Neck Pain

Neck pain is the second most common symptom reported by chiropractic patients. It can drastically affect quality of life - both physically, emotionally, and financially.

• Neck pain is the fourth leading cause of disability.

• 30% of individuals will go to their doctor for neck pain each year.

• Nearly 50% of individuals will continue to experience frequent occurrences of re-presenting pain following treatment.

Luckily, in the majority of cases, it is a treatable condition if approached from a researched, conservative approach. This article will cover what neck back pain is, what it is not, as well as research-based treatment.

What It Is

Neck pain is typically classified as neuropathic or mechanical in the majority of cases, and often, mechanical dysfunction is causing the neuropathic dysfunction. This means that neck pain is overwhelmingly due to poor alignment and movement, most frequently tied to poor posture and lifting strategies.

Mechanical neck pain arises from the spine, discs, or surrounding soft tissue. The pain can be determined to be mechanical if it is affected by positioning or by movement. When we move, force is transmitted onto various structures in the area. The right diagnosis depends on the tissue that is being overloaded, and different forms of treatment are available depending on which tissue is responsible. If a mechanical force caused the problem, then logic would have it that mechanical force can cause the solution.

Our bodies are designed to be able to flexibly adapt to all forces that transmit through the joints. When our body is not able to do so, tissues become overloaded and our body reacts. This is especially true in the neck as it houses the most nerves in your spine and connects to your brain. Poor spinal mechanics can affect the way our muscles function and the way our body regulates itself, and in chiropractic, we call this a vertebral subluxation complex (VSC). When our body senses stress upon the brain and spinal cord, it will lock up muscles to protect itself, which further snowballs the effect and heightens the neuropathic pain from the nerves. Therefore, proper mechanics through the spine, especially the neck, thoracic and shoulder area are paramount to your health.

A study from the Biomedical Research International Journal, 2018 edition concluded:

• Alteration of head and neck positions can have an immediate negative impact on respiratory function.

What It Is Not

Our bodies typically exhibit pain in an attempt to warrant a change, but only viewing the pain generator is linked with poor clinical outcomes.

It's important to note that degeneration and pain are not synonymous. Research has routinely shown that asymptomatic people can show large amounts of degeneration. A prior diagnosis of degenerative disc disease does not mean a patient is subject to a lifetime of pain

For example: A Systematic Review of Spinal Degeneration in Asymptomatic Populations by the Journal of American Neuroradiology published in April of 2015:

• 3,110 asymptomatic patients were given an MRI.

• Asymptomatic 20-year-old individuals demonstrated: 37% had disc degeneration; 30% had a disc bulge; 29% had a disc protrusion and 19% had tears in their discs.

• Asymptomatic 80-year-old individuals demonstrated: 96% had disc degeneration; 84% had a disc bulge; 43% had a disc protrusion and 29% had tears in their disc.

• The study concludes that imaging-based degenerative features are a part of normal aging and unassociated with pain.

Our discs slowly degenerate over time, and this can be a painless process. However, if abnormal forces wear our tissues down at an accelerated rate, the rapid breakdown of our discs induces inflammation, which can amplify a pain response.

A thorough chiropractor should look at degeneration for what it is. Our bodies degenerate and build bone spurs in an attempt to stabilize an area. More specifically, the joints that degenerate rapidly are the joints that move excessively in the wrong directions. Therefore, a chiropractor should examine WHY the body degenerates, not just accepting degeneration as the cause for their pain intrinsically. This is frequently missed by pain-based chiropractors and medical doctors alike. Using a hammer on screws is an ineffective treatment solution.

In September of 2018, The Journal of Spinal Surgery reported the following:

• Anterior cervical discal fusion with plate fixation is the current gold standard surgical treatment for cervical spondylosis with radiculopathy. Translated: disc removal and screws inserted is the gold standard for neck degeneration with symptoms in the shoulders and arms.

• The goal of this surgery is to decompress the spinal cord and/or nerve roots while maintaining bone integrity, spinal stability and restoring cervical curve.

• Following the surgery, arthritis increased by 24%, with prior studies showing this increases with the more vertebra they fuse. They also found a 64% increase in adjacent level disease. Because of this, the current re-operation rate is reported at 35%.

Zeroing in and focusing on just the overloaded tissue/pain generator has low evidence for long term solutions. Identifying degeneration (overloaded tissue) is not backed by evidence. By identifying pain as mechanical and finding dysfunctions that fuel the mechanical overload, both structural and functional, a chiropractor can best equip you with the care needed to not just live pain free, long term, but to get your life back, doing the things you love.

Treatment Options

Conservative treatment of neck pain includes adjustments, exercise, massage, physical therapy, and management of risk factors. Neck pain is quick to go away short term, but the long term re-occurrence rate is high. Only by digging to the root of the problem and maintaining it can one expect to lower the re-occurrence rate.

Since most neck pain is mechanical pain, then finding out why and where the dysfunction lies is a critical part of care. If a mechanical force caused the problem, then logic would have it that mechanical force can cause the solution. Take intentional mental notes on what you are doing and what makes your pain feel better or worse. This helps a chiropractor zero in on what movements your spine may need more of. It's imperative to keep moving, avoid prolonged sitting and to eat an anti-inflammatory diet.

We recommend utilizing evidence-based treatment options that are proven and backed by years of research. Specifically for neck pain, McKenzie Method of Mechanical Diagnosis and Therapy (MDT) has a proven track record of effective, low cost, and rapid improvement to mechanical problems. It is a systematic approach of finding out what movements the body needs and then utilizing appropriate treatment methods to get your spine and body moving again. We utilize MDT in conjunction with manipulation at our clinic. By truly finding the source of the problem, we are able to appropriately treat, leading to not just decreased pain, but increased function throughout the entire body.

For more information about our practice, please visit Thrive chiropractic by clicking below.

Remember that you were made to have life and have it more abundantly; You were made to thrive.

Sources

Cohen, Steven P. “Epidemiology, Diagnosis, and Treatment of Neck Pain.” Mayo Clinic Proceedings, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pubmed/25659245.

Han, Jintae, et al. “Effects of Forward Head Posture on Forced Vital Capacity and Respiratory Muscles Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4755989/.

Laratta, Joseph L, et al. “Outcomes and Revision Rates Following Multilevel Anterior Cervical Discectomy and Fusion.” Journal of Spine Surgery (Hong Kong), AME Publishing Company, Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6261756/.

Zafar, et al. “Effect of Different Head-Neck Postures on the Respiratory Function in Healthy Males.” BioMed Research International, Hindawi, 12 July 2018, www.hindawi.com/journals/bmri/2018/4518269/.