Neck Conditions
Neck pain is a common issue. It is one of the most common reasons why someone might seek care from a medical provider. Neck pain can be irritating and nagging. Sometimes it can cause headaches, shoulder pain, back pain, arm pain, tingling or numbness. In any case it should be evaluated and treated for a better quality of life.
Here is what I think everyone should know about the basics of neck pain and what you can do about it. Here are the basics of the most common causes of neck pain, the symptoms and what your next steps should be. Let’s get started.
Cervical Facet Syndrome
Facets are another name for the little joints in the spine. Facet syndrome is when these joints are causing pain. They may be causing pain due to a traumatic injury (auto accident, sports injuries, whiplash,…) or gradual onset (desk job, poor posture, sitting all day, text neck,…).
You may have facet syndrome if you have neck pain while moving your neck (looking up, turning your head right or left or tilting your head right or left). If you have pain while bending your head down as if you’re looking toward your Air Jordans, it could be a joint, but it is mostly likely pain coming from a muscle being stretched. It is possible to have a muscle and joint issue at the same time. (We may not want it, but we are allowed to have more than one thing causing pain at the same time.) This pain may refer (travel) down the spine to the bottom of the neck or between the shoulder blades. You may feel pain between your shoulder blades, but the issue may be coming from the neck, even if you don’t feel pain in your neck.
This is something that can easily be treated conservatively (non-invasive) with chiropractic adjustments which address the joints themselves. Therapeutic exercises that help address the muscle and joint imbalance will help correct the underlying causes that lead to this, such as upper cross syndrome. Read about the treatment further in this article.
Cervicogenic headaches (headaches generated from the neck)
These are headaches that are caused by neck pain. The neck pain and headache are increased with different head positions. Those positions are different for everyone.
When evaluated properly, research has shown that chiropractic treatment is very successful in treating these headaches and neck pain. Read about the treatment further in the article.
Here is a more detailed article on cervicogenic headaches if you want to learn more.
Cervical Disc injury
These disc injuries are similar to lumbar disc injuries. You could have a disc herniation or a disc bulge. If you have a disc that is causing pain, you may be feeling it constantly. Often, this pain will refer (travel) down your spine to between the shoulder blades, or down to the shoulder and even to the arm or hand. If the disc is applying pressure to the nerve near by, you may feel tingling, numbness, or even weakness in the arm.
This is the condition that probably costs the most financially and time wise. This can take 6-9 months to treat if managed properly. As a chiropractor we look at treating these conservatively (avoiding injections and surgery if possible). Chiropractic treatment as needed, and McKenzie physical therapy exercises are what we have seen great success with in our office. The research backs this up as well. This BOOK is a great start to treat it from home.
On top of treating through chiropractic care and McKenzie, we want to address the indirect causes and the function imbalances that lead to this: Upper cross syndrome, weak core, and instability. These need to be addressed for long term results.
Neck Sprain/Strain
This is a traumatic injury and is often seen in a whiplash accident. This is a common injury in car accidents, any contact sport (football, soccer, basketball, cheer, etc). These injuries can range in severity and when treated right, take a few weeks to resolve. A sprain and strain is an injury to the ligaments (sprain) and/or to the muscles (strain) of the neck. Just like spraining your ankle, you can sprain your neck.
When sprains and strains occur, your body will compensate for the injury you are dealing with. Therapeutic exercise, chiropractic care, and soft tissue work (massage) should be utilized to help with the recovery.
Upper Cross Syndrome
You’ve heard this before. This is more of a secondary issue that will lead to one of the issues listed above. This is a graduale condition that we get from sitting or being in one position for an extended amount of time (>30 minutes) day-in and day-out, like a desk job.
When you sit for a long time your body starts to adapt to that position long term. That position creates some muscle and joint imbalances that then leads to joint dysfunction, facet syndrome, disc injury, and headaches.
These muscle imbalances are: Tight/short pectoralis muscles and upper back muscles along with lengthened/inactive front neck muscles and upper back muscles.
This position looks like, shoulders rolled forwards, hunched back, leaning forwards, head jutted forwards, chin tilted up. This is a position that many people get to after sitting for a long time and get focused on the job in front of them. It is a constant battle to avoid this position.
What does treatment look like?
Chiropractic treatment
Chiropractic adjustment helps reset the nervous system by lowering the pain level (pain threshold), and increasing the regional range of motion as well as slightly increasing the disc space.
Therapeutic exercise
Exercises that should be done early on in treatment and right after the chiropractic adjustment so that the body can start to use the neck with less pain and increased range of motion. This helps correct the muscle and joint imbalances long term.
Physical therapy
Exercises and manual therapy, such as corrective exercises, stretching, and soft tissue work to help correct the muscle imbalances that you may have.
Nerve root injections
A shot that is taken in the area of pain to help reduce the chemical level of pain.
Surgery
A surgeon goes in to repair what physically needs to be repaired. This should be the last line of defense. There is no going back from a surgery.
What does the research say?
What is the comparison of chiropractic manipulation and nerve root injections for someone with disc injury with radiculopathy (arm pain). A large study occurred which took people who have been dealing with this neck and arm pain for at least a week and split them up evenly by symptoms, age and more. Half of them received regular chiropractic treatment, which was 3-5 treatments per week for 2-4 weeks, then 1-3 treatments per week as needed. The other half received one nerve root injection. They re-assessed everyone at 3 months and this is what they found:
86.5% of those who received chiropractic treatment showed clinical improvement (patients were better or much better) compared to 49% of those who received the nerve root injections. The injections results are simply a flip of a coin. If you had a choice, would you choose to have a 50% chance of getting better or a 86% chance of getting better? No brainer right?
Side note: a nerve root injection is deemed successful if the patient sees 50% improvement for at least 4 weeks. So it’s not 100% pain free and it’s not even long term. This should never be the first line of defense.
Research has shown that the best practices for conservatively treating neck pain is chiropractic adjustments with therapeutic exercises and nutrition for 6-12 treatments over 2-4 weeks for acute pain, 1-6 treatments over 1-4 weeks for chronic pain and 1-2 treatments per month for 6-12/months for maintenance care.
Exercises to do from home
Chin tuck: This exercise is targeting the muscle imbalances that lead to neck pain. Stretching the tight muscles that are at the top of your neck (base of your skull). At the same time, it also strengthens the deep flexor muscles in the front of your neck. These muscle imbalances come from the upper-cross syndrome listed above, working at a desk job for a long time, texting with your head down, etc..
Pectoralis stretch: This stretch is targeting the tight chest muscles that come from working out at the bench press and not enough with the back muscles, sitting at the desk, working at a computer all day. These tend to gravitate towards tight chest muscles and shoulders rolling forwards.
Upper back mobility stretch: This exercise/stretch is targeting the upper back tightness/stiffness that comes from sitting at a desk, working at a computer all day, sitting in poor posture for an extended period of time. If you sit at a desk all day, you should do this daily.
DNS 3 month hold: This exercise would be the next progression exercise after the “chin tuck” exercises above. This again stretches the top neck muscles, and strengthens the deep neck flexor muscles. On top of that, we start to engage the upper back and shoulder muscles to help stabilize the base where the neck sits.
McKenzie: These exercises are targeted for any discogenic pain. This BOOK will guide you through all the progressions of the multiple exercises. When to move up, when to move down. If you are dealing with any shoulder or arm pain, I would go through these exercises first and see the progressions.
ELDOA Exercises: “Strength Yoga”, there are a few exercises here that are very unique in nature. ELDOA is an exercise/stretch that targets stretching the fascia(connective tissue that connects everything together throughout the body). These exercises are targeting the neck, but you’ll feel stretching in your arms, lower back, feet, and feel an ab workout as well.
If you’re dealing with neck pain and haven’t tried any of these, give them a try. If you are dealing with neck pain and you don’t know where to start then schedule an appointment and let’s get some eyes on your neck to find the best tailored treatment for you.
Reach out to us by clicking on the Schedule now button above and we’ll help you out. We are located in Provo, Utah and enjoy servicing those in Utah County.