck pain left long enough can start to wear on cartilage and joints.  This leads to degeneration and osteoarthritis in the joints.  Sometimes a degenerated joint and disc can then bulge and impinge nerves.   It is rare to find arthritic or disc problems that didn’t start with some sort of mechanical issue.  Mechanical issues are related to the vertebral subluxation.

Vertebral Subluxation Complex

The common factor is what Chiropractors refer to as the Vertebral Subluxation Complex.  Or subluxation for short.  The subluxation is an issue where a vertebra has lost it’s normal position and motion compared to the vertebra adjacent to it.  This results in many different factors at that level of the spine.  For example, loss of movement in the joint between the vertebra means the millions  of little nerve endings (receptors) that communicate movement and balance with the brain are shut off.  That lack of input reduces stimulation to the brain and reduces the dampening effect on pain nerves.  When the pain nerve input to the brain is “louder” than the “balance” nerves, pain is the dominant sensation.

Other issues include weakness and tightness of the “intrinsic” muscles.  They are the tiny muscles between each vertebra.  They are under control of the balance part of the brain.  So if the balance part of the brain is not stimulated as much and then the intrinsic muscle are weak, can you see how this sort of problem can become “self perpetuating”?

Without help in restoring movement, that cycle of loss of movement and weakness of the little spinal muscles continues.  Pain may come and then go with rest/decreased inflammation after re-injury/aggravation.  The decrease in inflammation after an aggravation often heals with scar tissue.  The joints are further restricted.  Then the whole cycle starts again.

The Chiropractic adjustment restores motion to the vertebra.  Nerve receptors are stimulated and the brain can recognise and control this area of the spine again.  The improved movement then decreases the inflammation and scar tissue.   To get longer term improvements repetition and time are needed.

Our approach

Whatever the presenting complaint or condition we always take the time to find out what is causing the pain.  We will conduct a detailed history, examination and when necessary x-ray analysis.  Our focus is to see if the subluxation is present or not.  If we find signs of the subluxation, you may be a good candidate for Chiropractic care.  We will then discuss your treatment options and work on a plan to get you moving again, get the pain under control and then get you stronger to avoid overloading the trouble areas in the future.

If you are struggling with neck pain and would like help, there are 3 things you can do: 1. go to out blog and discover more about the exercise you can do to help your neck move better, 2. email j.patterson@coffstotalchiro.com.au to get more information specific to your problem or 3. call 6652 4025 to make an appointment to get your neck moving again.