Thousands of Americans suffer from episodes of acute or chronic neck pain each year as a result of injury, strain, overuse, aging, emotional stress and poor posture. A popular response to neck pain is to cover up the problem with drugs (aspirin, ibuprofen) or to merely address the symptoms (massage, hot packs, muscle relaxers). But neck pain isn’t caused by a deficiency of aspirin or drugs.
The Chiropractic Approach is to locate the cause of the pain and then address it with appropriate treatment. This starts with a complete case history and a thorough examination. Special attention is given to the structure and function of the spine and its effects on the spinal joints and the nervous system. Primary causes of spinal pain are 1. Degenerative Joint Disease, which includes wear and tear and thinning of the spinal joints and discs and the consequent development of bone spurs and sclerosis; 2. Disc problems such as bulging or herniated discs which can directly pinch nerves; or 3. (and this is by far the most common) spinal misalignment, also called Vertebro-Spinal Subluxation Complex or VSC which can cause painful dysfunction of the spinal joints and nerves.
Vertebro-Spinal Subluxation Complex (VSC) is a misalignment of the segments of the spine, the vertebrae, causing irritation of the joints, discs or nerves coming out of the spinal cord. VSC describes what happens when spinal bones lose their normal position or motion from stress, trauma or chemical or postural imbalances. Accidents, injuries, improper lifting, drugs, emotional stress, postural stress and long periods of sitting can all cause VSC, which it turn causes neck pain.
Two Types of Neck Pain
There are two distinct types of neck pain. The first is direct, localized neck pain brought on by irritation of the pairs of “facet” joints that are on either side of the neck. This is usually directly caused by misalignment or VSC of the vertebrae in the neck wherein the vertebrae have lost their normal position or motion causing a pinching or irritation of the facet joint tissue. These facet joints are highly innervated with pain-sensing nerve fibers that produce localized pain in the irritated joints. Chiropractic Manipulative Therapy (CMT) is usually very effective in helping this situation.
The second type of neck pain occurs when the nerves that come out of the openings on either side of the neck are pinched. This causes pain and/or numbness or tingling along the course of the pinched nerve. In the upper cervical spine this can cause pain that radiates into the base of the skull or up and over the head. In the middle neck a pinched nerve can radiate across the shoulders and down the arms. In the lower neck it can cause effects that radiate around the upper chest or the upper insides of the arms. There are three causes of pinched nerves in the neck. The first is intervertebral disc disease where the disc has either bulged or ruptured out to the side, pinching the nerve. The second cause of a pinched nerve is Degenerative Joint Disease, or DJD. This is a wear and tear type of arthritis that causes joint space degeneration and thinning. This then results in the production of reactive bone-spurring and it’s possible for one of these bone spurs to pinch a nerve. The third cause of a pinched nerve is, again, VSC, in which the vertebra is out of position enough that it pinches a nerve or causes connecting tissues such the disc or ligaments to pinch a nerve.
In evaluating neck pain chiropractors ask these questions: Is there a normal spinal curve or is it too flat or even reversed? Are the nerve openings between each pair of spinal bones free and clear? Is the head balanced or tilted or rotated to the side? Are the shoulders level? Is the head carried forward of the chest? These and other considerations are used to create a plan of specific Chiropractic treatments, sometimes along with other therapy modalities such as stretching, exercise, traction, electrical stimulation and others to help improve the motion and position of the spinal vertebrae. With improved structure and function, neck pain often diminishes or totally disappears, without drugs or harmful side-effects.